As I’ve said before, I was not a big advocate of obesity surgery, and viewed it as a ‘cop out’.
I’m glad though, that when I sought counselling earlier this year about how to change my lifestyle and my relationship to food, she helped me explore:
- my past relationship with food
- my current attitudes towards food
- my key goals / desired outcomes
- the major options for change to achieve the outcome
She asked me consider surgery as just as viable as other routes to achieve my goals… I wasn’t convinced but tried to keep an open mind.
My past relationship with food
Having been relatively slim most my life, I’d not really thought much about food, but in one counselling session, I spotted a pattern that my family had cemented around using food as ‘treats’, and ‘rewards’. That’s no major shocker, many people express their love through food, and feeding family and friends – my grand mothers being the epitome of food = love. But invariably that food was poor quality, or junk food. A Happy Meal, a KFC bucket, Pic n Mix sweets etc. So, even though I don’t identify with being a comfort eater, there was definitely a pattern around self reward that did include poor quality take outs / fast food. I’m not blaming anyone for the pattern, but acknowledging it, meant I could see the issue, and work towards a solution to it.
My current attitudes towards food
Increasingly, I knew the dangers of processed foods, and refined sugars, but my heavily carb centric habits were more entrenched than I’d previously admitted. Overall, like I said in previous posts, I didn’t think my diet was awful, nor my my portion sizes huge, but I didn’t HOW POOR a quality it was overall. I was drinking my calories via sugary fruit juices, was eating too high a proportion of carbs, yet was thinking ‘well I do eat proteins, and greens, and usually decent salads for lunch – so I must be ok’. But the question remained: why, when I’ve tried so hard to improve my fitness in the past, have I failed?
It comes back to the patterns from the past, habits in the present, and of thinking of food as a pleasure, rather than as a fuel for my body.
I was active – averaging 12K steps a day, rushing around doing school runs for my daughter, commutes for work, running around London on various meetings – but my weight was stagnant.
I started tracking my steps and recording my food on my Jawbone UP2 fitness tracker. And it was quite stark: my calorie in-take, was almost the same as my calorie burn rate. No wonder my weight was stagnant…
My key goals
Even before my counselling sessions, I knew my intervention was about avoiding poor health in future, not about vanity, or losing weight to look good (I like how I look!).
But what weight range would help shift the risk factors around diabetes and arthritis, and given my weight was 115kg, I’d need to lose around 40-50 kg to get into healthy range and significantly reduce health risks.
That just sounded ridiculously out of the realm of the possible to me. I know people have achieved it, and my friend recently dropped 4 dress sizes, and 25kg over 18 months – but it’s all she did. She wasn’t working, and she told me she had to be OBSESSED about her food and working out.
My app then lets me set some goals too, and I was looking at 4 years to lose the sort of weight I needed to… *wailing face*.
My counsellor then asked me a pivotal question – ‘do you have polycystic ovarian syndrome (PCOS)?’
YES!!! (This matters in the next section).
Major options for change
My key options were:
- Dieting – lower calories
- Working out – burning more calories
- Nutrition education and change – lower calories & improving food quality
- Surgery & Nutrition – lower calories, improving food quality, forcing smaller portions, plus potential to change hormone imbalances due to PCOS
We explored other options too, but these were the ones we talked through the most, including level of time investment, sustainability of the programme, and timescales to achieve the stated goals above.
I really was shocked that surgery came out as a strong option for me. It took me a few weeks to get my head around it, and I looked into having a consultation with a recommended bariatric professor (Professor Ameet Patel, from both the HCA London Digestive Centre, and Kings College Hospital – pictured above with his HCA colleagues) who also confirmed surgery was a good option, particularly given how the PCOS was exacerbating my dietary issues.
At the consultation with Prof Patel, it was actually refreshing to know that my weight issues weren’t just about my relationship and attitudes towards food – but that the PCOS was causing a hormonal imbalance that meant physiologically, my body was craving carb and sugar, and compounding my eating habits. It was affecting what I ate, how I processed the food, and how hard it was in the past to lose weight despite lifestyle changes. It was such a relief to get confirmation that I’m not a greedy gluttonous or lazy person, with low motivation or no self control, but that my body chemistry wasn’t my friend!
I changed my mind. Yes, I changed my mind about surgery – it became just as viable option to me as dieting and working out, and in fact, it became more attractive to me, as it’d go some way to help change my body chemistry, and be a more sustainable way to keep healthy.
I spoke to my family and close friends, and was surprised at how accepting they were of my decision. I was expecting having to defend and justify my decision, but they could see that I had (very anally) done my research, consulted professionals, and that surgery made total sense for me.
I considered different types of surgeries, and based on the advice of the bariatric professor, opted for a vertical gastric sleeve procedure, which permanently makes the stomach smaller in size (by about 75%), and removes the hormones for hunger (which are amplified when you have PCOS).
I decided to have the surgery privately (purely from a timescale perspective and work arrangements), and was due to have the procedure in July, which felt like months away!
After a very long few years, I started to feel hope that I could achieve my goals 🙂