For most of my adult life, I have been overweight. My weight gain really started when I was in middle school and continued at a fairly steady pace until I seemed to plateau around the 375 mark in my early forties. I wasn’t really happy being so big, but I was able to get around okay and the pain and inconvenience were tolerable. If I wasn’t happy, at least I wasn’t miserable.
That changed with the Job From Hell: the more stressful the job became, the more difficulty I had handling it and as a result my weight went up by almost 65 lbs, and in that 65 lbs lay the difference between “livable” and “utter misery.”
Since then, I have lost almost 18o lbs. My weight is now 260. I think the last time I weighed this much was in the late 1980’s, which would put me in college. While the number still looks significant, given I have been told by various “authorities” that my ideal body weight is between 120-150. By those estimates, I am still 100 lbs over what I should weigh. In fact, I would have no difficulty qualifying for almost any kind of bariatric surgery since I am still morbidly obese. Anyone who has lost a significant amount of weight knows two things: 1) weight loss fluctuates, sometimes dramatically; and 2) your body does not always change in ways that you like.
I have to admit that at first my weight loss was rapid and without almost any fluctuations. Because I was almost 450 lbs, positive changes to my eating resulted in rapid dramatic weight loss. Just changing what I ate from processed carbohydrates to more nutrient dense high protein whole foods, my body lost weight quickly since I had been eating so many carbs, most of which my body just stored as fat since it rarely had the opportunity to burn any. I kept eating because I was stuck on the carb roller coaster: once the body processes all the carbs into storable fat, the blood sugar drops, triggering the brain to release ghrelin (the hunger hormone) to raise the blood sugar again, so I’d eat more carbs, and ride the ride again, and again, and again. Just getting off the ride, my body was no longer taking in the carbs aka storable fat and was burning some of what was there. I dropped almost 100 lbs in the first year alone and it was almost one year before I hit my first significant plateau.
In the two years since then, I have hit a few slow-downs and plateaus, because as my body weight dropped, it had less stored fat to burn, and it required less calories to maintain. This is why calorie intake drops as weight drops. The Basal Metabolic Rate (BMR) is the number of calories your body needs just to stay alive. In plain language, when you’re sitting on the couch bingeing The Walking Dead, this is what your body burns. Your TDEE (Total Daily Energy Expenditure) is what you burn when you are out running around, working out, just working or doing what you normally do when you’re not bingeing TWD. To lose weight you need a calorie deficit: if your TDEE is 2400, you need to eat less than 2400 so your body can burn stored fat, but you should not eat less than your BMR since your body can start cannibalizing itself by breaking down muscle. Between those two numbers is the sweet spot, and the more weight you lose, the more muscle you build, the more those numbers change. You have to hang on to that shifting sweet spot, which is one of the reasons weight loss fluctuates and is never linear nor constant. What I was doing for the first year of my weight loss worked great, until it stopped working. That’s because my weight had reached a point where I was no longer hitting the sweet spot: I needed to change how I was eating and what my activities were to raise my TDEE and/ or my BMR. Building muscle raised my BMR because we all know that it takes more calories to maintain muscle than it does fat. I needed to raise my TDEE because the more energy I burned being active in the day, the fewer calories were being stored. Also more activity can mean more muscle building, which raises the BMR. I also needed to make sure I was eating at a deficit, but not such a deficit as to cause damage to my body (starving myself).
Generally, the easiest way to make sure you’re still hitting the sweet spot is to keep moving. The more active you are, the more calories you’re burning and hopefully, the more muscle you are building. You also need to keep your diet moving: try new things, keep eating seasonally and don’t get stuck in a rut with the same foods (this is one of my problems). Eating seasonally is one of the easier ways to keep fueling your body differently. If you mostly eat squash and root veggies in the fall and winter, eat more leafy greens in the spring and summer. Eating berries in the summer is a good way to fuel your body differently as well as get different nutrients. Trying new foods is another way to find out what works for you. Your body is amazingly adaptive and it’s always searching for homeostasis: its own sweet spot where it’s taking in as many calories as it’s burning. The fact that you keep trying to lose weight (either by lowering calorie intake and/ or output) means you are fighting your body’s natural tendency for homeostasis. It’s an odd kind of dance where both of you keep trying to get ahead of each other. So as you lose weight, you will hit slow downs and stalls (plateaus) and you will bounce up a few pounds or more (especially if you’re female or if you are building muscle). The best way to handle this is to make sure your overall trend is going down. I know it’s easier said than done, since I still tend to get really frustrated and impatient with plateaus.
Your body will also change in ways you don’t like. Usually, as we start to get thinner, we get pretty excited about losing weight and our friends start telling us how good we look. That’s the fun stuff: seeing your legs, your face, your waist get smaller and more shapely. You also start noticing you have muscles now! Yay for me! It’s kind of like a honeymoon period in your weight loss journey- everything is going great and you’re liking what you see! Your clothes start getting bigger and you start fitting into smaller sizes, accentuating your weight loss. You start being able to do more in everyday life and when you work out. One day you realize you are holding a plank for well over a minute without really thinking about it and remember when it was hard just to get into that position! You start feeling really fit and accomplished and proud of yourself.
Then it begins: honeymoon is over and the less than fun realities begin arriving. For me, it started with my thighs and my belly: my skin started getting looser, and looser, and it started getting saggy. I noticed when I was doing my pool exercises that it floats and ripples more like cloth than skin. I started noticing odd bulges (varicose veins) that I had never seen before because they were hidden by the fat. The more weight I lost, the more wrinkly saggy areas showed up, as well as odd divots in my lower legs where the muscles are more visible under the loose skin. The skin on my belly, hips and butt also started sagging and now I’ve been told that I have a droopy butt. I also have ‘batwings’ on my upper arms, wrinkles on my face now that it’s smaller and a turkey neck under my chin. There are times when I feel a lot like a melting candle (especially lying down) as my loose skin puddles around me on the bed or floor. It’s hard to feel accomplished, strong and fit when you look and feel like a deflated balloon, all stretched out of shape and wrinkled.
I never thought I would lose as much weight as I have and it wasn’t until I had lost about 70 lbs or so, and I began to notice the loose skin, that I realized skin removal surgery was something I was going to have to deal with. Seriously not thrilled about it, and therefore I am putting it off until it becomes absolutely necessary. I did discuss it with my doctor, who also felt that it wasn’t anything I needed to worry about until I stopped losing weight or the loose skin became an infection risk. Until then, I just had to live with it, and I am okay with that.
To be honest, one of my excuses for not losing weight was that I didn’t want to have skin removal surgery. I realized at some point around 300+ lbs that even if I lost weight, the only way to take care of the loose skin is to have it surgically removed, which is a really unpleasant experience. It’s a long invasive surgery with a long and painful recovery period and it can leave lasting effects. Almost anyone who has had surgery knows that the incision scars never feel normal again and even the most skilled of plastic surgeons can only minimize the scars as much as your body will allow. If you are someone whose body doesn’t heal smoothly and cleanly from cuts and wounds (like mine), your body may never look normal. Looking normal is extremely important to most people.
I have only a vague memory of looking ‘normal.’ My mom has a picture of me when I was in 6th grade where I was goofing off as she snapped the picture. In this picture, I am not overweight and I think it’s the last photo I have of myself looking like a normal pre-teen kid. In the forty years since then, I have grown used to looking and feeling different from everyone else. ‘Not-normal’ is my normal and I have also come to realize that many people have problems accepting that they are different from the mainstream. I remember when I was an overweight teen trying on swimsuits with my mom and her mother, and being told by my grandmother that I wasn’t going to find a swimsuit I liked because none of them would cover my fat. (She was a real peach, my maternal grandmother!) In the years since, I’ve grown used to people making rude remarks, laughing at me and treating me differently because of my weight. I learned to ignore most of it since it says more about their narrow-mindedness than my weight problem. At the pool, I’ve noticed some of my classmates walk out to the pool with towels wrapped around to hide their bodies. I know I look wrinkly, saggy and kind of deformed. I also know that I feel stronger, lighter and I enjoy my life a lot more than I did before. If looking a little freakish is the cost of feeling a whole lot better, then I am happy to pay it! Our appearance is always temporary and changing anyway. No doubt I will continue to look saggier and wrinklier as I continue to lose weight. The day may come when it bothers me enough to do something about it, but until that day, I will view the wrinkles as signs of my ongoing success. I worked hard for them!