Philadelphia Metropolis


The Last House on the Block

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By Kathryn Jones

Whenever I am in the supermarket, I am besieged by magazines at the checkout line. Invariably there will be at least three with cover stories about people who have lost massive amounts of weight.  Talk shows parade people out as well, and while showing their before and after pictures.  They praise them for doing it "the old fashioned way," without surgery. The message is clear; unless you've existed on tree bark and pine nuts, and jogged until you dropped somehow your weight loss doesn't count. When I heard it again on "Good Morning America" recently, I decided it was time to set the record straight.
I had weight-loss surgery and it worked for me.
Kathy Before.jpgPeople have many biases about weight-loss surgery. For some, it seems extreme, scary and foreign, and people tend to shun what they don't understand. Others believe it is the easy way to get out of doing the hard work of losing weight or somehow cheating or is just a "quick fix." Since I have had the surgery, I can attest that although it was extreme and scary, it was definitely not easy, nor quick. Weight loss surgery is just one of the tools that some people need in order to be healthy for the rest of their lives.
There are several variations of weight-loss surgery, but the two main types are the Gastric Band and the Gastric Bypass, which is what I had. The Gastric Band is less invasive, and it is just as it sounds.  A band is placed around one's stomach to block the intake of food and create a feeling of fullness, therefore less is consumed. The advantage to this procedure is that it is reversible and adjustable, so people have an out if there are complications. My procedure, on the other hand, has a dual function; my food intake was reduced by the stapling of my stomach. In addition, parts of my intestines were bypassed in order to decrease the absorption of food that does make it into the stomach.
I understand people's distaste for the procedure since there are serious risks involved. In addition to the normal surgery risks due to anesthesia, bleeding and blood clots, there is also chance of infection, stomach leaks and death.
When I had mine, the statistic was one in 200 died from the surgery, but most were due to non-compliance with aftercare instructions. There are also several potential serious side-effects. One is gall-bladder disease, due to the rapid weight loss, another is an incisional hernia. And if doctor's instructions are not followed to the letter, there is a chance of malnutrition from the substantial reduction in food intake. I did end up with a hernia.
Unlike some people think, not just anyone can waltz into a doctor's office and demand a gastric bypass to shed a few pounds. For those of us who qualify, this is the last house on the block.
One must have a Body Mass Index of at least 35, which is a weight-to-height ratio indicator, and several co-morbidities. Co-morbidities are life threatening weight-related health problems.  For example, I had gastro esophageal reflux disease, pre-diabetes, sleep apnea, fatty liver disease and Fibromyalgia, which causes muscle and joint pain.
Also, a reputable bariatric surgeon will also require proof of mental health, as well as a commitment to ongoing psychological and nutritional counseling. Insurance requirements demand that we document every attempt at weight loss since childhood, with dates, methods and pounds lost.
Everyone knows how to lose weight, but for some of us, we cannot keep it off and after so many attempts, our metabolism is so degraded that a healthy weight is impossible without surgical intervention. I have lost hundreds of pounds in my lifetime and gained back hundreds more. And so in April of 2004, at the age of 43, I finally got off the weight-loss roller coaster.Kathy.jpg

Before I had my surgery, I researched it for two years and interviewed several surgeons. I decided on Dr. Sheldon Randall at Lawrence Memorial Hospital. I lived in Massachusetts at the time and he had an excellent reputation. I had been in several eating disorder treatment programs and was totally ready for my outsides to match my insides. I thought that this would be the last step in the process but I was sorely mistaken. It took a year for me to reduce my weight from 270 to 145 pounds, and even now my BMI suggests that I'm still "overweight" because I am only 5'1". However both my doctor and I are in agreement that as long as my health goals are achieved, I'm fine where I am.
After losing the weight, I had several surgeries to remove the skin that had been stretched out from the massive weight gains and losses over the years. Parts of my body had to be reconstructed, and as previously mentioned, I had a hernia repaired.
 I have to take eight different supplements a day to prevent malnutrition. I had to change not only my way of eating but my relationship with food and its meaning and purpose. Contrary to popular belief, the weight can still come back if we are not vigilant and dealing with the issues that got us here in the first place. There have been several public figures that have trotted themselves out on display after massive weight loss only to go back into hiding after putting it back on. I have kept my weight off for almost 8 years.
There is nothing easy or quick about losing weight through weight loss surgery. We who make the decision to do so are just as strong, committed and brave as the people who did it the "old fashioned" way. The only difference is that we have a better chance of keeping it off for good.

Photos: Kathryn Jones before and after surgery.  Photos by author.

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