When Matt and Melody Geerlings, both 53, decided the time had come to lose weight, they did it together.

For each, however, the battle would prove quite different.

Melody, a real estate development associate with Habitat for Humanity, weighed 293 pounds.

“Although my highest weight ever was 382 pounds,” she said. “I lost that weight by giving up the jar of peanut butter I would eat every day. And by working out. But before surgery, I had stopped working out and had regained maybe 10 or 15 pounds.”

Matt, an insurance broker, decided to take action when the scale hit 376 pounds.

But mere metrics would not be the hardest part of their weight-loss battle.

The real struggle would come from what they carried inside.

Emotional weight

“I’ve struggled with my weight since I was 6 or 7 years old,” Melody said.

Adopted at 5 1/2, she suffered abuse until age 14.

“I realized later that had a lot to do with my weight gain,” she said.

As Melody lost weight, she began to have nightmares about her childhood abuse. She suffered from panic attacks.

It seemed as if taking off the weight allowed the suppressed pain to surface from somewhere deep inside.

Matt’s journey, meanwhile, would be fraught with its own set of emotional burdens.

As he recovered from an alcohol addiction, he found himself gaining weight.

“I was actually thin from drinking,” Matt said. “All through college I was an athlete, but in 2008 I had a health scare. My heart stopped after a two-week drinking binge and I had to be revived. That’s when my journey of recovery began.”

But his journey came with that cruel twist: “When I gave up booze, I started packing on the pounds.”

It became a matter of trading one addiction for another. He began attending Alcoholics Anonymous on an almost daily basis to stay sober. He relapsed in 2014, but pulled himself out of that soon afterward with the help of his sponsor.

“It was about that time when Melody and I met,” he said. “Well, re-met, actually.”

“We’ve known each other since kindergarten,” Melody said. “Then I saw Matt again on Facebook in later years. We’ve been married now for 5 1/2 years. God brought us together.”

The couple agree on a salient feature of their early relationship: “We were a hot mess when we met again.”

Making changes

Despite their best efforts, the Geerlings seemed to encounter nothing but trouble when it came to weight loss. Melody shunned peanut butter. Matt joined Weight Watchers.

But progress proved elusive.

“I would lose 5 to 10 pounds and then gain it back again,” Matt said.

Change came on Fourth of July weekend in 2016.

While watching the news on TV, the Geerlings saw a segment about a person who had gastric bypass surgery. The individual’s success looked truly tantalizing—overweight to slim and healthy.

Matt remembers looking at his wife and saying, “I’m going to pursue this. You?”

She had to give it some thought.

“It took me two weeks to say yes,” Melody said. “I had to pray on it. I had to be emotionally healthy first.”

Fortunately, emotional health is a big part of the bariatric plan.

When Kerianne Holman, MD, bariatric surgeon at Spectrum Health Bariatrics, met the Geerlings, she made sure they understood the full scope of the program.

Spectrum Health Bariatrics is one of the largest bariatric programs in West Michigan. Patients meet with a team that includes a surgeon, nurse, dietitian, behaviorist, exercise specialist and other professionals as needed.

Beyond the weight loss, the Geerlings had a handful of medical conditions they hoped bariatric surgery would help them address.

Melody battled diabetes. Matt had become pre-diabetic. They both took hypertension medication. They used continuous positive airway pressure, or CPAP, as a sleep apnea treatment.

In a surgical weight-loss seminar—part of the bariatric program—the two learned about bariatric surgical options.

The bariatric team helped them arrive at respective courses: Matt would undergo gastric sleeve surgery and Melody would have gastric bypass.

Mindset

Gastric sleeve surgery, or sleeve gastrectomy, is irreversible, Dr. Holman said.

It involves removing about 80 percent of the stomach, including a part that generates an appetite-producing hormone. Without the hormone production, along with the gastric restriction that the procedure provides, the patient loses weight.

The procedure also may lead to an increase in metabolism.

Gastric bypass surgery has a slightly higher chance of curing diabetes, Dr. Holman said. For this reason, it became the right choice for Melody.

The surgeon makes a small pouch that effectively bypasses most of the stomach and connects directly to the intestine.

“This type of surgery physically limits how much you can eat and how much is absorbed,” Dr. Holman said. “It also has a hormonal effect that makes your body more sensitive to insulin.”

The Geerlings underwent a comprehensive program to prepare for their surgeries.

But it also went beyond that. They had to prepare for lifestyle changes, too.

They had psychological evaluations to assess their readiness. They learned about healthy nutrition and dietary habits. They met with support groups and joined exercise classes.

And then came the surgeries—Matt’s in December 2016, Melody’s two months later.

“It takes women 12 to 18 months to lose the weight to reach fitness,” Melody said. “I did it in 7 1/2 months. I’m 5-foot-4 and my weight now varies between 139 to 143 pounds.”

Men typically lose weight faster.

Within a year and a half, Matt hit 225 pounds. And he’s been losing weight ever since.

“It’s still work, just like it is for anyone,” he said.

Healthy habits

The Geerlings routinely walk 12,000 to 14,000 steps each day. They ride their bikes regularly. They keep to a healthy diet with small portions. They avoid sugar and fried or processed foods.

Melody continues to attend counseling for post-traumatic stress disorder.

Matt attends AA meetings and individual counseling sessions.

For both, it all feels like it’s paying off.

With approval from doctors, they quit taking their hypertension medication. Melody no longer has diabetes.

“There’s an adjustment, too—I think especially for women—in looking in the mirror and seeing the real you as you look today,” Melody said. “I needed my husband’s affirmations that he liked the new me, because all my life I had been told I was fat and ugly.”

As they shed pounds, they underwent skin reduction surgeries to remove excess skin.

Dr. Holman cautioned that bariatric surgery is not a cure-all.

“That’s why we provide counselors and support groups,” the doctor said. “People can still regain the weight they lost—and the vast majority of that is because of unhealthy eating habits.

“Food can be a coping mechanism,” Dr. Holman said. “It’s important that people develop new coping skills before surgery for long-term success.”

For the Geerlings, bariatric surgery proved highly effective alongside changes in lifestyle and mindset.

It turned out to be “the best choice for our health and our lives,” Melody said. “For us, it was the only way to take the weight off and keep it off. I kept one of my 5X sweatshirts as a reminder of how far I have come. And it’s so much fun shopping for clothes now.”