Excerpt: Khaliah Ali's 'Fighting Weight'

Other bene?ts of gastric banding surgery: the operation takes an hour or less, whereas gastric bypass requires two to three hours under anesthesia. Furthermore, you're out of the hospital in one day (as opposed to two to three days) and back at work within a week. I was on the Today show talking with Ann Curry, Dr. Fielding by my side, just four days after my own procedure. With gastric bypass, it could be up to three weeks before you're able to resume your normal activities.

The recovery goes so fast because the operation does not entail rearranging your internal organs, the way gastric bypass does. As Dr. Ren says, the band simply acts as an effective appetite suppressant without the side effects of appetite-suppressing drugs. "This is not a grandstanding operation," she explains. "It's a very gentle procedure, a facilitator to diet and exercise rather than a body punisher."

Currently, only one out of ?ve weight-loss operations in the United States is a gastric banding, as opposed to four out of ?ve in Europe. Why? One reason is that gastric banding has been standard in Europe since the mid-1990s (and is also easily available in Australia and other countries) but was approved here only in 2001. But beyond that, surgeons do the surgeries they know. While Americans were perfecting the gastric bypass (an operation ?rst performed in the 1960s, after doctors observed that removing part of the stomach as a cancer treatment or ulcer therapy led to weight loss), doctors in other countries were cultivating the gastric band.

THE EASY WAY OUT?

A lot of people believe opting for obesity surgery is taking the easy way out, just one more sign that very fat people lack willpower. Again, I was one of them.

Like both fat and thin people everywhere, I had bought into the idea that thin people have more self-control than heavy ones, that they're more together. In other words, I believed I simply wasn't trying hard enough, couldn't stick with anything, and was living a sloppy, unstructured life and therefore deserved to remain miserable, constantly out of breath, my knees and feet always in pain, and being the subject of people's cruel stares and even crueler comments.

That belief, in fact, was part of the reason I hesitated before un¬dergoing the operation that ?nally helped me lose the weight I needed to lose. It was subtler than the fear but still insistent, and kept wearing me down and making it impossible for me to act. I was convinced that to lose weight by surgery instead of diet and exercise would be "cheating," in short, proof that I hadn't really taken hold of my life and was instead "surrendering" to my lesser self.

I was wrong. I was trying hard enough -- my entire life. From the time I was ?ve years old and a friend told me I wouldn't be so "blubbery" if I didn't eat so much blubbery steak, I dieted. I was even trotted out in front of Jane Pauley on the Today show as a nine-year-old as part of a program to slim down overweight kids.

As an adult, I dieted on my own, at one point taking off almost a hundred pounds. But the weight always came back.

Dr. Fielding had gone through the same thing. Fat from childhood, he lost -- and gained -- seventy pounds four times as an adult before opting for the very gastric banding surgery he had already performed on hundreds of others.

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