About a year ago my sister, younger by five years, the one who had always been the pretty, skinny one, told me that she was beginning the preparations to have a gastric sleeve weight loss surgery. It was true that she had gained weight over the years, but she was smaller than me, and it kicked me in the gut that at her smaller-than-me size she already thought such drastic measures were in order. I weighed about 300 pounds at the time, while she weighed less, but was still large enough that she had been relegated to plus size stores/sections for a while. She had begun to feel that her weight was beginning to make some of her favorite activities difficult, and she wanted to head off the problem before it got out of hand. And there was good evidence that it would get out of hand. I was larger than her, and our mother another 100 pounds larger still. In fact, we come from a long line of fat women. A portrait of my late grandfather’s mother used to hang in his dining room; in the 1920’s at about 40 years of age, she looked my size or larger, despite the enormous amount of exercise she must have gotten from gardening and caring for eight children. I’ve accepted long ago that these genes make us look fat.
While I was happy for my sister, and considered her decision a proactive and rational one, I was also worried because I had read a lot about weight loss surgery over the years and I knew that its benefits did not come without significant risks and long-term consequences. My primary concern was something going wrong with the surgery itself. But she made it through her pre-surgery weight loss with great success, and the surgery itself went smashingly. Since then she has lost so much weight that to my eye she looks the same as she did in high school, though she tells me she still has a little more to lose to reach that weight.
About three months ago, having seen her dramatic results, I decided I wanted to have the surgery too. I had concerns, of course. A major concern was the same one I had for my sister, that something would go wrong with the surgery, either during or after. In my case, though, I was worried about the long-term emotional effects of such permanent, irrevocable changes. I was concerned about never ever being able to enjoy a big meal again, never being able to enjoy certain foods (including some of my favorites), and of long-term concerns like malnutrition, heartburn, and difficulty eating.
When I saw my sister’s dramatic results, though, I started thinking about how different my life would be if I could actually lose that much weight and keep it off. To me, that was the biggest benefit the surgery offered: no turning back. While I understood that it would be possible to regain whatever weight I lost following a gastric sleeve surgery, it would be very difficult. Very difficult to not lose a lot of weight, and very difficult to gain it back once lost. I wanted that badly. I decided to do something that I’ve done a couple of times in the past when small fears were holding me back from a big decision that I knew was right: I would just throw myself into it; it would be easier to deal with the side effects afterward, because I’d have no choice.
I made an appointment with my primary care physician, with the bariatric surgeon, with the nutritionist, and with the bariatric psychiatrist (required for prescreening). My primary care physician had encouraged me to get weight loss surgery in the past, and was glad to hear about my decision. We both knew that bariatric results are better for patients who are able to lose ten percent of their body weight before surgery. Though most insurance plans require the patient to participate in a six month weight loss program, mine required only three months. It would be hard to lose 30 pounds in three months, but I thought I would try, and that if it took a little longer it would be okay, because my surgery wasn’t likely to be scheduled immediately after the 90 day period.
My doctor wanted me to participate in a very well-documented weight loss program so it would be easier to get insurance approval. She was the one who first suggested Weight Watchers to me. I really didn’t want to do it because I had tried it once way back in the day when everything was on pencil & paper and I wasn’t much of a planner or list keeper, plus I had a much smaller food budget. At that time I just couldn’t stick with it. It wasn’t that the plan didn’t work, it was that I didn’t work the plan.
Well, I thought that I could handle it for 90 days, so I signed up anyway. Being a big old introvert, I opted to go with the Weight Watchers Online plan. That meant no meetings, no weigh ins with a chipper skinny lady, and far less buzzwords and overly demonstrative encouragement. I’m just not a “school spirit” type of person.
Well, I have to say that I’ve changed and the Weight Watchers program has changed over the years, because I really, really liked this plan!
It was Ramadan when I started, so I was fasting during the day. That made it really easy to stick to my points at first, because I was spending almost all day not eating. It was a good transition. I loved the plan. I loved that there were weekly points for when I had an outing or social event that involved food, or for when I really needed some Ben & Jerry’s. I loved that the app was on the phone, which was always with me, and made tracking incredibly convenient. I loved knowing that a cup of rice is as large as my fist and that three ounces of chicken is the size of a deck of cards. I just really loved the program. Having succeeded at weight loss only on low carb plans in the past, and having always gained it back because I was unable to stick to a low carb lifestyle long-term, I found this program much more sustainable. Bread and frappuccinos were okay! Not too much, because they take a lot of Points Plus, but I don’t have to swear off of them for life.
I immediately saw myself making small changes to my eating habits, replacing things that were “worth too many points” with things that would “cost” fewer points as a matter of routine. Also, if I was going to eat something high calorie, I planned for it by eating little the rest of the day. This was a plan I could stick to long-term! And it was actually working. So I started to think that maybe it would actually be possible to lose weight and keep it off without surgery. Maybe not as much weight, maybe not as quickly, and maybe not with a built-in no-turning-back guarantee, but this might be the plan that actually gets me there long-term.
Suddenly all those emotionally painful long-term consequences, and the immediate and long term health risks of the surgery, just didn’t look so worth it. I’m 35 years old, and that surgery is permanent. At the age of 35 I don’t want to give up ever again having a big Thanksgiving dinner or a grande frappuccino. I don’t want to be nervous about having a slice of birthday cake, or whether I can get enough water into my tiny stomach during the nights of Ramadan to get me through the fast the next day. I don’t want to be worried about surgery or long-term medical complications. And to be honest, I am a little squicked out about the idea of part of my body being cut out and thrown away.
Since Weight Watchers seems so manageable and effective, I have shelved the idea of weight loss surgery. I expect that it will take three years to lose my excess weight, much longer than if I had weight loss surgery, but that isn’t really a concern to me. As long as I see progress, I’m happy. And seeing progress without taking on all of the risks and side effects of the gastric sleeve is worth celebrating.