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Gaining Strength

How a woman found the power to tackle her health's biggest threat

In the summer of 2005, Twanda Trader spent six weeks waiting for daily rations of food and water to be delivered by helicopter to her hometown of Gulfport, Mississippi.

She fled the ravages of Hurricane Katrina with her mother and son, moving to Charlottesville as part of a local relief effort.

But with Trader’s new beginning came a confrontation with a lifelong enemy: obesity.

“I gained 40 pounds after coming to Charlottesville,” she said. “I’m not sure if it was because of the conditions we went through with Katrina … we were never sure when we were going to get food.”

A Formidable Threat

The extra 40 pounds brought Trader’s weight up to 287. Her Body Mass Index (BMI) was 48, which put her in the category of morbidly obese.

“When we moved [here], I realized I wasn’t as fit as I thought I was. My back always hurt, my joints ached, I was always out of breath and I had borderline high blood pressure,” Trader says.

But the primary reason Trader began searching for a way to shed the weight was her 12-year-old son.

“I couldn’t keep up with him anymore,” she said. “And I knew I was going to go downhill quickly.”

Two floors above her office in UVA Health System’s Ophthalmology Department, Trader found someone who would help her alter her harmful course.

Surgeon Bruce Schirmer, MD, informed Trader that she could lose 60 percent of her weight with bariatric surgery.

“If [patients] have a body mass index of over 35 with a medical problem worsened by obesity, or a body mass index over 40 without a medical problem, they are eligible for surgery,” Schirmer says.

About 200 surgeries of this type are done at UVA each year. According to Schirmer, this number has increased dramatically since the mid 1990s due to the availability of laparoscopy, which makes it a minimally invasive procedure.

Weighing the Pros and Cons

Trader’s ultimate decision to go through with the surgery came only after much deliberation and research.

“I was apprehensive because I would have to change my eating habits forever,” she said. “I had to stop and think about the pros and cons.”

The many side effects of the surgery topped off Trader’s list of “cons.”

The inability to eat certain foods and excess skin are some of the more well-known, but patients may also lose their hair because the surgery involves bypassing a portion of the small intestine that absorbs valuable nutrients. To overcome this, Trader would have to take iron, calcium and a multivitamin every day for the rest of her life. “I thought it was worth it. And I still do,” she says.

Once Trader made her decision, she had to try one last time to lose weight the non-surgical way – through diet and exercise – in order to qualify for the procedure.

This six-month phase is a requirement for some insurance companies, Schirmer says. “I only lost a minimal amount of weight,” Trader shares. “After six months, I was ready.”

In March 2007, Trader underwent a roux-en-Y gastric bypass surgery and came through without any complications.

The Hard Work Begins

She was back at work two weeks later. She lost 26 pounds almost immediately. The remaining 134 pounds came off in the next year.

Today, Trader weighs 153 pounds and her BMI is 23. She cannot stomach large portions and sweet foods. She eats only four ounces at a time, five to six times per day.

“I’ll drive by McDonald’s and want those fries, but I know I can’t eat it. And I don’t miss it,” she says.
Maintenance of weight loss is dependent upon continuing good eating habits and regular exercise, Schirmer advises. “The operation is just a tool; used well, it gives a lifetime of ability to overcome obesity. Used poorly, weight regain slowly recurs.”

One year after her surgery, Trader had no regrets.

“I can’t even begin to tell you how [the surgery] has changed my life. I walk four miles a day. I have all kinds of energy and it’s certainly easier getting a date. I’m a whole new person … just a little lighter,” she continued. “I get up every morning, look in the mirror and I know the reason I did it.”