You have such a beautiful face but...

Ask me how old I was when I completed the sixth grade and I'd have to do the math starting with the age I was when I graduated from high school and work backwards. The same for my first marriage, first child, etc. Now, ask me what I weighed and I can respond without having to do any math because those numbers stay in my mind like a never ending nightmare.

On my first birthday I weighed 26 pounds and my baby book reflects the comments that I have heard almost every day for the rest of my life. "Patient is significantly overweight and has been put on a diet of skim milk."

Within days of starting kindergarten in 1955, my mother got a note from the school nurse. "Your daughter weighs 120 pounds and needs to go on a diet," the note read. In 1954, the world was introduced to the first weight loss surgery by Dr. A. J. Kremen. He did what he called an “intestinal bypass.” As the name implies, a section of the intestine was bypassed by connecting upper and lower areas of the intestines.

His surgery took out a good part of the middle section of the intestines and the hope was to reduce the amount of food absorbed. It worked, but encountered many complications such as electrolyte imbalances, dehydration, bypass enteritis, diarrhea, long-term liver problems, and various vitamin and mineral deficiencies. The problems were so significant that there was a 50 percent mortality rate.

The reason they experimented in this way with the digestive system was because of medical observations of patients that had short-bowel syndrome. People with this condition had a tendency to lose weight due to inadequate nutrient absorption. Based on these observations, surgeon A.J. Kremen, MD, started the medical field of bariatric surgery (although it was not named that until later).

At about the same time in Sweden, a physician did a similar procedure, but he removed the redundant portion of the small intestine. Throughout the 50s and 60s, many experimental operations were tested by physicians on morbidly obese patients. Eventually, intestinal modification was abandoned for the most part, and weight loss surgeries involving the stomach in some form or fashion became more prevalent.

In 1966, Dr. Edward E. Mason of the University of Iowa began work on developing an innovative bariatric surgery known as gastric bypass, also called stomach stapling or vertical banded gastroplasty. In the gastric bypass surgery, he isolated a section of the upper stomach by using staples to partition the stomach and decreasing the volume of food it can hold.

In effect, he was creating a smaller pouch of a stomach for the stomach that satiated the obese person faster during meals, therefore decreasing food consumption.

By 1966 I was in the tenth grade and had consumed enough calories to tip the scale at 254 pounds. I had also been put on the grapefruit diet, tea diet, Metrical (precursor to Slimfast). I had also survived the grapefruit, cabbage, lemon, water, no-water, bribery, and the six-meals-a-day diets, hypnosis, pills, powdered concoctions from Jack LaLane and the shots from the urine of a pregnant woman programs.

All of them started out with great determination and I lost weight; 104 pounds with the shots. However, as soon as I stopped the shots, pills, drinks and powders, the weight slowly returned and gathered extra friends along the way.

I do have to admit though that my 9th grade home economics teacher, Miss Brown, had a rather novel approach that had never been tried before. "You have such a beautiful face that I know you could be Miss Nevada so you're going on a diet," she said. "Every day you're going to weigh in front of the class and if you gain weight, you have to clean up the kitchens all by yourself."

When that didn't work, I had to sit on a dunce chair in the middle of class with a sign that read, "don't feed the animal." She was so sure of the embarrassment/shame diet that she filled out an entire packet of detention slips with my name on them. She ran out of slips about the same time as I ran out of excuses for why I needed to be at the school nurses office.

As with any new medical innovation, there were improvements that had to be made to refine the process following the initial procedures. As time went by, the complications became less and less (although even today there are chances of morbidity) There were more refinements, such as reducing the pouch size and eventually changing from metal staples to elastic bands. The main problem with elastic was that he bands began to stretch after a few years. This particular surgery is currently not done very much.

The next improvement brought the Proximal Gastric Bypass form which is by far the most commonly used gastric bypass technique today in the United States and around the world. This form of weight loss is the least likely to have nutritional problems occur. The small intestine at the base of the stomach is cut and rerouted in a Y shape connecting to the upper pouch created in the stomach through what is referred to as a Roux limb. The Roux limb is a section of 30-60 inches of the upper intestine, which still allows for plenty of nutrient absorption. Due to fewer complications, it is one of the most common weight loss surgery procedures of today.

Today, there are about eight different variations of bariatric surgery performed in most state-of-the-art hospitals across the United States. Next time I'll share the differences from having the surgery in 1981 and 2012.