April - May 2004

Proud to Be Losers

Today: from left, Virginia Ivanoff, EEO specialist, Elizabeth Ney, biologist, Nancy Wood, administrative technician, and Alecia Anderton-Brown, desktop system administrator.

These women know a thing or two about losing- weight, that is. Between them, Virginia Ivanoff, Elizabeth Ney, Nancy Wood and Alecia Anderton-Brown have lost more than 530 pounds. They can tell you about nearly every diet out there. They've have tried them all. And they all failed. Until now. But diets alone did not get them there. All four of the women work at the National Institute of Environmental Health Sciences in Research Triangle Park, N.C.

Weight-loss surgery has taken some bad publicity recently, including allegations that it is taking "the easy way out." But for these women, it was the only way out of a world of social isolation and precarious health problems that nearly guaranteed them a premature death.

Each of them will tell you about losing weight, then regaining it. Over and over and over. Five hundred thirty pounds is but a fraction of the weight these women have put on and taken off, then put back on. And they are not alone.

In 1991, an NIH consensus panel of experts released a statement based on their determination that gastrointestinal surgery is a valid therapeutic option for treating severe obesity. The panel noted that patients were able to keep the weight off.

The panel recommended two types of surgery. In one, a large section of the stomach is stapled off, creating a narrow, restricted pathway to the intestinal tract. The other form also calls for stomach-stapling, but also attaches a Y-shaped section of small bowel to the stapled stomach, rerouting the outlet from the stomach to the intestinal tract.

In America, the land of burgeoning waistlines, more than 1.5 million Americans with a body mass index greater than 40 are probably good candidates for such surgeries, the panel found. A BMI of 40 puts people roughly 100 pounds overweight.

Medical condition like diabetes, high blood pressure, arthritic symptoms in weight-bearing joints and disturbances in heart and lung function - commonly caused or aggravated by obesity - improve drastically after the surgery, according to the 14-member panel.

But you don't need to explain all that to these women. Not only have they already heard it, they are already believers. Now, they offer their insights, support, even clothing to other women who have had the surgery.

They have also suffered from discrimination based on their weight. Ivanoff, an EEO specialist, said discriminating against fat people is the last remaining, legal form of discrimination. Obesity is seen as a moral problem instead of as the complex psychological, biological, and environmental problem that it is, she said.

Ney, Wood and Anderton-Brown all had their surgery done at Duke. The Duke Weight Loss Surgery Clinic runs physical and psychological screenings on all potential patients. The surgeons who run the Duke program say that there is a small percentage of people whose bodies react very differently to dieting than do most people. The more they try to diet, the more their bodies produce a hormone that generates a powerful urge to eat. For this group of people, weight management isn't simply a matter of willpower or self-control. If they could overeat, they would. Their bodies insist that they do. But after gastric bypass surgery only a very small pouch remains from the existing stomach, and it cannot be overfilled.

Most gastric bypass surgeries are now done laparoscopically with only five small incisions. Super glue is often used in place of sutures to hold the skin incisions closed until they heal. But it is still major surgery.

"There's nothing easy about having your insides rearranged," Ney said. When you agree to the surgery, you agree to follow certain rules such as eating only small portions and eating very slowly. If you break the rules, you pay for it with nausea, pain and vomiting. "For some people, that is like giving up their best friend," Ney said.

"I have no regrets," Ivanoff said. She, like the others, say they would do it again, despite the substantial risk involved. Ivanoff also has Polycystic Ovarian Syndrome, a metabolic/insulin malfunction. She says the surgery allowed her to stack the metabolic deck back in her favor.

"I was flat out told I'd be dead by 50. I was heading up to 400 fast - and beyond." She had a so-called mini bypass, which leaves a larger pouch in the stomach and bypasses only 6 feet of intestines.
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