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Gastric Bypass: More Than a Physical Transformation

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Originally published in 2011, the author shares her experience with gastric bypass, self-perception, society's bias, and relationships.

Life as a fat person

Eight years ago marked the beginning of a journey that took me places I had never imagined. I was 33, morbidly obese and had spent my 20’s never having a boyfriend. I never had the experience of having a long-term, loving relationship with someone always in my corner. Society frowns upon obesity. People who are overweight have automatic labels placed on them by complete strangers they’ve never even spoken to. It’s assumed that they are “lazy, weak, unmotivated, undisciplined.” You’d be surprised by how blatant complete strangers can be with their disdain. Looks of disgust. Comments made to others with intent to be overheard. Sometimes comments made directly to you, as though you’re less worthy of the degree of respect the rest of society demands. I was given diet advice from complete strangers. I was an intelligent, educated professional…but I wasn’t worthy of respect. I had a bachelor’s degree and a master’s degree but those things didn’t matter. I dressed professionally and always had my hair and make-up nicely done. I remember many occasions when I would walk into the lobby of the building I worked in and head toward the elevator. People would look directly at me, see that I was coming to the elevator, and would get in and push the button to close the door before I got on the elevator. When I did happen to be on an elevator and would smile, out of courtesy and politeness men wouldn’t make eye contact with me. It was as if I could read a bubble caption over their heads, “Don’t smile or talk to the fat chick or she’ll think you want her.” Yes, society is cruel towards fat people…but I can’t place all of the blame for not having a relationship on society’s view of obesity. A good portion? Of course. But not all. I believe the primary reason I did not have a long-term intimate relationship was because I was more cruel towards myself than society was. I couldn’t imagine anyone loving me or being attracted to me. I couldn’t imagine anyone being proud to have me as a partner. I wasn’t able to envision myself in a relationship. I didn’t feel worthy. Feeling worthless made me very talented in one way: I was great at pushing people away. I didn’t nurture or maintain close friendships or relationships. I honestly believed that people were friendly to me because they felt sorry for me. I didn’t want anyone’s pity, and the last thing I wanted was to appear needy. As a result there were a lot of dynamic people that I had shared close relationships with and made great memories with that I didn’t maintain contact with. I look back now and think of how much of my life I wasted by feeling less-than others. Insecurity ruled me, though I was fairly good about not allowing my outward appearance show the depth of my insecurity. My family hated seeing me fat and miserable. Some members, unfortunately, couldn’t focus on anything other than my weight. One family member said terrible things to me, thinking they would motivate me. “I can’t believe you let yourself get this way! I can’t even stand to look at you. You repulse me. Why can’t you just quit eating!? You’ve destroyed your body.” These comments didn’t motivate me. They only helped me to feel more hopeless about my weight and more inadequate as a human being. They also made me distance myself from my family.

Feeling powerless in the battle against weight

I fought the battle of the bulge from my late teens until my early 30’s. I fluctuated between dieting and restricting myself to rewarding myself with food and binging. I never seemed to feel full. I had a voracious appetite and was frequently hungry. I never felt satisfied unless I stuffed myself to the point where I was in pain. I spent a lot of time obsessing about food. If I had a rough day and needed to relax I would often binge-mostly on high carbohydrate foods. I can remember the wave of relaxation that would come over me as I was entering what I now refer to as a “carb coma.” No, I never went into a coma…but satisfaction and warm, fuzzy fatigue took the place of whatever I was feeling…and then I slept. I was busy with full-time work and the internship for my master’s degree. When I wasn’t working I isolated myself. I became a hermit. I was so depressed I dreaded getting up every morning. I avoided the phone on weekends, letting all of my calls go to voice mail. I didn’t have the desire or energy to communicate. I wasn’t interested in anything-other than food. Tired of feeling “less-than” everyone kept me in my safe cocoon. Nobody could disapprove or criticize if they weren’t around. I could be as “disgusting” as I wanted without fear of offending anyone. I could also eat whatever I wanted, without disapproving stares from my family-or anyone else. I dieted, off and on. I would lose weight and then have difficulty sticking to the diet. I would gain the weight back…plus additional pounds. Then I would get motivated and decide to change my life and lose weight. I would begin another diet, making promises to myself and others that this would be “it.” The same cycle ensued…over and over. I got tired of constant failure. Tired of being weak. Tired of feeling deprived. I was ready to accept that I would be obese forever, because I was tired of the roller coaster.

Finding hope

A dear friend of mine also had weight problems. She had me over for dinner one weekend, as she had been seeing all of her friends and family before she had surgery. She was having gastric bypass in a few days. I remember saying, “Are you sure you want to do that? It’s permanent.” Her response stuck with me. She said, “That’s why I want to do it! It’s permanent.” She was an intelligent person and I’d always had a great deal of respect for her. She had done her research, explained things to me and I thought surgery was an extreme measure…but I wished her success. I watched my friend’s transformation over a year. I saw her rapid weight loss. Her frequent need for new clothes, because her old ones were too big. Her success got me thinking…and I decided that’s what I needed to do. I went to an informational seminar and went to a consultation with my surgeon, then began the grueling process of attempting to get insurance approval. I’ll spare the details of all of the hoops I needed to jump through. The doctor required all patients to have a psychological evaluation and take a long psychological test prior to surgery. So, I found a psychologist and went through the evaluation…feeling strange about it and hoping I “passed.” I did pass that exam, but my insurance company denied surgery. Apparently I was too healthy of an obese person to have surgery. I appealed their decision and had more hoops to go through. I was, again, denied by insurance. I appealed again, and became more familiar with the requirements for approval than I’d like to have been. I don’t remember how long it took. I believe it was more than 6 months but less than a year before I finally got the stamp of approval I was looking for. I was at work when I got the phone call and I was so thrilled I cried. I remember feeling silly about crying and being so emotional. My friend, Marcie, came and gave me a hug and I was a little embarrassed, because nobody could understand my elation about having weight loss surgery unless they had been where I had. I got the approval. The next thing I had to do was quit smoking. Yes, I had more than 100 lbs to lose and I was a smoker! My doctor would not perform surgery on anyone if they smoked. She even tested for nicotine. I had to do it. My determination was stronger than it ever had been, because I had a new lease on life. So, I did what I had to do. Quit smoking…and had to wait months for my surgery date. The wait seemed like forever…and then the time came!

Surgery and recovery

It was the day before surgery. I had to take the day off work because I needed to drink a lovely concoction that would clean me out and require being close to or on the toilet most of the day. It was interesting. I also discovered that, after a while, nothing (dry toilet paper, wet toilet paper, wet wipes) was safe to come in contact with my behind. It was raw and on fire! I highly recommend, to anybody having to do this, that you either slather your behind with diaper rash ointment or vasoline-BEFORE you start the process. I got through it…and was glad when it was over.

The big day arrived and I went to the hospital. My surgery ended up being postponed for a few hours so it was a long day. I was anxious to get it over with, and I was also really thirsty because I hadn’t been able to drink anything since the night before. I wasn’t even supposed to chew gum. There were a lot of people there. I don’t even remember everyone who was there. My parents, my sister, my fiancée, my future mother-in-law…and I’m not sure who else. My fiancée cried before I went into surgery because he was worried about my safety. The best part of having surgery rolled around. The anesthesiologist popped in and said he was there to put the “margarita” in my IV. The warm, cozy rush rolled over me. I laughed and said I was feeling it. I vaguely remember being wheeled down the hall. The next thing I knew I woke in my hospital room. There were more people than I’d ever expect there. I was drugged up, so I don’t remember everybody who was there. I don’t remember much of anything. I had a little button to push to have morphine (or something) go into my IV. It’s, of course, regulated. I remember feeling a bit too “out of it” and too loopy. My sister, a nurse practitioner, was concerned because my oxygen saturation was too low. I don’t remember, but it was somewhere in the 80’s. She said something and one of my only memories was my, in my drugged state, getting mad at her and saying I was fine. I remember her telling me not to hit the morphine button for a while. I wasn’t in pain. I think I was afraid that I would end up in pain. I rested and everyone left. That night, a few hours after surgery, it was time for me to get up and start walking. My attitude was great. I told myself I was fine, strong and healthy. I enjoyed walking around the hospital floor. It was better than lying in bed. The nurses joked with me, after a while, and said I was going to wear out the carpet. I walked a lot. I had to stay in the hospital for a few days, and was happy when the time for me to go home came. The surgery was laparoscopic, so I only had 4-5 little incisions. I, however, had two drains in my belly and they needed to come out before I went home. I was afraid it would hurt when they were removed but it didn’t. I hardly felt anything with the first one. The second one felt strange. They were tiny, skinny tubing…about the diameter of a cocktail straw. The second one was really long, though, and seemed to be threaded all across the inside of my belly. It didn’t hurt when it was removed, but it felt very strange-like there was an alien or some foreign living object in my belly. It only took 30 seconds for the drains to be removed. I got to get dressed and go home! I don’t really remember the ride home or my first day there. I do remember getting bored. I wasn’t thrilled about being home during the day when everyone else was busy working. It was boring. I had saved up a lot of my work time and was scheduled to have 5 weeks off, because that is what had been recommended. I quickly decided I wasn’t going to use up all of my vacation time. My job was a desk job so there was no reason for me to stay home. I went back to work 10 days after surgery and didn’t have any problems.

Eating

For the first time in my life I was eating only to sustain myself. I was faithful about vitamins and followed the direction to sip water all the time, to prevent dehydration. At first my stomach was reduced to, I believe, 15cc’s. That is the size of my thumb. There are all sorts of phases to go through to start eating again. Liquids first, then soft foods…then a gradual introduction back to different foods. I was forced to really think about what I took for lunch. Eating was, more than anything, a chore. At first it’s difficult to feel when you’re full. You learn to not eat too quickly or to try to eat a lot, because when food gets stuck in your “pouch” (new stomach) it is very uncomfortable. You can’t drink rapidly, because there isn’t enough room…so it can make you vomit. Shortly after surgery I remember eating some watermelon. It tasted so good, because I was really thirsty. It felt good going down and I didn’t feel uncomfortable. I discovered I’d overdone it when I had to run to the kitchen sink and it came back up. Another time, a couple of months after surgery (or maybe sooner) I was craving orange chicken. It sounded so good, and I figured if I bought a little sample size and only ate a couple of bites I’d be fine. Again, I thought it was glorious-until I was driving on the freeway and had to grab a plastic grocery bag and vomit in it. There were several occasions when I tempted fate and ate something that could make me ill and cause “dumping syndrome,” which is apparently when your pancreas dumps a bunch of insulin rapidly. I don’t fully understand how it works or what happens. I only know that the first part of my small intestine is bypassed. That is the part that absorbs the most calories, nutrients and also processes sugar and fat. If you eat something with too much sugar and not enough protein to balance it out you quickly suffer the consequences. The feeling is difficult to describe but you typically start to sweat, your heart beats very rapidly, you feel nauseous, you get weak and dizzy…and you’re generally unable to function for 30 minutes to an hour. If you have a severe bout of dumping it can take a good hour to feel OK again, and afterwards you’re worn out. Every time I allowed myself to believe I was invincible, since I hadn’t been ill in so long, I paid the price. I was forced to pay attention to what I ate-and that was really good for me. It’s been 8 years since my surgery. Now I can eat nearly anything-in moderation. There are a couple of things I never try, because I know I can’t tolerate them and they make me sick. Real ice cream? No way. I can tolerate sugar-free/low-carb…but not the real deal. Cereal and milk is something else I can’t eat. I used to love eating cereal. I can’t do it now. It makes me dump. For the first time in my life I actually forget to eat some times! Food doesn’t rule me or crowd my thoughts. I got the monkey off my back…thank goodness.

Rapid weight loss

I dropped weight quickly. The day of surgery I weighed 288 lbs and am 5’6” tall. I dropped 65 lbs in three months. It happened so quickly that I was able to notice people treating me differently. The same folks who wouldn’t look at me or would hit the close button in the elevator were now holding doors and elevators open for me. Perhaps it should have made me feel good? Not really. It made me angry. I was angry to see how differently people treated me. Most of the people probably didn’t recognize me-but I remembered them. I thought, “How dare you look me in the eye now, smile at me and hold doors open for me when you treated me like I had leprosy before!” My transformation was happening so quickly I didn’t have time to wrap my brain around it. I wasn’t really comfortable with people mentioning my weight loss. I understood people’s curiosity and interest and obliged their questions, but I wanted my weight to be a non-issue for the first time in my life.

After losing 100 lbs.

A year after my surgery I wasn’t finished losing all of the weight, but I had lost 100 lbs. I got married 9 months after surgery. My husband had cancer six years earlier and had a doctor recommend that he have sperm frozen prior to his surgery and chemotherapy, because he would not be able to father children after his surgeries. I was with him for the “donation,” and six years later we were married and I was anxious to begin the fertility process-thinking it was likely that it would take multiple attempts to conceive. I was still in the process of losing weight and still had to be pretty careful about what I ate. I went through the process of in-vitro fertilization (IVF), which is really all-consuming. My focus, at that time, was not my changing body or new attitude towards my body. In fact, I had been such a pro at ignoring my body for so many years, the change wasn’t very obvious to me. I did notice having to buy new clothes, but I still hadn’t wrapped my brain around the massive weight loss. In my mind I was still fat. When I shopped for clothes I often picked sizes that were too big for me and I was surprised when I tried things on and needed something smaller. I was also focused on having a baby, so my weight and appearance weren’t particularly important to me. I was shocked and elated that the IVF worked the first time! I remember the doctor calling to say I was pregnant. Immediately after saying I was pregnant she said, “Your hormone levels are really high so there is probably more than one.” I said, “Twins!?” She said, “Or more.” I was only about 7 weeks pregnant when I had an ultrasound and was able to see three little “circles” in my uterus on the screen. Inside each “circle,” which were really amniotic sacks, there was a little “peanut” with a flickering heartbeat! I was pregnant with triplets! At that point my gastric bypass and changing body (due to weight loss) shifted to the very background of my thoughts. Most important was I was not only pregnant…I was having 3 babies! The fertility doctor referred me to a perinatologist-a doctor specializing in high risk pregnancies. When I met my favorite doctor in the practice, who ended up being the one who delivered my babies, she very seriously said, “I really wish you were pregnant with only one baby. In order for these babies to be healthy you have to gain 80 lbs.” I was a bit shocked at what a big deal weight gain was. I was taking my regular vitamins, plus prenatal vitamins and several other additional vitamins the doctor told me to take. I was very faithful with my vitamins. The doctor told me to do things to add calories to my diet, like putting both butter and cream cheese on a bagel I was eating. I’ll admit that I did try to consume more calories, but probably not as diligently as I should have. In the end I think I surprised the doctors. I only gained 27 lbs during the pregnancy. My babies were born on their scheduled due date, at 35 weeks. Two girls and a boy. Two were close to 4 lbs each and one was close to 5 lbs. I believe the doctors were very surprised, because the babies were healthy! None of them needed any breathing support or major medical intervention. The nurses in the NICU called my smallest baby (one of my daughters) “Turbo Jet,” because she was so feisty she crawled across her incubator, on the day she was born, and tried to climb out the porthole! They had to spend a few days under bilirubin lights and doctors wanted them to gain a little weight before they came home. In the end, all three were home within 2 weeks of their birth. Today they’re three healthy 6 year-olds in first grade.

Emergence

I’d been at my job for 5 years. I worked there before and after gastric bypass, and also before and after having triplets. My focus and identity at work was “mother of triplets.” I enjoyed having the focus shift from my weight loss to that of motherhood. I was so in love with my babies and so focused on them. I worked 40 hours in three days so I could spend 4 days home with my babies. They were my world. I was so busy, between long work hours and three babies that I never thought about my changing body. When my babies were nearly 3 years-old I transitioned to a new job in a completely new environment. Rather than working with mostly women, my co-workers at the new job were mostly men. After about four months I was finally able to recognize and notice that it seemed as though men paid quite a bit of attention to me. This was beyond foreign to me! I’d been so used to not being paid attention, in being unattractive and being invisible that I didn’t know what to make of it. At first I thought the attention was simply because I was new. Then I decided it was because I wasn’t old and was a plain-clothes employee, rather than uniformed. After a while I was able to understand that the attention was because all of these men found ME attractive! Me!? I’ll admit it was really fun. I felt beautiful. I exuded happiness and couldn’t help but smile. I was finally acknowledging my new life and fresh start. I felt like I walked around with a secret. Nobody knew I was really an obese woman. Nobody knew being a fat chick was part of me. I was just a woman…and apparently they liked what they saw! I worked at a prison. I entered the building in the mornings and often noticed that some of the “higher-ups” stood around the scanner everyone had to pass through to go into the facility. I didn’t know what all of the symbols they wore meant. I didn’t know what stripes, bars or chevrons meant…and I didn’t know who ranked highest. Sergeants, lieutenants, captains, majors? I had no idea what was what. All I knew was when I went through the scanner in the morning there was normally a “higher up” there who would be watching me. He had a smile that lit up the room, and a jovial personality. He often joked with his co-workers, and joked with me whenever the opportunity arose. He made his presence known.

Arrested development.

I lost 145 lbs. When I look at my emotional transformation I often think I experienced some “arrested development” in my lack of boyfriends, romance and my inability to feel attractive…let alone “sexy.” My physical transformation came before I realized it, because I wasn’t finished losing weight before I got pregnant with triplets. After having triplets the last thing on my mind was what size clothes I was wearing or whether or not I was losing weight. I was much too busy with three infants, and much too in love with my babies to give weight a thought. My identity had changed from “gastric bypass patient” to “mother of triplets.” That was what I was known for. When I started my new job it was a fresh start for me, and people didn’t automatically know me as the mother of triplets or the formerly obese woman. I was simply a woman. Apparently people found me attractive. After a while I was able to believe it. It was fun. I felt beautiful. I felt worthy of acceptance for the first time in my life. These new feelings opened up an entirely new world for me. I was able to see myself as lovable. I was open and free to find someone attractive and accept that they could also find me attractive. This is where my “arrested development” came into play, though this is difficult to write about and certainly not something I’m proud of. One of the “higher ups” at my work (the one with the killer smile and jovial personality) and I developed a flirtation. There was an instant mutual attraction, though I was oblivious at first. I knew I found him very attractive, but I didn’t think I was in his league. We developed a friendship which didn’t take long to escalate to romantic interest. The friendship became close, and there was shared emotion. Things intensified and there was lust, passion and mutual love. It was the most powerful thing, on a purely selfish, emotional level I’d ever experienced. It was also the most painful. We were both married. I’d been frustrated and unhappy with my husband for a while…but I didn’t know what I was missing. Once I saw how love, on a multitude of levels could be, there was no way I could continue to settle for “mediocre.” I divorced my husband-not because I thought the other man was a guarantee…but because I knew how it could be and I, unconsciously, wanted to experience all I had missed. I was madly in love with my “friend,” and he was also in love with me. He talked about spending his life with me and got tears in his eyes and told me he wished I could have his baby. He planned to spend his life with me and told me he was divorcing. In the end his marriage won out. I had the rug yanked out from under me and that was the first true heartbreak I’d ever experienced.

After divorce I found myself with a couple of child-free weekends each month. I wasn’t happy about being without my children 50% of the time, but since I didn’t have a choice I learned to make the most of it. I dated. A lot. I learned that I could be attractive to a multitude of men. I also learned that physical attraction is much easier to come by than love. I made up for lost time and learned some lessons. I no longer feel the need to seek validation from men. I know I’m OK. Now I find myself wanting the “real deal.” True love, passion, partnership, friendship. It’s more difficult to find than I’d ever anticipated.

Would I do it again?

I’ve been asked if I’d make the same decision about gastric bypass if I had it to do over. Absolutely! It is, by far, one of the best things I’ve ever done for myself. There are things I know now that I wish I’d known then. I didn’t understand the emotional impact massive weight loss would have on my life. If I could do anything differently it would be to have had bypass much earlier in my life, before marriage. Before my “arrested development” and “making up for lost time” had an impact on my marriage and my children. All of the things I experienced were things I believe I needed to learn. I simply wish the timing had been better and my personal/emotional growth didn’t come at the expense of others. The emotional impact of gastric bypass is greatly underestimated and cannot be anticipated. I was a strong woman. I’d put myself through a bachelor’s degree and a master’s degree. I’d been independent and confident-with the exception of my weight. I simply had no idea how I would change.

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