“It has been a hard road, but it has been the best thing I ever did for myself.” This is how DeAnn Barfuss describes the emotional weight loss journey she embarked upon two years ago after deciding to undergo gastric bypass surgery. “I wish I would have done it sooner,” Barfuss said. “That is the only regret I have, but I wasn’t ready sooner. It was a huge step.”
When she was ready, Barfuss chose University of Utah Health’s Bariatric Surgery Program for what she calls a “life-changing experience.” Eric T. Volckmann, MD, is the director of the program and performed Barfuss’s gastric bypass surgery. “Patients like DeAnn are at a point where they are looking for something that can help them achieve durable, long-lasting weight loss, and we know that happens with weight-loss surgery,” Volckmann said.
The first step in the process is what Barfuss describes as bariatric boot camp. “If you don’t go through every step in the program, you cannot have the surgery, and there were 19 appointments before the operation,” Barfuss said. “Three months of dietician training, and you need to go do a psych evaluation.”
Ninety days into the program, Barfuss realized she was stronger and more determined than she had initially given herself credit for.
Only ten people (out of 22 who started the program with Barfuss) made it through the dietician’s course for surgery. So, you must be in a mindset where you realize you are going to make sacrifices. You need to be strong and understand you will have to change some of the mental issues in your life that have caused you to get so overweight.
Volckmann stressed that the bariatric surgery program is designed to help people motivated to lose weight decide which, if any, surgery is the right fit for them. “We try to recognize that it is not a one-size-fits-all phenomena, and different people have different goals and interests,” Volckmann said. “Our goal is to provide them with the tools that they need to be able to achieve the weight they want to maintain.”
Up until the day of her surgery, Barfuss was wavering between a sleeve gastrectomy procedure and gastric bypass surgery. Volckmann convinced her she was an excellent candidate for gastric bypass. “I wanted to lose 120 pounds so that I could get down to the weight I was supposed to be,” Barfuss said. “However, that negative voice a lot of people hear in their heads kept saying, ‘You’ll never get down to there.’”
The voice proved to be wrong. Eight months after her surgery, Barfuss had lost 122 pounds and was feeling younger and more hopeful about the future. “When I look at a picture of me before the surgery, it doesn’t even look like me,” she said. “I see how unhappy and miserable that woman was. I was living for other people. You know, my dad tells me now that he has never seen me this happy, ever! It is interesting because the first three or four months after surgery were really rough.” Volckmann warned her, as he does all his patients, these would be difficult days and weeks. But he also reassured Barfuss that where there is commitment to change, the results will be long-lasting.
“Overwhelmingly, we see that the patients who do the best and lose the most and keep it off are patients like DeAnn who have buy in,” Volckmann said. “They track what they eat, and they increase their activity, and they make significant lifestyle changes. It may be that the surgery was the tool that got them to make that lifestyle change but it is the ongoing lifestyle that they have that helps them to maintain the weight loss.”
A success story like Barfuss’ helps dedicated weight loss professionals like Volckmann educate more obese Americans about the benefits of weight-loss surgery. It also further lifts the stigma surrounding these surgeries.
What has been really nice to see in the 12 years that I have been here is the perceptions of weight loss surgery change. When people see folks like DeAnn make positive changes in their life that are associated with weight loss, they have a different understanding of the surgery. I wish more people could see how this operation helps our patients and makes them healthier.
Barfuss believes she has and will continue to improve every aspect of her life from the physical to the mental to the emotional changes she has made to her overall health. Gastric bypass surgery was not a cop-out, nor was obesity the way she chose to live her life. “[The surgery] is not an easy road or one for the faint of heart,” she said. “I have heard people say, ‘That’s the easy way out, but oh, you must make some major internal changes, or you will be back to where you were before surgery.’ And as far as I am concerned, that is never happening to me.”
One in four individuals living in Utah struggle with obesity. Volckmann would like to see that number lowered, and he believes it is now an attainable goal for the state. After more than three decades, guidelines that expand the requirements for a person to be eligible for bariatric surgery were published late last year. In 1991, these surgeries were confined to patients with a body mass index (BMI) of at least 40 or a BMI of 35 with at least one weight-related medical condition like high blood pressure or diabetes.
In October 2022, the American Society for Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) adjusted those numbers down. They now recommend that anyone with a BMI of 35—or anyone with a BMI of 30 and health issues related to obesity—consider surgery and also think about having gastric bypass or the sleeve gastrectomy procedure.
Volckmann said the new guidelines make a lot of sense in a world where the problem of obesity gets worse with each passing year. “One of the main reasons why we see the BMI criteria shifting down is because we see the long-term effects of obesity on health and quality of life and the risk benefit range has changed over the past 20 years,” Volckmann said. “Now, weight-loss surgery is a much safer procedure to do. It still must be done responsibly and with good patient selection.”
For surgical subspecialists like Volckmann, the positive impact of their work can be witnessed for years after they perform the surgery. “We are following our patients long-term and watching them get better and healthier,” Volckmann said. “It is really rewarding.”
Barfuss remains in constant contact with Volckmann and his team, reaching out for months and now years after her surgery with questions about diet, exercise, and even stress. Answers come in the form of phone calls and emails within 24 hours. Perhaps that is why Barfuss has this thought for anyone considering weight-loss surgery: “If I can convince someone to go into the bariatric surgery program and make this change, I guarantee it will be unbelievable how good you will feel on the other side.”