Stepping Out of the Bariatric Surgery Closet

Exactly one year ago today, on August 21, 2013, I had Roux-en-Y gastric bypass surgery.  Today, therefore, is my 1st “surg-iversary.” Perhaps this is old news to you… but it’s not one year old news, because this secret was mostly under wraps until recently.  Why, you ask?  I’m still asking that question myself, but this indeed is my first public “outing.”  Read on if you’d like to satisfy your own curiosity or indulge my need to finally share the story.

I was starting to write, “It all began last May,” when I realized that that’s not at all when it began.  Truly, the story starts at my first Diet Workshop meeting, 36 years ago, when I was 9 years old and in the fourth grade.  I feel a deep sense of sadness when I remember that chubby little girl stepping onto the check-in scale for the very first time, surrounded mostly by middle-aged and senior women seeking wisdom and fellowship on their weight loss journeys.  Not a single peer in sight, I realized in that moment that I had a problem reserved for grown-ups. What a fat, ugly, worthless little girl I must be if I, alone, was given this burden in childhood.  And so truly begins my story….

I have ALWAYS had a weight problem.  Even the photos of my toddler self in a ballerina tutu predict what was bound to be a life-long battle of the bulge.  Over the years, I’ve tried it all: Weight Watchers (at least 25 times… I’m a Lifetime Member!), gym memberships, my ill-conceived Facebook diet, HMR, Woman’s World, Zagorra hot pants, cleanses… you name it.  I had occasional success, in fact losing 60 lbs. in my 20s on the Weight Watchers at Work program (thank you, Lotus Development), but my lost pounds always found their way home.  At 44 years old, I was ever-so-close to accepting my fate as a forever fatty when I decided to pick up the phone and call a friend.

At the time, of course, I didn’t know that the conversation would be step one in changing my life forever.  My call was to a pal who had chosen gastric bypass surgery four years earlier and who appeared to have had quite amazing success.  And, even though I clearly remember telling my husband how absolutely crazy she was to risk her life for weight loss surgery and how I would never, ever, in a million years consider such a drastic step, I now found myself out of options and wondering if this might be the answer for me too.  I asked what I thought to be rather intelligent questions about her experience with both the surgery and the recovery, but it was this statement that unlocked the gate for me…  “Beth, I do a lot of things really well, but weight loss isn’t one of them.”

Freedom.  That’s the only word to describe the gift that was found in her words.  I had made hundreds of valiant attempts at weight loss with genuine confidence that I would finally be able to defeat the dragon on my own.  It hadn’t worked.  Each and every time I failed, the only thing I lost was another chunk of self-worth.  Perhaps I too could surrender, take someone’s hand and ask for help?

With a sparkle of hope in my heart, my husband and I attended an information session to learn more about weight loss surgery.  Together, we decided that I’d complete the evaluation process and trust that the results would lead us down the right path.  The summer of 2013 was spent meeting with bariatric surgeons, neurologists, cardiologists, nutritionists, and psychologists.  And, after thorough inspections of, literally, my heart and soul, they deemed me a qualified candidate.  Now the decision was fully mine.

I’ll admit that, during the months of May, June and July, there was no question in my mind that I would move forward with the surgery.  As I learned more at my doctor’s visits, talked with other friends who had chosen bariatric surgery (thanks, ladies… you know who you are!), and researched the subject online, I was convinced that this was the solution for me.  And then the call came to inform me that my surgery had been approved and we were ready to set the date.  In that very moment, uncertainty washed over me. Was I risking too much? What if I was one of the 0.5% who die as a result of the surgery?  How could I possibly leave behind a wonderful husband and four awesome kids… a family that was incredibly hard to build… simply to lose weight.  Would my friends and family judge my choice? Would they think me the ultimate failure? What if I went through with the surgery and it didn’t work?  What if?  What if?  What if?

And then I asked myself… What if your blood pressure continues to rise?  What if your sleep apnea can never be controlled?  What if you have a stroke?  What if you have a heart attack?  What if you develop colon cancer?  What if you live your remaining days feeling entirely overwhelmed by your size?  What if?  What if?  What if?

Saying “yes” to bariatric surgery was simply the most selfish yet most generous gift I ever gave to myself.  In the end, I was convinced (and I still am) that surgery would afford me a longer life with my family.  It would improve the quality of my declining health and, as a bonus, it might even help me to buy back some of that self-worth that I had lost along the way. I said “yes” and then an entirely new wave of questions hit me square in the face.

To tell or not to tell?  Throughout the evaluation process, only a handful of our nearest and dearest knew that I was considering surgery.  In fact, for fear that they would disapprove, I didn’t share my surgery date with my parents until two days prior, and – as predicted – it was not met with a positive response. They begged me to wait 10 years, until the kids were out of school and mostly independent.  They called me selfish.  They told me I was stupid to choose elective surgery.  They sent me articles quoting death rates.  And then, six hours after my surgery, they entered my hospital room with tears in their eyes and told me that they loved me and that they were afraid they would lose me.  Isn’t it interesting how much fear plays a role in the decisions that we make and the words that we choose?  It was both fear and shame that would keep me from sharing my surgery secret for many months to come.

Recovery was equally hard and scary in the first thirty days.  The liquid diet slowly transitioned to soft food like scrambled eggs and greek yogurt, and I was eating small protein-rich meals by the end of week six.  I tried to avoid events that would require food or beverage intake as I evaluated what my body could or could not handle.  And, on a few occasions, like in the North Street School parking lot, after a parent/teacher conference, I raced to find a private space where I could throw up.  The scary part wasn’t managing the food, though; it was managing my expectations of the scale.

I assumed that the weight would just fly off of me.  Haven’t you seen Star Jones or Al Roker?  Didn’t they go from fluffy to flat in a matter of weeks?  Well, that wasn’t my experience.  My surgeon, the nutritionist, the nurse practitioner and my own primary care doctor all assured me that losing slowly is the healthy way to go… that I may experience less hair loss, that my body will heal faster, that the nutrients will absorb better, that yah-dee-yah-dee-yah.  I didn’t want to hear it.  I had said yes to major surgery and if this damn procedure didn’t work, I was going to be pissed.  The end.

They were right.  The losses started and stopped almost cyclically, and once I got below the magic number (we call it “One-derland” and you can probably figure it out), my sense of panic subsided.  At this point, some people noticed my weight loss and offered their congratulations.  I accepted it but felt it was entirely undeserved.  Some went so far as to ask how I was losing the weight.  With 100% truth but not 100% full disclosure, I explained that I had significantly changed my eating habits, that I was on a high protein diet and that I had broken up with my beloved Diet Pepsi. (Bariatric surgery = no more carbonated beverages.)  My husband joked that soda sales were going to plummet thanks to my half-truth, but I still wasn’t ready to share my story.

During the psychological evaluation that was required prior to surgery, I was told that it was not uncommon for people to feel depressed after surgery.  What?  Depressed?  After achieving something that seemed unachievable?  After going off of meds?  After buying new clothes?  After walking up a flight of stairs without feeling winded?  That’s just crazy, I thought.  And then came the blues.

I’m not sure what played the biggest role.  Guilt about not coming clean about my surgery?  Fear that I would be judged?  Shame that I couldn’t lose weight (and keep it off) on my own?  Or was it that, now, at a shrinking size, people seemed to approve of me more.  If they liked how I looked now, they must have hated how I looked then.  Even when my husband hugged me and said, “you feel so good,” I wept, because all that entered my mind was how I must have repulsed him for most of our married life.  I was in limbo… not embracing my new shell and feeling betrayed by my old one.  Between months two and eight, I was in a very dark place.

One of my most telling moments came in month seven when I participated in a group service trip to Guatemala with my mother.  It was February and new t-shirts and capris were in order for the 70-80 degree temperatures that we were anticipating.  Dressed now in size medium from head to toe, I was not feeling at all like myself, so I found it quite interesting, in retrospect of course, that by day two of our journey, I had revealed to my new traveling companions that I had undergone bariatric surgery the previous summer.  It was as if I was saying… “I’m an imposter.  This is not the real Beth.  You could have met her last year when she was wearing size XL.”  Why would I find it nearly impossible to tell my friends and family about my surgery and yet feel absolutely compelled to share it with absolute strangers?

I guess it’s because I’ve ALWAYS been an open book… until now.  After struggles with fertility and the ups and downs of adoption (both domestic and international), I truly considered myself to be the “go-to” girl for information.  “Ask me anything,” I would say.  But my weight loss struggles seemed somehow more personal than my family building ones.  So, unless you were one of the dozen people who asked me if I was dying, I likely didn’t “come out” to you until recently.

So what’s it like to step out of the bariatric closet?  For one thing, it doesn’t necessarily happen in an organized way.  What I had hoped would be a methodical unveiling with those closest to me learning my secret first turned into something entirely different.  You see, it’s not a subject that’s easy to broach, so there were plenty of planned outings that never happened because I simply chickened out.  Or, there were times when my friends had stuff happening in their lives that was clearly much more important than my news, so it seemed insensitive to share.  For lots of different reasons, I didn’t necessarily honor the placement of people in my life with the timing of our eventual conversation.  And the good girl that I am feels rather crappy about that.  I’m sorry if you feel betrayed.  And I’m also sorry that I have spent so much time worrying that you feel betrayed.

I tend to think that my weight indeed “shaped” (no pun intended) the woman that I became.  You see, I’ve always liked the person that I am on the inside.  I’ve been a people-pleaser for as long as I can remember, and I’ve essentially dedicated my life to serving my family and my community, near and far.  Would I have (often desperately) sought the approval of others if my self-esteem was fully intact?  Has my life been full of do-gooder actions because I wanted you to like me… to really, really like me?  I think we all know the answers to those questions.  I’ve been looking for love and validation every darn day of my life… ever since my nine year old self stepped on the scale at that Diet Workshop meeting so many moons ago.

And now for the burning questions…  Are you indeed healthier now?  Yes, I’ve been off of my blood pressure medication and CPAP machine since last November.  Did you achieve your weight loss goal?  I truly never had a number in mind.  My only two goals were to sit higher in the water than my husband in a double kayak and to be able to wear the wedding ring that I had to have cut off of my finger 17 years ago.  Yes and sparkly yes.  And how much weight have you lost?  Well, I won’t tell you the number, but I will tell you that I’ve lost the equivalent of an average fourth grader. (You can Google it.)  Yup… I was holding her inside of me for 36 years, but – with these words - I’m finally ready to set her free.

One final story… About a month ago, I was snuggling with my 10 year old son and he mentioned that he could wrap his arms all the way around me.  So, I took the opportunity to ask him how he felt about my surgery.  His response?  “Happy.”  “Why are you happy,” I asked?  “Because you’re happy now, Mom.”

Sometimes, the greatest gift you give yourself turns out to be the greatest gift you give to those you love the most.