Jaylene Verhelst, 33, worried that like many in her family before her, obesity would take her on a path towards heart disease and diabetes.
Hollace Jacovetty, 61, feared that she was too old to take any drastic measure to reduce her weight.
But both women were able to lose 100 pounds after undergoing a major operation known as bariatric surgery.
Verhelst, who underwent the operation at Baylor University Medical Center at Dallas, said seeing one of her brothers after he underwent a bariatric operation known as laparoscopic banding reassured her.
"One day my brother had called and said he had the lap band, and it didn't really kill anybody," she said.
For Jacovetty, reassurances came from the literature given to her by the Cleveland Clinic, where she had her operation done.
"What helped me so much is what they published," she said. "It was like a bible to me."
Bariatric surgery is far from a quick fix for weight loss. Proper preparation for the surgery requires wholesale lifestyle changes like developing good eating habits and performing plenty of exercise. And those changes should continue after the operation to minimize risks, including weight gain, and to increase the chances for significant weight loss.
Jacovetty said that in the two weeks preceding her operation, she could only consume liquids.
"It's not the easy solution -- it's not the quick fix at all," she said. "You really have to be determined and I was."
And now, a major study from some of the nation's best centers for bariatric surgery says the operation is not just a possibility for those needing to lose weight, but a relatively safe one.
Researchers in the new study analyzed results from 4,610 patients who were undergoing bariatric surgery for the first time at centers designated as "highly skilled," and who were having either a Roux-en-Y gastric bypass or a laparoscopic adjustable gastric banding performed.
They found that the risk of death following the surgery was 0.3 percent, with 4.3 percent of all patients having some complication.
"The basic finding is that bariatric surgery as done in the centers participating in the NIH consortium is safe -- not perfect," said Dr. Bruce Wolfe, a professor of surgery at Oregon Health & Science University and one of the study authors. Of the rate of complications, he said, "As major surgery goes, that's very low.
"There's data that weight loss clearly benefits the health of severely overweight people, and surgery is the most effective way to weight loss," he said.
In addition to rates of complications, the researchers sought to find out which patients were most at risk for those complications.
The researchers found that the patients most likely to have a complication were those who had histories of blood clots; suffered from sleep apnea; had difficulty walking 200 feet with a cane or were unable to walk that distance; or were extremely obese.
The study findings appear in the most recent issue of the New England Journal of Medicine.