Growing up, Lisa Goetze always detested gym class. "I never liked to sweat. I believed running was pointless unless you were being chased by someone with a knife." In fact, running was never an option for Ms. Goetze. For her, the mere act of walking was a battle. Throughout her life Ms. Goetze had struggled with morbid obesity. Her world as an adult consisted of commuting from home to work, and work to home. Venturing anywhere beyond those places was rare and extremely difficult because at 550 pounds she could only stand for a limited amount of time. In 2000, Ms Goetze underwent gastric bypass surgery—a decision that changed her life, and more importantly, her attitude regarding healthy living and remaining active. Today, she is a 32-year-old full-time business professional and part-time personal trainer in Bergen County, New Jersey. After a very long and difficulty journey, she has learned to appreciate a full routine—and a little sweat in her life.
Ms. Goetze describes herself as "the fat kid at school," even going back to kindergarten. She says her food intake was always monitored, limited, and criticized. "If it were an official category in the Guinness Book of World Records, I'd hold the title for the most diets attempted in a lifetime," she says. By her 21st birthday, Ms Goetze had seen her fair share of therapists, doctors, and had been to countless weight clinics and programs. She had clinical diagnoses for depression and eating disorders, and had been hospitalized and medicated for both. "No matter how hard I tried, and no matter what I told myself each day, the binges would occur," she explains.
Obesity penetrated every corner of Ms. Goetze's life. "I could not fit in a regular size bathroom stall; I had to use the handicapped one. If I flew anywhere, I had to buy two tickets and dehydrate myself so that I would not have to use the plane's bathroom during the flight—and just forget the whole seatbelt issue. If I went to the movies or a concert I had to bring my own extra-sturdy folding chair and sit in handicapped areas," she explains. "By the time I had enough of my misery and was contemplating surgery as an option, I was 27 and already had type 2 diabetes, depression, suicidal thoughts, acute joint pain, chronic fatigue, severe back pain, difficulty walking, labored breathing, edema, and very poor mobility. I moved as little as possible and only on an 'as needed' basis. On a good day, I felt the physical age of 90."
"When I decided that surgery was the way to go, my next step was finding someone who specialized in not just surgical options and procedures, but who truly understood obesity. That meant understanding its very nature—from its origin, its progression, and its effects physically and emotionally," she explains. "I didn't want just any doctor who could and would perform the surgery. I wanted the right doctor. I went to NewYork-Presbyterian Hospital's website and learned of Dr. Marc Bessler and the Center for Obesity Surgery at Columbia. I remember I already had the information printed out and in hand when I approached my mom and told her, 'I want to have gastric bypass surgery.'"
Gastric bypass is the most common form of weight loss surgery in the United States. In a standard gastric bypass, the surgeon divides the top of the stomach to create a small pouch, which functions as the new stomach. The surgeon then makes a small opening in the pouch and attaches that opening to a limb of the small intestine, thus bypassing the majority of the stomach and portion of the intestine. The reduced stomach and digestive capacity typically leads to weight loss. The amount of weight loss depends on many factors, in particular the level of commitment to healthy eating habits and exercise. Generally speaking, most patients can expect to lose 50 to 70 percent of their excess body weight within 12 to 18 months of the surgery.
Ms. Goetze had her surgery on September 11, 2000. The decision to have the surgery was a clear one for her, even though her family was concerned. "I remember closing my eyes on the OR table and saying to myself, 'I can't wait to start my life,'" says Ms. Goetze. "I was very aware of all the risks, but what I had already endured physically and emotionally through struggling with my obesity was far worse than any of the possible risks that Dr. Bessler and his staff explained."
After surgery, Ms. Goetze says she was just happy to be alive and relieved that the surgical part was over. "I had no complications during or after the procedure," she says. "But after surgery everything was different. The most obvious difference was my diet—it was so regimented, specific, and strict. I was alternating a half ounce of food or liquid every 30 minutes whether I was hungry or not. Only specific foods were allowed and had to be pulverized to death in a blender for the first two weeks. Then for the next two weeks you can add to these foods but they still have to be put through a blender to baby food consistency. All I wanted was a stupid cracker!"
A new life filled with vitamin supplements also took a lot of getting used to. "The physical pain after surgery wasn't bad, but there were a lot of lifestyle adjustments. I maintained regular weekly sessions with my therapist, and managed to learn how to exist without using food," says Ms. Goetze. The youngster who hated gym class suddenly learned to embrace exercise. "I knew it was important to be active after surgery and not lie around, so I made walking several times a day a regular activity. I started by walking from my driveway to my neighbor's driveway. This was a real effort for me. Then I began passing my neighbor's driveway and made it two houses down. Eventually, I'd get to the streetlight, and from there to the stop sign at the end of the block, and then halfway around the corner of the next block, and so on."
Today, exercise has become an integral part of Ms. Goetze's personal life and professional life. Once she began feeling and seeing the changes exercise brought to her life, she decided it was something she wanted to do for a living. She explains, "I became a personal trainer because I know what exercise has done for me and if others need help incorporating exercise into their lives, then I want to be the one to help them. I still don't like to sweat, but feel great once I have, so go figure! And I still won't run unless my life is in immediate danger, but not because I don't see the point—but because my poor over-worn joints just can't handle the impact."
Ms. Goetze stresses that her choice of where to get her surgery was an important part of her success. "Dr. Bessler and his staff have supported me every step of the way. They gave thorough and extensive consideration of my background and prior weight loss attempts. They are genuinely concerned with determining that any person pursuing weight loss surgery is a viable candidate and that the surgery chosen is appropriate for the individual. The battery of pre-testing was very thorough, as was the follow-up. Dr. Bessler is a phenomenal surgeon. Everything I praise him and his staff for, I found sorely lacking from others' experiences. I see that there is a vast difference in the protocol at Columbia."
Since her surgery, Ms. Goetze has lost more than 350 pounds. Her current weight is under 200 pounds. Through sheer will and determination, she has far exceeded the expectations for weight loss that generally come with gastric bypass surgery. She has pleasantly surprised her surgeon—and herself. She says she would like to lose more weight but is comfortable where she is at the moment. "My focus is on maintenance, not in torturing myself, or keeping myself in a perpetual state of unhappiness until I reach what may be an unrealistic and unattainable goal."
Ms. Goetze's advice to others who have had weight loss surgery is simple and straightforward. It's not the advice of a personal trainer, but of a survivor, and of a believer. "Be patient and compassionate with yourself. When you receive compliments, thank the person who is giving you the compliment and revel in it. Smile and laugh. Don't diminish your accomplishments. Don't slack off on prescribed vitamin and mineral supplementation, and make smart informed decisions about your food choices. Most of all, charter your own course, and never, never put limits on yourself. Today, I realize I own it all. No one can limit my success. I have the power to either create my own failures, or achieve my own successes—and that's exactly what I did."