If the operation didn't work, there was nothing else to try. By the time she was 30, Dana Estrada had tried every diet and taken every pill. Now she was about to undergo a dramatic remodeling of her insides--a final effort before entombing herself in hundreds of pounds of fat for the rest of what could be a brief, unhappy life.
She'd already lost 100 pounds by working out and starving for nine months, but it wasn't enough. She'd shed a lot of weight before, and knew she could put it back on without any trouble. Her worst nightmare was to get even fatter.
At 5 foot 1 and 320 pounds, she had been miserable. She couldn't carry a bag of groceries from her car to the kitchen of her Oxnard home without feeling exhausted. Her husband loved dancing, but she just couldn't. At family barbecues, she'd drift to the isolation of her bedroom--anything to avoid being the center of attention, the fat lady, the elephant in the parlor.
"People would say, 'Oh, but you have such a pretty face.' And I'd think, well that's fine--but you guys don't have to be me."
Every day, you see a headline about millions of people who must feel the same way. Kids are getting fatter. Adults are getting fatter. Americans are the fattest people in the world. We spend $50 billion a year on diets--and Dana tried them all.
When fen-phen was banned, she went to Mexico for it.
"I didn't care what they said about the heart valve, or whatever," she said. "I had to have it."
She lost 60 pounds, and, predictably, regained it in no time.
On a bad day, or a good day, or a day of no special note, she'd sit down on the couch and eat, for instance, a whole bag of Reese's Peanut Butter Cups. Like a self-inflating life raft, she'd balloon uncontrollably. With every new pound, a void inside grew bigger and more demanding.
"I'd see shows about anorexia, and I'd pray for it," she said. "I'd say, 'God, please let me be that way.' I knew it could kill you, but I'd pray for it anyway."
There was a time when she was merely chunky.
She weighed 160 pounds when she graduated from high school. But soon she married and started having children.
And she got heavier and heavier--not merely fat, but what doctors call "morbidly obese," the ominous term for anyone overweight by more than 100 pounds.
She knew that none of this was supposed to matter. The person within is what counts, and the world had confirmed it. After all, she had a caring husband, four kids, an accounting job she loved.
But she also had high blood pressure and migraines. Constant fatigue made it no easier to raise her kids, now ages 6 to 15. When her doctor warned her that she was well down the road to diabetes, she decided to take the most drastic action available to anyone who is seriously overweight.
Last March, Beverly Hills surgeon Jamshid Nazarian blocked off her stomach so that less than one-tenth of it could hold food. A small length of her intestines also was blocked, keeping her body from absorbing as many calories.
Stomach-stapling has been around for years, and became known for its horrible complications; in some cases staples gave way, and in others patients suffered malnutrition. Surgeries like Dana's--technically known as a Roux-en-y gastric bypass--are done with new, tighter stapling techniques and involve less potentially harmful tinkering with the digestive tract. Better outcomes have increased the procedure's popularity, according to the American Society for Bariatric Surgery. In 1995, 20,000 people had similar operations; now it's twice as many.
"Unquestionably, it's a growth industry," said Dr. Robert Brolin, the society's president. "But people considering it should definitely think of it as a last resort."
Dana had researched the surgery on the Internet. She knew that even after the operation, compulsive eaters could sabotage themselves with constant nibbling. She was steeling herself, but many surprises lay in store.
"I wasn't prepared for the pain," she said, showing off "before" and "after" X-rays of her stomach. "It was 15 on a scale of 10."
Now she eats bird-sized meals, often pausing for minutes between tiny portions. If she eats two candy bars, she gets queasy and has to lie down for a few hours.
When Dana speaks of food now, it's of protein and nutrients--not steaks and milkshakes.
"After the operation, it was like I'd lost my best friend," she said. "I felt hopeless. I used to get so much satisfaction from eating. I'd envy people who were so depressed they couldn't eat. Now, nothing tastes really wonderful."
Dana said her family is strong, but she knows of marriages that have suffered following surgeries like hers.
"Suddenly, the woman is getting a lot more attention," she said, "and insecure spouses can't handle it."
She has to take vitamins daily, and B-12 shots to make up for the nutrients that aren't absorbed by her body. Her gall bladder has to come out in December--not an uncommon consequence of the surgery--and she has to deal with the stretch marks that remain after losing nearly 200 pounds.
But all that is outweighed by the feeling of being less, yet more.
"I feel like a teenager," she said. "I can do things with my kids. I can dance. I didn't do this to become a Barbie doll, but just to be healthy."
At a trim 128 pounds, she still is losing about 4 pounds a month. She hopes she can stop when she reaches her target of 115.
"I just don't want to become too thin," she said, smiling that she could even think of it.
Steve Chawkins can be reached at 653-7561 or at firstname.lastname@example.org.