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FASHION : Seeking a Secure Self-Image in Stomach-Stapling Surgery : The procedure, which decreases the body's capacity to hold food, requires 12 weeks of healing and a whole new style of eating.


In the beige-and-mauve ballroom of the Hyatt Westlake Hotel, a woman stands at the podium, addressing a small crowd of listeners who are clustered in the back three rows.

The attendees are small in number, but not, as it were, in volume.

They are here to learn about Lite Life, which sounds like a diet cola, but isn't. Instead, it's a program offering a fairly radical procedure, one that will ultimately yield what we all look for: a secure self-image.

The audience sees before-and-after slides of men and women who have slimmed down to less than half their body weight. They learn of an extensive psychological support system that is part of the package. Then they hear the procedure's name: vertical staple gastroplasty--having the major part of one's stomach stapled off.

The idea tends to take one's breath away, which may explain why, as details unfold, there are so few questions from members of the group.

Dr. Sheilah Clayton, a general surgeon who operates at St. Luke Medical Center in Pasadena, the closest Lite Life-approved clinic, lays out the procedure.

"Unlike Jenny Craig, this is surgery," she says. "It's serious and should be considered so."

She names the requirements for candidates: Healthy patients must be 100 pounds overweight, those who are medically compromised at least 75 pounds overweight. Each must have failed at other weight control measures.

"We want you to be desperate when you come to us," Clayton says later. "We don't want someone who has never been on a diet. We want you to have tried it all, and know that you need help."

She flashes a drawing of a stomach on the screen. It has four rows of surgical staples descending from the base of the esophagus, creating a very small receptacle for food. After surgery and months of stretching, this pocket will have a capacity of about six ounces, less than a fifth of the original stomach.

There is a ring placed around the stomach at the bottom of the staple line, reducing the outlet to about the width of a thumb--forcing the stomach's owner to chew food more thoroughly than he or she imagined practical.

As a result: The nervous system is made to consider a full pocket as a full stomach. When this happens, the brain receives a signal that all is well; the desire to eat shuts down.

The procedure was considered experimental by the general medical community until three years ago; but Lite Life clinics, now sponsored by Ornda Health Corp. of Tennessee, have performed it 700 times since 1987. In tracking those patients five years after surgery, Clayton says 70% of them have stayed within 30% of their ideal weight.

These results are far better than non-surgical weight loss programs, which Lite Life has documented at an overall 95% failure rate. But, the commitment is far greater: 12 weeks of healing, a whole new style of eating.

There is an unappealing discussion on what happens when one fails to maintain the required method of chewing, and the presentation ends. A Lite Life client, Jaz Zander, who is wearing a Size 6 pants outfit, is available for questions. But the attendees seem almost to avoid her and head for the doctor instead.

Zander, a contract specialist at the Port Hueneme naval base, can identify better with them than they can with her. She is just under 100 pounds lighter than in spring, 1993, when she needed help to tie her shoelaces.

In those days, her home was devoid of mirrors, and she bought her clothes without trying them on.

"I tended to want to blend against the background," she said. "I wore big, baggy sweaters and big, baggy pants. They always looked the same, although they were different baggy pants and different baggy sweaters."

Zander found herself increasingly reluctant to attend social events. She felt vulnerable, and she had trouble fitting into restaurant booths.

"I was gaining and losing 160 pounds a year over and over again. Weight Watchers had a revolving door just for me," she said.

Slim until her late 20s, Zander entered a period of stress when she began dealing with her anxiety by eating, and was unable to break the habit for two decades.

Millions of people have learned to deal with tension this way. They gain a fixation that can't be easily avoided--there's no way to swear off food. And there's no way to cloak the result. Compulsive gamblers can look pretty good at a party; compulsive eaters can't.

Worse, there's a kind of competitiveness about weight. People who don't have it seem proud of the fact, and they are sometimes constrained to tell those who have it what to do about it.

Zander's circle was supportive for the most part, but she was intent on change. Pleased now that she chose surgery, she talks of four years of indecision after learning of the procedure. There was always another diet to try--and, for a long time, there was an image hang-up.

"I kept thinking: 'I'm going to have this scar--I won't be able to wear a two-piece bathing suit.' Then, I realized, 'When you weigh 235 pounds, why would you be wearing a two-piece suit in the first place?'

"After that," she said, "I had a good laugh and decided to go for it."

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