Bariatric Surgery: My Personal Journey
BY ELIZABETH BRIGNAC
After decades of dieting, exercising, therapy and adopting a lifestyle-changing, can-do attitude, I accepted that I was running out of energy to continue the weight-loss cycle. Any weight I lost, I eventually regained—with interest. Despite following the suggestions of doctors, therapists and nutritionists, long-term I simply could not maintain the weight loss necessary to avoid weight-related health complications.
Research consistently indicates that I wasn’t alone in this cycle: 80–90% of people who achieve significant weight loss through diet and exercise alone regain the weight within a few years. It makes sense. For the vast majority of human history, my body’s tendency to hoard calories would have been a survival gift. In 21st century America, unless you are a contestant on “Alone,” it’s a dubious gift at best.
In October of 2022, I was deciding between: (a) weight loss surgery (which I had previously rejected as too extreme) or (b) resigning myself to remaining significantly overweight while living as healthy a life as possible—an option some therapists recommend as psychologically healthier than continually trying to lose weight. I chose option (a) and joined the WakeMed Bariatric Surgery & Medical Weight Loss Program.
The weight-loss surgery process takes time. The initial approval process is lengthy, because both the medical program and the insurance company have to sign off. Bariatric surgery is much safer than in the past, partly because patients undergo a barrage of testing before the surgeon will approve the procedure. Over the course of a month, I underwent heart tests, a psychiatric screening and a sleep apnea test. I was put in a NASA-like machine that turned me upside down and sideways to check for esophageal issues. Eventually, the WakeMed program cleared me for surgery. Meanwhile, I was fortunate with my insurance, which both covered the procedure and was actively supportive. Many people struggle to get insurance to cover bariatric surgery, and the requirements to become eligible can take months.
I also had to choose between procedures. The most routinely performed bariatric procedures these days are the gastric sleeve (which restricts stomach space so the person cannot consume too much food), the Roux-en-Y (which both restricts stomach space and alters the intestine so it cannot absorb as many calories), and the duodenal switch and the SADI-s (both of which combine a gastric sleeve with a shortened intestine that more extensively inhibits the body’s ability to absorb calories). After talking with my surgeon, I decided on the duodenal switch. There is no one “best overall” surgery. The right decision for each patient depends on that person’s physical circumstances, goals, personality, surgeon and insurance benefits, among other factors. At different stages throughout the process, I took three WakeMed-required nutrition classes, since learning how to eat with our new bodies is a complex endeavor. Before the surgery, I went on a two-week liver reduction diet, which included a week on a pure liquid diet. I was grateful when that week ended.
The surgery and hospital stay went largely as expected. I was under general anesthesia for about three hours. When I woke up, I groggily thought, “So it’s done.” The decision was final. I then turned to the important business of feeling horrible. Even with medication, recovering from this type of surgery isn’t easy. My health team encouraged walking right from the beginning, so I wandered my floor and even ventured down to the hospital garden a few times over my two-day stay. Roaming the halls with my IV on one side and my husband on the other, I was grateful to be wearing my own loose clothes instead of just a hospital gown.
For two weeks after the procedure, I remained on a pure liquid diet. I drank protein shakes until I was so tired of them that a cup of beef bone broth felt like ambrosia, because it didn’t have any sweetener in it. I sipped, watched TV, slept, and sipped some more. Slowly, my energy returned.
In the ensuing weeks, I graduated from pureed food to soft food, and at two months post-surgery to solid food. I recently hit the six-month mark and can now eat most lean, non-sugary foods in moderation. My life has changed in many ways. I do not drink liquid with meals. I track protein religiously, as I need a lot of it, and I take daily vitamin supplements to replace nutrients my new body is not absorbing. I feel sick if I eat too much fat or carbs, as my body can no longer process these foods easily. I eat much less than I used to at a sitting because I feel full very quickly.
Exercising these days is much easier. I joined a fairly intense exercise program, partly to retain muscle as I lose weight, and I can even (mostly) keep up. I have always loved hiking, but it’s way more fun now because I don’t get winded so easily. I went zip lining this summer, which I could not do before due to weight limits. It felt like flying. Most importantly, I got my labs back a few weeks ago, and the numbers that were scaring me before by steadily crawling up are now completely normal. Blood glucose? Normal. Cholesterol? Normal across the board. My blood pressure is better, too.
As I write this, I’m looking forward to a Thanksgiving heavy on protein-laded turkey and vegetables and very, very light on pie. No wine yet (I don’t get alcohol for another six months). Maybe a bite or two of the sausage cranberry stuffing I love. That’s how it will be going forward, even on holidays. This surgery is not an easy way out. But the difference is, all the things I am doing to try to stay healthy are actually working now. I can see results and can expect to see them well into the future. For me, so far, the exchange has been worth it.
I no longer feel trapped in a body I cannot control.