Every year, more than 200,000 people elect to undergo some type of weight-loss surgery — whether it's the lap-band surgery New Jersey Gov. Chris Christie had or the more drastic gastric-bypass surgery. For the most part, these are people who have tried and failed to lose weight through conventional diet and exercise, and for whom surgery is a reluctant last option.
Rarely discussed is the aftermath of these surgeries — particularly the psychological and social challenges accompanying drastic weight loss. For those who lose a lot quickly, the result is a complete change of identity that can affect an entire life and a marriage.
PBS recently aired All of Me, a documentary by journalist/filmmaker Alexandra Lescaze that follows a group of women in Austin, Texas as they grapple with the consequences of surgical weight loss.
“The Girls” are members of the National Association to Advance Fat Acceptance (NAAFA) and are part of Austin’s Big Beautiful Women community. They are friends bonded by mutual largeness, their identities tied to the idea of being big, beautiful and proud — no matter how much they weigh.
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That all changes when, facing health concerns, a few opt for surgery.
Meet ‘The Girls’
All of Me focuses on three women over 40:
• Judy, 53, whose gastric-bypass surgery is remarkably successful and who eventually trains to become a yoga teacher
• Dawn, 62, whose lap-band surgery has mixed results in every possible way
• Zsalynn, 43, who is saving up for surgery because her insurance won’t cover the procedure
The largest at close to 500 pounds, Zsalynn tried an early form of lap-band surgery and got down to 240 pounds at one point, but couldn’t stand the constant vomiting so had her initial surgery reversed.
All of these women are achingly honest about the reasons they are addicted to food: an abusive childhood, emotional sustenance, overwhelming grief, feelings of worthlessness and depression.
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Through their association with NAAFA, all of them have come to accept, and even like, themselves as fat women, and have found a community of support and friendship in the group.
But when the weight starts to come off, that support fractures.
Judy, who loses more than 200 pounds, stops going to NAAFA meetings altogether. She is energized by the compliments she gets from her co-workers and loves shopping for new clothes — but her husband isn’t exactly on board. She serves the family quinoa salads in order to model healthy eating and he supplements those meals with a trip to Jack in the Box.
Dawn goes to meetings, but gets mixed reactions from the group. Some are supportive; others see her desire to lose weight as a betrayal. Her identity is so entwined with her social circle at NAAFA that she starts losing her sense of self. No matter how much weight Dawn loses, she still sees a fat woman in the mirror.
“Many of these women have been fat so long that don’t know what it would be like to lose that much weight,” Dawn says of her NAAFA friends. Indeed, as a group they have come to see that it’s society that has the problem, not them.
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And Zsalynn, the heaviest of the three, has built such a dedicated online following that she has practically branded herself as an overweight sex goddess. It’s working for her, in a strange way, so she loathes to give it up.
Marriage and Weight Loss
The husbands in the film have the toughest time accepting their wives’ weight loss.
Judy’s husband is supportive at first, but gradually begins to resent the high moral ground his wife has staked out in the area of health, which wasn’t an issue when they were overweight together.
Dawn’s husband, an extremely large man himself, is sexually attracted to large women, which becomes an issue as his wife shrinks and — in his mind — changes the terms of the relationship.
Both men are angry, but their core fear is that they are losing the women they fell in love with.
As time goes by and their lives change in unexpected ways, the women in All of Me gradually discover that weight-loss surgery is by no means an instant panacea for their problems. Life after surgery requires a great deal of hard work, the discipline to change a lifetime of poor eating habits and the wherewithal to negotiate the social and psychological changes — many of them unpleasant — that come with a shrinking body.
As you watch All of Me, it’s hard not to be won over by the charm and candor of these women. Theirs is a battle that takes bravery and courage.
Tad Simons is an award-winning journalist whose writing has appeared in Variety, The Washington Post and Mpls.St. Paul Magazine.