Weight Loss Surgery, Part I :: The Decision


Being a fat person is complicated. In the media, we see an increase in representation and body positivity, which is a wonderful thing, full stop. All bodies deserve to see themselves depicted in media doing all the things they are capable of experiencing.

And yet the media and our culture constantly throw diet, health and wellness information and fads at us that impart a completely differently message. So, love your fat self, but also try to change your body into a more acceptable version of itself?

We are judged by what we eat, what we choose to put on our bodies, who we love, and who loves us back. The twists and turns in logic are mind boggling.

I’ve been some kind of overweight since I was a preteen, put on my first diet at age 11. Joining activities to hopefully lose weight and get stronger the remainder of my teen years. I did soccer in elementary school, was a Young Marine in high school, and regularly attended the gym with my parents as soon as I was old enough to do so.

Despite all this, my weight never really stabilized, it just kept gradually climbing. A sedentary job and going on birth control in my early 20’s ballooned my weight up to peaks of morbid obesity. Three pregnancies and various diet/wellness attempts later, I am not any thinner than I was then.

To be fair, I have not really tried to lose weight in a few years. It seemed pointless, hopeless, and destined for failure based on all the science and data out there that tell us that most individuals regain what they lost, and add some more, after each diet attempt. Why make myself miserable trying to do the impossible?

I’ve found, as a busy mom who likes to cook but also needs to hit the drive-thru, it is really, really hard to follow any kind of diet and cook food my kids will eat. When they were smaller, I could do low carb meals for dinner. I got really good at making cauliflower into pizza crust, risotto, mashed potatoes, grits, and more. Zucchini noodles went over like gangbusters when my kids were toddlers and preschoolers. As they aged into more palate discerning preteens . . . not so much. And so, I went back to making more conventional meals like spaghetti, meatloaf, curries, and casseroles.

I’ve tried to embrace my fatness – it is what it is. Dress the body I have. Move the body I have. Live the best life I can, making the healthiest choices I can. But also realizing, as I turned 41 this year, I want to live as long as I can in this body I have. How can I truly do that at the weight I am? I generally don’t have any major obesity related health issues that I know of. Maybe I do, and I just haven’t tried to figure it out. I’m horrible about going to the doctor except when a concern arises

I started seeing people around me get weight loss surgery. It worked for them. They lost weight quickly and have been able to keep it off for years. The longer these surgeries have been around, the more studies are showing that, for whatever reason, surgical weight loss has better persistency over time than diet and exercise alone.

I was intrigued… 

My first step

The first thing I did was check my insurance. Would they cover the procedure? What hoops did I need to jump through? The answer, in my case, was yes, they covered certain bariatric procedures, given certain criteria was met. I met based on BMI alone but could have met with a lower BMI and diagnosed comorbidities, like diabetes or high blood pressure. 

My next step

The next thing I considered was where to be seen. The Midlands offers two major hospitals with bariatric programs: Prisma Health and Lexington Medical Center. I looked through my insurance’s website at in-network providers and the estimated costs. For whatever reason, the costs at one local hospital was significantly lower than the other. I’ve had friends go through both facilities, so felt comfortable with either. My out-of-pocket expenses would be about the same regardless, but it seemed to make sense to me to go with the more overall affordable location, so I made the call and set up an initial consult once I watched the prerequisite videos on weight loss surgery basics.

Initial consult day

My initial consult day was a doozy of a day. The clinic was incredibly busy. I was weighed, measured, and given piles of information. I would need a ton of lab work, a cardiology consult, a psych evaluation, and eventually, an EGD to look at my particular anatomy. 

How I’m feeling about things after steps one through three…

Up to this point, the decision to have surgery or not is still theoretical. Going through with the preliminary work does no harm and may find issues that need to be dealt with and may encourage me to do more to lose weight. I firmly do believe that weight is not synonymous with health and that individuals can be healthy at a variety of sizes.

As I move through these steps, I’m finding I am not as healthy as I thought. My A1C (a blood value that measures your blood glucose average levels over time) was borderline diabetic. My blood pressure is definitely higher than it should be. My cholesterol levels are not bad but could be better. All in all, the trend is not good, but could be reversed if I could focus on losing weight and getting healthier. 

I admit, I do have some concerns. No surgery is without risk. My concerns do not really revolve around whether or not the surgery will be effective or if I will have complications. Statistically, if I follow the plan, weight will be lost. Complications are possible, but unlikely. 

I have been a fat person fully 75% of my life. Now, looking back, I was probably not, in fact, fat from ages 11-17, just built in a completely different mold than my parents expected and nobody knew how to approach that in a healthy way then. Nevertheless, by age 20, I was most definitely fat, and continued to be, despite my best efforts.

A lot of my identity has been built on being the fat, funny friend that loves to cook and knows the best places to eat. My closet is full of clothes from size 16 to size 22. My kids have heard me talk about body positivity and focusing on bodies are capable of versus what they look like. My daughter, especially, is built a lot like me, except she’s destined to be much taller. (I’m only 4’11”. Her dad is 6’6″. Genetics alone tell me she’s bound for greater heights.)

I worry what my decision to have surgery will say to my kids, and yes, I’ve talked to them about it. It’s not something to be ashamed of or hidden. Yes, the hope is that I’ll lose weight. But the real goal here is to reclaim my health. If I have less body to move, I can have more energy and do more with them. If my health markers improve, the chances of being around a long, long time to annoy them improves, too. 

I wanted to share this journey because I know I am not alone in being curious about the process and how others approach it. I hope to share more once I have surgery scheduled and performed early next year, both the good stuff and the more challenging aspects. 

For anyone else considering surgical weight loss, my advice is that you really can’t research too much. Dig into what options are available to you, what you may need to do to get ready for surgery and what to expect afterwards. 

Stay tuned for Part 2! 

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Katrina is a mom of three great kids and has been married to her first love for nearly 10 years. She’s grateful to have a job that allows her the flexibility to both work from home some days and in the office others. On the surface, Katrina is pretty crunchy – she loves breastfeeding, babywearing, co-sleeping, natural birth, and homeschooling — but still loves her stroller, having her kids in their own beds at some point, her epidural was fantastic, and she’ll be sending the kids through public school. Most of all she loves the fact that we have all these choices, which makes life interesting! One of her favorite experiences was moving to Japan in 2002 to live as an adult dependent with their USMC family. It was an amazing experience, and if it weren’t for that, she probably wouldn’t ever have met my husband.


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