Allen Neely

"In October 2002, my wife and I traveled to China," Allen Neely recalls, "and there, if you don't look like everyone else, you stick out like a sore thumb — especially if you're heavy."

Allen had been overweight most of his life — at his heaviest, weighing around 360 pounds with a 56-inch waist. "Everywhere I went, people followed me just to look at me, and I could hear them talking about me," he continues. "It was like a slap in the face. I couldn't wait to get out of there. And I thought, 'I don't want to be this way anymore.'"

The trip to China wasn't the first time Allen had experienced problems because of his excessive weight. Despite being an avid traveler, Allen was unable to participate in some cruises and tours because he was too heavy — and flying was another story. "I traveled with a collection of seat belt extenders, because the standard belt wouldn't fit around my waist," he explains. "I would note people's expressions as we were boarding a plane and it was always clear what they were thinking: 'I hope I'm not sitting next to him.'"

A change of mind

Allen Neely pictured at the Tea Museum Gardens in Hong Kong, before weight-loss surgery (October 2002) and after (February 2005).

Allen had repeatedly attempted to lose weight over the years, but never seemed to be able to lose enough weight or to keep it off. "There's a general assumption that if someone's overweight, they can fix it," Allen says, "but that isn't always the case."

Moreover, Allen was facing a number of weight-related health conditions including hypertension, sleep apnea, and diabetes. Dr. David Hanson, a physician in Mayo Clinic's Department of Community Internal Medicine, suggested that Allen consider undergoing bariatric surgery (weight reduction surgery). Although initially uninterested, the trip to China changed Allen's mind, so Dr. Hanson arranged for him to meet with Dr. Kristi Harold and Dr. James Swain, both physicians and surgeons in Mayo Clinic's Department of General Surgery.

Candidates for bariatric surgery at Mayo Clinic take part in a number of programs and evaluations designed to help them prepare for the lifestyle changes the surgery requires. In addition to nutritional counseling and physical and psychiatric evaluations, candidates participate in the Learn Program--a 12-week behavior modification course dealing with lifestyle, exercise, attitude, nutrition, and personal relationships. "It's a comprehensive look at how people approach food," Dr. Harold explains. "In addition to ensuring physical health, we need to make sure there aren't unresolved eating issues related to a person's weight problem."

"I always encourage patients to lose some weight during the months pre-surgery if they are able," Dr. Swain adds. "Losing weight isn't required, but it helps us to see that a candidate is serious."

"I actually liked the preparatory work because I was able to get my weight down from 360 to 332 lbs," Allen says. "My doctors and I felt very comfortable going forward with surgery."

A changed life

Allen's surgery was performed in February 2004. Bariatric surgery is a very effective weight-loss treatment, but is not a miracle cure. "The doctors can only do so much," Allen says. "The surgery provides a honeymoon period. But you have to pick up some of the responsibility and do what's necessary to keep yourself from backsliding." For Allen, that meant taking advantage of Mayo Clinic support groups--and beginning an exercise program. He started slowly, post-surgery, by standing up every two hours and walking around his home. "Each time, I'd try to go a little further before sitting back down. Within two or three weeks, I was walking half a mile." Now Allen follows a regular physical routine that includes walking, hiking, and working out at the gym. His 6-foot frame weighs a healthy 200 pounds.

"I keep my collection of seat belt extenders just to remind me of what life used to be like," Allen says. "Food is still a great source of enjoyment to me. But now I am very aware of what I eat, and how much."

Allen still travels regularly, and without any special requirements. In February 2005, he returned to China. "This surgery has changed my life," he says. "Without it, I never would have gone back to China. But I was able to return with no issues, and it was a really fun trip. I was just a normal tourist, a normal person," Allen smiles. "I finally fit in."