At 330 pounds, Maribel Flores Lira was in dire need of two knee replacement surgeries and worried she wouldn’t live long enough to see her children’s milestones.
Maribel, who then was 41 years old and the mother of a 3-year-old son and adult daughter, struggled to walk, play with her toddler, climb stairs and stay awake during the day. She knew she had to do something. Her doctor told her he would not approve knee surgery until she had lost weight.
“The knee surgery would be a Band-Aid if I didn’t lose the weight,” the Hobart resident said. “My doctor told me the pain would just come back. That was my breaking point. The pain was unbearable. I wanted to play with my son. I wanted to be around for him and my daughter.”
When she decided to lose the weight for good, she turned to Powers Health Bariatric Services. Maribel met with Bariatric Surgeon Yazen Assaf, MD, who sat down with her, listened to her story and explained the different types of weight-loss surgeries available.
“Dr. Assaf went over each one with me and answered all of my questions and concerns. After several discussions with him and with my husband and daughter, I decided on the SADI-S procedure.”
The Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S) operation is ideal for patients who have had a prior sleeve gastrectomy and have regained weight or have not lost enough weight, or for patients who have a body mass index (BMI) greater than 50.
Prior to working with Powers Health and having her surgery in June 2024, Maribel’s BMI was 60.4, she had high blood pressure, sleep apnea and was pre-diabetic. Today, at 160 pounds, her original BMI has been slashed in half, she no longer needs blood pressure medication, nor her C-Pap machine for sleep apnea, and her knee pain went from a 10 to zero or 1. And she no longer needs her knees replaced.
Her “nonscale victories” have not stopped there.
“Every time we go to California to visit family, Disneyland is on the list of things to do,” she said. “We love going to Disney, but because of my weight, I couldn’t fit on all of the rides. Now, I am able to get on every attraction with my son. On one of the rides, I had to be strapped in twice because the belt was too loose!”
Her experience with the sometimes-not-so-friendly skies also became a more enjoyable.
“I no longer have to ask for a seatbelt extender or squeeze myself into the seat to make the person sitting next to me more comfortable,” she said. “Even walking down the airplane aisle is so much easier.”
Her clothes fit better, too. She shrank from a 4XL to a size small.
“The number on the scale doesn’t capture the full magnitude of what it means to lose excess weight,” Dr. Assaf said. “The little things that improve your quality of life, that improve your relationships are the things that really change people’s lives.”
Bariatric surgery was just a piece of her weight-loss success. She changed her lifestyle. She reads food labels, limits her intake of sugar and fats, drinks at least 64 ounces of water a day and goes on frequent walks, a task that used to leave her mentally and physically exhausted.
Maribel credits her family and Powers Health Bariatric team with helping her stay on track. She meets regularly with a dietitian and visits with Dr. Assaf at least once a year.
“I make those appointments a priority,” she said. “Talking to them helps put things back in perspective and reminds me of what I need to do to stay consistent. It took me 15 months to lose 170 pounds. In that time, I never stalled. I still would like to lose more to reach my personal goal. It’s reassuring to know I have the support I need.”
Dr. Assaf’s understanding of patients like Maribel comes from a place of expertise in the field and his own experiences.
Obesity is a chronic disease, he said.
“Society blames patients for being overweight, and that’s not fair. Every patient who I see has tried to lose weight over the course of their life and has made progress before relapsing,” said Dr. Assaf, who struggled with his own weight most of his life. “Our bodies are designed to hold on to the weight that we have. What surgery does is break that cycle. It allows you to make the changes and stick with them, and the body is not trying to get you back to the weight you were before. It’s unfortunate that society judges. You wouldn’t do that to someone with cancer. It’s going to take time to educate people that this is a chronic disease. It’s not laziness or lack of willpower.”
Maribel said anyone considering bariatric surgery needs to know you also have to be mentally prepared. Dr. Assaf agreed.
“That’s why we have all our patients go through an extensive process,” he said. “We provide our patients with education through our dietitians, nurses and a counselor, who makes sure each patient is ready for the changes needed before and after surgery. It’s about maintaining, not just about losing.”
