Writer Biba Adams, before and after bariatric surgery (courtesy of Biba Adams)

On a break while shopping for Black Friday deals, a friend and I sat down for lunch in the Detroit suburbs. My friend quickly observed how I only ate half of my burger and picked over my loaded baked potato. I shrugged.

“Well, you know I had weight-loss surgery a couple years ago,” I said.

I’m not shy about telling people I had vertical sleeve gastrectomy surgery three years ago. I also advocate heavily for more women of color to consider it as an option. While millions of African-American women suffer from morbid obesity (and its attendant illnesses), we account for some of the fewest patients receiving this procedure.

For those who don’t know, vertical sleeve gastrectomy surgery is a type of bariatric surgery that removes part of the stomach, restricting food intake. It’s a minimally invasive procedure that reduces the stomach 80-85 percent, to about the size of a banana.

A study by the Journal of Internal Medicine, “Obese African-American Women’s Perspectives on Weight Loss and Bariatric Surgery,” states that black women rarely choose bariatric surgery as an option for many reasons, including lack of time and resources such as private medical insurance, as well as cultural issues, like identifying with larger body sizes. Other participants were concerned that surgery would be perceived by others as too extreme or cause them to have a lack of control over their food choices.

When I had VSG—or “gastric sleeve” surgery—the decision wasn’t made lightly. I have always been an overweight person. I was the only child of a single mom and was 11 years old when I started gaining weight; McDonald’s was a mainstay of my diet. I was also teased a lot in my youth, causing my self-esteem to take a beating during my formative years. Food became my primary source of comfort. By 11th grade, I weighed nearly 200 pounds.

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I’m not alone.

Doctors assert that 75 percent of overeating is caused by emotions. Consuming “comfort foods” can provide some relief from negative emotional states; however, emotional and binge eating ultimately lead to obesity, which then causes more depression and anxiety. It’s a vicious circle, to say the least. There are indications that the myth of the “strong black woman” has long contributed to the high rate of obesity among black women. Current estimates are that a shocking 82 percent of black women are overweight.

Like most overweight people, I tried all kinds of ways to lose weight. I had some success with Weight Watchers, along with experimenting with various shakes, pills and even shots. I exercised (sometimes) and went on fasts. Still, my weight fluctuated at between 200 and 250 pounds for years. Eventually I topped out at 274 pounds. In addition to the visual effects of my obesity, I was plagued with back and knee pain and an overall sense of fatigue. I was also prediabetic and had just started taking medication to stave off the disease. It was then that I began to research surgical options.

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But I was afraid, and a little ashamed. I wondered if people would think I was weak or lazy or that I had taken the easy way out. But most of all, I was desperate for change, so I did it anyway.

During the first year after my sleeve surgery, my life changed dramatically. I’d thought that I was prepared; I’d read books, articles and joined online support groups. Still, nothing fully prepared me for life after surgery.

A 2016 New York Times article explains that not only is the intestinal tract changed by any type of bariatric surgery, whether VSG or gastric bypass, but these changes also affect the more than 100 varieties of hormones regulated by the gut. These changes mean that tastes change—like my cravings for a whole pan of brownies. Not only do bariatric patients eat less, we desire less food. So it’s much easier to be satisfied after eating smaller portions.

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But what about all those warm fuzzy feelings I used to get from stuffing myself with chocolate or macaroni and cheese?

Without real work through therapy, many bariatric patients transfer their addictions. During my first two years after surgery, I found myself drinking alcohol more than I ever had prior, still chasing dopamine highs. According to the American Society of Metabolic and Bariatric Surgery, 15 percent of patients who drank in moderation saw an increase in their drinking habits after bariatric surgery. Doctors agree (and I echo) that psychotherapy is an important step prior to bariatric surgery. It’s vital to uncover the reasons behind emotional eating and to treat them in order to achieve the best outcome and avoid the transference of addictions.

In the three years since my surgery, I have lost nearly 100 pounds. My body has ultimately “settled in” at about 185 pounds. At 5 feet 8, my weight loss is significant, and I navigate the world in a noticeably smaller body. I have given away nearly two-thirds of my clothing—even my shoes are a half-size smaller. Where my fat was once a place to hide from the world, I now earn compliments on my figure. Bariatric surgery is an adjustment that affects more than just weight, but it has given me a better quality of life.

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Bariatric surgery motivated me to address the source of my food issues through therapy and helped me develop tools to improve my life. I now get my dopamine highs from walking a few miles a day, and I am falling more and more in love with the woman in the mirror—not just because of how I look, but because of how I feel.