Weight Loss Story the ran in our Sunday Paper yesterday

[Guest guest]

Hey list, here's a story that ran in our Sunday Paper

yesterday about WLS. It's also on line.

> http://www.ohio.com/bj/news/docs/003436.htm

>

>

> `ALL OF A SUDDEN I HAVE A SECOND CHANCE'

>

>

--------------------------------------------------------------------------------

>

>

> Slipping back into life

> Weight-loss surgery worth risk for many

> BY TRACY WHEELER

> Beacon Journal medical writer

>

>

> At only 9 months, Tori was on her first

> diet.

> The whole milk in her bottle was replaced by skim,

> per

> doctor's orders.

>

> With that, the stage was set. For the next three

> decades, weight -- and the always-disappointing

> attempts to keep it off -- would be a constant,

> unrelenting theme in her life.

>

> In middle school through high school, she tried

> low-calorie diets, low-fat diets and

> low-carbohydrate

> diets. In college, she suffered from bulimia, the

> dangerous practice of binge eating followed by

> forced

> vomiting. In her late 20s, she finally found some

> success with the prescription drug Redux, losing 100

> pounds only to gain back 130 when the drug was

> yanked

> from the market after a federal investigation showed

> that it led to life-threatening heart problems.

>

> Her weight was stuck at 375, give or take 25 pounds.

>

> Then in 1993, at age 27, she got sick with

> pneumonia.

> Over 18 months, she checked in and out of the

> hospital

> 13 times, unable to completely beat the pneumonia.

> She

> took high doses of steroids, sometimes as much as 80

> milligrams a day, to help her breathe. She gained

> weight and fell into depression.

>

> ``The weight caused the depression,'' she said.

> ``The

> depression caused me to eat more. The eating caused

> me

> to gain weight. It's all intertwined.''

>

> Before long, Tori reached 579 pounds.

>

> ``Basically, I'd given up,'' she said. ``I had no

> ambition. I began to accept, I guess, that this is

> what there is to life.''

>

> ``This'' meaning an oxygen tank to help her breathe,

> a

> bus to take her to doctors' appointments because she

> couldnt fit behind the steering wheel of her car, a

> wardrobe purchased through the mail because no

> stores

> carried her size. ``This'' meaning a life in which

> Tori 's biggest daily decision was what to

> watch on TV.

>

> But on July 29, 1999, 's life began to

> change.

> On that day, she underwent gastric bypass surgery.

>

> During a five-hour procedure at Akron General

> Medical

> Center, her abdomen was sliced open, her stomach was

> stapled and stitched down to a fraction of its

> former

> self, and her intestines were rerouted to limit food

> absorption.

>

> By early this month, she wasn't half the woman she

> used to be. In fact, she was 38.2 percent of the

> woman

> she used to be, down from 579 pounds to 221, a loss

> of

> 358 pounds in just over 16 months.

>

> ``The past year has been an incredible odyssey,''

> she

> said. ``I'd given up and all of a sudden I have a

> second chance for a career, for a future, for a

> baby.

> I really want a baby. It's actually conceivable I

> might meet a guy who might find me attractive.

>

> ``Anyone who grew up fat knows the power of that

> statement.''

>

>

> Surgical starvation

> In the United States, where more than half the

> population is considered overweight and one in five

> are deemed obese, there are plenty of people who

> know

> exactly what means.

> And last year nearly 43,000 Americans, including

> nearly 100 people in the Akron area, opted for

> gastric

> bypass surgery, which costs about $30,000. It's an

> option that continues to grow in popularity, with

> the

> number of surgeries nationwide nearly doubling in

> the

> past five years.

>

> The first attempts at obesity surgery, known as

> intestinal bypass, came in the 1950s and 1960s. That

> surgery, which bypassed almost the entire length of

> the small intestine, led to uncontrollable diarrhea,

> dehydration and electrolyte imbalance. It was

> abandoned by the 1970s.

>

> Now, obesity surgery comes in two forms -- simply

> restricting food intake (gastric banding) and

> restricting both the intake and the absorption of

> food

> (gastric bypass).

>

> Neither is for the casual dieter or the slightly

> overweight. The prospective patient must be at least

> 100 pounds overweight and have tried other

> nonsurgical

> weight-loss methods.

>

> Both procedures require an abdominal incision from

> the

> base of the sternum to below the navel.

>

> With gastric banding, a surgical band is tightened

> around the top of the stomach, creating a small

> stomach pouch. Patients then feel full after eating

> as

> little as 1 or 2 ounces of food. The food slowly

> enters the remainder of the stomach to continue

> along

> the normal digestive process.

>

> Gastric bypass surgery also creates a small pouch at

> the top of the stomach, but the remainder of the

> stomach is separated and bypassed. Food leaves the

> pouch and moves directly to the intestine, skipping

> the first segment of the intestine, where most

> calories and nutrients are absorbed.

>

> Gastric banding is the more common operation, but

> gastric bypass has been proved to bring about

> greater,

> longer-lasting weight loss.

>

> ``The main goal of this surgery is to limit food

> intake,'' said Dr. Mark Jaroch, an Akron surgeon who

> specializes in gastric bypass. ``So I make the

> stomach

> pouch as small as I can possibly make it.''

>

> In the weeks and months following the surgery,

> ``ketosis'' sets in.

>

> ``Another word would be starvation,'' Jaroch said.

> ``A

> better word would be hibernation.''

>

> With the stomach accepting little more than an ounce

> of food at a time, the body is forced to find fuel

> in

> its stored fat. Not only does the patient eat less

> and

> absorb fewer calories, but the body actively burns

> its

> fat reserves.

>

> The resulting weight loss is rapid, with patients

> losing 25 to 40 pounds a month for four to six

> months.

>

>

> Critics, complications

> The surgery does have critics.

> ``It's barbaric. It's insane,'' said

> Dobrovic, coordinator of the Northern Ohio Chapter

> of

> the National Association to Advance Fat Acceptance.

> ``I understand the desperation behind this type of

> surgery, the feeling that there's no other option

> left. But I find it horrifying that people are

> mutilating their bodies to lose weight.''

>

> Society needs to accept that ``not everybody was

> meant

> to be tiny,'' she said. Some people are meant to be

> outside the norm.

>

> If the medical community and insurance industry were

> serious about dealing with obesity, Dobrovic said,

> they would intervene earlier, before an overweight

> person becomes an obese person.

>

> ``I find it amazing that insurance companies are

> willing to pay for someone to carve you up,'' she

> said, ``but they're not willing to pay for wellness

> or

> exercise programs.''

>

> And, she points out, there are risks. According to

> the

> National Institute of Diabetes & Digestive & Kidney

> Diseases, 10 percent to 20 percent of patients

> require

> follow-up surgery to correct complications such as

> abdominal hernias (the most common complication), a

> breakdown of the staple line and stretched stomach

> outlets.

>

> Other side effects can be avoided with proper

> long-term care. More than one-third of

> gastric-bypass

> patients develop gallstones, but this can be

> prevented

> by taking bile salts. And while nearly 30 percent

> develop such nutritional deficiencies as anemia and

> osteoporosis, these also can be avoided by vitamin

> and

> mineral supplements.

>

> Bowel obstructions are another possible side effect.

> Just last week, required emergency surgery

> to

> clear an obstruction. During her week in the

> hospital,

> she lost 14 more pounds, receiving her only

> nutrition

> intravenously.

>

> And as with any surgery, there is the risk of

> infection and death (something that occurred in 17

> out

> of every 10,000 gastric bypass surgeries in 1997).

>

>

> Fighting for a life

> Still, the surgery has proved successful. The

> October

> ls of Surgery followed 275 patients who had

> weighed at least 300 pounds before surgery. Two

> years

> later, they had lost 83 percent of their excess body

> weight.

> ``I'm not looking to be a size 10,'' said.

> ``I

> don't need to be. I want to be an 18. I just want to

> be `normal' fat, you know? For some people, it's

> about

> being smaller, about looking better. For me, it's

> about feeling good and vital and being able to do

> all

> the things people take for granted.''

>

> Things like crossing her legs, buckling a seat belt,

> sitting in a booth at a restaurant, or walking into

> a

> room without instantly becoming the center of

> attention.

>

> ``I was never anonymous,'' said. ``I was

> always the fattest woman in the room. People would

> see

> me once and recognize me, know who I was. Now, I can

> go to the bank and have a casual conversation with

> the

> teller, go back a week later and she wouldn't

> remember

> me. I'm just like everybody else now. I'm normal.''

>

> Radak is envious.

>

> For the past five years, she has fought several

> insurance companies for coverage for gastric bypass

> surgery. Asked what she wants from the operation,

> her

> answer sounded very similar to 's.

>

> ``To be normal again,'' she said. ``I'm not wanting

> this because I want to be rich and famous and

> beautiful. I want to be normal. My dream in life is

> to

> walk into the Salvation Army and buy a pair of jeans

> off the rack.''

>

> At 43 years old, 5 feet 9 inches tall and 345

> pounds,

> Radak is slowly seeing her health decline.

>

> ``I've just been told I have mild congestive heart

> failure,'' she said. ``What's next? Diabetes?

> Where's

> this going to lead?''

>

> There's no question that obesity leads to all kinds

> of

> health problems. Just ask 65-year-old Drina Beeman.

>

> A little over a year ago, she was taking Daypro for

> arthritis, Cozaar for high blood pressure,

> Furosemide

> for heart problems, insulin and Glucophage for

> diabetes, K-Dur as a potassium supplement,

> Oxybutynin

> for incontinence and using two inhalers twice a day

> for asthma.

>

> After gastric bypass surgery last year, her weight

> dropped from 343 to 190 pounds. And she is now

> virtually drug-free, taking only allopurinol for

> gout,

> along with a megavitamin and a calcium/vitamin D

> supplement.

>

> ``I can do so many things I couldn't do before,''

> she

> said. ``I can walk without being winded. I couldn't

> stand up to do dishes or cook. Getting in and out of

> the shower and taking care of myself is so much

> easier. Just being able to breathe and to know I

> don't

> have to rely on all those medications.

>

> ``Not only that, but I look better than I used to.

> Every time I go to church, people tell me how nice I

> look. That's nice. You really don't get complimented

> too often when you're obese. People can be cruel.''

>

>

> Foods to live by

> Not only does the surgery help people lose weight,

> it

> helps them keep it off. The post-surgery diet is

> strict: no carbohydrates (bread, pasta, rice,

> potatoes), low-fat, protein-heavy (64 grams a day

> from

> chicken, fish, turkey, milk or protein powder).

> Jaroch said it's important that the weight loss

> comes

> from fat, not muscle. The protein is needed to help

> maintain muscle.

>

> Supplements, too, are important. The surgery

> decreases

> the body's ability to absorb some key nutrients,

> which

> can lead to anemia or osteoporosis. A multivitamin

> and

> a calcium/vitamin D supplement are part of the

> long-term diet.

>

> Jaroch has performed 500 gastric bypass surgeries

> since 1992. Early on, he found that patients were

> not

> following the diet.

>

> ``Out of total exasperation I said, `I'm going to

> have

> to go to the grocery store with you and show you

> what

> to put in your cart,' '' he said.

>

> He now leads once-a-month treks through area grocery

> stores with patients and prospective patients.

>

> Fish is one of the healthier foods, he said. But he

> warns patients to be careful in their choices

> because

> some fish is fatty. For instance, not all salmon is

> created equal -- farm-raised fish are fattier than

> wild salmon.

>

> ``There's absolutely no reason to eat a bad meal,''

> he

> said. ``You don't need a Big Mac. It doesn't take

> that

> long to make something good. You can go from the

> freezer to the microwave to the table in 10 minutes.

> There's no reason to eat junk.''

>

> If, however, a patient strays, Jaroch said, he or

> she

> will pay. Eating too much fat or too much food will

> likely lead to vomiting, he said, or at least severe

> discomfort.

>

> ``This is different than most surgeries you do,'' he

> said. ``Most surgeries -- a gallbladder, an

> appendectomy -- the offending organ is removed, the

> patient feels better and that's it. With this, you

> have to learn a new lifestyle.''

>

> For , a new lifestyle has been a better

> lifestyle.

>

> She pulls a small photo album from her purse. The

> first pictures show her before the operation, at 579

> pounds. The next shows her two months after surgery,

> about 100 pounds lighter. Then at four months and

> 173

> pounds lighter. Then at six months and 210 pounds

> lighter. And, finally, at 15 months, in her aerobics

> outfit, 335 pounds lighter.

>

> She expects to continue her descent toward 200 or

> 180

> as she continues to exercise three times a week. And

> she's awaiting insurance company approval for

> surgery

> to reduce the size of her breasts and remove excess

> skin left behind by the weight loss, especially

> around

> her upper arms, stomach and thighs.

>

> In the meantime, she keeps her photo album nearby,

> always.

>

> ``I'll get it out when I get frustrated,'' she said,

> ``when I think, `How can somebody who has lost 300

> pounds still be this big?' Or I'll get it out if Im

> tempted to eat something I shouldn't, like macaroni

> and cheese. I really miss macaroni and cheese. But

> I'll look at these photos and think, `Well, it was a

> lot harder to be that big than to do without

> macaroni

> and cheese.' ''

>

> Wheeler can be reached at or

> tawheeler@...

>

>

>

> News Story Index

>

> __________________________________________________

>

[Guest guest]

Ms.Magoo,

Great story, thanks!

Elaine

> Hey list, here's a story that ran in our Sunday Paper

> yesterday about WLS. It's also on line.

>

> > http://www.ohio.com/bj/news/docs/003436.htm

> >

> >

> > `ALL OF A SUDDEN I HAVE A SECOND CHANCE'

> >

> >

>

--------------------------------------------------------------------------------

> >

> >

> > Slipping back into life

> > Weight-loss surgery worth risk for many

> > BY TRACY WHEELER

> > Beacon Journal medical writer

> >

> >

> > At only 9 months, Tori was on her first

> > diet.

> > The whole milk in her bottle was replaced by skim,

> > per

> > doctor's orders.

> >

> > With that, the stage was set. For the next three

> > decades, weight -- and the always-disappointing

> > attempts to keep it off -- would be a constant,

> > unrelenting theme in her life.

> >

> > In middle school through high school, she tried

> > low-calorie diets, low-fat diets and

> > low-carbohydrate

> > diets. In college, she suffered from bulimia, the

> > dangerous practice of binge eating followed by

> > forced

> > vomiting. In her late 20s, she finally found some

> > success with the prescription drug Redux, losing 100

> > pounds only to gain back 130 when the drug was

> > yanked

> > from the market after a federal investigation showed

> > that it led to life-threatening heart problems.

> >

> > Her weight was stuck at 375, give or take 25 pounds.

> >

> > Then in 1993, at age 27, she got sick with

> > pneumonia.

> > Over 18 months, she checked in and out of the

> > hospital

> > 13 times, unable to completely beat the pneumonia.

> > She

> > took high doses of steroids, sometimes as much as 80

> > milligrams a day, to help her breathe. She gained

> > weight and fell into depression.

> >

> > ``The weight caused the depression,'' she said.

> > ``The

> > depression caused me to eat more. The eating caused

> > me

> > to gain weight. It's all intertwined.''

> >

> > Before long, Tori reached 579 pounds.

> >

> > ``Basically, I'd given up,'' she said. ``I had no

> > ambition. I began to accept, I guess, that this is

> > what there is to life.''

> >

> > ``This'' meaning an oxygen tank to help her breathe,

> > a

> > bus to take her to doctors' appointments because she

> > couldnt fit behind the steering wheel of her car, a

> > wardrobe purchased through the mail because no

> > stores

> > carried her size. ``This'' meaning a life in which

> > Tori 's biggest daily decision was what to

> > watch on TV.

> >

> > But on July 29, 1999, 's life began to

> > change.

> > On that day, she underwent gastric bypass surgery.

> >

> > During a five-hour procedure at Akron General

> > Medical

> > Center, her abdomen was sliced open, her stomach was

> > stapled and stitched down to a fraction of its

> > former

> > self, and her intestines were rerouted to limit food

> > absorption.

> >

> > By early this month, she wasn't half the woman she

> > used to be. In fact, she was 38.2 percent of the

> > woman

> > she used to be, down from 579 pounds to 221, a loss

> > of

> > 358 pounds in just over 16 months.

> >

> > ``The past year has been an incredible odyssey,''

> > she

> > said. ``I'd given up and all of a sudden I have a

> > second chance for a career, for a future, for a

> > baby.

> > I really want a baby. It's actually conceivable I

> > might meet a guy who might find me attractive.

> >

> > ``Anyone who grew up fat knows the power of that

> > statement.''

> >

> >

> > Surgical starvation

> > In the United States, where more than half the

> > population is considered overweight and one in five

> > are deemed obese, there are plenty of people who

> > know

> > exactly what means.

> > And last year nearly 43,000 Americans, including

> > nearly 100 people in the Akron area, opted for

> > gastric

> > bypass surgery, which costs about $30,000. It's an

> > option that continues to grow in popularity, with

> > the

> > number of surgeries nationwide nearly doubling in

> > the

> > past five years.

> >

> > The first attempts at obesity surgery, known as

> > intestinal bypass, came in the 1950s and 1960s. That

> > surgery, which bypassed almost the entire length of

> > the small intestine, led to uncontrollable diarrhea,

> > dehydration and electrolyte imbalance. It was

> > abandoned by the 1970s.

> >

> > Now, obesity surgery comes in two forms -- simply

> > restricting food intake (gastric banding) and

> > restricting both the intake and the absorption of

> > food

> > (gastric bypass).

> >

> > Neither is for the casual dieter or the slightly

> > overweight. The prospective patient must be at least

> > 100 pounds overweight and have tried other

> > nonsurgical

> > weight-loss methods.

> >

> > Both procedures require an abdominal incision from

> > the

> > base of the sternum to below the navel.

> >

> > With gastric banding, a surgical band is tightened

> > around the top of the stomach, creating a small

> > stomach pouch. Patients then feel full after eating

> > as

> > little as 1 or 2 ounces of food. The food slowly

> > enters the remainder of the stomach to continue

> > along

> > the normal digestive process.

> >

> > Gastric bypass surgery also creates a small pouch at

> > the top of the stomach, but the remainder of the

> > stomach is separated and bypassed. Food leaves the

> > pouch and moves directly to the intestine, skipping

> > the first segment of the intestine, where most

> > calories and nutrients are absorbed.

> >

> > Gastric banding is the more common operation, but

> > gastric bypass has been proved to bring about

> > greater,

> > longer-lasting weight loss.

> >

> > ``The main goal of this surgery is to limit food

> > intake,'' said Dr. Mark Jaroch, an Akron surgeon who

> > specializes in gastric bypass. ``So I make the

> > stomach

> > pouch as small as I can possibly make it.''

> >

> > In the weeks and months following the surgery,

> > ``ketosis'' sets in.

> >

> > ``Another word would be starvation,'' Jaroch said.

> > ``A

> > better word would be hibernation.''

> >

> > With the stomach accepting little more than an ounce

> > of food at a time, the body is forced to find fuel

> > in

> > its stored fat. Not only does the patient eat less

> > and

> > absorb fewer calories, but the body actively burns

> > its

> > fat reserves.

> >

> > The resulting weight loss is rapid, with patients

> > losing 25 to 40 pounds a month for four to six

> > months.

> >

> >

> > Critics, complications

> > The surgery does have critics.

> > ``It's barbaric. It's insane,'' said

> > Dobrovic, coordinator of the Northern Ohio Chapter

> > of

> > the National Association to Advance Fat Acceptance.

> > ``I understand the desperation behind this type of

> > surgery, the feeling that there's no other option

> > left. But I find it horrifying that people are

> > mutilating their bodies to lose weight.''

> >

> > Society needs to accept that ``not everybody was

> > meant

> > to be tiny,'' she said. Some people are meant to be

> > outside the norm.

> >

> > If the medical community and insurance industry were

> > serious about dealing with obesity, Dobrovic said,

> > they would intervene earlier, before an overweight

> > person becomes an obese person.

> >

> > ``I find it amazing that insurance companies are

> > willing to pay for someone to carve you up,'' she

> > said, ``but they're not willing to pay for wellness

> > or

> > exercise programs.''

> >

> > And, she points out, there are risks. According to

> > the

> > National Institute of Diabetes & Digestive & Kidney

> > Diseases, 10 percent to 20 percent of patients

> > require

> > follow-up surgery to correct complications such as

> > abdominal hernias (the most common complication), a

> > breakdown of the staple line and stretched stomach

> > outlets.

> >

> > Other side effects can be avoided with proper

> > long-term care. More than one-third of

> > gastric-bypass

> > patients develop gallstones, but this can be

> > prevented

> > by taking bile salts. And while nearly 30 percent

> > develop such nutritional deficiencies as anemia and

> > osteoporosis, these also can be avoided by vitamin

> > and

> > mineral supplements.

> >

> > Bowel obstructions are another possible side effect.

> > Just last week, required emergency surgery

> > to

> > clear an obstruction. During her week in the

> > hospital,

> > she lost 14 more pounds, receiving her only

> > nutrition

> > intravenously.

> >

> > And as with any surgery, there is the risk of

> > infection and death (something that occurred in 17

> > out

> > of every 10,000 gastric bypass surgeries in 1997).

> >

> >

> > Fighting for a life

> > Still, the surgery has proved successful. The

> > October

> > ls of Surgery followed 275 patients who had

> > weighed at least 300 pounds before surgery. Two

> > years

> > later, they had lost 83 percent of their excess body

> > weight.

> > ``I'm not looking to be a size 10,'' said.

> > ``I

> > don't need to be. I want to be an 18. I just want to

> > be `normal' fat, you know? For some people, it's

> > about

> > being smaller, about looking better. For me, it's

> > about feeling good and vital and being able to do

> > all

> > the things people take for granted.''

> >

> > Things like crossing her legs, buckling a seat belt,

> > sitting in a booth at a restaurant, or walking into

> > a

> > room without instantly becoming the center of

> > attention.

> >

> > ``I was never anonymous,'' said. ``I was

> > always the fattest woman in the room. People would

> > see

> > me once and recognize me, know who I was. Now, I can

> > go to the bank and have a casual conversation with

> > the

> > teller, go back a week later and she wouldn't

> > remember

> > me. I'm just like everybody else now. I'm normal.''

> >

> > Radak is envious.

> >

> > For the past five years, she has fought several

> > insurance companies for coverage for gastric bypass

> > surgery. Asked what she wants from the operation,

> > her

> > answer sounded very similar to 's.

> >

> > ``To be normal again,'' she said. ``I'm not wanting

> > this because I want to be rich and famous and

> > beautiful. I want to be normal. My dream in life is

> > to

> > walk into the Salvation Army and buy a pair of jeans

> > off the rack.''

> >

> > At 43 years old, 5 feet 9 inches tall and 345

> > pounds,

> > Radak is slowly seeing her health decline.

> >

> > ``I've just been told I have mild congestive heart

> > failure,'' she said. ``What's next? Diabetes?

> > Where's

> > this going to lead?''

> >

> > There's no question that obesity leads to all kinds

> > of

> > health problems. Just ask 65-year-old Drina Beeman.

> >

> > A little over a year ago, she was taking Daypro for

> > arthritis, Cozaar for high blood pressure,

> > Furosemide

> > for heart problems, insulin and Glucophage for

> > diabetes, K-Dur as a potassium supplement,

> > Oxybutynin

> > for incontinence and using two inhalers twice a day

> > for asthma.

> >

> > After gastric bypass surgery last year, her weight

> > dropped from 343 to 190 pounds. And she is now

> > virtually drug-free, taking only allopurinol for

> > gout,

> > along with a megavitamin and a calcium/vitamin D

> > supplement.

> >

> > ``I can do so many things I couldn't do before,''

> > she

> > said. ``I can walk without being winded. I couldn't

> > stand up to do dishes or cook. Getting in and out of

> > the shower and taking care of myself is so much

> > easier. Just being able to breathe and to know I

> > don't

> > have to rely on all those medications.

> >

> > ``Not only that, but I look better than I used to.

> > Every time I go to church, people tell me how nice I

> > look. That's nice. You really don't get complimented

> > too often when you're obese. People can be cruel.''

> >

> >

> > Foods to live by

> > Not only does the surgery help people lose weight,

> > it

> > helps them keep it off. The post-surgery diet is

> > strict: no carbohydrates (bread, pasta, rice,

> > potatoes), low-fat, protein-heavy (64 grams a day

> > from

> > chicken, fish, turkey, milk or protein powder).

> > Jaroch said it's important that the weight loss

> > comes

> > from fat, not muscle. The protein is needed to help

> > maintain muscle.

> >

> > Supplements, too, are important. The surgery

> > decreases

> > the body's ability to absorb some key nutrients,

> > which

> > can lead to anemia or osteoporosis. A multivitamin

> > and

> > a calcium/vitamin D supplement are part of the

> > long-term diet.

> >

> > Jaroch has performed 500 gastric bypass surgeries

> > since 1992. Early on, he found that patients were

> > not

> > following the diet.

> >

> > ``Out of total exasperation I said, `I'm going to

> > have

> > to go to the grocery store with you and show you

> > what

> > to put in your cart,' '' he said.

> >

> > He now leads once-a-month treks through area grocery

> > stores with patients and prospective patients.

> >

> > Fish is one of the healthier foods, he said. But he

> > warns patients to be careful in their choices

> > because

> > some fish is fatty. For instance, not all salmon is

> > created equal -- farm-raised fish are fattier than

> > wild salmon.

> >

> > ``There's absolutely no reason to eat a bad meal,''

> > he

> > said. ``You don't need a Big Mac. It doesn't take

> > that

> > long to make something good. You can go from the

> > freezer to the microwave to the table in 10 minutes.

> > There's no reason to eat junk.''

> >

> > If, however, a patient strays, Jaroch said, he or

> > she

> > will pay. Eating too much fat or too much food will

> > likely lead to vomiting, he said, or at least severe

> > discomfort.

> >

> > ``This is different than most surgeries you do,'' he

> > said. ``Most surgeries -- a gallbladder, an

> > appendectomy -- the offending organ is removed, the

> > patient feels better and that's it. With this, you

> > have to learn a new lifestyle.''

> >

> > For , a new lifestyle has been a better

> > lifestyle.

> >

> > She pulls a small photo album from her purse. The

> > first pictures show her before the operation, at 579

> > pounds. The next shows her two months after surgery,

> > about 100 pounds lighter. Then at four months and

> > 173

> > pounds lighter. Then at six months and 210 pounds

> > lighter. And, finally, at 15 months, in her aerobics

> > outfit, 335 pounds lighter.

> >

> > She expects to continue her descent toward 200 or

> > 180

> > as she continues to exercise three times a week. And

> > she's awaiting insurance company approval for

> > surgery

> > to reduce the size of her breasts and remove excess

> > skin left behind by the weight loss, especially

> > around

> > her upper arms, stomach and thighs.

> >

> > In the meantime, she keeps her photo album nearby,

> > always.

> >

> > ``I'll get it out when I get frustrated,'' she said,

> > ``when I think, `How can somebody who has lost 300

> > pounds still be this big?' Or I'll get it out if Im

> > tempted to eat something I shouldn't, like macaroni

> > and cheese. I really miss macaroni and cheese. But

> > I'll look at these photos and think, `Well, it was a

> > lot harder to be that big than to do without

> > macaroni

> > and cheese.' ''

> >

> > Wheeler can be reached at or

> > tawheeler@...

> >

> >

> >

> > News Story Index

> >

> > __________________________________________________

> >