Recently, Ruby Gettinger’s journey to lose weight and achieve better health came to my attention through a friend. What an amazing woman she seems to be! She's absolutely knockout gorgeous - her eyes, facial structure, expressive musculature, beautiful hair - for one thing, and she's compelling, irresistible. You're automatically drawn to her; there's a sense that an adventure or some kind of fun is either happening or just around the corner. (See http://www.mystyle.com/mystyle/shows/ruby/index.jsp) for more on Ruby.

My History: Years of Dieting “Success”

Now that I'm on the downhill side of my own journey, It's hard for me to watch Ruby’s struggle. Just like Ruby and most of you on this site have had your own experiences with diets over the years, I have been dieting in one form or another since age 6.

Years of formal diets, psychological counseling, medical programs, fad diets, fitness programs, and more were taxing on my health, confidence, self esteem, and ability to believe I could ever lead a normal, average-sized life. I always thought if I could just be disciplined enough, good enough... Here's the shortlist:

>Slender Now at age 7, Weight Watchers at 8,   Atkins at 9, more Weight Watchers, Herbalife...
>Duke University's infamous Rice Diet (age 11), where we moved to Durham and lived in a motel for two months in the summer. I ate washed white rice and specific fruits to get my sodium level to under 10mg (whereupon I was allowed unsalted canned tomatoes and a plain potato). I have actually wondered if that time of nutritional deficiency affected my growth in terms of height especially, but no matter - it's past. Lost 35 pounds in 2 months there, and it was mostly back before Christmas
>Shands Hospital (age 14), where psychological counseling led the young counselor-interns to tell my poor mother that she needed to stop nagging me about my weight (it's always the mother's fault, no?).
>More Atkins, Weight Watchers, Herbalife, and so on.
>I tried starving myself at 14, eating 1 can of unsweetened pineapple and walking 4-5 miles per day. Lost about 60 that time
>I cut out lunches and stopped eating with my peers (I was beyond college and well into my late twenties before I ate lunch with others again)
>On to college, where I tried Weight Watchers (age 19) again with a friend.
>I walked around the entire Cal State campus many times a week, generally 4-5 miles a day for at least 3-4 days per week
> While at MTSU, I ate nothing but noodles for months. I lost about 70 pounds, got up at 5am and walked 4-5 miles, practiced voice and piano to avoid food and express emotion. Got hit on a few times, encountered other new stressors, and *poof* the program was out the window.
>Went into credit card debt to do Nutri-System around age 23, where I put my heart and soul again into making this time the final success. Followed the program to the letter, lost 90 pounds, again hit stressors, got harassed by a fellow at work who wanted me to go out with him and arranged for me to be moved to his department right next to him (ugh), again hit some major stressors and the weight slowly began to creep back on.
>In between all that you'd find sporadic counseling and attempts at drugs like Dexatrim, Phentermine, Wellbutrin, and so on. All ultimately to no avail.

I resisted surgery every way I could until I was in my 30s. I always thought if I could just be disciplined enough, good enough...

My History: Years of Dieting Failure

My problem, though, was not just a lack of discipline. I had the discipline to lose 35, 60, 90, 80, and so on lbs over the years but to be able to sustain that drive minute after minute, day after day, year after year, was counterintuitive and required a paradigm shift at a level I could never achieve. So ultimately the weight would come back with bonus. Many, many times.

Gastric Bypass Without the Surgery...

Then while at Stetson University, I read an article in Woman's World about Satietrol. It was all natural - it consisted of potato fiber and alfalfa powder among other things. It tasted like swill until I learned to mix it with milk and stir it a certain way to keep the lumps out. The concept was traditional but the method and recipe new. I would drink a packet 20 minutes before a meal and find that the effect was (much like gastric bypass surgery although not as strong and distinct nor consistent) that I felt as full as if I'd eaten a full meal already and was barely hungry. I had lean protein with vegetables for lunch every day, after two weeks of reviling the stuff, I came to crave the Satietrol shakes for their taste (only with milk though!) and feeling of control they helped me achieve. 90 pounds slid off like nothing. I had found the answer! It was like I’d had gastric bypass surgery without the surgery!

Although 90 was the most I lost, I managed to sustain the majority of that weight loss for a few years - about 2 or 3 - before it began to creep back on to a point where I was heavier than I'd ever been in my life... and just in time for my wedding.

I finally accepted that there’s a lot more to weight loss than the mental aspect and the psychological control over hand/spoon/fork/chopsticks-to-mouth, the demons in one’s past, and one’s level of discipline.

Resigning to the Inevitable

Through looking back, counseling, researching, and talking with competent medical professionals, it became clearer and clearer that my best hope for an "average-sized" life would be gastric bypass surgery.

On the other hand, the surgery I opted for isn't a cure; it's just a powerful, powerful tool. Some surgeons report potential weight loss of 75 to 80% of the patient’s excess body weight in the first year. Many patients are able to discontinue heart, cholesterol, diabetes, and other meds, more and more reputable doctors report that their experience and statistics bear out that the surgery is more effective than diet and/or medication for the morbidly obese. Visit http://www.obesityhelp.com/ for more information about the various procedures, their risks, potential outcomes, and questions to ask your doctor and surgeon.

Have you heard of the Gremlin?

There’s a vicious little hormone called ghrelin (I refer to it as the Gremlin).

“Ghrelin is the hunger hormone. It’s made in the stomach, and it tells the brain when it’s time to eat. Ghrelin doesn’t cause obesity, but scientists think taming it might help us get our scales back in balance…. A mouse was injected with the hormone. Just 15 minutes later, he was absolutely wild for food, even though he’d already eaten enough to be full…Scientists are finding that ghrelin has the same power over people.” 

Just the single effect of the reduction of the ghrelin hormone has been enormously significant for me. When I woke up from surgery, the first thing I noticed - and significantly - was that I was not hungry. Now, I have to remember to eat.

You get so full!

When your stomach fills with food, it stretches. The stretching sends signals to your brain that you’re full. With gastric bypass surgery, the stomach is significantly reduced (typically 95%) with the effect that after anywhere from a couple of tablespoons to as much as a half-cup of food makes you feel STUFFED.

And SICK of sugar and fat!

The gastric bypass procedure I had done includes a bypassing of the duodenum. This means that anything I consume does not sit in the duodenum and get absorbed (good and bad), so there is a necessity to take supplements like Iron, B-12, and multivitamins to ensure nutritional health.

The plus side of this part of the bypass is what is called the “dumping” effect. Since whatever you eat shoots straight to the intestine, the intensity of the food is at its highest level. Instead of the food getting diluted by gastric juices in the stomach, this now happens in the intestine (really the Y junction).

So, for example, if you ate a brownie right now, you’d probably feel ok, or if you had 2 or 3 you might feel a little yucky. After gastric bypass, your bite of brownie shoots straight from the stomach pouch to your intestine unmolested and undiluted. So you get the full impact of all that sugar and fat and chances are your body will want it OUT. And then we have dumping.

As time goes on, many of us can take a small bite of this or that and I find that I am not at all frustrated that I can no longer eat a dozen cookies, two bowls of ice cream, etc It just doesn’t appeal to me any more, and I don’t miss it although I truly thought I would. A small spoonful of cheesecake or a quarter of a small piece of cake makes me quite happy now.

Whatever the cause…

Whatever the true causes of morbid obesity are narrowed down to be, statistics and studies have proven out that bariatric surgery is more successful than diet and/or drugs I feel like a "normal" person now that I'm a more average size. I'm not treated like a freak nor am I discriminated against. In fact, studies show that a significant number of obese receive promotions after achieving a "normal" weight. I was promoted myself just last year.

Finally, I’m normal (well, in context of size, anyway)

Bottom line, I can tell you that for me, having lost 150 pounds in the past year and a half after being very overweight my entire life from age 6 on up is like the miracle I prayed for every day as a child.

The old "Pull yourself up by your bootstraps, suck it up, you can do it!" routine is over for me now...

So, when I watch Ruby and see a psychiatrist telling her she needs to suck it up and take what she can get, I feel my face get red with the anger and frustration of all those years of being told that's all I needed to do. When I saw that particular episode with Dr. Bradley (http://link.brightcove.com/services/link/bcpid2890991001/bclid1840668509/bctid2954498001), I just wanted to drive up to Savannah (I love Savannah!) and say "look, honey, can I share some statistics with you? Can I share me with you? I’ve been right here where you are and I don’t want you to hurt one more second if I can prevent it.”

Everyone finds his or her own path

Obviously, though, Ruby is in the good and meaningful hands of her friends who love her and top professionals who are experienced and mean well for her. She has selected her own journey and will find the answers that work for her. In the meantime, it's heart-rending to watch.

I hope she finds less pain and more joy and happiness in the discovery that "right-sizing" one's body brings to oneself, no matter what the method.

Things like:
The first time you can cross your legs.
The first time you realize you've entered an elevator without thinking about its weight limit.
The first time you notice you've sat in a chair without estimating whether or not it would collapse, whether you would fit between the arms, or both.
The first time you run because it's faster, not because you're exercising
The first time your overtight pants are truly baggy
I could go on for hours; it's a whole new world!

Now it's like I have always been the "normal" sized person. Still overweight, but within the realm of the typical person. Mostly forgotten is the sense of having to overthink walking though a tight area, passing someone in the hall, whether or not to go to a theatre, take a flight, etc. because of the size of the chairs. Airline seats are even huge now. Seatbelt extension? No way, inches of slack. I have been taking everything slow and smooth for the past year and a half. The biggest challenge has been taking iron and b12, but I have been good about protein.

It's a whole new world that is the way it was always supposed to be... I'd do the surgery 100 times over in light of what I know now.

The following is the list I used when preparing for surgery. If you are preparing for surgery too, I hope that you find this helpful.
Grocery List: Sugar Free Jello, Sugar Free Pudding (Jello caramel is awesome), Plain yogurt, Gatorade, 2% cottage cheese singles, FF Milk, SF Popsicles, Protein Drinks, Low fat cream of chicken, mushroom, etc. (Campbell Selects are good and can be pureed with stick blender), SF Applesauc, SF Carnation Instant Breakfast, Smart Balance Peanut Butter, Smucker's Sugar Free Jelly, Crystal Light, Gatorade
Medical Supplies: Medical tape, Bandages, Neosporin
Clothing: Loose pants, Oversize, button-down tops, Slip-on shoes
Kitchen Supplies: Hot Shot (Target), Stick Blender, Kitchen Scale with easy to read ounces, Measuring Spoons, Pyrex Pint, Baby spoon, Baby fork, Gladware 1/2 cup containers, Press & Seal plastic wrap, Small-medium Strainer
Recommended Reading: Better - Atul Gawande, Exodus from Obesity - Paula Peck, RN
Recommended Household: Line up a maid, Have all laundry done, Move boxes/obstacles out of the way, Change bedding, Have a plan for keeping dogs/cats away from you for 4-6 weeks, Have a plan for helping kids not jump on you/ask to be picked up

Well, with weight loss comes a new interest in fashion! I've been having a great time with hairstyles, clothes, and jewelry and to support my happy new habit I am now selling Silpada Fine Sterling Silver Jewelry (As seen in Redbook and Oprah magazines).

My debut party is Wednesday, September 19, so if you're close to Daytona Beach and would like to come, please drop me an email and I'll send you an invitation. Visit www.mysilpada.com/wendy.read to see the catalog, and please let me know if you'd like to order or host your own open house!

Well, I can't rightly say that airplane seats have gotten bigger since I'm quite sure the airlines aren't going to budge on that. But they sure fit better! Had to take in slack on the seatbelt....

40 down, tons to go, feel quite normal. Out of clothes that fit - they're calling me "Sister Saggy Slacks" at work...

Watching out for slippery foods like mushrooms and pineapple, though. Had a bad, never-want-to-repeat with both apparently from not chewing enough. NOT a good experience.

The following is the list I used when preparing for surgery. If you are preparing for surgery too, I hope that you find this helpful.
Grocery List: Sugar Free Jello, Sugar Free Pudding (Jello caramel is awesome), Plain yogurt, Gatorade, 2% cottage cheese singles, FF Milk, SF Popsicles, Protein Drinks, Low fat cream of chicken, mushroom, etc. (Campbell Selects are good and can be pureed with stick blender), SF Applesauc, SF Carnation Instant Breakfast, Smart Balance Peanut Butter, Smucker's Sugar Free Jelly, Crystal Light, Gatorade
Medical Supplies: Medical tape, Bandages, Neosporin
Clothing: Loose pants, Oversize, button-down tops, Slip-on shoes
Kitchen Supplies: Hot Shot (Target), Stick Blender, Kitchen Scale with easy to read ounces, Measuring Spoons, Pyrex Pint, Baby spoon, Baby fork, Gladware 1/2 cup containers, Press & Seal plastic wrap, Small-medium Strainer
Recommended Reading: Better - Atul Gawande, Exodus from Obesity - Paula Peck, RN
Recommended Household: Line up a maid, Have all laundry done, Move boxes/obstacles out of the way, Change bedding, Have a plan for keeping dogs/cats away from you for 4-6 weeks, Have a plan for helping kids not jump on you/ask to be picked up

Well, over a month past surgery and I feel back to normal except not hungry. I still want food, but I cannot say I'm hungry, so my excuse for eating is GONE!

Joined the local health club and started working out with the help of a personal trainer (friend + free personal training = REALLY GREAT FRIEND!), so I'm achy and breaky today after huffing and puffing yesterday. But it's all good.

3 years ago I was a freak for ebay. I found this beautiful, Celtic, ethereal-looking white blouse with an empire-ish waist, long flowing sleeves, and lovely embroidery. The kind of style that makes things that should point up sit high, and the things that should not stick out disappear. I bid on it thinking if it fit it would be beautiful. When I received it, it did fit, but it hugged all the wrong things and to call the overall look a lumpy disaster is to understate the situation. Then too there was that day in Ross where I just wasn't in the mood to sift through the clutter back to a hot, dirty dressing room and try on a couple of $8 pants. So I bought them. And they DID NOT fit by any STRETCH of the imagination.

From the first week after surgery, I have been eliminating clothes from my closet that have become too big. Funny the things (other than dust bunnies) that hang around in one's closet unnoticed. There, tucked in the back behind my wedding dress, were those pants and that beautiful shirt. As I've done a few times over the past three years when I've lost some weight, I tried them out just to see if they could pass for wearable...

And they're baggy.

But the shirt looks beautiful even baggy. And the pinstriped pants are professional and slimming. How fun.

So, the ponderance of the day is, will this be yet another experience in the high excitement of "finally" losing the weight once and for all? Or will this, too, become a fading dream as the weight creeps back on after a few months or so. It's happened so many times. I knew I'd never gain it back, yet I did and then some. This time now seems too good to be true, too dangerous to get excited and hopeful about again. I still want pizza. And ice cream. And those cookies that were all over the office today. Sure, I had my Smart Balance peanut butter with Smucker's Sugar Free Blackberry Jam on dry whole grain (those cute little itty bitty rectangular loaves? Those make a 1-inch sandwich that's just perfect), but then I'm only a few weeks post surgery. Am I going to have the strength to turn to the peanut butter 5 years down the road? 10 years?

Well enough for now, time to check out what's new on ebay...

Suddenly, my car's a lot bigger. And I sit shorter in it. The couch is bigger. The pants I only wore around the house because they were too clingy are hanging. When I play board games with the gang, I'm shorter.

It's funny how that perception works. Of course, I'm the one getting smaller, but it doesn't feel that way - it feels like everything else is getting bigger. I'll take it, it's kind of fun!

People are different, too. Store clerks notice and acknowledge me more frequently and respectfully. My presence again commands attention and follow through. People tell me I look like so and so, something that used to happen when I was in my twenties and a little smaller. Saturday it was Kate Winslet. I was truly shocked at that comparison - would never have thought of it. Fortunately no recent comparisons to Kathy Najimy, although I did hear enough of that in the Sister Act days. Not that there's anything wrong with Kathy Najimy, but I just don't see the same level of romance in being compared to a giddy nun as, say, being compared to a flowing young maiden with an alabaster brow...

Anyway, it is true that the smaller I become, the more visible I become to other people. Of course, we can chalk this up to improved self esteem and more attention to appearance on my part, but the truth is a great portion is simply due to being closer to a socially "acceptable" size.

Speaking of attention to appearance, I went Saturday to Merle Norman and got the full makeover treatment. They did a great job - I learned that there is eyeliner out there that does not migrate over to become undereye shadows by the end of the day. And face countouring? Who'd have thought. Kind of fun to be able to see a more definitive jaw line and cheekbones as well.

The agony of the G-tube is now a thing of the past. And I do mean agony, it was really terrible there for a couple of weeks. Now, it's just a nuisance. I rarely have to take anything for pain now, and I feel pretty normal.

About sugar...
It's weird. Although I still want a hot, Krispy Kreme doughnut, I have no desire to put one in my mouth and swallow it. Somehow my brain knows now that I will get violently ill and it's not worth it. Plus I'm never ravenously hungry any more, so I'm sure that helps. When I go to the grocery store, I shop slowly and carefully, checking the fat, sugar, carbs, and ingredients of everything I buy. Knock on wood, I haven't had a single episode of nausea. I have noticed that sometimes I feel discomfort after drinking protein or eating. I also have a hard time drinking Gatorade straight; it doesn't make me feel ill, but it doesn't make me feel good to drink if that makes any sense. I water it down, but I'm finding that I actually prefer water along a lot of the time. I never liked drinking water before, so it's another strange change.

Significantly better today! Pain was very bad last night without pain med, but today it just feels like having a very bad cramp under my sternum, ribcage, and into my back all the time. I am able to sit up for longer periods of time, and the medicine is fairly effective against the worst of the g-tube pain.

No issues with nausea or indigestion and haven't had to take any anit-nausea or GI medication since last weekend. The vitamins are very easy to take, and I'm never hungry although there are times when I really "want" food, especially in the evening if I haven't eaten much through the day. I'm focusing very hard on staying hydrated and getting my protein in, so I keep 2% cottage cheese in the house (10 grams of protein per individual pkg) and can usually convince my palate that the Achiev One Cappucino (20g protein) tastes like a bottled Starbucks Frappucino - not too bad for a morning drink. The Myoplex (20g protein) also continues to be a favorite, as does the Unjury (medical quality protein).

I also find that I am antsy to get out and do things again. I want to swim, play tennis, go to the amusement parks, etc. but the g-tube really gets in the way of my being more active. I really question the value of leaving something so painful in for so long, but it appears that it is not painful for everyone, just very uncomfortable. I hope a better, more comfortable alternative to the g-tube is found for people who go through this in the future...

Oh, and I forgot - weight loss as of last Wednesday was 19 lbs, 7 since the surgery.