Whatever else you have on your mind,
Wherever else you think you're going, Stop for a moment and
look where you are:
You Have Arrived!
I believe in you.
You deserve to be healthy.
You deserve to be kind to yourself.
You deserve to achieve your greatest level of success with weight loss surgery when you harness your inner resources.
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Perseverance & Determination
Celebrate Your Journey
People often say that motivation doesn't last. Well, neither does bathing - that's why we
recommend it daily.
The Greater the obstacle, the more glory in overcoming it.
~Moliere - French Playwright
When the world says, 'Give up,' hope whispers, 'Try it one more time.'
Why does CDC use BMI to measure overweight and obesity?
Calculating BMI is one of the best methods for population assessment of overweight and obesity. Because calculation requires only height and weight, it is inexpensive and easy to use for clinicians and for the general public. The use of BMI allows people to compare their own weight status to that of the general population.
More from the CDC
Definitions to Describe Body Weight
The following are common definitions used by the health care industry to discuss body weight and health.
body composition: the proportions of muscle, bone, fat, and other tissue that make up a person's total body weight.
body mass index (BMI): an index of a person's weight in relation to height; determined by dividing the weight (in kilograms) by the square of the height (in meters).
central obesity: excess fat around the trunk of the body; also called abdominal fat or upper body fat.
intra-abdominal fat: fat stored within the abdominal cavity in association with the internal abdominal organs, as opposed to the fat stored directly under the skin (subcutaneous fat).
overweight: body weight above some standard of acceptable weight that is usually defined in relation to height (such as BMI).
underweight: body weight below some standard of acceptable weight that is usually defined in relation to height (such as BMI).
waist circumference: an anthropometric measurement used to assess a person's abdominal fat.
Apple and Pear Body Shapes Compared
Most of readily know body shapes are compared to apples and pears. Each body shape presents unique ody weight and fat distribution, as described by apple and pear shapes, correlate with disease risks and life expectancy according to the National Heart, Lung, and Blood Institute. Understanding body shape and the health risks associated with it improves our ability to take pro-active measures to decrease disease risk.
Upper-body fat is more common in men than in women and is closely associated with heart disease, stroke, diabetes, hypertension, and some types of cancer. The classic "beer belly" is considered an "apple" shape revealing upper-body fat.
In contrast, lower-body fat is more common in women than in men and is not usually associated with chronic diseases including cardiovascular disease, diabetes, and hypertension, to name a few.
The waist-to-hip ratio measurement helps assess risk level associated with being apple shaped. The American Council on Exercise describes this measurement as the smallest part of your waist in inches, divided by the largest part of your hips in inches. If your ratio is less than 0.88 for a woman, and 0.95 for a man, your risk is lower. The National Heart Lung and Blood Institute states that women should aim for a waist less than 35 inches, and men for a waist less than 40 inches for optimal health.
For you "old fashioned" Neighbors:
PO Box 311
Evanston, WY 82931
Because snail mail is swell!
Gastric Sleevers: Welcome to LivingAfterWLS
In the weight loss surgery community we are seeing more patients undergoing the gastric sleeve procedure. Many "Sleevers" have joined our LivingAfterWLS network recently and I personally wish to welcome you here. I believe you will find the LivingAfterWLS Neighborhood to be one of the few prejudice-free zones for connecting with other WLSers on the Internet. We welcome all people to our community regardless of weight or weight management method. As the sleeve procedure becomes more common I hope our Sleevers will grow in numbers and actively share their experience so that we may continue to build our body of knowledge for healthy weight management. I invite you to participate in all the Neighborhood discussions and point you to the Heart on Your Sleeve forum dedicated to the gastric sleeve procedure.
Follow this path:
The Neighborhood >> Town Square Knowledge Center >> WLS Chat >> Heart on Your Sleeve
A special forum dedicated to those who undergo gastric sleeve procedures. Named "Heart on Your Sleeve" because so many of us invest our hope and our hearts in a procedure to take back our life. Please share you knowledge and experience here.
To learn more about the gastric sleeve procedure read this article: Benefits of Sleeve Gastrectomy in the Treatment of Morbid Obesity
Beyond the Scale
Accepting Healthy Body Weight
In spite of
cultural appeal to our vanity the primary reasons for achieving and maintaining a healthy weight should be health and longevity. "Even if our society were to accept fat as beautiful," writes Ellie Whitney and Sharon Rady Rolfes in Understanding Nutrition, "Obesity would still be a major risk factor for several life-threatening diseases. For this reason, the most important criterion for determining how much a person should weigh and how much body fat a person needs is not appearance but good health and longevity."
Knowing this we can include an acceptance and appreciation of our overall health as part of our weight loss surgery experience and avoid the pitfalls of the single arbitrary finish line we call goal weight. Here are some helpful tips for accepting your healthy body weight:
Value yourself and others for human attributes other than body weight. Realize that prejudging people by weight is as harmful as prejudging them by race, religion, or gender.
Use positive, nonjudgmental descriptions of your body.
Accept positive comments from others. Dismissing a compliment is hurtful to the person giving it and lowers your self-esteem as well.
Focus on your whole self: your intelligence, social grace, spiritual connections, and professional and scholastic achievements.
Become physically active, not because it will help you get thin but because it will make you feel good and enhance your health.
Seek support from loved ones. Tell them of your healthy lifestyle goals and identify how they can support you in your efforts. Connect with others sharing the same goals.
Join the Safe Haven Circle of Friends
The Lies & Myth of Goal Weight
Avoid the Pitfalls Associated with a Single Goal
August 27, 2012
LivingAfterWLS, LLC - All Rights Reserved
|Greetings!|This is an encore presentation of one of the most important topics we have ever addressed in the LivingAfterWLS Weekly Digest: Goal Weight. As we again focus on our health and weight loss goals as summer comes to a close I invite you to consider the emphasis we place on goal weight. Today I'm addressing goal weight as it relates to our experience with weight loss surgery. Prior to surgery patients are in cahoots with their surgeons as they plan for bariatric surgery, set the course and denote the finish line which will be crossed when goal weight is achieved. I don't particularly like to hear what I'm about to say and I know it is a tough thing for my WLS Neighbors to hear, but I'm putting it out there bluntly so we can face it and take action:
Few patients will ever reach goal weight.
There you have it. Numerous studies suggest that fewer than 20% of patients achieve goal weight. My work with patients of all gastric surgeries for weight management suggests the same thing. In fact, it is fairly common for me to meet someone who introduces themselves saying, "I'm one of those people who never made it to goal weight." Here is what you need to know about goal weight so it will cease to be a barrier to your pursuit of overall health.
Know This Truth:
It is the random method of determining goal weight that is flawed; it is not the patient who is flawed.
Goal weight is a random data point set arbitrarily with reference to standardized tables that are irrelevant to an individual's health history, age, co-morbidities and genetic profile. In most cases the goal weight creates unrealistic expectations for the patient. When patients do not achieve this random point of measure called goal weight they consider themselves a failure and "one of those people." Patients become hopeless and frustrated. These feelings almost always lead to rebound weight gain.
Why do we use weight as a measure of health?
From the time of our birth when proud parents happily announce our weight and height and throughout our life these two data points (weight and height) are used to assess our health. The reason? Cost and convenience. Collecting these two measurements is easy and cheap. Most medical professionals agree that the current standards for body weight measured by weight in relation to height (called BMI-Body Mass Index) does little to reflect disease risk, identify body fat, and in general presents a misleading argument for overall health. In reality, the most these data points reveal is change over time without indicating a decline or improvement in health. Yet we are encouraged with weight loss surgery, and by conventional diet programs as well, to focus on a goal weight and BMI that may have very little to do with the health of our body.
Today we go beyond goal weight to help you achieve better results that are health focused.
Please join me with an open mind as we look at goal weight as it is used by weight loss surgery patients. Bear in mind that I'm not anti-goal weight. I am simply sharing the knowledge I have collected in building my understanding of how such a tight focus on goal weight results in difficulty and disappointment for many patients. As you read with an open mind add this knowledge to your personal experience and understanding. You are a powerful person. Harness your strength and intelligence as you engage in the pursuit of better health and better living with weight loss surgery.
This is a longer newsletter than our normal weekly digest. I know we are all limited on time and asking you to read this may be a burden. But the content here is very important to your life-long healthy weight management. I hope you find it worth your while. Please share it with your support groups as a means of encouragement and empowerment - We are all so much more than the bottom line measured by the bathroom scale.
Remember, We are all in this together!
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How Goal Weight Gets in the Way of the Goal
by Kaye Bailey
There is no shame in admitting we want to lose weight to look better and feel more attractive as measured by current social standards. Truthfully twelve years ago my focus was on improving my appearance. Of course, to my surgeon I made the compelling argument that surgery was the only option for reducing the signs and symptoms of asthma, early onset arthritis, and chronic pain. I am certain I genuinely wanted these discomforts to go away. But most of all I was tired of being fat, of hopeless dieting, and numerous weight management failures. I share this here because I know I am not the only person to undergo major surgery with the hope and intent of looking better. I made the all too common mistake of setting one goal - an arbitrary body measurement taken on the bathroom scale.
Because this goal was singular it led to extreme euphoria and sad despair. The joy of consistent weight loss was addictive. It was a thrill to step on the scale during weight loss and note a lower weight: clear evidence that I was "successful". But when the weight loss stopped as my body forced me into maintenance there were no more euphoric weigh-ins. In fact, maintenance is a tremendous letdown that feels empty and boring after the euphoria of weight loss.
As I entered this dark period I realize now the problem was that I had no other goals on which to focus. My goal was met and I was finished. Now what? Psychologists tell us people who achieve remarkable things at a very young age are prone to depression later in life because they cannot top their earlier achievements. Without a goal to pursue we miss the moments of euphoria that mark progress as we pursue a goal.
This is how with weight loss surgery the single focus on a very narrow and specific goal weight gets us in trouble. Some patients report a very dark depression upon reaching the goal. Others seem to practice self-derailment as they near goal because there is an inherent fear of success. Perhaps most sadly of all is that the intent focus on goal weight prevents us from mindfully acknowledging and celebrating the equally important moments as we learn to manage our weight and health with bariatric surgery. Other patients have told me their stories of disappointment associated with the single focus of goal weight.
"My goal weight, set by myself and my surgeon, was 135 pounds on my 5'5" frame," said Sharon R. from Alabama. "Having been obese all my life and a high weight of 255 pounds the goal weight of 135 pounds was completely foreign to me. I had never weighed 135 pounds in my life! In fact, my lowest weight by conventional dieting was around 170 pounds. Sure enough, when weight loss surgery helped me get to 170 pounds I ran into problems, started breaking the rules, and no surprise- my weight loss stalled. I was 35 pounds from the allusive goal weight and I was a failure. Never mind that I had lost 85 pounds and was sleeping at night without my CPAP or that I was walking 3 miles each morning. I was a failure. I became one of
people who never makes it to goal weight."
Is this similar to your story? Sharon was not a failure and indeed she had much to celebrate and deserved as much ado about her commitment to better health as she received for her ever-shrinking body. But socially - even in weight loss surgery communities - we tend to focus on those things we can see and measure simply at the cost of overlooking more important achievements toward better health and increased quality of life. I have never seen a "50-Days-Without-My-Inhaler" ticker on a WLS Neighbor's signature line. But few of us go without a weight loss or BMI ticker. Right?
I do not believe it is unhealthy to be mindful of goal weight in our weight loss surgery journey. In fact, updating a ticker or health journal with a new weight is exciting and empowering. Weight loss is a challenge and anyone brave enough to take the surgical route deserves to celebrate milestones marked by the scale. That said, we can improve our outcome when we include more goals and more milestones as part of our weight loss surgery experience.
Read the article below to learn how you can intelligently calculate your Goal Weight Range:
Another Way: Goal Weight Range
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Another Way: Goal Weight Range
To prevent negative feelings that may come with goal weight and maintenance I suggest setting a Goal Weight Range rather than a specific absolute number. At the time of surgery we lack the information we need to set a definitive number. Healthy weight varies throughout our life and is impacted by gender, age, child bearing, illness, and genetics. None of these things are factored into most goal weights that are grabbed from thin air and assigned as an absolute measuring point of our WLS success. Comparison shopping for a goal weight does not serve us well either. Just because a sister or friend weighs 145 that does not necessarily indicate 145 will be a healthy weight for us. In most cases goal weight is a randomly selected number to which we attach unfounded hope and emotion that often leads to self-loathing and disappointment.
It is equally disappointing and futile to attempt weight loss without setting a goal. How can you find your way to the goal if you don't have one to begin with?
Over the years I have worked with many WLS patients as they shared their journey with me. Over time I developed a method for finding a Goal Weight Range (GWR) that is rational and reasonable and happily quite attainable. This measure of progress treats weight loss as a learning experience. From that experience we take our knowledge and move in on more specific goals always building on the intelligence we collect along the way. I warmly invite you to use this formula to find a Goal Weight Range for weight loss and goal weight window for weight maintenance. You do not have to abandon a goal weight set at the time of surgery or after. Simply add this method of measure to the tools you already use to empower your weight loss surgery living.
To find a GWR (Goal Weight Range): First take your weight on the day of surgery and multiply it by .10 to get 10% of your total body weight. For Sharon this would be (235)x(.10)=23.5 or rounding up 24 pounds. Sharon will have a GWR of 24 pounds. Now we will find the high and low weight units in Sharon's 24 pound Goal Weight Range. We do this using the BMI scale. Sharon had a BMI of 39 on the day of surgery. It is statistically probably that most weight loss surgery patients can expect to lose ten points on the BMI scale. Sharon can realistically expect to reach a BMI of 29. We subtracted 10 from her starting BMI of 39 to get 29. A 29 BMI is on the high end of the "Overweight" category but a significant improvement over Sharon's starting BMI 39 which was on the cusp of "Extreme Obesity."
Using the BMI chart at 5' 5" (65 inches) Sharon with a BMI of 29 would weigh 174 pounds. Sharon then subtracts 24 pounds from 174 to find her low weight: 150 pounds. Sharon now has an intelligently calculated Goal Weight Range of 150 to 174 pounds. Sharon is the mother of two children and recently turned 39 years old. It is likely she will look healthy and vibrant when her weight is within this 24 pound range.
Free: Download and Print and Use this Worksheet
As you can see a 24 pound window to aim for is a much friendlier target than a single goal weight. In addition, this range can be adjusted higher or lower. And once a healthy weight is achieved we should set a tighter weight range for maintenance; a 10 pound range is appropriate for many people who work diligently to avoid weight loss or weight gain that exceeds the weight range. In weight maintenance slight body weight fluctuations are common and do not necessarily reflect a fat gain. Monitoring body weight and keeping within a range acknowledges we understand odd fluctuations and we allow tolerance of them without indulging feelings of frustration or disappointment that push us out of our maintenance goal range.
As you progress in the phase of weight loss frequently evaluate your weight in relation to goal range and be open to adjusted goals. Adjusted goals are not cheating; they simply make use of your personal health data as you collect it. In the sport of track and field the pole vaulter does not set the bar to the highest peg on the first jump: he starts from the lowest to get a baseline by which to measure progress and improvement. And so it should be for us as we march forward to better health.
Our friend Sharon, who stabilized at 155 pounds (20 pounds above the original arbitrary goal), has a body mass index of 25.5 which puts her on the low side of the "overweight" category. This is a healthy and maintainable weight for her. Other medical measurements including blood pressure, total blood cholesterol, and triglycerides indicate she is at low risk for coronary heart disease and other complications related to morbid obesity. Having lost her mother to a fatal heart attack at 56, Sharon appreciates the value of these significant improvements to her health. With the encouragement of her bariatric counselor she was able to see this achievement and celebrate the importance of it.
Free: Download and Print and Use this Worksheet
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Thank you for being a loyal Neighbor of LivingAfterWLS. We are proud to serve you in your weight loss surgery journey.
The health content in the LivingAfterWLS website is intended to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.