If you’re considering surgery, Alisa Brewster has some advice: Don’t wait
Alisa Brewster weighed 333 pounds by the time she came to OHSU for help losing weight. She had diabetes, a heart condition, back pain, and numbness in her hands and feet. Daily activities — such as putting on her shoes or getting in and out of a car — were becoming more difficult.
A year after bariatric surgery, she weighs 184 pounds for the first time since the 1980s. Her health and mobility have significantly improved. And she no longer needs to take heart or diabetes medication.
To her surprise, she’s often asked, “Are you sure you’re not losing too much weight?”
Or as her daughter put it, “Where’d your butt go?”
The surgery has been life-changing for Brewster, who had struggled with her weight since junior high. Her only regret is not doing it sooner.
“It was the first time that I had a tool where I felt in control, where I felt like I was going to reach my goals,” she says.
“They are there to help you”
Brewster, 56, had gastric sleeve surgery on April 1, 2017. During the one-hour procedure, her surgeon, Dr. Farah Husain, reduced the size of her stomach to a narrow pouch, limiting her food intake and appetite. The surgery has a high success rate and few risks.
“I had surgery in the morning, and by that afternoon, they had me up and walking,” she says. “Every time I walked, I felt a little better. At home, I walked a little farther each day.”
Her care team includes a dietitian, physical therapist and psychologist, who helped her prepare for the surgery and supported her as she recovered.
“They don’t just give you the information and leave you,” she says. “If you’re struggling and not getting where you need to be, they are there to help you.”
The weight started to fall off right away. At first, she dropped sizes so fast she shopped in thrift stores. She’d buy clothes that were too small and put them away for later. Sometimes by the time she pulled them out of her closet, they were too big.
Now she cooks most of her own meals, takes the stairs, walks at least 20 to 30 minutes a day and has started practicing yoga.
Managing food choices
She isn’t as hungry as she used to be, but she still sometimes has cravings. Food advertisements and references seem to be everywhere, and they are hard to ignore. Many work and social gatherings are also focused on food, especially around the holidays.
Brewster has found ways to have her favorites without compromising her health.
For instance, she bakes Christmas cookies with her daughter but cuts the sugar in half. Her occasional chocolate fix comes from one truffle, individually wrapped and kept out of sight. When she wants pasta or potatoes, she thinks about how bad she feels after eating them, and they don’t seem as appealing. Now one bite of a rich dish can satisfy her.
In a North Portland cafe a year after her surgery, she sips a half-cup of decaf coffee with a protein shake, her new favorite breakfast.
She looks trim in a soft pink sweater and dark, fitted pants. Short brown hair and glasses frame her face as she scrolls through photos on her phone. She pauses on one at her heaviest. Her face was rounder then, and her body, covered in a loose top, twice as big.
“Now I see how huge I was, but before I couldn’t see that myself,” she says. “I’m thinking, ‘How did I get there?’”
“I really beat myself up”
At 5-foot-9, she always felt tall and curvy, even at her lightest. Over the years, her weight yo-yoed as she tried different diets. The most she ever lost was 40 pounds before she had children, but she gained it back — and more — during her pregnancies and never fully lost it again.
As her body got bigger, she developed more health problems. Pre-diabetes turned into diabetes. She took medication to control a fast and irregular heartbeat. A nerve disorder and back pain limited her ability to exercise. She knew something had to change.
Still, when her doctor talked with her about bariatric surgery, she waited a year.
“When I first thought about it, it seemed so extreme,” she says. “I had lost weight before, so I thought, ‘I can do this. People lose a lot of weight with diet and exercise all the time. Why can’t I do this myself?’ I really beat myself up.”
Then her wife decided to have bariatric surgery, and Brewster decided to do it, too, so they could support each other. Brewster had the surgery first, and her wife followed in January 2018. Together, they plan meals and cheer each other on.
She also finds tips and encouragement in a Facebook support group. Members share weight-loss milestones as well as “non-scale victories.”
Brewster’s victories include crossing her legs, a new driver’s license photo and buying jeans online in a smaller size that turned out to be too big. She can also sit on the floor, get up without leaning on furniture and bend over to pick things up without struggling. Even showering is easier.
“You gain the weight so gradually, and you lose all those things so gradually,” she says. “You don’t realize what you’ve lost until all of a sudden you can do those things again.”
Her advice for others
When her 25-year-old daughter came home for a visit a year after the surgery, she asked, “When are you going to stop losing weight?”
Brewster didn’t trust herself enough to know the right time, so she asked her doctor.
She had already exceeded the clinic’s goal (a BMI of 30 or less). Her doctor said to listen to her body and stop when the weight became much harder to lose. She hopes to reach about 170 pounds.
Her advice to others considering bariatric treatment is to not put it off.
“I’m really lucky that I’ve had a beyond-expectations experience,” she says. “Not everyone has the same experience. But I’m gaining something more for what I’m giving up.”
— By Suzanne Pardington Effros, a Portland writer who previously worked as a communications specialist at Portland State University and as an education reporter at The Oregonian.