When Sandy Raffi-Rashed, a 60-year-old mother of two, went to the airport to pick up her youngest son visiting from Manhattan, he didn't recognize her.
Surgery Ends Decades of Obesity, New Life Begins
"I was waving to him from the car and he thought, 'Who is that strange woman waving at me?'" says Raffi-Rashed, of Novato, California. "Then, when he saw me, he said, 'Oh my God!'" His mother had undergone a transformation after weight-loss surgery.
In July 2011, Raffi-Rashed had gastric bypass surgery at the Bariatric Surgery Center at UCSF Medical Center. At 5 feet, 3 inches tall, she tipped the scale at 340 pounds by age 58. Obese since childhood, she battled her weight problem for decades but didn't have time to pursue the surgery.
Then, when laid off from her job at Wells Fargo Bank, she found a silver lining. She had time for the operation.
Even though she's now a slim 155 pounds, "I still think like a fat person," she says. "My head still thinks it wants more, but my body tells me that it doesn't." But she adds, "Now, I'm in control of my eating."
Have you always struggled with your weight?
If you look at pictures of me from kindergarten, you can see I was already obese at age 5. I remember sneaking food before my parents came home from work and stashing food in the bathroom. I learned early to eat large quantities of food. Even if I ate until I felt like exploding, I always wanted more.
Have you tried a lot of diets?
In the fifth grade and when I was a junior in high school, I lost a major amount of weight, but then gained it back. My father did an exercise program with me every night and my parents had me join a gym back in the '60s, before gyms were popular.
In 1994, I went on a liquid fast. I didn't eat anything but drank liquids for one whole year. I lost 198 pounds, and then gained it all back in two years. When you don't practice how to eat healthily, you go back to your old habits.
When did you decide to have gastric bypass surgery?
I had tried to have the surgery years ago, but wasn't approved by the insurance company. Then in 2011, I got laid off from my job. My GP (general practitioner) suggested surgery and I said, "Why not? I finally have the time."
It took about four months to do everything to qualify for the surgery. There were many medical tests as well as being seen by a pulmonologist for what I learned was a sleeping disorder, and I saw a nutritionist.
Since I wasn't working, I was able to concentrate on the tests and pre-work I needed. This became my job. (Raffi-Rashed was rehired by Wells Fargo Bank in September 2011, just two months after her surgery.)
Did you have a lot of health problems caused by obesity?
I had bad arthritis in both knees, which was a severe problem for me. I was on the verge of being a diabetic.
I was taking two different kinds of blood pressure and cholesterol medication and still my blood pressure was always high.
I also had fatty liver disease from a lifetime of eating and drinking too much. Now I've stopped drinking alcohol completely.
What is your diet like now? How many calories do you consume a day?
I count calories every day. I aim to eat 1,700 or fewer calories per day.
I also exercise almost every day now, either at the gym or by taking a walk. I really enjoy exercise now because it makes me feel good.
How have you adjusted to this new way of eating?
It's really hard for me to put into words. I still have those fears that I'm going to eat too much, like when I sit down at a restaurant with my family for dinner. I still think like a fat person. My head still thinks it wants more, but my body tells me that it doesn't. Now I'm in control of my eating.
How did you change your lifelong eating habits?
I had a lot of counseling from a psychologist who helped me through the whole process of having gastric bypass surgery. I also go to a support group at UCSF once a month and that really helps me. It's a good tool, but you still have to have self-control.
I talk to myself all day long. I tell myself, "I'm not going to eat, I'm not hungry, I'm only going to eat things that are good for my body." I used to want to eat a 16-ounce steak and potato with butter and sour cream, but I don't miss eating like that. Surgery actually changed my taste for food, so I don't want to eat things I loved to eat before, like beef and eggs.
What was the hardest part of having the surgery?
Believe it or not, it wasn't the surgery, the recovery or the incision. It was grinding up pills, which you then have to swallow in liquid for the first few months after surgery when your stomach is too sensitive to manage the digestion of whole tablets and capsules.
I would spend all day trying to get all the pills down. I had to take my multivitamin, thyroid meds, calcium, Prilosec and Cymbalta. All the pills had to be ground into a powder that I could mix with pudding, yogurt or applesauce. It was hard to stomach and had a bad flavor. That lasted a few months.
The hair loss was also really hard, but it grew back after a couple of months. Hair loss is typical after surgery. I think it has something to do with your body going through a major change. It was a short-term negative side effect. And compared with the improved overall health effects, it was not bad at all.
What's the best part of life after surgery?
I'm normal, I can fit in places. Before, when someone invited me for dinner or something at their house, I was afraid they wouldn't have a chair big enough for me to fit into. I felt like I couldn't go places. I even stopped grocery shopping. I had my husband do all the shopping for me.
My husband is from Egypt, and we used to go there every couple of years and visit his family. Eventually I stopped going because it was too uncomfortable to fly. Then, last August, I went to Egypt again. I was able to fit in my seat and use the tray table. It was a great feeling.
Do you have any goals for the future?
Well, I want to keep the weight off. I continue to lose weight. I've lost 185 pounds and I have 2 pounds to go to reach my goal of 150 pounds. My original goal was 130 pounds, but now I can see that I would be much too thin at that weight and below a safe BMI.
My doctor, UCSF bariatric and transplant surgeon Dr. (Andrew) Posselt, was wonderful and continues to be a supportive part of my recovery. He has encouraged me to seek out plastic surgery because he knows that having all the leftover skin (after weight loss) degrades how I feel about myself. He is right. It changes how I look and now I want to be the one in control of how I look. He understands how we think.
What advice would you give to other people considering weight-loss surgery?
Surgery has been a miracle for me. I would tell people, "You could be like me in a year." People look at 200 extra pounds and think, "I'll never get it off." But you can. You have to do it for yourself.