I’ve been dreading writing this post, as it’s one of the few times I don’t want to do a PSA. Those that know me will know that I prefer to shout loudly from the rooftops anything in my life which may be controversial. However, this time, I don’t want the stress of airing my dirty laundry and would rather cower in the corner in anonymity. And yet, I feel a strong sense of obligation to those who need someone to speak out for them.
In September this year, I had a gastric sleeve. For those that don’t feel like clicking the link, short story, they cut away 70-80% of my stomach (Let me quickly interject that I am in no way advocating weight loss surgery). I decided to be open and honest about this, because I just can’t lie. I suck at it and hate it. I lied briefly to those around me, who would see me during my recovery period, and then had to blab out the truth because the lying killed me. I was a lighter weight, but still had a BMI of over 35 and had three major weight-affected conditions: 1) I was told that within two years I will have type 2 diabetes, 2) I have hypermobility and the extra weight makes a massive difference to mobility, collapsing joints and a crap load of pain, 3) I have asthma which weight affects, albeit mildly.
I mention these because the point of this post is to open up dialogue about my operation and others, and to highlight things people say that they may not think is inappropriate. A surprising amount of people have asked me some form of inappropriate or really personal question. I am fully aware that no one intended it to be that way, so this is merely to help others in the future. If you have asked me any of the below or said anything like these, please don’t feel this is a dig. I assure you, I hold no ill-will and know it came from a good place 😉
- In 90% of the conversations I’ve had about my WLS, the first question has been: Was it NHS or Private?
- Please don’t ask us this question – there is no right answer! The NHS means we’re wasting the tax-payers’ money and going privately means we’re rolling in the dough or heavily in debt. It’s an incredibly awkward question and the equivalent of asking if you own your house, is it mortgaged, on benefits or rented.
- How much did you weigh before?
- Pretty sure I don’t need to tell you why that’s inappropriate.
- So, you’ve cheated.
Now, luckily, I’ve never had anyone dare say the third one to me and mostly I’ve had supportive responses, which was not what I expected. However, many of my bariatric friends have had people accost them with their judgements on this ‘quick fix.’ So, I would like to highlight some aspects of WLS for you.
Weight loss surgery is NOT the easy way out. It is bloody hard. So much harder than the movies and TV shows will make you think. It is always the last resort. You are having major surgery (yes, it’s keyhole, but someone cutting away 80% of your stomach, putting a band around your stomach or rerouting it all, is major surgery, no matter how you look at it). The recovery period lasts anywhere from 2 weeks to 6 weeks and often more. You run the risk of death. Not just from going under, but from leaks and sepsis, which is not as rare as you would like to think.
If you ignore the initial risks, you then need to take into account the following:
- Almost all WLS requires a pre-op diet, which is designed to shrink your liver for easy access. In most cases this requires either a 1000 cal limit a day for anywhere from 2-8 weeks, or a milk only diet. This is where you are allowed 4 pints of milk, 1 oxo cube drink and 1 small pot of sugar free jelly a day. That’s it. For at least 14 days. So, consider this when chatting to a person who had WLS: There is a good chance this person chose not to eat at all for 14 days. Don’t dare tell them they couldn’t follow a diet or didn’t have the perseverance. I did this diet. It was one of the hardest things I’ve done and I had an incredible sense of achievement from it.
- A lifetime of change.
- Foods you loved before, you will now either not love or be completely unable to eat. For bypassers and some sleevers, chocolate and sweet foods could result in dumping syndrome: palpitations, extreme pain and fatigue, and a good day or two on the loo, with everything flying out both sides. Again, you may think this is an easy way out of dealing with cravings. It’s not. It means every party you go to, every event, will be stressful, filled with temptation that pulls at your heart and filled with people asking you why you aren’t eating. You run this risk with every new food you try. For some people, it’s not just sweet things. For me, it was chilli. I can now no longer eat chilli and that’s not a lesson I’m willing to learn again!
- How you eat changes completely. You now need to follow the 20-20-20 rule for the rest of your life. Leave 20 seconds between bites, chew each bite 20 times and finish after 20 minutes. You can also add ‘eat only bites the size of a 20p coin’ to the list. In addition, you’re not allowed to drink anything while eating and need very small portions.
- WLS is not a quick fix – it lasts for 2 years and after that, you need to stick to these rules religiously, or run the likely risk of picking up all your weight again. This happens often. However, those that do stick to the rules, manage to keep it all off.
- Pain. So much pain.
- Some people have incredibly long recovery times after the op. I was lucky and was back up to ‘normal’ (albeit with pain) within a week or two. Friends have suffered in serious pain for over 6 weeks.
- Eating is agony. I’m 12 weeks post op and still have to lie down each time I eat. As the food goes down, it’s as if it I’m swallowing a knife (regardless of the food, thick yogurt does this, too). Then, as it settles in your stomach, it’s tries to find a way to fit and you’re stuck with a good 20 minutes of pain, food rising back up (trust me, when it doesn’t fit, it lets you know!) and general discomfort. And, for the love of god, don’t try bend down after a meal. The food finds the easy way out!
- A gastric sleeve often results in a lifetime of reflux and heartburn. Yay for us.
- After you’re fully healed, you will still have the risk of getting food stuck. Cue agony, fatigue, and pretty much all the ‘dumping syndrome’ symptoms, apart from the evacuations, mentioned above.
- Learning to talk about the weight loss. Whether you’re telling the truth or have a cover story, it is a huge thing in your life. Someone with a cover story has the stress of keeping that up and making sure they don’t contradict themselves forever (and please, please do not judge these people. Society has left them with little choice but to keep it secret). Those of us who choose to tell the world, have to then face criticism and also figure out when to tell people. I had a lovely lady tell me yesterday that I look great for a woman who has a 10 month old. I was quiet and then blurted out, rather loudly and suddenly “I had a gastric sleeve!” Obviously, the poor woman got a shock, as did I and probably everyone else in the room. I had been trying to figure out whether to just say thank you, or admit that it wasn’t ‘natural.’ And my anxiety overcame me…rather loudly. It’s a constant balancing act, which we often fail at.
- It may not work. Nothing in WLS is concrete and there are people these surgeries don’t end up helping. It’s a hard truth, but one every WLS patient must face.
These are the things we deal with because we have to. Please do not for a second think that this was easy for any of us. Before you judge, ask yourself if you could put yourself through all of this?
Cutting back to my story, I was living my life under a heavy cloud. I was unimaginably miserably and knew I was taking my life, my partner and my children for granted. Two weeks before my op, I was bed-ridden for three days in tears because I caught a glimpse of myself in a video. My appearance made me physically ill. I wasn’t the person on the outside that I was on the inside. I didn’t go out, I didn’t have fun with my kids, I wasn’t giving them the life they deserved and I sure as hell wasn’t giving myself the life I wanted. This op has changed my life. Merely being booked in for this op, having the balls to go ahead with recommendations and doing something about my weight, took a huge weight off. I am so incredibly proud of myself. My mental health didn’t change with the weight loss, it changed with the decision to do something about it. I suddenly me again. I still struggle with depression and anxiety, but at perhaps 10% of what it was before. I run with, laugh with and cuddle my children daily. I walk with my head up. I smile and mean it. I love myself. No amount of stigma, judgement, pain or discomfort can take that away. I’m proud of my decision and my move and you should be proud of me too.
So, if you’re looking for what to say to a WLS patient, here is my advice:
- Ask questions. If they’re telling you about it, they’re open to questions. Just be kind and respectful of their privacy. They can tell you whether or not they don’t want to talk about specifics.
- Instead of saying how thin they look, tell them how healthy they look. I’ve had a few people comment on my weight loss, but those who tell me I look healthy have made me feel wonderful.
- Congratulate them on doing something for themselves and the hard work it takes.
We each have to live our lives to the best of our abilities and those who have undergone or who are thinking of undergoing WLS know that we aren’t or weren’t doing that. If you had the chance to love yourself again, wouldn’t you jump at it?