Most people tend to think of the period after WLS where you have reached your goal weight as “maintenance”, but lately I’ve been starting to look at it in terms of something else; prevention. It’s something that’s been bouncing around in my head for a few weeks now, and I touched on it briefly during my talk at the NW WeightLoss Conference over the weekend.
See, in some ways, I am still a fat dude. I’ve lost a lot of the weight, but I’ve been slowly coming to terms with the fact that maintaining that loss may not be enough. I need to prevent becoming becoming … not so much obese, but rather prevent becoming unhealthy in the ways I was before.
Semantics? Possibly. But I think the two may have some subtle, yet important differences. See, I’m about 25 pounds up from my lowest point of about 18 months ago, but the majority of that has been muscle mass. And, at my current weight I am just a few pounds away from falling in to the “obese” category on the BMI charts. Yea, that means that I am “overweight”. Even at my lowest weight I was still about 12 pounds from even cracking in to the upper limit of “healthy”.
It can be a tough struggle against that label, against those numbers. It can be very hard at times to not become frustrated that after everything I’ve gone through, after everything I’ve done to be healthier, to look at that chart and realise how close I am to still being classified as obese… No matter how good everyone tells me I look, no matter how many accolades I get from family, friends, my doctors and nurses. Those feelings are still there, ebbing and flowing like the tide… they recede for awhile but they also continue to find their way back.
I haven’t talked about this much yet, because we’re still in the formative stages, but I’m working with some folks from my bariatric center at Unity Hospital and we’ve basically formed the Unity Obesity Advocacy Group. I am going to (hopefully) be arranging some meetings with my state reps in the coming weeks to tell them about myself, my struggle with my weight, some things about obesity and bariatric surgery in the hopes of building a relationship with them and educating them on some of the things facing those fighting obesity. Then ideally, as legislative issues come before them in their work that they have a face to put to the stories, information and knowledge to help them make a more informed decision and maybe even someone they can turn to when they need more information.
One of the key points we eventually hope to make that while all the talk these days about obesity prevention is great… there also needs to be some focus on treatment. I’ll get in to this more later, but it’s sort of what got me thinking about what I’m trying to say here.
I didn’t do so hot on the prevention side, in fact I failed at it. So I needed treatment. Bariatric surgery, in my case gastric bypass, has been an effective treatment for me, very effective. So now what?
If you look at the definition of “maintain” and it’s basically about staying at a certain place, a certain level. But my treatment has had effects on more than just my weight, it’s improved my health in so many other ways. And I’m not just talking about my physical health either, I’m talking mental and emotional health as well. On the other hand, “prevent” is about keeping something from happening.
So the more I have been thinking about it, the more I have to wonder why I would want to stay … to maintain where I am now. Cause I don’t. I want to continue to grow in the areas of my mental and emotional health. As far as my physical health, even if I couldn’t do much to further improve that, it’s not so much about maintaining my current health as it is preventing going back to being unhealthy. I’m sure my weight will continue to fluctuate, be it from changes in my muscle mass or even some fat here and there. And I’m (mostly) ok with that. What I’m not ok with is going back to being unhealthy, no matter what the number on the scale says.
I am NOT the same person I was 3 years ago. I am NOT the same person I was 160-170 pounds ago. I don’t want to be. So does maintenance presume that I will stay who I am today even if those numbers remain the same? I would hope not, but I simply do not want to continue to be who I am right now. I want to continue down this path I’ve been on when it comes to my mental and emotional as well as physical health.
Maintaining my weight isn’t as important to me as preventing becoming unhealthy again. And I can pretty much say the same thing when it comes to my mental and emotional health as well.
Ok, yea, I suppose I could say I’m at the point where I am looking to maintain a healthy weight, but again, that is only part of the picture. I am not my weight. I am not my surgery. These things are parts of a whole. I dunno, this is sort of something that has just been creeping in to my consciousness and I maybe I still need to spend some time considering it, but right now I have the feeling that a slight shift from a maintenance mentality to one of prevention is worth exploring.
I’d be interested in hearing your thoughts.
I agree good mind set! I think of all the weight I have lost I do fear regain, prevention is a offensive term I can relate too!
Hey Jeff! Good to see you still lurking around out there!
Rob, I really enjoyed your thoughts. Reality for me is that I am addicted to food, just now I have a tool to help deal with that. 165 lbs lighter, being able to move more sure helps. I admitted that I had/have a problem far to late. Obesity needs to be addressed from the insurance and medical industry as well. Bariatric surgery should be 100% covered as well as gym memberships. Direct medical costs due to obesity were estimated to be around $51,000,000,000.00 in 1995, 61 billion in 2000 and 75 billion in 2003. If you’re a math guy, those numbers are exponential, meaning every year the costs increase faster and faster. If this trend continues, by 2060 costs due to obesity will exceed 1 trillion dollars. By 2085 they will be over 3 trillion dollars.
This says nothing about all the other costs of being “fat”. I earned $3 an hour less as a fat guy. I can buy 5 t-shirts now for the price of one before. I was always depressed it seemed. My shoes last longer now. The other costs of being heavy goes on and on.
Kinda a rambling post, just stuff I have been thinking about. BTW $ info came from wikipedia
http://en.wikipedia.org/wiki/Obesity_in_the_United_States