By Colleen Chandler

On the Front Page...

These women know what it's like to lose — weight, that is. They can tell you about nearly every diet out there. They have tried them all. And they all failed. Until now.

Between them, Virginia Ivanoff, Elizabeth Ney, Nancy Wood and Alecia Anderton-Brown — all from NIEHS — have lost more than 530 pounds. But diets alone did not get them there.

Continued...

Weight-loss surgery has taken some bad publicity recently, including allegations that it is taking "the easy way out." But for these women, it was the only way out of a world of social isolation and precarious health problems that nearly guaranteed them a premature death.

Each of them will tell you about losing weight, then regaining it. Over and over again. Five hundred thirty pounds is but a fraction of the weight these women have put on and taken off, then put back on. And they are not alone.

In 1991, an NIH consensus panel released a statement based on their determination that gastrointestinal surgery is a valid therapeutic option for treating severe obesity. The panel noted that patients were able to keep the weight off.

Eli Ney, before surgery The panel recommended two types of surgery. In one, a large section of the stomach is stapled off, creating a narrow, restricted pathway to the intestinal tract. The other form also calls for stomach-stapling, but also attaches a Y-shaped section of small bowel to the stapled stomach, rerouting the outlet from the stomach to the intestinal tract. In America, land of burgeoning waistlines, more than 1.5 million people with a body mass index greater than 40 are probably good candidates for such surgeries, the panel found. A BMI of 40 puts people roughly 100 pounds overweight. Medical conditions such as diabetes, high blood pressure, arthritic symptoms in weight-bearing joints and disturbances in heart and lung function — commonly caused or aggravated by obesity — improve drastically after the surgery, according to the 14-member panel. But you don't need to explain all that to these women. Not only have they already heard it, they are already believers. Now, they offer their insights, support, even clothing to other women who have had the surgery. They have also suffered from discrimination based on their weight. Ivanoff, an EEO specialist, said discriminating against fat people is the last remaining legal form of discrimination. Obesity is seen as a moral problem instead of as the complex psychological, biological and environmental problem that it is, she said.

Virginia Ivanoff, before Ney, Wood and Anderton-Brown all had their surgery done at Duke University Medical Center. The Duke Weight Loss Surgery Clinic runs physical and psychological screenings on all potential patients. The surgeons who run the program say that there is a small percentage of people whose bodies react very differently to dieting than do most people. The more they try to diet, the more their bodies produce a hormone that generates a powerful urge to eat. For this group of people, weight management isn't simply a matter of willpower or self-control. If they could overeat, they would. Their bodies insist that they do. But after gastric bypass surgery, only a very small pouch remains from the existing stomach, and it cannot be overfilled. Most gastric bypass surgeries are now done laparoscopically with only five small incisions. Super glue is often used in place of sutures to hold the skin incisions closed until they heal. But it is still major surgery. "There's nothing easy about having your insides rearranged," Ney said. When you agree to the surgery, you agree to follow certain rules such as eating only small portions and eating very slowly. If you break the rules, you pay for it with nausea, pain and vomiting. "For some people, that is like giving up their best friend," Ney said.

"I was flat out told I'd be dead by 50. I was heading up to 400 fast — and beyond." She had a so-called mini bypass, which leaves a larger pouch in the stomach and bypasses only 6 feet of intestines.

Nancy Wood, before However, she said the surgery doesn't excuse you from taking care of yourself physically and emotionally. It is like giving yourself a digestive disorder to treat a metabolic one, and it works. She points to her head. "But you have to take care of the fat up here. Because if you don't, you won't keep the fat off down here," she said, pointing to her hips. The only thing Wood learned from the many diets she tried over the years was how easily she can be led astray. "I never met a carb I didn't like," she said. She was diagnosed with type 2 diabetes, and developed lactose intolerance. She began having more and more problems adhering to a diabetic diet. "I was just turning into a giant mess, with giant being the operative word," Wood said.

After the surgery, she watched her glucose drop, and knew she had done the right thing.

It was Ney's weight loss that triggered Wood's interest in the program. "I saw Eli, and I asked her what kind of diet she was on and how come she had hidden it from me," Wood said. She soon applied to the program. After getting her blood sugar down, she was scheduled for surgery. Since her surgery last summer, her pant size has dropped from a 32 to a 20, and her shirt size from 28-30 to 20-22.

Three weeks after surgery, Wood was off all diabetic medications, and after 3 months her glucose leveled out. She has improved her physical activity, and by the end of the year hopes to be able to run a mile.

"I just feel great, wonderful, awesome, empowered, invigorated, cute. Precious even — all those good Southern adjectives," Wood said.

Anderton-Brown had surgery in 2002. She said that in college she often felt like an outsider because of her weight. Two kids, a marriage and a divorce later, she said, her weight kept going up, up, up. She started looking at her options. She contemplated for just 3 months before deciding to have the surgery. She told herself that either way she could die and that she might as well die trying to do something about her weight.

Two years later, she is wearing size 14 jeans with confidence. She has more energy and can focus better than she ever has.

"I feel light as a feather, mentally and spiritually. I feel free. For once in my life, I don't care what other people think. I like what I see," Anderton-Brown said. "I am finally at peace with myself."

Today: From left, Nancy Wood, administrative technician, Elizabeth Ney, biologist, Virginia Ivanoff, EEO specialist, and Alecia Anderton-Brown, desktop system administrator.