Finding a woman in 2020 who has never struggled with her weight, too much or too little of it, is still rarer than an office birthday cake going around without a single, “just a tiny slice for me!”.
Weight-talk and the policing of bodies, our own and others, is both exhausting and inescapable. We exist in a news cycle that constantly reports on the national epidemics of obesity and heart disease, while the accepted most effective solution, Bariatric surgery, is wildly underfunded in the public system – with some hospital waiting lists up to an impossible three years long.
Bariatric surgery is evidenced based as the most effective way for people with obesity to lose weight and keep it off in the long term. And while almost 1.4 million Australians currently meet the criteria for bariatric surgery, only around 25,000 last year actually accessed it.
Dr John Jorgensen, one of the country’s most experienced bariatric surgeons, explains, “people choose bariatric surgery after years of struggling with weight loss. They’ve usually exhausted non surgical weight loss strategies including diets, personal trainers, drugs – and their obesity is usually starting to significantly reduce their quality of life. By then comorbidities, like type 2 diabetes and sleep apnea, are developing.”
For one of his patients Carol Angelosanto, a clever and charismatic CEO of a successful marketing agency, this was certainly the case. “I needed to lose about 80 kilos, I would go on severe diets and lose 25 or 30 kilos and no one would even notice. It was so disheartening, you just sort of resign yourself to the fact that this is how it’s going to be.”
But, like the majority of obese Australians, obesity was written in Carol’s genetic destiny. “I was never not overweight, but I didn’t grow up in a house where there was a junk-food mentality – it was very healthy Australian meat and three veg household.”
So with a healthy childhood and an active adult life she found the commonly held belief that overweight people are ‘just lazy, eating takeaway on the couch” as incredibly infuriating.
“I’ve worked hard all my life, for forty years, and I’m not into takeaway food – for me obesity was my heritage, it was genetic. I tried every diet known to woman…but then I got to the point where it was do it (bariatric surgery) or die.”
Standard preparation for surgery, says Dr Jorgensen, “is educational and nutritional. We have people on a protein sparing fast with a very low calorie meal replacement, like Formulite, for 2-4 weeks pre surgery. This puts patients into nutritional ketosis which is an optimal and safe place to be for rapid weight loss. They’re also encouraged to stay on that plan for 3 weeks after surgery – the shakes just make things simple and safe.”
For Carol it was,“two weeks on a meal substitute program and a teaspoon of olive oil. I absolutely love Formulite – no word of a lie. They do scientifically created meal replacement shakes and soups, it’s an Aussie company that has no nasties and tastes great – I still use it today, over a year later. And I’ve tried every other one on the market.”
Post surgery Dr Jorgensen says, “patients are in hospital for two or three days, usually off work for around two weeks. The main weight loss occurs for the next twelve months, and during this period they transition through many dietary stages. In the end we aim to be established on the CSIRO low carb diet, as a lifestyle.”
For Carol, now an incredible 80kgs lighter post-surgery life is, “absolutely amazing. No regrets, I feel fantastic. I wish I’d done it ten years ago. I feel like I lost ten good years of my life not having done it earlier.”
However she’s very careful to point out that surgery is only one part of long term success, “what put me off was that about 10 or 12 years ago, all these famous people were having it done and two years later you’d see them and they’d put it all on again. I don’t want that to be me.”
“My stomach is now about 80% smaller, I have to be realistic about what that means – I cannot overeat, I can’t eat certain foods. I take everything my dietitian says seriously. My main advice is don’t listen to online forums, there are so many of them full of opinions and misinformation, you need to see a specialist and only pay attention to them.”
Carol also continues to work with Dr Jorgensen to keep her mental health instep with her physical, “I know I’m very lucky to be able to afford the support I have – so many don’t.” Psychologically she’s still, “not accustomed to the size I am now, I’ve lost 80kg and I am now 80kg – and I have twelve more that I’d like to lose – but mentally I’m still not caught up with how I look now.”
But overall? “I feel amazing. This is going to give me a chance to live longer – I’m only in my 50’s and I was already talking to doctors about a knee replacement. It blows my mind that they were happier to offer me a knee replacement than to suggest Bariatric surgery which is what I really needed. I’m buying clothes off the shelf for the first time in years – yesterday I threw out twenty two bags of fat clothes. You are never too old, it’s never too late to start again.”