Amanda Kurtz, 29, couldn’t believe the numbers staring back at her on the bathroom scale: 199.4. Losing weight has been a lifelong struggle for the Philadelphia-based medical assistant, and in just five months she’d shed 100 pounds. She was 12 years old the last time she weighed less than 200 pounds. She felt tears rushing to her eyes, and she knew she had to document the moment. She snapped a photo of the scale, then a teary selfie, and she posted the pics side-by-side on her Instagram page @motivatedmanda, where she’s been documenting her weight-loss journey since undergoing vertical sleeve gastrectomy (VSG) in May.
VSG, also known as sleeve gastrectomy, is a type of weight-loss surgery that’s increased in popularity in the past few years. “The most commonly performed bariatric operation in the world and in this country and also in my practice is the sleeve gastrectomy,” Abraham Krikhely, M.D., a weight-loss surgeon at Columbia’s Center for Metabolic and Weight Loss Surgery, tells SELF.
During the procedure, a large portion of a patient’s stomach is removed, reducing it to about the size of a banana. The smaller stomach then limits the amount of food a person can eat by making them feel full faster than usual. “We take a stomach that’s ordinarily like a duffel bag and turn it into something that’s smaller and more like a purse,” Krikhely says. “You have to pick and choose what you put in there.”
But Krikhely explains bariatric surgery—which also includes gastric banding and gastric bypass—isn’t the first thing someone should turn to if they want to lose weight. It’s actually the last thing. Individuals should first make lifestyle changes—like dieting, working with nutritional experts, and changing their habits—to see if they can shed the pounds and keep it off sans surgery. If that doesn’t work and weight is putting someone’s health at risk, then surgery enters the weight loss equation.
“People who come to me have found it difficult to achieve much weight loss or they’ve had some success but not much and they tend to yo-yo and the weight keeps coming back,” Krikhely says. “And they’re starting to suffer consequences and medical problems related to obesity.”
Before turning to surgery, Kurtz went on Weight Watchers and worked on her eating habits multiple times. She lost some weight, but she could never keep it off. Her decision to get surgery came when she went to a hockey game—her favorite sport—but couldn’t sit comfortably in the stands. “I couldn’t even fit in the seats anymore without squeezing myself in,” Kurtz tells SELF. “So I hit a point like, ‘Wow, my favorite thing to do I can’t even enjoy it because of my weight. I need to do something.'”
At the time, Kurtz’s body mass index (BMI) was 50, well into the category of “obese,” which begins at 30. VSG is an option for people who fall into two categories: They have a BMI of 35 or over and a medical issue (like diabetes or sleep apnea) that could improve with weight loss. Or, they just have a BMI that’s 40 and above, which is categorized as “extreme or high risk obesity” by the National Institute of Health.
Kurtz had seen her mom undergo VSG a few years ago—both of them have struggled with their weight—and it worked well for her. So she decided to do the same. VSG is a major surgical procedure, and Kurtz learned firsthand that it’s far from the “easy way out” when it comes to weight loss. She had to stick to a liquid diet a few weeks before the procedure. Then, after the one- to two-hour long surgery, she stayed in the hospital for two days before she could continue her recovery at home. She’s since had to relearn how to eat. As Krikhely puts it, bariatric surgery isn’t going to do the work for you, “it’s going to help you help yourself.”
“Since I’ve had it, I’m basically learning how to eat food again,” Kurtz says. “It’s not an instant fix—like all of a sudden all the foods that I love are gone and everything—it’s a lot of stuff that’s hard to figure out.”
She decided to document her entire journey on Instagram, a place where she learned a lot about VSG and VSG recovery before her own procedure. She posts regularly about the major lifestyle changes she’s made, from the healthy diet she’s adopted to her new regular workouts.
Her most popular picture to date: That emotional selfie after her weight dropped below 200 pounds. It quickly went viral, with commenters cheering Kurtz on and sharing their own stories of weight loss after VSG. “YASSSSS GIRL! Get it!,” wrote on commenter. “I’ve been there and isn’t it amazing? So much more of that feeling to come!”
Six months since her surgery, Kurtz’s BMI is now down to 33. She says she has more energy than ever, and her goal is to get to a BMI of 24, which is considered a normal weight for her 5’4″ frame. Since her weight loss, she’s been back to hockey games, fitting more comfortably than ever in her Philadelphia Flyers jersey. But she’s still wrapping her head around the major weight loss she’s always hoped to experience.
“I really want people to know that if someone like me can do it, even the assistance I had with the tools and getting the surgery, it’s possible,” she says. “I’d hoped that I would get to this point, and it’s kind of been a mind game since surgery. The changes have happened so fast, and I’m still trying to catch up with everything. But I feel so much better about myself in almost every aspect.”