BF Basics: The Weight Loss Numbers Game

Obligatory Disclaimer: The views expressed in this BF Basics post are OPINIONS of Bariatric Foodie blogger, Nikki Massie. This post should NOT be taken in place of medical advice. If you have concerns about your weight, weight loss or understanding any of the numbers outlined in this BF Basics series please consult your bariatric surgeon's office or primary care physician. Ok...now carry on!

Your weight on the scale. The body mass index. Percentage excess weight lost.

What the HELL do all these numbers mean?

Never fear, BF is here! I’m going to break down each of these numbers, how they can be tools in your weight loss journey and why none of them should be the sole narrator of your success story.

Ready? Let’s go!

Your Weight on the Scale

What is it? It seems very obvious to most of us that the weight on the scale is how much we weigh, right? But for us there’s just a liiiiiittle bit more going on there. You see, when we get on the scale, somehow we (erroneously) think that we should compare ourselves to a person who has never been obese before. So when we see a higher number, we go through a chain of thinking that can go like this:

“Yowza! I weigh a lot!”  > “In fact, I weigh too much!” > “I must not be a success after all! I need to lose more weight!” > (Insert whatever you do when you freak out)

Yeah. That’s stinkin’ thinking. Stop that.

In reality there are several key ways we are different, namely:

• Your bones, from carrying around an obese OR morbidly obese person for so long, may be denser than a person who has never been overweight or obese. In short, you might actually be “big boned.”
• Unless you are made completely of rubber, massive weight loss probably resulted in some excess skin. This skin weighs something and it’s going to show up on the scale.
• If you are working out, there are a bunch of biological processes that can cause scale wonkiness. After workouts your body can retain fluids. It also saves fluids to metabolize the carbohydrates that your body needed to survive the workout. And of course there’s the matter of muscle. While it is NOT true that muscle weighs more than fat (a pound is a  pound is a pound), it IS true that muscle is more compact than fat, meaning in a given space you can fit more muscle than fat. So if you have a high muscle mass you may stay on the top of the weight curve. 

All this is to say that the number on the scale, while helpful, only presents a partial picture. Here’s what I think the scale is good for (take this with a grain of salt!):

• Differentials: "I used to weigh this and now I weigh this." This can go in both directions. Most post-ops have a "buffer zone" of how much the scale can go UP before they freak out. 
• Trends: If you pay attention you probably have a weight loss trend. Maybe you lose only a few pounds in the first week of the month, stall for two weeks and then lose a big amount that fourth week. Or maybe (ladies) there are certain times of the month when you tend to "regain" a few pounds of water. The scale can show you these trends and put your mind at ease. It is my belief that knowing these trends would SIGNIFICANTLY cut down on stall freak-out posts on the internet. Just sayin'.

The Body Mass Index

So if you want to read all about the history, in's and out's of the body mass index, you can click here. 

The simplified version is this. It's a calculation that is based on your weight divided by your height (there's a bit more to it but let's not muddle things). Based on that information you are given one of a few categories for your weight:

• Underweight (>17.5)
• Normal (17.5 - 24.9)
• Overweight (25 - 39.9)
• Obese (30 - 40)
• Morbidly Obese (40+)

So, you hear a lot that the BMI is flawed. But why? Here's my opinion.

• The same way the scale can't factor in skin and heavy bones, the BMI also cannot
• The BMI also doesn't account for muscle mass. If you are 5'5 and weigh 200 lbs. and are ripped, the BMI still assigns you a score of 33, which is still going to be considered obese. Which to said ripped person would probably seem laughable.
• On a personal level, I think when your fitness and body size say healthy and your BMI says obese it messes with your head.

Given this information, what exactly is the BMI good for?

• Showing you that you, as a 6'2 person are not meant to weigh the same thing as the 5'5 person over there. You are different and the BMI highlights that.
• This system works better (not perfectly, but better) in my opinion in measuring the severity of obesity and morbid obesity. The higher the number, the more disproportionate your weight is to your height and we know for a fact that's not healthy. 

Excess Body Weight Lost

Of all these numbers, I think this one has the most potential to show us our true progress. This is a number many surgeons use to determine if your weight loss is on track. Essentially this number is how much of the overall weight you needed to lose, that you've lost (I re-wrote that sentence three times and that's about as clear as I can get it!). So if you had 100 lbs. to lose and you lost 50, you've lost 50% of your excess body weight. Got it?

If you've never figured this number out, it's pretty simple, although it involves a few steps. Here's how you do it. 

• Subtract your starting weight from your goal weight (whatever that is, wherever it came from)
• The resulting number is your excess body weight that you need to lose.
• Now, go to this website. It's a percentage calculator. Go to the second row. In the first box, plug in how much weight you have lost so far. In the second box, plug in your total excess body weight. Then click "calculate." 
• The result will by your excess body weight lost. Trust me, you're going to have a moment. Have a box of Kleenex ready. (Psst..after you are done calculating, leave YOUR percentage in the comments so we can do the happy dance together!)

Many weight loss surgery patients lose 100% of their excess body weight but studies show us that 50 - 70% is more common, with around 50-60% in long-term maintenance. But still. This number is a good one because it only compares you to you! Where you came from. Where you are now. Nothing else. 

So these numbers can work together to help you along your journey. Here's how:

• The number on the scale can show you trends and warn you when something isn't going right (excessively slow weight loss, regain, etc.). In those instances, you need to call your surgeon's office. There is nothing I or any other post-op can really do that will effectively help. 
• The Body Mass Index can help you put your weight in perspective. Even though I am against comparing yourself to others, if you must, ALWAYS ask a person how tall they are. That factors into what they should weigh vs. what you should weigh. It keeps your head on straight. Because we do wonky things when our heads are not on straight.
• The Excess Body Weight Lost is a good indicator of how far you've come from your highest weight. It's also the number that's going to make you feel best about yourself. And if experience is any indicator, we tend to win when we feel we are winning. So pay attention to the winning number!

I hope this brief tutorial has given you all some insight. The numbers can drive you crazy (if you let them). But they can also be tools that propel you to phenomenal success!