Bariatric surgery leads to weight loss, but how much and how quickly varies from person to person. Susan Pinsky surpassed her weight-loss goal within six months of having gastric bypass surgery at Emerson. Before long, she was carefully trying to regain several pounds. Numbers aside and more importantly, the Acton resident is healthy again and back to enjoying hiking, traveling and ballroom dancing.
Ms. Pinsky is the most self-disciplined person she knows, which is why she found it difficult to accept the years of failed dieting. Her weight gain coincided with the time when she was raising her three children.
“I would put on 25 pounds and try to diet it off,” she recalls. “Then I would put on 35 pounds and try to diet it off. It was a challenge to stay on a diet with small kids at home. Dieting took too much energy, and I was hungry all the time.”
As her weight climbed, she developed sleep apnea and painful joints. Ms. Pinsky, a professional organizer, goes into homes and small businesses, where her work includes physical exertion. “My job requires me to move things, and sometimes I am on my hands and knees,” she says. “It hurt.”
She gave up favorite activities. “I had been an exercise instructor in college, but I reached the point where my ankles couldn’t compensate for my weight. Moving around became uncomfortable. The only thing I enjoyed was going out to eat,” she adds.
At an appointment with Alan Marks, MD, an Emerson rheumatologist, Ms. Pinsky began to consider having bariatric surgery. “Dr. Marks felt my weight was the source of my pain and referred me to the Emerson Center for Weight Loss,” she says.
She attended one of the center’s information sessions and was struck when a map of the U.S. was displayed showing the steady increase in obesity. “The other thing was they discussed how obesity is not a character failure; rather, it is a medical condition,” she says. “That made sense to me.”
“People who attend our information sessions and see the Centers for Disease Control map understand that they are not alone,” says Laura Doyon, MD, a bariatric surgeon. “There truly is an epidemic of obesity in the U.S.”
Seeing obesity for what it is — a medical condition associated with a long list of health problems, notably diabetes, cardiovascular disease and osteoarthritis — often produces a shift in thinking that motivates patients, says Dr. Doyon. “They stop thinking of themselves as flawed and are better able to change their lives and follow through on their goals.”
Ms. Pinsky understood what she needed to do to be successful, and she realized that the center would provide all the support she would need. “From there, the entire process was like driving behind the snowplow,” she says. “The road had been cleared.”
Following the rules, surpassing the goal
Dr. Doyon performed her gastric bypass in January 2016. “Dr. Doyon was great,” says Ms. Pinsky. “I’ve had tooth extractions that were tougher. I had no pain, went home after one overnight, and the weight started coming off. I wondered why I had struggled with my weight for 15 years when there was a simple surgical solution.
“I knew I would lose weight, but I was surprised it came off so easily,” she says. “I discovered that four bites of yogurt was enough. I never had success losing weight, but now I did.” Within six months of her surgery, Ms. Pinsky had lost 103 pounds, surpassing her original goal of weighing 165 pounds.
“It’s because I’m a rule-follower,” she says. “I measure my food, focus on grams of protein, drink enough water and take my multivitamins. As a professional organizer, I know that maintenance is important. I created an efficient system and am no longer fighting constant hunger.”
Ms. Pinsky applied her organizational skills to her post-surgery weight loss — and kept losing weight. Today, she is maintaining her new target weight of 128-135 pounds and wears a size 4.
“We occasionally see people like Susan, who exceed their expectations,” says Dr. Doyon. “They tend to be those who follow the diet plan, which takes work, and use our dietitians as a resource. When people do that, they are successful, because the surgery does the rest of the work by changing their hormones and metabolism.”
Support group helps with maintenance
Once she had reached a healthy weight and was back to favorite activities, Ms. Pinsky confronted the excess skin that appeared after her weight loss. “It was uncomfortable, and there was a certain amount of chafing,” she says. “I lost all that weight, but what happened to my body?” Dr. Doyon referred her to Paul Costas, MD, (pictured at right) an Emerson plastic surgeon, who performed two surgical procedures.
“I’m thrilled with the results,” says Ms. Pinsky, who is 56. “It never occurred to me to have plastic surgery. I don’t dye my hair or wear make-up. But I now have a better figure than when I was in my twenties. I’ve been rejuvenated.”
Ms. Pinsky understands the role of maintenance, so she attends the Center for Weight Loss’s support group on a regular basis. “I want to use every tool at my disposal,” she explains. “The support group serves as a reminder to do things like keeping a food log and weighing myself.”
She has picked up a few tips. “I learned how to incorporate alcohol and desserts — wine and dark chocolate — based on timing and portion control,” she says. Ms. Pinsky is enjoying life much more today. “I’ve referred people to the Emerson center, and I’ve become an evangelist about bariatric surgery.”
Plastic surgery after bariatric surgery
Those who lose 100 pounds or more typically feel happy and proud that they did something positive for their health and quality of life. Then there is the resulting loose skin that all the exercise in the world won’t fix. But plastic surgery will.
Paul Costas, MD, an Emerson plastic surgeon, notes that this problem arises for many people after they’ve had bariatric surgery. “They are often unhappy and frustrated because of the excess skin, usually across the abdomen.” The breasts, arms, thighs and face are other areas where excess skin can appear after weight loss.
“In younger individuals, the skin is better able to retract,” says Dr. Costas. “But those over 40 often are left with an apron of skin and fat, and no remedy other than surgery.” He encourages patients to wait until they are at a stable weight before discussing plastic surgery. “They don’t need to be at their ideal weight, but a weight they feel good about.”
Performing an abdominoplasty requires that Dr. Costas make an incision from hip to hip. “I make sure the scar is as low as possible on the abdomen so that it won’t be visible,” he says. “After the surgery, which removes the loose skin and fat, the patient spends one night at Emerson wearing a binder around their abdomen. Full recovery takes two to three weeks. The scars from their plastic surgery will fade over time.” Those who wish to have plastic surgery after their weight loss need to be cleared by their primary care physician as being healthy enough to have the surgery.