Fat girls of the world, you know this question well, how many times have you heard it yourselves? Oh, and by the way, YES! I did say “fat girls.” I know the word “fat” has become sort of taboo. People say “heavy set,” “overweight,” “plus-sized,” “big boned”…I could go on and on. Suffice it to say that, having topped the scales at 365 lbs myself, I feel I have a right to use the word “fat” if I choose. It’s not like I’m putting anyone down. Believe me, those of you who are reading this and who have never in fact been “fat” may be aghast, but I would bet that the majority of the ones who have can appreciate what I am saying here. Call a spade a spade. Believe you me, when you are a size 30, it doesn’t matter what word or phrase you use to describe it, there’s just no “tip-toeing” around the matter!

I’ve gone off on a tangent though, so back to the big question.

Why didn’t I just eat less and exercise more? This is the question I overheard one of my co-workers asking someone when they informed her that I was going to be taking some time off from work to have gastric bypass surgery. Maybe she was just irritated because my being out on medical leave for 4 weeks meant that she was going to have to pick up the slack where my accounts were concerned. Or perhaps her reaction was in part due to the drastic measures I was resorting to in order to have the surgery done (traveling halfway around the world, by myself, in a leap of faith to try the new “Medical Tourism” fad). 

What I DO know is that whatever that co-worker’s reason for asking that question, her words only reassured me that I had made the right decision. Also though, I was incensed! I mean, I had struggled with my weight my entire life! I thought to myself, “Does she really think that I have not tried everything under the sun, two, three, four times over? If it were as simple as she made it sound, would I really be this fat?”

Let me give you a little history about myself.

My earliest memory of dieting was at age 7. I recall my mom making me get on the scales one morning, and for the first time it topped out over the 100 lb mark. She put me on a diet right away. It was the one where you eat dry toast, boiled eggs, dry tuna, beets, and I think maybe cottage cheese, for like 4 days, and then you take 3 days off before repeating the entire unappetizing cycle all over again. It felt like I was being punished, and I was too young to fully understand why! I know now, (as an adult and a mother of two children of my own) that my mom meant well, and that she was only trying to help me and to protect me from the cruelties I would have to suffer if I couldn’t get my weight under control. At the time however, I was confused and hurt, the same way I would feel when she also issued many of her “well meant” dinner table comments, such as “Do you really need another helping of that?” or “Don’t you think one is enough?” or “Are you sure you really need dessert tonight?”.

I love my mom dearly, and like I said, I know she was only trying to protect me from the name calling and playground taunts that I was sure to experience (kids can be cruel as we all know). What she didn’t realize, however, was that those comments just perpetuated the problem. Sometimes I’d take the extra helpings just to spite her. Sometimes I’d refuse to eat at all to prove a point to her. Of course when I skipped meals, I’d be starving later on, so I’d wait until no one was around and then I’d raid the fridge and binge on whatever I could find.

Don’t get me wrong. I am not trying to blame my addiction to food and my poor eating habits on my mom or my upbringing. In all honesty I had a very happy childhood with loving and supportive parents and sisters. I had great friends who loved me the way that I was. I wouldn’t for a minute want my mom to think that I’m saying she is the cause of my obesity. I just don’t think she quite knew how to deal with it or how to help me at the time. The fact of the matter is: I ate when I was bored. I ate when I was happy. I ate when I was sad. Food was my favorite reward for all things; good, bad, or indifferent.

That first diet my mom put me on was just the beginning of hundreds of failed attempts throughout my childhood, adolescence, and adulthood. Much as mom wanted to protect me from them, those kids on the playground still called me names and poked fun. Fortunately, even though kids can be cruel, the ones who were cruel were few and far between. Or perhaps they just made most of their comments when I was out of earshot? Actually, in hindsight, they’d have probably had to be pretty stupid to poke fun at someone who was almost a foot taller than them and outweighed them by twice their own body weight! By age 10 I was already 5’ 7” and wore a women’s size 14. I was bigger and taller than not only all of the other kids, but also most of my teachers. Like I said though, I had some really good friends and a loving family, so my self worth rarely suffered and as a result I had a pretty good youth, despite those middle school dances spent as a chunky wallflower, wishing someone would ask me to dance.

By high school, my involvement in sports, choir and drama, along with my outgoing personality had gained me the respect and friendship of most of the kids in my school (if not any invitations to those darn dances still). I was happy, but by the end of my junior year I’d made a decision. I was not going to start my senior year out fat. I was going to lose weight if I had to starve myself. And starve myself is what I did. For 3 months, my entire days’ nutrition consisted of a carrot and a pretzel rod, which I’d eat when I got home from school. My mom didn’t notice my abstinence from food because I was so busy with all of those activities I just mentioned that I wasn’t at home enough for her to notice. I dropped 65 lbs in 3 months, and I definitely turned some heads and caught some attention my first days back to school my senior year. I finally got my first boyfriend, I went to my prom, and I was even nominated for some yearbook categories such as “best dressed”. Unfortunately though, by the time I was 19, the weight started coming back, and worse, those 3 months of starvation had forever screwed up my metabolism.

By the time I was 30, I’d been happily married for 10 years and had 2 beautiful children, but over the span of those years my weight had gradually gone up and reached new heights. Thankfully the man that I married has always loved me no matter what size I’ve been, and he’s been there through the many ups and downs, from size 12 to 30. I was happy with life in general and felt blessed for so many reasons, but my weight limited me so much. I had chronic back pain and joint pain. I couldn’t get down on the floor and play with my children because it was so hard on my joints and back, and it was hard to get myself back up again. I didn’t have the energy to take my kids places such as the zoo or the park. Doing that much walking was torturous. I could barely even muster up the energy to clean my own house and do the laundry. I finally decided that I needed to do something drastic. After so many failed attempts at different diets and nutrition plans, I decided to look into gastric bypass surgery.

The first thing I did was attend a seminar at the local hospital for people considering bariatric surgery. It was very helpful and informative, and armed with all of the facts and statistics; I made an appointment with the surgeon to begin the process. You have to be assessed to make sure you are a candidate. I knew there was no question that I would be. I had a BMI of 58% and was 200 lbs over the recommended weight for a woman my age and height. I checked my insurance policy, and found that weight loss surgery was covered. I was elated. I knew it was going to be a long and tedious process. Insurance usually requires you to first see a nutritionist and have several weeks or months of documented weight loss attempts via that old fashioned “eat less and exercise more” method. Then you also have to be evaluated several times by a psychologist to make sure that you are mentally prepared to make such a drastic change to your lifestyle. It was going to be worth it though because I was finally doing something to improve my health and my overall happiness and longevity and health.

A week after my initial consultation with the surgeon, his office contacted me to let me know that my insurance would not cover me because essentially I was too “healthy”. I had missed the fine print or the “exceptions” for coverage. In order for my insurance to pay for bariatric surgery, the person had to have 2 or more co-morbidities. In other words, before they would pay, you already had to be suffering from other serious and life threatening health issues as a result of your obesity, such as diabetes, high blood pressure, heart disease. Because I was so young, I was still in relatively good health. I had to try and make sense of the fact that insurance would pay for the surgery if you were already knocking on death’s door, but they wouldn’t pay if you were on a direct path to all of those other health problems and were trying to prevent them. I was devastated. I had seen this as my last hope really and now that hope was dashed. The only way I could have the surgery done would be to pay out of pocket, which at around $30,000, I simply could not afford.

After a few days of wallowing in my despair and depression over the insurance company’s rejection, and in a last ditch effort, I started researching online for any surgeons or clinics across the country who might do it pro-bono. You see that kind of thing on TV all the time, doctors or lawyers taking pro-bono cases. The recipients of their generosity are always average, everyday people such as myself. I figured it couldn’t hurt to at least try. It didn’t take long to find out those pro-bono surgeries really only happen on TV, and not in real life. During my online research though, I accidentally stumbled upon something else that I’d not previously heard of. It is called medical tourism.

Medical tourism is the term to describe when people travel to less developed countries, places like India, Thailand, Costa Rica, for surgeries that their insurance companies wouldn’t pay for. The obvious benefit being that the surgeries cost thousands, sometimes even tens of thousands, less than they would if you had them done here in the states. Of course there is plenty of risk involved too, but at this point I was so desperate to have this life changing surgery that I was willing to take the risk. I was ecstatic. I could finally see a way that I’d be able to afford the surgery, and because of the fact that I would be traveling to another country, I didn’t have to spend 6 or more months undergoing the pre-surgery evaluations by nutritionists and psychologists that are routine here in the states. From the day that I first learned about medical tourism, to the day that I departed for surgery, only about 6 weeks passed.

Now don’t get me wrong, I didn’t just jump in blindly. I did my research. As it turns out, there are companies out there that are basically like travel agencies who specialize in medical tourism. I found one who was accredited by the Better Business Bureau. They had lots of good reviews. So I contacted them and got information about their bariatric surgery options. At that time, the most affordable place to go for my surgery was India. So I researched the hospital that they used in New Delhi, and I also researched the surgeon who would be performing my surgery. The hospital was a fairly new, private facility which was also accredited. The surgeon had just recently moved back to India after a long stint in the United States, where he did his residencies. He is also a fellow at American College of Surgeons, a member of the Society of American Gastrointestinal Endoscopic Surgeons, and the American Society of Bariatric Surgery. All of these things made me feel pretty comfortable with my decision. The total cost for my surgery, including airfare, accommodations, and meals came in at just under $10,000. That was $20,000 less than having the surgery here at home.

I want you to imagine telling your family and friends that you are going to spend thousands of dollars on an elective surgery. Now imagine telling them that you are going to travel to a third world country, by yourself, to have the surgery performed. That information went over about as well as you would expect it to. They were shocked and angry. They said it was stupid and crazy. They tried to convince me that I didn’t need weight loss surgery. They said that I looked just fine the way that I was. What they didn’t understand was that this was not about how I looked. It was about my health and my future. It was about being able to be a better mother to my children and a better wife to my husband. It was about being able to live a fuller and more rewarding life, and hopefully a longer life too. I was a woman on a mission and my mind was made up.

In preparation for my trip, I made an appointment with my family doctor. I knew that I was going to need some immunizations, as well as someone who would be able and willing to care for me during the post operative phase. I was apprehensive about telling my doctor about my decision. I thought for sure he was going to tell me I was crazy just as my family had done, and possibly even refuse to treat me after I returned. Thankfully, he was very open minded and actually even a bit excited because I was his first patient to do something like this, and so he was curious to see how everything went and he was also curious to see how the bariatric surgery would help me and change my life. Finally here was someone who understood and was being supportive. I felt vindicated.

On October 21st, 2008, I boarded a plane bound for India. It was my first time flying overseas, and it was only the 3rd time in my life that I’d flown in a plane at all. The flight was a grueling 16 hours long, and if you think a plane ride is uncomfortable, try it at 365 lbs where you barely fit in the seat and the arm rests are digging into your sides, and you are embarrassed and also feel bad for the person who has to sit beside you because you are virtually spilling over into their seat. Again though, these are all things that just reaffirmed that I was doing the right thing for myself.

When I arrived in India, it was around 10pm. The company that my trip was arranged through had a driver waiting for me who took me directly to the hospital. I slept that night in my hospital room and my surgery was the following day. In hindsight, I am so very glad that this was how it worked out. Had it been daylight during that half hour drive from the airport to the hospital, I would have been able to see the trash piled knee high on the sides of the roads. I would have been able to see that every home had a security wall surrounding it with razor wire or shards of glass cemented into it. I would have been able to see that only a few hundred yards from the hospital, nestled under a highway overpass, was a sort of “village” of an estimated 2 to 3 hundred people, their only shelter besides the overpass itself, a make shift lean-to comprised of a few sticks with a tattered piece of cloth stretched across them.

I was more than a little scared being in a strange place and so very far from home by myself. The doctors and nurses, however, were extremely friendly and welcoming, and most of them spoke English so at least there wasn’t a language barrier. The hospital was new and very clean, if not a bit empty, which gave it an eerie quality. The next morning I found out from another American patient who happened to be with me in one of the waiting areas that the reason it was a bit desolate is that only the very wealthy citizens could actually afford to get treatment there. Most of the natives were relegated to public hospitals and when I heard this man describe those facilities to me, I shuddered.

My surgery went off without a hitch. I was in the hospital for three days, and then I was taken to my accommodations for the remainder of my stay, which was basically a bed and breakfast which catered mainly to medical tourism patients. The family who owned and ran the place were very kind and friendly. The other guests were all Americans. The house and the grounds were surrounded by a security wall that would have been impossible to scale. All of these things combined made me feel perfectly safe and even at home.

Nine days after arriving in India, I boarded a plane and headed home. I followed my doctor’s orders to the letter, and in the first year I lost 165 lbs, and by 17 months after surgery, I’d lost a total of 200 lbs. Gastric Bypass surgery is not a magical fix. You still have to work at it. You have to follow the doctor’s orders. Even now, 4 years later, I still have to monitor my weight and remind myself to make the right choices and exercise regularly. The statistics show that the majority of people who have gastric bypass surgery put some or all of the weight back on within 5 years. I put 20 pounds back on after 2 years, but I have stabilized at that weight and maintained it for 2 years now, and I am happy with where I am.

That surgery changed my life and probably even saved it too. I am healthier than I have ever been. I can chase my kids around and get down on the ground to play with them. I can take them to the zoo and to the park, and these days they tire out long before I do! Most of my aches and pains went away. My blood pressure and cholesterol went down. I feel like a new person, like I have been reborn!

Even more surprising to me is that the whole experience also gave me a new perspective and a huge confidence boost, and I’m not talking about the weight loss this time. I hopped on a plane, by myself, and flew halfway around the world to have a major surgery so that I could better my life, and as my best friend likes to remind me, that took an enormous amount of courage. It gave me a new respect for myself and what I was willing to do, what I capable of doing, in order to change my life for the better. These days I don’t let anything stand in the way of my goals, nor do I allow a limit to be put on the goals that I set for myself. I feel like I can do anything that I set my mind to, and I do. I lost the weight and found a new me!

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