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Body Image Questions and Concerns

Woman examines her body in the mirror after major weight loss and struggles with her body image during the changes after bariatric surgery You may have lived with excess weight or obesity for decades – even your entire life. And while you may have become used to living with all the physical and social impediments it causes, you may not be aware of how much it has affected your psyche, particularly when it comes to body image.

After bariatric surgery, patients who follow their postoperative diet and lifestyle often experience exceptional weight loss and disease improvement or resolution. We can objectively measure this using the BMI or body mass index and the results of simple bloodwork. However, there is a significant subjective component to post-bariatric life, and most of that revolves around you, the patient, and how you see and feel about yourself.

One of the most striking potential post-bariatric body image issues you may deal with is simply not seeing how much your body has changed and how much weight you have lost. You may look at yourself in the mirror and see the old, larger you when in fact, the reflection shows a highly successful, healthy individual. No, you’re not going crazy. Instead, your brain cannot wrap itself around such a significant change. Remember that years, decades, or even a lifetime of obesity has conditioned your brain into a new normal, and you literally can’t see past that.

For most, body image issues start to evaporate as friends and family members support them in their weight loss, and others begin to comment on the amazing transformation. At a certain point, you must believe them! However, for some, this may turn into body dysmorphia, a significant mental illness that doesn’t allow you to see your body for what it is – essentially always believing that it is inferior and in need of significant improvement. Body dysmorphia needs to be handled at its earliest signs to ensure that it is appropriately treated and that you do not develop a long-term psychological issue or eating disorder.

There are a few ways to help ensure you understand and appreciate your weight loss success:

First, develop a great support system. This will include support group buddies, Dr. Higa, and our staff, family, and friends who support your decision to have bariatric surgery and online resources. When you feel frustrated or are concerned about relapsing, the support system can be extremely helpful in pushing you forward and getting you back on track.

Take pictures of yourself in the mirror during the weight loss process. You can’t question documented evidence of how much weight you’ve lost. You may wish to take pictures every month in the first few months as your weight loss is the fastest during that time. Afterward, a shot every 2 to 3 months should do just fine. Breaking out the photos and seeing how far you’ve come is a great way to remain motivated and on track.

Keep some of your old clothes as well. Keeping those clothes is another tangible reminder of how far you’ve come. Once again, there’s no way you can question the fact that you once fitted into the jeans that may now be double your size. These tangible reminders are a great way to snap yourself out of any body image concerns.

Finally, before surgery, write yourself a letter and tell yourself what you should do if you start to develop an unhealthy image of yourself and your body. Sometimes others telling you to seek help or therapy is not enough. You need to do it yourself. You can even consider making a video to the same effect. If something is going wrong and you’re being told by friends and family that you need help, you can also recognize that at some point, the old you would’ve agreed as well.

Fortunately, with a proper support system around you and professional help if needed, most patients make it through their short- and medium-term postoperative lives without major psychological or physical concerns. However, it is always important that you look out for yourself and put together a team of friends and family that will look out for you. Body image issues are not uncommon, but they are also very treatable as long as you’re willing to address the concern and get yourself back on track.

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