When Sarah Nicholson says that bariatric surgery changed her life, she means it.
Sarah struggled with her weight for most of her life. Despite various weight-loss attempts, nothing worked, and her weight kept climbing. Her weight reached nearly 500 pounds, and it was causing her many different problems.
In fall 2023, she sought help from UPMC Bariatric Services at UPMC Magee-Womens Hospital. Bestoun Ahmed, MD, minimally invasive general and metabolic/bariatric surgeon, UPMC, performed a single anastomosis duodenal-ileal bypass with sleeve gastrectomy (SADI-S) on Sarah in April 2024.
Since the surgery, Sarah has lost 160 pounds and hopes to lose 50 to 100 more. She says her quality of life has also greatly improved.
“(Before), every single aspect of my life was lived in fear, almost as if my body was this rain cloud following me around,” says Sarah, 28, of Pittsburgh. “It’s just not there anymore, and it’s crazy. It’s a new lease on life.”
‘Weighed Down by My Body’
For most of her life, Sarah says she put on a brave face about her weight. She told people she was OK with her weight, but on the inside, she was struggling. She often turned to food to mask her emotions.
Sarah’s family had moved to a different area when she was young so she could get a better education. However, her looks and background differed from those of her classmates, making things more difficult.
“As an African-American, plus-sized person, I did not fit in with the thin, white, blond, blue-eyed type of group,” she says. “I didn’t come from money. Not that I was a poor kid who was bullied or anything like that, but I didn’t fit in.”
As time went on, Sarah says her self-esteem got worse. After she became an adult, she turned to substances like drugs and alcohol and became addicted.
Also, although she tried various weight-loss tactics — including some dangerous methods — her weight continued to rise, approaching 500 pounds.
As her weight climbed, Sarah says she felt her body deteriorating. She had back, shoulder, and knee pain, high blood pressure, and other health problems. Walking short distances left her out of breath, and she struggled with anxiety and depression.
She eventually decided enough was enough.
“I didn’t see a future, and I thought I was going to die from either obesity complications or drug complications,” she says. “I decided I didn’t want to live like that anymore. It was time to take a stand.”
In October 2022, Sarah sought help for her drug and alcohol addiction, entering rehab and getting clean. A year later, still struggling with her weight-related problems, she decided to seek weight-loss surgery.
“I wanted to basically get my life back,” Sarah says. “I wanted to take control of my life. I was being literally weighed down by my body.”
‘He Made Me Feel Like a Person’
Sarah had considered bariatric surgery before but hadn’t followed through. By October 2023, she was ready.
“I was changing on the inside, and I wanted my outside to change as well,” she says.
She researched her options for weight loss surgery online and decided to pursue treatment with UPMC Magee-Womens Hospital’s Bariatric Services. She was connected with Dr. Ahmed.
“When I first met him, I was nervous,” Sarah says. “I had this perception of the way health care professional workers treated me because I was in an obese body. I kind of assumed he would be a little bit — not standoffish, but not really receptive to me and my body.”
Dr. Ahmed quickly calmed those fears.
“He was just awesome,” Sarah says. “He made me feel so comfortable. I think what was most important to me that I’ll never forget is he made me feel like a person.
“He didn’t make me feel like I was somebody who was just grotesquely overweight and needed to be fixed. He didn’t look at me like I was disgusting or treat me like I was disgusting. I felt very comfortable.”
Dr. Ahmed told Sarah about her surgical options, including SADI-S. The procedure combines elements of gastric bypass and gastric sleeve procedures. It can lead to higher weight loss, making it particularly appealing to people with severe obesity.
After considering her options and discussing them with her family, Sarah decided to get SADI-S.
‘Everything Was Going to Have to Change’
Sarah’s SADI-S procedure was scheduled for April 2024. She vowed to lose weight before the surgery, preparing herself for a different lifestyle after she had it.
“Before, I expected it to be a magic pill, but this time around, I knew everything was going to have to change,” she says. “Because of the program I was in to get clean from drugs, I had the experience of giving things up for the betterment of the future.”
Beginning in January 2024, Sarah eliminated many unhealthy foods and drinks from her diet. She downloaded an app for her phone that tracked her calories and started restricting her calories to between 800 and 1,200 a day.
As a result, Sarah’s weight dropped from 497 pounds to 462 before surgery. She says it made the transition to her all-liquid presurgery diet easier.
“I didn’t want to go cold turkey,” she says. “My body was already used to surviving on less.”
‘You Are Strong Enough to Do It’
Sarah’s surgery took place on April 12, 2024. She experienced dehydration in the early stage after surgery. She reached out to her UPMC Bariatric Services Team for support.
“Everything worked out as it needed to,” says Sarah, who’s no longer experiencing that issue. “I have a great team who stayed by me, and I was able to call them with any concerns.”
The weight loss came quickly after surgery. By six months after surgery, Sarah weighed 300 pounds — and she’s not done yet.
“I would like to get down to 199 pounds just to see if I could,” she says. “I’d say between 200 to 250 would be my goal — which is crazy to think about that I’m not that far from. It still shocks me sometimes stepping on the scale or looking in the mirror.”
Because of the surgery, Sarah had to make changes to her diet. She has to restrict her calories and avoid unhealthy choices like fried foods, sweets, and caffeine. She takes smaller portions and eats more slowly.
She also exercises much more, finding joy in walking, and plans to join a gym.
Although adjusting to her new diet was sometimes difficult, she’s committed to it.
“There are some times when I get emotional, and I want to pig out, or I want to order this, and I want to eat that,” she says. “But I think about it in the long run and how I’m going to feel and how my body’s going to feel.”
Sarah notices positive changes in her everyday life. She doesn’t feel pain related to her weight anymore.
On a recent trip to Kennywood Park, she fit on all the rides. When traveling on a plane, she didn’t have to use a seatbelt extender.
“It’s little things like that, that I don’t have to worry about, that allow me to enjoy my life more,” she says.
Sarah plans to return to school in January 2025 to become a youth and family services specialist. She hopes to help people who are struggling with many of the problems she dealt with in her life.
Sarah says she would tell people considering weight-loss surgery to do their research and have a good support system. She also tells them to be kind to themselves.
“For all the people like me out there who have been struggling with their weight or feel trapped in their weight, I don’t want them to feel like there isn’t a way out,” she says. “Because there is, and you are strong enough to do it.”