Cathy, 58 “It’s Never Too Late”

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ContributorCathy, 58Read Full Bio

Biography

Cathy is a 63 year-old married woman and mother to a grown daughter. She is a high level sales executive in the entertainment industry. In a poignant interview, Cathy reflects on over 55 years of dieting, starting at the age of 5. As a child of the 60s, she was prescribed medication for obesity: speed and diuretics as a way to lose weight. Today she says how lucky she was “not to have a heart-attack” after developing a serious sleep problem due to those medications. Cathy talks about her fears prior to surgery of having to buckle an airplane seat belt and walking into a conference room worried that she’d break a chair. She had a sleeve gastrectomy 3 years ago, lost 130 pounds and continues to maintain that weight loss.

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ContributorDr. Adrienne YoudimRead Full Bio

Biography

Dr. Youdim specializes in medical weight loss, medical nutritional therapy and nutritional and metabolic support of bariatric surgery patients. Dr. Youdim received her bachelor’s degree from the University of California, Los Angeles and her medical degree from the University of California, San Diego School of Medicine. She completed her internship and residency at Cedars-Sinai Medical Center as a well as a fellowship specializing in nutrition and bariatric medicine. She is currently Associate Professor of Medicine at UCLA David Geffen School of Medicine and Assistant Professor of Medicine at Cedars-Sinai Medical Center. Dr. Youdim is very open about the issues associated with trendy diet medications of the past like Phen Phen, but is optimistic about new developments in this area in the near future. She does not shy away from discussing bariatric surgery with her patients and warns that obesity is second only to tobacco for cancer diagnoses today.

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Cathy is a 58 year-old married woman and mother to a grown daughter. She is a high level sales executive in the entertainment industry. In a poignant interview, Cathy reflects on over 53 years of dieting, starting at the age of 5. As a child of the 60s, she was prescribed speed and diuretics as a way to lose weight. She says today, “how lucky she was not to have a heart-attack” after developing a serious sleep problem due to those medications. Cathy talks about her fears of flying and having to buckle the seat belt and walking into a conference room worrying she’d break a chair prior to surgery. She had a sleeve gastrectomy 3 years ago, lost 130 pounds and continues to maintain that weight loss.

I'm Cathy. I work in the entertainment industry in ad sales. I've done that for about 30 years. I've been married for 35 years. I have a 25-year-old daughter. And I had sleeve gastrectomy surgery in January 2012 so that's about 3-1/2 years ago and I have lost and kept off 130 pounds.

Weight has been an issue for me since my earliest, earliest memories. I was on diets literally since the time I was five years old. When I was little, it was kind of a solitary relationship with candy bars or the forbidden things because I was always on a diet and my mother really was the enforcer of all these diets so I was at Weight Watchers from the time I eight years old so of course I was the youngest person there and my food was monitored at home. Sunday we would go to church and then have a family brunch afterwards and everyone would have these lovely plates of scrambled eggs and bacon and pancakes, which was our Sunday tradition, and my plate was always a hardboiled egg and half a grapefruit. I never had the food that anybody else was allowed to have because I was fat. But I was successful in many ways so I was an athlete, you know, even though I was pudgy; I was the captain of the tennis team. I was a good student so I had a lot of positive reinforcement in many areas of my life and I was very social. I had lots and lots of friends so there was just this one part of me that was wrong, it was bad, no matter how much success I had in all these other areas, I was essentially bad because I was 10 pounds overweight, 20 pounds overweight or whatever it was.

Doctors were so, so complicit in this craziness. I was ordered to take the speed and the diarrhetic on a daily basis. And I hated it. I couldn't sleep so I literally developed a sleeping problem cause I could not sleep and my heart was racing. So I took to hiding the pills under my mattress, and then one day when my mom was changing the sheets she found this stash of pills that I've been hiding, so I was walked off the pediatrician again to get scolded and told that I had to take this medicine. And I said but I can't sleep at night. And I will never forget the pediatrician saying, keep an encyclopedia by the side of your book table and when you're up in the middle of the night and you can't sleep read the encyclopedia and you'll be so bored you'll be able to go to sleep. Well, that was ridiculous and didn't work. My mother thought she was doing the right thing. It's lucky I didn't have a heart attack.

When it really started to be a bigger issue than that was after I had my daughter. Every extra second that I had that I wasn't at work I wanted to be with my daughter. So I wasn't going to take that extra hour and go to the gym anymore or even go for a walk. These were bad choices that I made but they were the choices cause plenty of people have figured it out with many more responsibilities. I was a great worker. I was a great wife and I was a great mom, but I didn't take care of myself. So over the course of her growing up, I would say I gained, like, 10 pounds a year just from poor eating choices and lack of any kind of physical exercise to the point where suddenly it was like a hundred pounds overweight and then 120 pounds overweight and then 130 pounds overweight, and it was like, oh, my goodness, this is a whole level of pudginess than I ever knew growing up.

I still had a senior level responsibility at my job, which required a huge amount of travel, and weekly entertaining. There wasn't a day that I woke up and didn't dread the day because I would have to choose one of the black tents in my closet to put on. When you're 130 pounds overweight you can't go to a normal store so you're at the fat lady stores, as people call them. Having to attend a conference or a business lunch or business dinner I was always anticipating what the reaction of people in the room was going to be to me and I've always felt that my weight preceded any other impression that people would have of me, and I think that's probably true. I would walk into a room for a meeting and I would notice what kind of chairs there were, and if they were folding chairs I would worry that the chair was going to collapse. I was in New York at a meeting and they took us to theatre at night and all I could think of was, oh my god, those theatre seats are so little; and I'm going to be spilling out of the sides of that seat, and people on either side of me, my work colleagues, are going to be horribly uncomfortable, and this play is going to on for three or four hours and it's just going to be a nightmare. And it kind of was. The other big, big nightmare for me with the traveling was the seatbelt and I'm sure this is a common theme for people who are hugely overweight is fastening that seatbelt. So I would travel a lot and every trip for the week I’d be hysterical about whether I was going to be able to get that seatbelt fastened. And was this the time when I was finally going to have to, you know, ask for the extender from the flight attendant. I knew exactly how to sit, how to position myself, to maximize the belt and I would examine it first to make sure it was fully extended and then I would go through the process of trying to get it buckled which was never easy and sometimes virtually impossible but I did always manage it.

It wasn't until four years ago when I started working with a really good nutritionist, and I have been to nutritionists over the years, too, that this notion of bad foods, good foods, was blown up. In the first meeting I had with her, she said, tell me some of the things you like to cook, cause I love to cook. So, well, I make this fake potato salad, I use potatoes and I know those are bad but I use fake mayonnaise and she's like, wait a second, potatoes are bad? And I said, yeah, anything white is bad. So she just started reworking the notion of food with me so now I'm at a place where there's no bad food, and had I known that as a child I could have had the pancakes, the breakfast, with everybody else.

For years my health had never been an issue. So, within a period of five years I had had to start taking cholesterol-reducing medication; I was on an antidepressant, which not for depression but was supposed to have appetite suppressant qualities. I don't think it did. I was pre-diabetic; I was this close to having Type 2 diabetes; on some scales I would have been identified as diabetic. I had been given a prescription for high blood pressure. My knees were completely shot. I am bone on bone on both knees and the surgeon was recommending knee replacement surgery in both knees. I was virtually handicapped. I could only wear certain kinds of shoes. And I could barely walk.

Probably the scariest thing of all is I have breast cancer in my family. My mother and two sisters had pre-menopausal breast cancer I had the highest risk factor that you can have, which is obesity, and because I was a breast cancer risk. The first time I ever had an MRI I was terrified. They have to run an IV and because I was so big anytime I ever had to have any procedure with an IV.I have rolling veins but I also had so much fat. It was an absolute nightmare to get an IV started. They would end up having to call the special surgical VIP team to, just to start the IV, which always was a process that took an hour. I would always end up in tears; it was horrible. We roll into the MRI room and they can't get me in the tube because I'm literally too big for the MRI tube. So fortunately for me it was available that day so I didn't have to come back but I had to go in the special MRI tube. And I think at that point I was, like, really, you know, I mean, what's next? What is next? This is ridiculous. This is no way to live and it is not going to get better. This is not going to end well.

So I reluctantly met with the nutritionist; she's the one who said potatoes aren't bad, bananas aren't bad. My one martini a night I said I could have sometimes. She said that's not bad. I learned so much about food, and it was fantastic. And that therapist was fantastic, and again I had been to therapy before. I didn't have any hopes that that would matter, either.

So I lost over 10 weeks, two months, three months.22 pounds. And when I went back to the medical doctor, monthly to check in with her, she was thrilled; she couldn't believe that with my history and my age that I was actually being successful and losing weight at the right pace, which wasn't too fast. And she said, okay, you've lost 22 pounds; that's fantastic; I really didn't think you could do it; and now let's talk about what's next. She said, at this point I would like you to think about surgery. And I was freaked out. I think I started crying because I felt like I failed again; I thought I was succeeding, and now I'm being told this isn't good enough. Now you have to have surgery. I said, but I don't want to have surgery; why can't I keep doing this; I've lost 22 pounds; I'm being successful; why can't we just keep doing this? And she said, here's the deal, the truth is at your age, with the amount of weight you still have to lose which is over a hundred pounds, statistically the deck is stacked against you. The stats are that it will come back; that to keep it off because your body is so accustomed now to being 130 pounds overweight, you would have to be in the gym four hours a day to be able to keep the weight off, and so statistically it's your choice, but I'm just telling you what the reality is.


At that point there were two procedures that people were really talking about, and that as the gastric bypass and the band. I was terrified of the gastric bypass because I knew people who had had it and while very effective, I knew that it was a big reworking of your insides and that scared me. The band I knew a little bit about, too. I didn't like the idea of having something artificial in my body although having it be reversible was attractive.

So I met with the nutritionist at that point, and I told her about the options that I was considering, and she said, well, what about the sleeve? It doesn't change the way your body metabolizes food; it reduces the size of your stomach as I later learned from my surgeon from a fully inflated football for normal people after Thanksgiving dinner to the size of a banana. You can eat the same foods that you eat now pretty much. You can enjoy a cocktail, a glass of wine, all things that with the gastric bypass were described as not being available options.

Once I decided to go with the sleeve I told no one about this. My husband didn't know I was on this program to get approved by your insurance. And there were all these procedures that you had to have, an endoscopy, a colonoscopy. I had to have a stress test and because I was so heavy I couldn't just do it on a treadmill. I had to have it in the hospital, lying down with like a recumbent bike to be tested. But I told no one I was doing this. Again, not my husband, not my daughter, not my sister, my best friend, any of my friends; nobody knew about this.

And then they called me to schedule me, and I was, like, oh, no, you know, and I had all these reasons why not to do it, like, Thanksgiving, nope, not going to have my last Thanksgiving dinner. Christmas are you kidding me. So then we finally settled on January.

I think I looked at it as a failure on some level that I had to have surgery; that I couldn't do this on my own; that I was so weak I had to resort to surgery and I was ashamed and I thought that people would think that that was horrible. So then in the week leading up the surgery I had an absolute revelation that as I actually told people that I was going to do this, there was an outpouring of support and love that I had never experienced and never expected, and it was just transformational. However, the surgery itself still terrified me. I was not ready. And in the weekend before there's a fasting like a clear liquid; I think that you're doing the three days before surgery. And during that period I really thought I cannot do this. I am not going to do this. I talked to my husband. He said don't do it; you know, he was very scared of surgery. Didn't want me to change anything inside my body; just thought that was a horrible idea. Talked to my daughter; she was at college; and she said, no, do it, mom, this is going to be great, it's going to be fine, you're going to do fine, do it, do it, do it. I talked to my therapist over the weekend and said, I don't think I can do this. She said, you can do it; you can do it. But, literally, literally, I went into the operating room thinking this is not my choice but everybody seems to think this is what I should be doing so here we go, you know, for better or for worse.

So immediately after the surgery I just was so happy I had woken up, so happy to be alive and that I had made it. My surgeon told me that they had also done a hiatal hernia repair while he was in there and he had discussed up front that that might be something they would do. So I think the hiatal hernia repair actually produced more pain after in recovery than the sleeve part but I did have pain. I was kind of out of it the first day, sleeping, and having the morphine, but I say that and I was up walking the hall because they do make you walk the halls with the walker. I remember doctors coming in to see me and my therapist came and visited; my regular internist; and they both remarked on how fantastic I looked; and the surgeon was thrilled with how I was doing and how much I was moving around.

So I took six weeks off of work, which was what the maximum that the surgeon's office signed me out for. My whole life I had never really had any time for myself and clearly I had never really addressed the weight issue in any comprehensive way, so I looked at the six weeks off of work as a time for me to really be able to focus on all aspects of my recovery and to make it my priority. I did everything that I was supposed to do in terms of my visits with the therapist. I started on an exercise program as soon as I was allowed, which was immediate. I was allowed to "stroll" on the treadmill.

I followed the six-week transition program which starts with clear liquids and then graduates to liquid soups, and then finally pureed foods like mashed potatoes. And then by week six, you know, which just seemed like nirvana, a salad and steak cut up. I gave up pasta and bread for six months and it really was great because I found out that I can still enjoy them. I just don't enjoy them in any kind of volume anymore

The weight loss right after surgery was not what I expected. I expected to have a really big drop in a short period of time. I can't remember maybe I lost 13 pounds in the first month and I was freaked out, but I remember being at the support group and crying and saying, it's not working for me, because I was so used to failing and diet and weight loss that to me this was, like, oh my god, it's happening again. And I went through all this and I'm not going to lose the weight and I was hysterical.

That's why the support groups are so great. People in the support group who had been through the process; they'd all been there; and to a person they each had their story and they shared it with me and they were so kind and they gave me hope that it really was going to be successful but virtually there was no way that it couldn't if I followed the plan. So it did start coming off but for me it was gradual. It was 1-1/2, 2 pounds a week, which doesn't sound like a lot, but over the course of the year that's a hundred pounds so and that's kind of how it went.

Hair loss, oh my gosh. Nobody told me about this beforehand, nobody, and I don't know why because it's a big deal. Around three months post-surgery my hair started thinning, you know, falling out when I would brush it after a shower and I don't have really thick hair to start with so it was freaky. The hair just thinned really, really big time! Now it's grown back so now it's normal, but I would take that head of thin hair any day over that body of being so overweight. I chose to believe what they said that eventually it'll be fine, it'll all come back, and it did.

I'm fortunate for losing as much weight as I did, I have what I think is very minimal skin issue. I don't know why because I wasn't in good shape but I'm very lucky. There is hanging skin, you know, the arms, and some of it is age, just loss of elasticity and heredity and some of it is the hanging skin. And my face, you know, is a little bit slack, you know, from the weight loss in my face, but I don't think I'm going to do anything about it so I'm okay. I don't have to wear sleeveless dresses and I don't have to wear really short skirts so I'm okay. I'm all good.

It never gets old having people say, you look so fantastic, and I'd say I lost 130 pounds, sometimes I tell people even when they don't ask. My daughter gets embarrassed cause when we go into a store I regularly tell the salesperson as I pull my size 4 dress off the rack that I lost 130 pounds, and it's just fun. People then say how did you do it? And I say, well it was a village; and it was a team; so I had a bariatric procedure; I went to a therapist who specialized in addiction; I went to Weight Watchers; I went to a nutritionist; I exercise regularly and religiously now. It is a comprehensive approach; otherwise, there is no way at my age that I would have been able to change 55 years of behavior and chronic disease and obesity. I know people who have one of the bariatric procedures who weren't as fortunate as me to be at a practice that insisted on all these disciplines being called into play. You couldn't get the procedure if you didn't work with all these different people. People I know who just went to a surgeon I've observed that sometimes they are not as successful and they're not as successful both in losing the entire amount of weight they wanted to lose and in keeping it off. I'm a big believer in putting all the pieces into place and taking the support from all those different disciplines that really will ensure success.

The most important thing for me to communicate to people who struggle with their weight or struggle with their health issues because of obesity is that it is never too late and I was someone who given up hope. I was so sad. I was in despair that I was never going to live as a normal weighted person. I was never going to have that experience. And I am. And I will continue living that way. It is a choice. And there are resources out there and look for them and find them and have hope because there really is hope to be the healthy, happy person that you want to be.

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