It's been 10 weeks since my gastric bypass and my body has been on a rollercoaster ride of changes. It's almost as bad as pregnancy! Nausea, finicky food picking, mood swings, humongous body changes, we bariatric surgical patients enjoy them all. It's hard to believe it's all come about from having a smaller stomach. And stomach size really can't explain it all because a gastric bypass also results in enormous hormonal changes... just like in pregnancy.


Last week my doctor gave me permission to discontinue all my diabetic meds, and my blood tests show that I'm now in the healthy range in every sense. But one change that has surprised me more than the others is in my face. I've lost 45 pounds, but it doesn't feel as though my face is getting thinner. Instead, I feel that it's simply returning to normal, which is weird since I haven't been thin since I was a late-stage teenager. So I've had a fat face for the vast majority of my life, and continuously for the last 20+ years... shouldn't that face, the one I've begun shedding over the last couple of months, be my most memorable mug? It should, but it's not. Instead, I have the feeling of finally arriving home. As if the fat version was just a facade and the mask is finally falling away.

I'm not alone. Susana, who also has lost weight recently due to drug treatment for hypothyroidism, feels the same way. She doesn't viscerally feel thinner in the face--she instead feels that she's reappropriated her real visage. She recognizes herself better in the mirror now than she has for years.

From a neuroscience of body image perspective, this seems opposite to a common problem with rapid weight loss. Patients sometime gain back the weight, partly because their body image does not update to match their new actual body quickly enough. Sandra and Matthew Blakeslee explain this effect in detail in their excellent book "The Body Has a Mind of its Own". This known problem suggests a potential solution, in the form of special exercises to retrain weight loss patients’ brains to "own" the new thinner version of their bodies, lest the brains sabotage all of their efforts and seek to rapidly regain the weight, to get their bodies back to "normal".

I'm not sure what my experience with “facial restoration” means about the brain, or even its significance to how we process our own body's self-image. As I do have the simultaneous experience of being a fat man in a thin(ner) man’s body, the co-existence of these two feelings (normal face and thin body with roughly equivalent weight loss in both)could suggest that the self-image of the face and body are handled by different brain circuits, or else the effect of weight loss on self-image would go in the same direction for face and body.