The View on Size

I don't know about you, but I've been overweight for all of my adult life. I've fallen into the "obese" category. There were times when my weight was more in check than other times, but I've always remained obese.

One thing to keep in the back of your mind when you're on any weight loss program whether it been Weight Watchers, Jenny Craig, Nutri-System, or good old fashioned diet and exercise is how are people going to perceive you? How are you going to see yourself?

Do people treat overweight people differently than average weight people? Out of the people I've spoken to about post surgery life the answer is overwhelmingly "yes". Is it right? Of course not, but I suppose it depends on who you ask. Our society is bombarded with images of super thin women and athletic looking men. It always makes me giggle when Whitney Thompson, winner of the tenth cycle of America's Next Top Model, is called plus-size. Seriously? She's a size 10! If I were a size 10 I would consider myself healthy, not plus-size.

Last year I met a girl named Monique who had undergone gastric bypass. Out of everyone I had met who'd had the surgery, she made the most impact on me. Monique is about the same age as me, had the same weight history and was about the weight I am now when she had the surgery. She looks fantastic! When we got to talking about the surgery I thought it was interesting when she made the comment, "I hope you and your husband have a strong relationship because you just wait until you lose all your weight." What was that supposed to mean? She went on to explain that in her experience she was treated differently once the weight came off. This was something I hadn't yet considered.

Once I have my surgery and my weight is in a normal range I am interested to see if I will be treated differently. I've often wondered how I will change, other than physically of course. Right now I have no idea and I hope to relay some of my observations as I continue on in my quest to become healthy. As a daughter of the most High King, I trust that He's led me to this place of acceptance of myself and the will to change my lifestyle. I also trust that He will protect my heart and mind!

The Wild World of Ghrelin

One thing I have been appreciative of is the education provided by the bariatric department at North Valley Surgical Associates. I originally started my surgery process with another surgical center -- oh wait, make that two prior surgical centers. I had not received the type of education I've received with NVSA. The doctors and nurses introduced a new concept to me. You may agree or disagree with their theories, you have to make the call yourself. As a person who has multiple failed attempts at weight loss, I tend to agree.

We all know that our society has a love-hate relationship with food and weight. They place the fresh bakery at the front of the grocery store to draw you in. They've put fast food and high calories coffee shops on every corner in this country. How many calories in a medium sized white chocolate mocha? 470. Do I need 470 calories at 6:10am? Probably not, but it sure tastes good. ;-) We're bombarded with high calorie foods at literally every turn. What makes an average, healthy adult different from an obese adult? Increased ghrelin and decreased leptin.

Ghrelin is the appetite stimulating hormone produced in the fundus (large rounded bottom area of the stomach). This hormone is said to be extra prevalent in obese people. If you have never dealt with a weight issue, try to imagine this: never feeling satisfied. It is worse when we diet. Our body is used to a certain amount of food so when we decrease what we eat, our bodies literally tell us we're starving. Diets don't always work! Actually, talk to any bariatric patient and they will yell at you, "DIETS NEVER WORK!"

If you think I (and I'm speaking for anyone thinking about weight loss surgery) "just" have a problem with will power and my lack of exercise, guess what? It's more than that. I have more ghrelin in my body which makes me more hungry more often. I also have less leptin in my body which means I have little to help suppress my appetite. Because of this problem my metabolism is way off from the average sized adult.

So where does the Roux-En-Y gastric bypass come in and how does it help? The cutting of the stomach is the most drastic measure. The surgeon cuts off the fundus which cuts off the production of ghrelin. This means I won't have an appetite post surgery and instead of eating for a variety of reasons, it is just out of necessity and the satiety will finally be present.



Resources:
http://en.wikipedia.org/wiki/Ghrelin
http://en.wikipedia.org/wiki/Leptin
http://www.sciencedaily.com/releases/2009/05/090520055519.htm
Image borrowed from http://www.texashealth.org/body.cfm?id=1525

Way Back When...

I don't remember when or why I started to gain weight. I know that there were some things that came up from my past when I was a small girl, but it's easy to blame an incident on weight gain. It doesn't seem right to continue to blame that time on years of learned bad habits. Here I am, a 29 year old well adjusted and successful married mom of two. I know what good eating habits are. I know the basics. Calories in - calories burned = +/- calories. The more negative the number, the more the body uses thus resulting in weight loss. The more positive the number, the more the body stores which equals weight gain.
Here is where I have found my pitfalls to be, and guess what?? There are more than one!

• Portion control, portion control, portion control. Yes, I like tacos. If one is good, 3 are better! I had an epiphany a few weeks ago when I ordered a foot long sandwich from Subway. Upon looking at the length, width, and height of the sandwich, I thought about how large our stomachs are. Not as huge as some of wish - about the size of a football. At the time I was about the indulge, my stomach wasn't empty. I had eaten within that past 2-3 hours and I'd had something to drink. It finally dawned on me - how was this 12"x 4"X 5" sandwich going to fit into my stomach?? Portion size is incredibly important when it comes to discussing weight loss and even more so when it comes to surgical weight loss. When your stomach becomes as small as a medicine cup , good luck fitting a $5 footlong in there!

• Food choice. Okay, I know I'm preaching to the choir here. Why choose low fat Ranch dressing when the real thing tastes SO much better? Actually, I don't have much of an argument for this one. I absolutely hate low cal Ranch. Just pass the balsamic vinaigrette please. I know some people make the switch to everything low fat when it comes to weight loss, but in my opinion the sacrifice of taste is simply not worth it. What I've done is adapt the recipes I enjoy to be more calorie friendly. I've cut out sweets (though I have to confess my sweet husband did buy ice cream last night and I had some - but it was a small amount equaling the suggested serving size on the package) and instead eat fruit. I've tried a dozen different drinks at the local coffee shops in the sugar free variety and I like a couple of them and I try to think of them as a completely different drink rather than a new version of my favorite. In preparation of surgery, you will be required to give up caffeine for a number of different reasons, so the best thing you can do for yourself is to cut it out completely. At my pre-op class the nurse promised that a big key is cutting out all sugar as it is problematic for Roux-En-Y patients. She stated that if you can wean yourself of sugar, your journey is easier. We'll see!
  

• Lonely/boredom eating. I will admit that when no one is around I think of yummy things I can make out of what I have in the cupboards and fridge. I haven't found a solution to this problem yet. It's easier with the kids being around, it keeps me honest. I'm hoping that with the creation of a new, smaller stomach it will keep me from binging because I will have the inability to do so.

I'm hoping that I will be able to identify more behaviors when the surgery is done. I'm curious. Until then...!

Post... 1

Hi there. Come follow me on my weight loss journey. After 17+ years of being overweight, I've finally made the decision to have gastric bypass surgery. I have had my ups and downs trying to get the surgery but I know the trials will be worth the end results. Right now I am approximately 5-6 weeks pre-op which seems incredibly close considering I have been actively pursuing the surgical procedure for 18 months.

When I first began researching surgical options for weight loss online I came across very few personal stories other than Star Jones (Did she or didn't she? She did?!), Al Roker (who had many good things to say), and Randy Jackson. Sure -- it is great to have public figures to refer to. Remember that they have access to more amenities than you or I do such as personal trainers and cosmetic surgeons. I hope that my blog can give you an idea of what I've gone through and if you are researching weight loss surgery yourself or for someone you love let this be just one example to either encourage or discourage you. Surgical weight loss (thus far) is not for the faint of heart.

With that being said, stay tuned as I go for a fantastic adventure. I hope to come out the other side as a much smaller person.