BMI Bullshit

Fat, how I hate thee. Let me count the ways!  

My weight has basically leveled off. My surgeon and my husband are both pretty convinced that this is where my body has decided it wants to be, but I'm not done yet. I can't accept it. I did not have gastric bypass surgery to still be fat. I flat out refuse to roll over and accept the fact that I am still in the OBESE category after losing 145 fucking pounds. 

I am 5' 5" tall and I was 330 pounds, give or take, at my highest. I weighed 292 pounds on the day of surgery in November 2011. Today, I weigh 184, with a BMI of 30.6. A BMI over 30 is considered obese. Oh, HELL no!

I'm not happy with the number on the scale, nor will I ever be. I realize this. My thinking is flawed, I'm slightly sick in the head, and I am totally delusional. Reality sucks a good portion of the time, so I do prefer to live in my own little bubble, but there are things that I know must be faced. This is most definitely one of them. I will NOT still be obese after bypass. 

I did some calculating and I would need to get down to 150 to even hit a BMI of 25, which is the start of the "overweight" category. Really?! I would die if I were to see a number that low register on my scale. A number that low seems unattainable and the thought of even attempting to get halfway there is daunting. How can I lose another 40 pounds? I've been stuck in the 180's for way too long now and I just don't know if I have it in me to lose that much more. I want it, trust me, but do I have the chutzpah to go for it? Do I have the strength and determination to actually make it happen?

As far as motivation goes, I'm either all in, or all OUT. There is no in-between for me. I'm either a manic mess of clean eating and hardcore exercise, following rules to a fault, or I'm Debbie Downer, confined to my bed because depression has crushed me into my mattress and I can only get up to stuff stupid carbs in my face and fall back into a coma of loathing and self-pity. I'm working with a new psychiatrist and I've seen the surgeon's food addiction/eating disorder counselor, and both have encouraged me to go back to treatment. That's all fine and dandy, but "ain't nobody got time for that!" Seriously, that would be a tremendous hassle added to a life that's already a hassle, so that's just not gonna happen right now.

So, do I get off my ass, lose another 40 pounds, and probably still hate myself and my body, or do I give up and face the fact that I'll always be fat, no matter what I do? Man, choices, choices!  

The Fear of Failure

I honestly believe that a bit of fear can be a healthy motivator. But, at what point does that fear become a problem?  At what point does the fear invade all your thoughts, take over your rational thought process, and become the norm? I just might be at, or at least rapidly approaching, that point.

My clean eating lifestyle experiment is going really well. I might be more than a bit obsessive, but I feel great and I've dropped another five pounds. I've hit the gym hard and am lifting the "heavy weights", so I like to tell myself that I'd be down a few more pounds but that I'm building solid muscle. (In case you haven't noticed, I like to "tell myself" things quite a bit. I have this amazing/terrible ability to rationalize just about anything. Ask yourself, "WWVD? What would Vera do?" With my irrational ability to rationalize, you can essentially do whatever you want. It's both a blessing and a curse, but mainly a curse. Oops.)

Even with my new healthy habits becoming a lifestyle rather than a diet, I still let the fear of fat and failure drive me to freak out, follow "my rules" too well, binge, purge, hate myself, and do it all over again. I am terrified not only of being fat again, but also of still being fat. I'm scared that I've gone through all this, worked so hard, and that this is as thin as I'll get. I can't consider myself a true success if I'm still fat after gastric bypass. If I'm still fat, just over 180 pounds, how can I not be a failure? I hear everyone ooh and ahh over my "success", but I'm afraid that it's not permanent, that I'm destined to fail...again.

What...is...wrong...with...me? 

At least I've been honest about it, I guess. That should count for something, right? Baby Daddy knows my MO, but I don't think he really knows what to do with me. And honestly, what COULD he really do? So, I just try to do the best I can and not beat myself up because that never gets me anywhere but right back to the beginning of the cycle. 

What do you fear? Does it drive you in a good direction or toward the dark side? I'd love to hear how you deal with it, especially if you know how to beat it. Drop me a line in the comments or at bypassingbulimia@gmail.com and let me know if you have any secret super powers!

Happy Halloween!

If you wouldn't mind, pretty please, send a little voodoo magic my way to hopefully give me the strength to resist the urge to eat every piece of chocolate in my daughter's bag tonight. She's tube fed and couldn't care less about the candy part of Halloween, so the candy burden always falls on dad and me. Don't get me wrong...I LOVE it...but I absolutely in no way need chocolate around! I can't be trusted around chocolate of any kind, baked goods, or even cakey carby things that I don't like.  I become a monster and nothing is safe.  

Yep.  That's me with the fangs.

I'm planning to take what she and dad don't want to work with me, but there will still be almost a 24 hour window with candy in the house. I'm going to have to have him hide it, but the problem is that I WILL find it. Nothing can hide.

Wish me luck! Good luck to everyone facing the same temptation tonight and always. Sugar is the last thing we all need after weight loss surgery, but sometimes the temptation is just too hard to take and I cave. Do I want to regain anything? NO. Do I want to dump and feel like crap? Maybe, but only if it would totally deter me from ever being "bad" again. 

Don't.eat.the.candy!

F.R.E.A.M. and the 5DPT

Holy acronyms, Batman! Like cash to the Wu Tang Clan, food rules everything around me. Sigh.  

Because food is all I ever think about, I decided that I needed to do the 5DPT, the 5-Day Pouch Test. I was able to relate to all these fears:  

• Does my pouch still work?
• Have I broken my pouch?
• Am I doomed to be a failure at this, too?
• Can I lose the weight I've regained?
• Is the honeymoon over?

I was relying on too many "slider" foods: yogurt, cottage cheese, protein shakes. I had let way, way too many bad habits sneak in: eating freaking BREAD with gobs of honey butter at work, gorging myself on dessert (which promptly makes me throw up violently and feel like pure hell, yet I can't control myself), eating way too often, grazing. I thought I should try to teach myself to be "ok" with the full feeling of eating solid protein, like meat, with the hope that it would keep me full and keep me from making bad food choices. I have had such a hard time with meat, partly anatomically but mostly mentally. I've always been "funny" about meat and was a vegetarian for a long time, but after surgery, I found that I couldn't eat meat without pain and puking. After going through treatment, I realized that it was probably, at least partially, another way to subconsciously restrict. Blah.

So, how did that work out for me? I'll let you guess, lol.  

The first day was rough...really rough.  But, I DID IT.  I made it through the entire day on nothing but shakes, water, coffee, and iced tea. The second day started out really well, but by about 8:00 at work that night, I was STARVING.  Despite consuming a ridiculous amount of protein powder, water, tea, coffee, etc., I felt like crap and just couldn't keep on keepin' on. I gave in and ate bread. It's there, it stares me in the face, and it was so easy to just grab to get *something* into my system. I did finish off the night by eating 5 oz. of seared scallops for some good solid protein, but I felt like a total failure because I couldn't even do TWO of the five days. How lame!

So, even though I kinda screwed up, I'm still trying. I want to feel that tightness and I need to know that I'm not eating too much. What I really need to know is whether or not I've completely ruined my pouch with all the puking. It makes me so nervous. I feel like I can hold too much food. I have some weird pain in weird place at weird times, like any time I'm straining and sometimes when I'm not. It's like a pulling or tearing. That makes me worry...a lot. I also think I feel an ulcer. I need to see my surgeon's office soon and I think I'm going to ask for both a scope and a barium study. Something just doesn't feel right.  

I will be SO upset with myself if I've screwed up my surgery by being stupid and resorting to "behaviors" to deal with things, but really, I can't help it. I try so hard, but sometimes, I just can't deal and that's the only way to make things "all better". I try to use the coping tactics I've learned, but even with the best intentions, I still seem to screw up more often than not. Hate it.   

Getting Back on Track

I've felt myself slipping a bit lately and reverting back to some unhealthy behaviors and it's happening way too often.  *shame*  

After going back to work at the end of August, we have been so busy that all my after-treatment care plans have pretty much been put on hold.  I haven't had time to myself at all, and when I do, I have to sleep.  Not quite sure why, but I am beyond just exhausted.  I am tired in my bones.  I can't wake up with out venti redeye.  My labs look great, I'm not anemic, and I always eat at least 70-80 grams of protein every day.  I'm crazy strict about my vitamin regimen.  Maybe I'm not eating enough calories?  I'm pretty sure that I am and I always feel like I'm eating too much (ED thinking, for sure!). Yes, my sleep is broken due to beeping pumps and my daughter's needs, but I shouldn't be this tired.

Because of all this fun stuff and the fact that we're without a car, I hadn't seen my therapist since the beginning of August.  Oops!  I also see a prescriber at my therapist's office for all my "crazy meds", which I desperately need, and am required to see the therapist in clinic at least once a month to be able to keep them.  So, back to therapy I went today.  The good news is that she can see that I'm in a much, much better place psychologically than I was a few months ago and my husband totally agrees.  Lamictal is a good thing.  Hooray for mood stabilizers!  I feel so much more even, my anxiety is lower than it has been in many years, and I just feel better overall.  

But, I know that I am in no way "cured" of my mood disorder, depression, anxiety, eating disorder, etc.  Treatment was a huge step in the right direction and an enormous help, and the right meds are definitely helpful.  But, I know there is so much I need to work on in therapy that it's almost a little overwhelming to think about.  The list is pretty lengthy.  

We're planning to focus heavily on the ED and body image right now and take the rest in bits and pieces as they come up.  I'm going to blog all of my therapeutic writing assignments and I'll also continue to try to journal some of the daily struggles when I have time.  I need to focus on getting back on track and staying on track, because I can definitely see where I'm making mistakes, enforcing "rules" again, and reverting to purging.  *shame*  In addition to the mental stuff, I'm feeling some physical effects, too.  I think I might have an ulcer because of some nagging stomach pain and I've had some pretty serious nighttime reflux that I think may have actually caused me to aspirate last week.  My throat hurts and I have a yucky cough that I can't really get rid of, without actually being "sick".  Must I blame it all on my bad behavior or can I get away with a changing-weather-and-fall-allergies excuse?  Hmm...

Body Image

While self-esteem and confidence have never been my strong suits, I do a fairly decent job of pretending. Shockingly, I've even had several people tell me over the years that they were intimidated by me, particularly before really getting to know me. I find this absolutely preposterous, mainly because I have never been sure of myself, never felt good enough. Apparently, I am a much better actress than I thought.

So much of my idea of self-worth is wrapped up into my body image that it's almost hard to distinguish between the two, even now. I have never been happy with my body...or myself. Never. I remember going to a pool party in third grade and feeling absolutely disgusting, hating myself and not wanting to go. Being slightly bigger than many of my classmates never helped matters. When I say "slightly" and look back, I can honestly say that I do mean only slightly. I wasn't obese or even really all that overweight, but I wasn't perfect and thin. From then on, before I was even 10 years old, I knew that I hated myself. I knew that how I looked directly correlated to how people thought of me, how they treated me, and ultimately, how I treated myself.  

I've said this a million times over the years, but I would give anything to be as "fat" as I thought I was in high school. I see pictures of myself then and my heart hurts for the pretty blond girl who hated herself so much and could see only flaws. It breaks for the girl who thought her only redeeming quality was a huge pair of boobs and believed that she could use them to her advantage to find "love". My heart shatters into a million pieces when I think of the girl who pretended to be so cool, more one of the boys than a bitchy girlfriend. I thought that being the good-time girl was the ticket to love. Ha. That got me absolutely nothing but use and abuse.  I read Gone Girl earlier this summer and   Gillian Flynn hit the nail on the head with this one:  

“Men always say that as the defining compliment, don't they? She's a cool girl. Being the Cool Girl means I am a hot, brilliant funny woman who adores football, poker, dirty jokes and burping, plays video games, drinks cheap beer, loves threesomes and anal sex and jams hot dogs and hamburgers into her mouth like she's hosting the world's biggest culinary gang-bang while somehow maintaining a size 2 because Cool Girls are above all hot. Hot and understanding. Cool girls never get angry; they only smile in a chagrined loving manner and let their men do whatever they want. Go ahead, shit on me, I don't mind. I'm the Cool Girl'. Men actually think this girl exists...” ― Gillian Flynn

That was me. I was Cool Girl. The drugs, the booze, the sex. Always a Cool Girl, never a girlfriend. The Cool Girl image morphed out of my own self-hatred, which I know after many a therapy session over the years. I honestly thought that was the only way to love and attention. What I wouldn't give to go back and be able to save myself. Yes, I had a lot of fun. I had enough fun for myself, for you, for your best friends, and your entire graduating class. I don't remember much of it, to be honest.  Much of it has been blocked from my memory entirely. I can't even count all of my "conquests", and frankly, I don't honestly think I'd want to know. SHAME.  

I only felt attractive when someone wanted to sleep with me. It was approval.  It told me that my body wasn't freakishly awful, that I wasn't enormous, and that someone thought I was "OK". My standards were pretty much nonexistent, likely because I thought so little of myself. I shudder to think about my life from 16 to about 22.  

Right before bypass, I had given up. I was morbidly obese and absolutely disgusting. I hated myself, but in a different way than I did when I was younger. I didn't even hate myself that much during and after pregnancy. Now, after bypass, I hate myself in yet another way. It's funny how things change, yet the theme remains exactly the same, huh?  

My boobs have deflated completely and now look like two huge empty, wrinkly scrotums on my chest. I was a J while nursing my daughter and am now down to a DD, if that tells you anything. My nipples point to the floor and there is no evidence of the Cool Girl I once was, at least not there.  

My enormously fat stomach has become a sagging apron/skort of excess skin and fat. It hangs, it flops if I try to move too quickly, and I absolutely detest it. Looking in the mirror is pure torture. I dream of just cutting it off. I could probably wear pants that were four sizes smaller if it would just go away.

That sagging mass of nastiness ends right at the top of my flabby thighs, adding insult to injury.  God only knows what sort of lift can be done to fix that mess.  

My face is so thin now that I could swear my already large nose has grown, even though my rational mind knows that it's probably only because my nose was dwarfed by the size of my bowling ball head. Looking at pictures from a little over a year ago, it looks like my face was going to explode. So, now I'm not only thinking about a breast lift with implants, a tummy tuck and skin removal, and whatever can be done about my thighs, I guess I'll need to add the Ashlee Simpson treatment for my nose.  

Don't get me wrong. I've lost over 120 pounds and I am THRILLED with that success. I love being more mobile, having more energy, and having a little more confidence. I love the compliments. I love seeing the numbers on the scale continue to fall. I love having more than two stores to choose from when shopping for clothes. But, I just can't be happy.  It's not enough for me. I've only swapped one set of body image issues for another. Will I be happy with myself after plastic surgery? I like to think I will be, but I know myself well enough to know that I probably won't ever be happy. Do I even have it in me to be happy?

Issue #5,347 to work on:  Figuring out how to be at least OK-ish with what I have to work with.  

Any thoughts and suggestions on how to deal with this, apart from continuing in therapy, are more than welcomed and will be very much appreciated!

For those rainy days...

Because I've had more than a few "rainy days" lately, I thought I'd share one of the writing exercises from treatment that's meant to be reread in times when you're not feeling well and are struggling to cope. It's a letter offering support and guidance from your strong, calm, and wise self to your vulnerable, lonely, hurting self.  

Things to include in your own "note to self": what helps you feel better at particularly difficult times, what has helped you keep on keepin' on in the past, guidance on what to do and what distraction techniques you can use, advice on what NOT to do, and reminders of your personal strengths and resources. Be compassionate, caring, supportive, understanding, and encouraging. Your vulnerable self needs your love!

Opening Up

INVITATION If you are a dreamer, come in. If you are a dreamer, a wisher, a liar, A hope-er, a pray-er, a magic bean buyer . . . If you're a pretender, come sit by my fire, For we have some flax golden tales to spin. Come in! Come in! -Shel Silverstein

Come in, come in!  Welcome to a dark little corner of my life. Ok, so maybe it's a little bigger than just a corner. Not quite as big as a guest room, since no one would ever want to stay in here...on purpose, at least. Maybe a den? Either way, it's (slowly) becoming a smaller and smaller space, occupying less of my mind, my time, and my life. As I open the door to the closet and let (most) of the skeletons pour out, I'll open the shades and let in the light so I can see myself a bit better. You, lucky you...you'll get to come along for the ride.  

This blog will chronicle my lifelong battles with food addiction, binge eating, body image, and bulimia. I had roux en y gastric bypass surgery (RNY) on November 29, 2011, naively expecting it to be the supreme road to happiness and weight control, and have lost over 120 pounds so far this year. However, I realized that the old demons had managed to sneak back into my life, manifesting themselves in more and more covert ways. I entered eating disorder treatment in July 2012 and completed six weeks in August. Am I "cured"? Of course not. Am I in a better place than I was? Absolutely.  

The content will definitely not always be pretty, of that I can assure you. But, I promise that I will always present my stories and my ramblings with absolute honesty. My main goal in opening up and putting it all out here is to be able to help those who are walking the same path, since I know I cannot be the only one dealing with disordered eating after weight loss surgery. My surgeon's office claims that most people turn to alcohol or drug addiction as a substitute for food addiction after surgery, but I know disordered eating after surgery has to be way more prevalent than anyone knows or cares to admit. Honestly, you don't get to over 300 pounds and the point of needing your insides rearranged to manage your weight without some form of disordered eating. If you really think about it, the eating plan and way of life after surgery are all about eating disorder behaviors: constant weighing and measuring, restricting carbs, tiny portions, etc. I just hope that I can maybe convince anyone considering surgery to be extremely honest with themselves about the "why" of their problem with obesity BEFORE surgery.  

Even though I was completely open about my history both with my surgeon and at the pre-surgery psychological evaluation, I don't think anyone could have predicted how I would respond to life after surgery. Body image issues, which everyone has, are amplified to an extreme. Sagging, drooping, extra skin, hair loss. Even though the compliments keep coming, the negative thoughts seemed to outnumber them 10:1. Oh, how I wish someone would have forced me into treatment before surgery, if not 15 or so years ago. Of course, hindsight is 20/20. But, if I can help even one person face the facts and get help, sharing my story will be fulfilling and worthwhile. It's not easy to open up, even anonymously, but I need to do this for myself as much as I hope to be able to help someone else.  

So, follow along for all the "fun". I'll let it all out, work on recovery, and continue working on my weight loss to get to a strong and HEALTHY weight.  I'll laugh, I'll cry, I'll bitch and moan. And, I always promise to take it one day at a time.  

It's all I can do.