My Duodenal Switch Weight Loss anniversary is on June 5th. It’s an anniversary that I honestly celebrate more then my marriage anniversary. It’s the day that changed my life in the most dramatic and wonderful way. So I’m going to take this opportunity to gush a bit about it and put my feelings out there.

First the stats: I lost 160 lbs at my lowest. Currently as of this morning, at three years out, I have kept off 150. I pretty much bounce around 145 to 155 lbs lost. I did have a couple days where I hit 160 lbs lost but was unable to maintain it without lots of extra effort. Also, statistically for the DS, patients tend to put back on 10% of their excess weight loss between the 2nd and 4th year. So I figure I’m beating my statistical norm so far. Anyway… I’m THRILLED. Even if you say I have “put on” 10 lbs… that’s amazing.

I do have to take multivitamins, extra vitamin D and mega doses of calcium for the rest of my life. And I am having issues with not absorbing enough calcium. I will probably have to take more - which is bumming me out. I’m waiting to hear from my doctor who is reviewing my latest blood test results.

My cholesterol is under 100. My triglycerides are at 57. My blood sugar never goes over 140 even if I eat cake. My blood pressure is 115/65. I feel great.

First of all, unlike many people, I consider obesity a medical disease. You might be asymptomatic, but if you have over 75 lbs or more to lose, there is something medically WRONG. Sure, your habits might suck, but I can show you just as many skinny people who eat the same thing and are just as lethargic who are not that overweight. And success should not be measured by how much you can lose or that you can lose it… but rather can you maintain it for years. You can diet and exercise it away… but the next time a crisis hits and you eat, the weight comes back on. I was always a dieting whiz… hell I could lose the weight but not ONCE did I keep it off in a two-year period. Morbid obesity is a disease that needs medical intervention to be successful over the long term. Pure and simple. You wouldn’t tell someone who had high blood pressure to “only lose weight”. You wouldn’t tell someone with blocked arteries to only “stop eating fat”. Those are parts of the puzzle…but the puzzle can NOT be solved with that alone. Not over the long haul. I am a firm believer that drugs or surgery MUST be part of the solution if you define success as maintaining a normal BMI over years.

For the record, I was dead set against weight loss surgery. When my sister came to me and told me that she was having it I was against it. Told her that if she spent half as much time working on her self-esteem as she did trying to lose her losing battle with weight… she’d be happier. I tried to convince her that happiness with herself was the metric, not what the scale said.

Then Sept 11th happened. I was down in Florida buying the land for our house. And of course 9/11 was catastrophic and made me feel so vulnerable. And on that weekend, my father’s dementia became obvious. Dementia brought on by untreated sleep apnea (over years) and diabetes. My father is about 70 lbs overweight. He was downright cruel to me and not at all the man I remembered. And my mom…. She was facing amputation due to diabetes. She too was about 80 lbs overweight. Her diabetes has always been under good control and yet she was going to lose toes. How could this be? It killed me that weight was actually something that was going to impact their life and happiness directly. And even worse, it was impacting my life!! No more “indirect” in the future stuff. This was happening now and it was all linked to weight. Crap!!!! I was losing the security of my denial. I was sad.

And what was worse was that I knew I could diet and lose at least 50 lbs… but I was pretty sure, as history had shown me, that I would not be able to maintain it. And it hit me then… I can’t keep expecting a different outcome if I keep doing the same thing. Dieting and exercise aren’t working for me. Not over the long haul. And although my diabetes was in excellent control and that was the only co morbidity I had besides sore feet… I saw with my own eyes the effect that diabetes has on the body long-term. It was time to get real about what the extra weight would mean DOWN THE ROAD for me. It was time to take a more long-term view of my health and the impact the weight was going to have on it.

The other thing that 9/11 did for me was focus me on thinking about the quality of my life. Understand, that for me, my weight was not a problem. I had a high level successful career. I have a husband who loves me and finds me attractive no matter what my weight. I have three children. The obstacles brought on by my weight were nothing I didn’t find insurmountable. In fact in truth, I think I love challenges so much that part of me even liked the challenge of being successful in spite of being morbidly obese. I had a great quality of life as a fat person. I was happy. No need to change.

But the problems with my parents made me focus on my weight in a way I hadn’t before. I was a mother. My choice in lifestyle could literally mean the difference between life and death for them or happiness or unhappiness. First, with 9/11 I focused on what would happen if I died. What would happen if I couldn’t run carrying my son? I couldn’t run alone let alone carry him. And how would they feel about me if I died because of a complication due to weight? Would they resent me? What would their life be like dealing with the profound loss of their mother simply because I was in denial about the potential impact of my weight? Would they be proud of all I accomplished in spite of my extra 170 lbs? Or would they resent the fact I didn’t do something about it?

Then I got honest about quality of life. What is important to a toddler? What is important to a school aged child? I hated going there. It was painful. And people who know me know that I avoid pain at all costs. But my kids were in Washington on Sept 11th and I was in Florida and I was in pain with my parents. I resented them and what their weight and their choices to not do something about it were doing to me as an ADULT. And I sat with my pain and examined it from the perspective of my kids. I went from the negative consequences of not doing anything to what life would look like if I did something and was normal. How would my kids lives be different?

I can’t even express to you the nuances of how my weight loss surgery has improved their life. Small things… so small, but so big when added up over time. I sit on the floor with them more. Their friends aren’t going to point at me. I swing swings with them. I run with them. I have a lap for them to sit on. I have the stamina to do athletic things now… I don’t drive around looking for closer parking spaces. I don’t not go places because I’m worried about my stamina. I can MODEL a correct activity level without the life and death effort. I am also modeling better eating habits. Small stuff… that wouldn’t be huge if they didn’t have it, but isn’t life about giving more to your kids and always giving them the best? And really, it’s only with hindsight I can see what a difference it made. Even after I made the decision to have the surgery, I still didn’t really think it would make that huge a difference in our quality of life.

You won’t hear this too often: But I was wrong.

And of course, now I don’t ever have to worry about them holding my hand in a hospital wondering if I am dying because of a complication due to my weight. Every illness is not attributed to my weight. They would not be angry with me like I was with my parents.

So… I realized I had to do something. Now I had to decide what. Trust it was painful to go from being dead set against weightloss surgery to accepting it and embracing it. And actually picking the most extreme version of it. I was terrified by the possibility of death as a complication of weightloss surgery. I had only had my

In my research I found out that if you have less then 200 lbs to lose, having this surgery is less then .05% chance of death more then having surgery if you appendix ruptured. Put another way…. If you require some surgery when you are 100 lbs overweight? Your chances of death are around 1.5% from just being put UNDER. So the possible “death” thing… yeah… well… fat you are a walking time bomb anyway. I figured I might as well have surgery with someone who is EXPERIENCED with fat people and fix the root problem before there is an emergency.

I started doing all kinds of research focusing on health. I was so sad about my mom and dad and what they were facing. And I was angry too. And I used that anger. I needed to arm myself with information to “face the music” about what was going to happen with my body if I didn’t make changes. I needed to motivate myself. Another fact that pushed me towards weight loss surgery was that you store estrogen in fat. Estrogen feeds many types of cancer. Studies have shown that overweight women have as much as 60% greater chance dying from cancer. Again… I say that not to put the fear of God in anyone, but rather to simply put out there the things that pushed me towards my decision.

The DS surgery is technically more difficult but is different then the other weightloss surgeries. My sister has put on 80% of her weight. She had the RNY 8 months before my DS, like Carnie Wilson and Al Roker. I would not recommend that surgery. However, it’s the most common. It’s the one that doctors make the most money doing. But if you define your success by HOW LONG you keep the weight off… it’s not as successful. Not saying there aren’t folks out there that aren’t successful with it. I have many friends who have been… I’m just saying for me… It wasn’t a good choice.

That said, there are like 15 different weightloss surgery procedures and weightloss surgery isn’t a “one size fit all” determination. It’s imperative that you educate yourself on all the different options and go for the one that best suits you and your eating style. Do NOT expect a doctor to tell you about all the options. DO expect your doctor to only tell you about the procedures he or she performs. You must advocate for yourself. Here is a great link to a comparison chart that outlines the four major types of weight loss surgery and their outcomes.

If I was going to go through surgery, I wanted a surgery that was going to take me as close “metabolically” normal as possible. I wanted to eat regular sized meals. I wanted to not have to obsess about food for the rest of my life. I wanted to be a Normie. I like to eat a large volume of food… so for me, I needed something that would allow me to eat larger amounts. I didn’t want to not ever eat sugar again. I didn’t want to never be able to take an Advil. All these things weighed (pun intended) into my decision.

The biggest impact on my quality of life is that now I can eat with no guilt. I can eat HUGE quantities of food and not have to obsess over everything that goes into my mouth. Amazingly, I now obsess about the quality of things I put in my mouth. I just don’t like processed foods anymore…. but there is a freedom in not having a punative consequence to food anymore.

It’s been three years. I count the decision to have the Duodenal Switch surgery as one of the 5 best decisions of my life.

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