Reflect & Refute

A week ago, the plastic surgeon that did my abdominoplasty consult said a few things that rubbed me the wrong way.  Some of those things were just hard truths ("It's going to be harder to lose weight at 37 than it was at 30."  UGH!!), some were things based on his experience and not just me ("I find it's better to do the surgery after the weight loss because people are more inclined to keep the weight off when they are pleased with what they see in the mirror."), and two things in particular just annoyed me and I want to address.

Does this mean that I don't like the doctor?  Hardly.  I like him and his staff but these are things near and dear to my heart and register as pet peeves. 

1.  Fat People Must Have Shitty Self Esteems

I have my moments of looking at myself and being frustrated with what I see in the mirror.  Not because what I see looks bad, but because I know that's not me 100% of the time from every angle. I close my eyes and envision some sexy minx in an ornate floor length mirror who then slinks her way across the room draped in a Catherine D'Lish gown. I envision stepping over the torn letters of desperate suitors that have been rejected from consideration. At the door is a delivery man with champagne, roses, and a kitten with a very large bow.

The only time I realize the error of my fantasy is when someone tries to shake me out of it by pointing out that I'm not that person.  If no one points it out, then I'm happily oblivious that I might not be every man's fantasy, that women want to be me and be my bff, and that I can speak to all the tiny creatures of the world.

Okay, all kidding aside -- I know what he meant.  Most people don't seek out plastic surgery because they're in love with their body as is.  BUT I'd like to think the only reason why I fight so hard for my health and my body (all 5 orthopedic surgeries, all my "day one" start overs), is because I'm delusionally in love with my body as it is now and as I know it can be.  The only way I know how to do this is through love.  I can't heal my injuries, I can't lose the weight, I can't even consider surgery from a place of shame or hatred.  It's just not me. 

When I see the bits and pieces that I don't like, I am reminded of how I got them.  It's like after each trauma, someone gave me the physical weight as a way to display to the world my actual emotional weight.  I don't carry the emotional baggage anymore (just a few postcards), and I'd rather not carry the physical weight either. 

But please trust that I'm pleased with what I see in the mirror. 
Maybe a little too much.

2.  "People Usually Lose Weight After a Celiac Diagnosis"

(Disclaimer:  I'm not a doctor or scientist, just a nerd)

Let's cover some basics first: 
Gluten Intolerance/Sensitivity: inflammatory reaction
Celiac Disease:  auto-immune reaction
Wheat Allergy:  not the same as Celiac Disease, and can sometimes present as an anaphylactic reaction.
Gluten Free Diet:  dietary choice OR dietary necessity
Gluten Free Item:  reliance on manufacturer labeling and testing; no international standard (but many place it at under 20 parts per million)
Celiac Safe Item:  ideally 0 parts per million (and for many this means cross-contamination is still an issue)

There are two types of people with Celiac Disease:  people that have had the disease since birth (and presented as "failure to thrive" -- abdominal distention, bloating, not growing or gaining weight) and people who have been diagnosed later in life (on average it takes 6-10 years to get a diagnosis, but I hope with awareness that it's getting better -- diarrhea, abdominal pain, vitamin malabsorption, skin issues, etc.). 

When you are diagnosed with Celiac Disease, you CANNOT eat any glutenin or gliadin.  No amount of wheat/barley/rye is safe.  And for some people who are cross-reactive, no dairy or oats either (the proteins are similar, body makes an identification error and floods body with antibodies). There are no "cheat meals," for someone that has Celiac Disease

Once upon a time, there were no gluten free or Celiac safe analogs for things like bread, pasta, cookies, pizza dough, etc.  So you just had to avoid eating those things.  By nature of excluding whole food groups, people would lose weight.  And it wasn't always cause they wanted to -- remember, they've been sick for a long time and just want to eat and not feel gross.  And believe me, you cannot easily eat that many fruit and vegetables to replace the calories delicious fluffy croissants could give you.

But now.... there are analogs.  And quite often they are not nearly as delicious as what they're trying to mimic. Quite often, the solution is to add fat and sugar to gluten free items to make them taste better. Instead of wheat pasta, you're now eating corn/rice pasta.  You're not bypassing all of those calories in your diet. 

And because you're not sick (though it can take a long time for some people to get past the symptoms, and years for your body to repair the physical damage), newly diagnosed people with Celiac Disease are often really excited (but cautious) to eat, now that they know not everything will end up with them white-knuckling their knees while they use the loo.

So that's why people with Celiac Disease do not automatically lose weight after their diagnosis.  Because they know what they can eat without getting sick AND there are options!  At some point the euphoria wears off, and you stop wanting to try all the new analogs, and your weight may or may not be an issue.

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