A Look Into Weight Loss Surgery

Self-proclaimed “fat girl” Charlene Hinson has beaten the battle of obesity.A Look Into Weight Loss Surgery

Charlene Hinson’s struggle with weight began when she was 9. The 58-year-old Tallahassee esthetician said that was her age when she went on her first diet – the first of countless weight-loss schemes that always ended in disappointment and sadness.

Her battle with obesity will forever be linked to her childhood.

“The children always made fun of me by calling me names and excluding me from activities because I was chunky,” Hinson said. “I never felt that I fit in with the kids my age because of my weight. Something as simple as roller skating was difficult for me. I remember in the third grade, I was chosen to be in the class play, ‘Peter Cottontail,’ because they needed someone to play the ‘Chubby Bunny.’”

As Hinson reached her teen years, she longed for a boyfriend – but never attracted the interest of a boy. In high school, she wanted to do normal things such as go out for cheerleading, but she knew it was not an option. Clothing was an issue for her too.

“I can remember, many times on field trips, I would never allow myself to wear shorts or go swimming around the other children,” she said. “Also, I remember thinking during lunchtime that everyone was watching what I ate and how much I put on my plate, and that they were thinking, ‘Why doesn’t she make better choices?’ or ‘Just stop eating. It can’t be that hard.’ I always wished that was true.”

Her older sister was popular and beautiful. And, although Hinson looked up to her, she couldn’t help but make comparisons.

“It made my self-confidence even lower because I was so different from her,” she said. “She had the hourglass figure, and I had the ‘roly-poly’ figure and was nicknamed ‘Doodlebug.’ I can remember, every night of my life, when I said my prayers, I would always ask God, ‘Why me?’ I asked him to please send me a gift so I could feel normal, too. I can remember, many times, I just wanted to die and make the pain stop. I felt so lonely and hated myself. Death would have been easier than life as a fat person.”

Over the years, Hinson tried everything to lose weight. You name it, she did it.

“The question should be, ‘What diet did I not try?’ I tried Weight Watchers, Nutri-System, Atkins, and the infamous ‘cabbage diet.’ I took diet pills. I would drive three hours on any given day for a physician to administer shots of a pregnant woman’s urine. Another time, I even went to a doctor in another state. And part of his regimen consisted of having coffee enemas administered daily. I had a client at the time ask me, ‘How much coffee do you have to drink on your coffee diet?’ I explained that I didn’t drink the coffee; I had to give myself coffee enemas. She then replied by asking, ‘Does it matter if it’s regular or decaffeinated coffee?’ After we both stopped laughing, I thought to myself, desperation is more than just a word!”

Hinson did lose weight, but she couldn’t keep it off.

“Every time, I would gain it back and plus,” she said. “The yo-yo is so common for anyone who has lived the diet style of life.”

Being obese was a day-to-day struggle.

“There are not enough words to explain what an obese person feels,” Hinson said. “The tears, frustrations and feelings of failure were constant. Simple things are not always easy for obese people. For example: sitting in a theater chair, finding ‘in style’ clothes in larger sizes, having to walk across a parking lot and not losing your breath, being able to get in and out of a car with ease, or not being able to get on rides at a fair because of your size. And another struggle is all of the health issues that a large person may develop.”

By 2003, Hinson had a number of medical problems typically associated with obesity, including obstructive sleep apnea, gastro-esophageal reflux, degenerative joint disease and high cholesterol. Her body mass index was 44. She had been on diets for more than 45 years. She estimated that she had lost 400 pounds over the course of her life and still was at her heaviest weight ever.

That’s when Hinson realized that her health plan would cover the costs of bariatric surgery.

“I felt as though a miracle had been presented to me, to give me a second chance at life,” she said.

Dr. Eliot Sieloff, medical director of the Bariatric Surgery Center at Tallahassee Memorial Hospital, performed Hinson’s surgery. He said that she, like any candidate for gastric bypass surgery, had to meet the National Institutes of Health criteria for morbid obesity.

“Charlene had attempted countless non-surgical weight-loss programs but had been unsuccessful at maintaining her weight loss,” Sieloff said. “She had a number of medical problems associated with her obesity and had no other health factors that would cause surgery to be an excessive risk. She attended a preoperative informational seminar and had a good knowledge of the surgical procedure and expected results. She also had undergone a psychological evaluation and was felt to have the potential to do well.”

Hinson said she experienced gas pains typical after abdominal surgery and had no complications – although she did need additional surgery after three weeks “because I felt so good I overdid things and tore the internal stitches loose,” she recalled. “Once this was corrected, I followed the doctor’s orders and did nothing or very light duties for approximately three weeks following surgery.”

After bariatric surgery, “we recommend patients eat at three regular meal times during the day, and meals are limited to what the patient can eat comfortably in 20 to 30 minutes,” Sieloff said. “Once the patient feels full, that meal is over. We discourage snacking or eating frequent small meals but do encourage patients to take in at least 48 ounces of liquids during the day. Each patient is individual and will develop different habits that help them maintain their weight loss.”

Hinson said she adjusted well to post-surgical eating restrictions, feeling satisfied with the foods she ate and never feeling hungry.

“I was able to drink and eat what was brought to me while still in the hospital,” she said. “When I came home, I followed exactly what they told me to eat and in the amounts. The only restrictions I had was to eat smaller meals several times during the day, and I was to avoid meats in the beginning. I gradually could add meats to my diet.”

Now, “the only foods I have problems with are dairy products,” because her stomach is much smaller and doesn’t produce the amounts of acids used to digest foods. “I know that I will have to take certain vitamins the rest of my life, due to the way by body breaks down and absorbs the nutrition,” Hinson said.

It took a while for Charlene to adjust to the physical and emotional changes caused by the surgery.

“Emotionally, I definitely had to prepare myself that the lifestyle I had in the past was going to be gone, and there would be a new person and new lifestyle,” she said. “Physically, I did not start seeing myself as a thin person until approximately one year after the surgery. I did lose a lot of muscle mass, which I was informed I would, and I have had to really work at getting my strength back.”

Now, more than three years later, Hinson has lost 155 pounds and maintained a healthy weight.

“She exercises regularly and is cautious regarding her diet,” Sieloff said.

“For the first time in my adult life, my blood panels are in the normal range in every area, so I know I am a healthier person now and this definitely was the right choice for me,” Hinson said.

Sieloff pointed out that obesity is a major problem in America today.

“Countless studies have shown that the degree of obesity is increasing rapidly and affecting younger and younger people, with more severe, long-term health consequences for many people,” he said. “Diet and exercise programs will only help 5 percent of morbidly obese patients lose a substantial amount of weight and maintain that weight loss. Our lifestyle and diets currently allow us to consume thousands of calories a day without expending much energy. A significant amount of research currently is focused on developing drugs to reduce appetite. However, many obese and morbidly obese patients eat for a variety of reasons other than hunger. Appetite suppressant medications, new food pyramids or diet programs are unlikely to help these patients.”

Bariatric surgery is not for everyone. Sieloff said that there are plenty of people who do not meet the necessary criteria.

“A bad candidate is someone who has not attempted any nonsurgical weight-loss methods or who is unable to follow recommended post-op care guidelines,” he said. “Typically, in Tallahassee, we don’t perform this surgery on adolescents (younger than age 18). And older patients (those older than 62) need to be closely evaluated for risks versus benefit of these operations.

“The likelihood of dying from gastric bypass surgery is reported between 2 percent and 4 percent (on a national average),” Sieloff pointed out. “The likelihood of a complication of any sort after surgery is between 5 percent and 10 percent. The average morbidly obese patient has a life span that is 20 percent less than a normal-weight patient, so the risks of surgery need to be judged versus the risks of staying severely overweight. In Tallahassee, our statistics are a mortality rate of 0.8 percent and a complication rate of 5 percent.”

Hinson said she would recommend the surgery to those who understand that it is a lifelong commitment, and she hopes that those who have had the surgery stay on track.

“I think it’s important for individuals who have had the surgery not to lose focus,” she said. “I have such compassion for those who struggle with their weight. I will never forget where I came from and will always be grateful for where and who I am today. For the first time, I actually love myself and realize that beauty begins in the heart. I feel like a real person who can live a real life, knowing that I have added years to my life. My self-confidence is better. I actually enjoy looking forward to the next day.” 

 

How Bariatric Surgery helps you lose weight 

Bariatric surgery is a field of surgery focusing on weight-loss procedures. It also includes non-surgical personnel such as dieticians, psychologists, psychiatrists and exercise counselors. There are a variety of operations that can be done to help people lose weight; generally, these are divided into three categories:

Malabsorptive operations: This includes BPD (biliopancreatic diversion) or duodenal switch surgeries. These operations change the digestive tract so that only small amounts of calories and nutrients are absorbed. Such surgeries generally are associated with the greatest weight loss; however, nutritional deficiencies associated with them can require patients to take vitamin and nutritional supplements permanently, as well as limit them to eating high-protein diets.

Restrictive operations: This includes lap band, VBG (vertical banded gastroplasty) and gastric sleeve surgeries. These operations limit how much food a person can eat at any time and help people lose weight by reducing the number of calories taken in. They are associated with fewer nutritional problems but have the least amount of weight loss of the available bariatric operations.

Gastric bypass, also called Roux-en-Y: This is a combination of restrictive and malabsorptive surgeries that limits the amount of food eaten per meal, as well as reducing the absorption of calories. People are required to take a multivitamin and vitamin B12 supplements.

Source: Eliot B. Sieloff, M.D., bariatric surgeon and medical director of the Bariatric & Weight Management Center at Tallahassee Memorial Hospital

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