In This Issue

* Determining Our Destiny
* Father’s Day Special
* See You in Orlando
* Research Article: State Mandates for Obesity Treatment and Its Costs
* Recipe:  Cottage Cheese Mousse
* Success Story:  Lori Weaver
* Abdominoplasty Revisited

So is it any wonder that when the Window of Opportunity closes and we hit our lowest weight and then bounce up a few pounds, that we see this as the first step toward the climb back to morbid obesity?

One of the problems is that there is insufficient research around this issue.  In my book, “Weight Loss Surgery; Finding the Thin Person Hiding Inside You,” I reported on a study published in the journal “Obesity Research,” August 1997 issue. In a 4-year study of Roux en-Y patients, the study found:

There are several ways that you can look at this study. First of all, the study was done in 1997 when there were few if any support groups and on the whole, patients were left on their own to succeed or fail. But, I think what is interesting is that between the 1st and 4th year, there was an 11% weight regain.

An unscientific but very interesting study was done by someone 2 days ago on the ObesityHelp Main Message Board. What Lei decided to do was to spend some time tracking down profiles of people she had “angeled” who were 2 or more years post-op, or people whose profiles were her "guiding light" as she was researching weight loss surgery in the early stages.

There were 31 names, of those, 16 profiles had been updated on ObesityHelp within the last 90 days - so those are the ones she pursued. This is what she found:

3 - At goal for a year, healthy, happy, no regain.
4 - At goal, bounced back 20 to 40 lbs within 12 months.
2 - At goal, bounced back 50+ lbs within 12 months.
1 - At goal, bounced back 100 lbs in 2 yrs. - REVISION scheduled
1 - Reached goal, bounced back 90 lbs in 2 yrs - REVISION done.
1 - Severe medical problems due to vitamin deficiencies, 50 lb gain.
2 - Severe medical problems due to vitamin deficiencies, no gain.
2 - Surpassed goal, trying to gain the weight.

Both revisions were due to SLD (Staple Line Disruption)

Again, this is unscientific. My overall impression of this study is that of the 16 people, almost half are at or below goal weight. Furthermore 11 people or 68% are at least within 40 pounds of goal. That means 32% have somewhat lost control. These numbers may be scary, or they may encourage you.  If you concentrate on the 32% who have lost control you can look at that as a 32% chance of failure.  However, if you consider that without surgery your chance of being out of control would be 95% (because that is the accepted number of people who regain weight after dieting) than 32% looks very good.

What is clear is that we determine our own destiny. And having the surgery is no guarantee that we will remain of normal weight for the rest of our lives. We have to learn new eating habits and exercise.  It is hard work, but it is worth it.  

If you do not have your copy of my book “Weight Loss Surgery; Finding the Thin Person Hiding Inside You,” what are you waiting for?  It is recommended by surgeons across the country and has been dubbed the “unofficial bible of bypass patients” by the Philadelphia Inquirer. Order your copy at http://www.wlscenter.com/1shopmain.htm

Father’s Day is right around the corner.  Now is the time to ask for a gift of health for your special day. Forget the usual ties, shirts and pajamas and ask for something that will truly help you on your weight loss surgery journey.  And if you are a wife or daughter, then there is no better gift to your Dad than your good health.

As my Father’s Day gift to you, all of our special book/CD packages are on sale. Each of the packages already offers great savings.  But in addition, from now until Father’s Day, each package will be an additional 10% off if you enter the code DAD on the shopping cart just as you check out. For instance, my book plus the accompanying “A Thinner Way of Life” CD if priced separately is $38.90.  Normally the package is $29.90.  With this sale, the package is $26.91.  So you are saving $13.99! Now that’s a bargain. 

This special will expire on midnight Eastern time June 30th

To see all of the other packages, click here http://www.wlscenter.com/package_deals.htm.

I hope you enjoy your very special day!!

I received the following email and was very disheartened, until I read the article that follows this email.

Hi Barbara,
Just wanted to let you know, I was at a ball game last night with Health America/Assurance. The rep was mentioning to me how wonderful the insurance is etc. She then brought up to me that they are no longer paying for gastric bypass surgery, no matter what. She said companies can buy riders for their contracts, but who is going to do that. She went on about how the long term effects have not been researched enough and people are having too many complications. She tried to tell me more people have died on the table from gastric bypass then heart bypass. Of course I did not mention that I had the surgery, because of the situation I was in, it was a work event. Have you heard anything about this?

Tracey

This is an article that I feel contradicts what that insurance rep tried to tell Tracey.

Fitch, Kate, et al, “State Mandates for Obesity Treatment and Its Cost.” Business Journal (Central New York), 11/5/2004, Vol. 18 Issue 45, Special Section p10b, 3p.

While insurance companies and HMO’s in some respects decide what they will cover and what they won’t cover, these companies are regulated by the States (with the exception of self-insured programs). And if an individual State decides that insurance companies will provide coverage for morbid obesity, then insurance companies must comply.

Most States follow what Medicare does, and with Medicare now covering weight loss surgery, and with the introduction of Centers of Excellence, insurance coverage may become easier rather than harder. 

This article also looks at insurance coverage from a purely business standpoint so you have a better understanding of how the “other side” thinks.

For the full text of the article, Click Here for Adobe Reader file.
(Allow extra time to download with dial-up connection)

Hi Barbara,
This recipe has been used by many of us in our Simply Support group and is a real great way to get in your protein in a delicious way!

Ginny’s Famous Cottage Cheese Mousse

1 large container cottage cheese
1 8 oz. Cool Whip
1 small package s/f Jello, or s/f pudding
fruit (optional)

Put cottage cheese in a blender, and blend until smooth. Pour into a bowl, and add the s/f Jello, or s/f pudding. Stir until mixed well. Fold in Cool Whip. Add fruit or nuts if desired, refrigerate for 1 hour.
(Use mandarin oranges w/ orange Jello, strawberries w/strawberry Jello, etc. Can use chopped walnuts with chocolate pudding, etc....whatever you would like)

This is a very tasty way to get your protein in. A 1/2 c serving has approximately 19 - 20 grams of protein.

Your friend, 

Donna Swirynsky

If you have a recipe that you would like to share in future issues of this newsletter, please send it to me at Barbara@WLScenter.com

I want to offer a special thanks to Lori Weaver.  Here is her story:

It began when I was in high school. I was a junior in high school getting ready for the prom in 1990. I weighed 210 pounds and finding a decent dress in a size 20/22 was not easy. I found a dress but had to have it altered. The alterations were bad. So in order to get the dress looking back to normal, I had to lose weight. I stopped eating school lunches and basically starved myself, but I managed to get the dress back into the size 18 that it claimed to be. I continued to lose weight until I graduated the next year losing a total of 60 pounds. Thanks to college, all you can eat meals in the cafeteria, Dominoes delivering during late night cram sessions and just not taking care of myself, the weight came back and then some. Ever since then I would lose 30 to 40 pounds only to gain it back and then some; the same routine that most everyone dieting goes through. Finally, I had enough of the yo-yo dieting.

I watched my aunt have gastric bypass surgery and how well she was succeeding and knew that was the only option for me. I had high blood pressure, high cholesterol, aching joints, borderline sleep apnea, and was slowly becoming a diabetic. July 1, 2003, was not only my brother’s 24^th birthday; it became my "re-birthday." I had gastric bypass surgery at Marshall Medical Center in Boaz, Alabama with Dr. John Groves. The surgery went without a hitch.

Things were going fine until around four or five weeks out. I started having problems keeping soft foods down and even some liquids. Dr. Groves was on vacation the week I had just had enough of the vomiting and having no energy. His associate scheduled me for an X-ray the next day on a Tuesday. That night I ended up going to the ER just drained. The ER doctor was not well informed as to possible complications that may arise with weight loss surgery.

Strictures can be common. That is when the opening from the "new" stomach to the small intestine tends to heal tighter than normal. The ER doctor was not going to do anything except give me medicine to calm my stomach. A lot of good that did since NOTHING would stay down. He would not get me in touch with a GI doctor to see if it was a stricture and dilate it. He flatly refused. He said I wasn’t dehydrated despite that I was pale as a ghost and they had me hooked up to an IV. Go figure that one out.

I had my regularly scheduled appointment the following Tuesday with Dr. Groves. By then I was worse than ghostly pale. My friends said I looked gray. I felt like the walking dead. Dr. Groves sent me to a GI doctor then told me to go to outpatient to get an IV. I was dehydrated. This was a week later after the trip to the ER. By now not even water or my own spit would stay down. That Thursday, the GI doctor tried to dilate the stricture, but he couldn’t find the opening to dilate it. He sent me to a different GI doctor, Dr. Philpott, at Baptist Medical Center Montclair in Birmingham. Dr. Philpott was supposed to be "slick" but even he could not find the opening to dilate it. I had totally scarred shut and it would require surgery to repair this problem. Dr. Pennington at Montclair did my revision. He cut off the scar tissue, placed in a stint, and sewed around it. After recuperating from that ordeal, I did fine and have been fine ever since.

I went into surgery on July 1, 2003 weighing 258 pounds. Since then I’ve lost 117 pounds. I’ve gone from a 24/26 to around a size 12. I feel great! It is so nice to be able to shop and say, "Oops, it is too big! I need a smaller size!" Not only have I lost weight, but also I have gained the self-confidence I never had.

Lori Weaver
Blountsville, AL
lori@urisp.net

By the way, Lori will be getting married on June 22nd!!! Best wishes from all of us, Lori!

Before	After

I love good news.  If you have good news, a success story to share, or inspiration, please send it to me at Barbara@WLScenter.com so that I can include it in future issues.  

Following my article in the last issue of the newsletter in which I said that an abdominoplasty is never covered by insurance, I heard from someone whose abdominoplasty was covered and another whose surgery was covered because it also involved a hernia. Their point was well taken, that abdominoplasties are in some cases covered. I ended my article with “Insurance companies vary in how lenient or strict they are with covering plastic surgery,” so it is always a good idea to submit your claim and if denied, fight it.  But as weight loss surgery patients, we are accustomed to fighting, aren’t we!