Angela Hopson

Angela Hopson had gastric bypass surgery in 2015, and she’s lost over 200 pounds since. Bariatic procedures are becoming more common in America, but the long-term commitment required after surgery can be a challenge for some. (Photo provided)

Angela Hopson got her wake-up call at a funeral. There she saw so many of her family members who were too heavy to walk on their own. They needed canes and walkers to get around, and Hopson knew she was getting close to that point, too.

“I have to change this,” she said.

Hopson, 50, knew one of her options: bariatric surgery. She thought about it a couple years before, but it didn’t feel like the right time to go ahead with a decision that would drastically change her life.

It turned out that waiting for more certainty was the right decision because it gave her more time to prepare. Hopson had gastric bypass in 2015. She had the surgery when she was 491 pounds and said she had lost 210 pounds by January this year.

Those who perform the surgery and have the surgery said it’s not something to take lightly. They recommend doing research to make sure there aren’t any surprises before or after the surgery, and it’s important to be dedicated to the process.

There are four common bariatric procedures in the United States: gastric bypass, sleeve gastrectomy, adjustable gastric band and biliopancreatic diversion with duodenal switch. More people are opting for these surgeries, according to estimates from the American Society for Metabolic and Bariatric Surgery, with about 228,000 having one of the procedures in 2017, compared to 158,000 in 2011.

Bariatric surgery is not a cosmetic fix that removes existing fat. Dr. Margaret Inman, a bariatric surgeon at St. Vincent, said this is one of the most common misconceptions for people considering the surgery, along with thinking it’s the “easy way out.”

Instead, bariatric surgery is supposed to kickstart the weight loss process, and it’s up to the patient to follow through for results. Most patients go through stages of eating and drinking after the surgery to retrain (or, in some cases, train for the first time) their body how to eat healthy.

“You commit to a complete lifestyle change,” Inman said.

Gastric bypass, for example, shrinks the stomach to about the size of a walnut, so patients need less food to feel full. As expected, this retraining is not always an easy adjustment.

Brenda Mack, who also had gastric bypass, is a nurse and knew about bariatric surgery. She did her own research for a few years before deciding to have the procedure in 2009 because of a family history of heart disease and high blood pressure that was starting to affect her.

The surgery has worked for Mack — she started at 312 pounds and is down to 178 — but she’s also relapsed along the way.

“I thought it was going to be easier than it was,” she said. “… I thought it was going to take away the cravings and all that, but it doesn’t.”

Mack, 63, called herself an “emotional eater” and said she goes through periods where she eats too much food that doesn’t have much nutritional value and she’ll gain some weight back. Like many who choose to have bariatric surgery, Mack was used to eating whatever she wanted whenever she wanted, and that urge doesn’t automatically go away.

Mack and Hopson both took a class before the surgery to get the information they needed. Some hospitals offer these classes, along with support groups, before and after surgery. This helps patients understand that they’re not alone in this process that some choose to keep private, leaving everyone else to think these procedures are rare or even something to be ashamed of.

Inman said celebrities who have the procedure — including “Today” host Al Roker, who had gastric bypass in 2002 — has also helped make it less taboo.

Because of variations in what researchers consider a successful weight loss journey after bariatric surgery, it’s impossible to say exactly how many patients lose weight and keep it off, but it’s clear this has transformed many lives.

“To be able to walk in the store and pick out anything you want, yeah!” Mack said. “I feel better. I sleep better. I look better. My outlook on life is better.”

Contact staff writer Tyler Fenwick at 317-762-7853. Follow him on Twitter @Ty_Fenwick.

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