Question:
Does anyone else think they weren't big enought for WLS?
I recently went to seminar offered by my local Hosp. In this class I felt that I was the "thinnest" one there. Now my BMI is 41, but I don't 'feel' big. However when I look in the mirror or at my picture, I look huge. Are these feelings why I must have a psych eval? — John B. (posted on March 27, 2003)
March 27, 2003
John - I can relate. I seemed to be one of the smaller people at my clinic
when I had lap rny 3 months ago (down 90 pounds). My BMI was 43 (6', 317#)
Some friends and coworkers were shocked that I was pursuing this, they
never would have guessed I weighed over 300#s. I was concerned the
insurance would be a big roadblock because I was a "light
weight". But "thanks" to my sleep apnea and high blood
pressure I was approved. I had a distorted body image too - never thought
I was fat. (I actually came out of the gay closet loooong before I came
out of the fat closet!)
— Smitty B.
March 27, 2003
John-I was at a BMI of 36 and I thought I was huge. My doctor, a sports
medicine specialist, told me NO WAY to WLS. He told me to not mess around
with cal. intake, and start a sport that I like. I took up running, and I
stopped eating poptarts and cheeseburgers every day. I am now at my goal
weight and I'm actually kind of happy that I didn't need surgery (I did not
have any co-morbs, either, so I probably wouldn't have gotten approval
anyway)
— Brittany C.
March 27, 2003
Yes, I too was considered a lightweight. I was so tired of everyones
unsolicited comments on being too small for surgery. Funny, I have always
been to large for everything else in life. All of a sudden I was 'not that
big'. Whatever. I had a BMI of 40-41, have lost 104 lbs. and it has been
the very best decision of my life. I was always uncomfortable at the
support group meetings as a pre-op, people would ask me 'how much have you
lost?' and it would make me crazy. Even the anethesiologist gave me a hard
time in my pre-op interview. Said that he hadn't had anyone as 'small' as
me. That was between myself and my surgeon. I qualified and I had
surgery. I am so much healthier now and I love it. Don't let others spoil
what you are trying to do to better your health.
— Cheri M.
March 27, 2003
John, I was one of the "thinnest" people when I went to a support
group meeting, too. There were over 200 people there, mostly over 300lbs. I
was 250 starting out, my BMI was low 40's. BUT when I saw myself in the
mirror, I was FAT. And compared to the people around me, i was fat as well,
although no one ever called me or said that. And most people didn't believe
I weighed what I did. From what I have heard from others, we all don't
realize just how obese we are. We know we're heavy, and most hate the way
we look, but the reality of how big we are does not set in until after
surgery. If you are seriously considering the surgery, and honestly
understand and know all the risks, go for it. But I think you're feelings
are pretty normal- so I wouldn't worry too much. Goodluck to you!
— Lezlie Y.
March 27, 2003
John,
The pyschological testing is done to see if you are mentally healthy
enough for the surgery. If your doctor requires it, (which most do) it's
required that all of his patients to take the test regardless of their
perceptions of themselves. Good luck on your journey!
— Sandy P.
March 27, 2003
I too was the slim one at the preop group. Funny at 277 really! I think
that we get used to our appearance because I had the rare day when I
thought I looked good. Since just before my surgery and certainly since I
think I finally see what my body really looks like. I have lost 60 pounds
and can't imagine carrying it around again. I really don't see much of a
difference so far but in reality I am half way to my goal. It took some
preop pictures fo rme to see myself too. I was shocked. I also think that
it takes a certain amount of denial about our size to continue gaining and
maintaining a very unhealthy size. The psych eval was really not a big deal
for me, almost a formality. They really just want to make sure that you are
not a puker or suicidal. A bmi of 41 makes you morbidly obese! Morbid means
that it will cause death. I think if you are going to have this surgery
that it is a good idea. You will be amazed at how you feel even half way to
your goal. Good Luck!
— Carol S.
March 27, 2003
John: Yes, I understand what you're feeling. I'm considered a lightweight
at 260, but believe me I feel every ounce of the excess! I don't look that
bad, really, and most people think I weigh around 225 or 230. I have
always carried my weight pretty well, and have a larger, athletic type
build. So I'm not real big anywhere, just all over. I just
"feel" this weight so much now, more than I ever have. It is
preventing me from being active, because of knee, heel, and lower back
pain. I have tried every reasonable diet, succeeded, then failed as the
weight came back on, so I know I'm ready for this, even if the world
doesn't think I need it. As for the psych eval, I think they just want to
see that you'll be mentally equipped for the changes, and don't have eating
disorders, etc. If you've suffered depression in the past, they want to
know that too, as you are more at risk for it again. Best wish to you for
your success!
— Carlita
March 27, 2003
The psychologist who did my psych eval said I was the skinniest person he'd
interviewed! LOL! That said, I think I never quite realized how large I
had become. For me, the weight crept on gradually over the last 5-6 years.
I have never been skinny, but was never really obese either. I think it's
called "denial". A really useful tool at times but it can also
be devestating when you don't realize you need help (I mean "you"
collectively). Like you, it wasn't until I saw pics of me that I realized
how fat I was (am -- I am a pre-op). It's funny that people are
reinforcing my denial by being shocked that I would qualify for WLS. I
remind myself that I more than meet the criteria at a BMI of roughly 43.
— [Deactivated Member]
March 27, 2003
I know what you feel like. I am scheduled for surgery on April 3rd and
still sometimes think that I am not big enough. I do have a BMI of 40.5- I
think I have actually brained washed myself to not think I am as big as I
'actually' am.<<DENIAL>> I do not feel really fat, only when I
find myself in a position that would be easier to handle if I were
thinner-like at the movies or shopping. I know I am fat and need this- I
may not weigh 300+ or have an extremely high BMI, but I DO qualify-so why
not do it and get healthy? I think this is going to be a total shock to me
when it is all said and done with. Probably will need a little
psychological help- who knows- Well good luck with your journey.
— Jan S.
March 28, 2003
The psych eval is to discover any underlying psychological reasons for
obesity and to assess your mental "readiness" for the changes
WLS brings. My BMI was just over 40 and my husband's is 38.5 and he is
scheduled for surgery on 4/9/03. I felt huge, and I know he does. I think
having the surgery with a lower BMI is a great idea. Why wait until your
BMI is higher? The surgical risks and co-morbidities just increase. I've
been in that same place - the smallest person in the room (and that was
pre-op!) But I knew I was way overweight and knew I was ready for the
surgery. I remember going to the Optifast program many years ago, when I
weighed much less than before I had surgery. Some of the others in the
group wanted to know why I was there, since I didn't appear to be as
overweight as they were! But I sure felt like I was. Even now, today, a
co-worker commented on that fact that I am looking good and getting
smaller. After I thanked her for the compliment, I looked down at my
thighs - and they looked just as big and fat as they ever did! (I know they
aren't, but it still looks like it to me - and I am wearing my size 12
jeans ). Another reason for the psych eval - it's a hoop that you have to
jump through to get to surgery. The surgeon was very candid with my
husband and said some of these things eliminate people who aren't dedicated
enough to go through with what needs to be done and they probably aren't
well suited to have surgery.
— koogy
March 28, 2003
i just want to say i am very small...196.2 to be exact
my bmi is about 36-37 and i have a comorbidity of diabetes.
so dont feel small.....i was told by several friends and family i
wuld not qualify...but i have a surgery date in august ...go figure
you cant just go by what other people tell you...have to see for yourself
— monica R.
March 28, 2003
I was just 40 BMI when I had surgery so I know what you mean. I do think
that "distorted body image" plagues people, especially women, due
to a number of sociological reasons. When I was in my mid 30s I was
working out with weights and doing aerobics. I exercised every single day
including a 20 mile bike ride on Sundays, ate right and got enough sleep.
My clothing sizes fluctuated between a 4 and a 8 petite. Still I could
only see the "love handles" that wouldn't budge or the inner
thigh jiggle that wouldn't firm up. I was THIN and HEALTHY and I was
obsessively focused on the few "bad" areas. So when I started to
put on weight by the 10 lb measurement, I couldn't see that either. I was
almost 80 lbs overweight before I recognized I had a problem and almost 100
lbs overweight when I threw in the towel. Then the people in my group tell
me I'm "small". Aiy-yi-yi. This is not why we need psych evals.
Psych evals are to rule out something major. But this is why we need good
support groups and people in our lives after surgery. The body image
distortion doesn't go away with RNY.
— susanje
March 28, 2003
Wow, I can REALLY relate to this question. I have similar stats to
Monica... bmi between 35-36 with a co-morbidity of malignant hypertension
(the worst kind). The one positive thing about my struggles with weight is
that I never gave up working out, so as a result I'm pretty solid; guess
that's why no one would guess my true weight. When I first started
bringing up WLS to my family they all replied the same way: "But
you're not that big!" Of course I was thinking to myself, "If
you only knew!" lol But on a serious note they have no idea what it
feels like to carry around 75-80 extra pounds and to always be foggy as a
result of the 6 blood pressure pills I take each day. I guess in the end
everything is relative, but the commonality is that whether we're carrying
around 80 or 200 extra pounds, we're all classified the same way by the
medical community: Obese.
— Leni M.
March 28, 2003
Everyone needs to have a psych eval to make sure we're ready to take on a
life-altering change in our eating post-op. It's for our own safety. To
answer your question, pre-op,I didn't feel nearly as big as I actually
looked. It's not uncommon for our inside feelings and our outside looks to
be out of synch. I started at BMI 43, and I'm now BMI 24. Now I look back
at the pictures and I can't believe that I could have been in such denial
about how huge I looked. Now post-op, I don't see how thin I look to
others. Part of the healing for me, post-op, is getting my mind and body
back in synch. I'm doing it with long-term therapy.
— Kathy J.
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