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Saturday, June 25, 2005

‘Morbidly obese’ means progress

Originally published June 25, 2005, in Our Town for the Tracy Press.

It’s been four months since I had gastric-bypass surgery, and life just keeps improving.
I’ve lost about 74 pounds — 100 pounds since my highest weight last summer — and the sense of accomplishment is almost indescribable.
As I’ve mentioned in previous columns, I was never able to lose more than about 30 pounds with other weight loss methods. Though I knew that gastric bypass boasts a 95 percent success rate, in the back of my mind, I thought I would be among the 5 percent for whom it didn’t work.
Instead, I’m amazed every week I step on the scale. I’ve gone from a body-mass index, BMI, of near 60 — considered “super obese” — to 41.6 — the low end of the no-less-scary “morbidly obese” distinction.The BMI is a number often thrown around by health-care and fitness professionals to determine whether a person’s weight is healthy for his or her height. I had originally reported my BMI in this column as being 56 before I had surgery.
Unfortunately, that was at a time when I thought I was taller than I really am.
The funny thing is that even after losing a total of 100 pounds, my BMI is still high enough to qualify me for surgical weight loss and have the procedure covered by most insurers. Talk about putting things in perspective.
I continue to be amazed by people’s reactions to me. A woman at the gym the other day told me I looked like my sister. Not that I have a sister, but she said my features have changed so much that I look like a relative of my former self.
I get asked a lot if I’m considered a success. I generally say that success is relative. If I had dropped 100 pounds through standard diet and exercise modifications, my physician wouldn’t mind if I chose to stop losing weight right now. After all, anything is better than where I was before, and maintenance is the hardest part of weight control.
Having gastric-bypass surgery changes that perspective.Doctors have varying opinions on what constitutes success with this surgery. Most insurers are happy if a patient loses 50 percent of his or her excess weight. But some doctors set higher goals to put a patient’s BMI closer to the “normal” range. The accepted average is that surgical weight loss can help patients lose about 65 percent of their excess weight.
I’m on track to lose 75 percent of the extra weight I carried at the time of surgery.
Because I am 5-feet-3-inches tall, insurance charts say I should weigh 130. Rounding my pre-surgery weight down to 309 pounds, that means I’m on track to weigh 175 pounds after 18 months, for a total loss of 134 pounds. That gives me 14 more months to drop 60 pounds.
Chances are, I’ll lose more than that over the next year, but at least I have an idea of the weight at which my body may decide to rest. And I hope that knowledge prevents me from obsessing over the fact that 175 pounds on a 5-foot-3-inch frame is still considered obese.

Saturday, June 18, 2005

Feeling reformed

Originally published June 18, 2005, in Our Town for the Tracy Press.

Exercise can be a tedious chore. That’s probably why so many Americans don’t do much of it. In bigger cities, health clubs recognize this and try to offer unusual options to attract members. Spinning, kick boxing and even stripper-cise are all examples of recent fitness trends that professionals have tried to cash in on.
I started doing yoga when the most-recent craze hit town about five years ago, and for two years, I was a yoga fanatic — who knew you could get such a great workout by breathing and stretching?
Classes have never been my thing. I always find that I’m the least coordinated or fit person in the class, and I rarely have the stamina to make it to the end. But when I was in my yoga craze, I craved more instruction. I tried every class related to yoga offered by my gym — cardio yoga, power yoga and even something called Pilates.
Sadly, the experience wasn’t as rewarding as I hoped. The yoga craze had created a monster, and most of the hybrid classes weren’t really yoga at all, at least not the type of yoga I learned and was growing to love.
I had been told Pilates was the same as yoga, only it focused more on the core muscles of the abdomen and back. I didn’t have any luck in the Pilates class either. The moves were very difficult and fast. I tried the classes twice a week. But after a month of leaving with a sore neck and back, I gave up and figured I was just too big to do it.
It wasn’t until I started reading more about Pilates that I realized that the instructor I had wasn’t teaching true Pilates. Created by Joseph Pilates, a performer and boxer in the early 1900s, the exercise form has been widely used by dancers. His goal was to give people who were injured the ability to exercise their muscles. Pilates incorporates controlled breathing with controlled movements to offer a total-body strengthening workout with minimal risk of injury.
Part of the reason the risk of injury is low is that Joseph Pilates also invented an array of contraptions to help people do his exercises correctly and safely.
When I was preparing to have gastric-bypass surgery, I picked up a Pilates DVD. Many gastric-bypass patients swear by Pilates. Patients who have open procedures (a 4- to 7-inch midline incision) aren’t usually allowed to do standard abdominal exercises, because they are at risk of incisional hernias. Pilates is a way to exercise their abs and back without injuring themselves.
Though I could tell the instructor on the DVD knew what she was doing, I still had difficulty. Controlled breathing is very important in Pilates. It’s so important that if you can’t breathe properly, there’s really no benefit to doing the exercises.
My problem with the DVD was that if I was concentrating on my breathing, I couldn’t figure out the moves. But if I concentrated on my movement, I couldn’t maintain the breathing. I turned off the video and shelved what I figured would be another $20 down the drain.Fast forward four months. Bored with my exercise routine, I started to feel that no matter how much I was exercising, my fitness level was dropping.
I decided it was time to visit my personal trainer to see if she could help me rework my routine.She asked me if I wanted to try something called the Reformer. The Reformer is an exercise machines invented by Joseph Pilates.Apparently, the gym had recently bought one, and the trainer was eager to use it. I looked at it, gulped and told her I would. To be truthful, I wanted to say no. The machine looked like a medieval torture device. But just recently I wrote a column about wanting more adventure, and the Reformer seemed like a good place to start.We started by taking off our shoes, and the trainer showed me how the machine worked.
Joseph Pilates constructed the original Reformer by taking apart a hospital bed. The platform glides back and forth. Springs attached to the base govern the resistance provided for each exercise. There are a variety of straps and pulleys that attach to the springs as well.At first, I just sat on the platform to get a feel for its movement. Once I was comfortable with that, I laid on the platform, and my trainer coached me through Pilates breathing. The breathing technique can be difficult to master. It involves pulling in your navel toward your spine and breathing into your lower belly.
Once I seemed to have a grasp on that, and keeping my spine in a neutral position, I actually started doing some exercises. The exercises were difficult because of the level of control needed to perform them as slowly as the Pilates method demands. When breathing correctly, I would be dripping with sweat. When my body began to cool, I realized that I needed to correct my breathing.
After the workout, I was spent. I’m sure to those around me, it didn’t look like I did much. But I felt it for six days. It was truly an Abs of Steel workout.
Since the exercise session, I have become like a convert, preaching the Gospel to the world. I tell everyone that Pilates done right is the best workout around. It’s a mental and physical challenge that leaves you feeling rejuvenated and exhausted all at the same time.

Saturday, June 11, 2005

Adjusting to a whole new world

Originally published June 11, 2005, in Our Town for the Tracy Press.

Before having gastric-bypass surgery, I loathed placing myself in the category of being overweight. I considered myself more active and more nutritionally educated than most of my peers, obese or not. I also thought I had more confidence than other women. I had a husband who never complained and thought I was gorgeous. I paid attention to my appearance and tried my best not to be slovenly.
Of course, the bigger I got, the less those things seemed important or even possible and the more I saw myself as a hopelessly obese person. I felt that there was no point trying to improve myself because it wasn’t possible or even worth the trouble.
Taking the elevator to my second-floor office became more of a necessity than an example of laziness. My knees just couldn’t handle lugging all 300-plus pounds of me up a single flight of stairs. Even getting out of my office chair to walk across the room to the printer seemed an impossible feat.
At home, things were no better. I stopped painting my toenails because I couldn’t reach my feet. Shaving my legs stopped being an absentminded shower habit and started requiring advanced planning. When would I have time to lock myself in the bathroom for hours as I tried to contort myself to reach hairy patches of skin with a sharp blade? To be truthful, I lost the energy to even think about shaving.
While others spent their weekends planning hiking, skiing or boating trips, I preferred to be a homebody who would rather go to dinner and a movie than the lake or anywhere outdoors. It’s not that my husband doesn’t enjoy the outdoors — he does. It’s that I have never had the self-assurance to actually enjoy the outdoors. Anyone whose thighs rub together can tell you how miserable being outside in the summer can be.
Beyond that, I’ve never felt comfortable using outdoor furniture. I would avoid picnics and barbecues because the white or green plastic patio furniture most people have wouldn’t fit me or, even worse, would break under my weight.
Being the life of the party is one thing, but being the person who gets laughed at because she broke a chair and fell to the ground is entirely different.
I know from experience.
So as I got bigger, my world became smaller. Now the reverse is occurring.
I’m losing weight at what feels like a rapid pace, and the world is opening up to me just as quickly. My husband and I are making plans for activities and getaways that I only dreamed about before. We’re talking about flying to New England in the fall to visit friends and see the leaves change color. That’s possible, because I won’t have to worry about fitting in an airplane seat anymore. And I hope to spend some time on a friend’s houseboat this summer. I’m even going swimsuit shopping this weekend to prove my willingness.
I know we’re going to be a much more social couple this year than ever before, and the prospect is equally scary and exciting. Doors are wide open for us, as if there’s a whole new life waiting for us out there.
It’s as if I have a chance to be a child again.Now that I don’t have to be as concerned about social catastrophes related to my size, I’m more willing to attend those backyard barbecues, picnics and houseboat parties. And who knows what that will lead to? For the first time in my life, I’m open to new adventures.

Saturday, June 04, 2005

The side effects of weight loss

Originally published June 4, 2005, in Our Town for the Tracy Press.

I’m constantly amazed at the differences between the person I was before surgery and the person I’m becoming. I say “becoming,” because I’m changing in various ways all the time.
I’m not the first person in the world to lose weight — nor am I the only person who has ever undergone weight-loss surgery — so most of the changes aren’t unique to me. And yet, for me, they are unique. In fact, they’re shocking.
Every woman's dreamEvery women’s magazine features stories that tell of better body image, increased self confidence, new-found energy and a general improvement in quality of life after weight loss. But few of us get to experience those feelings for ourselves because, as the media frequently points out, dieting has a 95 percent failure rate.Having spent much of my life among the 95 percent, I would read those articles and dream that I would one day have similar success. I could probably recite the basic formula for those published success stories on demand.
Giving upI was a loyal subscriber of both Shape and Self magazines from the time I was 17 years old until late last year. I spent so many years reading the magazines because they provided what I considered to be balanced information regarding diet and exercise, and I was hooked on the readers’ success stories featured in every issue.
I stopped subscribing because I realized those magazines negatively affected my self-esteem. Every issue featured a new eating plan that I didn’t have the money or time to start or stick to and a workout plan that I didn’t have the physical ability to follow.Every month, I’d feel like more and more of a failure, until I eventually stopped reading them all together.
A new perspectiveI hadn’t so much as glanced at a fitness magazine until last weekend, when I picked up a copy of Shape at the newsstand. I grabbed it because it had a workout plan that I thought could help me add a little variety to my exercise routine.
Flipping through the pages, I found myself easily sucked in to the success stories, as always. The difference now was that I didn’t look at those stories to be a measure of my failure.
As I looked over the workout plans featured, I saw quite a few exercises that I would be comfortable incorporating into my routine. The most useful feature I saw was “Remodel Your Butt,” which professes, “Big butt, no butt, droopy butt? Reshape your assets just in time for swimsuit season with our six super-effective moves.”
I know it won’t get me to my “best bikini bod” in 30 days, as the magazine promises. But the exercises shown are an appealing addition to my workout routine.
Aside from my new outlook regarding fitness magazines, I have an ever-changing outlook on myself.
A month ago, I was jumping up and down because I could reach my feet to paint my toenails. Last week, I indulged in a pedicure, because I finally wasn’t afraid of being “too big” for the pedicure chairs. Of course, the fact that my feet don’t swell up like potatoes anymore makes me a little more interested in their appearance.Speaking of appearances, I’m rarely willing to leave the house anymore without at least a little makeup and some attempt at styling my hair (what little I have).
In the months before surgery, when I felt like I was choking on my own fat, I would have said that I just wasn’t vain enough to worry about trivial things like makeup and hairstyles.But the truth is that I don’t think vanity — in healthy doses — is a bad thing. And though I wish I could have felt this good about myself before gastric-bypass surgery, I’m thankful I’m experiencing it now.