Below is my before photo taken in January of 2001, just a few weeks before I had my gastric bypass surgery on March 2nd, 2001. I always remember my surgiversary. I usually write a pretty detailed post for our website, Facebook and ObesityHelp detailing how far I’ve come and how much better I feel. How did I forget this anniversary? At each seminar, when I’m doing our introductions and I speak about being a patient I always tell how many years postop I am. On Saturday when doing the opening, it hit me. Saturday was March 3rd. The day after my surgiversary. I’m now 11 years post laparoscopic Roux-en-y gastric bypass surgery at Centennial Medical Center in Nashville, Tennessee.

Wow. Eleven years. Weighing 330 pounds seems like a life time ago. It also seems like yesterday. That woman in the photo below, I know her well. I know for example that while many view her as a WLS success, she views herself as always one step away from sliding back into severe obesity. I know that she still misses treating herself with food so instead she treats herself with shoes, clothes, techno gadgets, etc. (some might say this is a transfer of addiction, I will address that later this week.) I know she has daily conversations with herself about her food choices, about trips to Starbucks, about what is more important today-the taste of a certain food on her lips or the fit of a certain skirt on her hips?

January, 2001 at 330 pounds, two months before gastric bypass surgery

A few weeks ago, it was my honor to be invited to speak at a Obesity Roundtable discussion held at Boston University. There were researchers and presenters from BU, Cornell, Stanford, Harvard and me (representing the patient, patient advocate, designated nurse and non-researcher.) Suffice to say, this was a very intimidating crowd. My topic was how we HAVE to change the public perception of obesity. Without doing so, these researchers will struggle to obtain the funding they need because, well, let’s face it, obesity is not a “sexy” disease. Without a change in the public perception of obesity, no matter what the research finds for cause and suggests for treatment, obesity will continue to be simply a character flaw, a lack of will. During my presentation, I shared my personal story of obesity. I shared the struggle of others too. I showed some of the images that are typically shown in the media, images used in the CHOA childhood obesity campaign, excerpts from media articles and sadly from healthcare journals that are disheartening, derogatory and downright demeaning. My plea, to understand while these images may have a certain “shock” value, these images are inappropriate and directly contribute to the way those with severe obesity are treated.

After the presentations, we had lunch (yes, it was healthy!) I was pleased that a few people actually wanted to sit with me and ask more questions. One gentleman is a professor at Harvard who teaches a mandatory 9 hour nutrition course to their medical students. I was very impressed with both this young man and that Harvard required this training…until we discussed it further over lunch. He shared with me how the students really dislike this class and look at it as something they are forced to do. He asked me how he should ingrain in these students the message they should treat their obese patients with respect. I responded that as future physicians, they should be taught to treat ALL of their patients with respect and be sensitive to their needs. I asked if he agreed with me that patients should be treated respectfully regardless of their age, sex, gender, race, ethnicity, sexual orientation, and physical and mental disabilities. “Of course,” he said. Then why is their physical size any different? Why does that number correlate to the level of respect due to an individual. His response was so simple but so true, “It shouldn’t, but we both know that it does.” There is so much work to be done.

Over lunch, we also discussed what life is like as a bariatric patient. I described a recent afternoon when I had had a really rough day at work. As I was leaving, I had that thought, “I’m going to Starbucks. It’s been a crappy day, I want Starbucks, I deserve Starbucks, I’m going to get Starbucks.” Then I reminded myself that what I really wanted has about 300 calories in it and my skirts have been a little snug lately so I really shouldn’t go because I really didn’t need those calories, especially since I could fix me a cup of coffee with SF creamer and splenda when I get home. As I was walking to my car, I started bargaining and negotiating, “well, just drive by there and if the drive thru line doesn’t go past where you order, you can stop; but if the line’s longer than that, well it’s a sign you shouldn’t stop.” Then, as I’m driving down West End, quickly approaching Starbucks, I’m thinking, “You know, you tell you’re patients all the time, they don’t deserve food rewards, remember you’re still a patient, crappy day or not, Starbucks is not going to make it better. This deal about how many cars are in line will determine if you stop or not is crap, don’t even look at the line, you don’t need it, don’t stop.” So, I pulled over in the far right lane, I didn’t look left, I don’t know how many cars were in line, I didn’t stop. When I finished that story, this poor professor is looking at me with his mouth hanging open and looking totally perplexed, he says, “Wow, I have never, ever put that much thought into anything I was going to eat or drink, if I want a cup of Starbucks, I just stop and get it.” I told him he should think what it’s like for a patient who has similar thoughts about pretty much any and all foods and drinks they take in, constantly trying to find ways to “justify” what/how/why/when and how much they are eating. Realizing that it’s not always feeding a true physical hunger, but often feeding an emotional need. We then had a great conversation about how what I described is just one factor that influences our weight. With so many complex factors at work, how can obesity treatment ever be so simple as eat less and exercise more? How can we continue to look externally and judge so severely what occurs internally?

I am a 46 year old white female with severe obesity. Eleven years ago, I underwent successful surgical treatment for the chronic disease process of severe obesity. I continue to keep my severe obesity in remission by committing to lifelong dietary modifications, lifelong lifestyle changes, regular attendance at support groups and weighing daily. I can slip at any time, I am susceptible to recurrence of my severe obesity. I am a patient deserving of ongoing treatment. I am a person deserving of your respect regardless of my size.

BariBelle