Suzanne’s Gastric Bypass Transformation

When Suzanne Marques had gastric bypass surgery at Salem Hospital in December of 2022, she’d been almost too healthy to qualify. Though her top pre-surgery weight was 304 pounds, she was 5’ 10” and an avid hiker in her early 30s.

She had none of the conditions typically seen in many people with overweight or obesity, such as diabetes and high blood pressure. However, she did experience joint pain and had other health issues, including sleep apnea and polycystic ovary syndrome (PCOS), that had affected her for some time.

Jaime Alfredo Rivera, MD, a Mass General Brigham bariatric surgeon at Salem Hospital, regards Suzanne as another success story for the hospital’s Surgical Weight Management Program. She had no major complications from the gastric bypass procedure. And a year after surgery, she weighed almost half of what she had in December 2022.

Polycystic ovary syndrome and modern weight loss drugs: Not a solution for everyone

In her early 20s, Suzanne was diagnosed with polycystic ovary syndrome (PCOS). PCOS is a hormone disorder that affects the reproductive system. It can affect appearance, too, and increase the risk of obesity, diabetes, and heart disease.

Suzanne says PCOS was at least partially responsible for her struggles with weight from the outset. PCOS causes many hormonal issues related to metabolism and healthy sleep. Metabolism is the process your body uses to get or make energy from the food you eat. She struggled with PCOS for 12 years prior to having gastric bypass surgery.

“I always tried to exercise and eat the right foods, but my weight kept creeping up on me,” says Suzanne. “And even when I started hiking, I did lose a little bit of weight, but then I kept gaining weight again. I was like, what is going on?”

Before her gastric bypass surgery, Suzanne tried a few modern weight loss drugs, but she says they didn’t work for her.

“I didn't like them at all,” she says. “They made my mouth super-dry and sped my heart up a bit. I was injecting myself with that stuff for a while, and I was like, ‘what am I doing?’”

Qualifying for surgery with a sleep apnea diagnosis

Eventually, Suzanne researched weight loss surgery and found her way to Salem Hospital. The location was a convenient option for her as a resident of Ipswich, Massachusetts, 25 miles to the northeast.

Suzanne didn’t have typical chronic health conditions many people with overweight or obesity have, like diabetes or hypertension. However, a diagnosis of sleep apnea finally secured Suzanne her spot in the Salem Hospital program. She had completed a required home-based sleep study through the hospital, which revealed she had the condition. 

Patients with sleep apnea can wake up out of breath. It occurs when their body stops and restarts breathing, or they breathe irregularly during sleep. Sleep deprivation from sleep apnea can lead to insulin resistance and obesity. It also makes it much harder to lose weight and keep weight off.

Suzanne had struggled to sleep for years and had attributed it to general anxiety or other mental and emotional stresses. Sleeping on her back, specifically, caused problems, largely due to her size and weight. Once Suzanne learned she had sleep apnea and qualified for surgery, she took the next required steps. She followed the weight loss program’s nutritional guidelines and completed the required psychological evaluation. She lost 45 pounds on her own before surgery.

Experienced weight loss surgery team sets patients up for success

Dr. Rivera’s experience in the field was a comfort for Suzanne. He’s performed over 1,000 bariatric surgeries. Dr. Rivera has practiced at Salem for 24 years and acted as director of the program for 5 of those years.

“We have an organized, class level 1, certified program that's been in place since the onset,” he says.

“Currently we do the sleeve gastrectomy, the gastric bypass, and revision cases,” Dr. Rivera says. Revision surgeries typically correct previous surgeries that haven’t yielded ideal results, often from procedures like gastric banding that few surgeons perform anymore. “I do revisions personally,” he says, “I do a lot of gastric sleeve to gastric bypass for severe reflux revisions.”

The gastric bypass surgery that Suzanne had is more complex than the gastric sleeve, which is a purely restrictive procedure (nothing is removed or re-routed). But Dr. Rivera says the bypass has an advantage in that the sleeves are less likely to resolve issues like reflux.

“Reflux is difficult to predict,” he says. “In both operations, it can improve. However, it's much more likely to improve with a gastric bypass than it is with a sleeve.”

Weight loss improves sleep apnea

Suzanne’s sleep apnea improved after her gastric bypass surgery.

“I had such trouble trying to stay asleep through the night to the point where I was on an antipsychotic medication,” she says. “I had a medical marijuana card just to be able to stay asleep too. I was desperate to find anything to keep me asleep.“

Suzanne says following surgery, she now sleeps through the night without medical marijuana or medication.

Weight loss impact on PCOS

According to Suzanne, the gastric bypass surgery was nothing short of life-changing. The constant up-and-down weight gain and loss she’d experienced with her PCOS stopped, as did many of the other hormone-related symptoms of the condition. For many people, PCOS can cause an entire range of problems related to the ovaries, menstruation, and skin. These symptoms can seriously affect quality of life, in addition to weight-related struggles, which are also common.

“It’s the only treatment I would suggest for anyone who's struggling with PCOS and being overweight,” she says. “It has changed everything.”

Spreading the word about PCOS and weight loss surgery

Suzanne has no regrets about her decision to have gastric bypass surgery, other than not having it earlier.

She had a few minor side effects from her gastric bypass surgery. One of these was a small hiatal hernia, a condition where part of the stomach bulges through muscles in the upper abdomen. Some hernias like these can require surgery to repair, but Suzanne says hers resolved on its own.

To address another side effect, Dr. Rivera will remove Suzanne’s gallbladder. Following gastric bypass surgery, the gallbladder works overtime to process fats. This can often lead to developing gallstones. Gallbladder removal is a common procedure and in most patients has a minor impact on their future lifestyle.

“I wouldn't go back and change it for anything. Even with the complications, it’s been worth it. You learn so much about who you really are, doing all the psych evaluations and sticking to the diet.”

Since her surgery, Suzanne has become an advocate for raising awareness about PCOS.

"I think a lot of women have this condition and don't even realize it," she says. "There are so many symptoms that are associated with PCOS that might get misconstrued or misdiagnosed as something else."