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Sunday, April 03, 2005

Will my body temperature ever regulate?

Body temperature is the result of your body generating and radiating heat. The body is adept at keeping its temperature within a narrow range even though ambient air conditions vary. A normal body temperature is 98.6F. It is common during the period of rapid weight loss for bariatric patients to feel cold or chilled, even when their temperature reads normal.

People who experience the massive weight loss associated with weight loss surgery experience feeling cold for two reasons: loss of insulation and less energy generation.

Fat is a highly efficient insulator. Consider animals native to cold climates: for example sea lions and polar bears. They are loaded with insulation and thrive in cold climates. Because you are following the rules: eating your protein and exercising, the weight you are losing can only come from fat or stored energy. In effect you are losing your insulation. Less insulation increases the likelihood that you will feel cold.

The second reason for feeling chilled is that the metabolic cell processes are not working as hard as when you were heavier; it takes fewer calories and less energy to maintain and move a smaller body. Think about using an electric mixer: if you are whipping egg whites for a meringue the mixer will do this task effortlessly. But use that same mixer to knead bread dough and it will become warm to the touch, it is working harder because it is moving more mass. The same thing happens with your body; the more mass it must move, the harder it works. As a result more heat is generated.

The body has two well-tuned mechanisms for regulating body temperature: sweating and shivering. What overweight person hasn’t been embarrassed by a sticky bout of sweating at the most inappropriate time? Sweating is a mechanism for cooling your body when it becomes too hot inside. The body rids itself of excess heat by expanding the blood vessels in the skin so the heat may be carried to the surface. When this energy or heat in the form of sweat reaches the skin’s surface it evaporates and helps cool the body.

You will become more familiar with the second temperature regulator, shivering, as you lose weight. When you are too cold your blood vessels will contract reducing blood flow to the skin. The body responds by shivering which creates extra muscle activity to help generate more heat. If you allow your body to shiver it will begin to feel warmer. But this is also a good clue that it’s time to put on a sweater or turn up the heat. I think most weight loss patients will happily wear a sweater – a sweater is much easier to shed than that insulation we’ve worked so hard to lose!

Most weight loss patients report that their body temperature regulates after their weight is stabilized, usually eighteen to twenty-four months after surgery. In the meantime celebrate this change with your body because it is a clear measure that you are succeeding at your weight loss! Keep in mind your body is rapidly losing weight and the rest of your body’s functions are caught off guard when this weight loss begins. Your body’s thermostat needs time to catch up to the weight loss, and it will. Patients who incorporate exercise in their weight loss program experience less chilling than patients who do not – one more reason to follow the rules!

For many, the lower body temperature is a welcome relief. After years of embarrassing sweating and hot flashes it feels amazing to cool down! One svelte woman I know who used to be an arctic-ready 320 pounds told me of the summer her cold water pipe broke and she could only take very hot showers. When the building superintendent finally arrived to fix the pipe she told him she was too damn fat to be taking hot showers in the middle of the summer in Philadelphia! Now she laughs at that experience! But overheating is a very real problem for obese people. It is a problem that will resolve itself with weight loss surgery.

People in Southern climates are particularly tickled with the change. I know of one woman who exchanged the fan on her desktop for a space heater at her feet just to keep warm. She lives in Florida!

It seems like I was always cold during the infancy stage of my bariatric life. I’ve always enjoyed dressing up and going to swanky clubs. For years I dreamed about wearing the lovely little skimpy spaghetti strapped dresses that the skinny girls wore. Well, the pounds melted away and I felt fabulous about myself and bought some of those sexy little dresses. Dolled up in my new “never thought I’d wear that” dresses and stepping out in some seriously dangerous high heels I was ready to party. My husband took me to the finest clubs and hottest nightspots. Air-conditioned all of them! How I did freeze! I shivered my way through every outing and had the time of my life – Goosebumps and all!

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