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I didn't want to go to this obesity lecture. I was not the only obese person in the room, and I was afraid that everyone would be staring at me. And then I saw the first slide of the lecturer's presentation with the slogan: "TRUE: you are obese, so you eat too much and move too little." I thought: I love this guy! A year later, I underwent a bariatric surgery. Now, as a doctor certified in the treatment of overweight and obesity, I help other patients.

Here is our heroine: drug. med. Beata Koszewska-Jóźwiak, a specialist in family medicine. She founded and runs a he alth clinic in Łyszkowice in the Łowicz district. When I ask her to talk about her obesity disease, she agrees right away. He knows that many women could subscribe to her story. He visits them almost every day in his office. It is for them that she joined the National Certification and Accreditation Program of the Polish Society for the Study of Obesity. To help them in the reliable treatment of overweight and obesity.

Sweet and s alty start

I've never been that skinny. But I wasn't "plump" or fat either. Height 180 cm, a little more fat on stomach and hips. I was just a tall, solid woman.

I started gaining weight when I finished my studies at the Medical University in my hometown of Lodz and started working. I did an apprenticeship in a hospital in Łowicz, but also at a he alth clinic in Domaniewice. I also got a business flat there. It was then that I had problems with compulsive eating under stress. First, something sweet, and when it "made me sweet", I grabbed something s alty, e.g. yellow cheese.

Mom "hungry"

I was already married and the mother of one son. When I was 28, I got a second pregnancy. While with the first one I didn't gain anything above the norm, the second one was completely different. I was always hungry. There were times when my hunger drove me out of bed at night. I gained weight up to 92 kg. I thought it was a lot.

My second son was born weighing almost 5.5 kg. The symptoms that I observed in myself would indicate that during pregnancy I had glycemic disorders, possibly even gestational diabetes, but at that time, in the early 1990s, glycemic parameters were not checked in pregnant women. Afterin childbirth, I was diagnosed with an overactive thyroid gland. I even had a nodular goiter surgery. Then, by contrast, he developed hypothyroidism.

Threshold exceeded

In 1999, I divorced. The process was emotionally difficult. Sorry - I won't talk about it.

About the same time, on the wave of changes in the he alth care system, I took over the Non-Public He althcare Institution (NZOZ) and created my own he alth clinic. As you can guess - there was a lot of work to do with it: organizational, technical and reporting. I was in constant motion. Often tired, I fell asleep in the chair. And despite the fact that I started to gain weight "in power". Then I exceeded the "magic" threshold of 100 kg.

It was classic abdominal obesity, where fat is only deposited on the abdomen. My legs and arms were still slim. So the patients thought that I was in another pregnancy and, as is the case in a small town, began to wonder with whom. Would that, not with my ex-husband, because we lived together for some time after the divorce.

Suppressed awareness

Did I realize then that I am suffering from obesity? Well, I must admit, like many people, I thought that morbid obesity is when you weigh over 200 kg. And I didn't weigh that much. Well, I was taking 5 medications for high blood pressure and was always wet from sweating. Well, the fact that I had problems with glycemia and my back pains were so severe that I drove a car everywhere, even for short distances. And when I got out of it, I only used Nordic walking poles. Not for training, but for support. Because I was ashamed to use bullets.

I was over 50, weighed over 100 kg, and still thought I wasn't sick. The more that no one made it a problem for my obesity at work or at home.

I knew there were bariatric surgeries. I have had several patients after such procedures. And I admit that I did not have the best opinion about such obesity treatment. But in 2016, during a conference of the Polish Society of Family Medicine in Wrocław, I met a man who completely changed my perception of obesity as a disease and myself as a sick person.

"I want you to operate on me!"

I didn't want to go to this lecture. I was shocked when the previous speaker spoke about obese people as animals deprived of their own will. I did not want to suppress tears of humiliation once again. I wasn't the only doctor at the conference wearing a size 56, but I was afraid everyone would be looking at me. However, I succumbed to persuasionfriends.

I remember this scene as if it happened quite recently. Behind the lectern for lecturers stood a handsome, similarly to me an above-average tall doctor - dr hab. n. med. Mariusz Wyleżoł, one of the most experienced Polish bariatric surgeons. He showed the first slide: " FALSE: you eat too much and move too little, which is why you are obese. TRUE: you are obese, so you eat too much and not move enough”. And I thought:Finally someone who speaks wisely about obesity. Well, I love this guy!

After the lecture, I broke through the garland of listeners who came around Dr. Wyleżoł and said loud, hard and with a joke that I also never missed: -I want the Lord to operate on me. Because I want to dance the Argentine tango and my stomach bothers me!

Operation: operation

It was 2022. After full diagnostics, I was waiting for the day of my bariatric surgery, when suddenly the news came that Dr. Wyleżoł had broken his arm and would not appear in the operating theater for a long time. I didn't want to wait, so I started gathering opinions about other bariatric surgeons and other hospitals. I chose Dr. Cywiński from Łódź.

May 25, 2022 I had a sleeve gastrectomy. I was 53 years old and weighed 122 kg. My BMI (body mass index) was less than 40. I was obese of the 2nd degree, but I was qualified for the procedure because of numerous complications of obesity.

I am a doctor, but I must admit that I was afraid of surgery. Not the medical aspects. I knew if there were complications they would just happen. I was afraid that I would be this exceptional case of a patient who would not lose weight after surgery. Fortunately, I have such a character that when I decide to do something, I implement it without looking back at my fears.

The operation was performed on my laparoscopic technique. The leak test of the clipped stomach is performed by Dr. Cywiński while still on the operating table, injecting blue contrast fluid. I know that the test was not completely successful and additional stitches had to be applied. It's clear that I woke up weak and sore after the surgery, but I wasn't nauseous. Shortly after waking up, I was spied, dressed, and went to the bathroom. I returned home on the second day after the surgery.

I'm losing weight

My staff knew I was going for a bariatric surgery. We arranged the schedule so that my absence would not disturb the functioning of the clinic. I returned to work 2 weeks after the surgery. First only for the afternoon, then for the whole day. I had no problems with changing my diet. I did not get tiredalso seeing that someone is eating something that I cannot or do not want. I was most happy that I didn't sweat anymore and my hair wasn't coming out. And because I'm losing weight! All in all, I've lost 32 kg since the surgery.

I didn't openly tell my patients about the surgery, but when someone asked, I confirmed it and didn't make a big deal out of it. Sure, I was glad to hear the compliments that I look beautiful. I also noticed that people started looking at me with more sympathy. But not because I have less body fat. Rather because I have more energy and am kinder now. I used to be a real bitch. I was hungry and angry on all these diets.

More life

Yes, after the surgery, both me and my life have changed. Medically: I only take 1 drug for high blood pressure. Physically: I'm in much better shape. I go for long walks with my friend's dog and are not accompanied by wheezing and back pain. I often go on longer trips without fear of not being able to walk. I also dress differently - in more fitted clothes.

I became interested in a new medical discipline - lifestyle medicine. I have found out that with chronic diseases (such as my obesity) or recurrent infections, an important aspect of treatment is lifestyle change. Together with others, with active ladies from Łyszkowice, we created the Rural Housewives' Association. We promote he althy cuisine in our activities, but also implement such ambitious projects as, for example, the one concerning the planetary diet. Well, I was always drawn to social work, but I used to have neither the strength nor the idea for it …

To help other obese patients

I am a doctor, I am obese myself, but I knew little about the treatment of this disease. Except for bariatric surgery, maybe. But it's a treatment for the last stages of obesity. But what about other patients …?

The treatment of obesity is not about waiting until the disease is so advanced that the patient can only be sent "under the knife". Thanks to Dr. Wyleżoł's lecture and conversations with him, I understood that it is more important to treat obesity as a "mother's disease", and not the complications of obesity itself.

There is no specialization in the so-called obesitology - obesity treatment. But there is the National Certification and Accreditation System of the Polish Society for Research on Obesity. I signed up for training and obtained such a certificate. If there was a specialization, I would love to do it.

Transformation

It's not physical, but mental. And not me as a human being, but me as a doctor. BeforeI had obese patients with my bariatric surgery. And like many other doctors, I looked at them and thought:nothing can be done here . I thought obesity was the patient's fault, and surgery was a "shortcut". Another thing was that I wasn't credible to my patients. When I tried to explain to a patient, for example with pain in the knee joint, that he must relieve this joint and lose weight, I heard:But you are fat yourself, what do you tell me such things . In fact: if I myself was not aware that I was sick and that I was not motivated for treatment, how could I pass them on to patients?

Are patients willing to heal obesity? Not. First, because it is still difficult for them to understand that obesity is a disease. Mostly, they don't want to talk about it. And if anything, they say that "they are fine as they are" or that "their beauty":some are bald, others have humps on their noses, and I am fat / fat. And secondly: when they hear that it is a disease, they want some magic pills, syrups, ointments, and there are no such.

Obesity is a complex chronic disease. To use medical terminology: no self-resolving tendency. This means that if we do not treat it, it will not pass by itself. And treating obesity is not about losing weight: sudden, violent, once in a while. But for treatment. And from the first stage, that is, being overweight. And this treatment must start with a complete change in the perception of obesity and such aspects of life as nutrition, physical activity, weight control, etc. I made this change in myself. I wish her to you too!

Obesity is a disease
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Obesity has been officially recognized as a disease by the World He alth Organization. Obesity has reached epidemic proportions in Poland. Already 700,000 Poles with third degree obesity need a life-saving bariatric surgery. A bariatric patient requires the interdisciplinary care of specialists in the fields of surgery, psychology, dietetics and physiotherapy.

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Poradnikzdrowie.pl supports safe treatment and a dignified life of people suffering from obesity. This article does not contain discriminatory and stigmatizing content of people suffering from obesity.

Magdalena Gajda A specialist in obesity disease and obesity discrimination of people with diseases. President of the OD-WAGA Foundation of People with Obesity, Social Ombudsman for the Rights of People with Obesity in Poland and a representative of Poland in the European Coalition for People Living with Obesity. By profession - a journalist specializing in he alth issues, as well as a PR and social communication specialist,storytelling and CSR. Privately - obesity since childhood, after bariatric surgery in 2010. Starting weight - 136 kg, current weight - 78 kg.

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Obesity