After weight-loss surgery, a year of joys and disappointments (2016)
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I'm overweight, not obese, going by BMI (though pretty close to the borderline). but I still look fat in all the old places I used to look fat. I've gone down a couple clothing sizes, but it's very hard to see the change in a mirror unless other people tell me.
Can you be specific?
For the first ~70 lbs, I was able to lose 10 lbs in 1-2 weeks by staying on the diet religiously each day. I mainly ate the same exact meal plan every day. (I spent a lot of my day thinking about all the great food I missed.) After that week or two, I would "take a break" and get takeout or other nonsense each day for some weeks following that. Perhaps lucky on my part, I wouldn't generally see much weight come back, maybe only 2 or 3 lbs. In summary, my cycle was diet 1-2wks, break for a while until I convinced myself to get back on the wagon, and repeat. It always helped to see that the first few days of dieting were the ones where I lost the most weight, before it slowed down.
To answer the exercise part, literally all I did was take 1-2 walks a day of 30 min each. Not a brisk walk, just walking around the town or our trails. Occasionally I felt like trying to jog or run, or do some lifting, but never got consistent with it. Sometimes I paced around my apartment thinking about how to solve work problems, but that was about it.
Since I lost that first 70 lb, the rate of weight loss has gradually slowed. These days I sometimes lift weights or do cardio to help see a little more loss each day. If I'm consistent, my weight loss is like 3-4 lbs/week, but I haven't done it lately. Gotta get back on my diet soon.
[1] sidenote, that includes fiber calories which I think technically are not supposed to be included. I'm no nutritionist, even though I came up with a lot of this diet myself using some Internet research and Cronometer.
The most I ever lost in recent years was when I went on Kaiser's medically monitored weight-loss program (a soft prerequisite to be eligible for bariatric surgery through them). Liquid diet, 860 calories a day, frequent blood work, etc. I lost 50 lbs in 3 months. Gained it all back over the following year. Fearing all the side effects, I never ended up doing the bariatric surgery.
This time around I'm not "cheating" my way through it. Keeping track of everything religiously has kept me honest about what I'm eating, and I've been taking a 3+ mile walk most days. Been trying to keep a pace that makes me sweaty even in the cool weather of my area. I'm back down to the weight I was after the Kaiser thing (50 lbs lost), but I'm not craving all the things I did then.
Diet has basically been whole grains, lots of veggies, turkey, fruit, nuts, oats, and the occasional fish. Overnight oats is my go-to breakfast - steel cut oats, chia seeds, soy milk, fruit, nuts. I've been making a bunch of things from the Forks over Knives vegan diet. I can't bring myself to go full vegan, I love fish too much. Either way, mostly keeping it under 1700 calories a day.
I recently joined my friends' gym group and plan to go regularly. Been keeping up with them for the last two weeks so we'll see where that goes. Maybe try to get some muscles to fill in some of the loose skin I'll have.
Congrats!!! Wishing you more success!
Not sure if this will help but I recently purchased an Apple Watch and the Activity rings and notifications for activity, breathing etc has helped me get myself sorted.
I'd also recommend measuring weight loss as percentage of body weight.
I know everyone has their weight loss strategy but this is by far the least mentally taxing method I’ve used. It helps to stay motivated when you see results every other day as well.
Losing 110 lbs is going to be very obvious even on someone with a very large frame, but, your perspective may be highly warped preventing you from seeing the weight loss. It might be worth talking to a professional trained in body image issues.
Edit: Oh, and I should say congratulations! That is awesome progress!
One thing your comment reminded me of -- I was surprised to see a lot of my sense of weight loss came not from a mirror, but just feeling my old fat body parts. It used to be more dense, due to the fat, now it feels a lot more like excess skin. The skin is almost as big as before, but much lighter and more hollow, if that makes sense.
[edit: added "sense of"]
That’s exactly what it is. When one loses a lot of wait after holding it for a while the skin may not be able to shrink back down. There are various remedies for that from supplements to surgery but you should talk to a medical professional about your options.
So even after four years of being at the lower weight, in reality the only way to get rid of excess skin is surgical. I am not willing to do that, so I have come to accept that even after all my efforts, I am never going to look svelte.
While this has been some time ago and I have not met her for years, an acquaintance confided that the skin reduction gave her the confidence and joy that kept her from relapsing into old bad habits.
My inner thighs always felt chunky, large, - literally, full of fat.
After starting to work out a couple months ago - I felt my inner thighs randomly one evening and I stopped myself because they felt so _different_... Better than looking in the mirror honestly - more tactile feeling of accomplishment rather than visual.
What weight did you start/end at?
It might be worth your while to talk to someone about body dismorphia.
This goes into a bit more detail:
I guess your must have body must have dumped fat directly out through urine?
Negative side: My parents/doctor thought I was on crack because bones were sticking out.
My back loves the lower weight. I miss the look of the extra weight.
Visually it only occurred to be because a friend sent me a picture from a dinner I had with them and I saw how much smaller I looked.
I lost 55 pounds and still felt like a chonker. At the time, I only had about 10 pounds to go to hit the "ideal weight" I'd set for myself (which was still at the high end of the acceptable range, based on BMI). I never did hit that number; I ended up wandering around that plateau for 1-2 years, feeling thoroughly fat the entire time.
A recent injury led to me not being able to lift (for now), and so I've lost about 3-7 pounds of muscle and gained about 14-18 pounds of fat. Now I can definitely notice the difference! For me, it's the little stuff that really drove it home -- my face is noticeably chubbier (to me), and my rings and shoes fit more tightly.
I wouldn't recommend going about it this way, but it definitely drove home a lot of retroactive gratitude for what I had -- and sparked some motivation to get it back.
So once you get the weight off you gotta live the active life and the fit shape will emerge.
Being normal weight is basically easy mode for being active, but it doesn't guarantee fitness if you still don't play the game.
That said, even bottoming out at 6'2" 155lbs, there were still noticeable pockets of fat in the "bad areas" (chest, belly). This was probably due to low muscle mass, but it can be pretty crushing.
All that work and you don't look any better without a shirt on... but cloths fit better and I definitely looked better. That weight makes around a 5-20 year difference in appearance for me.
You could argue this should be a part of the fitness conversation. You probably won't achieve perfection and people with long term weight issues may never really get the desired results. This is definitely an area where body positivity is important.
https://www.nejm.org/doi/full/10.1056/NEJMoa2206038
and for a more gentle read
https://medicalxpress.com/news/2022-06-diabetes-drug-patient...
Bariatric surgery is fantastic, but I know people who learned how to eat "around" it and the net effect was to undermine the "win" -If the same $ went into the psychology of food, into support, into dietary interventions AND exercise AND mental health, as went into the surgery, I wonder if that would have been true?
And then in the end, you have self-ideation, how you look at yourself in the mirror. Maybe others see change you can't see or maybe you see change you do not see in the reaction(s) from others. Its hard.
It's going to be an absolute revolution in the fight against obesity.
If people are ok with the tradeoffs they should be able to go for it. It's not like this is back alley drug dealing. If people are getting these drugs from their GP or over the counter then they can be informed.
Honestly, I feel the more you delve into the pharma business, the less it seems to differ from back alley drug dealing, apart from the marketing & lobbying budgets.
Easy not to look like you're drug seeking when you don't actually need the meds.
This is the principle I as talking about and it lines up just fine. The difference is that you're saying it's different "because controlled substances". Yes this is a difference, but as far as I'm concerned this is simply arbitrary, as it's a different authority making decrees (vs. doctors just deciding on their own)
I'm talking about the policy as a whole. I'm not interested in asking the various stakeholders why, only to have them point fingers at each other.
Unfortunately, there literally does not seem to be a free lunch.
Reading the article I’m glad I’ve never been tempted by surgery, but at the same time, gosh it’d be nice to have my brain rewired with the stroke of a scalpel. But surgical intervention just feels like it’s too much, especially when I know that calorie counting and putting in some effort to get active achieves the results I’m after.
What does this mean? How is activity of genes altered?
> But surgery only alters the intestinal tract. That tells you, Dr. Kaplan says, that there are whole classes of signals coming from the gut and going to the brain and that they interact to control hunger, satiety, how quickly calories are burned and how much fat is on the body.
This makes sense - you're disrupting signaling. But what does altering genes mean?
Should be updated to reflect (2016)
My take as someone who has some personal anecdata is a) no one really quite knows what is causing the incredible and nationally, geographically, socioeconomic/culturally, etc divergent crisis in weight gain and obesity, however b) there is a lot of interesting and useful information at the intersection of biomechanical, endocrinological, psychological, cultural, etc research and attempt at explanations.
What's worked for me is a moderate all-of-the-above approach: eat real unprocessed food, do some lazy IF/low-carb, focus on nutrient and protein-dense plant and animal foods, find enjoyable exercise outdoors in the sun, lift some weights, eat fermented and fiber-rich foods, etc. Basically there's a slippery slope and positive feedback loop, where if you're sedentary and eat processed junk you're going to gain weight and wind up feeling like remaining sedentary and eating processed junk, which will cause you to gain more weight, and so on.
"her urge to eat, as powerful as the urge to breathe when holding your breath, defeated her" just seems like learned (taught?) helplessness "misinformation" - you need to breathe every one or few dozen seconds or you die. You certainly don't need to eat every one or few dozen seconds or you die. This isn't to understate the difficulty and I was never hundreds of pounds overweight, but fundamentally you need to commit to turning the dial in the other direction at a pace that feels sustainable, and then sustain it. Nutrition science provides good explanations for why the urge to eat low nutrient crap is going to be very powerful if you're 200lbs overweight, not totally unlike the urge to inject heroin is going be very powerful if you've been injecting heroin for a decade. Your body down to the cellular level has adapted to it and you can't just hit an off switch.
At a personal level I'd urge everyone to disregard the learned helplessness narrative and try to make a healthy lifestyle work - at a societal/policy level I think we desperately need to stop greasing the path down the slippery slope. It's as if a syringe full of heroin ready to inject was on sale BOGO for $2 at the supermarket and completely socially accepted while you had to cook up aspirin yourself on the stove for $8/pill with 30 minutes effort. "Why are so many addicted to heroin? Experts have no idea." Please.
https://www.youtube.com/watch?v=keBZfGAmq2Q
A massive oversimplification of the above video:
Most people aren't consciously choosing to be more obese compared to people in the 1950's, there's simply a much higher availability of high caloric foods and marketing/psychology around it.
I went to a place that markets itself as super healthy foods. I had just finished a 7km run and was feeling like treating myself to something other than the usual calorie controlled foods i usually eat.
I ask the girl behind the counter "how many calories are in this salad" ... She gets a big book and starts flipping through the pages.... After what feels like 5 minutes she says "1500 kcal"
That's heaps. So I decide to enter the things inside it and some rough weights into MyFitnessPal... The salad came out to about 200-300 kcal. So the dressing must have been the rest.
I ordered it without the dressing.
My point to this is even at the healthy places that are marketed as healthy so order anything.... You could be eating more than a big Mac meal.
This is a v good analogy.
That requires a hell of a lot of time and effort investment. Time and effort are a finite resource. It's probably better for society as a whole if we find a way to be healthy that doesn't involve all of us to actively work at it every day. That's like expecting people to grind their own coffee and hand wash their clothes. Sure it's theoretically possible but in aggregate less coffee will be drunk and less clothes will be washed.
The aggro-food industry has been relentlessly aiming for maximal consumption/addiction in an epic Darwinian race to the top for decades. The results are incredible. Every aspect of that simple bag of crisps has been tuned to maximize recurring consumption. Hacking into the gut biome for behavior control has been trial and effort so far, but is bound to take a next revolutionary step as predictive models emerge to steer the research.
And do not count on regulators to defend your sanity. They've been captured to the core. Good luck.
I bet that others can see the difference if they've tracked you.
I get told that I look different when I can't see it.
Try and have someone honest close to you point out what those differences are by holding two pictures up.
https://www.mayoclinic.org/medical-professionals/endocrinolo....
Apparently despite such drastic efforts, the weight finds its way back