Wrestling with Body Image After Gastric Sleeve Surgery

The pounds are dropping off thanks to VSG, so why is your body image still suffering? With most social media posts focusing on new and improved post-bariatric bodies, many vertical sleeve gastrectomy patients believe they’re the only one whose brain hasn’t caught up with their body. The truth is that body image issues are incredibly common during and after a weight loss journey.

Why you may be struggling on the inside
Many gastric sleeve patients don’t know what a healthy body looks like for them, which can lead to feelings that you haven’t lost “enough” or aren’t actually as thin as you are. My patient, Stephanie, shares, “I’m four years out from surgery, and I still see the fat me. I still look at plus-size clothes and even try them on, then go down in sizes. It’s definitely a mental game.”

Years of not being at a normal weight distorts things, as do comments from well-meaning family and friends. Compliments may make you uneasy, as you hear a negative (ie: how fat you were before) instead of a positive. And when loved ones say, “You look great—no need to lose any more weight,” it can make you question your goals. Sometimes your goals need to be questioned, by the way. But it can be confusing to sort out what’s real about your body, what someone else’s motivation is, and even what your own motivation is.

Speaking of which, your primary reason for undergoing gastric sleeve surgery seems to play a role in body image issues afterward. There’s no right or wrong reason to pursue a healthy body; healthy is always better than unhealthy, no matter what’s driving you. But VSG patients who are driven primarily by aesthetics rather than health may be a bit more prone to body image issues following the procedure. Again, that’s not a judgment on “better” or “worse” reasons; it’s just reality.

Prioritizing your mental journey
The good (and bad) news is that you’re not alone in your feelings. Here’s some food for thought on overcoming this mind-vs.-body clash:

• Tip #1: Maintain connection with people who’ve walked in your shoes. Friends and family who’ve never lost a lot of weight may mean well, but they simply can’t understand what you’re feeling or, most likely, what healthy means for your unique body. Our private Facebook page is an invaluable resource for sharing highs and lows and receiving “been there, done that” advice from folks who know exactly what you’re going through.

• Tip #2: Talk to yourself like you would a friend. Have you ever noticed that you say things to yourself that you never would to a pal? Our internal dialogue has a funny way of shaping what we see in the mirror, so the next time you think, “Ugh, you’re still so chubby,” run it through your “friend” filter. Is it nice? Is it helpful? If not, erase that tape and replace it with something constructive like, “Your hard work is clearly paying off!”

• Tip #3: Give yourself time to adjust. Your physical weight loss may happen at a faster pace than your mind can keep up with. You’ve seen a fat person in the mirror for years—or decades—so seeing a much thinner person there for a few months is a short time in the grand scheme of things. Eventually, you won’t be surprised at your reflection anymore.

• Tip #4: Get to know yourself as you are now. Had a goal number in mind since the beginning of your weight loss journey? Now is a good time to reevaluate whether it’s serving you well. It’s possible to sabotage your self-esteem by holding onto a random weight, pant size, or even BMI as a goal. Bodies are so incredibly different. A small-boned friend might look fabulous at a size 4, whereas you’d look like a cadaver at that size. Take the number out of the equation and ask yourself how you feel right now. Nancy says, “I would LOVE to be 125 pounds but can’t seem to quite get there. I’m just not sure 125 is realistic for me at this age/stage of life.” That’s a great question, Nancy.

• Tip #5: Seek outside help. A therapist who specializes in weight loss patients can be a tremendous asset for people who need a little extra support. In the same way that choosing weight loss through bariatric surgery should be seen as a sign of strength rather than weakness, enlisting a therapist shows that you value yourself enough to bring in the pros.

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“Changing lives…one sleeve at a time”.