Clothes- big, small, medium, keep or get rid of.

Clothes - What to do with them?

The best thing about WLS is getting into smaller clothes.The worst thing about WLS is getting into smaller clothes. Why do I say it is the best and worst thing? At the beginning you may lose weight fast enough that you may only get one wear out of the clothing item before it gets too small and sometimes the first time you put it on it slips off again. This can become expensive.

One way that makes it less expensive is to set yourself a weight goal for your next item of clothing. This means it can be an incentive and a reward. It might be 14 lbs or 5-10 kgs. That usually gives you a good enough difference in your measurements that you have probably gone down a size as well. To go from size 28 NZ to size 16-18 NZ made me, personally, feel very happy.

I am second from the right

Still big but able to work out now

If you are wondering why I would be happy to be able to work out; previously the size of my breasts would have almost meant black eyes from the bounce of my boobs if I tried anything. I need to work more intensively on my diet as well as the amount of exercise to keep my weight loss stable or decreasing still. I wondered why people did not change their habits after WLS. I have found out why. The brain is a very important part of on-going weight loss. You have to figure out why you are sabotaging yourself (then and now) and decide on some strategies that are positive and helpful. In the photo above my hand is holding 8 inches of fabric so that the top conforms to my body. Eight inches or more that my body has lost.

Get rid of "FAT" clothes

This means that you have to go through your closet when you reach your set goal of weight loss. Try on everything. Have a box with Donate on the outside. If it doesn't fit you toss it into that box. Big women can never find fitting second-hand clothes at the charity shops. The volunteers will love it every time you take clothing in to them. Who doesn't love a beaming smile directed at them?

Why get rid of your clothes? Why not keep them? Your goal is to lose weight. You won't be wearing these clothes ever again. If, heaven forbid, you do regain some weight then they will no longer be in style. You may not believe in feng shui but it is active  in your life anyway . Discarding old useless or hurtful items allows positive and helpful items into your life. Sorting out and making clear space in your home works on your body as it is no longer being dragged down by old negative things. If you don't believe me go now and toss all the clothes that are too big, out of style or need mending. 

Hang your clothes on beautiful coat hangers, sort them into an order or colour sequence that makes YOU happy, get rid of anything else in your closet you have not worn or used in the last year. Those shoes that don't fit; get rid of them. It was only money you used to fill that hole. Now you are taking charge and finding something else that makes YOU happy. You will feel lighter emotionally and would you believe it you will become lighter in your body also. Who knew?

I know you may not have a space like this but even small closets can be transformed. You might like padded hangers or wooden ones, metal or plastic. You can do something to them to make you happy with how they look. I knitted covers for padded hangers using "Feathers" acrylic wool. The jumpers stay on better and I handle colourful, warm hangers when I bring them out. Sorting out your cupboards means your clothes don't get creased. If you want a top, skirt, dress etc you can find it easily. Shoes, purses, scarves etc can all have their own spaces. No tossing out half the contents to find that one important thing you need before heading out the door. A time saving in our busy lives.

Clothes for Right Now

Go to your usual place, or somewhere new, with an idea of what you need at this moment. If you are at the start of the WLS weight loss them you don't want to buy a heap of clothes. You will keep losing fast and don't need to buy a lot. Some clothes can be used with a nip/tuck here and there, or by using a belt. You want clothes that fit exactly now but are shaped so they will look good during your next set goal weight amount. It is probably a good time to have a mix and match wardrobe that has a few items that can be used in many ways.

You can have some fun here with wearing colours you like, not just the ones everyone expects you to use; default colour -black- can become apricot, sapphire, lemon or whatever your favourite colour is that always gets you a compliment. Find out if you are a Spring, Summer, Autumn or Winter. The definitions that many years ago came out in a book called "Colour Me Beautiful" still hold true. It is an easy way to find a range of colours you can use to look good in. You will recognize in their colour pages the colours you always felt good in. Use some of them. Do not be timid any longer. Be proud of how you are changing your body to one much healthier for you.

The Aim Outfit

If you have a very special event coming up you can buy the outfit you want to wear to it in the size you want to fit at that time. Do not set yourself an impossible task though as it will effect you emotionally. The reason for that Aim Outfit is to get you out of bed and exercising on the day you just want to curl back under the covers. It can be photographed and put on your pantry door or fridge door to make you think about what you are about to put in your mouth. It helps you want to make the good choice for your body.

It could be the Prom,  the Oscars,your wedding, a resort trip or a new job that you want the Aim Outfit for. Be adventurous. Aim for a reachable goal you are happy with and have fun. It is only one outfit. You won't go bankrupt.

Clothes help make the person but it is only one part of you. Don't stress over them. Celebrate the changing sizes. Celebrate the day you can buy something from the store most others do, not the Big woman/man store. Celebrate the changes you are making to your body and life. It is all your hard work.

Things to do:

1. Try on then get rid of the clothes/shoes that no longer fit
2. Put them in the Donate Box, put that box in the car right now, drop it off the next time you are out.
3. Buy only as needed till you reach final goal weight
4. Use interim set goal weights to buy a new clothing item as a positive reinforcement of how well you are doing
5. Inject the colours you like into your clothing
6. Sort out and organise your wardrobe then the rest of your house and life
7. Have an Aim Outfit (like the Biggest Loser contestants) for an important occasion but give it a reasonable time frame
8. Use that AO to help encourage yourself on your journey
9. Enjoy your new clothes whether they are brand new or second hand.
10. If you really want to keep your biggest outfit you can tuck it in a deep drawer for the day you can wear it to show the difference from then till now IE your body fitting in one leg of your old pants
11. Do remember the underpinnings of pants, bras and other underwear. Look for the pretty underwear as your size goes down. Shapewear will be very useful too. Ask to be fitted for your bras as you won't always know the right size.
12. Be joyful with your choices.

One problem most have after WLS - Pooping

Just so you get an idea of what sort you need to see happening

Pooping - the main grumble after WLS

The Reasons Why It Happens

1. You have had a major bowel operation. The operation and anaesthetic can slow gut movement
2. Little or no food being eaten post-op then that amount stays a lot less than you are used to for ages afterwards.
3. Not enough hydration (glasses of water)
4. Lower fiber in food eaten
5. Less exercise immediately post-op
6. Stress, and you only know what your stress reasons are
7. Position on toilet

What can help you get better Poops

Water

1. Water. You need to drink 8+ glasses of water to get a comfortable poop. I carry bottled water with me when I go out. At home I take note of what I am drinking to make sure it is enough. I refill the glass as soon as I finish it. Yes, I know how hard it is to drink enough as the urge to do so is often absent. Sometimes when you feel hungry it is actually because you are thirsty; drink a full glass of water and see. Coffee actually dehydrates you but it is a bowel stimulant so may help you go.

Exercise

2. Exercise each day. This may only be 3 10 minute walks just after your operation but it does help. 3 years post-op I often have to hit the toilet not long after I do the 1/2 hour walk into town. The exercise massages your abdominal muscles over your bowel and make it move more. They strengthen your muscles also. Being sedentary slows down your whole body. If I do a lot of exercise I may go to the toilet more than once in a day.

Massage your abdomen

3. Massaging your external abdomen can encourage your bowels to keep everything moving along. You start upwards on your lower right side, across just under your ribs and down on your left side as this is the way your food goes through your bowel. I push in a little more in this left lower area and have been known to bend over my hand to get a little more pressure. This can work very well but be careful just after your operation as you don't want to cause any problems with internal stitches.

Stool to get better angle

4. "A stool in the toilet. What do I need than for?" This actually gives you a semi-crouching position. Why do we need that? There is an internal ligament that helps keep your bowel closed when you are moving around. It bends the bowel so it is blocked off a bit more. The squat position moves this ligament and you have a straight drop. Think long drop toilet instead of S-bend - much easier to use if it's a bit hard down there. For many weeks I used a step stool to raise my knee level (semi-crouch) each morning - it was easier on me.

Regular toilet time with no interruptions 

5.Regular toilet habits. It isn't easy at the start and it becomes more difficult if the kids/significant other are lined up at the door saying that they have to go. I am lucky as most days it is the first thing I do on waking. If it doesn't' happen then a walk may do to get a result. Last resort I take my sure fire remedy (kiwifruit) later in the day. So, literally pick a certain time each day that used to be your norm and re-establish that bowel habit. Have a drink of water before going to sleep, and on waking, can also help here.

Not only infection but to help constipation.

6. Diet is an important part of improving your bowel habits. Some of it is due to fibre - both soluble and insoluble -  that the food contains. Sometimes it is the vitamins and minerals in them that strengthen all muscles including the bowels. Some create more movement and gas in the bowel. Probiotics in some foods repopulate your bowel with good bacteria used for digesting your food properly. My favourite way is to have 1-2 kiwifruit if I am a bit hard. I love the sweet/tart flavour and I have a good result either later in the day or the next morning. Remember to check with your surgeon or dietitian when certain foods can be introduced.

Bananas help in so many ways

Helpful foods

Beans have helpful fibre (beware of gas eruptions)

Fibre and breakfast - a twofer

Oats and linseed - fibre and oils

Kiwifruit - works wonders

Wholefoods are better for you than processed food as you know exactly what you are putting in your body. You have more control over the amount of carbs, protein, fats, vitamins/minerals, salt and fibre that you eat. The portion size is correct as is the frequency of when you eat. MyFitnessPal is a quick and easy way to check on your intake as you can track your intake. They automatically tell you what it contains and let you know what your daily totals are. It can show if you have reach your target or not.

The Times Nothing Works.

What to do.

• Ask the chemist (pharmacist) as some OTC items work well
• Ask your doctor as you may need suppositories/enemas to help clear the backlog
• Head for the ED if you can't stand or walk due to the pain as it may be causing further bowel problems.
• See your surgeon as the problem may have been caused by something to do with your op

Start with the top person and work down as all you may need is some extra fiber or mild laxative to get back to normality.

Enemas to clear bowels

Soluble fibre to soften things

Suppositories to help at the bottom end

Softener and lubricator

 Good luck and get on it early. It literally gets harder, and causes even more problems, if you take a wait and see approach. Most people go every 24-36 hours and that is your aim.

Exercise and Weight Loss Surgery Patients

 Why is Exercise Needed?

Exercise is needed both pre-op and post-op. I hear a swear word being uttered out there but it is important. We have often gained our excess weight by eating more food/drink calories than we use in our exercise (movement). Our metabolic rate has probably been lowered by the number of diets we have tried before. Exercise helps to raise the resting metabolic rate for a time after the exercise. If you exercise regularly it stays at a higher rate than without exercise.

Pre surgery exercise needs

In New Zealand if you are getting your weight loss surgery done then you have to reach certain targets of weight lost and keep it off. You are encouraged to start exercising before the surgery for a number of reasons.

Reasons for exercise pre-op

1. To get healthier, meaning less risk during the operation
2. To improve core strength which keeps you stable and upright
3. To lessen the amount of abdominal fat making it easier to do the operation
4. To heighten the chance of you continuing to exercise post-op as it is already a habit.

Difficulties in exercising pre-op 

1. Inability to move freely because of physical size
2. Very sore joints in your lower body that limit how much you can do
3. Comorbidities that make exercise difficult
4. Depression that makes it hard to motivate getting up and out to do the exercise
5. Finding clothes to exercise in
6. Finding an exercise to do that won't cause further physical problems

Exercises that can help pre-op

1. Walking: start with a small amount of time, 30 minutes a day can be divided into 3x10 minutes if that is your limit. Wear comfortable loose clothing and supportive shoes. The shoes don't have to be expensive as long as they support well. This can be done outside or on a treadmill inside. Speed can increase as you find it easier to do and you can include inclines to add extra effort. I used this as a way to learn what my local area was like. It was lovely.
2. Swimming: this supports the majority of your weight and has the added benefit of the resistance of the water to push through. It includes water exercises for range of movement, water walking and aqua jogging etc. You do find that when you get out of the pool you feel heavy for a while. I liked to walk and swim laps as I felt longer and looser afterwards. I could lose 20 kgs each summer. It is hard to see bodies through water so you don't have to be self conscious. Check with the Pool if you can swim in something other than a swim suit if you are currently unable to find one in your size. Some pools open earlier or stay open later for certain groups. Ask them about it.
3. Cycling: using a recumbent cycle is easier on the body than the ordinary cycle. The seat is larger making it easier to sit on and you extend your legs forward instead of up and down. This means you are likely to cycle for longer and get better results from it.

Things to keep in mind

1. Personal safety. Forget those headphones as you can't hear what is happening around you. Be aware of people, animals, cars and other moving objects. Stay in the now when you are outside. Enjoy the weather, the trees, the flowers, saying hi to fellow walkers, the clouds in the sky, the feathers you find and anything else you enjoy looking at. I have harvested crabapples (for jelly) and picked up litter to make the area I live in a better place. Carry a personal alarm, safety feature in you hand (keys) or a phone to call for help if you are worried at all.
2. The downers. Those slobs that go past in their grotty car and call out derogatory remarks. They have no right to and it can cause further depression if you take it onboard. I usually catch up to them at the next lights. "I may be fat but you are ugly and I can diet" is a phrase I use to good effect. Gestures can get you into trouble with some idiots so be careful with those. Be proud. You are actively working on reducing your size, they are not. Kudos to you. Idiot Award to them.
3. Don't push too hard. If you do too much your body will let you know. It makes it harder to get out there the next day and do something to get closer to your goal. Do use enough energy to help lose that weight and/or get fitter.
4. Write down what you have done. There are many food/exercise diaries out there now. Even a school notebook that you rule up is useful. It shows you what form of exercise, how much, time taken, amount of repetitions, weights used or anything else you want to note. It helps you to decide when you have to up the intensity or even add new forms of exercise.
5. Decide on your goals you want to reach. When those goals are reached, celebrate. Set your next set of goals. Onward and upwards (or in our case, downward in weight)

Post Surgery exercise needs

Diet is very important post surgery but for quite a while the surgery keeps what you eat to the forefront. Eat too much or the wrong sort of food and you will either be sick or experience "dumping". You mostly need a high protein, low carbs diet that has enough fruit and vegetables to keep your body healthy. Supplements are needed by most people for the vitamins and minerals but that is fairly normal. Drinking enough water is something you learn to do. That water bottle is never far from your hand. Sip, sip and sip all day. Keep it up during your exercise. I find I automatically drink more when exercising. Weight loss support groups, whether online or physical, help to keep you on course. They are places to talk out feelings and problems. You get solutions and support from them. Exercise completes the triad that helps you lose the weight and keep it off.

Importantly at the start of your WLS exercise regime be guided by your doctor on when to start exercising, how much and what form of exercise as you don't want any problems with the operation site.

Reasons for post-op exercise

1. Those who exercise regularly helps you lose more weight (can be 4.2% lower BMI)
2. 2.5 hrs of moderately intense exercise means more actual weight loss compared to those who haven't done the same.
3. It can give you more than 5% extra weight loss in 6/12 months
4. Sticking to an exercise program usually means you are sticking to the diet as well. You are making your new body a priority.
5. I find it helps to define muscles more and some of the skin will appear to be less (always good)
6. Exercise has been proven to improve the mood.
7. Exercise can help your mobility improve.
8. Your metabolic rate stays higher than it would have. Your body thinks you are starving so it lowers the metabolic rate to conserve your body reserves. This makes it difficult for you to lose weight.

2010

August 2013

February 2016 _slight weight gain back to 103 from 99 kgs

 Physical results in your body due to exercise

• Longer life span
• Less abdominal fat which leads to less risk of heart disease
• Lower blood pressure so less heart/stroke risk
• Triglycerides improve; less bad cholesterol, more good cholesterol
• Better insulin control/improved or no diabetes
• Lower risk of cancers in its many forms
• Improved balance so less risk of injury (very good if you are older)
• Muscles,bones,heart and lungs are stronger so you are fitter
• More bounce (vitality) in your step

Mental results due to exercise

• Improvement in mood. I think if doctors prescribed 90 minutes of good frequent exercise to their patients that the need for antidepressants would drop
• Improved appearance as you become taut, trim and terrific
• Mental acuity improves so it is easier to complete that crossword etc
• For the guys and gals; improved libido (yay, a sex life again, hehe)
• I get through my housework faster after I have been to the gym

Things to think of

• Start slowly and work up carefully. You are relearning your body in a new way
• Wear supportive clothing so you don't create problems
• Drink plenty of water while exercising
• Wear good supportive footwear. It doesn't have to be expensive it just needs to hold your foot in a good position, inserts may help here.
• Warm up and cool down with exercise. A cold muscle may tear more easily. I briskly walk to my gym then do the recumbent bike as my first exercise. A brisk walk home is my cool down.
• When aerobically exercising your heart rate needs to be between 50-85% of the Maximum for your age - this is easily found on the Net.
• If it is painful, stop! No, that doesn't mean the ache at the end of your rep, it means pain. 

So what forms of exercise are good for post-op WLS people

You want the exercise you do to fill three needs: endurance, flexibility and strength. These may have waned when you were bigger and it is time to treat your body as a temple; not a waste disposal unit. You have worked on how much you can eat and what sort of food helps you feel fit. You are working on why you want to eat and this can be on-going after your operation. Now the third part of doing the best for your body is to get it physically fit. Exercise in its many forms is a way to meet this need.

Walking (Endurance)is the first form of exercise that doctors encourage you to do. Even 10 minutes/3 times a day helps. Each day you should try to get just a bit further. The best way to know how much you are doing is to get a Pedometer or today's gadget; a FitBit or others similar. Write down or record in some way just how much you have done. This gives you something to improve on tomorrow but you can look back at other days and see how far you have improved. 30, 300, 3000, 10,000+ steps; it is a positive result you can celebrate. When it gets too easy add hills or steps to climb up/down. Attempt that hill walk you never thought you could do. Enter a 5 or 10 km walk; finish it. Why? Because you can. The progression from there is a stationary bike or something similar.

And you can take time out together

Yoga (Flexibility) This is to get those joints moving freely again. Start in a beginners class and, as you improve, progress in the forms you do. There are classes, videos, downloads and YouTube videos that you can follow. You might want to check out something like Tai Chi. You might just do the stretches on the wall-chart in the gym. To get you body moving freely through the full range of movements you may even need to use other health professionals to get you going at the start. Use them.

Big and flexible -high aims

Oh, to be so flexible

Weights (Strengthening) You can do these at home or at the gym. Many forms of weights are available for limited cost. Start light, between 1-5 lbs, and work up as your strength grows. Gyms have machines that assist you as well as free weights. Lower weights and more repetitions improve your muscles but still keep you trim. Most males want bulging muscles so they use higher weights and less reps. Whatever you desire to look like is up to you. Do get formal help with higher weights as you can cause injuries if you do them incorrectly. An added benefit is they strengthen bones and stave off osteoporosis which is a possible side effect of WLS. Exercise balsl help with core strength and there are other exercises you can do using them that improve your body strength.

Start small

Aim high

Swimming (Strength, flexibility and endurance) The best all round form of exercise is in the pool. You can go swimming for as long and what ever style you are comfortable with. You can walk the pool lengths and you can do flexibility exercises holding on to the edge of the pool. This can be done pre/post-op with good effect. You are supported by the water and you have to push against it. Win/win for your body. You don't feel your full body weight in the water so you move more freely.

Leg exercises in water

Water exercising

Best things to help you keep exercising

Set and track your goals as it makes you happy to see improvements happening. This can be weighting your self regularly; taking your body measurements afterwards so you see changes happening. Sometimes your measurements go down and the scales don't. Having a partner that works along with you can help get you out there on the days your mind doesn't want you to do it. Fit-bits mean you can have a digital partner if the physical one is too difficult. They encourage you to better your own targets too. Try different forms of exercise or different places. Mix it up and you won't get bored. Your body can get used to doing the same thing and it doesn't get as much result from it. So use the gym today, go for a swim tomorrow, climb Mt Kilimanjaro, do something different. Do something you have always wanted to do and never thought you could.

https://www.youtube.com/watch?v=Y0_a2gnlSA4 and https://www.youtube.com/watch?v=kjsh4Z3GMUk  are two big girls that prove anyone can be a yoga body.

Be consistent with when and where you exercise as your body gets used to it and makes you feel antsy when you don't do it. Share what you are doing with other because you know they are going to check up and you want to be able to say "yes,I did". Don't push yourself but do progress each time. Injuries will stop you otherwise. Gyms are useful as they have equipment you can't afford and trainers to make sure you use it right.

At home you can do your exercise routine outside in good weather. If not, then have one particular space inside where you exercise every time. Have what you need stored there. Set a definite time to do it then carry through. There are DVDs, online resources and cheap equipment out there. Use it. Be the best you can be for you. 

Gym at least 3-5 times a week for me; back there tomorrow. How often do you exercise and what sort do you do?