The Easy Way Out

1345951608-rocky-no-easy-way-out-400x400I'm lucky that I haven't actually had someone say to my face "you're taking the easy way out". Mainly because I'd likely have to contact my attorney about defending me against charges of battery, and that probably gets expensive.

Or assault. I used to think I had the distinction clear in my head (assault is the threat, battery is the actual touching), but I've had people tell me that it's just assault. (But I digress.)

Right now I'm on my pre-op diet. The surgeon calls it a fast, but I do not think that word means what she thinks it means. (Any opportunity for a Princess Bride quote should not be squandered.) She has me drinking protein shakes 2-3 times during the day, and having a "healthy dinner" and can have "healthy snacks" if needed. MyFitnessPal informed me after I closed it out last night that if I continued eating like that, I'd lose 15 lbs in the next 5 weeks. Well, heck. I should just do that, then, instead of having 75% of my stomach cut out, right? I mean, isn't this really just a way to get out of having to have discipline and self control?

One of the things we've learned about dieting and maintaining weight loss is just how freaking HARD it is. Some of us are genetically programmed to put on weight easier than others. That's not an excuse, it's science. Then our bodies adjust to the new weight and fight like a cat in water to keep it on. This is what's commonly referred to as "Set Point". Our brains use a bunch of hormone signals to make us crave salty, sugary, fatty foods in order to maintain the weight the body thinks is correct. When we successfully lose weight, our metabolism lowers and our caloric intake decreases, requiring us to eat even less, all the while fighting against this tide of hormones. Food manufacturers know this, and create convenience foods that are full of the salt, sugar, and fat our bodies are screaming at us to eat. Culturally, we don't expend as much energy as our ancestors, and cram our schedules full so that eating home cooked foods is a struggle. Worse, the more weight you pack on, the worse this uphill battle gets.

Whew. And that's without even touching the emotional and mental barriers we face. Talk about the deck being stacked against you.

Yes, some people do successfully lose a lot of weight. And some of those are able to keep it off for a long time. And some of those are able to keep it off (mostly) for the rest of their life. It's possible. Possible does not mean realistic, though. It's possible for me to become a concert pianist. However, starting at the age of 46, it's really really damned unlikely. Likewise, it's possible for me to lose the 120-140 pounds I need to and keep it off without the surgery, but it's really really damned unlikely. Seriously. A 5% chance I'll keep *any* of it off past 5 years. Surgery raises that chance to somewhere between 50% and 70% depending on the study reported. Commitment to the lifestyle changes can bump either of those estimates up, certainly. The starting line is a little better at 50% or 70% than it is at 5%.

Wait a minute, didn't I just make an argument for it being the "easy way out"? Depends, I guess, on how you look at it. If I am running a race, and it's uphill, is it taking the easy way out to ditch the 50 lbs of sand someone put in my backpack? Is it taking the easy way out to buy good running shoes with good ankle support, or should I just go ahead with the 3" heeled pumps because that's what I was given? I'm choosing to equip myself better for the long haul. To me, that's smart, not cheating.

Let me talk for a minute about how "easy" this is. Once I made the decision to move forward with this, I had to schedule a string of appointments. A seminar with the weight loss surgeon. A one on one appointment with the surgeon. One with my cardiologist. Followed by a stress test with the cardiologist. One with a nutritionist. One with a psychologist to clear me for surgery. Three months of a supervised diet with monthly lectures from the doctor supervising me. Another with my primary physician to clear me for surgery. An upper endoscopy with my surgeon to check for ulcers and hiatal hernias. A follow up appointment with the surgeon about the endoscopy. Another appointment for the final preparations once insurance approved me. Pre-op testing, though I can skip the EKG since my cardiologist had to do a stress test. All totalled, I have spent almost $900 out of pocket for co-payments and co-insurance. I'll spend another $1,000 out of pocket over the next couple of months. (I'm grateful to have excellent insurance, without it I'd have to go to Mexico and it would cost me on the order of $5,000 plus travel, or some $10,000 to $15,000 to have it stateside.) That doesn't count the $1,200 I've spent so far with a therapist facing some of the food issues that would derail this process if left alone, because I'd have that expense if I tried to do this with just diet and exercise.

Now I'm on a two week "fast" and it's hard. The snack machine at my office tempts me every time I walk by to refill my water mug or mix up another powdered protein shake. The fast food restaurants taunt me as I drive by them. I want to EAT ALL THE THINGS because I'm starving, I have a headache, and I'm groggy. Oh, and I have to be off all of my PsA meds for the surgery, so I also have pain in my hands, my feet, my back, and my knees. I can't distract myself with crafts because my hands hurt. I can't take a walk because it feels like spikes in my arches. I'm on day 3 of 14, and I'm fairly miserable.

After surgery, I'll be on a full liquid diet for 1-2 weeks. Then I get to have pureed food for another week or two. Then I get to "graduate" to soft foods like eggs and tuna. It'll be 4-6 weeks before I can have "regular" food again. Even then I'll have to add foods one at a time and be very careful because my tolerances and tastes will have changed, and any given food - or too much or to fast - can make me very ill. I'll very likely be on a fairly restrictive diet for up to a year. Once my system recovers, and I'm at or near my goal weight, I'll get to add foods to my diet in a measured way. 18 months after surgery, my diet should look fairly normal, though with slightly smaller than normal portions.

Meanwhile, I'll have to get creative in order to stay clothed during this time. People report changing a size or more every week or two through this process. I should count myself lucky that it's culturally acceptable for me to wear skirts, because I forsee many months in drawstring maxi skirts. If I were a guy, this wouldn't be as easy, and that might be the first time (and likely the only time) I'll ever say that regarding fashion. Oh, and a lot of my hair might fall out.

But some will still say it's the EASY way out.

No. The EASY way out is to keep doing what I've been doing and not make any changes in my life. The EASY way out is to keep trotting out the tired and worn excuses as to why I can't do better. Not trying, THAT is the easy way out.

Anyone who is out there making changes to improve their health and life is NOT taking the easy way out. Choosing different tools to help make those changes is not taking the easy way out. Dietary changes are a valid choice. Exercise is a valid choice. Surgery is a valid choice. Medications are a valid choice. Any combination of the above and more is a valid choice. Each has risks and benefits that are unique to each person. Not one of these (or any combination of them) is the "easy way out".

So do me (and my attorney) a favor. Don't tell me I'm taking the "easy way out".

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