Five years ago, Jodi Edsall, 50, a mother of four in Lehighton, Pennsylvania, had gastric bypass surgery. She's proud of her transformation – not just how she looks, but how she's kept up with exercise and a healthy diet. Her health is better, her energy's higher and her confidence shows. Even so, she's faced emotional fallout.
For many severely obese people, life improves after weight-loss surgery – but changes can have a ripple effect on partners, family and friends. And after years of shrinking from the social radar, it can be tough to adjust to the spotlight. Patients and experts discuss what people can expect after dramatic weight loss.
Moment of Truth
Edsall contemplated weight-loss surgery for eight years before she went for it. Her life was an endless roller coaster of diet and exercise programs, losing weight and regaining it. Her energy was fading, and her health was faltering with signs of diabetes and high blood pressure. She suffered from back pain, aching knees and heels spurs. When she brought up bariatric surgery to her husband, "He was afraid," she says. "Because it is a serious surgery."
She agreed to try one more diet and give it her all – to no avail. Now it was time. Since surgery, her weight has dropped by half – from about 250 to 128 pounds, a number she continues to maintain today.
Counseling Needed
Lynne Routsong-Wiechers, a bariatric psychotherapist in Dayton, Ohio, specializes in issues surrounding weight-loss surgery, which she has undergone herself. "Our society is not completely sold on bariatric surgery," she says.
"To lay down on that operating table, look your surgeon in the eye and know that it's come to this – that's a really hard reality," she says. "When people say it's the easy way out, I beg to differ – because it's not."
It's important for all patients to receive counseling before weight-loss surgery and afterward to set realistic expectations and learn to navigate related changes.
When researching surgeons, Routsong-Wiechers says, "Make sure they use a holistic approach. Usually there's an exercise physiologist, dietitian, psychotherapist, support groups. All of those team players can help increase the success rate."
Attitudes Around You
After bariatric surgery, strong marriages tend to get stronger, while troubled marriages may go south. Fortunately, Edsall's marriage was solid. "My husband loved me no matter what," she says. "I've known him since I was 13 years old, so he didn't look at the outside shell. He saw me inside."
Some family members – like her grandmother – found it hard to accept her new look. Stinging remarks from acquaintances ("She took the easy way out with a little snip-snip") held only a passing effect.
Friendships can take a hit, Edsall found. For example, a former friend of more than 35 years became "extremely angry" over the surgery. Yet Edsall received support she never expected from others in her life.
Your Mind on Major Weight Loss
Dr. Robert Huizenga is an associate professor of clinical medicine at the School of Medicine at University of California–Los Angeles, head of The Clinic by Dr. H, a multidisciplinary facility in Los Angeles, and an expert on the cast of "The Biggest Loser." Huizenga say weight-loss surgery should only be used as a third-tier, last resort. Even with nonsurgical major weight loss, emotional issues can crop up, he says. One is body dysmorphia – an unrealistic self-image.
"At the start of the show, people look in the mirror and they don't really think they're that overweight," he says. "Sometimes when they lose a lot of weight, they can't necessarily see that weight loss."
Mood swings are the biggest challenge, Huizenga says. A contestant who loses 200 pounds but regains 70 after life upheavals may feel like a failure. It's all relative, Huizenga reminds people, and their weight loss is still an "incredible success."
From 'Invisible' to Spotlight
Severely obese people face painful stigma and social bias, so it's no wonder they try to become invisible.
"We call it blending in," Routsong-Wiechers says. "We kind of stay below the radar. We don't want to be noticed. We'll go grocery shopping at night. Exercise and walking is usually done at night."
Once you start losing a lot of weight, she says, the comments and extra attention can make you feel vulnerable.