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January 2018 #obsm chat: Dealing with the Aftermath of Successful Weight Loss

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You’ve lost a lot of weight either through bariatric surgery or another weight-loss method.  Now what? Before embarking on a weight loss or bariatric surgery program, most individuals are informed of the lifesaving benefits of the treatment and anticipate the possibility of a brighter, healthier, longer future.  Visions of greater choice of clothes, friendlier numbers on the scale, decreased pain, and increased self-confidence perfuse the pre-weight-loss psyche.  Outstanding weight-loss success can bring so many positive things into one’s life, yet much less attention is typically paid to the emotional costs of that success.
 
The Guardian recently published an excellent article on the issue of dealing with excess skin following highly successful weight loss.  Reading the post offers an honest window into the torment of no longer feeling comfortable, or even literally fitting into, your own skin.  Despite dramatic weight loss success, many individuals experience a newfound insecurity when their familiar curves are replaced by loose appendages.  This can be both physically uncomfortable and emotionally scarring.
 
Highly effective weight loss can lead to very different responses from some around the successful individual, some of whom are enthusiastically supportive.  Spouses or significant others, however, may become jealous or resentful and fear that their relationships will be jeopardized.  Changes in sexual interest and responsiveness may sound enticing, but what if it puts you out of sync with your partner? Newly differing levels of physical activity may be another source of disconnect.  Eating buddies may mourn the loss of the shared joys of eating out together as they had in the past.  Though some may treat successful weight loss patients with more respect, this raises suspicions that they were being judged by their appearance, rather than their personhood in the first place.  That can feel good yet be confusing and even upsetting at the same time.  Getting attention for your physique may seem desirable, but not always, especially when there is a history of sexual abuse.
 
With bariatric surgery, there are increased risks of substance abuse, particularly with alcohol, especially following gastric bypass.   Some have struggles with acid reflux, particularly with the band or sleeve.  Others find that taking medications can be challenging in addition to trying to remember to take all the necessary vitamins and supplements in the proper amount and at the right time.  Going through a period of thinning hair can be unnerving and can impact self-confidence.  Finding that you can no longer tolerate specific foods can be quite an adjustment as well.  Lastly, while many experience a boost in mood, there is still the specter of increased suicidal risk over time, a very serious concern.
 
In our next Twitter chat (Sunday, January 14 at 9 pm EST) we will discuss dealing with some of the less positive aspects of successful weight loss. Specifically, we will be addressing the following:
 
Questions:
 
1. How does overcoming #obesity impact one’s personal relationships?
2. In what ways has excess skin after weight loss proven to be a concern, and what role does body contouring surgery play?
3. To what extent do substance issues, sticking with vitamin regimens, food intolerance, and issues such as thinning hair affect the successful weight loss patient?
4. How does successful weight loss affect self-esteem and mental health? How can those changes be addressed?
5. What are some other negative or unexpected consequences of successful weight loss?  What are ways to deal with those?
6. What can healthcare providers do to help one prepare for and deal with some of the downsides or challenges of successful weight loss?

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