Monica Muñoz: Weight-loss warrior
Monica Muñoz boarded the plane and buckled up, grateful that she didn’t need a seatbelt extender and pleased that she wasn’t taking up more than her seat. Yet the passenger in the seat beside her was not pleased. After sizing up Muñoz, he implored a flight attendant to move her.
The flight attendant encouraged him to take his seat. Although he finally did, Muñoz stood and prepared to move. When he reconfirmed that he now was willing to sit next to her, she replied, “Perhaps, but I am not willing to sit next to you.”
Muñoz had recently undergone weight-loss surgery, a procedure called bariatric vertical sleeve gastrectomy. The stomach is reduced to about 20 percent of its original size; people feel full more quickly, so they don’t eat as much and lose weight.
She had already lost some weight by the time she boarded that plane, but her seatmate couldn’t see that. More importantly, he couldn’t see that the core of who she was, at any weight, was worth getting to know.
Muñoz, who was born and raised in Salinas, was 12 years old when she developed agoraphobia, an anxiety disorder that caused her to fear and avoid places and situations that left her feeling panicked, trapped, helpless, or embarrassed. For months, she was unable to leave her home. She also began to gain weight.
By her late 20s, Muñoz had tried every diet and exercise program she could find. A personal trainer told her she must be eating wrong. Weight Watchers® told her she must not be exercising.
“I had reached the point where I could not continue on the same road,” she says. “It was scary to watch my weight continue to climb, and to wonder how far it was going to go.”
In 2016, she met with Dr. Mark Vierra, a gastrointestinal surgeon who founded the bariatric surgery program at Community Hospital of the Monterey Peninsula. By then, she was carrying 310 pounds on her 5-foot-2-inch frame.
They discussed her history, her health, and surgical options. He explained the available procedures, their potential benefits and risks. She was apprehensive.
“I said, ‘If I were your daughter, what would you tell me to do?’ I could tell he cared about me,” she says. “The most important message he gave me was that my success would be based on my willingness to change. I could want to change, but unless I was willing to do so, it wasn’t going to happen.”
Muñoz approached her surgery and weight-loss journey the same way she had addressed her agoraphobia. “I realized, with any journey, you have to learn to be OK with being uncomfortable, pushing yourself more than you did before.”
"It’s important to love yourself at any weight, but had I accepted myself at 300 pounds, I wouldn’t be where I am today: so much happier and healthier."
— Monica Muñoz, patient
“I know everyone’s experience is not the same,” says Muñoz, “but my recovery was very easy. When you’re in a good place, and everyone knows what they’re doing, it tends to go smoothly.”
The surgery marked the start of what Muñoz calls her journey toward health and wellness. She has modified not only the amount she eats — her stomach can accommodate only a little at a time — but also the quality of her diet.
“I create balanced meals for a balanced life. I eat natural, healthy, wholesome foods, with enough proteins, fruits, and vegetables. Instead of focusing only on what tastes good, I pay attention to what nourishes me. Before, I didn’t really taste my food. Now, when I can eat only a little at a time, I set up the perfect bite and savor it.”
Muñoz also incorporates a diverse exercise program into her daily routine. She works out at a gym. She hikes local trails. And she set up a backyard “warrior” routine at home, with a kettle bell, agility ladder, punching bag, and battle ropes, with plenty of room to run. In May she completed a spartan race, a grueling obstacle course.
“I used to fall into the trap of comparing myself to others,” Muñoz says. “Now when I work out, it’s just me against me. Or maybe for me. Every day I’m learning and trying to better myself. I’m proud of myself, but I want to keep challenging myself. It’s important to love yourself at any weight, but had I accepted myself at 300 pounds, I wouldn’t be where I am today: so much happier and healthier.”
Two years after her surgery, Muñoz had lost 108 pounds, more than a third of her weight.
“Having weight-loss surgery is a very personal decision,” she says. “I am very open about mine, and I am happy to share my story with others if it will help them in some way. But people need to make their own decisions. When you do this for the right reasons, it works better.”
Weight-loss surgery veterans share lessons learned
Pinkie Weesner approached weight-loss surgery with a clear-eyed view of what it could —
and couldn’t — do.
“I knew the surgery wasn’t magic; it was a tool, a lift up into the stirrup,” Weesner says. “From there, I needed to do the work. It wasn’t easy, but I wanted it.”
That perspective and her commitment have paid off. Eight years later, she’s lost half her body weight and she’s also shed numerous medications that she no longer needs.
To help stay on track, Weesner attends a support group offered by Community Hospital of the Monterey Peninsula for people who have had weight-loss surgery. She and three other participants shared their experiences and their advice.
Procedure: Roux-en-Y gastric bypass, September 2011
Why: I’m 5-foot-1. I quit weighing myself at 260 pounds. I wasn’t comfortable sitting up or lying down, in my clothes or out of them. I’m a therapist and I had a client who was demonstrating resistance to therapy. I thought, “Why is this client so resistant to a path of change?” And then I realized I needed to ask myself the same question. I thought, “I got myself into this mess, I ought to be able to get myself out.” Then I realized that surgery was the way to get myself out of this mess.
How did the surgery change your life? I got my life back! I lost 20 pounds in preparation for the surgery, and 130 pounds total — half of me — in nine months. I no longer take blood pressure or cholesterol medication, only thyroid; and I’m religious about vitamins and supplements.
Staying on track: I’m really thoughtful about dessert choices, about which are better for me. And I never shop in the freezer section. Only the perimeter of the store, where food is fresh.
What would you tell people considering surgery? Food is not love, and love is not food. Find as many people as you can and ask about their journey. If you comply with your doctor’s orders, you will be successful.
Procedure: Vertical sleeve gastrectomy, December 2016
Why: I had the surgery mainly because of family history. My father passed away from a heart attack, and everyone on his side of the family suffers from high blood pressure or cancer, as does my mother’s side. I started gaining weight at age 7 or 8. As I got older, I’d lose 100 pounds and then gain 120. I tried every diet, but was unsuccessful and felt really deflated. I was on the fence for about five years about doing a procedure, but was gathering information.
How did the surgery change your life? It completely changed my life. I’ve lost close to 140 pounds and kept it off. I have more energy than I’ve had my entire adult life. At the beginning of my journey, I’d try to walk, but was out of breath in a couple of blocks. My most recent walk covered 23 miles. Some changes are so subtle they’re not even on your radar: sleeping better, having more mobility and the confidence that grows from that. I was on eight prescriptions; I’m now on only one for thyroid. I’m astonished.
Biggest challenges: The surgery was more emotionally than physically taxing for me. I’m an emotional eater; if I’m happy or stressed, eating is my security blanket. My stomach now has a permanent restriction, so there’s only so much I can eat. The first year, it was very important to get all my protein and to hydrate, so I was retraining myself how to eat.
Staying on track: Staying on track: I keep a health journal; I can express how I’m doing and how I feel about it. I also have a program, MyFitnessPal®, to log my nutrition. When I do feel a moment of discouragement, I walk to the grocery store, I fill two bags with groceries that weigh close to the 140 pounds I’ve lost. Then, I walk the mile home, thinking about how I used to carry that weight every day, and celebrating how far I’ve come instead of being critical.
What would you tell people considering surgery?You need to be informed and take time making your decision. You need to hear the real positive and negative.
Procedure: Vertical sleeve gastrectomy, January 2016
Why: I had my daughter and then, three years later, triplet sons. I became overwhelmed and depressed and started eating more, which became a lifestyle. Once I decided I wanted to feel better, to be more active for my kids, I started looking into bariatric procedures to determine which would be best for me. While I was losing weight and going through pre-op procedures, I had a heart attack, which required another two years to be ready.
How did the surgery change your life? I have lost 138 pounds and feel I have a little bit more to go. Now I have more energy and feel better about myself.
Biggest challenges: Getting in exercise is hard; I have an active job, but I need to develop a habit of exercise, a routine that works for me. At first, a big challenge for me was preparing my meals in advance. When I don’t, my eating is all over the place.
Staying on track: I threw away every article of clothing that was big, so I have to stay in the clothes I have now. After all those years of pounds creeping up, I’m trying hard not to fluctuate. It’s also good to have long-reach goals, but some of us just need to make a goal for lunch. I don’t overthink it. I keep it simple.
What would you tell people considering surgery? Do your homework. Make sure this is really something you want to do, to stick to. Read everything, follow everything. What your doctors tell you is key.
Procedure: Vertical sleeve surgery, August 2017
Why: I had been having some fatty liver issues, partly due to a lot of yo-yo dieting over the years. I could lose weight, but I would gain it back. I’ve lost 72 pounds, which was my goal. I am healthier, my liver is healthier. What held me back at first was that I didn’t want to be the person to whom everybody says, “You took the easy way out via surgery.” It isn’t easy.
How did the surgery change your life? The outcome has rejuvenated me, given me a sense of confidence on a personal and a professional level. Losing weight made me more empathic to people in their struggles; in all ways really, but with weight especially.
Biggest challenges: I was supposed to take two weeks off from work, but I took six weeks. I had a vitamin B1 deficiency and had to have shots every day. I also had an abdominal hernia, so I had surgery for that. A lot of people don’t talk about the mental health piece. I’m a therapist myself, so I thought, “I’ve got this.” But I see a therapist twice a month because there’s a lot going on within about why I got where I was. This experience actually led me to work on becoming a certified bariatric counselor.
Staying on track: My support group has become my second family; it’s where I go to be held accountable. I get together with friends who are on the same path; networking helps me. I exercise; walking works for me. I don’t like to live by the scale. People tend to fixate on numbers; I focus on my health.
What would you tell people considering surgery? Prepare for an up-and-down journey. Ask a lot of questions; even the dumb questions. I had great doctors and a great support system. You have to do it on your own terms, when you’re ready.
Is weight-loss surgery right for you?
Bariatric surgery is designed to help people lose and keep off large amounts of weight to improve health and quality of life. Being severely overweight increases the risks of heart disease, high blood pressure, diabetes, arthritis, sleep apnea, cancer, and depression.
You may qualify for bariatric surgery at Community Hospital if you have:
- Body mass index (BMI) between 35 and 40 and two severe, obesity-related illnesses, such as diabetes, sleep apnea, high blood pressure, joint disease requiring joint replacement, or heart disease
- Body mass index higher than 40
- Tried to lose weight without success
The first step is to attend an informational seminar, held monthly in both Monterey and Salinas. Find a schedule at chomp.org/weightloss
Community Hospital offers the two minimally invasive (laproscopic) weight-loss procedures found to be the safest and most effective:
- Gastric bypass
- Vertical sleeve gastrectomy
In gastric bypass, the stomach is divided into two parts — an upper pouch about the size of a thumb, and the lower part, which contains well over 95 percent of the volume of the stomach. The small intestine is then divided and brought up to the small pouch so that food goes directly from the esophagus through the tiny gastric pouch and into the small intestine, bypassing the stomach. Because food does not enter the main part of the stomach, people generally can’t eat as much as quickly as they once did. There are also hormonal changes that probably help feelings of hunger go away more quickly once you start to eat. There appear to be some unique hormonal changes with a gastric bypass that may help treat type 2 diabetes, as well.
VERTICAL SLEEVE GASTRECTOMY
In vertical sleeve gastrectomy, approximately 80 percent of the stomach is removed. This part of the stomach generally stores food after meals. Because the storage part of the stomach is removed, sleeve gastrectomy patients cannot eat as much as quickly at one time, contributing to weight loss. Food enters the small intestine more quickly, which may help hunger go away more quickly after eating, and there are hormonal changes that may also diminish hunger.