By JAN GLIDEWELL
Special to the Times
I had been hearing it from doctors since I was an 18-year-old Marine, tipping the scales at 160 pounds. I kept hearing it through the years, as I ballooned as high as 320 pounds.
They were always clear on what I should do, though a little short on how.
I think I have a better idea now.
I will spare you all of the "woe is me" stuff about being overweight most of my life and the diets that didn't work or worked briefly before I regained the weight.
When I heard about bariatric surgery, I dismissed it as being too extreme. Not until I was lying in a hospital bed after open-heart surgery did I realize I was running out of options, health and time.
So I reinvestigated, talked to some people who had the surgery and found out they were pleased with the results. A little more research told me that gastric banding was the best option for me, so I had the procedure 14 months ago.
The numbers don't lie.
I have lost 68 pounds, going from 269 to 201. My waist has gone from 48 inches to 36 inches, and my shirt size from 2X to large — sometimes I can even wear a medium.
My cholesterol and triglycerides have gone from problematic to healthy levels. I had become a Type 2 diabetic; my blood sugar tests are now normal.
I had become pretty much a slug; now I walk 3 to 6 miles every day and do resistance training twice a week.
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A quick primer here: Most people call what I had Lap-Band surgery, but Lap-Band is a registered trademark and not all bands are that brand. Mine for instance is a brand called Realize.
The concept is simple. The band, surgically placed around the stomach, creates a small pouch that holds about 4 to 6 ounces of food, around a half-cup to a cup. That both limits your capacity and sends signals to your brain that you are full. The band is adjustable with a simple office procedure. Responses differ, but if I eat more than I should I get some mild discomfort and hiccups. If I persist, I get what is delicately called, "productive burping," in which food comes back up from the pouch.
After a while the conditioning kicks in and you know when you are about to, as I put it, hit the wall, and you stop. I have to chew and eat more slowly to give my brain a chance to heed the "stop eating" signal I had been ignoring for years.
In addition to watching the amount of food I eat, and how quickly I eat it, I also must watch the content. High-fat foods, for instance, are off-limits because of what they do to my system.
As long as you follow orders, initial weight loss is pretty steady and even dramatic, or at least it was for me. I lost 24 pounds the first two weeks after surgery, 13 the week after that.
After a while it slowed down, including a couple of week-long plateaus. One week I even gained a pound. In the last nine weeks I have lost three pounds, and I am fine with that.
It helps to keep in mind that fluctuations are expected and that it is only logical that weight loss will resume if you keep working at it. I find slow and steady vastly preferable to riding the roller-coaster so many times over the years.
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My clinic, hospital and physician's costs were $10,000 for the simple gastric band, though there's a costlier procedure for patients who've earlier had gastric bypass.
Insurance companies are more and more frequently covering the procedure, a wise choice in a nation where one out of three adults is obese and the cost of treating related conditions will likely be more than the surgery. With my Medicare Advantage plan, the total out-of-pocket cost over an 18-month period has been around $1,000.
Medicare has slightly more stringent requirements than most insurance companies. Before it would pay for the procedure, I had to jump through some extra hoops, including going on a six-month physician-supervised diet to demonstrate that I couldn't lose weight on a normal diet plan. I also had to provide evidence of "comorbid" conditions — heart disease, diabetes and joint pain in my case. I had a psychological evaluation, met with a nutritionist and had a complete lab workup.
An important part of the process involves determining your body mass index. A BMI of 30 or more qualifies you as obese. A BMI of 25 to 29.9 makes you overweight. Mine, right now, is 31.48 (down from 41.97).
After I lose a few more pounds I graduate from obese to overweight.
Right now I am at 196 pounds and hope to level out at around 175 or 170.
I had to go on a preoperative liquid diet for a couple of weeks. After surgery I was on clear liquids for a week, regular liquids for three weeks and soft foods for a brief period after that. The surgery itself is done in a hospital under general anesthesia with a laparoscope, meaning the scarring is practically nonexistent.
I left the hospital five hours after the surgery and was able to walk a quarter of a mile when I got home.
In a few days I will be leaving for Thanksgiving dinner at the Ballastone Inn in Savannah, Ga. As usual I will be eating a delicious dinner of turkey, potatoes (no gravy), dressing and pumpkin pie.
In the old days, I would eat two heaping plates of food, set more aside for a late-night snack and then eat dessert.
This year — just like last year — my entire meal, including dessert, will fit on a bread plate. I won't mind at all.
There is a pair of size 34 slacks in my closet that I know I'll be wearing someday soon.
Jan Glidewell is a former Times columnist who lives in Dade City.