How I lost 100kg

By admin
02 September 2009

After successful gastric bypass surgery and an extreme lifestyle makeover Durbanite Yusuf Rawat is living and loving his healthy new life. He may have won the battle of the bulge but one thing remained: to surgically remove the stretchedout skin that stayed behind after the fat melted off his body …

By Debbie Reynolds

He’s the really fat guy at the gym. The man you try to avoid looking at for too long or too hard. But as terrible as it sounds he probably makes you feel a bit better about yourself as you slog away on the step machine. Why? Because, regardless of how many extra kilos you’re carrying at least you’re not that bad.

He is Yusuf Rawat and he weighs 115 kg. Sound like a lot? Well, not too long ago this 30-year-old from Durban tipped the scales at a whopping 215 kg. His 100 kg weight-loss journey has been one of courage, commitment and raw determination.

It all started in 2005 when his life was at an all-time low. Yusuf had just completed a marketing diploma and hit the job market only to have many doors slammed in his face.

“I was always short-listed for interviews,” he says. “But as soon as they saw me I knew I was doomed.” Yusuf suffered from low self-esteem which has dogged him since childhood and was morbidly obese due to a long history of bad eating patterns, no exercise and unknowingly suffering from bipolar disorder which led to binge-eating.

All these factors converged to convince him he had no reason to continue living. So on a Saturday in September 2005 he swallowed 100 painkillers. Yusuf’s parents found him soon afterwards and he was rushed to hospital just in time.

“It was here that I met a caring and understanding psychiatrist, Dr Keshika Singh, who diagnosed me with bipolar disorder,” Yusuf says.

“When I was depressed I ate. But at last there was a reason for my obesity and therefore, hopefully, a cure.” He describes bipolar disorder as “K3G”, the abbreviated Hindi title of the Bollywood movie Kabhi Khushi Khabie Gham, which means sometimes happy, sometimes sad.

“Half the problem is solved with medication and the other half with counselling,” he continues. “But Keshika treats the symptoms as well as the problem. She has taught me that I can change myself.”

As Yusuf’s mental health improved Dr Singh suggested he consider gastric bypass surgery which in layman’s terms means creating a smaller stomach pouch (about the size of a wine glass) that is separated from the rest of the stomach.

This smaller stomach significantly reduces the amount of food that can be consumed. It also has a newly created outlet that bypasses the rest of the stomach and smaller intestine, resulting in fewer kilojoules being absorbed as food passes through the body.

According to the South African Society of Obesity and Metabolism (SASOM) the procedure results in a feeling of fullness that reduces the desire to carry on eating. But after surgery the patient needs to stick to a prescribed eating plan for life – or risk feeling nauseous from overeating.

In some cases the diet needs to be supplemented with multivitamins and a few patients may suffer low blood sugar levels that could lead to blackouts.

Although gastric bypass surgery is an established and effective extreme weight-loss aid that medical aids pay for if a patient’s morbid obesity is considered life-threatening, Yusuf, who didn’t have medical aid, had no way of finding the R80 000 needed for the procedure. “But Dr Singh said she would motivate for it to be done at a government hospital,” Yusuf says.

“And on 22 May 2006 I said hello to a new beginning.” Before the surgery Yusuf had to undergo numerous tests and evaluations with a multidisciplinary team from Durban’s Inkosi Albert Luthuli Hospital – an endocrinologist, laparoscopic surgeon, anaesthetist, plastic surgeon, dietician, biokineticist and psychiatrist.

“There are risks in having the operation. But the risk of not treating morbid obesity is actually far greater,” Yusuf says. “For me there was simply no option.”

Yusuf’s story continued with a radical change in diet, exercise and attitude. As a child he’d tried several weight-loss treatments with little or no success.

“My mother put me on plenty of diets including Weigh-Less at the age of six*. Then there were all the slimming pills. But nothing worked. If I lost weight I just piled it back on. In high school I even had my jaw wired but the wires soon snapped so that was a waste of time.”

By the time he matriculated Yusuf weighed a staggering 170 kg. His typical lunch was a junk-food jamboree, comprising a fizzy cooldrink, a cream doughnut, a chocolate éclair, two rolls, a packet of chips and two ice creams. But he gained another 45 kg before what he calls his “rebirth”. He was 27.

Immediately after the procedure Yusuf started to lose weight. Six weeks later he got a job as a marketing manager. “Suddenly people were laughing with me rather than at me. When my pants fell down at work the staff applauded then rushed to help punch extra holes in my belt. My pants size dropped from a 10XL to an XXL.”

Of course, losing such a vast amount of weight brings its own set of problems – one of which is excess stretched skin that often needs to be surgically removed. Yusuf had to undergo two operations to remove excess skin.

To help with his weight-loss Yusuf enrolled with a personal trainer. “My trainer, Michael Reimers, helped me to lose another 30 kg after which I could have the second skin-removal operation. I do cardiovascular and weight training five days a week and I’m much more energetic now.”

His diet, planned by a dietician, has also changed radically. On an average day he’ll have oats or bran cereal for breakfast, grilled chicken, salad and a slice of bread for lunch, and fish or chicken with grilled vegetables for dinner with fruit and yoghurt in between.

“I’m allowed to cheat every now and again,” he says. “But my life doesn’t revolve around food any more.”

Yusuf may have hit his thirties but he feels as if his teens have only just begun. He has a lot of good years and good times to catch up on. “I still have to lose about 25 kg to reach my goal weight but I will get there,” he says resolutely.

Although he still hasn’t finished his journey to health he has goals to strive for and aspirations to fulfill.

“I want to go swimming without my T-shirt for the first time in years,” he says with a laugh. “I want to learn to play tennis and squash. I want to wear fashionable clothes. I want to travel. And I want to know what falling in love feels like.”

*Weigh-Less recommends their eating plan only for children from age nine.


Excess skin removal

Losing a large amount of weight generally results in massive folds of excess skin that don’t shrink in relation to the body weight lost. This redundant skin is found around the abdomen, waist, upper leg, upper arm and breast or chest areas.

In Yusuf’s case two operations were necessary to remove his excess skin. The first procedure in July 2008 removed skin from the abdominal area which Yusuf says was like an apron hanging from his waist.In June this year he underwent surgery to remove skin from his chest and arms.

Both operations were conducted at Inkosi Albert Luthuli Hospital by Professor Anil Madaree, head of plastic and reconstructive surgery at Nelson R Mandela School of Medicine.

Professor Madaree, who was part of the multidisciplinary team that treated Yusuf, stresses the importance of a patient’s real commitment to losing weight and changing his lifestyle because this is a complicated process that starts long before the gastric bypass operation and continues almost indefinitely.

“Thanks to the team I was properly educated, prepared and supported,” Yusuf says. But there were certainly challenges. For instance, after his second skin-removal operation Yusuf needed to be hospitalised for about 10 days.

“It was more complicated than just removing excess skin,” Professor Madaree says. “Morbid obesity in men can cause abnormal enlargement of the breasts, known as gynaecomastia. Yusuf’s surgery required breast removal and the reduction and replacement of the areolas.”

Yusuf’s areolas, the skin surrounding the nipples, were extended because of the large breasts. They were removed, then made smaller and replaced to fit with the smaller breasts. Skin also had to be removed from his chest and upper arms.

“The excess skin was cut off and great care taken to place the scars in acceptable areas,” Professor Madaree says. “The wounds also have to be stitched very finely.” That’s why this procedure takes two to three hours under anaesthetic and recovery has to be strictly monitored.

Calculate your BMI

BMI is considered a useful tool for assessing body weight and health – although it should not be used in isolation. For instance, it overestimates body fat in athletes and those with muscular builds but underestimates body fat in older people who have lost muscle mass. It should also not be used for children.

To calculate your BMI multiply your height in metres by your height in metres. Write it down. Now divide your weight in kilogram by this number. This gives you your BMI.

Generally, if your BMI is below 18,5 you’re underweight. If it’s above 25 you’re overweight and if it’s over 30 you can be classified as obese. Morbid obesity is indicated by a BMI of 40 or more.

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