Emotional stages of bariatric patients

Before and after

There are two emotional stages of a bariatric patient: before – they are very impatient, they are so looking forward to starting their new life, they are counting the days to the surgery, and yesterday it was late. And then the second one, when they finally had the surgery and they are seriously questioning their former decision.

I remember myself, and I see it all the time in the forums. I want to have the surgery now. It is frustrating to wait, it is taking forever, and I have to undergo so many “useless” tests. I am so prepared and I want to have the surgery now. And it is understandable.

You are sick of all the weight, the limitations, and the medication you must take, you feel like a sluggish blob and you want to have the change now. You have decided that you go for it and thats it. So, world, act quickly.

First reality check

Well, then comes the first reality check in the form of a pre-op diet, which comes as a huge shock. It is mostly liquids and tons of veggies usually, so your taste buds suffer, your tummy complains, you might have diarrhea, and you are weak, tired, and grumpy. Hopefully, it is only a week. I had three 😀

You are constantly thinking about food. You want to chew something. You want to taste your favorite meals. Your life becomes a compulsive obsessive disorder. All are related to food. The lovely, tasty, all the food you can’t eat now. Tell me about frustrating…

New stage, new life, new obsessions

But then you somehow make it to the surgery and instead of food you become obsessed with two new things. Is this normal? And: Why am I losing so slowly?

Luckily, most of the things that you are experiencing are normal, it is not very often that you would have some severe complications. You just don’t know what is going on, and you are hyper-alert about any minor thing, so, understandably, things are somewhat bumpy. But only from your point of view. To your surgeon, you are doing just fine and all is under control.

The second obsession about losing too slowly is most likely related to previous exposure to the internet and related unrealistic expectations. Omg, she lost 100 pounds in 5 weeks! Ok ok, so it means I will be XX by the date XWZ. And ooops, it is not happening. You lost “only” 25 pounds in the first month. Or even less. You are freaking out that you won’t lose the weight, that you are doing something wrong, that they didn’t do the surgery right. Ruminating about all possible explanations of your sure “failure”.

Reality check No 2

You are doing just fine. When during your pre-op time did you lose 25 pounds in a single month??? NEVER! You have had a major surgery, you are barely eating, everything tastes funny at best and if you are not puking like a sick dog, you are lucky. And still, your body is doing its best to make it all somehow work. It is your head that is playing with you.

Patience, your new friend

At this time, you are given a good lesson on what the word patience means. And you are not patient at all. You might be patient from the medical point of view, you are the person who has had a major abdominal surgery, but regarding the linguistic meaning as an adjective, you are anything but. You want to the results now. And have a slim toned (and tanned) body like the girl from the ad you had seen. And it is not happening… charlatans!

You haven’t gained it all in a month, you won’t lose it all in a month. You will have to be very patient patient. I know you don’t want to hear this. You are moody and frustrated, you can’t eat, you hate protein shakes, you have already drunk a sea of liquids, you can’t stand them, you want real food, everybody is eating around you, you can’t have any fun eating, all smells weird, this makes you even gag… what the heck have you done, right?

Doubts set in

You are questioning your decision to have the surgery. Nothing is as they told you or what you had seen online. All those success stories are fake and made up. You hate yourself, you are completely demoralized and you wish you never did this. At least you could have been eating pizza and flushing it down with a good old Coke. And what do you have? Sipping this nasty-tasting protein shake and if everything goes great, not likely, you will have a veggie soup for dinner.

It all seems like a good nightmare. No doubt about it. The beginning is really harsh. All the emotions, the head hunger, the slow loss, being nauseous all the time, you are weak, you can’t eat, you are tired… this is too much for an elephant. Let alone for you… I get it.

Light at the end of the tunnel

The break comes after the first month, maybe two, when – even if you keep thinking you haven’t lost anything – you want to put on your old pants and they fall down buttoned up. What??? Yup, it happened. It is your head playing games with you. You have lost a lot of weight already. It is not there anymore. So it is a first encouragement. People start commenting on your glow-up, you have a little more energy, and you can go to places without feeling like a slug. Things are starting to fulfill your expectations. It was about time, I know…

But you are still very busy counting calories, finding where to add your protein, what else to eat, what is this new veggie, and how to add it safely into the diet. Then the post-op visits, and checks, you are super sensitive to your weight. You developed a love-hate relationship with your scales. You have stalled a few times. But altogether, the thing is working and it is peeling off. Slowly but steadily.

Ok, it is over!

Then you reach your final weight, you are super happy, and you renew all your wardrobe. You realize that you have lost some friends on the way – this was not what you subscribed for, you are more confident, maybe more happy, and definitely more healthy. So all in all, it is a success story. What a ride, right? It was the busiest year you have ever had.

Unexpected third stage

And much later comes the third stage, when you inevitably start sliding back to old habits and the weight starts to go a little up again. The question is what you will do at this point. Will you win and keep doing what you should be doing, and lose the weight, or you will give in to your old habits and you will inevitably go back to your previous weight?

They won’t tell you this

This is something the doctor won’t tell you. This is what it all really feels like. It is an emotional roller coaster, going up and down in very unprecedented ways. One moment you are crying, and ten minutes later you are laughing like crazy. No, you are not manic-depressive, you are bariatric 😀

The biggest lesson I had to learn was being patient. Patience is the word that will resonate with you for the whole time when you are losing weight. It doesn’t happen overnight. Obviously, you want to have it all now. But it is a process. You are undergoing a huge transformation, in and out, and you will have to pass all the stages, suffer all the mishaps, and enjoy all the great things. You can’t skip them. They are there waiting for you. You will learn a lot during this process. About you and the people around you as well.

But you will come out of this as a completely new person, someone you longed for so many years to become. And you will fondly remember the times when you were going through the tough times, and you will acknowledge in the end that it was all so worth it. I know that a lot of bariatric patients keep saying this all the time. But it is no empty phrase. Once you have gone through the process, you will understand 🙂