Also: being smaller and dedicated to regular exercise (like it or not) cuts into your slothful creative time. If you're a writer or any kind of artist engaged in projects that require extended periods of quiet contemplation, you may find your ability to summon and prolong this important mental state is impaired. My concentration is nothing like it used to be, which sucks arse.
I have days when I think myself three sizes larger than I am and that can be unsettling, to say the least. I don't know which clothes I'm going to fit into or what I should wear now; that's exacerbated by the whole hitting-forty thing and having to let some looks go, but still... the dysmorphia is a constant battle. My recommendation: skip the scales and just measure the shit out of yourself right from the start to combat the mad mental business that can keep you from recognising and being rewarded by your own progression.
Hair Loss: Ever wonder why fat chicks go for a pixie cut once they start dropping sizes? Your fucking hair starts falling out, yo. No one tells you it will probably happen as a result of caloric restriction and stress which sends a good portion of your follicles into 'drop and sleep' mode, but it's incredibly common. Mine started shedding like a fucking Labrador around 3 months into a 1000 calorie/day regime and I probably lost about 15% in total. After clogging the shower drain for 6 months, my hair has more or less recovered but I had to cut it short.
Benign Positional Vertigo: I started getting briefly dizzy from lying down, sitting up and turning/angling my head too quickly. I narrowed it down to BPV, which is a condition caused by shifting of crystals in the inner ear, affecting balance. Anecdotal evidence suggests it's moderately common amongst people who lose a lot of weight, I suspect because of altered fat deposits in your face, skull and neck etc, so it makes sense that minute, stasis-dependant stuff gets slightly out of whack. It resolved after a few months.
I managed to dodge the all-over droopy-dog excess skin thing, but only through a combination of stupid luck, slow-paced reduction, good nutrition and replacement muscle mass through the boring toil of protracted physical exertion. Others are not so fortunate.
Teeth: I suspect caloric restriction was instrumental in one of my rear molars cracking. You need to watch that shit, especially if you've got smoking/drinking/addiction issues or low bone density/incipient osteoporosis etc.
Arms: Fat arms and big boobs tend to go together and thusly I was blessed with both. Oddly, my upper arms have been the most stubborn holdouts as far as reduction is concerned although I tend to minimise this mentally; thanks, dysmorphia. Went through a phase of rather unsightly underarm looseness (bingo flaps) that seems to be slowly resolving despite my being no spring chicken. It's taking a year longer than everything else, though. Caveat: I did jack shit as far as dedicated upper body work goes. There's also the small matter of hand-shrink; none of my rings fit very well any more and I have to swap them to my largest digits.
Gut: Changing your diet, especially if you're heading away from regular ingestion of processed carbs, alters the composition of your gut flora and therefore tampers with your entire fucking biology in ways we are only beginning to understand. The transition can be unpleasant with bloating, discomfort, hunger pangs, headaches, low energy, poor absorption, shitty sleep and poopy disruption- you name it. You may need to white-knuckle a month of internal discomfort while your commensal situation adapts to your new inputs.
Whenever you smoke a bowl and inevitably backslide into a weekend of greasy gourmandising your puritanical innards will cane you with headaches, lethargy, effervescent bowel treachery and stinky carb sweats. There is no best of both worlds.
Belly: I still have a small one and this seems to be another area that resists all but the most draconian measures. But the fat pad is exterior rather than organ-adjacent so I don't really care, especially since accepting that it'll probably take another full year of punishing restriction to shift it, which will fuck up my proportions elsewhere. Not sacrificing my epic arse for a flat stomach. A bit of navel jelly isn't the worst thing that could happen. I tell myself.
General Joint & Skeletal: The frame remains the same. Losing weight won't magic your mighty thicksetedness into daintyhood. If you're in the upper proportional percentile, sleeves will still end two inches from your wrists and people will still ask you to lift heavy stuff for them even though you're thinner. I don't feel more conventionally, acceptably feminine but then that doesn't really bother me personally.
Shit moves around, loosens out and tightens up when you're shedding significant weight. Downsizing is a state of flux, obviously. I had a host of minor tectonic-style alignment and adaptive issues- back, hips, knees, tendons etc- but they all resolved without treatment. Glad I didn't panic and have anything 'treated'.
Feet: After making them carry my fat arse around for so many years I thought they were fairly inured to whatever life could throw at them but the hard walking regime I adopted was still a big shock to their sedentary comfort. I got a shifting cascade of moderate sesamoid, arch and heel pain as the bones and tendons cried a plaintive WTF and tried to duck their new responsibilities. Nothing bad enough to put me on the bench, so I just toughed it out and that seems to have been the right thing to do. My feet took a full year of daily walking to really adapt and that process sucked.
From starting out walking in Chucks I progressed through a number of fancy sports shoes. There's fuck-all difference between cheap and high-end shoes as far as 'performance' is concerned; they're going to make your feet look like hideous loaves of sporty bread and shit themselves in six months to a year, no matter what you spend. I always try to pick them up second hand. Which leads me to...
But not as annoying and expensive as having to abandon and heavily remodel my entire fucking wardrobe. Depending on your personal style and how materially pedantic you are, going down a lot of sizes can involve some fucking horrible sartorial bereavement. I collect vintage garments, make a lot of my own from really nice hard-to-get fabrics and was not happy about having to give them up. Losing weight meant a lot of my treasured pieces just didn't work any more, no matter how many times I altered them and even though I sew, larger, less defined body shapes are relatively easy to dress in comparison with my new emphatic hourglass- possibly the worst shape to try to buy or construct for. For the fastidious dresser, that loss of personal autonomy can be horribly demoralising and at a time when you really do not need the extra drama.
Prepare to part with some of your best gear. For maybe having to construct an entirely new exterior expression right in the middle of your fucking adult life. And for the hideous trauma of possibly having to wear the same basic shit that other people are wearing whilst formulating your new look. The prospect of spending money on those tragicomic high-street items should give anyone with an eye and a conscience sweaty nightmares; I would advise the (smarter than I was) punter to limit investment to a few stretchy staples and maybe a cool belt (for cinching older pieces) to tide you over rather than running out and panic-buying/making a whole new kit for your mid-stage self. Ride it out until you're at your preferred size.
I'll talk about the special and entirely separate hell of other peoples' reactions next time.