In the past 15 months, Melissa Groeneveld has lost more than half her body weight and gone from a size 36 pants to a 20.
The owner of the Scruffy to Fluffy Pet Salon, 22 Ortonville Road, is barely recognizable to some clients and even family and friends after losing more than 200 pounds thanks to bariatric surgery and the resultant changes in her eating habits.
‘I didn’t really notice a big change as (the weight loss) was happening, but now I look at old pictures and new pictures and it’s crazy,? said Groeneveld, 36. ‘I don’t look anything like I used to. An ex-boyfriend didn’t even recognize me. My family and friends are ecstatic, my mom cries everytime she sees me. I think they were really worried. It’s a big relief knowing I am in a lot better health now. My blood pressure is good and I’m no longer pre-diabetic. It’s amazing, I feel great. My face looks a lot different. The guy I am dating now says the eyes and smile look similar, but I look completely different. It was worth it, I’m so glad I did it now.?
Making the decision to have gastric sleeve surgery, in which doctors remove a large portion of the patient’s stomach, in essence leaving a banana-shaped sleeve, was not easy despite a lifetime battling weight issues.
When Groeneveld looks at photographs from childhood, she pinpoints sixth grade as around the time she really started to gain weight, after she stopped taking dance classes. She had high blood sugar as a child, but was not diabetic. She recalls having to eat different than her friends? while they had doughnuts for snacks, she had veggies. While she believes part of her weight problem was genetic, she also acknowledges that weight gain is also attributable to the way people are raised and how they eat. In 11th grade, she moved from one high school to another and estimates around that time she carried 300 pounds on her 5?8″ frame. She didn’t go to parties, but was a loner, with only one or two friends, who also had weight issues. Despite her large size, she described herself as invisible.
‘I wasn’t social, I was shyer back then because of my weight,? she recalls. ‘I think people didn’t want to be around me or be friends with me because of my weight. When kids are looking for someone to hang out with, they want popular kids and I wasn’t a popular kid.?
She remembers children pointing her out to their mothers. People questioned her physical ability to do her work, and while her weight never stopped her from being able to care for dogs, it did limit her in countless other ways. She couldn’t stand for long periods of time and would take chairs to various places. She couldn’t sit in booths at restaurants and had to carefully consider which chairs could hold her. Movie theater seats left her with bruises. She hasn’t flown on a plane since she was 12. She always sought the closest parking spot as walking any distance winded her.
Hygiene was more difficult. Urine tests were challenging. At the hospital, she had to wear two gowns instead of one.
Groeneveld had tried a variety of diet plans and gym memberships to lose the weight? Atkins, Weight Watchers, South Beach, eating more natural food and less processed.. She had been to nutritionists and tried different personal trainers.
‘I lost 30 on Atkins, but you are cutting out a lot of food, no carbs,? she notes. ‘I don’t think a person can do that long-term when you are cutting out half the food you normally eat and whole food groups for a long-term process… There were times when I tried to eat healthy. I was on a diet where you’re eating canned tuna for three days. I tried to incorporate salads, which I loved, but then you fall off the wagon with the pizza at work they’re having, or someone brings in cookies. It’s hard to keep on the right path when everything around you is unhealthy. I had issues with food? I ate way too much and ate the wrong food… I would do good for awhile, but my cravings were very pronounced… I’d go to Lifetime Fitness and Curves, but they were never close, timewise, and a pain in the butt to get to. When I was there, I didn’t mind working out. I’d do the bike or some of the weight things, but it was trying to get there, rush hour traffic and trying to get to work, all the excuses you can think of.?
Her weight caused her to be depressed, and the depression caused her to gain more weight as she sought comfort in food. She wanted to have children, but knew she could never chase after kids when she weighed 450 pounds.
She got to a point where her physician even told her she couldn’t do it on her own and needed help, but what finally pushed Groeneveld into seeking surgical intervention was the plea of her best friend? her only friend? Mary, who lived in Virginia and was diagnosed in spring 2012 with stomach cancer, only a year after she was married. That May, Groeneveld went out east to see her friend and take her to chemotherapy.
‘She made me promise to do something about my health, she was worried about me,? said Groeneveld.
Just two months later, Mary died. Groeneveld knew then she would honor her friend’s wish and have bariatric surgery, but it took her a few more months to finally take action. In January 2013, she had her first bariatric consultation.
‘Any surgery is major, major for me, because I get blood clots,? said Groeneveld. ‘It took me a long time to say, ‘I cant live like this anymore, I have to do it.? Once I made up my mind, that was it, nothing was going to stop me.?
Groeneveld completed physical tests and psychological counseling intended to ensure candidates are mentally stable and can handle post-surgery changes. She began taking classes at Hurley Medical Center on what to expect after surgery, including possible complications, and diet changes.
More than 200 bariatric procedures are done per year at Hurley, said John Stewart, service line administrator for the bariatric program at Hurley Medical Center. The majority of these procedures, about 50 percent, are sleeve gastrectomies. Roughly 30 percent are gastric bypass or roux-en-y, and less than 20 percent are lap band procedures. Bariatric surgery has been performed at Hurley since 2000 and the hospital was one of the first to develop a center of excellence program. Sleeves are a less complicated procedure than gastric bypass, generally resulting in less hospitalization as well as less interference with absorption of nutrients. Lap band is very minimally invasive, but doesn’t have the post-procedure success rate? roughly 60 percent? that the sleeve does.
Stewart cites American Society of Metabolic and Bariatric Surgery data that suggests a gradual increase in bariatric surgeries since 2011. He attributes the popularity of the surgery to its demonstrated results in resolving obesity-related conditions including diabetes, cardiovascular disease, GERD (gastroesophageal reflux disease), high blood pressure, sleep apnea, and joint pain as well as the improvement in appearance. Primary care physicians are also recommending bariatric surgery to their patients as a viable alternative when they have failed to lose excess weight though dieting and exercise.
‘Surgery is a large step, but it’s a safe procedure and there are a limited number of side effects,? Stewart said. ‘We can say wtih confidence, this is a reasonable alternative. Our program is comprehensive and can deliver what we promise, it’s then up to the patient to make sure they sustain those changes post-surgery, and we offer support in that… Key to success is keeping them engaged and lifestyle changes to help them embrace long-term success.?
To qualify for the surgery, candidates must have a body mass index of 35 or higher. At 5?8″ and her heaviest weight of 460 pounds, Groeneveld had a BMI of nearly 70.
Stewart notes that in a nation in which obesity is an epidemic and the American Medical Association has recognized obesity as a disease, there is no shortage of candidates for bariatric surgery. The obesity problem can be attributed to multiple factors, he said, with some people genetically predisposed, but lifestyle changes also often responsible, with less active careers and easy access to fast food and bigger portion sizes.
But bariatric surgery is no quick fix for these problems and still requires a lifestyle change.
‘We are giving them a tool and it is up to them to use this responsibly,? said Stewart. ‘Physiologically, there is flat out less room for food to go. The hormones that trigger hunger are suppressed, because they have the full feeling earlier, but there are the right things to eat, in the right amount and order… Once they see results and changes made to have invasive surgery done, it makes the success rate higher than conventional changes.?
Groeneveld underwent the gastric sleeve surgery in February 2014 at Hurley and she agrees that by no means did she take the easy road as opposed to losing the weight through diet and exercise alone. Following the surgery, she broke down on multiple occasions and even initially told her mom she wished she hadn’t done it as she tried to force down protein shakes that she calls ‘disgusting,? and ate so many eggs that she doesn’t like them anymore.
Shortly after surgery, she broke up with her then-fiance, who she believes was jealous that she’d had the surgery. The stress of the break-up, as well as going back to work early caused her to have anxiety and trouble swallowing food. After two weeks of a liquid diet, then two weeks of shakes, she was able to add in soft foods.
Recovery took about six to eight weeks and she now eat whatever she wants, but in tiny amounts, and she tries to pick out her protein first, after which she is usually not hungry.
‘I can only eat a tiny bit compared to other people, but I get hungry sooner,? Groeneveld said. ‘You may have a big meal and not be hungry again until lunchtime, whereas for me, I eat something small, and in an hour I’m ready to snack on something.?
Groeneveld notes there are foods she doesn’t enjoy as much anymore, like pizza. Other foods, like the barbecued ribs and loaded baked potatoes she had on Mother’s Day, she still loves, but is disappointed she can only have small portions.
‘It’s hard, because you feel deprived and the shakes and pills you have to get down are a whole meal in itself,? said Groeneveld, who takes vitamin supplements. ‘I don’t crave like I used to though, eating isn’t a big deal. I eat now because I’m hungry and need to survive. It’s not a huge pleasure thing for me like it used to be. Before the surgery, I would get a craving? ‘I just have to have a burger from McDonald’s? and you run out and get it, but now I don’t have to have it. It feels different, but it’s kind of freeing.?
If patients do not embrace the new lifestyle changes, Stewart acknowledges it is possible to stretch out the pouch and gain the weight back.
Groeneveld calls such a scenario ‘very scary.? She recently had a hysterectomy and tummy tuck to remove loose skin. She plans to have more excess skin removed after Christmas, with reconstruction of stomach muscles. Insurance covered most of the bariatric surgery and part of the tummy tuck, but more skin removal will not be covered.
‘After everything I’ve gone through, to go back to what I was, that would be devastating,? she said. ‘I am at 212 pounds. I lost more than half my body weight. I lost more in the beginning, but it’s still coming off… I will have to get the skin removed, I didn’t go through all that to have all this excess skin. It’s such a big reminder of what I was and I want to know what I look like underneath it all. I’ll have lots of scars, but not all that skin holding me back.?
Indeed, nothing is holding Groeneveld back these days. She is amazed at the amount of energy she has and likes to literally run and grab things when she needs them.
‘People are like, ‘Why are you running?? and I say, ‘Because I can!?? she said.
Soon, she hopes to be running after children. She is in the process of applying to be a foster care parent and wants at least two kids.
‘I’m working on my dreams,? Groeneveld said. ‘It took years for me to come to the decision to have the surgery, because I was scared, but it’s either do it or you’re going to die anyway.?
She smiles as she quotes a line from the movie Shawshank Redemption:
‘Get busy living or get busy dying.?