When Cassie Pisano couldn’t get her eating (or her weight) under control.
she turned to surgery as a last resort. Here, she explains why it wasn’t the “easy way out” — and how it’s given her the happy, normal life she always wanted.
“I had more fun as the school mascot than as a cheerleader.”
I used to love being a cheerleader in high school — until my senior year, when I quit the team. I was tired of kids yelling nasty comments at me during cheer routines because of my weight, which fluctuated between 170 and 200 pounds, and it was embarrassing to have to special-order a size 18 uniform. I became the school mascot instead, and hiding in the lion costume was such a relief after all the public ridicule. I constantly measured myself against other people, and though I don’t remember asking them to, my friends did the same: They would tell me who I was fatter than and who I wasn’t as big as. They made me feel so self-conscious; even when I was just hanging out with them, I felt anxious and isolated. I had never been an overeater as a child, but now food was my only comfort. It totally owned me: I’d eat freely, then feel guilty after, and gain more weight. Every once in a while, I’d try to diet, but the scale never moved.
“I failed a class because I was too self-conscious to go.”
When I got to college, I felt like every girl there was a size 2. Just being in school while obese was hard: I failed a class because I was too self-conscious even to go. I played trumpet in the school band, and when we flew to away games, I was mortified to see my hips oozing over onto the seat next to me. I tried Weight Watchers, the South Beach Diet, the cabbage soup diet, diet pills, everything. I’d lose maybe 5 pounds — a drop in the bucket.
By the time I was 20, I had developed an eating disorder. For two years, I ate only half of a bagel or a PowerBar a day and made it down to a size 14. I stopped after a guy I was dating sat me down and convinced me I was being dumb. Then he slept with my roommate. Again, I turned to food for comfort. By senior year, I was 250 pounds — the biggest I had ever been.
After graduation, I got my first job, and shared an office with someone who’d had gastric bypass surgery. When I met her, I thought, She’s beautiful. I could never look like her. But then she told me her story. So I went to an information session where a surgeon explained the three types of weight-loss surgery. Afterward, I felt optimistic. If this worked, I wouldn’t ever have to worry about fitting into a seat. I could finally have a normal life.
Next, I was checked out by a cardiologist, a pulmonologist, and a psychiatrist; I also went to nutrition seminars. This gave me time to decide if surgery was what I really wanted. I still wasn’t sure. I started a journal of things I hated about being fat — like those looks at the gym that said, “Why are you here?” Finally, I decided surgery was the only way to lose a significant amount of weight and keep it off. I chose gastric bypass because with other procedures (like stomach stapling or lap band) I’d still be able to eat sugary, high-fat foods with no consequences. I needed to make a bigger change. But I was scared. I scheduled the appointment, then felt like I was going to throw up. I’d always wanted to be skinny, but to dream it is one thing. To live it is different.
I had my surgery on April 11, 2006. I took some pictures at home, said good-bye to the old me, and walked out the door. Once I got to the hospital, everything happened so fast. The surgery took about two hours. My surgeon stapled across the top of my stomach, creating a small pouch the size of a golf ball. Then he sewed part of my small intestine directly into the pouch. This would redirect food to bypass most of my stomach and enter my small intestine instead. I was in the hospital for two days. When I woke up, I felt like I had done 200 sit-ups, but that was the worst of the pain. Over the next three months, I went from a liquid-only diet to soft food to regular food. I was frustrated at first, but excited and anxious to see results. I thought, I can do this.
A week after my surgery, I’d lost 11 pounds. A month after, I’d lost 30 pounds. Less than two months later, I bought a size 16 — down from a 22! Was that really me in the mirror? For the first time, when people told me I was beautiful, I believed it.
Today, I’m in charge. I used to be a slave to my appetite, but my life no longer revolves around my next meal. I never feel physically hungry anymore — which is so freeing! It offends me when people say surgery is the easy way out. This certainly isn’t easy. I still fight emotional eating; I get that “head hunger” when I’m bored or stressed. When that happens, I try to focus on my family and friends, scrapbooking, or going to the gym. And I know what the consequences would be if I were to eat a meal as big as the ones I was used to: an entire frozen pizza, or a burger, fries, and a soda. The surgery rerouted food away from the part of the intestine that helps me digest sugar and carbs, so if I eat too much of them, I go through “dumping” — my body tries to get rid of what I just ate. I get sweaty and light-headed. And if I overeat anything, it comes back up.
“I’m a completely different person.”
I used to get dirty looks when I went out. Now people offer me drinks! I love the attention — I just eat it up. My weight had always made it too difficult to play sports. But today, I’m a hiker, a skier, and I’m training for a triathlon. I have everything I ever wanted, thanks to surgery, and I’m so grateful. I have respect for my body. I’m getting my MBA and I have a wonderful boyfriend. I want to be healthy, to have a family, and to be a good role model for them. That’s enough incentive for me to keep off the 100 pounds I lost. I keep my size 22s handy to remind myself of how far I’ve come.
What Cassie Learned to Do
Cassie Pisano, 28
Height: 5 feet 8 inches
Starting weight: 270 lbs
Current weight: 170 lbs
Pounds lost: 100
1 MAKE HEALTHY SUBSTITUTIONS. I keep a log of what I eat, and once a week I review everything I’ve eaten to figure out where I can make better choices. For example, I realized that I drink a lot of smoothies. But they’re high in carbs (a Naked Juice smoothie has more than 30 grams per serving!), so I’ve switched to Diet V8 Splash — only 3 grams of carbs per serving, and it satisfies the craving.
2 TAKE ADVANTAGE OF WHAT RESTAURANTS HAVE TO OFFER. Quiznos has 200-calorie sandwiches, and Starbucks now has lower-cal, sugar-free versions of everything. I still drink my Frappuccino — just a lower-calorie version, and I skip the whipped cream.
3 INSPIRE OTHER PEOPLE. I’m not going to eat the cupcakes at the birthday party just because everyone else is. I adjust my diet to fit my lifestyle, and hopefully other people see that and do the same. I like to think about helping others make healthier choices, not about what I’m giving up.
4 EMBRACE COOKING. Sundays are devoted to cooking. My boyfriend and I make food for the entire week, putting every dish into single-serve, calorie-controlled portions. It’s easy to just grab it and go, and we’re less tempted to go out and spend money on fast food during the week.
5 MAKE IT FUN. Buy a really cute gym outfit; make playlists of the music you like. Find little ways to encourage yourself to go to the gym and stay on track.
Is Weight-Loss Surgery For You?
Cassie knew that having a new body would require more than just surgery; it would require a new mind-set — a realization all patients must come to before going under the knife, says Robert W. Sewell, M.D., president of the American Society of General Surgeons. “Weight-loss surgery is not a quick fix,” he stresses. If you’re considering surgery, Sewell suggests asking yourself: 1. Am I serious about losing weight? 2. Am I ready to make the lifestyle changes it takes to be successful? 3. Am I willing to commit the necessary time and resources? 4. Do I feel this is the best option for me?
If you answered yes to all four questions, start educating yourself about the different types of bariatric surgery. Gastric bypass is the most common; other options include lap band and stomach stapling. Keep in mind that all surgeries carry serious potential health risks and that generally only patients with a body mass index of 40 or higher (considered “morbidly obese”) are eligible. Check out the American Society for Metabolic & Bariatric Surgery website, asbs.org, to learn more.