re: post-op changes question

[Guest guest]

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: Your friend brings up some interesting and thought provoking issues,

imho. Personally, I think the mental/emotional changes that one is apt to go

through (although this surely varies from person to person) and the general

unexpected nature of them (many may not anticipate these changes nor

necessarily be well prepared to work through them) is one of the reasons why

a psych consult is often considered as an essential pre-op measure. I'm

not saying we're mental for being morbidly obese, but there are so many

issues that often accompany living in a society that is quite unaccepting of

obesity --- issues of being loved, fear of rejection, anger over such

discrimination, a feeling of freedom when one no longer 'fits' such

classification and the like.

I think that many morbidly obese people already suffer from depression BEFORE

having the surgery. It can be experienced more powerfully afterwards because

the meds may not be absorbed as effectively (at least initially) and/or

because of the hormonal/physical and mental strains the body and mind are put

through in the period of weight loss, but I haven't read about too many

people not having any depression beforehand and all of the sudden becoming

depressed after the surgery. I'm sure this is always within the realm of

possibility, but I don't think it's the norm?

I do believe that there can be different issues that individuals have to work

through post-op and the surgery type may shape this in some way: For

example, many of my friends who have had the RNY often experience 'withdrawl'

from food --- Not only is the physical limitations of eating shotglass-sized

portions but also the inability to eat for comfort, eat certain foods, etc.

Not everyone experiences this, I'm sure but I do believe that generally there

is a different set of issues with food and adapting to post-op lifestyle. I

wouldn't say that RNY folk are 'more prone' to depression, but perhaps they

must deal with food-related issues more often or more drastically than those

who have had the BPD/DS?

I think it is totally possible for individuals to encounter emotional

difficulties and experience hardship adapting to post-op life as a 'thinner'

person regardless of whether one has the BPD/DS or RNY.

Do our personalities change? I've read many people feel that their

personalities finally EMERGE. They feel a tremendous freedom to be who

they've always wanted to be and/or be seen as they truely are. However, this

being said, people can also feel hostility in general that they have been

kept back/discriminated in the past and people now 'accept' them in ways they

didn't before. People in relationships usually have to work through a

spouse/significant other's jealousy/fear or even finally confront an abusive

spouse who has preferred to keep them in a dependent state. Single folk may

have issues about fearing rejection and/or being afraid to be loved (this

goes for those in relationships, too LOL).

I wonder why your friend wants to keep you the 'way you are' instead of

advising counselling throughout the pre and post op period? Doesn't he/she

see the potential dangers of being morbidly obese? What kind of toll has it

taken on your personal life and/or emotional well being?

I guess YOU really need to ask yourself this question: Do I like myself now?

What would I like to change about my personality, if anything? I would

highly recommend counselling for anyone considering the surgery and also

following through post-op to help deal with any issues that may arise. This

is one way to assist you to keep personal integrity but allow positive

changes to occur along with the weight loss.

Also, be aware of your expectations. An individual may hope/expect for

things to totally change as a post-op: ie. they will finally meet that

'special someone' or finally be given the chance to be promoted, etc. They

*may* be disappointed if those things don't occur in the period of time they

anticipated. Of course, we all KNOW that weight/appearance isn't everything

but sometimes we have to be brutally honest about our expectations of how

things will be as a post-op and cultivate ourselves/work through emotional

issues to ground ourselves in who we are -- The image in the mirror DOES hold

sway and has influence not only over others perceptions of who we are but

ourselves as well.

I know it sounds corny, but if you are satisfied with yourself at 'any

weight' (and I mean comfortable with yourself and like your core self, not

necessarily always being accepting of others' prejudice, etc.), you *may*

have less adjustment to make in your post-op emotional life. Being a

generally happy person as a pre-op is NO guarantee that you will remain

'happy go lucky' after the surgery. People can use friendliness and

happiness as a front to ensure acceptance, even though there is a lot of

resentment and fear broiling underneath. It can come out in unexpected

ways when the weight comes off and one realizes that one doesn't have to be

so self-effacing due to one's weight. Perhaps this is what your friend

is referring to: That happy fat person turning into a surly, snippy thinner

person! LOL

I wouldn't expect that there wouldn't be some adjustments, not all of them

'positive' in the fact that negative emotions arise and should be dealt with.

But, I think that having support will help us through those rough times.

Your friend really should realize that this is a MAJOR adjustment for your

body and your mind -- and hopefully will commit to helping you work through

things instead of saying 'hey, just avoid them all together'.

I am almost 10 weeks post-op and I personally have never felt better in terms

of my energy level and relationships. However, my husband and I WILL have to

work through our fears, expectations, etc. as I undergo my transformation.

Due to my rather independent personality, I can't say that I was severely

affected by others perceptions of me while obese/morbidly obese (my highest

bmi was 45). My problem will be when I LOSE weight, since weight has been my

comfort zone and 'hiding place'.

All the best,

laparoscopic BPD/DS with gallbladder removal

Dr. Gagner/DR. Quinn assisting/Mt. Sinai/NYC

January 25, 2001