40F, 5’8” SW: 478 CW: 171 GW: whatever I want it to be
Hey! You may or may not have seen me posting around this sub and other related subreddits about my weight loss, but I’ve yet to do global post about all of it. When I first started lurking on the loseit subreddit, I found a lot of great info, but not the exact type of post I was looking for (mostly about body composition stuff and loose skin, but some other topics as well), so I promised myself if I got to a good bench mark (basically when I decided to start eating at calorie surplus for bulking instead of a deficit) I would do a big post that hopefully would be helpful to someone else in my position. So here we go. This is probably going to be long, so I’m going to just do my best to bullet point the big topics; please feel free to ask me questions about any of them.
The basic info/pictures:
Here’s me in Christmas of 2020: https://imgur.com/PgeFcOt
Here’ s me this morning: https://imgur.com/8b97AUc
I started losing weight seriously in May of 2021. I can’t really give you much insight into why, other than this: I spent all of my life obese. Before losing this weight I cannot remember a time I wasn’t extremely overweight. I did not care about it or value being healthy, thin, or living long. It just wasn’t a priority to me. Then one day I woke up and the realization hit me that the co-workers and acquaintances I had now would likely spend the next decade or so watching me slowly kill myself grotesquely and would probably view me with nothing but pity. I found that intolerable and resolved to either fix it or stop wasting everyone’s time about the direction I was heading in. I kept those two alternatives in mind and just hit the ground running. Three years later I was around 166 and sub 10 percent body fat. Thats the basic gist. More detail follows.
CICO and sematglutide
Because I wanted this time to be a serious attempt, I actually went to a weight loss doctor. By the time I got in around August of 2021, I was at 440. I was put on Wegovy (the weight loss formulation for semaglutide). I don’t want to belabor this stuff too much, but here is the bottom line for me: These drugs are excellent tools for people that are morbidly obese. Most of them (me included) have something wrong with their hunger/appetite regulation systems that keeps them from feeling full on the correct amount of food and makes food cravings/intrusive thoughts about food incessant and hard to control. Semaglutide, when working properly, absolutely can fix these things for the many people who have these pathologies and give them extra support they need to be able to successfully lose weight through diet and exercise. My overall view after being on them for three years is that its a medication that treats a condition like any other.
What it isn’t is a magic bullet that is the be all and end all of weight loss. For one, it didn’t fully work like it should for me. Yes, it made me less physically hungry on less food, but I still did (and still do) obsessively think about food and my next meal and how nice it would be to eat a whole pizza in one sitting. I could and sometimes did still do that when I did not maintain control. What semaglutide did for me is act as a bridge to develop healthier habits to control these problems. That is, when it worked properly. Towards the end it kind of stopped working altogether and caused me pretty severe anhedonia (which resolved itself when I titrated down). Again, its a medication like any other with its plusses and minuses. People shouldn’t be judged for using it any more than taking drugs for any other medical condition, and its not an instant fix. I can elaborate more, though I don’t know the exact subreddit rules on this.
Otherwise, I just did CICO for the first 200 or so pounds of weight loss. I exercised very little, and just ate at a pretty decent deficit (while being medically supervised and tested). I mostly ate protein shakes, vegetables, chicken breasts, and a lot of low calorie easy to make instant meals. Other than just staying the course, it was relatively easy, though again, I did occasionally fall of the wagon and eat that whole pizza (or two or three weeks of whole pizzas). When this happened, I just reminded myself of why I was doing it, and got back on the horse. For me, avoidance and abstinence were big musts. I will just graze on food if its around (I still do) so I just have to keep myself away from it. I am starting to train myself to behave otherwise, but during most of my weight loss I just did not put myself in situations where I would be massively tempted, and if I was in one of those, I just completely abstained from stuff rather than trying to have a little cheat here and there. I know myself and know that it would not work for me, but I also know everyone is different.
Exercise, strength training, and learning BMI is a lie
When I got to about 230/240ish in summer of 2023, I decided it was time to start seriously adding exercise to my plan. I researched everything I could about cardio and strength training (the r/fitness wiki is an amazing resource). Then, I started doing high intensity cardio for 30 min every day, and an hour of weight lifting every other day. I lost no weight for 4 weeks, despite still being at a pretty severe calorie deficit. Then I lost like 20+ pounds over the course of two weeks, and started losing weight like normal afterwards. I upped my calories slightly and continued on. Speaking of which, I also got insanely into nutrition and managing protein intake. I’m literally very boring about these topics.
Eventually, around Christmas, I decided I needed to find out what my actual body composition was to decide how close I was to my goal weight. I wanted to get skin removal surgery because I obviously had a lot of loose skin (more on that in a sec), so I needed to know if I was actually mostly just loose skin or if there was still a decent amount of fat on me. Here’s me at around 188 for my first DEXA scan (NSFWish, as will the rest of pictures be):
https://imgur.com/cUCN3CA
The DEXA scan came back at 17 percent body fat, lol. That’s uhhh pretty low for a woman. However, 188 is actually overweight by BMI for my height (its actually decently close to obese, in fact). Basically, this is when I learned BMI is basically useless for me as I’m some sort of big-boned freak. I can speak more on this as I spent a lot of time obsessing over it, so feel free to ask questions.
Skin Removal Surgery
So basically the ultimate goal was to fix all that loose skin. I went to a plastic surgeon in my area who specialized in it, and learned that I could get at least my arms, thighs, and stomach covered by insurance because of conditions I had. I can again elaborate more on this process, but basically the basic stomach surgery is often covered by insurance, but for the others you generally need some pathology that goes along with it to get it covered. I also wanted to get my breasts done but those are basically never covered, so I may pay for that out of pocket later down the line. (I may get some others, but again, more on that in a sec). Here’s pictures of me right before the surgery that kind of highlight how bad my skin was:
https://imgur.com/Bxg5osR
https://imgur.com/iF8PP6n
This is at 166 and 8 percent body fat. I went this low simply because I wanted as much skin removed as possible, and the more of me that was loose skin and not fat, meant more could be removed. I knew I could always add more latter, but to remove more skin requires more surgery.
Some other important facts about the surgery and loose skin:
- Once your skin reaches a certain point of elasticity from being obese, the elasticity essential “breaks” like a rubber band and will never return to its normal level. This is true even after getting the excess skin removed. What this means if that I gain like 20-30 pounds or more, I will have loose skin again, and simply losing the weight slowly or in ways that would be fine for normal people will still cause me to have loose skin. Sucks, but thats life.
- The surgery for all three areas took around eight hours. Afterwards I was not in any particularly great pain and was able to make myself food and get around pretty easily that night. I was, however, rushed out the door at night because they started late, and was pretty groggy from still being on anesthesia. I did have pain if I hit my stitches the wrong way.
- I did have one major complication. They told me I needed to get compression garments that covered my arms, midsection, and legs, and that there was affordable stuff on Amazon. So I used my best judgment and got some stuff I thought met those requirements. Turns out the leg stuff did not go down far enough. They aren’t sure if the lack of compression there caused this to be fair, because apparently I just also had abnormally swollen legs regardless. But, eventually I had massive seromas in my thighs and had to have the leg surgery redone, which pushed out my recovery another six weeks, into when I was moving into a new house! I couldn’t help with my move and it was a massive shit show. Basically, just make sure you get the compression garments right, and if you feel like they aren’t, slap on some ace bandages to further compress yourself until you can talk to your doctor. It was super annoying!
- They only removed about six pounds of skin from me overall. I think this is because there was so little fat to remove in the problem areas.
I’m sure there is more stuff I should add. Please ask questions, this is the main thing I personally wanted information on when I was looking around the subreddit.
Final results:
Here’s some pictures of me now, where you can see some of the scars:
https://imgur.com/CV7uYzV
They are getting better every day, with obviously the leg ones being the roughest. (Also the reason there is no sweet puppy in this is that HE FUCKING GOT RAPID ONSET LYMPHOMA DURING MY SURGERY RECOVERY AND DIED. AND MY OTHER DOG DIED TWO WEEKS AGO - there was more terrible stuff that happened during that period.. This was the worst, but it was just a terrible period for me). I got a DEXA scan this morning and it came in at 7 percent body fat at 171 pounds. Now I’m going to start eating 2000 cals a day and see if thats enough for me to put in serious muscle mass. (I have been back to doing my full spectrum workout for about a month now). Eventually before the end of the year, I may see about fixing the rest of my legs (they could only go down so low and the areas around my knees and calves are still pretty rough - they also told me this would have been the case regardless of the complications) and some of the loose skin on my back and ass. I need to see if it will be covered by insurance. But generally I’m pretty happy with the results (if not the process). Yes, its not perfect, but its certainly better than I was.
My life is not perfect (especially not these last two months, jesus). I am not perfectly happy. Certain things are actually worse mental health wise than they were before. But in general, I am in soooo much of a better place than I was before I started this. I just want you all to know that you can do it to, and you can do it at any time. I am more than happy to answer any questions anyone might have, and I will continue to monitor this thread for that. But I think I am done generally lurking on weight loss sub reddits, at least maybe for while. Its time to move on. Thank you all so much for this resource, and I wish you the best of luck!
