Some obsessions are dangerous. Like sometimes, being as obsessed about reaching your goals as I am can make something that shouldn’t be a huge life ending issue a seriously emotionally traumatic event for me. So my three worst obsessions:
- My obsession with having a “Normal” BMI and my “Goal” Weight of 149lbs
- My obsession with the scale and my inability to deal with weight fluctuations
- My obsession with what “I think I should weigh”.
So my need to be normal: I have no idea why I set this as my goal, I think it is because I feel that I need to have a normal and healthy BMI and body weight in order to meet the image I think I need to meet my goals as a personal trainer. The rational side of me says, it’s ok if you don’t meet this goal, you don’t have to be perfect to help people, you are a huge success story no matter what your weight ends up being as long as it under 170lbs I’ll be content. I really wish I could say that and believe it, the irrational side of me says I HAVE to meet this goal, and I’ll keep pushing harder and harder until I do. Right now I keep reminding myself that I have another skin removal surgery to do, and that those last 10lbs are hard for everyone. I’ve got about 15-20lbs to go, so of course, this is when it gets really hard, I knew that going in. Time to push harder… as soon as my body is healed and will let me J
My obsession with the scale: completely unhealthy: I weigh myself 3-5 times a day. I get obsessed on what I think I should weight, and then I allow for like a 1-5lb weight fluctuation and if it gets above that I start to get a little panic attack, but if it gets above 10lbs god help me I’ll have a mental breakdown, seriously. Right now my lowest weight on the scale showed up at 161 and my highest 171 I tend to stay right in the 165-168 range without any freak-out but if I see 170 on the scale that’s a whole different two digits and I go bonkers. Try living with me after excess skin removal surgery!
My obsession with what I think I should weigh: After my first surgery I went in weighing 175, they cut off 12lbs of skin and I was convinced that I should weight 163lbs. But with fluid and swelling I came home weighing 192lbs and was pretty much in tears sobbing and having a mental breakdown in my PCP’s office. Granted I had a lot of complications during that reconstructive plastic surgery, a lot of excess swelling. But for the entire duration of time between my surgery in February and my surgery in August I was chasing that magic number of 163lbs. I saw it, a few days before the surgery, though the morning of my second surgery they weighed me in at 166, my second surgery took off 3lbs of skin and in my head now I SHOULD weight 160lbs, and of course I will be all consumed with it until I am. On the scale, freaking out, adjusting my food intake each day based on my weight, it, exhausting being this scared of being fat again.
Kaye Bailey from Living After WLS has written several article about Goal Weight Ranges instead of goal weights and she offers simple calculations to figure out what your goal weight range should be. The theory behind this is that you don’t end up setting a weight that is unattainable for you. Following her math these would be my weight phases looking for a goal weight range.
Phase One – Initial Weight Loss: (420 X .10 = 42) My starting weight times .10 = an acceptable 42lb weight range. My Starting BMI would have been 69.9 so we’ll round up to 70. I need to lose enough weight to get a BMI of 60 shooting for a change of -10 to my BMI during each GWR Phase. At 5’5 to achieve a BMI of 60 I’d need to weigh 360bs. My GWR (Goal Weight Range) for this phase would be 360-42 so 318 lbs. I was right in the middle of that the day I went into surgery at 335lb after doing the pre-op diet requirements and milk only liver shrink diet pre-op. So this is making a lot of sense to me so far. Coincidently this is very similar to what was required of me pre op. Since my BMI was in fact over 60 when I first started seeing the doctor that needed to sign off on my health to enable me to have my gastric bypass three things were required of me.
- I had to get my BMI under 60 to be able not be to must of a risk to put on the table
- I had to get my blood sugars under control
- I had to heal up any rashes or yeast infections or open wound sores I had prior to surgery.
If you do the math, I had to pretty much get to exactly where this Phase one Math Calculation would have landed me.
- Start Weight 420: BMI 69.9 “Super Obese or Malignant Obesity”
- ( 420 X .10 = 42 ) 42lb Weight Range
- BMI = 70 (-10) = <60 Goal BMI ( 360lbs )
- 360-42 = 318 – New Goal Weight Range ( 360 -318 )
- Recalculate @ 339lbs
Phase Two – Continued Weight Loss: You use the same calculations used above and recalculate your GWR every time you reach the middle of your goal weight. So if my weight range was 360-318 I would recalculate my GRW when I reached 339lbs. using this method I would have had the following GWRs during this phase.
Current GWR 242-276lbs
- Start Weight 339: BMI 56.4 “Morbidly Obese”
- ( 339 X .10 = 33.9) 34lb WR
- BMI = 56 ( -10 ) = <46 Goal BMI ( 276lbs )
- 276 – 34 = 242 – New GWR ( 276 – 242 )
- Recalculate @ 259lbs
Current GWR 172-198lbs
- Start Weight 259: BMI 43.1 “Severely Obese”
- ( 259 X .10 = 25.9 ) 26lb WR
- BMI = 43 ( -10 ) = <33 Goal BMI ( 198lbs )
- 198 – 26 = 172 – New GWR ( 198-172 )
- Recalculate @ 185lbs
Phase 3 – Exiting the Obese Category: Ok so at this phase you are shooting to get out of the obesity range and into the “Overweight Category which is a BMI of 25-30. I am already extremely close to this during Phase 2, but we’re going to do the math anyway. According to What Kaye Bailey suggests our math changes a little at this point and instead of subtracting 10 from your BMI you are using a BMI of 30 (Which is the High end of “Overweight” as your goal BMI. Let’s look at that math.
Current GWR 160-179lbs
- Start Weight 188: BMI 31.3 “Obese”
- ( 188 X .10 = 18.8 ) 19lb WR
- BMI = 31 / <30 Goal BMI ( 179lbs )
- 179 – 19 = 160 – New GWR ( 160-179 )
- Recalculate @ 169lbs
- This would put my MAINTENANCE weight at 169 ( Median of 160 – 179 )
This math all makes perfect sense to me. And actually it is right in line with what my doctors had to say considering that my surgeon told me I was done losing weight at 195lbs and sent me off to the plastic surgeon. She was happy with that outcome. I wasn’t though and I was down and existing the “Obese” Category even before the skin removal surgeries and I am currently in what Ms. Bailey would consider my Maintenance and realistic goal weight range area given that I started at 420lbs have lost over 250lbs to date. I actually agree with this math completely and think that in most cases Kaye is right on the money and these are realistic expectations for most post op gastric bypass patients. I definitely think that if I had been following this outline with my goals along the way I’d have felt much more successful and much less of a failure at certain places during the journey.
Now all that said, I am just not happy being at a BMI of 25-30 and being considered “Overweight” I want to be “Normal” and “Healthy” and as with all things there are those of use that are an exception to the norm and will chase and aspire to that. So let’s continue Ms. Bailey’s math calculations and see what my GWR would be if I wanted my end goal to be a BMI between 22-25 which is considered “Optimal”.
Current GWR 132-149lbs
- Start Weight 165: BMI 27.5 “Overweight”
- ( 165 X .10 = 16.5 ) 17lb WR
- BMI = 28 / <25 Goal BMI ( 149lbs )
- 149 – 17 = 132 – New GWR ( 132-149 )
- This would put my MAINTENANCE weight at 140( Median of 132-149 )
- Incidentally 132 would put my BMI at 22 and 149 at 24.8 which has always been *MY* personal goal weight
All in all I think Kaye Bailey’s calculations and figures are amazingly accurate and if you break it down in phases like this it seems to be very in line with what a Post Op WLS patient like me can expect to see, realistically at the end of their journey. For me personally, my journey isn’t over and my goals are a little deeper because of my desire to become a personal trainer and because of my skin removal surgeries which to date have removed 15lbs of skin and aided me with a little bit of the weight loss. In fact when you consider that I went into the skin removal surgery at 175lbs that would have put me right in that weight area that Ms. Bailey recommends as a realistic place to be after WLS.
My current weight fluctuates between 159-171lbs right now and I’ve so far had 15lbs of skin removed which should have put me at about 160. So a lot of the weight I have lost since then is largely contributed to the skin removal and doesn’t even always quite equal it. I have one more skin surgery to go and I am still willing to work out hard and often to achieve my goals. I’m not sure I will ever shoot for that 140 that might be a bit steep of an expectation for me, but I’m going to see 145-149 for sure… and keeping that scale below 150 is going to be a lifetime goal for me.