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Saturday, June 25, 2005

‘Morbidly obese’ means progress

Originally published June 25, 2005, in Our Town for the Tracy Press.

It’s been four months since I had gastric-bypass surgery, and life just keeps improving.
I’ve lost about 74 pounds — 100 pounds since my highest weight last summer — and the sense of accomplishment is almost indescribable.
As I’ve mentioned in previous columns, I was never able to lose more than about 30 pounds with other weight loss methods. Though I knew that gastric bypass boasts a 95 percent success rate, in the back of my mind, I thought I would be among the 5 percent for whom it didn’t work.
Instead, I’m amazed every week I step on the scale. I’ve gone from a body-mass index, BMI, of near 60 — considered “super obese” — to 41.6 — the low end of the no-less-scary “morbidly obese” distinction.The BMI is a number often thrown around by health-care and fitness professionals to determine whether a person’s weight is healthy for his or her height. I had originally reported my BMI in this column as being 56 before I had surgery.
Unfortunately, that was at a time when I thought I was taller than I really am.
The funny thing is that even after losing a total of 100 pounds, my BMI is still high enough to qualify me for surgical weight loss and have the procedure covered by most insurers. Talk about putting things in perspective.
I continue to be amazed by people’s reactions to me. A woman at the gym the other day told me I looked like my sister. Not that I have a sister, but she said my features have changed so much that I look like a relative of my former self.
I get asked a lot if I’m considered a success. I generally say that success is relative. If I had dropped 100 pounds through standard diet and exercise modifications, my physician wouldn’t mind if I chose to stop losing weight right now. After all, anything is better than where I was before, and maintenance is the hardest part of weight control.
Having gastric-bypass surgery changes that perspective.Doctors have varying opinions on what constitutes success with this surgery. Most insurers are happy if a patient loses 50 percent of his or her excess weight. But some doctors set higher goals to put a patient’s BMI closer to the “normal” range. The accepted average is that surgical weight loss can help patients lose about 65 percent of their excess weight.
I’m on track to lose 75 percent of the extra weight I carried at the time of surgery.
Because I am 5-feet-3-inches tall, insurance charts say I should weigh 130. Rounding my pre-surgery weight down to 309 pounds, that means I’m on track to weigh 175 pounds after 18 months, for a total loss of 134 pounds. That gives me 14 more months to drop 60 pounds.
Chances are, I’ll lose more than that over the next year, but at least I have an idea of the weight at which my body may decide to rest. And I hope that knowledge prevents me from obsessing over the fact that 175 pounds on a 5-foot-3-inch frame is still considered obese.

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