Glenn, Thank you so much. It is sooo important to me that I remind myself constantly that this *isn't* a magic pill, won't be fun and easy, and is a last chance effort to getting my life back. Your sharing has touched me the most. It reminds me again, why I am doing this, what I hope to achieve by doing it, and what I am willing to sacrifice to get there. I am so at peace with my decision it is amazing, and I have people like you to thank for it. So thank you again for keeping it real.
— Megan

Your information and sharing have been most helpful in finalizing my decision to have the weight loss surgery. I have been researching weight loss surgery for over a year now, and you have answered my questions and relieved my anxiety.
— Bob M.

Through Thick and Thin #26 (August 8, 2003)

Shame, Blame and WLS

Since my surgery I've been devoting 10 or more hours a week as a volunteer email "coach" to people who are considering Weight Loss Surgery. I've even begun formal, regularly scheduled telephone coaching sessions with a few folks who have decided to have the surgery and are highly motivated to use this tool to achieve the health, mobility, comfort and longevity we all crave.

One theme that continues to emerge in both my informal and formal coaching sessions is the shame and self-blame WLS candidates almost invariably feel about their historic inability to lose weight "the normal way" - through diets, exercise and sheer willpower. "Why can't I lose weight the way that others seem to be able to do it?" I'm no stranger to this sense of shame myself: it was my constant companion and the negative critical voice in my head for most of my life.

While I'm certainly no medical expert, I have become convinced through my process of WLS and recovery that confronting and disposing of this shame is one of the most vital pieces of emotional work that each of us must deal with before we can use this tool with optimal effectiveness to achieve our personal goals.

There were certainly times in my life - my adolescence and young adulthood for example - when I now realize that I could have lost my excess weight and maintained that loss by completing my emotional work (i.e. understanding and resolving my dysfunctional battle with my parents over control of my body); by nutritional education; by a more thoughtful and prudent eating plan; and by finding a way to incorporate daily exercise into my busy life. However, I didn't. And those times have been gone for many decades. Then I reached a point, heading towards 400 lbs., with no upward limit in sight, when I forced myself to get real about the fact that I don't see many very-fat elderly people. They die young. I tried my best, for one last year, to lose my life-depleting obesity through careful eating, eliminating my binging, and trying my best to exercise (although the pain always stopped me before long.) With my co-morbidities - diabetes, sleep apnea, and an immobile body - and daily pain, discomfort, humiliation and limitation, my choice was simple: choose Weight Loss Surgery or choose a premature death. I choose WLS and it has literally saved my life. I'm grateful every day that I've chosen life.

I'm not sure if it's because we're simply carrying too much weight to deal with it incrementally, or if our metabolism slows down and gets stuck and nothing we do will speed it up, or if our appetite regulator simply doesn't work and never has, or if it's just the accumulated burden of a lifetime of blame, shame, hopelessness, and despair. But my experience is that for me, and for many other morbidly obese people, WLS may be the ONLY realistic alternative for achieving a long, healthy life.

As I've cited in the "Top Ten Reasons Why WLS is NOT the Easy Way Out", the newest research provides irrefutable evidence that body weight is largely a function of genes - just like height or a family propensity for cancer. These genes help regulate appetite and metabolism. People prone to obesity seem to gain excessive weight easily, while finding it difficult or impossible to lose it. That's why diets almost always fail and why WLS is currently the only viable weight loss option for many morbidly obese people, according to endocrinologist David Cummings of the Veterans Affairs Puget Sound Health Care System.

He reports that most people can lose no more than 5-10% off their "natural" body weight by exercising and eating wisely. Decades of diet studies show that more than 90% of people who lose weight by dieting gain it all back within 5 years. "There are exceptions, but when you are speaking of general rules, the only people who are able to lose more than 10 percent of their body weight and keep it off are people who have had gastric-bypass or other bariatric surgery," Cummings notes.

My personal experience confirms his conclusions. To transform from a morbidly obese candidate for premature death into a healthy, active, fit man with a "normal" life expectancy, I needed a tool - my Weight Loss Surgery. And there's no shame in that. With a functioning appetite regulator - my still unstretched stomach pouch and my testy digestive system severely limiting my food and caloric intake - I've been able to do what had previously been both unthinkable and impossible. And once it didn't hurt to move, I've embraced a love affair with exercise. This has been my final proof that IT WASN'T MY FAULT ALL THIS TIME! This has been the ultimate documentation that it hasn't been a matter of my deficient willpower, insufficient commitment, sinfully gluttonous appetites, or laziness. I had a medical condition that required a medical intervention and tool. I can now put my motivation and strength to good use. Now I'm almost at my goal and, on top of the restored agility of my body, I feel so much lighter without the burden of shame I carried with me for so many lost decades.

Today, about nine and a half months after my WLS, I have lost 145 pounds (165 pounds if, as my doctor suggested, I count the cumulative weight of the folds of empty skin that drape my body) and on two recent foreign trips I walked ten miles a day or more, in the heat and humidity, and loved every minute of it. Yesterday was my annual physical exam, and my doctor confirmed that I no longer function as a diabetic, that I no longer suffer sleep apnea, and that I'm a very healthy and vigorous man, close to and rapidly approaching my "goal weight". My blood pressure was a sublime 104/64 and all of my tests confirmed my excellent state of health. In gratitude, today I began what will be a three-times-a-week program of weight training to further strengthen and firm up my body.

I respectfully suggest that, at least for those of us who are still morbidly obese, the kindest and the most helpful thing we can do for ourselves is to finally throw the self-blame and shame into the trashcan where it belongs. Then, just maybe, we may be liberated to "change the things we can" (in the words of the Serenity Prayer, which I live by) and do everything in our power (which may include WLS) to live a long and healthy life.

Are you hanging onto your shame like a comforting teddy bear? Are you ready, at long last, to cast it away, once and for all? I'd love to know how, if at all, shame has kept you from reaching for your dreams - with respect to your body, your relationships, or your life.

Glenn

Glenn Goldberg, J.D., R.C. is a Writer, Coach, Counselor and Mediator. He has lost about 110 pounds in his first 6 months after his Weight Loss Surgery in October, 2002.

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