Get surgery, eat right

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Click to see Teresa's "before" picture.

Teresa Steele
34, fashion stylist

What she lost: 158 lbs in 27 months

How she did it: At 5 feet 2 inches and more than 300 pounds, Steele was morbidly obese, with polycystic ovarian syndrome and type 2 diabetes. She tried everything to get thin—Weight Watchers, Jenny Craig, prescribed diet pills and even a macro vegan diet—but nothing worked. So she decided to undergo gastric bypass surgery. After meeting with five doctors, she chose Mitchell Roslin, M.D., from Lenox Hill Hospital, because he offered the most support (such as free lifetime access to a nutritionist). In June 2007, she underwent surgery, which shrunk her stomach, making it nearly impossible for her to overeat. Currently she’s 148 pounds. She dropped from a size 28 to an 8, grew two inches taller (for real—the weight was pulling her down), and her feet shrank four sizes. “After the first nine months, I lost 102 pounds—and I cried,” Steele says. “It’s motivating when people no longer treat you like a second-class citizen.”

The facts: After the operation, your stomach will be about the size of an egg, and you’ll learn how to eat all over again, starting with a liquids-only diet for about two weeks. Eventually you can eat normal foods, but in very small portions. “If I eat more than seven or eight grams of sugar, I get physically ill,” Steele says. “The same goes for fatty foods.” The idea is to consume five mini meals a day of protein, veggies, fruits and complex carbs, and exercise regularly. Steele sees nutritionist Sharon Zarabi to keep her on track. Among Zarabi’s (universally applicable) guidelines, patients are advised to not eat in front of the computer or TV (she calls this “mindless eating”), to read labels and look for foods containing fewer than 12 grams of sugar per serving, and to keep a food journal in order to identify problem habits, like emotional eating or waiting too long between meals. According to Dr. Roslin, post-op gastric bypass patients can head back to their jobs after about a week, depending upon how healthy they were presurgery.

Exercise plan: Now that she’s fit, Steele says she doesn’t feel like exercise is a chore. “I pop in a Windsor Pilates DVD, do an on-demand free class through FitTV, or go on a 30-minute walk through Central Park, climbing the rocks and hills. “You can also hit the gym for free by getting a two-week trial or asking a friend to take you as a guest,” she says. “Some gyms offer unlimited guest passes—Planet Fitness [177 Dyckman St at Vermilyea Ave; 212-304-4500, planetfitness.com] is wonderful about this.”

The cost: Gastric bypass rings up at about $25,000. According to Dr. Roslin, 98 to 99 percent of New York City insurance firms cover the surgery if the patient is morbidly obese, which means at least 100 pounds overweight or with a BMI (body mass index) of 40 or higher. Steele also asserts that now that she eats less, her grocery bill is lower, and she can splurge on higher-quality foods.

The permanence factor: “The surgery makes lifestyle changes possible,” Dr. Roslin says. “But it doesn’t do the work for you.” If post-op patients don’t make the effort by eating healthily and staying fit, they will eventually gain back 10 to 30 percent of the weight after 12 to 18 months. “Your metabolism actually slows down when you lose weight,” Dr. Roslin says. The solution is to exercise to build muscle mass and metabolically active tissue. Zarabi recommends that her patients eat their foods in the following order: protein, veggies then carbohydrates. This causes them to fill up on protein first, which helps build muscles.

The drawbacks: While after two years, the average weight loss is 70 percent of the patient’s excess pounds, it’s definitely not 100 percent effective. Generally speaking, Dr. Roslin says the surgery works best for those who are doing well in life—they have satisfying relationships and a decent job—but have a weight problem. They’re most likely to be able to maintain the surgery’s effectiveness. Dr. Roslin also points out that people, especially women, often experience social and psychological issues after they shed the weight. Says Steele, “Don’t assume that once you have weight-loss surgery, your life is perfect. One friend looked me dead in the face and told me I was her competition—it was okay for me to be her fat friend because she got all the guy attention.” Steele adds that although the weight is gone, the “fat-girl brain” remains. “When there’s a seat on the subway,” she says, “I’m apprehensive to sit between two people even though I know I can fit. But then I’ll have a ‘wow’ moment when the bath towel fits around my waist and overlaps. I’ve taken control of my life and I’ve made it better.”—Lauren Levinson

For more information on gastric bypass surgery (and videos featuring Zarabi), go to nycbariatrics.com.