Lisa Howard

My good friend Lisa just underwent bariatric surgery last week, for a procedure known as the Duodenal Switch. She’s be reporting on her recovery and progress here.

Lisa is many things, a great friend, wonderful mother of two young girls, and hilariously cynical. She kept me awake many a night when we used to work third-shift technical support together several years ago with her witty commentary and DVD player. So, I asked Lisa if she would like to be featured in a Q&A for this site, to share her experiences with weight and weight loss, and what led her to choose weight-loss surgery.

What is your weight, height and/or BMI?

280 lbs, 5’6″, BMI is 45

Briefly describe the procedure you are about to have…

The BPD/DS is two things..a partial gastrectomy, removing the outer curvature of the stomach, leaving a smaller stomach that works as nature intended. The second part is that the small intestines are rearranged to separate the flow of food from the flow of bile and pancreatic juices. This inhibits the absorption of calories and some nutrients. Further down, the two paths are rejoined to form the “common channel” and proceed to the large intestines. The common channel is where food and digestive juices are mixed and nutrients are absorbed.

Does insurance cover the procedure?

Insurance approval varies with each provider and also depends on if your company has an exclusion policy forbidding weight loss surgery. Some companies will only allow for the RNY (Roux-en-Y), which is the current “gold standard” in WLS. Your provider will want documentation, which also varies by provider.

Approximately how much does it cost?

I’ve seen prices quoted in the US from 30K-45K. A lot of people go to Brazil, Mexico, and Spain to the world renowned surgeons there. I believe the Dr. in Brazil costs 15K and that includes the amenities of staying in the hotel that adjoins the hospital for aftercare. My insurance pays 90%.

What are the risks of the surgery?

I’m pulling this straight off of my surgeon’s website at

* Anemia due to inadequate iron, protein and vitamin absorption
* Insufficient amounts of vitamin D can result in vitamin or calcium malabsorption
* Calcium deficiency which can lead to osteoporosis. If these problems occur after surgery, they are correctable with supplements
* Food is not absorbed, resulting with very foul smelling gas and
stools, which can be a social problem (this can be controlled and maintained with adjusting your diet to what works best for you. Most of the DS’ers I know don’t consider this a big deal as they know what foods cause these issues and avoid them)
* Ordinarily patients can control their bowel movements and learn to deal with this quite effectively with the use of special deodorizing sprays

What led you to choose this procedure over other bariatric surgeries?

I began by looking into the lap band due to all the advertising it gets. But then I read testimonials of people whose band eroded into their stomachs or had excessive slippage. On the word of another DS patient, I did a lot of research on the DS and noticed that there are a LOT of people with the band and with the RNY surgery who are getting revised to the DS.

I chose it over the RNY for a number of reasons. The long term success rate is higher with DS. You lose more weight overall with the DS as well. The stomach is kept intact as nature created it, just smaller, where as the RNY procedure creates a stomach pouch and bypasses the pyloric valve and the duodenum. After the creation of the stomach pouch, the rest of the stomach sits blindly in the abdomen.

What led you to consider bariatric surgery as a weight-loss solution instead of traditional means like diet/exercise?

I find it interesting that you use the word “instead” here. I think it is a huge misconception among the general public that fat people don’t exercise or eat right. But on to the question..
I have been fat since I was four years old (I’m 33, btw) and have been dieting/exercising all of my life. At most I have lost maybe 10lbs only to regain 20. After doing a lot of research and looking at my family history, I accepted the fact that my problem is not an issue of diet and exercise alone. There are others issues involved such as genetics and metabolism as well. The surgery will provide me with a tool to use in conjunction with proper diet and exercise to reach the weight that is right for me.

Why do you want to lose weight? Do you experience health problems? Is it for cosmetic reasons?

Health issues for the morbidly obese are called comorbidities. Until I hit 33, I didn’t have anything except for depression. However, now I experience joint pain in my lower extremities. Fortunately that’s the only issue I have.

The reasons I want to lose weight are future-based. On my mother’s side of my family, my mother, grandmother, and great grandmother are all overweight. The issues among them and other females in the family are: heart disease, thrombophlebitis, diabetes, hypertension, not to mention cancer. I’ve watched the pain that my great-grandma, grandma, and mom have gone through and I want to do all I can to change this course that I’m heading down.

My kids are also a factor in that I want to be able to keep up with them and be a very active parent. I want to run with them, hike with them, play tag, ride bikes, etc.. right now my 6yo beats me in tag. I just don’t have the energy to keep up.

The cosmetic thing..that’s just something extra that comes along with all the other things I’m losing weight for.

Tell me about your struggles with weight. Did it start at an early age? After childbirth?

According to my mom, I was an average kid til about age 4 and then I began gaining weight for no apparent reason. I grew up riding bikes, playing sports, etc..and was never a big eater. She had me tested for thyroid issues and anything else that may cause weight gain. A reason was never come up with. I was diagnosed for hypothyroidism in my early 20s, but never prior to then.

Do you think weight-loss surgery is a viable solution for most who are overweight and obese? Why or why not?

WLS isn’t a solution, it’s a tool to help the morbidly and super obese people to attain what they are physically unable to do on their own. I’d like to say that the simple solution is for everyone to eat right and exercise, but if that worked for everyone, then there would be no fat people. Now more than ever, we are finding out that obesity is not something you get from sitting on the couch eating potato chips and ice cream, but is something that can be caused by genetics as well. I think WLS is a very good tool to give to the morbidly and super obese so that they can have a better quality of life while eating right and exercising.

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  1. 1 On November 17th, 2008, Food for Thought: School nutrition programs, eating disorders, poverty and more » said:

    [...] Lisa Howard [...]

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