I weighed 245 lbs. on the morning of my Extended Tummy Tuck in January of 2022. Dr. Yamahata cut off 17 lbs. of skin and subcutaneous fat during the procedure and another 2200 mLs of fat via liposuction to my back and flanks. That’s approximately another 5 lbs. off. In one day. My diet changed significantly after my tummy tuck. With repair of the 4 inch gap of my diastasis recti, my abdominal cavity has less room for all the organs, including the stomach. Eating large portions is extremely uncomfortable, which means my binge eating was forced out of commission. I focused on getting 100 gms of protein in each day, a lot of that from protein shakes, just because it was convenient and also hydrated me, even when I didn’t feel like eating much. My body needed extra protein to heal from my surgeries. When you are practicing loving yourself, you realize that it includes nourishment. Walking and activity is so important for post-op recovery, so I also focused on getting at least a 20-30 minute walk in each day, even when my pace was very slow. Some days, that just meant a trip to Costco. With the time off from work for recovery, 4 months in all, that daily activity became a habit that I enjoyed. I probably could have gone back to work at the 10 week mark after my tummy tuck, but that is when I had my breast reduction, so my leave of absence was extended another 8 weeks. I’m lucky to live in California where any surgery is covered under State Disability, they do not ask if it was “cosmetic.”
I managed to maintain the weight loss that Dr. Yamahata gifted me, all this time. You would think with decreased portions, better nutrition, and increased and consistent activity that I would continue to lose. I did not. Even so, the maintenance and body changes afforded me from my surgeries completely changed my body shape and sizing. Body dysmorphia be damned! It took a few months, but I was really starting to feel good in my own skin.
After years of yo-yo dieting and trying every diet medication and program under the sun, I decided I would never starve myself again. I was done putting my body and mind through the highs and lows and right back to the highs all over again. Failure. Judgment. Self-hatred. I had been between 240-265 lbs for several years, since making that decision. I was lucky and did not yet have any other diagnoses that put my health or surgical recovery at greater risk. Not yet anyway. Obesity is a chronic disease, and I will battle it for the rest of my life. Years ago, I was diagnosed with PCOS. And now, at age 49, I believe I am starting to go through perimenopause. This part hasn’t yet been diagnosed by my MD, I am self-diagnosing the menopause part based on symptoms I am having. Difficulty sleeping, increased anxiety, brain fog, occasional hot flashes, etc. I should probably talk to my OB about all of this, but I haven’t yet. I know nothing about hormone replacement therapy…maybe next year I will deal with it. I have enough on my emotional roller coaster plate right now, lol. In any case, PCOS and menopause makes weight loss and maintenance extra hard. That’s science, not excuses.
A few months ago, I started seeing TikToks about a new medication called Mounjaro or tirzepatide. It is currently only FDA approved for Type 2 Diabetes. It is a once a week injectable that studies and clinical trials have found to also aid in weight loss, specifically for obese patients without a diabetes diagnosis. And anecdotally, I have noticed a trend of particular success among patients that also have PCOS. Mounjaro works on two receptors in the brain, where most of the other weekly injectables target just one receptor. It is my understanding that Mounjaro lowers your A1C (thus preventing diabetes in those of us that are prediabetic with an A1C of at least 5.7) and it affects satiety in the brain, so an obese brain can work normally so you stop eating when your body is satiated. A whole new concept for those of us that have been in this battle for most of our lives.
So, I jumped on the bandwagon. I presented the medication request to my primary MD. He had not yet heard of the drug. So he researched it, read the studies and published clinical trials, and decided it was very promising for someone like me and he ordered it. We knew my insurance would not approve it. At the time, Eli Lilly, the manufacturer of Mounjaro, offered a discount coupon for patients whose private insurance denied coverage for it. With the coupon, the cost to me is only $25 per 4 week dosage. This coupon will apply for me until the end of June 2023. After that, I do not yet know what will happen.
Mounjaro is currently being fast tracked through the FDA (much like covid vaccines were) for approval for Obesity and Weight Loss. I am hoping that it will be approved before June of 2023 and that my insurance will see the benefit of covering it for people like me. For the improvement of my quality of life and prevention of diseases related to obesity. It would save the insurance companies a lot of money in the end…fewer hospitalizations, fewer heart surgeries, fewer daily medications for heart disease and high blood pressure, etc. We will all be crossing that bridge together at the end of June 2023.
Obesity is currently defined by having a BMI >30. I’m sure many people don’t even realize that they are technically obese. What I wouldn’t do to live in a body with a BMI of only 31 for all these years! Obesity is a chronic disease that really starts in the Hypothalmus, deep inside the brain, so it won’t be “cured” by this medication. It can only be “treated” by this medication. It is possible I would need to take it for the rest of my life in order to maintain the weight loss and other health benefits. There are so many unknowns right now. Despite all of that, I started taking Mounjaro two months ago.
I started on the 2.5mg dosage and stayed on that for four weeks. After four weeks, I was down 11 lbs. without making any intentional changes to my diet or activity level. I was just living my life and letting the medicine work it’s magic in my brain. Yes, my appetite was curbed and I did occasionally have short-lived, intermittent mild nausea, usually on day 2 after the injection. Never actually barfed. Day 2 is usually accompanied by fatigue, as well. I did experience some mild constipation, and occasionally take Magnesium Citrate or Miralax to help with that. One of the effects of the medication and how it helps to curb your appetite and induce satiety is that it slows down gastric emptying, so the food stays in your stomach and intestines longer, making you feel fuller. I also have had an increase in heartburn, despite taking Pepcid twice a day. So all of this makes sense. The science backs it up. Side effects and all, still worth it.
Then on Week 5, I jumped up to the 5mg dosing. By the end of week 8 I was down a total of 16lbs! I weighed in at 208 lbs. with a BMI of 35.7! I started this whole journey with a BMI of 41! I can wait to have my labs drawn next month to see what my A1C is!
Currently, I’m on Week 9. I was planning to titrate up to the 7.5mg dosage, but that particular dosage is currently on backorder, per the staff at CVS, and they were not able to fill it in time for my next dose. So my doctor and I decided to stay on the 5 mg for now, while Eli Lilly works out the kinks. I’m sure I’m not alone, so I bet next month the 5mg will be on backorder since many of us stayed on it another 4 weeks. We will see how the manufacturer and/or suppliers keep up with demand.
Let me list the ways this 16 lb weight loss, combined with my plastic surgery, has made my life better/easier:
- I can jog and my knees don’t hurt while I’m doing it! The combination of having the tummy tuck and breast reduction with the weight loss allows me to comfortably be more active on a daily basis. I have more energy in general and want to move.
- The weight loss has enhanced my tummy tuck and liposuction results. My apple-shaped belly seems flatter and my waist is a little more defined. I do not have loose skin.
- I have had to size down to size 12 petite in pants/jeans. I may have to size down again soon. I can’t keep up financially with my new clothing needs…will make TikTok videos for free clothes! Please send, lol! Before my surgery, I was wearing anywhere from a size 14W to 20W in pants! I haven’t been a regular size 12 in at least 20 years! My top size has gone from a 3X to a Large or XL. I am no longer Plus Size. That is crazy to me!
- I finally know what it feels like to love the skin your in. It’s actually fun to shop and try on new clothes. I don’t feel the need to hide under a tunic anymore. I walk around naked all the time now that I am also an empty nester. Ask my husband…he doesn’t object.
- I wear bikinis! Flaws and all! Nobody said I was going for perfection! The self-loathing has been replaced by self-love. Not conceit or vanity, just acceptance and knowing that loving myself means so much more than liking what you see in the mirror. *
- When you don’t hate yourself and you stop beating yourself up for the years of failure, it makes room for happiness and light. I’m not so angry at the world. I hope that translates to how others perceive me at work and in my personal life. Maybe more people will see the funny, kind and loving Annie instead of fat, angry Annie. Even though angry Annie was just a defense for years of other people’s judgment of me and their perception of why I was fat. I still can’t tolerate stupidity, though. So if you still think I’m a bitch, you might need to take a look at yourself, just sayin’
- Renewed love life with my husband. It may not be as often as it was in our 20’s-30’s, but going into our 50’s is going to be a whole lot more fun, lol.
So you see, this whole journey to loving myself is worth every struggle. Worth every extra pandemic shift I worked to pay for my tummy tuck. It was worth all the pain of physical recovery, all of the time off of work, all of the selfishness of the last 10 months, and all of the $$ spent on new clothes.
It’s a wonderful life, friends.
I have said this before, but the shortest distance between two points is a straight line. I strongly believe that whatever it takes to get you to a place of loving yourself, you should do that. Even if the world thinks you are doing it wrong.