Southcoast Health System & Southcoast Hospitals Group

'I don't live to eat anymore'

Gastric bypass patients' health and confidence increase as their pounds decrease

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By JENNETTE BARNES
Standard-Times Staff Writer
January 5, 2007 (reprinted with permission)

Tiffany Machado, 22, of New Bedford calls the experience of fitting into a size 9 dress "surreal." Nine months after gastric bypass surgery, she still feels no hunger, but eats to keep her energy up.

Photo by Jessica Raimondi/The Standard-Times special

Life has changed for Tiffany Machado and Robin Thompson, the two SouthCoast women whose stories of weight loss surgery The Standard-Times has followed since last March.

Ms. Thompson has dropped 102 pounds and virtually reversed her diabetes, and Ms. Machado, who had less weight to lose, recently slipped into a size 9 dress when she went out to celebrate her 22nd birthday.

"I don't live to eat anymore," she said, "and that's the best feeling."

Ms. Thompson, 43, who lives in Falmouth, reported in July 2006 that she had stopped taking two of her three diabetes medications. Now she's off all three and she looks forward to a good checkup when she sees her endocrinologist later this month.

"I'm hoping that he will declare me a non-diabetic," she said.

The women had Roux-en-Y gastric bypass at Tobey Hospital in Wareham, Ms. Machado in March and Ms. Thompson in May. The surgery creates a 1-ounce stomach pouch, bypassing the rest of the stomach and part of the small intestine.

Patients typically feel no sensation of hunger for a year afterward. They move slowly from a liquid diet to small portions of solid food, and they must be careful to get enough protein, water and vitamins.

The women braved the culinary temptations of the holidays by eating small portions and concentrating on socializing with family and friends.

At home in New Bedford, Ms. Machado said she was nervous she would overeat. Unlike many dieters, her holiday strategy involved putting a lot of food on her plate, knowing she would eat only a small amount.

"That helped me get through it," she said. "If you take something away entirely, it makes you want it more."

Nine months after surgery, she still feels no hunger, but knows she needs food when her energy dips.

From a high of nearly 300 pounds, she lost a significant amount of weight on her own before entering the Tobey program at 235 pounds. She lost more — as the program requires — before the surgery, and has since dropped down to 150. Her goal, at a petite 5' 2.5", is to reach 125 pounds.

She never liked the recommended protein shakes and eats primarily "regular" food. When she goes out to dinner, she asks for a take-out container right away, so she can put some of the food out of view and not pick at it endlessly, out of habit.

Her new habits stand in stark contrast to her pre-surgery self. She used to stop for fast food all the time — before work, after work and while driving during the workday.

Late last fall, she called her surgeon. She was struggling at a plateau of 168 pounds. He sent her back to the program nutritionist, and Ms. Machado reverted to a near-liquid diet for a few weeks to restart the weight loss. Now she's back to solid food.

Ms. Thompson's food experience has been different. Finding things she can eat is still a matter of trial and error.

Some foods cycle in and out of her diet. As soon as she was allowed solid food, she ate chicken without incident, but later she experienced a period of about six weeks when she couldn't stomach it. Now chicken is fine.

"What works today might not work tomorrow," she said. "Scrambled eggs is a mainstay. Soups are a big thing. Sometimes I have a little corned beef hash."

She's down to 258 pounds, compared to 360 when she entered the program. She tries to keep her sugar intake under 15 grams a day.

"I don't dare push it and go over," she said.

If she wants chocolate, she reaches for a chocolate protein shake. These days, indulgence means adding fruit to her shake and whipping it.

Doctors and nutritionists have warned her, as they do with all gastric bypass patients, that sugar can cause intestinal distress because the body can't break down the sugar before it reaches the intestines.

More daring with food, Ms. Machado had an episode of what doctors call "dumping syndrome" — the rapid passing of large amounts of food into the small intestine — the one time she tried sugar.

"I got sick," she said. "The room sort of feels like it's spinning, and I was nauseous and clammy."

On Nov. 25, she experienced her first no-cake birthday. Unlike immediately after surgery, she can have a small amount of alcohol, including wine. The natural sugar doesn't bother her.

Social changes are evident for Ms. Machado, the 22-year-old from New Bedford. She takes advantage of newfound confidence to go to bars and parties, whereas the not-so-shy Ms. Thompson still sings karaoke at the same Chinese restaurant as before the surgery.

Ms. Machado said people treat her differently now that she's thin — and it's not just the young men, it's everyone. They are more likely to hold doors for her, to look at her and say "hello" on the street, and to be nice overall.

"It's still hard for me to cope with," she said. "At the end of the day, I'm still the same person I was nine months ago."

Both women are dating — Ms. Machado casually, and Ms. Thompson a steady boyfriend she met shortly after deciding to have the surgery.

Ms. Machado jokes that she's a "cheap date" because she eats and drinks so little.

Shopping for clothes, too, is different.

Ms. Thompson said her mind hasn't caught up with her smaller body.

"I'm still looking for the largest size. Then I put them on, and they fall off," she said.

She volunteers with a local emergency response team, and when they ordered T-shirts, she automatically asked for an XXL. It was way too big.

"I cannot wear any of my rings. I just do this," she said, gesturing outward with her hands, "and they go flying."

Ms. Machado promised to buy herself a new dress for her birthday and go out to celebrate.

"When I ever went to a store that I would never think of going to and picked up a size 9 off the rack and it fit, it was surreal," she said.

After a year passes, many gastric bypass patients are given medical clearance for other kinds of surgery, such as repair of joint damage caused by excess pounds.

Ms. Machado wants to have loose skin removed from her stomach — a common, though not universal, procedure for gastric bypass patients.

She has another surgery in mind, too — breast implants.

The weight loss has taken her from a DD to a B cup, and she's not happy about it.

She took a second job, delivering pizza, to help pay for the implants. She has plenty of energy to work, she said. Before the surgery, she could barely make it through her primary job as a phlebotomist, taking and processing blood samples.

For Ms. Thompson, the one-year anniversary can't come fast enough, because she's waiting for knee surgery. She suffered a torn ligament while getting out of a vehicle years ago, and the pain was so bad she went on disability pay, leaving her job as an office manager.