Lisa Delaney is one of the rare souls who know what it’s like to be an “after.” This journalist and author of Secrets of a Former Fat Girl shed 70 pounds—and six dress sizes–and has kept it off for 20 years. She answers your questions here each week.
DEAR FORMER FAT GIRL: I have been overweight all of my life, and it’s getting to the point that it’s harming my health. My doctor just told me that I have prediabetes and if I keep going the way I’m going, I’ll be a diabetic before the end of the year. I am seriously thinking about having weight-loss surgery. I know it’s a big decision but I feel like no matter what I try, I can’t do it without help. What do you think?—Renee
DEAR RENEE: Well, there has certainly been some good news regarding weight-loss surgery and diabetes recently: In two studies, patients undergoing a type of gastric bypass surgery have seen their diabetes go into remission. The surgery also seemed to lower high blood pressure and high cholesterol. In the most recent study, all of the patients undergoing the surgery had a body mass index (BMI) of 35 or over; the average BMI was 41. After the surgery, their BMI went down to 28 (30 is considered obese).
Only your doctor can tell you whether you would qualify for such a surgery, and how well it might address your health issues. But I would urge you to do some homework before making your decision. I’m pretty conservative when it comes to taking a surgical approach to anything, especially nowadays when there are all types of nasty drug-resistant infections you can get in hospitals. Understand what you’re getting into regarding recovery time, as you should with any surgery.
The other thing to know about gastric bypass is that it doesn’t take you off the hook as far as diet and exercise are concerned. Yes, the surgery physically reduces the size of your stomach and thus helps limit the amount you can eat, but it’s still important to do all of those same things you need to do to maintain a healthy weight the non-surgical way: focus your diet on lean proteins, fruits and vegetables, whole grains and healthy fats, and exercise to keep your heart, muscles and brain (yes, your brain benefits from exercise too) healthy. Many surgical patients are unprepared mentally for life after surgery, and end up gaining the weight back (yes, it is possible) or learning the hard way that surgery alone is not the answer. Case in point: Several years ago, I had the opportunity to spend time with a guy who had lost over 125 pounds via gastric bypass. I met him about a year and-a-half post-surgery, and he was JUST beginning to wrap his head around what it meant to eat healthfully and exercise. His outer transformation had happened, but what I think of as the REAL work that needs to happen for you to be successful at long-term health and weight loss—the internal work—was just beginning. He was still mired in many of the same emotional behaviors and challenges that led him to overeat in the first place, and was just starting to feel stronger and more confident and less of a victim of his appetite as he began to embrace exercise and healthful eating.
I would suggest talking all of this over with a trusted physician, and coming up with your own post-surgery plan that includes healthy eating goals and exercise. You might even benefit from something like Weight Watchers after surgery, where you will gain support for the healthy changes you need to make as well as information about how to control portions and use your calorie “budget” wisely. Whatever you decide, my very best wishes on the journey ahead.