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Drea Aldeguer always considered herself to be a ‘bigger’ girl; when she was born she weighed 9lbs 9oz, and struggled with her weight throughout grade school, dreading participating in PE classes with her ‘normal’ weight classmates.

But by the time she turned 13, she had turned her love for fashion into a way of expressing herself, bringing her a self-confidence she hadn’t experienced before – and others noticed as well. “Back then, being a confident, plus-sized woman was rare in the Philippines. This was probably why in my hometown Cebu, I had some sort of a following.”

But in 2016, Drea hit her heaviest weight at 288 lbs. The confidence she gained through selling her fashion line did not remove the underlying issues she had with her body – issues that went beyond size and weight loss.

Drea’s Weight Loss Journey

Drea was facing health issues beyond the surface-level issues that stem from obesity – she had become borderline diabetic, and was also suffering with gallstones. After consulting with a healthcare practitioner, she decided to undergo bariatric surgery and have her gallbladder removed at the same time.

Drea underwent surgery on September 7, 2016, but her journey began a week before. 7 days before her surgery, she was only allowed a liquid diet to reduce the fattiness of her liver. On this liquid diet alone, she lost 11lbs and went into her surgery at 277lbs.

Her surgery lasted for 3 hours and was done laparoscopically, leaving her with little to no pain from the 5 tiny incisions that were made. For the first 24 hours, she did not eat or drink and was barely able to sit up straight.

On day 2 of her recovery, she was able to walk around her hospital room slowly, to help ease her discomfort. She also started consuming liquids again, or at least as much as she could.

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After 4 days in the hospital, she was discharged and returned home. For 2 weeks she was on a liquid diet as her stomach was still delicate. After 2 weeks, she was able to eat soft foods like cheese and eggs, and in that first month she lost 30lbs.

When she began introducing other foods into her diet, like meat and vegetables, her weight loss began to slow down. She went from losing 15lbs a month to 10, and sometimes she lost no weight at all. After nine months, she had lost a total of 120lbs.

“In those nine months, I’ve learned that weight loss surgery was the farthest thing from just a “quick fix”. I still had to watch what I ate, and I had to learn about portion control.”

Understanding Bariatric Surgery

During the 1960’s, doctors began to notice significant weight loss in ulcer patients who had portions of their stomach removed as part of their treatment. This led to the creation of bariatric surgery; surgery on the stomach or intestines to help a person suffering from extreme obesity to lose weight.

Since then, these surgeries have been refined and there are a multitude of weight loss surgeries available, with the 3 main surgeries being gastric bypass, gastric banding, and gastric sleeve.

While weight loss surgery is an option for some, it should only be a last resort and it isn’t for everyone. A person who is considering weight loss surgery must be evaluated by a team of professionals, usually a physician, dietitian, psychologist, and surgeon.  

Before you can even be considered there are a few criteria that you have to meet [2]:

  • Efforts to lose weight with diet and exercise have been unsuccessful
  • Your body mass index (BMI) is 40 or higher
  • Your BMI is 35 or more and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea
  • You’re a teenager who’s gone through puberty, your BMI is 35 or more, and you have serious obesity-related health problems, such as type 2 diabetes or severe sleep apnea

Nutrition is the best way that you can begin to lose weight. Look at what you’re eating and how much. Also consider why you eat certain foods. Is it stress? A coping mechanism? By tackling these issues, you’ll begin to notice a positive change in your body.

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Exercise is also crucial to weight loss. This doesn’t mean you’ll be running marathons right out of the gate, but you can start small. Walk to the end of your driveway and back, then maybe the corner and back. You’ll see that as you push your body, it will push back, but eventually your ability will grow as your waistline shrinks.

The Different Types of Bariatric Surgery

As mentioned above, there are multiple types of bariatric surgery, and each one comes with its own set of pros and cons [3]:

Gastric Bypass

This surgery splits the stomach in two; the first stomach collects food and is connected to a lower part of the small intestine. The second stomach’s only function is to create digestive fluids to pass on to the small intestine to help digest the food. By creating a smaller stomach, the person feels fuller faster, and since some of the digestive system is skipped, a smaller amount of calories is absorbed from the food.

Pros: In 6 months, as much as 50% of total weight loss takes place, and rapid recovery from a variety of weight-related afflictions, such as high blood pressure, sleep apnea, and even diabetes, plus the results tend to last.

Cons: There are fewer calories absorbed by the body through gastric bypass, but this also means that there are less nutrients absorbed by the body, like calcium, iron, and certain vitamins. People who undergo this weight loss surgery must take supplements every day to make up for these missed nutrients. Also, the surgery itself comes with significant risks, like blood clots, infections, and gallstones.

Gastric Banding

The gastric band is an inflatable band surgically placed around the stomach that can create a smaller upper stomach and a larger lower one. With this smaller upper stomach slowly passing food through the small channel to the lower stomach, people feel full faster, causing them to eat less.

Pros: Compared to gastric bypass surgery, gastric banding surgery is safer and can be recovered from faster. It also isn’t permanent, and the band can be removed at any time. The band can also be tightened or loosened with the injection or removal of saline from the band by a doctor.

Cons:  Weight loss with a gastric band tends to take more time compared to gastric bypass. This means that the weight-related afflictions can remain longer after surgery. There are also fairly significant risks that are unique to this surgery, like the band slipping or leaking, which can cause extreme pain that can only be relieved with further surgery.

Gastric Sleeve

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A gastric sleeve, also known as a sleeve gastrectomy, is another form of bariatric surgery. This surgery removes approximately three quarters of the stomach, and what remains resembles a sleeve which connects the esophagus to the small intestine, similar to the shape of a banana.

Pros: Unlike gastric banding, there is no foreign device left in the body to cause potential complications, slip, or cause infection. Also, a sleeve gastrectomy causes the patient to lose weight faster, typically, 30-50% of weight loss occurs in the first six months to a year and can continue for up to two years.

Cons: A gastric sleeve is permanent. Part of the stomach is completely removed, and this surgery cannot be undone. The stomach is stapled where it is cut, and these staples can leak, causing a variety of health problems, including infection. While the surgery is not reversible, this does not mean weight gain is impossible. The nature of the stomach is that can stretch, and this does not change post-surgery. With poor dietary decisions, one can stretch the stomach back to its original size.

Post-Surgery Is No Cake Walk

While it may seem like an easy way to lose weight, surgery requires making some serious changes to your lifestyle in order to not undo what the doctors have done. At first, the weight will just fall off, mostly due to the fact that for a while your body won’t be able to handle much food, mostly liquids and eventually soft foods.

But eventually you’ll notice that your weight loss plateaus. This is where it gets tricky and where people can fall back into bad habits. While weight loss surgery can help the amount of food your body can take, it’s up to you to determine the kind of food you put in it. Eating unhealthy and living a sedentary lifestyle can have you bouncing back up the scale.

Drea understood the risks and made the call to have this surgery to help improve her health and not just to lose weight.

I think what people don’t understand is that bariatric surgery can only control how much you eat in terms of quantity. It doesn’t change your relationship with food, which is where the real work is.”

Bariatric surgery is not a get-out-of-jail free card or a fix-all solution. It is just another step in a journey to having healthier habits for a healthier life.

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