Weight loss- A clients account

January 2016. Another January where I find myself feeling angry for putting on all the weight that I had struggled to lose the year before. Another Slimming world group to join and another battle, yet again, to lose the same 3 stone that I have lost every year for the past 5 years. The panic of not fitting into the airplane seat already booked, or having to buy more new clothes because I can’t squeeze myself into the wardrobe of clothes organised into boxes labelled “too big” and “too small”. The realisation that the clothes from the “too big” box are now hanging in my wardrobe, but should really be moved to the “too small” box… 

I found myself sat in front of my GP, asking for help, asking for whatever scheme was currently available, anything that might help break the cycle. 

 

The GP looked at me, I didn’t see the look of disapproval that I was expecting, but she just said that she honestly didn’t know anything about it, but she would find out and get back to me. Before I left her office, she wanted to weigh me. She informed me that my BMI was 50.4. I was ashamed. 

 

Two weeks later the GP did call me, she told me that because my BMI was over 50 I could be referred direct for surgery. I didn’t have to do the tier 3 weight management program. Wow. Finally, something was going to happen. I never expected to have surgery, but I might get some help! 

 

I received a date for a bariatric group appointment, this involved a talk on surgery options, a dietician introduction, a meeting with a mental health practitioner and a brief appointment with the consultant. 

 

I worried about the mental health practitioner, could I second guess them? would they consider me ok for surgery? They gave me a sheet of questions to answer and I could see what answers would be red flags to them, I could see what would be a good answer and on some I knew that my true answer would not be the good answer. I did a mixture of truthful answers and white lies. I passed with flying colours and was told there would be no problem with me having the surgery, I didn’t need any further psych referral. Result! 

 

I thought that my encounter with the mental health practitioner was done, that I wouldn’t have to see one again. I was wrong. After a number of further appointments with the dietician and consultant, I was cleared for NHS surgery, but opted to go privately to avoid the waitlist. My package, with the Spires hospital included appointments with a therapist, I didn’t want those appointments. I didn’t want to discuss my feelings about food. I didn’t want to have to go through that again, but I wanted the surgery, so I had no choice. 

 

I sat at the start of that appointment like a child in the headmaster’s/ mistress’s office. I must have had a look on my face that said “go on then, analyse me”. I didn’t want to be there. Within 5 minutes I was in tears. The person opposite me had unraveled me within 5 minutes. They understood. They knew my thought processes, my feelings and my fears. My protective shield came down and I cried. I was vulnerable and scared, but at the same time in awe that someone finally understood me. It wasn’t just me, other people must be the same. I came out of that meeting shocked, but also knowing that after my surgery I would be happy to have that next appointment and also intrigued as to where this was going to go. 

 

Surgery wasn’t easy, the first few weeks were terrible and I wondered what on earth I had done to myself. I had read about “buyers regret” I knew that there would be times where I would hate what I had done to myself, but I also knew that I had to push on through and that things would gradually improve. They did slowly and I went from liquids only, to pureed food, to soft food and then to gradually introducing a more normal healthy diet back into my life. 

 

I had two more therapy appointments included in my package after the surgery and I wasn’t sure what to expect. Still on edge, desperate for answers but scared to open up too much. I guess like most overweight people I struggle with image, struggle with acknowledging myself, with allowing myself to be proud of myself, just allowing myself to like myself is a scary prospect. So, being taken to a mirror on the wall and being asked to look at myself was a shock, it was emotional and it was tough, it was something I didn’t do, actually I actively avoided it up to that point. I couldn’t do it, I could only look at my face, nothing else, how could I have let myself get to the point that just to look at my body in a mirror was traumatic for me? 

 

We talked about relationships, painful events surrounding my parents, about control and lack of control, we looked at coping mechanisms, but most importantly we looked at mindfulness and how to implement that both around food and life. 

 

For me control and mindfulness have been the most important parts of my weight loss journey and I wouldn’t have known that if I hadn’t had my appointments with the mental health practitioner. In fact, I felt so strongly that this was the most important part of my recovery that I extended the number of appointments, because I wasn’t ready to stand on my own. 

 

I learnt how important it was to compare, to look at how far I had come and to look at the changes as they happened. I focused more on clothes size and body shape than what the scales said and I looked at photographs from before and after surgery. I was prompted to empty my wardrobe of the “too big” clothes and understood my reticence to do so stemmed from a belief that I could still fail, my head was telling me that I might still need those clothes. I was given the strength to clear out my wardrobe, to remove that safety net and to see it as a new start. I cannot and I will not fail this time. 

 

I had felt pretty upset following an appointment with my consultant where my weight loss was compared to a graph. My percentage excess weight loss was not quite where they would have liked it to have been, I was devastated. I wasn’t living up to their expectations and all I wanted and needed was approval. 

 

In therapy we discussed how it wasn’t important where I was on that graph, we looked at all the advantages that my new body was giving me, all the NSVs (Non-scale victories) that I was having. The smaller clothes, buying clothes in normal shops, fitting into chairs, not worrying about where to sit in a room, which chairs had restrictive arms, or about fitting into an airplane seat without having to ask for a seat belt extender. My fitness was improving, there was less strain on my bad knee, I walked up stairs instead of waiting for the lift and I was feeling better in myself. These were the real life gains, the real life reasons for the surgery. 

 

I am not perfect, but the difference now is that I am aware of it and recognise it for what it is. I have the control to stop myself slipping and I know that I don’t want to go back to where I was. 

 

I have more control than before. I have mindfulness tools. I can look in the mirror now, in fact I don’t mind looking in the mirror, I actually like looking in the mirror.