Struggling to decide where to stop losing...

 Hi all.  I initially had my RNY surgery October 3, 2011 so I am almost a year post op.  my presurgery/pre-optifast weight was 313 pounds and now 11 months later I weigh 159 pounds.  I am 5'5.  I had my surgery at Toronto Western Hospital and it was my experience that in all of my pre-op appointments I was neither asked to choose a goal weight or told what my goal weight should be.  Pre-operatively I always said that I wanted to measure my success based on my ability to function and complete or participate in certain activities.  I was more concerned with my ability to do things like fit in chairs and seats, cross my legs, bend over to tie up my shoes without holding my breath, exercise, go on amusement park rides etc. as well as the improved health that would come with weight loss.  

Since surgery and as my weight began dropping, however, my perspective began to change.  I quickly began accomplishing all the functional milestones I looked forward to and at my check ups I began to become aware of the BMI calculator on the computer screen in each exam room I was put in.  I began to fixate on my weight and the number on the scale every single morning and I began obsessing about exercise and every piece of food that I put in my mouth often severely restricting certain types of food (carbs or fats) and at times not eating for much longer periods of time than I should.  I quickly identified this was a problem and spoke to my clinic to seek out help.  My clinic was fantastic about immediately setting up weekly telephone therapy appointments with the bariatric psychologist and these appointments have continued every week since December.  

My current challange ishtar I am getting close to the point where I need to decide when to stop and I simply don't know how to decide when that should be.  I still weigh 159 pounds and according to the BMI charts for a woman my height this is still considered overweight. My clinic and my therapist tell me that the BMI charts are very controversial and not a good measure of a persons we

 Part 2 -I am told BMI charts r not a good measure of a persons healthy weight but my argument is that they can't constantly use this measure when I go for appointments to determine my general health and well being/success etc and then turn around and tell me it's not important.  I had set a goal of 150 pounds for myself along the way which is still four pounds over the 'normal' weight in BMI calculator and I keep thinking I should try to get down to a 'normal' weight.  I am constantly being told by people now that it's time for me to stop losing and that I am getting 'too thin'. 

How does one decide when they are done and how does one get rid of this constant fear of gaining weight again?  

My surgery was in Feb 2011 at TWH, and like you my goals were really function oriented, not a number.  I started at 350 lbs, and told Katie I would be happy to reach 250, and ecstatic to reach 199 - which quite honestly I didn't think was possible.  Like you, as my "functionality" improved, my attitude to goals changed, and I had trouble deciding what was REASONABLE.

I agree completely with Sandy that faces do become gaunt, AND that the weight seems to redistribute as time goes along.  My ankles are thinner now than they were, although the scale hasn't changed.  I also agree that there is a certain amount of "shock and awe" reactions from those who see us change so much, and that it doesn't  necessarily  mean we really are too thin.  

My solution to the goal NUMBER was to pick a dress size rather than a goal weight as my target.  In my case a range of size 6 to 8.  Once I got there, I chose a weight which comfortably fit into that size (in my case 142lbs at 5'4") and that became my maintenance weight.  I now weigh myself daily and allow myself a 2lb swing either way before I either increase my exercise or eat more.  It's working for me, and has given me some freedom from the obsession with every mouth full of food. 

Claire
HW 350lbs
CW 142lbs
Surgery Feb 16, 2012

PS _ Don't forget that we also carry a fair amount of excess skin - in my case maybe as much as 15 lbs given the 210 lb loss.  While the skin folds do take up room in clothes, I have realized my "boney -ness" is more reflective of a normal someone who weighs less than the 142 which the scales say I am now.  Maybe 130 -125lb?  That's plenty small enough for me!

I always pay extra close attention when you post, because you are a couple months ahead of me on this journey and you always give me some insight into what's coming my way. 

When I read your post I realized that it's possible I too have some questions about  my goal weight. TWH wanted it to be a number much higher than I was comfortable with. On paper we agreed to 175...but since then, I changed it to 165 and that is the number I have focussed on since.

I sort of doubt that number will be the magic number I stop at...but I keep thinking I will worry about that when I get there. I am trying so hard just to get to goal...if once i get there I am happy with what I see, then hopefully I will be able to handle maintenance...

One thing I keep trying to tell myself is that number might NOT be the thing I want to focus on. For example....I am running and using weights for strength training and toning...this is creating denser muscles...and muscles weigh more than fat.... so if I get all bent out of shape focussing on a number, how do I account for my new hard-earned muscles in that equation.

After reading your post, and reading the replies on this thread, I finally have an answer to that question... body fat percentage! Great!

Thank you for thinking out-loud with this post...you have given me information I didn't even know I was looking for! 

Congrats on your success so far girl! 

Only you can decide where you want to end up.  Although the BMI standard is controversal, I do believe its  starting point or at least a rough guide.  People will tell  you, you are getting too thin because they are not use to seeing you like this, but they'll get use to you and people also tend to look a little gaunt in the face at first, but weight will redistribute after a while and that will change.  My only real advice to you is to go 5-10 lbs lower than you want to because bounce back is a ***** lol.

Congratulations on your success! 

This was given to me by another OH member

Might I make a suggestion... Why not focus on a "Body Fat" percentage. Here is a good chart that can explain what is needed better than I can. http://www.bmi-calculator.net/body-fat-calculator/body-fat-c hart.php

Perhaps it will help you

 This thread is so up my alley.  I'm feeling overwhelmed by maintenance and trying to stop the weight loss.  I didn't expect to be thrown into it so quickly...I was thinking maybe in a year or 18 months.  I have people telling me that I'm too thin and then I have other people asking me how much more I have to lose.  Talk about making me crazy!  I've decided that I don't want to lose any more weight at this point...but I also don't want to gain any.  Trying to figure out the sweet spot for calories at this point and then getting them all in feels like more work than the losing phase did.  Its all a big mindfuck.  Hang in there and trust your gut about what is the right weight for you...and of course, consider the feedback you are getting from others and from experts, but ultimately its up to you....as long as you can get your body to agree,lol!  Good luck with your early days of maintenance!

BMI is not good because it doesn't distinguish between fat weight and muscle weight, but it has the advantage of being one number, and there are studies based on it, so it is a reference point.

I agree with looking at body fat percentage. After I lost 80 lbs on weigh****chers I was still 44% fat, I considered myself a butterball turkey (hence my desire to exercise this time).

Re being "too thin", in my experience, one is too thin when one is thinner than the person one is talking too. A lot of people gain weight in accompaniment to their generation, i.e. "everyone our age has 20 lbs of beer fat on them". Or "all women who have had children are 40 lbs heavier than in high school".

When someone comes along who doesn't have that 20 lbs, they are too thin.

"Too thin" is about them not you. Plus, we tend to lose it in our faces first, so I notice my face is a "different size" than my hips.

When I was losing before I was shocked to learn that Madonna (older than me and my same height was 12 lbs lighter than my skinniest goal weight. I think she looks very fit. No one could argue that she did not sustain a very active lifestyle.

I think in some ways we should let our bodies find the way out, to stop. Like, what are we saying "no" to that we really want? If we add it into the diet, and continue to lose, is it so bad? I don't know if this will work or not.

Your comment about becoming scale obsessed and eating in what you saw as an unhealthy manner in the middle of your journey was very interesting. I'm going to think about that.

Best wishes.

 I think "too thin" does exist and its not just about what others think. For instance, slipping outside of the healhy BMI range and into the underweight BMI range is likely to be really "too thin" for the majority of people...even given the above discussion about the relevance of BMI vs. body fat percentage.  I think believing that there is no "too thin" is a risk factor for slipping into eating disordered thinking and behaviours for me.

This is true, but I've seen so many people diet and get down to a weight that is still in the overweight range (including myself) and then had friends and family say, "Don't lose anymore, you're too thin."  I think this might be what Linda was talking about.  One member of my family lost a whole bunch of weight, but he was never "skinny" at his lowest - he was still probably technically "overweight" by the BMI, and it wasn't muscle - and he had people telling him, "Don't lose any more, you'll get too skinny."

My personal thought is that when people do that when you aren't really thin, it's sabotage - perhaps unconscious on their part, but still sabotage all the same.  They may be wanting to make you feel good by saying you're so thin, but it's also a way of saying, "I like you big - don't change!"  And there are lots of reasons why family and friends might not want to see you get thin (or thinner than they are).  It's more complex than simple jealousy - they might think you're going to become a new person that they don't know, and they don't want to get used to it.

And there's a certain security to having someone else be the fattest person in the room, the person who makes it okay for other people to overeat because at least they're not eating as much as the fat person, the person they can always count on to go out for supper and overindulge with them, etc.