Ortonville- At his heaviest, Tim Dibble weighed 467 pounds.
He worried about breaking chairs, was unable to sit in restaurant booths, was uncomfortable in movie theater seats and bought seat extensions for plane rides. His weight even determined the car he bought.
Emotionally, his feelings were hurt by jokes and comments people made about his weight. Physically, his knees hurt, his feet hurt, he had water retention problems and his blood pressure was spiking.
‘Just getting out of bed was painful,? says Dibble, 46, who is married and has two stepchildren. ‘I said, ‘I can’t live like this anymore.??
Last fall, the 5?9? pastor of Ortonville United Methodist Church went online and began researching bariatric surgery. On March 17, he underwent gastric bypass.
The operation involves stapling a small part of the stomach away from the rest of the stomach, says Dr. Mark Pleatman, the laparoscopic surgeon who performed Dibble’s surgery. The small intestine is attached to the small pouch created from stapling and food bypasses the lower part of the stomach as it passes into the intestine.
‘It (the pouch) doesn’t take very much food to fill it up,? says Pleatman. ‘We’re not bypassing the stomach for any reason other than to make it tiny. By bypassing the stomach, we get rid of hunger. They (gastric bypass patients) can only eat a small amount of food. Within a year, patients that are 100 pounds overweight, will lose 70-80 pounds.?
Dibble is well on his way to shedding his excess weight, losing 36 pounds in the first 24 days following his surgery and almost 100 pounds since the end of November, when he first began dieting.
Dibble was not an overweight child. He was active, playing football, basketball, baseball, tennis and golf. When he graduated from high school, he weighed about 187 pounds, but lifted weights and was physically fit. He gained some in his early 20s, but was still very active. It was when he reached his mid-20s that his lifestyle changed, and his weight increased.
‘I was working long hours and got into real estate development,? says Dibble, who describes his father as fit, but notes his mother has always struggled with her weight.
‘It was stressful. To deal with it, I ate a lot. I spent lots of time in hotels. It was not a healthy lifestyle.?
The first 40 or 50 pounds he gained slowly, Dibble says, then, ‘it just got out of hand.?
By the time he approached 30, he was really struggling and tried a number of diets, including low carb, Weight Watchers, and calorie-counting.
‘They all worked, but my life circumstances kept changing,? Dibble says. ‘I moved or changed jobs. My life was not regimented.?
At 31, he joined the ministry. He traveled a lot and ate fast food, processed food and often ate in the car.
He moved to England and as a single minister, says he was constantly fed.
‘People take it for granted that because you’re bigger, you want to eat more, which isn’t true,? Dibble said. ‘But because you’re a guest, it’s hard to say no.?
Dibble would lose weight and put it all back on again. At one point, he lost 70 pounds by working with a doctor and going to the gym, but then hurt himself at the gym, got pneumonia and put all the weight back on, ‘plus some.?
On Jan. 9, Dibble had an appointment with Pleatman, who is director of bariatric surgery at North Oakland Medical Center and also performs laparoscopic surgeries, including gastric bypass, at St. Joe’s Hospital in Pontiac.
Dibble met the insurance requirements for gastric bypass? he was morbidly obese (generally, 100 pounds or more over a person’s ideal weight); he was in generally good physical condition and not too old; and he had tried losing weight by dieting for 12 consecutive months.
‘This is not the easy way out,? says Pleatman. ‘You have to have tried and failed every other way before you can try this operation. In spite of how good this surgery can be, it can also go wrong. When you’re morbidly obese and something goes wrong, you can spend a million very easily.?
The odds are on the patient’s side. Pleatman says the main risk with gastric bypass is leakage where the staples aren’t holding, which can result in an infection. This complication is a two-percent risk, while the risk of death is less than .6 percent.
?(Gastric bypass) has very, very safe results,? says Pleatman, who has performed 172 gastric bypass surgeries in four years. ‘More people are accepting it… You live longer if you lose weight rather than staying fat.?
Pleatman notes that excess weight causes a variety of medical problems, including high blood pressure, sleep apnea, diabetes, high cholesterol, arthritis, and incontinence.
On March 17, after having lost another 30 pounds in two months, Dibble had the life-changing surgery that would reduce his stomach to about the size of a large egg. Just two days later, he went home. Within nine days, he was released for full activity.
‘I never experienced any pain, other than my back hurting from lying on the steel table,? Dibble says.
Now, he is never hungry and has to be reminded to eat. He can’t drink liquids during meals or for a half-hour before or after eating, because there is no room in his stomach. He can no longer drink from a straw because he could take in air, for which there is no room. He chews the 3-4 bites he takes for each meal 25-30 times, until the food is chewed to ‘nothingness.?
‘Food still smells and sounds good, but I’m not hungry,? says Dibble. ‘I’m not tempted to eat, I have to remember to eat.?
Dibble also no longer eats sweets. Pleatman explains that people who eat sugar after having a gastric bypass suffer from ‘dumping syndrome,? where sugar that goes directly into the intestine causes nausea, dizziness, and queasiness.
‘People learn if they eat sugar, they get sick,? Pleatman says. ‘Ice cream or pop can make you ill.?
He notes this is what some people need.
‘People eat because it’s a final pathway of happiness,? he said. ‘We want to change them so they get happiness from something else? shopping for clothes and feeling good about themselves. Gastric bypass is a tool to help people lose weight… They can eat what they like and not be hungry all the time.?
Pleatman says this can also cause some challenges. Losing four to five pounds a week for the first month or more makes patients tired and they must focus on getting enough calories. Persons who have had gastric bypass must also take vitamin supplements for the rest of their lives.
On average, Pleatman says patients lose 80 percent of excess weight the first year after surgery and maintain their weight after that. Another 10 percent is commonly lost by second year. The average weight loss is 100 pounds, but people who are more than 100 pounds overweight can lose more, although they may not lose all the weight they want and he notes that it is possible to gain weight back as the pouch stretches, although the percentage of people gaining weight back is small. Long-term, individuals may put 20 pounds back on.
‘The tool is still with them, but they can learn how to cheat it,? Pleatman said. ‘People who have an eating disorder will figure out how to eat. We’re trying to help them fight it, make it harder to fail.?
Dibble says he is committed to making his surgery work. He is looking forward to being more active and joining a gym.
He also has some other plans? he can’t wait to be able to ride roller coasters again and says Cedar Point is on his list. He wants to buy a Mustang GT eventually and would like to ride a bike again, which he hasn’t done for years.
He wants to go hunting, fishing, camping and golfing and, perhaps most importantly, he says, ‘I want to live long enough to spoil my grandchildren… This surgery means freedom. It’s a victory.?