Darnall Nutrition Services patient embraces healthy eating plan; foregoes Lap Band surgery

By Ms. Patricia Deal (Army Medicine)March 13, 2012

Coco Hopkins gets advice from CRDAMC dietitians, skips surgery
1 / 3 Show Caption + Hide Caption – At 265 lbs. and suffering from related health issues, Coco Hopkins was considering Lap Band surgery. She opted to try a healthy eating plan under the guidance of CRDAMC Nutrition Services and lost 45 lbs. in 10 months, plus her blood pressure is back... (Photo Credit: U.S. Army) VIEW ORIGINAL
Patient enlists help of CRDAMC dietitians to lose weight; gets healthier
2 / 3 Show Caption + Hide Caption – Coco Hopkins (right) discusses portion sizes with Ruth Manuele, registered dietitian with CRDAMC's Nutrition Services. Hopkins was considering Lap Band surgery, but opted to try a healthy eating plan under the guidance of Manuele, and lost 45 lbs. i... (Photo Credit: U.S. Army) VIEW ORIGINAL
Husband encourages wife to lose weight, get healthy
3 / 3 Show Caption + Hide Caption – Coco Hopkins (right) shows off her new weight to husband Jesse. Hopkins was considering Lap Band surgery, but Jesse urged her to try a healthy eating plan first. She lost 45 lbs. in 10 months, and is still losing. (US Army photo by Patricia Deal, CR... (Photo Credit: U.S. Army) VIEW ORIGINAL

FORT HOOD, TX -- We've all heard the late-night infomercial adds promoting miracle weight loss options guaranteeing you can lose 50 percent or more of excess weight in the first year, or live the life you want for as little as $8 a day.

Think these promises are too good to be true? So do the dietitians at Carl R. Darnall Army Medical Center who warn there is no quick fix for losing weight. There is no 'magic pill', nor is surgery a simple solution.

"I thought that lap band surgery would be the way to go for me," admitted Coco Hopkins, a 53 year-old Army spouse who struggles with her weight. "I had even met with the doctor."

But her husband, Jesse, a retired non-commissioned officer, was not sold on the idea and researched the risks involved and what happens after the surgery.

"It wasn't good. They don't advertise the risks as much or go into detail about the complications. Lap band patients still have to make major changes to their diets and deal with their emotional eating habits," he said.

Adjustable gastric banding (Lap Band) surgery is one of several types of bariatric surgical procedures used in the treatment of morbid obesity for adults. According to Food and Drug Administration (FDA) standards a patient must have a Body Mass Index greater than 40, or a BMI of 30 with a co-occurring health condition related to obesity, such as high blood pressure or diabetes.

However, TRICARE, Veterans Administration and DoD Clinical Practice Guidelines have not approved any weight loss surgeries for patients with a BMI less than 35 even with if they have a co-existing condition.

There's risk with any surgery, and although there's a very low mortality rate for Lap Band surgery, there is a still a possibility of minor or major complications. Any weight loss surgery can be unsuccessful if a person does not change their lifestyle.

"People are always looking for the easy way out. But you have to be ready physically and mentally to undergo weight loss surgery. I'm glad Coco came here instead because she had doubts about the surgery," said Ruth Manuele, registered dietitian with CRDAMC's Nutrition Services. "We've worked out a plan for her that has set her on the path to safe weight loss."

Coco weighed 265 lbs. and had high blood pressure and pain in her joints. Following the nutritional advice of Manuele, she dropped 45 lbs. in 10 months. Her blood pressure is normal, and the aches and pains are gone.

"I started the program as a way to show my husband that this wasn't going work and that I needed the surgery. He pointed out that I would have to make major lifestyle changes after the surgery, so why not try that first," she said. "In the first month, I instantly lost six pounds. I've been losing steadily each month. So, I have to admit that I was wrong. I can do this on my own, without surgery."

Manuele and Coco worked on correct portion sizes and making healthier choices in foods.

"It's been so easy. I'm not depriving myself of anything, just watching how much I eat," she said. "I am strict about following my guidelines. If I can have five pieces or four ounces of something, that's the amount I will have. The only drawback is that it takes longer to measure, weigh and count everything. But now it's second nature to me."

Another big lifestyle change for her was substituting more healthy choices for the typical fattening or unhealthy foods she enjoyed.

"For my home-made mac and cheese, I'm using healthier ingredients such as 2 percent milk and low-fat cheese and whole wheat pasta. I drink mostly water instead of soda," she said. "One of my bigger challenges was my weekly breakfasts with my church group. We have everything from grits, eggs, bacon, sausages, biscuits and fried potatoes. The group wasn't too happy about making healthy substitutions, but now that they see how much weight I've lost, they are coming around."

Food budgets are always a concern, and Coco said her costs did increase slightly. "It balances out though. I'm not spending as much money on chips and other snacks and soda. I often buy frozen vegetables which are as good as fresh but cost less."

Coco is good about sticking with the program. Even when they eat out, her husband said, she sticks to the diet, foregoing high calorie foods for healthy choices.

"I'm so proud of her. I really didn't want her to have that surgery, especially this late in her life. She's losing weight now and I don't have to worry about her," Jesse said.

Coco said she is committed to following the plan forever. Her goal weight is 150 lbs., and once she reaches that, she said she will still eat healthy to maintain it.

"I see many people just like Coco who think surgery or some fad formula will solve their woes. But in most cases, just making small changes in your diet can work wonders. Many of our patients who opt out of the surgery and follow a good dietary plan, end up losing 30-40-50 pounds or more. The best part is they did it the safe way with no risk. They adopted healthy eating habits that will stay with them for the rest of their lives," Manuele said.

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