Bariatric patients for sizing surveys?

Existing sizing surveys only take “snapshots” of any given subject, the data of which is compared to other “snapshots” of other subjects -entirely different people. I’ve always felt a better study would be longitudinal, in other words, better grade rules can be derived by studying the differences of one given subject (pools of them) as compared to an earlier measure. In this way, as one person grows or shrinks in size, a more accurate measure of what constitutes an accurate grade rule is derived. However, this has been an impractical approach for many reasons the least of which would be funding for a multi-year study. Still, I don’t think there is a better way to derive accurate grade rules as applied to children’s clothing. I believe accuracy in children’s sizing can only be determined through longitudinal study of children’s growth.

Several years ago I was so frustrated by the lack of accurate grade rules that I deliberately gained over 50 pounds. Upon reaching my target weight, I had my body molded (I have since lost the weight). With the form of the fat-me, I was able to determine the accuracy of grade rules used to grow and shrink sizes irrespective of height. I won’t quibble that some people may believe I’m obsessed about sizing to have done so but that doesn’t mean that my approach is largely untenable for the purposes of measuring large groups of people. Rather, there is a growing population of people from whom we can derive these measures easily. I am speaking of people who have undergone bariatric surgery for weight loss. I believe that we have an unparalleled opportunity to derive more meaningful measures by studying the before, interim and after measurements of surgical patients through out the duration of their weight loss. I’ve often thought of approaching surgeons who perform these surgeries with an interest in recruiting sizing study participants. If I had the means (infrastructure) to manage such a study of bariatric patients, I’d apply for funding and grants. I can only hope that those with the means of managing such a potential study will take my suggestion seriously enough to pursue it.

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  1. sandra says:

    This is an interesting idea, but I don’t agree that bariatric patients would be the ideal group. Surely the fact that the subjects start off overweight and then lose weight would be problematic in that the smaller body wouldn’t necessarily resemble the body of someone who has never carried extra weight with all the metabolic adjustments that entailed. Also, most people don’t gain or lose enormous amounts of weight over a short enough space of time to exclude other factors such as the body shape changes caused by childbearing or menopause. I think that size ranges need to be quite small in order to realistically cover the changes in size an average woman would experience. I have kept a record of my measurements since age 18 or so, and I noticed that until I was about 25, I put on 1/2 stone per year, and then stayed stable. I gained weight after my pregnancies (none during, how weird is that!) but lost it when I weaned my youngest through calorie control. I lost interest in dieting after 3 months, and have stayed stable since then at what my prepregnancy weight was, although my waist has increased by 2″. Maybe I’m typical, maybe not, but my size since age 18 has varied only over 3 sizes. I’m now 38.

    I do agree that a long term study of the size changes in specific women would be far more valuable than the current system.
    Also, I remember hearing of a study done on children’s growth patterns, where the measurements were done by the same person at the same time of day, in the same manner, over a long period of time. They found that children often don’t grow at all for a long time, then increase in height a considerable amount in several weeks.
    The research was reported by Karl Kruszelnicki from the University of Sydney, on an audio cassette which didn’t cite the source.

  2. Susan says:

    This is so interesting! I would be interested in any consistencies you may have determine with the weight loss of bariatic patients.

    I myself went through the surgery over a year ago. I have lost 167 pounds. I was 367.

    My big problem now as I am working at losing an additional 50 pounds is finding clothes that fit. I have as of now clothes that range from a size 10 to 20.

  3. Carol says:

    Despite the changes (women’s) in growing, aging, and particularly childbirth, the skeletal structure remains largely consistant, hence Kathleen’s proposal has much to recommend it.

    The most critical fitting area – most easily noticed, and hardest to address with mass-production – is the neck/shoulder width and slope. In bariatric patients, this would remain more or less constant. The second hardest area is proportionally the shoulder width to the bust width. In bariatric women, the shoulder width would remain close to constant, while the upper arm and bust would change dramatically.

    You have to start somewhere. With this target group would be an excellent place.

  4. Marie-Christine says:

    I don’t think that’s such a great idea, Kathleen. People who lose weight after surgery rarely exercise while doing it :-). My close observations of a couple people who’ve gone through this shows that their post-op figure is very different from their previous one, with sagging being much more prominent than slimming. You won’t get accurate measurements of the reverse process, and will get the impression that everyone is subjected to a sort of reverse entropic lifting as they get fatter..

  5. Nancy says:

    Your topic here is from a couple of years ago…but I stumbled across it… This is of great interest to me as I had WLS (Weight Loss Surgery — for me it was the gold-standard Roux’n’Y procedure) four years ago. My measurements now do not approximate what I was when I was this weight when I was in that great middle ‘normal’ part of the bellcurve… I now have some pretty unsightly pockets of fatty tissue & too much skin in many many places. Take breasts for example… like a former 5 pound sack, but only 3 pounds of filling! I would love a boob-job and a tummy tuck and something needs done about the saddle bag butt/outer thighs, flabby bat wing arms… I could go on and on… If I keep my clothes on I look pretty good!

    While I am most pleased with the success I have had — a blessing, and bless my surgeon & his program…, in no way have I returned to my former shape. I lost close to 120 lbs. I don’t think your measurements would workout the way you might envision. Marie-Christine made me laugh big time with the reverse entropic lifting… Thanks for the giggle.

  6. Brenda P says:

    when you speak of bariatric patterns, what type of patterns do you mean? I lost just over 250 lbs many years ago and with some ups and downs, have managed to keep the weight at around 300 lb which is still a lot but also a shadow of my former self. No surgeries to remove the apron or address the arms and other areas but that may be coming. As for searching for a pool of patients, check out university hospitals, Bariatric units. There are support groups that I am certain would be willing to participate.

    In the area of RTW, my biggest pet peeves are in the neck and arm area. It seems that the arms are usually proportionally correct – for a normal person but plus-size people have larger arms to begin with and RTW is not forgiving. If more was added at the beginning it would fit a larger number of people. You can take it in but you can’t let it out!

    There doesn’t seem to be enough adjustments in the area of the upper back and back arm area. You will see many plus-sizes wearing their blouses buttoned at the neck. They aren’t being modest. They’re trying to anchor that blouse to keep it from slipping to the back. In sewing my own clothing, that is one of the hardest adjustments to make. Usually takes at least 3 tries to get it right or at least acceptable.

    I’m switching to jumpers simply because you can fit a knit into an acceptable top but fitting a dress is a lot of work. My jumpers will be using some of the older jumper patterns to design those extra large armholes!

    Short-sleeve tops simply don’t cut it. I’ve started searching out knit tops with 3/4 sleeves that will stay anchored down on the arm. Besides few people have upper arms that look nice. My arms are so large they were used in a pattern study. Yippee. If I’d been in New Orleans during Katrina landfall I probably would have been able to fly better than the flying nun and I wouldn’t have had to hold on to my hat. She would have beat me in landing. I would have landed with a very painful WHOOMMP.

    I have one RTW dress taken apart right now. I purchased it in a 6X and need to take in the neckline a few inches so I removed the binding and will gather it as best I can. The arms are tight but barely acceptable. When I find a piece of denim the same weight and close to the color i will add in about 3 inches in the arm, tapering it into the bodice. Getting older means that the extra width that was once mid-arm is now drooping around the elbows.

    Pants: I use the extra wide (2.5 in) ribbed elastic in the waistbands. That narrow elastic is hilarious. Like tying a piece of thread around Momma Michelin. Much more comfortable and since the blouse, shirt, top etc is hanging over the waistband, who’s going to notice. To eliminate bulk, I face the inner side of the waistband with a cotton or other thin material. Since the waist on a large person is more curved by cutting the inner band fabric on the bias it will fit easily around the curves. I use serger stitching on the bottom edge and stitch it all flat.

    Also, I started putting gussests in the crotch seam. MUCH MORE COMFORTABLE. If you have thunder thighs, no ones going to notice and if they do, they’re much to close. They are also used in better mens work jeans and in active wear (for the skinnies). The same company putting in the gussets in their work jeans also puts narrow gussets in their shirts (including t-shirts). I’m going to try that.

    Most tops, especially knits are TOO SHORT in plus-sizes. I love the tunic styles – some shirts are actually long enough for my liking. You can’t cammoflage a battleship but you don’t want to call attention to the ballast tanks either!

    Biggest RTW joke on fat ladies: hi-cut undies and the search for full-cut!

    Blessings, blessings and more blessings to Connie Crawford. I purchased her patterns when she was just starting to manufacture patterns for the super plus sized ladies. I still need to tweak her patterns but they have saved me hours and hours of pattern drafting time.


  7. Miri says:

    Wow, my weight has been up & down over the years – I’d be a perfect case study. (230 -> 160 -> 230ish again). Hopefully will be smaller again someday, but who knows when. I know measurements would be best, but I wonder if anything could be gleaned from pictures people (like myself, and others with similar stories) might have of themselves at various sizes? (Might give something of an idea of how/where people’s proportions change?)

    I’m very impressed you did the gain (and then lose again) 50 pounds thing for the purpose of your study. Reminds me of the doctor who figured out bacteria caused ulcers, finally he had to infect himself (and get ulcers) because no-one would believe him. (I think you may have mentioned him in the posts about the “Cognitive-Dissonance of Experts” – I can’t remember if you included the bit about him infecting himself or not, but I know I’ve certainly heard before that’s what he did!)

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