Found And Lost, Part 9

 (A New Machine, Pt 1 - Pink Floyd)

I have always been here.
I have always looked out from behind these eyes.
It feels like more than a lifetime.
Feels like more than a lifetime.
Sometimes I get tired of the waiting
Sometimes I get tired of being in here
Is this the way that it's always been
Could it ever have been different
Do you ever get tired of the waiting?
Do you ever get tired of being in there?
Don't worry, nobody lives forever.
Nobody lives forever.

- David Gilmour

----------

Somebody else was in the mirror looking back out at me.

I hadn't noticed him at first.  I don't spend much time looking at myself in mirrors, and when I do, it's usually when I'm covered in shaving cream.  One morning in early February 2020, I had occasion to do just that, and that's when I saw him for the first time.

He was me, of course, but...not.

Logically, I knew that what I was seeing was the reshaping of my face due to weight loss. By the time I was ready for my mid-February check-in, I'd gotten down to 410 pounds, a whopping 45 pounds down from where I started.

The Bariatric team's original estimate was that I was losing around a half pound a week, sometimes a little more.  Ultimately, that meant that I would be looking at around 45-50 pounds of weight loss, give or take, by July 2020.  Given that I'd already lost 45 pounds, I should have been happier about the fact that I was ahead of schedule.

All of that sort of...didn't seem to matter whenever I looked in the mirror.  Once I noticed that he was there, I spent more time looking for him.  Which just made the problem worse.  I wasn't sure what bothered me more, the fact that I logically understood why I looked different in the mirror, or the fact that it didn't seem to help at all.

----------

"Your edema is all done, your weight loss is progressing right on schedule, you're completely off of the HCT, it's no longer necessary to wear your compression socks..."  My physician spread her hands.  "You're on track for your next major milestone at 400 pounds, probably within the next two and a half months.  You could weigh less than 400 pounds for the first time in over a decade by mid-April.  That's huge."  Then she tilted her head.  "I get the feeling that you're not as excited about this as I think you should be."

I'd found that space a little behind her head with my eyes again and was studying it.  "This won't last," I offered after a moment.  "I'm not doing enough work for this to last."  Then my eyes moved back to hers.  "I'm riding on the coattails of my caloric deficit right now, but that can't last.  That means I'm going to have to step things up a little.  I'm still too large for any kind of impact-based cardio to be advisable, which means bodyweight movement or resistance bands, or something similar, right?"

My physician nodded slowly. "That's correct.  You're most likely benefitting from increased levels of a phenomenon called Non Exercise Activity Thermogenesis.  Basically, you've started a rather large rock rolling along a shallow decline.  Right now, you've pushed it hard enough that you're benefitting from some of the decline that the rock is on.  The decline being a corollary for your calorie deficit, that is.  Right now, you're able to exert comparatively light levels of effort to keep the rock rolling because of that decline."

"But eventually the ground is going to level out, and I'm going to need to work harder to keep the rock moving," I finished.  "The rock is my weight loss and metabolism." I raised a hand. "A thought here: I could ramp up my work prior to the decline leveling out to sustain the ease with which I move the rock once the ground gets level."

It was my physician's turn to press her lips together for a moment before she leaned in. "Yes.  Your theory is sound."  She held up a hand of her own. "You just need to be very careful about how you go about that.  And in the mean time, you need to appreciate where you are right now, and where you've come from."

It was a mark of how much I'd grown to respect her as a medical professional that I didn't immediately dismiss her statement outright.  I sat there for a moment before I smiled a little and murmured, "All his life has he looked away, to the future, to the horizon.  Never his mind on where he was, hmm?  What he was doing."  I'd found that spot behind her head to look at again.

"Luke didn't listen either," I added after a few heartbeats.

----------

"When is it enough?" I asked.  "When have I lost enough weight?"

I found that I was restless as the meeting with my psychologist was winding down.  We'd made mostly small talk up until that point.  He knew something was bothering me, and also knew there was no point in trying to pry it out.  The fact that I'd just asked him a very loaded question hadn't helped either.

In spite of that, he didn't hesitate at all with his answer. "When you decide you have."  He spread his hands a little.  "As much as society and the media have tried to convince the world otherwise, as much as some people continue to think that the Body Mass Index is still a valuable metric, the decision to start or stop your weight loss has always been yours to make, first and foremost."

"Some people don't know how to make that decision," I countered.  I wasn't one of those people, and he knew it.  This kind of back and forth was part of getting past the head and shoulders though, and we both knew it.  

"You started your visits with us because you had a problem.  We've solved that problem, if the evidence of your steady weight loss is any indication.  I don't have an issue with the fact that you've continued to pursue weight loss now that you're capable of it.  I think you've seen some of the benefits that come with weighing a little less.  I think you'll continue to see those benefits if you continue to pursue weight loss, to a point."  Then he settled himself in a fashion that told me the delivery was almost over. 

"Only you can decide when you're done.  Only you can decide when you're at a point where you have no qualms about the quality of your life.  That's your choice to make.  You don't have to do anything if you don't feel the need.  I think you're aware enough of your situation to understand the full consequences of your actions, whichever one you choose to take."

Translation: You're not an idiot and there are consequences that come with being fat.  Decide what's worth it and what isn't.

Yeah, I know. I'm not even trying anymore.

I took a deep breath and considered my personal history.  "The lightest I ever got as an adult was 245," I mused.  "I was 21, working out four days a week, and working manual labor six days on top of that."  I glanced over the desk at my psychologist.  "Is that even remotely realistic at my age?"

He shook his head in response. "You're still focusing on the importance of losing weight versus being capable of living a happy life.  What is and is not realistic is irrelevant unless you're specifically concerned with that."  He eyed me after that, holding the conversation's baby out.

"How concerned are you with that?  How concerned are you with losing weight?"

I didn't have to wait long to answer.  The baby was nice and all, but I'd known it was coming for, ironically, nine months now. "I want to do what I can to remove myself from the realm of serious health risk due primarily to weight and nutrition."

My statement was rewarded with one of my psychologist's warm peals of laughter.  "God, you don't ask for much, do you."

----------

The reminder of the discussion with my psychologist revolved around final healthy target weights.  He knew that numbers were what I was after.  He wanted to be sure that I was thinking about the meaning behind the numbers rather than looking at the process from an entirely analytical standpoint.

My target weight was now 325.  My Hail Mary weight was 300.

Was it possible to get down below 300?  Possibly, but it would most likely involve an incredible amount of work on my part.  We wouldn't know until I got there, of course, but...  

Thus far, I'd been coasting on the massive calorie deficit that I'd been living with.  While I was taking the necessary steps to prolong my NEAT, that wouldn't last unless I augmented my efforts with additional work, additional deficit, or both. Given that it took a great deal of physical exercise to maintain my 'low' weight while I was in the prime of my youth, I was likely staring down the barrel of more hard work. 

My psychologist did give me a silver lining, albeit one made entirely out of lightning.  Pretty, but also potentially destructive.

Modern medicine has absolutely proven that there's a genetic component associated with weight.  How much you weigh, how easily you gain and lose weight, your predisposition to a particular weight, all of it.

This isn't to say that some people can't lose weight or gain weight, but some people can be predisposed towards or against this ability.  It also means that some bodies might just be happier being a little overweight.  Society and medicine tended to demonize that sort of thing by suggesting that being overweight at all was immediately and grossly unhealthy.  This was rapidly being proven untrue.  The key was moderation and common sense.  

If I was going to hang out at 300 pounds for the rest of my life, I needed to take steps to make sure that my body -- and my mind -- were both happy there.  This meant physicals, bloodwork, and continuing to live life in much the same was I was doing at that point.  Try not to be a complete couch potato, eat something green, and prioritize good lean proteins.

My psychologist wasn't telling me it was okay to stop losing weight at 300 pounds.  He was telling me that I could stop losing weight whenever I wanted to as long as I was happy and intelligent about it...and as long as I understood the risks.  There was a general corollary between lower weight and lower risk.

It wasn't a guarantee, but it was the closest thing I was ever going to get.

----------

My psychologist and I were in the process of concluding our visit when I decided to drop a bomb on him.

"Listen, I don't...are you like, a regular psychologist too?"

This wasn't his first rodeo.  He knew where it was going.  "I am," he said calmly.  He made no sudden moves in an effort to avoid scaring off the wild-eyed animal in front of him.

"Can I ... next time.  When I come in next time, can we talk for a bit longer?  All of this..." I waved vaguely in my own directly.  "...has scared some stuff out of the woodwork that I think I should probably talk to someone about."

My psychologist was quiet for a moment before he murmured, "I can certainly talk with you, but you should know that if this is going where I think it is, you may be better suited speaking with one of my associates.  Most of my time is spent speaking specifically with bariatric patients. You may want to speak with someone more frequently than I'll be able to."

I was exerting super-human levels of control to keep my voice level and my feet planted at that point.  "I don't...trust them."  It was an asshole card to play.  It also had the virtue of being true.

My psychologist understood all of that.  He always did, somehow.  Perhaps that's why they gave him the coat.  

He smiled and said, "I'll make the time.  See you in March?"

I exhaled the breath I didn't know I was holding, nodded, and hurried out of the office before I could burst into tears.

Neither of us knew what was waiting for us in March.  

The guy in the mirror didn't know either.