When I speak about having had weight loss surgery, people sometimes ask what my ‘moment of clarity’ was; the point at which I knew that I needed to take drastic action to alter my circumstances.

I’d known someone who had had a very drastic form of bariatric surgery… But I’d never considered it for myself then… (nor needed to, at that point…).

And then someone else had told me, anecdotally, about a newish weight loss operation, that was extremely effective, but with less side effects than some of the more traditional procedures. I’d banked this information, but probably still didn’t really need it.

I rack my brains, in response to the moment of clarity question, as I’m not really wired to think in such linear, binary ways. I know that my grief after the traumatic loss of my father played a massive role. I ate about it. For months and months. And I went from my former ‘politely plump’ status to what I felt was ‘obnoxiously obese’, in quite a short time. (And that’s the problem with being ‘politely plump’, in general, in life… Whatever arena your metaphorical ‘polite plumpness’ takes. If you walk a fine line between “OK” and “not OK”, there is no slush to buffer you when crises hit and things unravel).

But truth is that there wasn’t one ‘Damascus Road experience’ that set my plan in motion.

Rather, there were moments, experiences and learnings, all of which gathered critical mass, like individual dew drops on a window that find each other and create a downwards stream in their union.

And isn’t life usually like this..? Aren’t all big decisions preceded by a myriad of interlinking streams and tributaries, flowing ultimately into one big river of action..?When there’s enough tension in the system… When the flow has reached a particular momentum, we step into our power, through action. But it’s seldom due to one incident. Even when it feels as though it is.

For me, there was the Friday afternoon run-in with a ‘horrible’ 5-year old at my daughter’s school… (I say this somewhat tongue-in-cheek, as I truly don’t believe in horrible children, but it was an horrible experience). It had already been a long and taxing morning, and I walked in to fetch Ariana, feeling quite burdened and preoccupied. When all of a sudden, like an assault from the blue, a little boy torpedoed himself towards me, punched my ample gut, and announced loudly that “YOU ARE VERY VERRRRY FAT!!”.

Horrifying.

Mortifying.

Public.

I was surrounded by moms and dads I knew, and moms and dads I didn’t. And had actually been walking in with and chatting to a mum who runs 90km ultra-marathons and has the physique to confirm this!! She, thankfully, was incredibly deft at decompressing the situation, making some light but incredibly empathic divergence. (I marvelled for months after at how she managed to short-circuit my humiliation).

So there was that…

And then there was the TED talk by a medical scientist, who introduced me to the concept of the body’s ‘weight set point’.  I’d stumbled upon it six or nine months before my terrorist attack at the school (tongue-in-cheek again). The content of this speech percolated in the recesses of my mind for nearly a year before I first sought out a surgeon.

This medical scientist spoke about how, for 90-95% of the global population, it is basically impossible to lose a significant amount of weight, and maintain that loss. She presented new research which found that the human body will somewhat readily shed up to 10% of its mass. But once it gets to an 11 or 12% loss, it becomes an untamed gangster, hell bent on shooting that body mass right back up to it’s original weight, and beyond. That we all have a ‘weight set point’, which becomes our body’s reference point and equilibrium mark; an indelible number that it will always fight to maintain. (And when I say ‘fight’, I literally mean evoke RAVENOUS cravings that make a person, unaware of this theory, just feel loser-ish, defeated, self-loathing, and self-deprecating).

And the sad and sobering truth, the lady asserted, is that set point can and does increase without too much trouble. But that it takes SEVEN YEARS at a reduced weight for that lower number to become the new natural set point. Seven YEARS, girls and boys. Seven years of FIGHTING NATURE… Of being hungry and moody and cranky. Of your body singing exile songs and fixating on all things sugar and fat.

Her advice: radically accept your current weight. And realise that it’s likely the least you’ll ever weigh, give or take a few kilograms. Efforts to lose will backfire, and you’ll end up gaining. So focus on health and happiness, but realise you’ll never, ever be sustainably slim if your set point is already in the ‘overweight’ or ‘obese’ range.  Science. Fact. (For 95% of the population… There are always those outliers who manage to win against all odds. But this is, in my view, normal distribution. And history tells me that I am not distributed at the extreme ends of this particular ability!).

Or have weight loss surgery, she said (and many, many medical professionals, online and offline, echoed and developed this sentiment after my first exposure to the concept). Weight loss surgery, it has been found, is generally the only mechanism that seems to override set point… After surgical intervention and subsequent weight shedding, studies show that the set-point resets, and resets much lower. Hence patients lose 20, 30, 40, 50% of their body weight, but don’t usually suffer that vicious backlash and urgency to binge. Weight loss surgery patients were found to be less tormented by a physiological compulsion to ‘break their diet’ and gorge themselves back up to and beyond their original weight. (Some bariatric patients do suffer regain, so it’s not a ubiquitous miracle cure, per se - but these cases are the minority, and usually due either to surgical error or a very profound food addiction).

And then, in the discussion around factors leading up to my ultimate decision, there was the Cult of Banting. The Low Carb High Fat movement, for those not familiar with the former term. The panacea.  Every fat person’s ticket out. I think I lost (and gained) 17 kilograms twice, banting… It really does seem to work. If you’re perfect. If you are sugar free forever. Carb free, bar for a spinach leaf and half a tomato. And as long as you learn very quickly how calorific cream, cheese and butter is, and ensure that you adjust for this new consumption. But miss a beat. Lick the spoon when icing cupcakes for your kids, and you are done for. BOOM! There comes the Set Point Thug, to push and shove you right back up to your starting weight.

• Banting.
• SureSlim.
• Simply Slim.
• Weigh Less.
• Weight Watchers.
• Thinz.
• Duromine.
• Sibutramine.
• Boiled eggs and beetroot.

You name it. I did it. From the age of 14, to the age of 38.

The hard part about being an intelligent, successful FAT person is that you never look, on the outside, the way you feel on the inside. (I remember reading a journal article once, which found that larger interview candidates had the odds stacked up to 80% against them, due to the perceptions people typically associate with fatness. And then, much like internalised homophobia, I guess, overweight people internalise these societal perceptions and associations,and ferment an unhealthy dose of self-loathing internally. I certainly did).

I had, for a while, really really wanted to start THE SHRINK ON YOUR COUCH… THIS forum… I had been really excited and energised by the idea of taking a chunk of my business online. And preparing digital courses and programs based on all that I’ve learnt in my 15 years of psychology practice. To have a wider reach. To have a greater impact. But I had reached the point that I could hardly look in the mirror. I started my online business, but hit a wall when I realised that an online presence requires real confidence. People in my own world, and practice, knew I was credible. But I really battled with the idea of going on film, to complete strangers, on a forum that is fundamentally anonymous and therefore more readily judgmental, feeling so grotesque and wearing what I felt was the mark of defeat.

And it’s not good for anyone to feel out of control… I’ve always thought that eating issues are somehow worse than narcotic and gambling addictions, for example. So many ‘poisons’ can simply be removed, eradicated, obliterated from lived reality. But FOOD is a daily requirement. But exactly the right type, in exactly the right quantity, forever.

And so, with all of these factors - and many, many more - in tow, I bent my knee to medical intervention. I surrendered to the new truth I had learnt. Because it resonated so impeccably with my experience of nearly three decades.

And I was desperate to transcend my current reality.

As the popular Facebook meme says, “I just realised that I didn’t want to feel like that. Anymore, or ever again. So I changed”.

But you see how it’s not as simple as that meme would have you believe. These journeys take years. Even if, to the naked eye, they can even seem impulsive, irrational and out of character.

Some people suggested that I had taken the easy way out… That I had ‘cheated’. YES! YES! I absolutely did take the easy way out! (I’ll anger some of my bariatric peers with this sentiment, as many of them feel their surgery and subsequent lifestyle to be incredibly difficult, physically, logistically and mentally. Weight Loss Surgery is not a magic bullet. Some people don’t lose. Some people regain.  Some people get ill. Or have complications that affect their standard of living. Also, discipline, mindfulness and consistency is required more than ever). But, for myself, I am convinced that it was the easy way out. For me, it was the surgical removal of my ‘set point’. Yes, I have a strict diet now. Yes, I eat minuscule portions of deliberately nutritious food. Yes, I consult a dietitian fortnightly, and probably will, forever. Yes, I had a dramatic, life-threatening post-surgical complication which resulted in mechanical ventilation in ICU, and having a more extreme version of the surgery than I’d originally signed up for.

But my body no longer fights me.

I lost 5kg, 10kg, 15kg, 20kg, 25kg, 30kg without ever feeling that hideous ‘changing of the tides’ where willpower is impossible and failure inevitable.

I lost all of my weight. I completely revolutionised how I eat. And I removed from my experience all of the ramifications of having an unconquered battle hanging over my head. Only people who struggle with weight issues (no matter their set point) will know the constant anguish… The cyclical dieting, recoil, regain, diminished self-esteem - less from fatness than from not overcoming.

 I surgically removed my set point, and this has made all of the difference.

I believe that it’s really silly to hand-wash towels and dishcloths if you have a washing machine. It’s really foolish to brave a bacterial infection with Panadol and sleep if you have access to antibiotics and cortisone. It’s a judgement call to fight your set point, if you are fortunate enough to have the means and resources to remove it.

I have similar debates with my private practice patients who are really significantly enough depressed to warrant pharmacological intervention. It’s noble and sound to work through challenges of everyday living and the human condition in psychotherapy. To confront uncomfortable and overwhelming emotions. To master tolerance of these states, and flex your muscles of skillful, adroit, empowered living. But there’s a tipping point. We need to be really clear on where a person is in their journey, and what that means. It’s such a balancing act. The former reality is great when it’s working. When therapy is bearing fruit, and the client is going from strength to strength in their psychological and spiritual growth spurt.

But what of the person who, for no lack at all of trying, just isn’t..? The person who, despite being of sound mind and positive predisposition, finds him/herself racked with irrational fear, or unable to leave their bed. Who is moody and raging to the point of destruction, and plummeting into despair. And where, much like weight loss surgery, an actual concrete solution that could dramatically alter these experiences is viewed as a ‘cop out’…

I’m not a doctor. I’m a psychologist. And so the best I can do, by way of analogy, is to explain to such clients that we all have a metaphorical shooter glass sunk deep into our brains, that stores and replenishes serotonin, our ‘happy hormone’. If the shooter glass is at least 75% full, the serotonin can replenish itself, through natural physiological processes, as well as sex, exercise, laughter, achievement and various foods. If the level has been critically depleted, whether for organic reasons, or chronic stress and low mood, it literally can no longer replenish itself. And so chemical intervention is required, at least to get the serotonin ball rolling again.

This explanation is not the best science, but it’s ‘there or there abouts’. But the overriding argument is for the honouring of medical means for seemingly non-medical issues, if such means are going to be life-changing and liberating.

I know that this article has been lengthy, and diffuse.

My take-home messages for you are the following:

1. All decisions - even seemingly impulsive ones - are usually informed by a string of related and unrelated events which, cumulatively, lead us to the paths we will take.
2. We need to manage the areas in our lives in which we are on thin ice (‘polite plumpness’), because these areas will be under significant attack when we are particularly distressed and in crisis.
3. As with the weight set point, we need to embrace and accept new truths, as they emerge, and allow them to go to work in our lives. Be aware of your resistance to knowledge. Knowing is dynamic. Facts grow and change.
4. Sometimes it’s less about an easy way out, and more about the only way out. We need to learn to know the difference.

POST PUBLISHING NOTE:

Since releasing this article, I've had hundreds of people contacting me wanting more information, or to chat more about weight loss surgery.

I have created a Facebook group called BARIATRIC MIND MASTERS that you are welcome to join, if this is of great interest to you - whether you have actually HAD bariatric surgery, or interested to research further.

The group will ultimately deal with the PSYCHOLOGICAL factors and ramifications of Weight Loss Surgery. It will draw heavily on Dialectical Behavior Therapy, to assist patients to manage their emotions sufficiently to ensure success. Your're so welcome to join.  Click here to access the group!