Woman wins fight against obesity
This story is Part 8 of a 15-part series that examines health care needs in Gary, Ind.
Part 1: Scary ER visits a matter of routine for staff
Part 2: Teaching hospital would fill a need in Gary, region
Part 3: Without a trauma center, NWI out of time on 'golden hour'
Part 4: ER drama offers glimpse into Gary health system
Part 5: High-tech system helps track hospital patients
Part 6: Health reform threatens funding for Methodist
Part 7: State 'missing out' on health funding
Part 8: Woman wins fight against obesity
Part 9: Diabetes 'scared me to death'
Part 10: Methodist financial turnaround 'remarkable'
Part 11: City suffers from chronic shortage of physicians
Part 12: Health-care officials rip Gary's snow response
Part 13: City's history, economic vitality chart course of residents' health
Part 14: Community health centers a safety net for urban populations
Gary resident Teresa Johnson said she recognizes the woman in the “before” pictures and remembers her pain.
Johnson, 50, who worked with developmentally disabled adults in Lake and Porter counties before becoming disabled, said she has been overweight all her life.
“I had very little success losing weight on my own,” she said. “I’d lose weight and then gain it right back. But last year I needed a knee replacement surgery and didn’t want to have it while I was still morbidly obese.”
Gary physicians and health officials estimate that at least 30 percent of Gary’s population is obese. In 2003 the U.S. Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System survey ranked Gary with the second-highest obesity rate of any American city — 28.8 percent — at a time when 21 percent of Americans were considered obese.
Johnson took what was once considered a radical step and agreed to have bariatric surgery in November 2009, specifically, the gastric band bypass surgery.
That procedure resectioned a portion of her stomach, essentially shrinking the size of her stomach and reducing the volume it can hold. A New England Journal of Medicine study found bariatric surgery can reduce mortality rates of obese patients dramatically.
“It has worked wonderfully,” Johnson gushed. “I’ve lost 130 pounds.” At her heaviest she weighed 375 pounds.
“My goal is to be 195 pounds and I have not reached that yet. But I am still losing weight. And the surgery has transformed my life.”
She was diabetic before the surgery, but after her weight loss she no longer needs diabetes medicine and the disease has gone into remission. She had hypertension, or high blood pressure, but she said her physician is weaning her off the medication and she is now taking only one half pill per day.
“I eat smaller meals more frequently and I’m on a low fat, sugar free diet,” said Johnson, an ebullient woman with an ear to ear grin and lively eyes. “Nothing fried. No sweets. No baked goods. I feel absolutely wonderful.”
Johnson said her excessive weight did not diminish her sense of self worth.
“I always thought I was an attractive person, even with the weight, and now I’m even more beautiful,” she said. “When I was heavier I could only shop at three area stores carrying my sizes, but now I can go to almost anywhere and find something that fits. The greatest thing is my improved health. The pain in my knees is gone. My blood sugars are beautiful. My blood pressure is a lot better. I exercise at least one-half hour every day and I am able to walk farther distances without having to stop and rest. I can get out in the yard to work. Before I hired someone to do my raking and lawn work. I feel a greater sense of independence now.”
‘Food became a comfort’
Johnson, a widow with two children in college, is on disability due to multiple sclerosis. She said the pain and stigma of obesity have followed her throughout her life.
“But I always had a positive image of myself,” she said. “I’m a child of God and I know he loves me no matter what state I’m in.”
Johnson said she was a normal-sized baby, but believes she may have been genetically predisposed to obesity. “I have a picture of myself at age 6 and I was overweight for a child. While I was the only morbidly obese person in my family, others were overweight, some heavier than others. My grandmothers were overweight. I have sisters with weight issues. My mother has a weight issue. It is, of course, about the food.”
She grew up eating lots of fried foods and sweets, consuming large portions quickly and failing to work it off with exercise.
“At 375 pounds, there’s not a lot of exercise going on,” said Johnson.
Besides overeating and a lack of exercise, Johnson believes stress contributed to her obesity. In 1992 her husband was shot and killed, so the mother of two toddlers assumed both parental roles. Police never found her husband’s killer.
“I gained 125 pounds during that time,” she said. “Food became a comfort to me. I felt real loneliness, especially in the evening hours when the day was over and the kids were in bed. That’s when I would eat: Mostly cookies, ice cream and cakes. I don’t buy that stuff at all now.”
Johnson’s bariatric surgery was performed at The Methodist Hospitals and she goes to the Restart Center in Merrillville for ongoing support and follow up treatment.
“Several members of my family thought the surgery was too drastic of a move and were kind of apprehensive about it,” she said. “Now they’re proud of me and are glad it went well. I’ve had church members who, based on my success, have gone for the surgery and others I know who are working with the program now.”
‘Ambassadors for weight loss’
Dr. Hung Dang, a general surgeon who specializes in bariatric surgery, said only 5 percent of obese patients are successful in losing weight permanently through diet and exercise. “But lap band and gastric bypass surgery is 90 percent successful in the long term. People lose weight and keep it off. Many come to bariatric surgery as a last resort after yo-yo diets. We tell them surgery will help.”
But he said patients must be prepared to change their habits. “It’s a forced change because if they eat as much as they used to, they’ll get sick.”
Dang said dietary habits are worse in Gary than in the rest of Northwest Indiana because of its high poverty rates and few supermarkets.
“Poor people eat what they can afford and that usually means consuming more high-carbohydrate and high-sugar calories, such as you find in fast-food restaurants,” he said.
He said that after the surgery, which is usually covered by both Medicare and Medicaid insurance plans, other health problems improve. “Sometimes diabetes goes into remission, arthritic pain lessens, sleep apnea disappears and the patients have more energy. We’ve also seen improvements in people with acid reflux and asthma.”
Dang said most bariatric surgery patients lose 70 percent of their excess weight, essentially shrinking themselves over time. “After the surgery, patients attend follow-up classes and are weighed monthly and eventually yearly,” he said. “They are a part of the program for life.”
Bariatric nurse educators advice and counsel them about the diet and lifestyle changes.
Dang said bariatric patients like Johnson become ambassadors for weight loss. “Sometimes one person educating one family member can help a whole family,” he said.
“We see generations of obesity, but sometimes one patient in a family can come in and break those chains.”