According to the Centers for Disease and Prevention, 69.2 percent of U.S. adults are overweight, and 35.9 percent of these are obese. Those are sobering figures. Carrying extra weight is not only an aesthetic issue but also a health hazard that predisposes individuals to diabetes, cardiovascular problems, cancer and a number of other conditions. Losing weight is not easy, but it can be done. Below are stories of four San Antonio women who were determined to win the battle of the bulge, each in her own way.

From fat to fit
To look at the slim and chic Cherie Borden now you would never guess that she once weighed close to 250 pounds. A member of the Church of Jesus Christ of Latter-day Saints, she married young and had her first child at 20. She and her husband knew from the start that they wanted a large family, so Borden chose to be a stay-at-home mom. Today, the couple have six children ranging in age from 31 to 16. One child died as a baby. “We are Mormons, very family oriented,” says Borden. “When we all get together with the kids, I go ‘Wow, look at what we did!’ I am so proud of all of them.” Unfortunately, the multiple pregnancies took a toll on her body. Attempting to deal with it, the busy mom sought various exercise programs, especially those that involved music and dancing. “You name it, I tried it,” she quips. One of those was Jazzercise, which she first tried in 1986 after receiving a coupon for a few sessions. Though she liked it, the family soon had to move to another city, and that was the end of it. Borden returned to Jazzercise in 2006 when she was at her heaviest and reluctant to even step on the scale. But it wasn’t until a couple of years later that the realization hit her that she must devote herself seriously to this exercise business if she wanted to really slim down. “My kids were older; it was time for me to focus on myself,” she explains. “Both my grandmothers and my mother were heavy, and I thought, ‘I am not going down that path.’” The now determined Borden started attending sessions four to five times per week, and lo and behold, the pounds began melting away.

Many people associate Jazzercise with the 1980s, but the program has evolved and is, in fact, constantly changing, she points out. Every session combines a cardio routine with muscle toning and stretching, all of it choreographed to contemporary music that includes jazz, Latin rhythms, hip-hop and other beats. “It’s a total body workout,” she emphasizes. “Not only has it helped me to lose more than 100 pounds, it also reshaped my body. I lost 83 inches total, along the full length of my body. Diet cannot do that for you. You need exercise.” Two years into it and 70 pounds lighter, however, she hit the infamous plateau and stayed there for seven miserable months. Then someone suggested doubling up on the classes at least a couple of times a week, and it worked. The remaining extra fat dissolved. Today, the new Cherie weighs only 135 pounds and fits into size 2. To complete the transformation, she recently underwent two skin-tightening operations. Best of all, the former student has now become a Jazzercise instructor who teaches both here in San Antonio, at the Perrin-Beitel studio, and in Schertz, where the family lives. “It’s fun and upbeat,” she explains enthusiastically. “Every 10 weeks we receive a new DVD (from the company’s headquarters) with new moves and music. There’s no improvisation. Dances are designed for maximum benefit, and we instructors have to learn new material every time. Once a year, we are inspected. It’s also very social, and there are no contracts to sign (for participants). At our center here, you can join for $50 and then pay a monthly fee for an unlimited number of classes.” Since working out is her job now, she’s confident that the weight will not come back.

The rewards of being in shape are many, but a recent experience involving her son, Brett, was particularly precious. The college student, who is majoring in kinesiology, came to see her teach a class as part of a school assignment. When it was over, he said, “The whole time you were up on that stage I couldn’t get over it that it was my mother up there. You are so amazing!”

Step by step
PR and business development consultant Michele Krier was an active young woman with no weight problem until she got married and settled into a more sedentary lifestyle. As the years went by, she watched her figure expand, but because the process was so gradual — 5 pounds one year, maybe 10 the next — there was no sense of alarm. “It never seemed to reach the freak-out point,” she remarks. She would tell herself that she was going to lose the latest 10 pounds, but it just did not happen. Life was busy, what with career, home, a child, travel and everything, so there was no time to worry about weight. Even when her husband decided to get his own weight down by eagerly embracing exercise, Krier was not ready. Her household had a treadmill for 10 years before she considered using it.
“The weight did not affect my self-image,” she says. “I knew I was fun, well-read, cultured, and I had lots of friends. Weight did not affect any of that.”
Still, when it was time to post a picture of herself on Facebook in 2010, her displeasure with the photo induced her to seek photoshopping services “to shave off” 15 pounds or so. That’s when she started making small changes in her lifestyle. At first it was just skipping doughnuts or tacos during morning meetings, treats that she never refused before. Next came smaller food portions, then fewer “white” foods (bread, pasta, rice). Hey, this is going in the right direction, she thought, when her scale registered a loss of 15 pounds. What would happen if I walked a little on the treadmill without telling anyone?

“The treadmill was a big step for me,” admits Krier. “I started really slow.” Gradually getting more confident about her abilities, the budding exerciser started joining a couple of friends in the gym once in a while and even took up fencing, a sport her son had briefly engaged in in third grade. He didn’t like it, but she appreciated the sport’s elegance while she watched the experienced fencers fight each other. “I love the pageantry of it,” says Krier, “and it has made me more aggressive with people in general.” Now best friends with her treadmill, she walks a total of 5 to 6 miles a day, morning, lunch time and evening, and she sleeps “like a baby. I work from home, so I can do that,” she notes. Being the PR pro that she is, Krier wants to help others in their slimming efforts. When she sees considerably overweight individuals in the gym, she is not shy about approaching them to encourage them to persist, step by slow step, like she did. Some are flabbergasted, but they usually thank her. Though she has lost some 60 pounds, she hasn’t yet reached her goal. Her diet includes five small meals a day without a whole lot of variation, to keep the cooking simple. For instance, she will make a turkey chili on Sunday and eat it for lunch throughout the week. Dinner is mostly vegetables, both cooked and in salads, minus the dressing. “Find a food that you like, that you can eat on a repetitive basis” she advises, “and find something that makes you move.” Like Borden, Krier recently got a kick out of an unexpected compliment. “Honey, you are just plain sexy,” her stepmother told her.

With help from the pros
Like so many overweight people, Diane Jacobs has had her share of yo-yo dieting and regaining. When she reached 290 pounds and her doctor warned her that she was pre-diabetic, the Pleasanton ISD chemistry teacher knew it was time to change course for good. Her physician recommended Dr. Rogers Weight Loss Centers, telling her forthrightly that “if you can afford it, go” Sadly, her insurance didn’t cover medically supervised weight loss. With the initial cost for a 12-week period of about $1,000 and subsequent 12-week stretches costing $800 each, it was not cheap, but Jacobs was willing to give it a try. “Cheaper than surgery,” she quips. And she is glad she did. Following a consultation with Dr. Tamyra Rogers, who is an internist, she had the appropriate tests — blood work, electrocardiogram, oxygen uptake — and her measurements and a picture were taken. The prescribed high-protein diet put her on 1,000 calories a day, which entailed weighing everything consumed on a food scale. “So that’s what 2 ounces look like!” she remembers thinking. “The weighing helps you become aware of how much you are eating,” explains Jacobs. The program also incorporated HCG hormone shots, FDA-approved appetite suppressant medication, helpful vitamins and the advice to drink lots of water. Twelve weeks later, the surprised dieter discovered that 45 pounds had melted away without any exercise. Such a result was all the motivation she needed to continue. Jacobs is following Dr. Rogers’ Rapid Results plan, which is one of five programs the three San Antonio clinics offer to their patients. The goal is to help the patient lose 10 percent of her weight during each 12-week span. “With each 10 percent of loss, blood sugar, cholesterol and other health parameters improve amazingly,” says Dr. Rogers. “When Diane started with us, her BMI was 40.4, which is in the morbidly obese range. Now it’s 29, in the overweight range. That’s a major accomplishment.”

For those who would rather not measure and cook themselves, the company provides pre-calibrated, prepackaged meals that meet the caloric requirements of the various programs as well as healthy bars and shakes for snacks — all of which Jacobs has used to supplement her own cooking. Her lunch usually consists of a salad with an egg or some chicken, while dinner is meat with plain veggies. Her husband eats the same but with added carbs. After the first three months, Jacobs incorporated a daily walk into her routine. Altogether, from April through mid- November of 2013 she lost 80 pounds with only 20 more to go to reach the ideal weight for her 5-foot-11-inch frame. Knee problems have disappeared, and she can’t wait to see her primary doctor’s face when she next goes for a checkup.
Her physical transformation happened mostly over the summer months, so when she returned to school for the fall semester, students were impressed. “I looked a lot different than when they last saw me,” observes Jacobs with satisfaction. “I was size 22-24 before starting this program; now I am 14-16. I no longer have to go to the plus sizes store. I also lost 15 inches in the hips. Clothes fit so much better. What I like about this program is that you are eating something every two or three hours, so you are never hungry and tempted to overeat. I am not going to mess with this at all. I intend to stick to what I’ve learned. As you get closer to your ideal weight, they start working with you to get you to a more normal diet that will still protect you from ballooning back. I went on a cruise recently, and I ate what was offered, but I did not gain. I just ate less than I would have before. I am kind of a stubborn person.”
At school, fellow teachers have supported her throughout her slimming journey, and one of them signed up with Dr. Rogers to lose 40 pounds, which she, too, successfully accomplished. “I highly recommend it,” says Jacobs. “Everyone (at the clinic) is so nice; they seem to genuinely care about you.”

Sometimes surgery is the answer
Tammi Sligh is a dynamic woman interested in a lot of things, but her weight often kept her from pursuing her dreams or even ordinary activities. She just lacked energy. “I hated climbing stairs or hills. I was so slow, everybody had to wait for me,” she says. “Sometimes Dave (her husband) had to help me out of a chair. I was like a slug.” These problems disappeared after she had bariatric surgery. But the road to that decision was long and hard. Like Jacobs, she had tried different weight loss options that invariably ended up badly. After an early loss the weight would always come back. At her heaviest, the 5-foot-4-inch forensic scientist for Bexar County Criminal Investigation Laboratory tipped the scale at 244 pounds and wore size 20. Try as she might, her weight refused to go lower than 170 pounds. She came close to giving up altogether. Eventually, Sligh started toying with the idea of surgery. The first seminar she attended on bariatric procedures was a disappointment, however. No physician was present, and the two people in charge of the presentation hardly inspired confidence. Still, this was where she first learned about the sleeve operation.

“Then a girl at work had this type of surgery and recommended the Bariatric Medical Institute of Texas,” she explains. “It so happened that there was a seminar soon after, on a Saturday. It was a completely different experience. Not only were the doctors there, but there was a line of people who had already had the surgery ready to speak to us. I signed up to see the doctor on Monday and scheduled the procedure for the following Monday. I was scared a little. What if I don’t wake up? But I was also determined.” Post-operatively, Sligh maintained a liquid diet for four weeks, slowly transitioning to soft foods and eventually to a variety of choices, with emphasis on protein intake. As “the original cookie monster,” she has not excluded sweets altogether, but must remain vigilant in that area. The only problem she experienced for a while was fainting upon standing up quickly, caused by very low blood pressure, which was remedied by adding salt and potassium to her diet. Since weight loss surgery essentially reduces the size of a person’s stomach and thus the amount of food that can be consumed, dramatic weight loss is fairly common. Thirteen months after the operation, Sligh was down to 135 pounds and ready for size 4. To perfect her new body, she also underwent skin-tightening operations and had breast implants to reshape her sagging breasts, all paid for out of the family budget. “I am totally bought,” she jokes, indicating her body. As a bonus, ailments such as the irritable bowel syndrome and plantar fasciitis disappeared. (To help her pay for surgery in installments, Sligh obtained a Care Credit card, designed especially for health care not covered by insurance.)

Today, the mother of three and grandmother of a toddler is finally doing all those things she couldn’t do before. To advance at work, she earned a master’s degree in forensic science last May and was promoted. With an interest in medicine, Sligh then underwent training as an emergency medical assistant, which led to her weekend job for the Bandera County Fire Department. And if two jobs weren’t enough to keep her busy, she also teaches criminalistics at SAC once a week. “I have also decided to go back to school to get a paramedic’s license (the highest EMT rank),” she adds matter-of-factly. “It’s going to be a hectic year.”
Her example inspired her husband to have the surgery, too, so now the spouses often share a single restaurant meal and still take a doggy-bag home. “One restaurant portion is like six meals for me,” says Sligh. Though enormously pleased with her new figure, she admits to being “terrified” of gaining again. Bariatric patients who relapse into overeating may stretch their new stomachs again, leading to bad consequences. “I am so much more active now. This has opened up so many possibilities for me that I absolutely don’t want to go back to the old me,” she says emphatically. “You only live once, and what you do with your life is up to you.”

Choosing Bariatric Surgery
For those who can’t lose weight through diet and exercise, there are presently three different surgical options: gastric bypass, sleeve gastrectomy and adjustable lap band. All three essentially involve reducing the size of the stomach that receives the ingested food, but they accomplish this in different ways and may combine the reduction in size with additional mechanisms that make it harder for your body to absorb calories. It’s important to do your research carefully before making a choice, as all three have pros and cons. What’s more, they cost thousands of dollars. According to Dr. Terive Duperier of the Bariatric Medical Institute of Texas, patients who suffer from heartburn, diabetes or hypertension are steered toward the gastric bypass, as this operation very often resolves these problems. In this procedure, the surgeon creates a much smaller stomach — a pouch — and seals it off from the rest of your original stomach. The pouch is then connected directly to the lower section of the small intestine. For younger people who have not yet developed the above mentioned conditions, “the sleeve is a great option,” says the doctor because “it treats the problems that the patients don’t have yet.” The lap band is the least invasive option as well as easily reversible, and a lot of patients think they want it until they find out what it entails — namely, a longish period of monthly adjustments of the band that squeezes the stomach into two sections. In this case, the two sections remain connected, but the opening between them is narrow, which slows down the emptying of the upper pouch. Most popular at present is the sleeve option, says Duperier, which leaves you with only 25 percent of your original stomach, but the intestines are not affected.

Post-operative weight loss will depend on how well the patients follow a healthy lifestyle, but if they do, they can lose up to 75 percent of their body weight. Most lose about 20 pounds in the first three weeks. “They have to exercise and find a diet that works. Usually that means working with a nutritionist,” explains Duperier, who has performed some 2,000 surgeries so far. As with every surgery, there may be complications, but “most people do very well.” In fact, they often wish they had done it sooner, says the surgeon.

By Jasmina Wellinghoff
Photography by Josh Huskin