I didn’t think I’d have any issues after losing over *** pounds. I’m not sure if I have more issues now than I did then or if I’m just more aware of the issues now. I was introduced to this site thru a Women of Faith conference. I want help in understanding something. Other women who have lost this much weight and want to tone up without surgery are still struggling with body issues. I don’t want to be told to just accept myself. I want to know if it’s possible to tone up all this stretched out sag on my body and do it without surgery. I make $24,000 a year and don’t have the money or desire to go to an extreme of surgery. I can’t stand my body. It’s unbelievable. I have other issues that I’m not describing here. You’d think I’d feel so desirable but I don’t. I’ve had boyfriends who are perfectionistic, want women with the perfect, toned bodies. I just can’t meet these standards and it’s left me quite depressed. Jessica
Dear Jessica,
From your letter is sounds like you have been both hurt and frustrated. You have had some significant challenges, so it is easy to understand your feelings. I am not a physician or medical professional, but I sent a draft of my response to you and to two primary care physicians who have many years of treating eating disordered individuals. Both of them are females so they have an understanding of the pressures and messages women face in addition to being excellent medical practitioners. They both agreed with the response that follows.
In your letter you seem to be asking for advice on various medical/physiological methods to help you with the excess skin, (“…want to tone up without surgery”). Exercise will not help in any significant way with this problem. Exercise tones muscles, but it does not tone skin. Toning your muscles may help some, and it will be important to incorporate moderate exercise into your lifestyle, but it is highly unlikely it will solve the problems you are talking about.
Individuals who lose as much weight as you did almost always have problems with excess skin. Our skin stretches as we gain weight, but it does not shrink when we lose weight. The problem you describe is common for people who have lost weight through diet and exercise as well as through various surgeries. Being uncomfortable and upset about the excess skin is both normal and understandable. It may feel like you are being punished for doing something healthy. While these feelings are very normal and are easy to understand, they can interfere with our decisions in dealing with various issues in the best way possible. I would like to talk about the emotional component later, but first want to focus on the physiological issues.
You mention that you cannot afford surgery and don’t have the desire to face extreme surgery. Again, I am not a physician or an expert of plastic surgery, but I have a modest amount of knowledge in this area and I have done some research into the problem of excess skin secondary to weight loss. In my research, surgery appears to be the best option, and perhaps the only option, in terms of achieving your desired outcome. My goal is not to talk you into surgery when you don’t want it and cannot afford it. I do believe, however, that you would be wise to schedule a consultation with a physician who schedules this kind of surgery, even if you don’t have surgery. Allow me to explain why.
Plastic surgeons are the experts who have the best understanding of the physiological issues you are describing with your skin. Scheduling a consultation would not involve a large financial fee and would give you the best available information about your condition and options. There may be something affordable that you can do to make some improvements. The surgeon will know. This consultation, therefore, gives you the facts so you can make wise decisions. This may save you time, effort, frustration and money in researching some treatment, exercise program or product (e.g., a cream) that will not work.
Even though you cannot afford the surgery right now, the surgeon can explain the surgery so you have an understanding of what is involved and how extreme it is. It may be worse than you imagine, but it might not be as bad as you imagine. It may cost more than you think or less. The surgeon may also have a sliding fee schedule and/or allow you to make payments you can afford over a period of time (some even do so interest free). At the very least you will get all of you questions – about the physical aspect of this problem – answered.
Some people have a hard time trusting doctors, in a few cases wisely so. However, in my experience working with a lot of doctors, the vast majority genuinely care about their patients. If you worry that the surgeon may try to sell the surgery instead of discussing your condition, seek a referral from you primary care doctor – even the small number of doctors who try to sell patients on expensive treatments don’t want to get a bad reputation with referring physicians.
I would like to shift my focus to an area where I have more of an expertise and that is the psychological issues. Again I have very little information about you so what follows is just an impression based on a few statements that may or may not reflect various issues. Direct face-to-face counseling is the only way to truly understand the emotional issues.
My guess is that you have had a lot of insecurities over the years, perhaps due to family of origin problems and/or other painful events. For people who have truly been overweight, weight loss can have a positive psychological/emotional benefit, including an increase in self-confidence and self-worth. Although diet and exercise equipment commercials and our culture will try to convince you otherwise — underlying and unresolved issues and insecurities are seldom solved by weight loss. Girls and women are taught that weight loss is the panacea to all of their problems. This indirectly relates to another underlying cultural myth that the perfect romance will help me to live “happily ever after.” The weight loss promises merge into the happily ever after myth and ultimately create a plethora of problems for women.
Some women become attracted to the “bad guys,” “the hard to get guys,” or the “the players.” Why? Because the cultural message tells them that their status is connected to the status of the guy they are able to win. Cinderella fell for a prince, not the local blacksmith. Nice guys who are free with loving comments and who don’t play games are too easy. This can be compared to someone who, down deep, believes she is stupid, but is constantly trying to prove she is indeed intelligent. If she takes a test that everyone does well on – it does nothing for her. Her grade doesn’t mean she is smart, it means the test was easy. However, if she does well on a test that most people do poorly on – she reasons – it cannot be that the test is easy – so it must mean that I am smart after all. If she truly believes she is stupid, doing well on this test will only help for a short period of time and then she will need to be tested again.
In the same way, women who have had problems in the past causing them to feel insecure need a test that is demanding – one that not other women can pass – and the nice guy who is not overly focused on the woman’s body is not the right test. She needs the men you describe – men “… who are perfectionistic, want women with the perfect, toned bodies. I just can’t meet these standards. And it’s left me quite depressed.”
My concern is that your reasoning is – “I need one of these types of boyfriends to prove I am okay, but I cannot get one/keep one because I have this problem with excess skin and I cannot get toned. I am depressed because I cannot feel good about myself if I don’t have this type of guy.”
You may not consciously be saying this, but I would encourage you to ponder the possibility that this is happening. You wrote that you didn’t want to simply be told to accept yourself. Accepting ourselves does not mean that there are parts of us (physical parts, psychological parts, spiritual parts) that we don’t like. I accept my wife and two children, but they each have some characteristics that I would like to see them change and I am certain that they would like me to be different if a few areas. But that doesn’t prevent overall acceptance of the individual.
My message is not “accept yourself and don’t worry about the problem with stretched out skin caused by the weight loss.” My message is: although you have a problem that would upset most people, you can still accept yourself AND actively seek help in doing whatever you can to change the skin that is sagging. The dangerous issue is this: even if you find some miracle treatment that makes your skin toned exactly the way you want it and one of the demanding boyfriends came running back to you, it would not ultimately solve the underlying wounds and insecurities.
It is important to ask yourself why “all” of your boyfriends are “perfectionistic and want a woman with a perfectly toned body.” We are created to need soul-mates – not playmates. Although physical attraction is a part of romantic relationships, your boyfriends sound hedonistic and appear to treat women like trophies and objects whose role is to gratify them. Such men will not make a good soul-mate.
Jessica, you sound like you have been hurt emotionally, perhaps deeply. I would encourage you (if you are not already doing so) to seek counseling with the goal of accepting yourself in the same way you’d accept a sister or best friend. You might encourage her to get help (to whatever degree possible) for the sagging skin, especially if it was an emotionally painful issue for her and hindered her relationally. However, you would still accept her as a person and want the best for her in her relationships. Seek out help for the physical condition as much as is possible, but also work on the underlying issues. Realize that a toned body will help somewhat, but it can’t change what’s going on deep down. See “Finding Treatment.”
God bless you,
David Wall, PhD