To Sleeve (or Not to Sleeve) Series - #10, Isn't Having Surgery too Extreme?

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com. An index of all posts in this series is located at the bottom of this article.)

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In other words, “shouldn’t I be able to do this on my own? — without the extra tool WLS provides?”

At it’s root, I think my question comes from my ego. I don’t want to have to NEED the help. Not for this. I mean, I’m an accomplished man in so many other areas of my life. I was senior class president in high school and finished at the top of my class, I completed a double major magna cum laude in undergrad and had a job offer several months before graduation, and I earned my Master’s degree (summa-cum-laude) while working full time. I’m married to an amazing woman, I’m father to two wonderful sons, and I have the privilege of working as a pastor in the largest church in my denomination for 1000 miles. I’m in the middle of writing a book, I’ve traveled internationally to speak, and I’ve done a ton of personal/psychological/spiritual work in my life. I’m emotionally intelligent, extremely competent in terms of household, automobile, electronics, and carpentry maintenance. And to top it off, I’m an excellent cook (I do all of it in our home). The list goes on and on. (I’m humble too btw. HA!)

So why can’t I muster up the self-control to put the fork down?
Why do I need to get my stomach cut open in order to accomplish this one thing?
When I’m so proficient in so many other areas of life, why is it that I can’t figure out this singular area?

I had a the first consult with my (potential) surgeon last week (Dr. Mathew Rawlins of the Rockwood Clinic in Spokane, Washington) and I actually posed to him these very questions. Surprisingly to me, he’d heard this line of thinking before. Many times.

In fact, he told me that he’d had a physician not long ago who had gone through the process of having bariatric surgery who had expressed the exact same sense of exasperation. As a doctor, this person knew well the sweetness of success in life — and yet at the same time this person was also morbidly overweight.

Dr. Rawlins told me the same thing he told that physician — he talked about how I need to give myself a break. About how our culture and state of food works against our biology. About how there’s so so so much more than willpower or self control that contributes to getting a person into the health situation I’m in. And about how there’s so much more that gets people out. He talked about how the stigma we’ve created around weight is unhealthy and damaging to people; making the problem worse even. And then he finished by saying that he has many patients who end up putting surgery on hold for a while — or permanently. Some are successful in changing their lives and losing significant weight without surgery. Many are not. And he says that he cheers them on no matter what.

All of this was incredibly encouraging and humanizing to me.

I feel the stigma regarding my weight that sifts through in this American culture. Although internet comments can’t be regarded as mainstream thought, I do think they give an idea of many people’s unfiltered feelings. Read through the comments section of any mainstream article about bariatric surgery and you’ll read countless negative tomes about the shame of cutting oneself (as opposed to what is assumed as buckling down and getting one’s eating under control — as if that hasn’t been done dozens of times only to fail again). (See This Atlantic ArticleThis one from Mercola, and this one from CBS). It’s hard not to internalize that.

For now — I see surgery as a tool. Just like the scale I have on my counter and that crazy protein powder concoction in my pantry. Those are tools for me to lose weight. The app in my phone? A tool. My bicycle I ride for exercise? A tool.

If I end up going through with having surgery, I will simply be adding yet another tool to my belt. It certainly won’t be taking the easy way out. It will be more thoroughly equipping myself for the task at hand. And that’s something I know a whole lot about!!

To Sleeve (or Not to Sleeve) Series - #7, The Social Cost of Being Overweight

(This is part of a series I posted on my other (formerly anonymous) blog, tobypass.wordpress.com)

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An aspect of obesity those who are normal weights might not automatically appreciate is how it affects ones social life. In addition to contributing to all kinds of health problems, obesit also has the tendency to isolate a person in depression, decrease the depth of intimacy he/she enjoys in many interpersonal relationships, and weaken dating opportunities.

A key underlying contributing factor in all of this for me is the way we have stigmatized excess weight in American culture. Fat people are pariahs. Objects of scorn. Disgusting. Worthy of disrespect, judgment, unsolicited criticism, or paternalistic control.

Overweight people are considered to be in the position they are in because they lack self-control, are lazy, or have poor character. Because food is something everyone has intimate experience with — many who are at normal weights feel justified by assuming these things. “I’m not that heavy! I control myself! Maybe you should slow down a little bit at the buffet! Or go for a jog once in a while!”

Our culture celebrates and idealizes a certain body size – lean and thin. Women feel this more acutely than men in part because of our collective objectification of the female body; I’d argue that men feel it as well however (and this is often overlooked). Hugh Jackman’s physique as the Wolverine is just as ridiculously unattainable as ‘the norm’ as Angelina Jolie’s cover shots in fashion magazines.

These standards are difficult to not internalize for anyone who is not lives and moves through American culture. We inherit them through advertising, television, movies, and consumerism. Even product sizes available in certain stores tell us of how big or small we should be. (Even though I’d like to shop for higher quality clothing at Nordstrom, designer lines are cut a full size to a size and a half smaller than more standard or ‘bargain’ lines).

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As a consequence of these dynamics, I (and many other obese people) have developed an inner narrative that runs like a tape in my head — whether I actually hear the messages from others or not. The tape that tells me I should push back from the table and get on those running shoes? Ever present. The tape that calls me ‘fatty’ when I look at myself in the mirror when I’m undressed? Ongoing. The one that says I look sloppy and unkempt in my poorly styled xxl clothes? Every day. The one that tells me those people probably think I’m gonna go home and binge after I only ordered a salad for lunch? Like clockwork. The tape that berates me for my weight gain, even before I get in the lobby of the doctor’s office? Mine.

These voices are painful. Some have been developed from actual conversations but not all. Many are my own design – invented by an astute understanding of America’s stigmatization of fat.

One of the biggest casualties from these tapes in my life has been my confidence. It burns through it like gasoline in a dumpster fire. It’s incredibly hard to stand with my head held high, shoulders back, eyes clear, chin up, speaking clearly — when at the same time I’m telling myself that I look like a fat slob who everyone probably hates. I overcome it quite often — but it takes it’s toll.

These tapes in my head lead me to put words of judgment in the mouths of others — to assume others aren’t interested in friendship or think lowly of me. Of course, I had no way to know if those people were holding negativity overly head — and in reality, I WAS THE ONE PREJUDGING THEM!! Regardless, this dynamic has hampered intimacy in my life in many many ways.

Flowing out of these messages — I think — in part is a sense of depression. I’ve been on a mild antidepressant for the past month or so and I feel as though it’s really given me a boost. But I do think that my weight — and my inner dialogue has played a role in creating it.

Depression for me tends to drive me into isolation. I want less and less to do active things I know I like to do — or at least I used to like. I eat alone. Sometimes I compulsively crash a fast food drive through and get an ice cream cone or a hamburger — even though I know I’ll be eating dinner with my family later. There have even been times when I’ve turned down invitations to people’s homes because I just didn’t want to be around anyone – I didn’t want to have to visit – I didn’t want to be subject to whatever food they happened to cook at the time.

I think I sometimes use food to medicate my depression. I eat to try to make myself feel better. But like any addictive cycle – those chicken wings or cheerios or soft pretzels with cream cheese – only make me feel worse in the end (and usually it’s immediately after consumption).

Now — before I go on — I should say that I doubt these tapes will just end as soon as I lose weight. There is some truth to the movement afoot ‘healthy at any size’ and especially the categorization of obesity as a disease — both (in their own ways) attempt to destigmatize weight gain and to try to rescue people from these kinds of negative cycles I’m describing for myself. I’m sure I have some work to do in this area above and beyond weight loss. Dumping pounds will not be a panacea – it’s not a cure all – and it will not fix everything in my life.

Continuing on with the theme of ‘social cost’ — another way I’ve seen my weight impact my relationships is the rate at which I get invited to do active things with other people. I think I wrote about my love of sports in another post — but I’ll elaborate here a tiny bit. I LOVE SPORTS. Pretty much any one. I love playing, watching, following, talking about….etc.. There’s almost no sport that I find uninteresting…even those I’m scared of (skydiving, bungee jumping, etc) I’m absolutely fascinated by.

One of the things that happens when to people who are overweight — and i have certainly observed in my life — is that they get invited to do active things less and less. I often have large groups of friends who run races, go biking, play basketball, go camping, etc, etc, together (I know because they talk about it later, post pictures on social media, etc.) — but they very rarely invite me. These same friends regularly go to the gym together to work out, play raquetball or tennis, or do other physically intense activities with one another… These take scheduling, coordination, planning. Again – I very rarely have been included.

Now — I think there are several reasons for this. The first is the most insidious. As a heavy person, I’m not as fit as some of my leaner friends — I can’t run as fast or for as long — I can’t hike as hard — and i can’t bike as far. If they invite me to join them, I hold them back. This is aside from any determination I might have or willingness to really push myself. My 110% is the equivalent of some of my athletic friends’ 65%. It’s not fun for them to invite a lame duck to join them in their exercise. They don’t want to be held back. They don’t want to be slowed down. And I don’t think this is an entirely unreasonable concern. They have every right to want to pair themselves with workout partners that match their skill so as to maximize workout time.

The problem emerges for an overweight person in that it’s a nasty cycle… I walk alone. I bike alone. I jog alone. I go mess around on the basketball court alone. I hike alone. Accountability and a team spirit is super helpful in exercise programs. I do mine by myself. I rely fully on my own motivation and umph to get it done. The less I engage in athletics with others, the poorer fitness I have, and so the less likely they are to invite me to participate. It’s a nasty cycle.

All of this leads to a lower overall quality of relationships.

For men — we often bond by doing things with one another. Sports. Work. Adventures. Activities. We build friendships and trust by being active. My weight keeps me from a whole world of fun and by consequence — impacts my intimacy with many people. I feel sad as I write this.

This isn’t about being a victim — I certainly know I have personal responsibility and initiative in all of this — and certainly there are other factors that contribute to my situation specifically. But my weight DEFINITELY has an impact on how active I am simply by virtue of not being included in many of the active sporting things my friends and acquaintances take part in.

To state it in a positive way, one of the reasons I want to lose a large chunk of my excess weight (125lbs at this point) is so that I can be more active — work out with friends and do active things without such limitations. Activity breeds activity which breeds healthy weight — and the opposite breeds the opposite.

Finally — a word about dating.

This piece hasn’t affected me a great deal per se. I’m married to a wonderful woman who I love and adore – and have been for 10 years now. We have a pair of amazing sons – and she is a fantastic mom. She has helped me grow SO SO much over the years – emotionally, spiritually, personally. I can’t imagine life without her.

And in our case, my weight didn’t play into her attraction to me (of course when we started dating, I was about 50lbs lighter — so there’s that too). And I felt confident enough to return her affection, commitment, and kindness.

With that being said – I do think that in my dating life before I came to date my (now) wife, my weight did affect my confidence level and therefore willingness to ask girls out. I was scared. I was afraid of rejection — and I think arguably to a larger degree than other normal-sized men — because of my weight.

My sense is that the dating scene is particularly fraught for women — who, as I’ve noted, are subject to a far more strenuous and irrational standard of feminine beauty than men. An overweight woman is seen as unattractive by many many people — including women themselves. How do obese girls fare on dating websites and in bars? My only knowledge on this is anecdotal but my sense is that it’s fairly rough. (and certainly stressful).

While singleness isn’t a death knell for anyone — the prospects of not being able to create a long-term relationship or a family (or even delaying that process for many years), the prospects of having a limited sex-life even outside of a long term commitment, and the prospects of even being able to go through the fun of dating and relating are all negatively hindered by obesity. The cost is simply too real to ignore.

Yes, fat people get dates and marry.

And yes – it’s also arguably more difficult than those who are more normal sized.

Others might have dozens of other social realities that come from their excess weight. I like this little article that samples people from interviews and tries to coalesce a picture of the day-to-day experience of morbidly obese people. Check it out!