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Kobs quickly adapted to eating six small meals a day — and small is the operative word. Since undergoing Roux-en-Y gastric bypass, in which a stomach pouch is created that is about the size of a walnut, meals can’t be more than half a cup. A meal for Kobs might be a packet of string cheese or a protein bar. Weight loss is achieved by limiting the quantity and absorption of food.

Kobs discovered one of the drawbacks to her surgery the day she took her grandkids out for ice cream and experienced the “dumping syndrome,” which occurs when the stomach’s contents enter the small intestine too quickly. “I had two teaspoons of Ben and Jerry’s, and I had to head for the parking lot to throw up,” she recalls. “I thought I was going to die. All the blood was rushing to my gut, I started sweating and felt sick because of the high content of carbs.”

But Kobs doesn’t feel deprived. “Before surgery I never met a sweet that I didn’t like, trust me. But I just don’t miss it,” she says. “I’m rarely hungry.”

Although Kobs is ecstatic about the outcome of her surgery, she admits that she was a reluctant convert, spending almost a year researching the procedure before she went under the knife.

“I was very, very picky about who was going to do my surgery. I did not want a surgeon who does a gallbladder, then a hip, then a bypass. I wanted someone who would show me his outcomes. That was hard to find. I also wanted a comprehensive program.”

Living in Phoenix at the time, Kobs found what she was looking for in the Wish Center in Chicago. “All they do is bariatric surgery. Their offices have broader chairs. Prior to surgery you have 14 hours of face-to-face time with all of the team members.”

Nearly two years later, Kobs not only weighs a whopping 175 pounds less, but her life — and her health — have taken a dramatic turnaround. She is a newlywed who wore a size 10 dress at her wedding. And she is free of diabetes, high blood pressure, and cholesterol, as well as sleep apnea and back pain. The only pills she takes are hormones, vitamins, and calcium.

“I feel better now at 60 than I did at 30,” Kobs says. “I have loads of energy.”

The new you

Kobs’ case is not unusual. A recent study in the Journal of the American Medical Association found that bariatric surgery not only helps people shed pounds, but also appears to alter the patient’s body chemistry, relieving conditions such as diabetes that can lead to heart attacks, strokes, or kidney failure.

Kobs’ 35-year-old daughter, Amy Summers, a nurse practitioner in Ohio, was so impressed by her mother’s experience she underwent bariatric surgery in August. The results? Summers, CNP, MS, who weighed 280 pounds at the time of her surgery, lost 45 pounds after nine weeks, and she’s confident that’s just the beginning.

Bariatric surgery isn’t cheap. But with annual medical spending on overweight and obese patients estimated at almost $93 billion — 9% of U.S. health expenditures — many insurers are willing to pony up part or all of the $15,000 to $30,000 tab.

San Diego nurse Nancy McGovern had to pay more out of pocket for her bariatric surgery, in part because she chose a more expensive and complex procedure out of the area.

McGovern had seen two coworkers cope with the side effects of gastric bypass surgery, and decided it wasn’t for her. “They had vomiting problems, dumping syndrome, and weren’t losing weight all that easily. I knew that it wouldn’t work for me,” she says.

After spending time on the Internet, McGovern found that Pacific Laparoscopy in Northern California specialized in the duodenal switch procedure. According to the JAMA study, the duodenal switch results in the greatest weight loss, but is a more complicated, lengthy surgery.

McGovern, 58, couldn’t be happier. Weighing 315 pounds when she had surgery in July 2001, she lost 160 pounds in 18 months. “I had struggled with weight all my life. Three to four years before surgery, I just gave up.”

McGovern’s weight had forced her to give up her job as an emergency department nurse. Even a more sedentary job as an advice nurse in Kaiser Permanente’s regional call center was a struggle.

“There were only certain chairs that I could use and certain places that I could sit. There was no elevator, and I had to go up stairs extremely slowly, going up 12 steps to a landing, then resting and going up another 12. Going down, I was terrified I was going to fall.”

Now, having gone from a size 36 to a size 12 or 14, she zips up and down the stairs at work, and sits in a regular chair. Her foot and back problems, sleep apnea, respiratory distress, and depression have disappeared.

“I’m living today the way I always wanted to live. I can eat normally, I’m not starved. I can do what I want physically when I want,” she says. “I have been given my life back.”

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