Necessary Mutilation

Weight: 193.3 lbs.

I have to start with the fortune from my cookie while celebrating Tom’s last day of school (as a bus driver) last night. It was at the mmpphhh (shhh…Chinese Buffet)…but I didn’t eat the cookie, I swear! In fact, I ate largely decent protein foods, like chicken and broccoli, chicken on a stick, shrimp something or other, and won ton soup. The fact that there was a disgusting worm in my watermelon served me right, as well as caused me to stop the indulgence right then and there, and practically upchuck what I had already eaten.

But, I digress. Here is what my fortune read: “What are you waiting for? Start moving now!!

Who ever heard of such a fortune? Tom’s said the usual philisophical ya ya of most cookies, and usually mine says even stupider stuff about wisdom or luck or optimism or something.

Perhaps if listening to Debra and others wiser than I fails, I can just crack open a fortune cookie and pay heed, and I’ll do alright after all!

And speaking of which, I am excited to write about this awesome magazine my friend “stole” for me from the waiting room of a clinic she was at recently. She brought it to me yesterday, and I have read every word. It is called “Journal of the American Dietetic Association” and it is their April 2010 issue. If I knew how, I’d scan some of the relevent articles in here, or reference a website where you too could access it. If anyone reading this finds a link and knows how to post it here, please let me know or do so in the comments section. There are four excellent articles in this issue regarding bariatrics, including one chapter called: Dietary, Weight, and Psychological Changes among Patients with Obesity, 8 Years after Gastric Bypass.” Another is titled:” Bariatric Surgery-A Surgeon’s Perspective” and another is about the role of registered dieticians for bariatric patients.

These are all study based articles, and quite fascinating, albeit disheartening for me. For instance, in the 8 year longitudinal study, ” more than half of the patients achieved successful weight loss and that factors associated with this outcome were “younger age at baseline (time of surgery), a leaner body composition 1 year after surgery, and lower energy intake (calorie intake) at last visit (in the 8th year interview). Also, a higher number of pre-surgery psychological consults seemed to help with successful outcomes.

(I am screwed on all accounts!)

Patients who were classified as successful had lost over 50% of excess body weight (which would then include me - yeah!), however only 13% of the study participants lost over 5 kg (does anyone know how many pounds a kg is?? )after the 12th month. (Ack…no wonder its been so much harder to stay on track/lose!)  On the other hand, 26% stabalized weight wise in a range of + or - 5 kg. from their first years weight, and 61% regained more than 5 kg of weight.

At 8 years out, 67% had a BMI under 40 ., and 16% shifted from obesity to the overweight category (BMI under 30.) A normal BMI of under 25 was achieved by only 1% of the participants. And Debra - ha ha!  And 10% are said to still have a BMI over 40.

In summary, “most weight loss occured in the short term after surgery” (Crap!) “However succesful this result may appear, more than half of pateints regained at least 5 kg. between the first year and the last visit (in the 8th year), and they expressed feelings of guilt and shame” (And they didn’t even poll me!) It goes on to say that a lot of patients felt abandoned by their doctors or systems they needed support from, and felt “left alone with their new body, their scar, their fears.” It discusses the huge importance of support and oversight for bariatric patients, and expecially those who began as super obese (like me!), who “have often been reported to have disturbed eating habits, including binge eating. night eating syndrome, and frequent snacking or grazing.” (Eeep - do they have a hidden camera in my house!?) It states that these disorders remain frequent in bariatric patients, and the definition of success should encompass not just degree of weight lost, but “also problematic eating behaviors and psychological well being.”

Also, there is an excellent article on the resolution of diabetes post surgery, and why this seems to occur and in what percentage of people.

Its all great, informative, factual stuff - but a little disheatening for me, especially given some bleak statistics regarding weight loss after the first, critical year. And how commonplace snacking and other bad habits are after surgery and especially as time goes by. I mean I know that I was fighting an uphill battle here, but geesh!

Oh well, at least I now have facts and stats to prove that I am not alone!

Whoopie for me!!  (Crap!)