Before having the surgery that would transform her more than 300-pound body, life for Shelly Bazensky had taken on the feel of slow torture.
At the gym, people stared. Going to nightclubs meant dealing with men who would often laugh and yell out insults like "fatty." On airplanes and in movie theaters, it was humiliating trying to squeeze into seats too small for her.
"I didn't want to go out," says the 35-year-old Pikesville resident, an administrative assistant who works in Baltimore. "I cried a lot back then. People in this world can be so nasty and shallow. I was miserable."
Emotional woes weren't her only problem.
As is common among the severely overweight, Bazensky had a string of health ailments. She suffered from back pain and was taking medication for diabetes and hypertension. Her body was rebelling after years of poor eating habits and excessive weight gain.
"I wasn't very healthy or happy," says Bazensky, who had developed a serious weight problem by the time she entered college.
"I tried every diet," she says, ticking off popular weight loss programs such as Weight Watchers, Jenny Craig, Atkins and the so-called cabbage diet. "I'd lose 50 pounds and gain back 70."
She began to consider bariatric, or obesity, surgery after being inspired by singer Carnie Wilson. Wilson, part of the pop group Wilson Phillips, shed about 150 pounds -- half her body weight -- after having the surgical procedure three years ago.
Once considered radical and risky, obesity surgery (the term actually refers to several types of procedures) has emerged in recent years as a viable treatment option for the severely obese.
In the medical community, obesity is measured by a formula known as Body Mass Index -- basically, weight divided by height.
A healthy BMI falls somewhere between 18 to 25; numbers over 30 generally mean that a person is about 30 pounds or more overweight.
According to guidelines from the Centers for Disease Control and National Institutes of Health, a BMI higher than 40 represents morbid obesity, loosely defined as an individual about 100 pounds or more overweight.
Growing interest in surgery
Obesity is considered a disease -- one that affects about 59 million Americans, according to the National Center for Health Statistics -- and is different from being overweight (123 million Americans are considered overweight).
Experts say as obesity rates continue to climb, the net effect will be sharp increases in related chronic health conditions such as diabetes and cardiovascular disease.
"We estimate that 75,000 to 100,000 patients will undergo some type of obesity surgery this year," says Pat Watson, a spokeswoman for the American Society for Bariatric Surgery, a Florida-based educational group.
Though once controversial, obesity surgery is now endorsed by the NIH, and recognized by the American College of Surgeons and other prominent medical groups. The American Heart Association recommends the procedure in some cases.
"We get calls from all over the country and world," Watson says. "We have also seen an increase in new surgeons wanting to take our courses and other members of the medical community continuing their education."
In the Baltimore area, the University of Maryland, Sinai, St. Agnes and Johns Hopkins Bayview Medical Center are among the hospitals that perform obesity surgery.
"In the last five or six years we have seen a rebirth in these types of operations," says Dr. Thomas Magnuson, chief of general surgery at Hopkins Bayview and a specialist in gastrointestinal surgery.
"There has been acceptance in both the public and medical community," he adds, "and patients are demanding the surgery. It can dramatically improve medical problems. It can also improve your psychological well-being and quality of life."
Obesity surgery is usually considered after other options such as dieting and lifestyle changes have failed. The surgery is typically not performed on patients under age 18 or older than age 65.
Magnuson has performed more than 350 obesity surgeries and is currently the only physician in the Hopkins system doing the procedures. He operates about three times per week, working with a team of nurses, anesthesiologists, a psychiatrist and a dietician.
A few weeks ago, 56-year-old Sharon Hostetler joined Magnuson's growing patient roster. The 5-foot-4, 317-pound Lusby resident says the surgery wasn't about losing weight for vanity's sake.
"I've struggled with weight for 30 years, especially after I had my sons," she explains. "There are a lot of reasons why I started looking into surgery. I am a diabetic, I have sleep apnea and use a machine to breathe at night. But most of all I wanted to be able to play with my grandkids."
Hostetler, who works as a hospital payroll clerk, says her insurance paid for the surgery, which typically costs $12,000 to $15,000.
While policies vary, weight loss surgery may be covered by a patient's health insurance when the perceived risks of continued obesity are greater than the risks of surgery.