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Out of Fatlandia


Posted on April 18, 2017

What’s it like, having bariatric surgery? A local changemaker shares her journey to losing almost half her body weight.

Photography by Beth Baugher

In the summer of 2013, the number 253 blinked in small electronic type above my toes, as if announcing, “Welcome to Fatlandia, now serving your highest weight.” Crossing the threshold over 250 pounds at 5 feet 4 inches meant I was officially in the morbidly obese zone with a body mass index of 42. I wanted to throw the scale out my bedroom window, but that wasn’t going to happen because I didn’t even like bending over to tie my shoes. I didn’t have the stamina to breathe while hunched over, plus it gave me heartburn.

That time of my life felt like a disaster, even though if you were my Facebook friend, you couldn’t see the depression I hid. My Facebook feed showed a happy life starring my two children, 4 and 6 years old, who were the center of my universe. Yet it was around that time when I stopped appearing in pictures with them because I couldn’t stand to see my face and body in a mirror, let alone a photograph. Purposefully, I was creating a history of their life without their mother, and internally, I was plotting. I daydreamed about how I could vanish without hurting my loved ones. Depression was not new to me, but these feelings were intense, like a cobra bit me in the brain, poisoned my mind and intended to swallow me whole.

I berated myself that I had nothing to be depressed about because I was happily unmarried to a man, Nicholas, who I’d been in love with for the past 15 years, and together we were having a blast raising our two creative and smart children. Also, I worked in my dream job as the founding executive director of a popular and successful literary arts nonprofit for children, 916 Ink. I had recently won a 40 Under 40 award from Sacramento Business Journal and was being profiled around the city as someone making big changes in kids’ lives. I wondered if the sole reason I was depressed was my weight, but I’d been fat my entire life. I convinced myself that being “large and in charge” was peachy keen and didn’t bother me.

That summer, I told my best friend (who was also overweight) about my scary suicidal thoughts. She demanded I see a therapist and get medication. We made a pact that we’d get healthy together, day by day, hour by hour. I rejoined Weight Watchers and made an appointment with a psychiatrist. Before I could be prescribed medication, the psychiatrist insisted I complete a blood panel and a sleep apnea test. When the results came back, I moved from being prediabetic to having Type 2 diabetes and I needed a CPAP machine hooked up to an oxygen mask to sleep. I wasn’t shocked, because the weight of my neck crushed me at night, yet I had devised a way to sleep comfortably by propping my chins (yes, plural) onto a stack of pillows.

One would think that the depression alone should have been the final straw to commit to a healthier lifestyle. Long gone were fantasies of wearing bikinis and anything less than a size 20. After all, I was a working mom of two in her mid-30s hustling to make ends meet—and in the stressful world of nonprofits, no less. However, I lusted after “Onederland,” a magical place where you weigh 199, forever banished from the 200-pound zone.

OVER THE YEARS, many carrots were shoved in front of my nose to make me lose weight. At least two or three times a week, strangers asked me when my baby was due. Even one of my board members asked me at a dinner party, “How come I didn’t know you were pregnant? The baby is coming soon, yes?” My life was a series of these awkward moments.

In 2007, my sister (who is blind and developmentally delayed) was diagnosed with kidney disease and within seven months of diagnosis needed a kidney transplant because she was not a candidate for dialysis. The doctors wouldn’t test me to be her organ donor until I lost at least 60 pounds. You would have thought that saving my sister’s life would have inspired me to kick my sugar addiction and drag my butt to the gym. Nope. The horror I felt for failing her is nearly unspeakable. (She survived, thankfully, but I’ve yet to recover from the shame I felt for not being her organ donor).

I’ve been frantically running on the diet-industry hamster wheel since I could remember. Jenny Craig, Atkins, Curves, Zumba, Dr. Oz, SlimFast, fen-phen, Paleo, detox teas, hypnosis, gym-sponsored weight-loss challenges, cabbage soup, lemon water with cayenne pepper . . . I’ve been on them all, and not just once. Every Monday was like waking up to the same old New Year’s resolution: Start again, try again, count your calories, be good, lose weight.

The first time I realized my largeness was in the fourth grade when I overheard Grandpa tell Grandma, “Katie’s really fat, don’t you think?” This moment defined our relationship forever. When I was 24, after not having seen him for seven years, the first words out of his mouth were “You’re still fat, aren’t you?” when I walked in the room. I had to keep Nicholas from punching him in the face.

After before
The author now and in 2015. Right photo by Beth Baugher; left photo by Sarah Marie Hawkins

At a sixth-grade slumber party, a girl dared me to step on the scale and divulge my weight. I was 158. Since then, stepping on the scale became an addiction, a measurement by which to understand my value. The higher my number, the more I felt like a weak individual. I can recall my weight at nearly every moment in my life. For example, “Oh! That’s when I won the Women Making History award and weighed 227 pounds.” Every achievement was overshadowed by the number on the scale and how I felt in my body.

The looming CPAP machine with its mask of doom was ready for pickup, and I refused to take it home. There was no way I was going to let my super-hot Nicholas or our children see me hooked up to a machine to breathe. I called my bestie. “Start planning my funeral, because it’s not good news.” This sounds melodramatic, but if you couple my emotional state with juggling several physical comorbidities, it was either lose weight, kick the depression, wear the mask, take the insulin pills or do nothing, then die.

FAST-FORWARD A YEAR LATER . . . I was now on Prozac, seeing a therapist regularly, and the cobra depression had subsided. I’d grown tolerant of my own self-imposed disgust and committed to not being hard on myself because, clearly, I was a successful woman doing great things for my community. Then one day, I was at lunch with a girlfriend who was talking about gastric bypass surgery, and she said, “You should look into it, too. We can do it together.”

I literally dropped the messy rib I was gnawing and uttered, “I’m not big enough.” She laughed. I wasn’t offended, but I never considered weight-loss surgery, even though my mother had tried to talk to me about these options, repeatedly, over the years. But that afternoon, I called my doctor and within a week was referred to the bariatric department at Kaiser Permanente South.

At the bariatric clinic’s orientation, they laid out an intense plan: To qualify for surgery, I must lose weight by eating like a post-bariatric patient, pass a series of psychiatric tests and an in-person evaluation, meet with nutritionists to have them review my diet log, complete several blood panels, have a colonoscopy and endoscopy, complete an internal organs ultrasound and give up coffee. Coffee! I nearly walked out—but I didn’t, not after throwing an internal hissy fit of epic proportions that made me realize I was acting like a toddler when it came to how I treated my body. Was I seriously going to keep living in this madness because I loved copious amounts of coffee, cream, and sugar? I learned, too, that without a heavy daily vitamin regimen post-surgery, I could develop other disorders because my body wouldn’t absorb certain nutrients. I hated pills, and I’d have to take 10 to 14 of them per day for the rest of my life. OK, I decided, I can live with that.

After I passed the first set of time-consuming tests, the bariatric surgeon said I had to lose 14 pounds and maintain it before he’d assign me a surgery date. This felt impossible, but I wanted off the hamster wheel of diets, shame and frustration.

I slowly began telling people about my upcoming surgery and was met with trepidation. I called my bestie first. “Don’t kill me, but I’m looking into gastric bypass,” I said. She’d lost nearly 60 pounds since our pact and was looking like a pinup model. I feared she’d disown me for “cheating,” as if surgery were the lazy person’s way out of dieting. Nicholas was anxious, too, repeatedly declaring, “I love you the way you are at any weight.” He was fearful (and rightfully so in our fat-shaming culture) that because he was a muscular, good-looking health nut, people would assume he pressured me to lose weight. In the end, he came aboard, and today he’d tell you that we’re never going back to Fatlandia. Lastly, my mom was happy, but cautious about the permanence of the operation, along with the possibility of unforeseen complications. However, the three of them became my biggest cheerleaders.

Others didn’t understand why I succumbed to having surgery because I “wore my weight well.” I heard this more often than not and interpreted it as code for “You have confidence and look polished.” Indeed, I owned a highly curated wardrobe of ’50s-inspired dresses sewn out of funky fabrics. Indeed, I embraced the “curvy girls are beautiful” movement. (I’m still a card-carrying member.) I tricked myself into believing “You only live once so eat up, cupcake. Be yourself and ignore the salad menu.” Those days were up.

So I endured the horrifying colonoscopy, lost 14 pounds in four months and, on May 14, 2015, the surgeon cut me open to create a pouch the size of an egg below my esophagus and rerouted my intestines, ultimately shoving most of my stomach aside.

I WOKE UP FEELING LIKE a boulder was on my chest. My pouch had a hard time healing and I vomited blood for two days, which resulted in a blood transfusion. The gas moving through my stomach and guts felt like being in labor. I actually gained weight in the hospital from the IV fluids, and I bawled because I believed I’d made the biggest mistake of my life.

In the six weeks that followed, I ate nearly nothing but sugar-free Jell-O and pudding, mashed avocados, broth and protein shakes. I had no energy and my hair began to fall out. Lots of hair, which was devastating because, besides my ankles, my red hair was the only thing I liked about my body pre-surgery.

But unlike with diets, I couldn’t quit, so I let go of my pity party and focused on getting well and loving my body in its transition. By the end of June, I arrived in Onederland. I hugged my scale (#notkidding) and began to build a new wardrobe of clothes I’d dreamed about wearing my whole life.

As things normalized, my relationship to food was revamped. I only eat four to five bites of food at a meal, and I always eat protein first. I have to chew my food at least 35 times before I swallow or it will become stuck inside my pouch. When this happens, I get something called “the foamies.” The foamies is the gastric-bypass patient’s version of bile or acid. My pouch produces clumps of white foam that help push the food out. I’ve ended up in the hospital after not chewing chicken properly and, after throwing up the foamies for more than four hours, I went to the emergency room. The ER doctor had me take two sips of a Diet Coke. The carbonation pushed out the food and I felt immediately better. Needless to say, that was the most expensive Diet Coke I’ve ever bought. If I eat more than 15 grams of sugar on an empty “pouch,” I become violently ill and dizzy. This also can happen if I eat something fried or super fatty. (Goodbye, pork belly—we had a great love affair while it lasted.) My iron levels didn’t recover from surgery, and for six weeks I had iron infusions.

The doctors at Kaiser refer to any bariatric surgery as a tool. For me, this tool has a series of consequences if I violate the rules by eating something too sugary, too fatty, too much or too fast. It’s exactly what I need to keep myself in check. Because my relationship to food and my body has drastically changed, I’ve had to rediscover nearly every aspect of my life, from sex to feminism.

My journey is about self-worth and focusing on the people in my life who insist I’m an amazing human worthy of love and success. My saving grace was not only my family and friends but, unexpectedly, the Mountain Valley chapter of the American Leadership Forum. It’s an honor to go through their intensive leadership program, which includes a backpacking trip on the Pacific Crest Trail to the summit of the Sierra Buttes. For me, this was a three-day, 23-mile hike in August, just three months after my surgery. When I stepped onto the trail, I weighed 178 pounds.

I pushed myself up the steep mountain, crawling at times while cussing and crying, then climbing 178 steps up the fire lookout to gaze out over the Sierra Nevada. It was not lost on me, the divine coincidence of my weight matching the exact number of steps. Pound for pound, I moved my aching muscles up to see the world. As I paid witness to the humbling landscape below, I had a long conversation with the universe, and on the silent walk down, my cobra slithered away to live in the forest. I let go of the old me, the negative bystander judging my every move and thought, and became open to what I could become.

Would I do it again? In a hot second. Altogether, I’ve shed 112 pounds. But perhaps the thing I’m most proud of is the extra brain space I’ve gained, which allows me to be creative and present in the gifts of life. Ninety percent of my energy is not spent obsessing negatively about how I look or how crummy I feel. A part of me feels guilty that my emotional health depended on losing weight, because the true heroes are people of all shapes and sizes who love their bodies and live without shame of their exterior. But now, I work on being my own hero, every single day, by loving me.

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