Bypass Surgery is a big decision, and it is a last resort. I have not always been obese or, as I am now, morbidly obese. In high school, I was not as thin as other girls, and my frame will always be pear-shaped, just like my Aunts on my father’s side. In high school, if I felt like I was putting on pounds, I could drink slim fast and eat a banana for lunch and attend swim practice each day and the pounds would come off. In college, I put on a freshman 15 or 20, but when I focused on eating better, I was able to drop those pounds as well. Even as a young band director in my mid-20s I started to have slim fast for lunch, not having time for anything else, and lost the extra weight and got to about 125, which is an excellent weight for me.
But, alas, you don’t stay young forever. I believe my weight gain is directly related to both my history of major depression (began in Summer 1998) and the accompanying medications. Some people (my sister, for instance) drop all sorts of weight when they are stressed or depressed. I, on the other hand, eat more and put on weight. So, fast forward a few years, through losing and regaining 70 pounds with Jenny Craig, being on Weight Watchers 3 or 4 times, giving South Beach a go, partaking in months of the lovely NutriSystem boxed foods, and Doctor’s Care (my MD Allergist’s weight loss program) and you’ll see a history of gaining weight, then losing some or most of my weight, and then regaining everything plus some. I can be really controlled and methodic given a decent diet, as I’ve always been a compliant student and into following guidelines. Trouble is, when food is your main source of comfort and/or joy, you can only go without those things for so long before reverting back to your old, comforting and familiar routines. For me, sweets are my downfall. I remember in Grad School loving the little café near the music school where they had these AMAZING homemade, multi-layer cakes that a local lady made. A slice of those several days a week adds up, of course. Or my love of Dunkin’ Donuts which I first found in Athens as a treat after church and later frequented in Baltimore because I loved their coffee and what better to accompany their coffee than a donut. But, WAIT, there is a deal when you get two donuts with your coffee, so that MUST be a normal serving size! Then there is the fact that I’m too lazy and uninterested in bringing healthy lunches from home. In Baltimore, our building had a Cafeteria with all sorts of options, and in Georgia, there are fast food restaurants nearby for lunch. When you’re single, it’s not worth the effort of cooking at home and cleaning up, so some days you’re “good” and get Subway, but at other times Fuddrucker’s Milkshakes lure you in. Also, most social gatherings --- especially with churches, y’all--- involve yummy food. And, did you know that I am an excellent baker?!? Guess who becomes the best baker? The one who loves and adores baked goods… So, between boughts of depression or loneliness or feeling that my day was awful so I’d earned some yummy reward for my troubles, I added many pounds. I think my highest weight, before doing the low carb for the surgery, was about 275. Now, mind you that I am 5 ft 3 in. That BMI is something like 49, and clearly morbidly obese.
Next, infertility was an issue once I finally found my wonderful husband. We both have fertility issues. PCOS (Polycystic Ovarian Syndrome) is common with overweight women, and they won’t even do IVF if you’re too overweight because of the risks involved. Ben’s counts are pretty low, which may or may not be related to his weight. We prayed a lot, and decided on the adoption route for us. (We’re still waiting on God’s timing, but feel certain that He has used the time we’ve been waiting to adopt to better prepare us for parenting …. I mean, among other things, we’re both about to lose lots of weight!)
So, when I first heard of weight loss surgery, I was definitely against it. I saw no reason that if fat people put their mind to it, they would not just lose the weight. I mean, they got there by eating too much, so why don’t they just do the opposite? And, many years ago, it required a 6 month recovery period and often involved tons of malnutrition. There was a surprisingly high death rate, and an even higher likelihood of serious complications. I mean, WHAT were those doctors thinking, and WHY would they put their patients at such risk? And why wouldn’t those lazy people just take control of themselves?
Working at SSA, though, I came to meet a few people with complications, but mostly I spoke with people who completely recommended it. I was still skeptical, and was still in my lower 200s, so didn’t think too much about it as an option for me. In the back of my mind, I wondered if it’d be a good option for my husband Ben, but never did anything about it.
In the last 4 years or so, though, I’ve known several people who had the surgery. When I asked if they were happy with their decision to do it, they emphatically responded YES!. It turns out that many insurance carriers do cover the surgery if you meet a few guidelines including being above a certain BMI, at least 5 years of obesity recorded by a doctor, prior attempts at losing the weight, referral from your primary care doctor, and passing a psychological evaluation. Hmmm, I thought, that might be an actual option!
Sometime in Summer 2009, after becoming quite discouraged from 2 serious yet failed attempts of weight loss with Doctor’s Care and weight watchers, and thinking more about both of us being unable to run after our future toddler, I did a little research. I had discussions with 3 people who had the surgery and talked about it with them and asked about my questions and concerns, their experiences, what the worst part about it was, did they feel successful, etc. Then I checked with my insurance company to see if it was covered, and if any in network doctors were near me. Then I went to Dr. Macik’s monthly Bariatric Surgery Information Session at Northside Hospital in October (and asked Ben to join me knowing he’d ask me a zillion questions about it if he didn’t come!).
Throughout my research I remained skeptical and prayerful. I was only thinking about myself and the possibility of surgery for me, but I included Ben in case he might also be interested. I never told him I expected him to do it, or that he should, or anything of the sort. My research was for me alone, but it did help him learn more about the options, the risks, and our coverage. At first, I thought maybe I would do the Lap Band, which seemed less invasive. I mean, they simply put a ring around your stomach and adjust it with saline. But, the more questions I asked, the less I thought I wanted that. People don’t lose as much as quickly, you have more difficulty with hunger with the band than with bypass, there are no metabolic benefits, and you have to go in often for “fills” and adjustments. Not to mention have a permanent thingy in your belly!
In the end, I decided on Gastric Bypass Roux-En-Y. The gastric sleeve might have been my choice, however it’s so new it is not covered by my insurance. The lap band did not promise as good as results, nor the promise of having a period of time of not feeling hungry. The final decision came from Dr. Macik. Lap Band was not an option for Ben due to the amount of weight he wanted to lose, and since the two have different dietary needs after surgery, Dr. Macik recommended we both get the same procedure.
My research helped me discover why gastric bypass surgery was sometimes a good choice toward a healthier future. First of all, I found out that you have several months where, even though you are not eating much, you do not feel hungry. (What diet offers that?) Also, the current procedure is done laproscopically, and has a much faster recovery time. They’ve changed and updated the surgery many times. There is still some malabsorption, but not to the degree the prior surgeries had. Also, believe it or not, Gastric Bypass surgery is considered to be a metabolic surgery because, in addition to limiting how much food you can eat, it also causes changes in the connections between your gastrointestinal tract and brain, effectively helping your brain “want” to go to a lower weight. According to one book I am reading, “the metabolic aspects of gastric bypass essentially help level the playing field against unfriendly weight genes.”
So, after years of getting nowhere but heavier, I decided on weight loss surgery. It is not an easy road, there will be lots of unlearning years of bad habits, as well as dealing with food addictions, emotional eating, and just general overeating. But, I have a head start and a lot of hope of getting to a place where instead of an uphill battle, I’ll be gaining ground.
