Even With Surgery, Weight Loss Doesn't Come Easy

By Ginger Sigmon Fox, The Charlotte Observer

STATESVILLE, N.C. -- I grabbed the slender black dress off its hanger. A size 14. Fifteen years of my life, two children, a college degree and a new job had passed since I wore that size.

I closed my eyes and sucked in my gut, an old habit from years of trying on clothes that didn't fit. I couldn't look. I felt the fabric clinging to my body.

Two years ago, I would have never tried it on, opting for something that would camouflage my extra 100 pounds of fat.

But not today. Thanks to an experimental obesity surgery I had in November 1997, I'm 80 pounds lighter. And my courage is strong.

I opened my eyes. Except for the cotton knit slightly hugging my abdomen, the dress fit.

In May, I wore the dress to Atlanta to meet a frind I hadn't see. His face brightened wen he saw me. look the same He was right. the same.

Experimental surgery

The surgery I had is called adjustable gastric laparoscopic banding, and although it's in its second year of trials, it isn't yet approved by the Food and Drug Administration. I was one patient in 300 nationwide to participate in the first part of the study.

My surgery was performed in Greenville, N.C., by Dr. Kenneth G. MacDonald Jr. of East Carolina University School of Medicine.

The surgery wasn't cheap. My insurance company only paid part of the $12,500 cost. That's a lot of money. But every day that I am able to walk up a flight of stairs without resting, play softball with my family or pass a restaurant without feeling guilty, I am confident I made the right decision.

Gastric banding divides the stomach into two sections by tightening a silicone band around the upper portion of the stomach. This forces patients to eat only 3 to 4 ounces at a time. It is major surgery, but it has advantages: No incisions or staples are used on the stomach or intestines.

The band is adjustable to allow more or less food to be eaten. This is done with a long needle inserted into a small port stitched to a muscle in my abdomen. It's really not as bad as it sounds. I don't feel anything while the band is being adjusted, which I've had done five times.

MacDonald said the FDA has halted the procedures to study preliminary outcomes, but he can resume performing the obesity surgery in July.

Gradual recovery

The surgery wasn't easy. It took me three weeks to recover. And losing weight will never be easy as long as there are chocolate eclairs and K & W's egg custard pie.

The first 25 pounds seemed to disappear overnight, but there were months when I actually gained.

Last summer I didn't lose a pound, even after emergency gall bladder surgery. I had thought surely the organ itself must weigh something.

Gall bladder surgery is a common side effect of any rapid weight loss program. I had five gall bladder attacks before the doctors figured out I needed surgery for gallstones.

It was a small price to pay for my then 60 pounds of weight loss. The week after I had surgery, I was dancing alongside my 13-year-old daughter, McKenna, at the Spice Girls concert in Charlotte.

For days before my gall bladder surgery, I hardly ate, instead sipping milkshakes to soothe the fire in my stomach. I gained 5 pounds. I'm lucky I didn't gain more, drinking thick chocolate shakes, Oreo twisters and Reese's Cup swirls. Didn't I owe the treats to myself for all I was going through?

That way of thinking went way back to my childhood and the eating patterns I had used to cope with being teased at school or not being chosen for games at recess, or when I saw myself in a leotard and tights in Miss Betty's dance-room mirror.

I still eat comforting foods _ almost always fattening _ when I'm emotional: chips, ice cream, chocolate. It doesn't matter what emotion: happy, sad, angry, scared. If it's a feeling, I associate it with food. It's my reward or punishment.

The band around my stomach just limits how much I eat. Only self-control and creating new eating patterns will overcome the psychological barrier. I'm learning about nutrition and nonfood-related ways to cope with strong emotions, but it's a lifelong pursuit.

I'd been feeling good about my progress until I gained weight after my gall bladder surgery. I felt like a failure, my self-esteem on a roller-coaster ride, plunging me downward into one of those dark tunnels just before the ride's over. I was tired of trying to control food. Shouldn't this high-dollar contraption do that for me?

The good thing about roller coasters is that the cars always emerge from the dark tunnel, sto and let you ofu can run and get back in lin for another riining those 5 pn my psychologi to think that y lifelong food compulsion was going to be fixed with a silicone rubber band.

I was warned that the surgery wasn't a cure-all. Dr Mac told me it's possible not to lose weight. I just didn't choose to listen. The surgery doesn't prevent patients from eating fattening, high-calorie liquids like milkshakes in large amounts; they just slide through the opening.

''You're responsible for your weight, your body and what you put in it, '' Dr. Mac says every time I see him, every six months.

It was time for me to stop whining about gaining 5 pounds and get on with losing the remaining weight. Time to take control.

Of course, losing weight is never easy. If it were, obese people wouldn't spend millions of dollars on weight loss programs. We'd lose the weight ourselves, using our willpower. But I needed to hear Dr. Mac's mantra again. If I ate high-calorie foods, no matter how emotionally comforting at the time, I would pay for the calories later by gaining weight.

In December 1998, I snapped out of my weight gain and self-blame. I woke up one morning and couldn't eat... anything. I thought my stomach was irritated from eating some tough grilled chicken the night before. But for the next three weeks, over the Christmas holidays, I didn't eat solid food. I sipped water, milk and cream soups. Anything else made my stomach hurt.

After Dr. Mac withdrew some fluid from the adjustable silicone band, widening it, I ate mushy foods for two weeks, building back up to solids. Possibly, he said, an ulcer had developed. Whatever the cause, the problem resolved on its own.

The upside of three weeks of not eating much and tolerating pain? I lost weight, bringing my total loss to 65 pounds. Instead of making empty promises yet another year for my New Year's resolution, I charged into 1999 with 10 fewer pounds.

'Fat experiences'

When I found out about the experimental surgery in the summer of 1997, I was desperate for a quick fix. I had never weighed as much, busting out of size 22 clothes. And I was tired of having ''fat experiences,'' as I call them.

A kid locking the protective bars on a roller coaster ride at Carowinds had stopped at my car.

''Are you pregnant?'' he asked, his duty, I suppose,to see that no pregnant women take the thrilling ride.

''No, I'm not pregnant,'' I said. ''I'm just fat.''

I laughed so the kid would laugh. He was embarrassed. It wasn't his fault that I looked like I was nine months pregnant. Everyone stopped talking and stared.

The surgery stopped the fat experiences. But I still look in mirrors and don't see beauty. I see every remaining dimple.

One day, I hope to accept my body as it is, less the 20 pounds I still want to lose. I won't be a fat person on the outside. But I know I'll always be one on the inside, wincing when I hear a fat joke or see kids laughing at an obese person.

I'm learning to respect my body. It's taken years of self-loathing to shape the mental image of my self. That won't change overnight.

Life-changing effects

My journey into creating a new me isn't all about the physical aspect. Sure, I feel and look better carrying less weight. But I find that I participate in life more. I used to let it pass me by, too sared to draw n to myself. The more weight I lose, the more confidence I gain in tring new things,w people, even 've had for yeao losing weighton't hesitate to jump into projects or work assignments anymore. Spending time with committees and ball practices sometimes makes me miss out on time with my husband, Danny.

I volunteer for a youth athletic association. I'm the softball coordinator. That's something I would never have done a few years ago for fear of not being a good role model. I now think I am right for the job.

I like encouraging girls to become active and to play sports. I want them to try new things, and feel good about themselves, set realistic goals and work hard to achieve them. I also want them to know that being a good person doesn't require being a size 8.

Becoming a fit and healthy person is something I hope my 14-year-old daughter, McKenna, learns from me. She's been a standout softball player on Iredell County All-Star teams for years. But she isn't in the best physical shape, due to two knee surgeries and pain that kept her sidelined most of last year. McKenna, like me, is slightly overweight.

Today, McKenna and I understand the importance of exercise. But it wasn't always that way. While McKenna was in physical therapy for her knees in Winston-Salem, we met Lee Howard.

Lee was McKenna's physical therapist, but more so, he was a fitness role model to her at a time when all I did for her physically was to drive her to and from her appointments. After my obesity surgery, I walked some, but gave it up because I lost weight without it.

One day Lee stared at me and said, ''You could benefit from some exercise, too.''

My mouth flew open. Lee knew about my surgery and that I had lost a lot of weight. He also knew that my weight loss had slowed. He had confronted the one thing I had hoped would not become a reality. I had to exercise to lose weight.

He also knew that for McKenna to accept a healthy way of life, I needed to adopt one, too. With Lee by our sides to make sure we're lifting properly, McKenna and I work out with weights two to three times a week. At first I was shy around the trim women and men with big biceps in the gym, but Lee constantly encouraged us.

Since January, McKenna has lost 5 pounds and over 8 inches. I've lost 15 pounds and can feel muscles starting to develop. I've also started walking again.

Lessons learned

I've learned some valuable lessons: My happiness isn't determined by how I look, although it's a nice side effect; weight loss doesn't come easy, even with this band around my stomach, and exercise isn't always a chore.

For fun, McKenna, my 9-year-old son, Dylan, and I go to the local softball fields and run bases, hit balls or practice fielding. It's exercise, only we don't think of it like that. It's become our lifestyle.

My life isn't centered around losing weight. I have many goals I want to accomplish over the next year besides losing 20 pounds: graduating with my master's degree, teaching my daughter to dive, coaching asoftball team.

Mostly, I'm ready to greet my40th birthday ahy person at is a staff wriver's regional Neighbors. She can be reached at 215 W. Broad St., Statesville, NC 28677. E-mail address is gsfritesi(at)america.net