Weight Loss Surgery: Shakira Williams

"There's no point in being cute and dead."

Shakira Williams is a world-traveling elementary-school teacher whose weight has never been a sore point for her -- in fact, when she talked with her family and friends about having weight loss surgery, many of them were against it, she says. “African Americans do not prize being thin as much as mainstream society. As a matter of fact, ‘having some meat on your bones’ is often considered an asset. And even though I was at least 100 pounds overweight, I didn’t see it as a major problem.”

But at age 30, Shakira hit a turning point. “Before that I never had any health problems -- my doctors would say ‘Well, you need to lose weight,’ but they would basically leave me alone. Then when I hit 30, everything went wrong.” In addition to her battles with migraine headaches and insomnia, her doctor diagnosed her with polycystic ovary syndrome (PCOS) and told her that her biggest impediment to a healthy pregnancy -- Shakira’s heartfelt desire -- would be her weight.

Shakira also was diagnosed with thyroid cancer, and after successful treatment for that illness she began to consider her options for permanent, healthy weight loss. About three months after her gastric bypass surgery at Duke, Shakira sat down took a break between traveling the globe and teaching her fifth graders to talk about her experience and her desire to help other African American women feel comfortable with the idea of weight loss surgery.

Why She Wanted to Lose the Weight for Good

I was always popular. I was a dancer, I did horseback riding and scuba diving -- my weight was never an impediment to any of those things. I have a large bone structure -- even now [as of November 2007] I’m a size 12 and I still weigh 175 pounds but I often used being “big-boned” as an excuse for being overweight.

Many of my relatives are comfortable with being overweight and at my heaviest I was 280, but I still felt attractive and I dressed well. My doctor told me that just because I looked a certain way didn’t mean I was healthy. She really pushed and pushed. She said, “There’s no point in being cute and dead.”

Ultimately, I knew wanted to have children, and a girlfriend of mine gained 80 pounds during her pregnancy. Having survived cancer, being in my thirties, and then adding 80 pounds to my 265 -- I knew I couldn’t have a healthy pregnancy that way. So I wanted to do what I could about the weight to make sure that when the time came, I could have a healthy pregnancy.

What Led Her to Choosing Surgery

I tried NutriSystem, Weight Watchers, Phen Fen, fasting, everything. They all worked for a time, I lost 80 pounds once and kept it off for a year and a half. But it always came back.

I finally started to consider surgery once I was able to let go of the piece of me that kept thinking, “You should be able to do this on your own.” I had to get over this sense of failure, that [losing weight] was the one thing I couldn’t do.

On Finding the Surgery Program that was Best for Her

What impressed me the most, which is the bottom line of why I chose Duke, is one thing they said in the information seminar: that after you go through the application process, we’ll help you decide whether surgery is best for you or not. [Duke isn’t] a surgery factory -- they have an overall holistic approach to weight loss that I didn’t see at other programs.

I had previously found some surgeons on my own. And when I went to see them it was this glitzy sales pitch -- I felt like I was going on Extreme Makeover. There were movies and they brought out fruit trays. I was thinking, this is great! They really want me!

When I went back to my doctor she asked, “Are they a center for excellence?” I said, “I don’t know, I just know they had good strawberries!” My doctor said she would only recommend the surgery if I went to [a center of excellence], and she had experience with Duke because another patient of hers had gone there for the surgery.

On Life after Surgery

It’s been really good physically -- I feel really good. I used to be an insomniac, and now I can fall asleep when normal people do. It’s really obvious to me that I’ve got more energy, and it’s nice to not be taking all those medications [for cholesterol, blood pressure, and PCOS].

Psychologically I’ve still got some work to do. Changing my eating habits has been like being a social drinker who stops drinking. If you take alcohol out of the equation, can you still have fun? I’ve had to learn that socializing around food is really about the socializing. It’s okay to be at dinner and not order a thing.

I have a lot of girlfriends who have struggled with their weight, and some of them have taken my choice very well and some have taken it as a rejection of my former self.

On Social Changes after Surgery

I’ve had some times when I pushed myself [in a social situation] and ate too much. I tried to eat a piece of cheesecake at a bridal shower, and I threw up and broke out in a sweat and couldn’t walk. I learned the hard way -- at those times I can have a taste of cheesecake, but not a whole piece.

It’s also taken some time for my family to adjust. At first I’d explain [about how my eating habits had to change after the surgery], and they’d say, “Okay okay, but just taste this macaroni and cheese.” So I’ve learned to cope -- I’ll take a nibble here or there, if an aunt wants me to taste her cake. But now I know just not to fix a plate. That way nobody’s ever telling me, “You didn’t finish that!”

On Fears after Surgery

My biggest concern was getting too thin. I don’t want to be 120 pounds -- that’s not attractive to me. In fact, people are already saying to me, “How much more are you going to lose? Don’t lose any more!” I even backed off of my exercising to try to slow my weight loss. The [follow-up] support group [at Duke] told me that’s not going to help, and they also explained I need to keep exercising to maintain my health -- exercising isn’t about weight, it’s about health.

Her Advice to other Women

I really want to tell other African American women that this is about health. You can be cute, you can be thick, and you can be healthy. I think it’s going to take time for women of color to realize that even if we feel good about ourselves and are accepted in our cultures, obesity is a major problem in our communities. Or for any woman to think that if you have high self-esteem or a man you don’t need to lose weight. I hope to help change these perceptions.

At first I saw myself as separate from most women [who underwent weight loss surgery] because I never saw many women of color having the surgery. It seemed as if most of the women having the surgery were middle-aged and white, and I thought they were doing it for vanity. As if health could not be part of their concern. But this surgery is about you, it’s about your being healthy and happy and living a complete and fulfilled life -- being able to run around with your children and fit in an airplane seat.

On Being Beautiful -- Before and After Surgery

I’ve always had high self esteem -- when I was 16 I weighed 160 pounds, and I thought I was the cutest thing. Now that I‘m older, I know the difference between looking good and feeling good. And more importantly, I know the importance of looking good and being in good health.

Honestly, one thing that made me reluctant about surgery was that I didn’t want my skin to sag. And I’m not happy about the saggy skin, but my skin didn’t stretch from losing weight, it stretched from gaining the weight in the first place. I figure, whatever the downside as far as vanity is concerned, I will be alive and healthy. So what if I have some extra stretch marks, they remind me of how truly beautiful being healthy is.