By Biddi Rorke

An irreversible operation to reduce the size of her stomach saw Tanya Bornman lose 68kg.

But that didn’t mean an easy ride. I have always struggled with my weight. At my heaviest, I never walked between pieces of furniture and hated corridors because I worried I was too broad to pass someone. I also disliked walking on the beach because I knew my footprints were always deeper than those of my friends.

I never sat on a chair before testing it – and picnics made me really uncomfortable because I never knew how I’d get up from the ground. Since childhood, I’d always carried extra kilograms, and doctors in the rural Zululand town where I grew up eventually diagnosed Irritable Bowel Syndrome. I started dieting at the age of seven and it has been an ongoing yo-yo affair ever since. You name it, I’ve tried it: Atkins diet, the grapefruit diet, the egg diet, the Beyoncé diet, fat-burning creams and machines. I was disciplined when following an eating plan, but as soon as I reached my goal weight, I’d start binge eating. It was a reaction to feeling so restricted.

Needless to say my constant battle with the bathroom scale was incredibly disheartening. Everyone around me tried to encourage me but I was losing faith in myself. Being fat is not for sissies. I used to laugh it off when I was teased at school because I didn’t want to give the bullies more ammunition to hurt me. And as I got older, I remained ashamed of my size. At one stage I tipped the scales at 160 kgs, and as I’m 1.55 m tall, it wasn’t a pretty sight. I thought I was doomed to carry my weight for the rest of my life.

But two years ago, I started working as an IT Support Co-ordinator at Mediclinic Bloemfontein and was exposed to the idea of bariatric surgery. I researched the pros and cons of the procedure to make sure my weight-loss expections were realistic. I didn’t want this surgery to be “just another expensive disaster”.

I knew it wasn’t a quick fix and would take a lot of hard work and commitment. Of course, determining whether I was a candidate for bariatric surgery required a multi-disiciplinary approach.

My GP referred me to Dr Geofré Heyns at Mediclinic Bloemfontein’s Bariatric Centre of Excellence. Under his guidance I saw a physician, a clinical psychologist and a dietician. I also had an endoscopy to ensure my intestines were healthy and there were no underlying causes for my obesity. Once all the tests were completed, a report was compiled and sent to my medical aid for approval. In the pre-operative phase, I followed a few important preparation measures. With the help of Mediclinic Bloemfontein dietician Ilsabe Spoelstra, I managed to lose 10kg to shrink my liver. This is because a fatty liver is unstable and can tear when moved during the surgery. Biokineticist Liliola van Wyk offered ongoing support and helped me with cardiac preparation. After three days in hospital following my Roux-en-y-gastric bypass (see above), I recovered at home for six weeks.

For the first month I lived on yoghurt, porridge and mild, clear soups – a tablespoon at a time because I wasn’t hungry. But it was important to keep nourished, so I drank protein shakes too. After a month, I graduated to soft meat, veggies, stews and rice. I had to steer clear of bread and potatoes because they filled me up too quickly. A crucial part of ensuring this irreversible operation is a success is watching what I eat. Bariatric surgery is not a miracle cure and some people who have it regain all the weight within five years.

To ensure that didn’t happen to me, I had to find alternatives to food when I got bored or stressed. I began following an exercise programme, as well as writing down all the positive aspects of life I am now able to enjoy. It has been 13 months since my operation and I’ve shed 68kg and dropped from a size 54 to a size 14. It’s so lovely to buy clothes from a normal shop and to watch the needle of a scale hover at 82kg. After years of being sidelined and ignored because of my weight, I am now seen as an inspiration to many people, including the staff at the Bariatric Centre of Excellence. The only thing I regret is waiting so long to have the surgery!

Do you qualify for surgery?

“Bariatric surgery is a major procedure and should be viewed as a method for alleviating debilitating disease,” says Dr Geofré Heyns at Mediclinic Bloemfontein’s Bariatric Centre of Excellence. In most cases, to be considered as a candidate you would have:

  • A body mass index (BMI) of 40 or higher;
  • A BMI of 35 or greater with co-morbid health conditions (like diabetes Type 2, hypertension, hyperlipidemia, osteo-arthritis or sleep apnoea);
  • Proof that your attempts at dietary weight loss have been ineffective; or
  • To demonstrate serious motivation and a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the rest of your life after having bariatric surgery.

Roux-en-y-Gastric Bypass 

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. “In this laparoscopic procedure, a small part of the stomach is stapled to create a new, egg-sized stomach pouch,” Dr Heyns explains. “The outlet from this newly-formed pouch empties directly into the lower portion of the jejunum (the middle segment of the small intestine). This means food bypasses the duodenum (the upper portion of the small intestine) and is delayed in mixing with bile and pancreatic juices that aid nutrient absorption.” The result is an early sense of feeling full which reduces the desire to eat. 

Vertical Sleeve Gastrectomy

During this procedure, approximately 60 – 85% of the right side of the stomach is removed, creating a “sleeve” or tubular stomach. Afterwards, the stomach functions as before but the quantity of food it can manage is considerably restricted. “Because the greater curvature of the stomach is removed, fewer hormones are produced, including ghrelin that makes you feel hungry,” Dr Heyns explains. Vertical Sleeve Gastrectomy can be used as the first stage operation of a two-stage procedure.

The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.