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Past the Finish Line of "Thin": What Comes Next?

From the WebMD Archives

Thin = happy, right?

Well, not by itself. You've made big changes and worked hard to reach that magic, healthy number: your goal weight! But there's no finish line, says Michelle Vicari, who's kept off the 158 pounds she shed with the help of gastric bypass surgery in 2006. "No balloons fall from the sky," she says. "In fact, you wake up the next day to more of the same."

Lisa Durant lost 115 pounds using Weight Watchers and My Fitness Pal. But when she got to the "after weight loss" part, she felt lost.

"I spent so much of my life with 'lose weight' as my primary goal. I had no idea what to do with myself once that was accomplished," she says.

So she wrote about it in a searingly honest blog post called "The 'After' Myth," which went viral. "Losing weight does not mean you no longer struggle with your weight; I wish I had truly understood that. I still struggle with food. I still struggle with me," she wrote.

That doesn't mean it's not worth it -- it is. But if what Durant says is true, there's no "after," then what does the next phase look like?

You're Still You

Everyone, small or large, is dealing with challenges of some sort. If you've been focused on just the weight, once it's gone, the other issues will surface.

Rosalia O'Donoghue, a teacher from East Stroudsburg, PA, dropped 103 pounds with diet and exercise. "I really thought I'd have more self-confidence after," she says, but "being thin didn't make me an outgoing person."

Sometimes people do feel let down or sad once they've lost weight. "They realize that their lives still aren't perfect," says Deborah Beck Busis, a diet program coordinator at the Beck Institute for Cognitive Behavior Therapy. "Solving that one [problem] doesn't solve the rest."

Think of some healthy-weight people you know, she suggests, and ask yourself, "Do they have perfect lives?" The honest answer is "No."

"If weight were the only thing that determined our happiness, it would be a simpler world," Durant says.

Luckily, perfection isn't required -- from your body or any other part of your life. If you find it hard to handle what comes up, try working with a therapist or counselor.

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Your Body Image

The pounds may be gone, but the memory of them often lingers. O'Donoghue says she felt fat even after going from a size 18-20 to a size 6-8.

"I still have so many hang-ups," she admits. "Everyone said I looked good, but I would point out, 'I have a roll over here, and there.' It's hard to accept your new body."

Instead of thinking of yourself as "fat" or "out of shape," give yourself new labels, suggests Susan Albers, PsyD, author of Eat.Q. Try "healthy," "energetic," "thin." Repeat the words to yourself. Write them on sticky notes, then post them to your car visor or your bedroom door so you see them throughout the day. This retrains your brain.

Another thing: "People still wear clothes that are too big for them, not realizing they're too big," Albers says. "They avoid looking in the mirror and, when they do look, they're surprised when they see a thinner person."

"It's so true," Durant says. She was packing for a business trip after she'd lost a lot of weight. Without thinking about it, she grabbed a suit, which was three sizes too big.

"I had to put my arms up for the scanner [at the airport], and I thought my pants were going to fall down!" She laughs about it now.

Even when Durant went shopping, she'd reach for dresses that were too big. "It didn't dawn on me that the clothing was the wrong size. If a dress felt weird on my shoulders or came too low, I thought it just didn't work with my body."

A family member eventually put her in a size 2 dress that zipped up, and she was floored. "It's really like learning to dress a new person," she says.

Albers recommends making friends with your mirror. When you feel good, look at yourself and smile. Then focus on something specific that you like about your new body.

How Others See You

People tell you, "You look terrific!" They'll hold doors for you, help you with groceries, go out of their way to be nice to you.

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Whether you love the recognition your new body gets or not, you'll need to figure out how to handle it. It can be uncomfortable in the spotlight, even when the attention is positive. Although the comments you hear now aren't the same as before, they can still feel intrusive and too personal. That's a great topic to bring up with your counselor.

If you're riding the high, be prepared for the fawning to slow down or stop, Albers says. Eventually, people will get used to your new look.

Some people don't find the compliments flattering. "Women get angry at the world for being so shallow," says Caroline Apovian, MD, director of the Nutrition and Weight Management Center at Boston Medical Center. You're being treated differently because you look different. Her advice? "Feel the anger. It's an unfair world. Just knowing that may be helpful."

Instead of praise, you might get the opposite reaction: criticism. "People started telling me I lost too much weight, and I looked sickly," O'Donoghue says. "I was offended." But she decided to not take it personally.

"They're just used to me being overweight," she told herself. "Their minds are telling them I look too thin."

Albers agrees; it's not always about you. People often say things that reflect their own relationship to weight or food.

The People You Love

Your weight loss can also affect your partner, family members, and friends. "Many [people] eat to deal with the conflicts in their relationships," says Domenica Rubino, MD, director of the Washington Center for Weight Management and Research. "But once they don't eat for that reason, they're ready to tackle the conflict. Many times, a partner isn't. That can cause friction."

Just as you may have unrealistic expectations about yourself, you could have them about your relationship. For example, "[Men] often think if they lose weight, their wife will have sexual relations with them," Apovian says. "And it doesn't always go that way." In a healthy partnership, both people are on the same page.

A boost to your confidence can shift the balance between you, especially if the other person is insecure. The changing dynamic might make someone feel guarded and defensive.

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But it doesn't have to. "Work on your relationship to make sure it's solid," Albers says. Look for ways to reassure them that they're still an important part of your life. Tell them how much you appreciate them being there for you.

When someone feels threatened, "It's the darker side of human nature to try and level the playing field," Vicari says. Like when her friend said, "Oh, you had that surgery," and then told her about another friend who did, too -- and regained the weight. Now she distances herself from people who aren't positive and supportive.

It's OK to move on from people who hold you back or bring you more hurt than happiness, especially after you've tried to work it out.

What if your new lifestyle causes some tension? "Maybe you want to get up early and exercise, not lay with your partner and read the paper," Rubino says. "Sometimes even cooking different food or not having his chips in the house can cause disagreements."

She suggests finding something you can do together to bring you closer, like taking a cooking class or joining a recreational sports team. Or take turns stretching while you read articles out loud to each other.

Put yourself in charge of setting up new outings with your friends, too. Instead of avoiding after-work happy hours because of the beer and hot wings, ask if they'll try a group dance class, Rubino says. "Your friends may be up for something new because they're in their own funk, regardless of weight."

Enjoy Your New Body

Fill your life with the things you couldn't do before, Apovian suggests. Maybe that's traveling, playing with your kids, volunteering at a community garden, learning how to scuba dive, or shopping for a new wardrobe.

Ask yourself what you've been putting off. Then go for it! "I threw myself into hiking and getting out," Durant says. "That's my new project: loving life -- and loving myself."

WebMD Feature Reviewed by Michael Dansinger, MD on 1/, 015

Sources

SOURCES:

Michelle Vicari, secretary, board of directors, Obesity Action Coalition; chair, Your Weight Matters National Convention.

Lisa Durant, blogger, Can Anybody Hear Me?

Caroline Apovian, professor of medicine, Boston University School of Medicine; director, nutrition and weight management center, Boston Medical Center.

Rosalia O’Donoghue, teacher, East Stroudsburg, PA.

Deborah Beck Busis, LCSW, diet program coordinator, Beck Institute for Cognitive Behavior Therapy.

Susan Albers, PsyD, psychologist; author, Eat.Q.

Domenica Rubino, MD, director, Washington Center for Weight Management and Research, Ashburn, VA.

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