Dawn O’Brien stood in her kitchen holding a pair of size 26, blue-and-white flowered pants in front of her.
“I’ve always wanted to do this,” she said, laughing. “Look at my pants. This is not me.”
She flicked her wrists and tossed her pants to the floor.
“Tada,” she giggled, striking a pose.
Behind the pants was a size 9 figure.
More than three years earlier, Dawn was sitting on her couch wearing the same pants — then so tight she couldn’t zip them up — when she decided something drastic had to change.
“It was just one of those moments where you are thinking, ‘How much bigger am I going to get?’ ” O’Brien said. “And I had gone, seriously, probably two sizes bigger than these pants, but I wouldn’t buy them the next size up.”
Instead, she decided to get a Lap-Band, a weight-loss surgery that places a band at the top of her stomach making a small pouch about the size of a golf ball. The procedure restricts how much she can eat.
The 41-year-old Lawrence single mom convinced her mother, Elizabeth “Bizz” O’Brien, to do the same. Together they have lost 250 pounds in about 30 months.
“I am so excited about life — where I don’t think I was very excited about it before,” Dawn said. “I was trying to figure out, ‘Do I have to go through life with the morbidly obese title, or is there something better out there for me?’ And the Lap-Band was it.”
A growing obesity epidemic and advance medical technology have contributed to the skyrocketing number of weight-loss surgeries across the country and state. The surgeries have gone up almost 300 percent in the past decade. In 2006, 758 such surgeries were performed at community hospitals in Kansas compared to 190 in 1996. More surgeries are done outside hospitals at specialty centers. Nationally, about 200,000 surgeries were performed last year.
Depending on the procedures, costs can range from $13,000 to $40,000.
Proponents of the procedure believe the latest research overwhelmingly points away from the stigma of a quick-fix surgery that comes with risky complications and mixed results.
“There is a preponderant amount of evidence that it’s not only effective, but when done in the right conditions, with the right surgical training, it is safe and has a low mortality rate associated with the surgery itself,” said Candace Ayars with the Kansas Health Institute.
In recent weeks, weight-loss surgery has grabbed headlines.
Kansas legislators have heard pleas to require insurance companies to cover the procedure.
And, according to a study published in the Journal of the American Medical Association, Australian researchers found patients who had stomach band surgery were five times more likely to see their diabetes disappear over two years than patients who followed the standard practices of medication, diet and lifestyle changes.
Athletic in her youth, Dawn’s battle with weight began when she was pregnant with her second child. She gained 100 pounds. After the birth of her son, she lost 50 pounds. But the weight returned and then continued to climb.
Weight Watchers, the grapefruit diet, then the soup diet, joining gyms, pills — Dawn can rattle off the number of weight-loss techniques she tried.
“It just gets more and more intense as you go, and you keep trying all these different things to lose weight. You wake up one morning and you say, ‘I would rather not be here. I would rather not be on this earth this way.’ And, I think that is the point where you kind of go, ‘I need to do something drastic,’” she said.
Dr. Carlyle Dunshee, a weight-loss surgeon with the Tallgrass Bariatric Program in Topeka, said most of his patients are great dieters who have lost pounds 100 times over. However, he said even with successful diets, five years down the road, most people regain the weight.
“This surgery needs to be coupled with lifestyle changes, but just telling them that alone, that is not going to work, that is not the solution,” he said.
Dawn knew that Lap-Band, formerly called laparoscopic adjustable gastric banding, wasn’t a magic pill, but a tool. A tool that came with risks.
After attending an educational seminar in Topeka, she was sold on the procedure.
She was even more convinced that this was a surgery her mom needed. The Lap-Band is the least invasive weight-loss surgery; other forms involve moving intestines and disconnecting parts of the stomach. A surgery that would keep her anatomy intact was appealing to Dawn’s mom, Bizz.
Bizz, or Grandma Bizz as some call her, weighed 430 pounds. The 63-year-old Lawrence woman knew things had to change when she started using her grandmother’s cane. At work, she took breaks while walking from the parking lot to her desk as a customer information specialist at Lawrence Memorial Hospital. She used the motorized carts at stores. She had diabetes and heart problems.
“I love my mom, but I did not want to become my mom,” Dawn said. “I didn’t want the weight problems or the medicines.”
“And I am grateful for that,” Bizz said. “Because I didn’t want to see her go through what I had gone through.”
Dawn, chief executive officer of the Leavenworth County nonprofit Nurturing Families Inc., looked for insurance plans that would cover the surgery, but found none. Bizz appealed to her insurance company five times, but was denied. Dawn ended up drawing on her retirement to pay for the procedure. She did the same for her mom, who has now paid her back.
It made sense. With the extra weight, they feared they might not see retirement.
Aug. 29, 2005 — Dawn went into surgery at Tallgrass. Six weeks later, Bizz followed at St. Francis Health Center.
To prepare, it was 10 days of nothing but liquids. The same was true for the week or two after the surgery. Then it was soft foods, followed by solids and eventually anything they wanted.
While they can eat what they want, it must be consumed in small quantities — a quarter of a cup at a time. Ten almonds or half of an egg is a meal.
It was a mind shift that took some getting used to. Both had moments — at a favorite restaurant or Thanksgiving dinner — when they loaded up their plates only to realize they could manage just a few bites.
“For me, the psychological part of it was probably the hardest. Because you are so used to doing whatever you want food-wise,” Dawn said.
Bizz and Dawn have learned to chew slowly, pick food based on nutritional value and recognize when to stop eating before a strike of pain indicates they are beyond full and about to regurgitate. They don’t get hungry. They take vitamins; without them, their nails break and hair goes limp.
Kuda Chimanya, a clinical dietitian at Truman Medical Centers, said the surgery requires lifestyle changes: no more fast food or caffeinated beverages, and eating out is curtailed. The most successful patients are the ones who have follow-up programs that help them address the issues that drove them to be overweight in the first place.
Ayars, of the Kansas Health Institute, said a study in Sweden showed that 10 years after surgery, Lap-Band patients had gained back just 16 percent of the weight they lost in the first two years. For gastric bypass patients, it was 25 percent.
Bizz calls the Lap-Band her safety net. She has lost 130 pounds. So has her daughter. Bizz is halfway to her goal of about 150 pounds. Yes, there is the fear that the weight could come back, but roughly a pound or two a week is still steadily melting away.
Dawn wants to lose another 20 to 30 pounds to reach her goal of 125. She’s saving money for her next surgery, a body lift.
Life has changed. For Bizz, the cane hangs unused. The diabetes medication is gone. She can tie her shoes.
People say her voice has changed. Even her smile is different.
“When I go down a hall and I pass someone who hasn’t seen me in awhile, they walk by me like they don’t know me. And then, they stop and go, ‘Bizz?’” she said. “I love it. I just love it. That is the best compliment in the world.”
Two and a half years ago, Dawn would have told you that her weight hadn’t kept her from doing anything. But that wasn’t true. She now has more energy, makes eye contact during conversations, volunteers and finds herself connecting to more people.
But she keeps mementos of the old Dawn. Among them are the pants and her pre-surgery driver’s license. And, if she never hits that 125-pound goal, it’s OK.
“I like who I am now,” Dawn said. “To have come through that and to look back at my driver’s license and know, ‘Wow, that was two years ago.’”
