I went back to the nurse this afternoon and it went great (this was to talk about my issues with trying to deal with my weight). She told me that I look great more than once and told me repeatedly (maybe five times) that "I'm really proud of you Emma"
We got the tape measure out again and she measured my waist.
And yes, that image IS 4.5 inches long... to give me a visual reminder. But looking at it just then I thought that "lost" isn't the right word as such as lost has negative connotations, losing things is bad. And losing weight/inches off of my waist is a very good thing!
So... presenting the visual reminder, mark 2: