Ah, the newfound joy a brand new post-surgical patient feels as they step onto that once-feared, formerly dreaded piece of equipment called "The Scale"! Now your new best friend, that welcoming square of metal, has become your reason for eagerly hopping out of bed in the morning, shedding every stitch of clothing, and joyfully stepping onto "The Scale's" platform in anticipation of seeing that magical number get smaller and smaller and smaller. What happens when the weight loss slows down and the number on the scale decreases more slowly? What happens if, horror of horrors, there is no weight loss, or even worse: What if you actually gain weight?
To weigh or not to weigh?
OH members appear to fall into three categories of weighers: Daily (one or more times), Weekly, or Not-At-All. The Daily Scalers seem to agree that the best regimen is to weigh at the same time every day – first thing in the morning, after using the facilities, and on an empty stomach. Rosie in Illinois, who weighs daily, refers to herself as being "totally obsessed with the scale, but that is what holds me accountable for watching what I eat." Trish in Maryland says, "I am a little obsessive about the scale. I actually weigh 2 -3 times a day." She records her weight only once a week, however, in order to get an overview of her weight loss over time.
Those who weigh-in weekly appear to follow the same protocol, as described by Kathy in Montana, "Set a once-a-week scale time. Weigh right out of bed, after potty, before shower, stark naked. Log it and call it good for another week." Another weekly weigher, Susan in New Jersey suggests, "Weigh once a week - no more," adding "I use my fitness/endurance and energy level – and the way my clothes fit (which I wear very close now…no elastic waistbands!)…to gauge how I'm doing." Some post-surgical OH members choose to completely refrain from weighing themselves. "I stopped letting my life be defined by the numbers on a machine YEARS ago; I go by my clothing size. Things get too tight, I back off," says Lynn in California. One of the ways she remains accountable and keeps her weight off is by "continuing to journal. I have to make myself be brutally honest or else my memory conveniently 'forgets' to note some intake or other." A Texas Girl in Connecticut "quit weighing daily. Even weekly. I rely on how my rings and clothes fit." She adds, "What's weird is, when I was heavy, I NEVER stepped on the scale. That got me in trouble. Now the scale is like a friend who I don't call daily! So… maybe just consider how you are USING your scale."
"The Scale" – Friend or Foe?
The Connecticut Texan makes a good point about weighing and what "The Scale" represents to each person. Diana, another Texan says, "If you find you're making yourself unhappy by weighing in, don't do it. I think putting the scale away in a closet, on a shelf, or under a box is a good way to 'just say no'." A blue-eyed member of OH doesn't own a scale, noting, "I have not bought a scale for my house because I KNOW I will get obsessive and that will lead to disappointment and then frustration and we all know that usually leads back to the fridge!" She does weigh herself "once a week or every other week," stopping by her doctor's office and using the scale there.
A member from the United Kingdom warns "Careful with that scale. Try to look at the big picture." She makes a useful point when she says, "I am going to say that we need a bit more attention on the WHY we do this," referring to why people "fear a few pounds."
The scale as Friend.
Weighing yourself after surgery can be a positive behavior for reasons that include the following:
• keeping track of the direction your weight is going
• making comparisons over time regarding weight patterns
• immediately identifying weight changes and being able to adjust food consumption and physical activity accordingly
• providing positive reinforcement to continue healthy behaviors that result in weight loss and maintenance of a healthy weight
• providing an opportunity to work through emotional reactions to "The Number" on "The Scale" (this may require the assistance of a therapist)
The scale as Foe.
Weighing yourself after surgery can be problematic for reasons that include the following:
• the activity of weighing oneself and/or seeing the number on the scale can induce thoughts and feelings related to failure, perfectionism, stress, expectations, self-esteem, lovability, etc.
• it can trigger obsessive thinking related to weight, food, or body image, possibly resulting in the development or worsening of an eating disorder
• it can trigger a negative feedback loop whereby negative thoughts about food and/or self lead to negative feelings that lead to unhealthy behaviors
• the development of a phobia of the scale, leading to complete avoidance of weighing oneself, which could result in weight regain due to a lack of self knowledge in relation to one's weight.
What noted authors say: Colleen M. Cook, author of The Success Habits of Weight-Loss Surgery Patients says, "The most successful weight-loss surgery patients are those who weigh themselves regularly. They each have a profound sense of personal responsibility for their success, regard their surgery as a tool, and are committed to always knowing where they are." In relation to frequency of weighing oneself she says, "More frequently than once a week can become a bit obsessive and even counter-productive. Weighing less than once a week makes it too easy to get off track a pound or two at a time." She believes in maintaining "consistency in your weigh-in routine. Weigh yourself at the same time, in the same place, wearing the same amount of clothes."
Paula F. Peck, RN, author of Exodus From Obesity promotes weighing on a daily basis. "The purpose is not to place emphasis on the scale, the 'Iron Goddess of Weight Loss,' but, instead, to deemphasize the scale. Hopefully, since it is only one measurement of weight loss, you will learn not to have an ecstatic, dance-on-your-toes day if you lose weight, nor a day of depression if you didn't. It is just information at a point in time. That's all. Within a year or so your weight should be where you want it to be, so why despair at each and every little bump alone the way?" Ms. Peck advocates maintaining a weight graph: "When you can see a whole month demonstrated on a weight graph, you come to know and to anticipate your own weight loss pattern."
The Verdict?
It appears that in order to determine how often to weigh yourself after your weight loss procedure, or whether to weigh yourself at all, you need two things:
• education about the purposes of weighing yourself, along with the potential benefits and potential hazards related to "The Scale" and/or "The Number" on "The Scale"
• self-knowledge relative to your past relationship and past emotional experiences with "The Scale" and/or "The Number" on "The Scale"
Understanding the potential benefits of regular weigh-ins, whether they be daily, weekly, or monthly, combined with knowing your emotional reactions to weighing will help you make a personal decision about weighing yourself following surgery. Ask your in-person and online support group members to share their experiences related to "The Scale" with you. Allow them to assist you in assessing your emotional reactions to "The Number" and in determining how frequently to weigh yourself. As always, get professional help from a therapist if you experience emotional distress in reaction to weighing yourself or if you find yourself truly becoming obsessed with either the act of weighing yourself or the number on the scale when you do. A healthy tool: Work on making "The Scale" a healthy tool in your weight loss and weight maintenance journey. Become friends with it and visit it as often as the two of you can get along amicably!
Connie Stapleton, PhD, is a Licensed Clinical Psychologist and owner of Mind/Body Health Services in Augusta, Georgia. She is the author of Eat It Up-The Complete Mind/ Body/ Spirit Guide to a Full Life After Weight Loss Surgery.
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