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From Candy to Keto Bagels: A Weight Loss Transformation

Patient Version

Physician Version

Patient Version

Patient: Stephanie

Interview Date: 4/30/20

Age: 50

Height: 5’2”

Highest Weight: 230 lbs.

BMI: 41

Current Weight: 177 lbs. — 53 pound weight loss

BMI: 32.7

Goal Weight: 130 lbs.

BMI: 23.7

Bariatric Surgery: Gastric Sleeve

Surgery Date: November 2019

Largest Size: 18-20

Current Size: 12 or Medium top

Weight related diseases: fatty liver disease, diabetes, high cholesterol

Medications: None

Current status: pre-diabetic, liver levels back to normal, high cholesterol is hereditary

Before Surgery

Stephanie married her high school sweetheart 31 years ago, in April 1989. By September, she had gained 30 pounds. Stephanie’s weight continued to increase slowly over time, especially with each of her three pregnancies. With a self-described sweet tooth, Stephanie would snack throughout the day in addition to regular meals. Her go-to foods were Lucky Charms, powdered donuts, Oreos, and the big Reese’s peanut butter cups. Over the years, Stephanie was continuously depressed and could never stop thinking about how she looked because of her weight. In addition to having low self-confidence, Stephanie wasn’t able to do the physical activities that she enjoyed before getting married such as running, jogging, or high intensity workouts. Not only was Stephanie winded from trying to do these activities, they caused her severe knee pain.

Stephanie did try to control her weight at various points over the years. She attempted fad diets, joined Weight Watchers several times and signed up for Beach Body. Stephanie even tried more extreme measures such as taking the weight loss pill Centromine and getting HCG shots. While she would temporarily lose weight from these methods, Stephanie would regain any weight she lost plus additional pounds.

Getting to Surgery

She had no self-confidence for several reasons. She was tired of looking in the mirror and not being happy with her appearance. She was always the heaviest person in a group photo, and her clothes never fit. She had also gone from being pre-diabetic to having type 2 diabetes. With her health declining and constantly feeling depressed, Stephanie knew that instead of putting everyone else in her life first, it was time to take care of herself.

Already acquainted with his wife, Stephanie was familiar with Dr. Sutker as a surgeon and followed him on Facebook. Originally, she saw a post explaining Obalon, a non-surgical gastric balloon procedure. However, Dr. Sutker explained insurance did not cover that procedure and that weight loss surgery, which is covered by insurance, would be an effective option for permanent weight loss.

During her initial consultation with Dr. Sutker in June 2019, Stephanie felt he was very outgoing, easy to communicate with, and explained the weight loss procedures in layman’s terms instead of using confusing medical jargon. Together, they decided the gastric sleeve was the best procedure for her. During this procedure, the stomach is reduced by 75% and is reshaped to the size of a banana. This results in portion control and reduces constant feelings of hunger.

Before this consultation, Stephanie had always believed that weight loss surgery was the “lazy way out.” Stephanie’s husband originally didn’t want her to undergo the procedure, however she decided this was the best decision.

Being an aid in a special education class, Stephanie decided to wait until November during Thanksgiving break to undergo the procedure. This way, Stephanie was able to avoid taking time from work even though she was cleared by insurance in September.

Before her surgery, Stephanie started to feel anxious the night before. “Am I making the wrong choice?” she wondered. But the day of the surgery, she wasn’t nervous at all. Stephanie knew she was making the right choice. During the surgery, which Dr. Sutker performed laparoscopically, he was also able to remove scar tissue from a previous hernia removal. After the surgery, Stephanie stayed over one night. She was even able to walk around the floor without the nurse’s help. Only one incision was painful, where the stomach tissue had been removed.

After Surgery

Diet

Breakfast: protein shake

Lunch: Protein + vegetable. This includes choices such as hard boiled eggs, beef jerky, Babybel cheese (light), flavored tuna packets, OR

leftovers from dinner the night before.

Afternoon Snack: protein shake

Dinner: If she goes out to dinner with her husband, they will split an order of fajitas. Stephanie will just eat the chicken and vegetables. At home, instead of eating the pasta or rice Stephanie serves her family, she will make cauliflower rice

Patty also has a plate where food is portioned out for protein / carb / vegetables. She highly recommends this for bariatric patients. When she goes out to eat, she will now split an entree with her husband and only have one drink. Of course there are times when Petty feels tempted to slip into old habits. This happens especially during family gatherings, where both her family and her husband’s family want to celebrate gatherings centered around food. During these times, Petty will remind herself, “I can’t eat that much anymore. Look how far I’ve come, I’m going to keep it this way.

Stephanie has also been experimenting with new recipes, especially during Covid-19. Recently she made a salad with lettuce, tomatoes, garbanzo beans, feta cheese, cucumber, olives, salt pepper / and olive oil. She also made keto bagels made with cheese, milk, and egg and baked them in a bagel tin. Yum!

Stephanie has completely retired fast foods from her diet. The only exception she makes is the kale salad or grilled chicken nuggets from Chic Fillet.

Words of Wisdom

Stephanie admits weight loss surgery may not be for everyone, but for those who are able to change their mindset and stick with the program, it will give you your life back. “You can’t go to McDonald’s after leaving the hospital,” she reiterates. Although Stephanie hasn’t necessarily publicized her surgery, she is open about it when people ask how she has lost so much weight. After seeing Stephanie’s success, her husband is now considering the gastric sleeve as well.

Stephanie’s biggest regret? “I wish I had the surgery sooner.”

Physician Version

Notes as of 4-30-20

Patient: Stephanie

Age:  50

Height: 5’2”

Highest Weight: 230 lbs.

BMI: 41

Current Weight: 177 lbs.

Total Weight loss: 53 lbs.

BMI: 32.7

Goal Weight: 130 lbs.

BMI: 23.7

Bariatric Surgery: sleeve

Surgery Date:  nov. 2019

Largest Size: 18-20

Current Size: 12 or medium top

Weight related diseases: fatty liver disease, diabetes, high cholesterol

Medications: no

Current status: pre-diabetic, liver levels stabilized, high cholesterol is hereditary

Pre-Op

Lifestyle:

Stephanie’s weight gain began after she was married in April 1989. With each of her three pregnancies, her weight would increase. She attempted everything from fad diets, joining Weight Watchers several times and trying Beach Body. Stephanie even tried more extreme measures such as taking the weight loss pill Centromine and HCG shots. While she would temporarily lose weight from these methods, Stephanie would regain any weight she lost plus additional pounds.

Exercise:

Unable to jog / run / anything high intensity

Getting to Surgery:

During her initial consultation with Dr. Sutker in June 2019, Stephanie felt he was very outgoing, easy to communicate with, and explained the surgical procedures thoroughly. They decided the sleeve gastrectomy was the best bariatric procedure for her.

During the surgery, which Dr. Sutker performed laparoscopically, he was also able to remove scar tissue from a previous hernia removal. After the surgery, Stephanie stayed over one night. She was even able to walk around the floor without the nurse’s help.

Post-Op

Diet

Breakfast: Protein shake

Lunch: would take a protein + vegetable. Hard boiled egg, beef jerky, Babybel cheese (light), flavored tuna packets, OR

leftovers from dinner the night before

Afternoon Snack: protein shake

Dinner: If she goes out to dinner with her husband, they will split an order of fajitas. Stephanie will just eat the chicken and vegetables. At home, instead of eating the pasta or rice Stephanie serves her family, she will make cauliflower rice.

Stephanie takes recommended vitamins daily: Calcium, Multivitamin, Iron, vitamin B nasal spray.

Exercise

  • 30 minute interval workout on treadmill 4x per week

Stephanie now feels confident in her appearance and has the energy to do physical activities she wasn’t able to do prior to surgery. Her only regret is, “I wish I hadn’t waited so long to have the surgery!”

Patient Version

Patient: Petty

Age: 45

Height: 5’4”

Surgery type: gastric sleeve

Surgery date: October 2018

Highest weight: 275 lbs.

Current weight: 182 lbs.

Goal weight: 160 lbs.

Largest Size: 20

Current Size: 10

Before Surgery

It started when Petty was growing up. Her weight always fluctuated due to poor eating habits and fad dieting. When Petty was 20, her mother passed away. The loss led Petty to turn to food for comfort. Once Petty was married and wanted children, she needed IVF treatments to get pregnant. The hormones from the treatments caused Petty to gain more excess weight.

Although Petty did not eat specific comfort foods, she ate large portions during meals. After she had her children, Petty would work out and maintain a healthy lifestyle, but she wouldn’t see results and would still feel hungry from dieting. At 275 pounds, Petty wasn’t able to lean over to tie her shoes or cross her legs while sitting down. At this point, she was also on medication for high blood pressure, which was caused due to her excess weight.

In August 2018, Petty was running on the treadmill and began having chest pain. She went to a cardiologist who recommended switching her blood pressure medication. Feeling overwhelmed, Petty cried and explained she couldn’t get the excess weight off despite her efforts. The cardiologist recommended that Petty consider the gastric sleeve procedure. Petty’s immediate reaction was, “No way. Plus, my husband would never let me.”

Dr. Sutker’s wife is an RN who also provides cosmetic treatments. The Saturday after Petty saw her cardiologist, she had an appointment with Mrs. Sutker. Petty repeated that the cardiologist had recommended the gastric sleeve. Petty knew Dr. Sutker was well-respected in Dallas, so she decided to have a consultation with him. Her husband also met with Dr. Sutker so he would understand the benefits of utilizing bariatric surgery as an effective weight loss tool and to eliminate weight related diseases such as high blood pressure.

Throughout this process, Petty and her husband found Dr. Sutker to be “a very kind human being, very caring, understanding, and supportive. And he’s smart.”

After Surgery

Diet

Petty worked with a dietitian to work on creating healthy portion control habits. The dietitian also helped Petty create a meal plan that would help address her metabolism which did not function properly. Over time, Petty has successfully practiced not turning to the pantry as a coping mechanism. Instead, she recognizes her emotions and has learned to deal with a situation properly. Now, Petty can tell when she is physically hungry, or whether she wants to eat due to an emotion.

Below is an example of Petty’s daily food plan.

Breakfast: Premier Protein shake

Lunch: Tuna from a pack with one slice of whole grain bread OR

Two boiled eggs with a couple of whole wheat crackers

Snack: cheese stick, ½ cup yogurt with fruit, skinny popcorn, or Robert Irvine cheese balls

Dinner: grilled fish, or grilled chicken and veggies.

Patty also has a plate where food is portioned out for protein / carb / vegetables. She highly recommends this for bariatric patients. When she goes out to eat, she will now split an entree with her husband and only have one drink. Of course there are times when Petty feels tempted to slip into old habits. This happens especially during family gatherings, where both her family and her husband’s family want to celebrate gatherings centered around food. During these times, Petty will remind herself, “I can’t eat that much anymore. Look how far I’ve come, I’m going to keep it this way.

Exercise

Petty also maintains weight loss with a consistent exercise routine. She does orange theory twice a week, and a yoga or pilates class one time per week. She can also work out at her home gym.

Life Today

Before surgery, Petty always presented a happy, bubbly front, however deep down she felt miserable due to being overweight. However, today her attitude has completely changed. Petty’s confidence has skyrocketed and her husband notices this. Before Petty’s surgery, her weight strained their marriage and they decided to see a therapist.  The therapy and Petty’s weight loss has helped their marriage immensely. Petty has chosen not to be private about having surgery. She told her friends and family about the procedure. Petty appreciates the “little things” such as being able to go on the swing with her daughter.

Petty advises those considering weight loss surgery to do their homework in terms of researching the surgery and surgeon. “You need to be mentally prepared to have the surgery and change your eating habits. You don’t want to go back to where you were.” Petty views the surgery as an amazing weight loss tool that will help her successfully keep the excess weight off long-term. In order to be successful, Petty explains patients need to have a specific goal in mind. Her lifetime goal: keep the weight off.

Physician Version

Notes as of 3-30-20

Patient: Petty

Age: 45

Height: 5’4”

Surgery type: gastric sleeve

Surgery date: October 2018

Highest weight: 275 lbs., BMI: 47.1

Current weight: 182 lbs, BMI:  31.2

Target weight: 160 lbs., BMI: 27.4

Largest Size: 20

Current Size: 10

Comorbidity: High blood pressure

Pre-Op

Petty’s weight struggles began during adolescence and continued into adulthood. When Petty was 20 years old, her mother passed away. Petty turned to food as a coping mechanism to deal with the grief. After undergoing IVF treatments, Petty was unable to lose the excess weight caused by the hormones despite maintaining a relatively healthy lifestyle of diet and exercise. Eventually, Petty was diagnosed with high blood pressure and was prescribed Toprol.

In August 2018, Petty was running on the treadmill and began experiencing chest pain. Although Petty’s cardiologist recommended adjusting the medication for her hypertension, the real issue was addressing Petty’s excess weight. The cardiologist recommended for Petty to undergo the gastric sleeve procedure. Petty was already acquainted with Dr. Sutker through his wife and agreed to have a consultation for the surgery. She describes Dr. Sutker as being understanding, supportive, and thorough in his explanation of the sleeve gastrectomy. Not only would the procedure enable rapid weight loss safely, it is a long-term solution for resolving weight related diseases, such as hypertension.

Petty’s insurance did not cover the procedure, and she opted to be a cash patient. Even though Dr. Sutker could have operated immediately, he was diligent in making sure Petty underwent all the same pre-op testing insurance companies require.

Dr. Sutker is able to select his anesthesiologists, which he did for Petty’s surgery as well. During the laparoscopic procedure, Petty’s gallbladder was also removed due to the presence of gallstones.

Post-Op

After the surgery, Petty stated having minimal pain and being able to walk around after waking up.

Diet

Petty worked with a dietitian after her surgery to create a meal plan that would provide the nutrients she needed while enabling steady weight loss. Below is a sample day of Petty’s diet:

Petty worked with a dietitian to work on creating healthy portion control habits. The dietitian also helped Petty create a diet plan that would help address her metabolism which did not function properly. Over time, Petty has accomplished not turning to the pantry to cope with her emotions and to deal with a situation properly. Now, Petty can tell when she is physically hungry and then when she is full versus wanting to eat as an emotional coping mechanism.

Below is an example of Petty’s daily food plan.

Breakfast: Premiere Protein shake

Lunch: Tuna from a pack and one slice of whole grain bread OR
Two boiled eggs with a couple crackers

Snack: cheese stick, ½ cup yogurt with fruit, skinny popcorn, Robert Irvine cheese balls

Dinner: grilled fish, or grilled chicken and veggies.

Patty also has a plate where food is portioned out for protein / carb / vegetables. She highly recommends this for patients. When she goes out to eat, she will now split an entree with her husband.

Exercise

Orange Theory: 2x / week
Pilates/Yoga: 1x/week
Home Gym: 2x / week

Comorbidity: Hypertension

Petty’s hypertension was resolved six months after her surgery. She no longer requires medication to treat high blood pressure.

Patient Version

Title: Ann’s Amazing Journey

Patient: Ann

Age:  49

Height: 5’5”

Highest Weight: 234 lbs.

BMI: 38.9

Current Weight: 201 lbs.

BMI: 33.4

Goal Weight: 160 lbs.

BMI: 26.6

Bariatric Surgery: gastric sleeve

Surgery Date:  12/20/19

Largest Size: 18

Current Size: 14-16

Weight Related Conditions Pre-Op: Knee pain which required injections

Weight Related Conditions Post-Op: Knee pain resolved

Medications: Flexor injection

Life Before Surgery

Ann’s weight problems began due to in vitro fertilization treatments in 2003 when she was first married. Over the course of 12 years, she gained approximately 80 pounds. Weight gain is a common side effect of the treatments from the hormones. During this time period, Ann’s sweet tooth contributed to her weight gain as well.

Ann did attempt to lose her excess weight several times. In addition to taking weight loss pills and seeing various endocrinologists, Ann did Jenny Craig, saw dietitians, drank apple cider vinegar, “practically everything you can imagine,” she says. When Ann did Weight Watchers, she actually gained weight because the program allows dieters to eat simple carbohydrates, which is highly ineffective when trying to lose weight.

Ann even attempted the HCG diet for 30 days. The HCG diet involves placing an HCG tab sublingually daily along with following a restrictive 400 calorie per day diet. The HCG is marketed to suppress your appetite and “guarantees” a 35 pound weight loss in one month. However Ann only lost 18 pounds.

Maintaining physical inactivity was never an obstacle for Ann. She would do various cardiovascular activities such as swimming, using an elliptical, and doing Zumba classes with friends up to six days a week. Even with her diet efforts and physical activity, Ann was never able to lose the weight she gained from in vitro treatments.

Meeting Dr. Sutker

Ann thought about weight loss surgery for several years before visiting Dr. Sutker. Over the years she visited various doctors, however Ann never felt comfortable with them. “I always felt like they were just selling me something and didn’t really care about me,” she explains. Ann was referred to Dr. Sutker by his wife who does medical spa treatments. When asked to describe Dr. Sutker, Ann says he is a warm doctor who demonstrates his thorough knowledge of the surgical procedures in terms she could understand. She felt he was much more genuine than other doctors and felt comfortable working with him. After trying endless methods, Ann decided weight loss surgery was the best option and that as a surgeon, Dr. Sutker was the best choice.

While the majority of weight loss surgery patients may be nervous or anxious before their procedure, Ann was the complete opposite. As she was wheeled into the operating room,

Ann remembers thinking, “I’m taking control of my health.” After the surgery, Ann did not experience pain or have any post-operative issues when she returned home.

Life After Surgery

After Ann’s surgery, she quickly discovered that she becomes full much more quickly, but does not get to the point where she feels sick. Normally, Ann eats around 1,000 calories per day. She eats six small meals a day from getting full so quickly. For those who have recently undergone weight loss surgery, Ann highly recommends using a measuring cup for portion control and to prevent overeating. Covid-19 has made this more challenging for three main reasons: there is extra idle time, and her two children often bring home food from the drive-thru.

Diet:

Breakfast: Premiere protein shake

Snack: Carbmaster Yogurt

Lunch: 100 Calorie bread sandwich with tuna / turkey

Snack: Carbmaster Yogurt

Snack: 1 Slice of american cheese

Dinner: Shrimp or Salmon – or Sashimi

Snack: Sugar-free pudding

Exercise:

Ann is an inspiration for maintaining a varied workout routine, even during Covid! Six days per week, Ann does an exercise class on demand such as Beach Body, barre, or weight lifting. After the class, she walks on the treadmill for 45 minutes.

Words of Wisdom

After undergoing the gastric sleeve with Dr. Sutker, Ann advises not listen to the “horror” stories one may read about the surgery due to her own safe, easy, experience where she was provided all the support necessary to be successful.

Covid-19 and quarantine has been challenging for everyone around the world. Weight loss surgery patients are no exception. However, through Ann’s new habits and experiences, she has been able to prove that weight loss surgery is a safe, effective, long-term solution to weight loss.

Physician Version

Patient: Ann

Age:  49

Height: 5’5”

Highest Weight: 234 lbs.

BMI: 38.9

Current Weight: 201 lbs.

BMI: 33.4

Goal Weight: 160 lbs.

BMI: 26.6

Bariatric Surgery: gastric sleeve

Surgery Date:  12/20/19

Largest Size: 18

Current Size: 14-16

Weight Related Conditions Pre-Op: Knee pain which required injections

Weight Related Conditions Post-Op: Knee pain resolved

Medications: Flexor injection

Pre-Op Experience

Ann’s weight problems began due to in vitro fertilization treatments in 2003. Over the course of 12 years, she gained approximately 80 pounds. Along with the hormonal side effects, Ann’s diet frequently consisted of simple carbohydrates, which contributed to her weight gain.

Ann did attempt to lose her excess weight several times. Initially, Ann participated in several commercialized weight loss programs, took weight loss pills and saw various endocrinologists and dietitians.

Ann even attempted the HCG diet for 30 days. The HCG diet involves placing an HCG tab sublingually daily along with following a restrictive 400 calorie per day diet. The HCG is marketed to suppress your appetite and “guarantees” a 35 pound weight loss in one month. However Ann only lost 18 pounds.

Ann maintained a vigorous exercise regimen, doing various cardiovascular activities such as swimming, using an elliptical, and doing Zumba classes with friends up to six days a week. However even with these efforts, Ann was never able to lose the weight she gained due to the vitro treatments.

Ann thought about weight loss surgery for several years before visiting Dr. Sutker. Over the years she visited various bariatric surgeons, however Ann never felt comfortable with them. When asked to describe Dr. Sutker, Ann says he is a warm doctor who demonstrates his thorough knowledge of the surgical procedures in terms she could understand. She felt he was much more genuine than other doctors and felt comfortable working with him.

Dr. Sutker performed the gastric sleeve procedure on Ann laparoscopically. During the procedure, Dr. Sutker also found a hiatal hernia which he was able to repair. Ann did not experience complications post-op.

Life After Surgery

Normally, Ann eats around 1,000 calories per day. She eats six small meals a day from getting full so quickly. For those who have recently undergone weight loss surgery, Ann highly recommends using a measuring cup for portion control and to prevent overeating. Covid-19 has made this more challenging for three main reasons: there is extra idle time, and her two children often bring home food from the drive-thru.

Diet:

Breakfast: Premiere protein shake

Snack: Carbmaster Yogurt

Lunch: 100 Calorie bread sandwich with tuna / turkey

Snack: Carbmaster Yogurt

Snack: 1 Slice of american cheese

Dinner: Shrimp or Salmon – or Sashimi

Snack: Sugar-free pudding

Exercise:

Six days per week, Ann does an exercise class on demand such as Beach Body, barre, or weight lifting. After the class, she walks on the treadmill for 45 minutes.

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