Beating obesity

Barb Beck wrote a list of 1,703 things she couldn’t do – things she “lost,” she said – because she was too fat.

They were measures of obesity’s toll on every aspect of her life, including her basic dignity: Sit on chairs with arms. Do a somersault. Ride the rides at amusement parks.

Buy regular clothes at regular stores, rather than ordering size 9X garments online.

Clean herself after using the bathroom.

Beck’s heaviest recorded weight was 753 pounds.

Today, Beck has crossed 1,703 items off that list.

Saturday, she’ll spearhead Spokane’s first Walk From Obesity, an event at Spokane Community College with several goals: to raise money for obesity research and education; to combat the stigma associated with obesity; and to advocate for improved treatment of obesity.

She’ll do it minus a lot of baggage.

Two years and a month after undergoing gastric bypass surgery, Beck, 39 – a licensed mental health counselor in Moses Lake and a married mother of two sons – weighs less than 180 pounds.

Gone with the weight are Beck’s pre-diabetes and her hypertension. “Every day,” she said, “I’m a new person.”

But that transformation wasn’t magical. While recent studies have highlighted the successes of weight loss surgery – particularly, recently, to treat type 2 diabetes – medical professionals and diabetes educators say surgery should be the last option explored.

“It’s the ultimate commitment you can make to changing your lifestyle,” said Dr. Mathew Rawlins of the Rockwood Surgical Group and Weight Loss Surgery Center in Spokane. “It’s not the easy way out.”

As Beck said: To undergo bariatric surgery is to undertake a “giant, meteoric thing.”

Close to goal

At the time of her surgery, Beck weighed 471 pounds. That was after losing 120 pounds in the year leading up to her surgery date.

The rest of Beck’s weight loss came post-surgery. In the first two days as she recovered in the hospital, she lost 34 pounds. Within 60 days, she’d lost another 120 pounds. Then the weight loss slowed, as doctors say it should.

Now Beck is within 30 pounds of her goal, and her weight includes pounds of excess skin hanging on her arms and around her middle. She said her health insurance won’t cover surgery to remove the skin, although she’s still petitioning her insurer; without coverage, she said, she’d have to pay $24,000 out of pocket for the surgery.

A ‘vicious carousel’

Beck attended her first Weight Watchers meeting at age 6, she said, urged by her doctor to drop pounds. As a 5-foot-6 adult, she stayed until her mid-20s around 150 to 170 pounds, losing weight, gaining it back, losing it, gaining it.

She was in her second year of graduate school – she earned a master’s degree in clinical psychology at Eastern Washington University – and divorcing her first husband when her weight started its serious climb. She hit 180, 280, 380, 580.

Beck was a binge eater, she said, restricting her food intake all day, then consuming perhaps 10,000 calories in a few hours at night.

She’s never tried an illicit drug, she said, and she gave up drinking long ago. But when it came to food, she said, she was on board the same “vicious carousel” ridden by drug or alcohol abusers.

“You eat rather than face your fear or your imperfection or whatever issue you have,” she said. Then, feeling worse for bingeing – or at least that you have nothing to lose – you do it again.

But while Beck’s divorce and the pressure of graduate school caused her stress, she said, they didn’t force her hand to her mouth.

“I could blame that,” she said. “But really it was me and a choice that I made.”

Beck got remarried. She and her second husband, James, had a son, Logan, who was born with part of his brain missing. Studies have linked neural tube disorders with maternal obesity.

Logan wasn’t expected to live past 2. As he continued to survive past that birthday, Beck’s sense of guilt made way for the realization that if her son was going to live, so should she. She began to investigate bariatric surgery.

Now Logan is 8. He runs and jumps and reads and adds. He’s in a mainstream classroom. He’s a little “spazzy,” Beck said, but he’s an 8-year-old boy. While doctors are cautious, Beck said, she thinks her son is just fine.

A ‘strategic’ diet

A typical gastric-bypass patient might eat five or six half-cup portions of “dense” food a day, said Megan Vulcan, an advanced registered-nurse practitioner who works with bariatric patients at the Rockwood surgery center.

Depending on the patient, it works out to about 800 to 1,200 calories a day.

Beck, who exercises two hours daily, eats six carefully planned three-quarters-cup servings of food a day. She can’t eat bread, she said, or anything containing more than 10 grams of carbohydrates. Too much sugar, and “you’re completely incapacitated.”

She can’t have caffeine, because of its dehydrating effects; she can’t drink anything carbonated, because her stomach can’t handle it. She has to drink water 15 minutes before eating or 30 minutes after eating, but not while she’s eating.

She carries cheese sticks and beef jerky with her in case of a hypoglycemic reaction after meals.

She has to consume 80 to 100 grams of protein a day “so my hair and teeth don’t fall out” and take calcium and iron supplements and a multivitamin. The supplements must be timed so they don’t take up stomach space she needs for food. If she eats too much at once, the food will come back up.

In all, her diet totals 1,000 calories a day.

“It’s very strategic,” Beck said. “It’s chess.”

Advocate for change

Beck, who holds a doctorate in counseling studies from the online Capella University, leads therapy groups for people with eating disorders.

She sees her own therapist once every three months and keeps a journal. She participates in an online support group.

She said she’s not worried about gaining a “transfer addiction” – when bariatric patients stop overeating, but end up with new compulsive disorders, such as a gambling addiction or alcoholism.

But it’s a significant problem among bariatric patients, she said – and one she hopes surgery centers work to address as part of patients’ lifelong post-surgery treatment.

Calling for improved treatment in general of obese patients is among her goals in organizing Saturday’s Walk From Obesity, as is taking on stereotypes.

“Surgeons, doctors, the community in general are not very understanding or do not believe that obesity is an illness,” Beck said. “They just think you’re lazy or stupid or incapable of being disciplined.”