Dr. Patricia Arnett has spent 25 years fighting a battle familiar to many Americans — her weight.

Arnett, an obstetrician-gynecologist with Advanced OB/GYN Associates in Butler, saidthat through the years she tried diet after diet but always ended up gaining what she'd lost plus a few pounds more.

"Its seems like whenever I would get to the point that I was feeling better or people were beginning to compliment me on my weight loss, I would quit," she said.

Arnett said despite her academic, professional and family success, she had self-esteem problems that undermined her weight-loss efforts.

By the summer of 2003, Arnett weighed 295 pounds.

"I knew I would never be able to keep the weight off without help," she said.

So she turned to gastric bypass surgery, which reduces the size of a patient's stomach and bypasses much of their intestines to cause weight loss.

A major surgical procedure, gastric bypass holds potential complications and risk to life.

But for Arnett and other morbidly obese adults in the United States, the risks are small in comparison to living their lives with sometimes hundreds of extra pounds.

"I had gotten to the point that I would rather die trying (the surgery) than to live another 20 years like this," Arnett said.

Dr. Tony Maalouf, a Butler surgeon who specializes in bariatric surgeries, which includes gastric bypass, recently explained the bypass procedure reduces the size of a patient's stomach to a small pouch that can only hold tablespoons of food at a time.Then much of the patient's intestines are bypassed, giving the body less time to absorb food.Maalouf did not perform Arnett's surgery, but he did help her find a surgeon. Arnett said they are good friends and because of their relationship, she saw a surgeon in Pittsburgh instead.But before Maalouf considers a patient for gastric bypass, he studies the patient's ability to lose weight through other means like diet, exercise and new prescription weight loss drugs."Once we determine that those methods will not work for the patient or if the patient is morbidly obese and had other life-threatening conditions, such as diabetes or high blood pressure, then we begin testing them for bariatric surgery," he said.The surgery is not just a matter of finding a surgeon and scheduling the procedure."We have to find out if the surgery will truly help the patient and if the patient has the ability to do what is necessary to make the surgery successful," Maalouf said.These tests include a complete psychological profile, cardiovascular assessment, overall medical checkup and consultations with a dietician.Patients who pass these tests are recommended to their insurance company for the procedure.While waiting for insurance company approval, patients will meet a dietitian to begin work up to six months before the surgery is performed."If they begin changing how they eat before surgery, patients usually find it easier to comply with the diet restrictions after the surgery," said Carol Landis, a therapeutic dietitian with Butler Memorial Hospital.She also explained that besides changing eating habits, gastric bypass patients will find more success if they begin an exercise program as soon as possible."Exercise also helps with the skin issues patients may have after they started losing the weight," she said.Landis explained that as people who are hundreds of pounds overweight begin to shed the fat, their skin begins to sag — a condition that can ultimately lead to surgery to remove the excess skin, which is usually not covered by insurance.Exercise can help the body re-absorb excess skin by adding to the elasticity of the skin.Finally, Landis said, Butler Memorial Hospital offers support groups for gastric bypass patients and their families."This surgery completely changes a person's life and these groups give patients someone who understands what it is like to only be able to eat a spoonful or two at a time," she said.

Arnett said that after her surgery she "felt like a freak" because of how little she could eat at a time, but that has gotten better along with the rest of her life and her self-esteem.She had been healthier than a lot of people whose last chance, as Landis called it, is gastric bypass."I had been on high-blood pressure medication and that night I went off it and have never needed it since," Arnett said.When she got home, the weight began to "melt off of me," Arnett said. "It really was amazing, but then again what the surgery does is essentially put you in a state of starvation."Gastric bypass patients can eat so little and with so few calories actually being absorbed, the body is forced to burn its fat stores."Some people think that you get dizzy or nauseous or weak without food, but it was amazing to me that I didn't feel those things and that I didn't feel hungry all the time after the surgery," Arnett said.Also, before having the surgery Arnett hired a personal trainer from the Butler County YMCA in Butler to help her begin stretching and exercising — a relationship that lasts to this day."People will say they can't afford a personal trainer, but think of it this way — after the surgery you aren't going to be eating near as much as you were and you will be saving on your food bill, so spend some of that savings on a personal trainer," Arnett said.She said a trainer takes the responsibility for having to exercise off of her shoulders."I think, 'I'm spending money on this, so I must go exercise,' or that there is this person who is waiting for me to show up and exercise, so it's not all on me. I don't have to rely on my willpower alone to exercise," Arnett said.Efforts to stick with dietary and exercise plans post-surgery have paid off for Arnett, who has lost 150 pounds in about a year and a half and who barely has any skin that needs to be addressed by other surgeries.Now a fit 145 pounds, Arnett runs races and last summer bicycled 150 miles over two days from Cranberry Township to Conneaut, Ohio, raising money for multiple sclerosis.She said one of her favorite teachers in grade school had MS and she wanted to honor that woman."But also it was doing something on my own. Those 150 miles are very hilly and it was really, really hard, but as I neared the end of the route I started to cry because I had done something that just a few years ago I would have thought impossible."I bicycled those miles — no one did it for me," she said, "and I finished."While Arnett has worked and continues to work on her fitness, she also knows that without gastric bypass she would not be where she is today."If I could have done this 25 years ago and saved myself all that heartache all those years, I would have, but they didn't have the procedure then," she said."And if I can help just one person now, by telling about my surgery, then that's all I want."