Nancy “It Does Work”

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ContributorNancyRead Full Bio


Nancy is married and a mother to a grown son. She has worked in the book publishing industry as a publisher and author for many years. Nancy’s weight took on greater significance when she was told that her obesity caused diabetes and that if she did not lose weight she would have to be put on insulin. This health scare prompted her to pursue bariatric surgery. She had a lap band procedure done and lost 70 pounds. Six years have passed and she’s maintained the weight loss. Nancy stresses the importance of both pre-surgical counseling and post-surgical support groups. To this day, she gets up for her pre-dawn exercise regime to ensure that her weight stays off. The one word she uses to describe what happens after surgery is “awareness”.

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ContributorDr. Adrienne YoudimRead Full Bio


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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Nancy is married and a mother to a grown son. She has worked in the book publishing industry as a publisher and author for many years.  Nancy’s weight took on greater significance when she was told that she was officially diabetic and that if she did not lose weight she would have to be put on insulin. This health scare prompted her to pursue bariatric surgery. She had a lap band procedure done and lost 70 pounds. 6 years have passed and she’s since maintained the weight loss. Nancy stresses the importance of both pre-surgical counseling and post-surgical support groups. To this day, she get’s up for her pre-dawn exercise regime to ensure that her weight stays off. The one word she uses to describe what happens after surgery is “awareness”.

My name is Nancy. I have a fabulous husband named George and a great kid named Ian who I get to see very once in a while now that he's out of college. I am in the publishing industry. I'm a book publicist and author and have been doing that for more years than I care to admit.

Weight has been an issue for me for my entire life. The dinner table in my house was a terrific place, a lot of laughs, great food. That's my orientation towards food and it was an era before all the knowledge about healthy eating. So it's kind of a cultural thing, an environmental thing, and it's been my whole life.

I was never a thin kid. I wasn't morbidly obese but I was always a chunky kid. Growing up it can be murder in high school for a lot of kids, especially these days where there's just so much pressure on being thin and perfect and wonderful. I had a social life. I had boyfriends. I had a lot going on so that really wasn't an issue.

I have a very close personal relationship with food. I love to eat. Everything social revolves around food. You want to go out for breakfast? Where are we going to go for lunch? You know what's for dinner? Every time you got together with friends no matter what it was, it revolves around food. And it becomes a problem, very difficult to deal with.

I don't think that there's any question that eating to excess can be an addictive behavior. I don't feel that in my case. I understand addictive behavior. I smoked for 17 years. Quitting smoking was the hardest thing I ever did in my life. I am surprised that I am any friends or family who still talk to me. That was a very difficult thing to do. This was more of a health issue than that was at the time because things were starting to break down physically for me.

It didn't become an issue for me until well into adulthood when I was diagnosed with diabetes. We had taken our son to Japan. And all the way through Japan I couldn't stop drinking. And I thought, god, it must be the food; it's got to be all that salt. Well, I got home and it wasn't and by the time I got to the doctor, I said this is very strange, I can't really feel my toes and I said, oh, crap.

And I was officially diabetic. That was handled with medication and the continuing effort to lose weight and I have done everything that anybody could possibly think of to lose weight. I have been on all the programs with varying degrees of success and zero maintenance. You know, you can take it off and you can keep it off for 20 minutes but then, I tell people I was a size 12 for an hour. So everything was controlled for a number of years until it wasn't.

I had a bad back and the knees were starting to go. Everything that carrying too much weight will make happen was beginning to happen. But when it came to the possibility of kidney damage, my doctor just sat there and shook his head, and I said, what's wrong, and he said, I don't know what to do with you cause I made a deal with him years ago. I said, you can look as long as you don't find anything you can't fix, and he said, I don't know if I can fix this and insulin is the next step and once you're on it's possible you won't come off. I said, oh, not for me, so I asked him, what do you know about weight loss surgery and he said I thought you'd never ask.

Everybody who's had weight loss surgery has the same story. We've all tried everything, and very few people who lose weight, even a substantial amount of weight on any of these programs, it's a small percentage that's able to keep that weight off. So I needed a more permanent solution. That's why Weight Watchers really is very good; it's my program of choice. So I fall back on that. I think Weight Watchers. I count points in my sleep. I go back to that because it's an awareness of what you put in your mouth and I think that's key.

It was about six-and-a-half or so years ago when I finally got up my guts to make the appointment and see what weight loss surgery was about. At the time there were two choices. You could have the adjustable gastric band or the lap band. And I walked into the doctor's office on the first day and said I didn't want some guy I hardly know to rearrange the plumbing. So I got cleared for lap band, and I did well. Over the course of the first couple of years I probably had 60 pounds off and I've maintained that loss for all six years.

The first year I lost 40 pounds and I was disappointed, and the doctor said, disappointed? I was off diabetic medication. I was considered in remission. I looked good. I felt good, but I was disappointed. Gee, 50 would have been nice; 60 would have been nice. I got to that point but I didn't get to that point in the amount of time I thought I would. I followed all the rules.

I hear from a lot of people, oh, everybody knows somebody who had weight loss surgery and it didn't work. Had gastric bypass, had lap band and it didn't work. Gained all their weight back and it didn't work. It worked fine. They have said to me, you know, is the lap band working for you? So what do you expect it to do? It's 28-cents worth of plastic. You know, I gotta make it work. It gives the patient the ability, the tool, to accomplish what has been anywhere between difficult and impossible to accomplish in the past.

The first week post-op is awful, and you are very restricted in terms of what you can eat; it's all liquids. At the end of the second week I called my doctor and I got him on the phone, and I said, very calmly and coolly, give me something to eat or I'll kill you. So at that point I was allowed to puree some soup and had something to taste to it. I had to taste something because orange popsicles were not cutting it anymore. And if I never see Jell-O again it'll be too soon.

But, it's really not a terrible recovery. So the first day is not so terrific. The second day is a little bit better and from the third day on each day is appreciably better. So it's not a long recovery. You do have to be diligent about doing exactly what they say to do.

The first thing most of us do that's against the rules is forgetting to chew your food very, very well. When you're all by yourself and you're sitting at the table and you can cut little tiny pieces and you eat them by yourself, but if you're having a conversation with somebody and you've got food in front of you, and you're talking, a bite could get in that is too big to go down, and it'll get stuck, doesn't feel good. You may not know it's stuck immediately but when the next bite goes down, even if you chewed that one really good, it's just sitting there, and the pressure builds up and it's not a pleasant thing. That was carelessness and anytime it happened to me it was my own fault.

After surgery, it's essential to change your eating patterns They want you to put higher stress on the protein and the vegetables and less on the carbs and only certain types of carbs and then if you add diabetes into the mix there's certain things that you cannot eat or should not eat. And skipping meals for me because of the diabetes is not an option. They don't recommend it for anybody, but if you're diabetic, you gotta eat. So I created a breakfast. I have a protein shake in the morning and that is what I have every single day of my life. And that gets me going. That holds me until lunch.

Fortunately I have a husband who is so health conscious. He's like you are what you eat. So he had no problem really foregoing a lot of the crap that was in the house for a healthier diet. For part of that time, I had a kid still at home. A teenage guy you gotta feed, so they could eat the pasta and they could order in pizza if they wanted, but all of that stuff was just gone for me.

A lot of food that I used to enjoy are foods that I can still enjoy but not as frequently and not in large quantity. You know, I grew up, you know, finish what's on your plate; children are starving in Europe. When I'm done eating what I'm allowed or what fills me up, I'm very happy to have it the next day or the next day. And you go to a restaurant that's why God made doggie bags. You have something you really enjoy but you don't have to eat like it's Thanksgiving. And those of us who have had surgery, any one of the three kinds, don't have the room anymore, so we can enjoy what we eat but just much smaller amounts.

When I had surgery, I had a teenage kid just going off to college that I wasn't done with yet. I needed to be around. If I didn't have the surgery and comply with the rules, I would have been on the little scooters at Walmart. That was going to be me. If I didn't have a parking space right up by the store, I'd drive around and around til I could get closer because I couldn't make the walk. I remember the one trip that we had as a family where they went off and did all the walking, in Japan to see some castles and I would sit there on a bench and say I'll see you get out. I'm looking at steps. I couldn't make that; if I lived to be a hundred I couldn't do that. I can do it now. And so I had more life to live. In my family one side there was longevity and on the other side nobody's left. I am the last man standing and I wasn't going to subject my family to that because I was next; I was next.

The word that I use to describe what happens after surgery is awareness. You have to be aware of everything you do, everything you put in your mouth, how many times you exercised this week, how much you've increased your exercise, all of the things that they tell you to do. There is no magic bullet. One of the criticisms of these procedures is they're taking the easy way out. There is no easy way out. I am here to tell you this is not the easy way out. But for some us it's the only way out.

I've been a gym member for 20 years so and I went regularly a few times a week but I kept it very light because things hurt, After surgery, there was a group of us who met at the gym and we're gym friends, you know, we met there, we got friendly there, and we go pre-dawn. Usually somewhere between 3:30 and 4a.m. because doing cardio on one of those machines, whether it's a treadmill or it's the bike, the half hour goes much faster if you're chatting with somebody; if you're chatting with a buddy; if you're solving the problems of the world; because I gotta tell you the mornings when I'm alone it's the longest half hour of my life.

And then I started adding the weight machines and started very light weights, one set of 15, if I could make it, and I'm at higher weights and 3 sets of 20 on these machines now. And so I do have much better muscle tone and I will tell you that I have not had a backache since I've had surgery. All of that weight that was causing the pain, that extra weight that's causing the knees, the hips, the back, it's gone. I used to start my day with three Advil, just to get out of bed, just to start moving. Getting out of bed was just murder.

I'm just a couple of weeks away from the sixth anniversary of the lap band. I started to run into some other health problems and one of these problems is gallstones. This can be caused from being overweight for a long time guilty; being of a certain age that's me; and I didn't know what it was; it was incredible pain. I thought something's going wrong with the band, you know, something exploded.

Well, gall bladder surgery is now done fortunately laparoscopically and as luck would have it they go in the same places they went in to do the lap band. Now, I am also experiencing some difficulty with food going through because the band is so tight. I don't know if it slipped; it seemed to be getting worse. I'm not fun to eat with; I don't enjoy it like I used to. So I said to the doctor, who's taking out the gall bladder, you want to take out the band? The sleeve gastrectomy, which takes your stomach down to the size of a banana from a football, was not available when I had surgery. I said over the years, you know, if the sleeve had been available when I had surgery I might have had that. The doctor said, no, you wouldn't because he knows that by religion I'm a devout coward. But as long as he had to go in and he's in the same neighborhood, the exact same place, I said as long as you're there maybe it's time to get rid of this band and to do the sleeve because there's really nothing wrong with the band right now but what if there would be in ten years and then I'm ten years older and then surgery becomes a whole new ballgame.

I'm excited because I think this will be a way to maintain this loss, to perhaps take off a few more pounds. I'm not going to have the dramatic weight loss that a new sleeve patient would get if they started up here cause I'm already down here and I understand that. But I do expect some pounds off and then the ability to maintain that weight in far more comfort than I am now so that's the good news.

And by the way for this particular program you have to take the classes over again; you have to get the information over again; things have changed over the years. You have to be educated. I think that is so important for patients not to go in blindly, saying fix me, because they can't. You've got to in completely informed and I can remember that the doctors would come into the pre-op support group, the surgeons would show up and introduce themselves, and they would say, that weight loss surgery is a lifelong commitment and requires a complete change in relationship with food. And then I would get up there and I would say, actually, weight loss surgery is a lifelong commitment with a huge difference in your relationship with food because it is. That's the way it is. You have to be ready to change your life. It's a complete change in the way that you deal with food and it goes on forever which is hopefully a long time.

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