Don Hare in the press room of the Adirondack Daily Enterprise (Photo — Andy Flynn)

This week: 401 lbs.

Last week: 410 lbs.

Start: 470 lbs.

Total lost: 69 lbs.

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Don Hare and his daughter before surgery (Photo provided)

I’ve seen Lake Placid’s Don Hare shrink over the past two-and-a-half years, and every time I see him in the press room at the Adirondack Daily Enterprise, I swear he’s lost even more weight. Inspired and awestruck at his transformation, I asked him how he did it.

Bariatric surgery.

Three years ago, Hare was 330 pounds. On his feet all day as a pressman, standing on concrete floors, his 35-year-old body — especially his feet — was aching by the end of the day. For years, he’d lose weight, gain it back, lose weight, gain it back. It was the typical yo-yo routine of a chronic dieter.

“I would always gain back more than I lost,” Hare said.

There was no end in sight. Hare would continue to gain more weight unless he did something drastic. But it wasn’t a major health scare that turned him around. It was life. His daughter was a year old in 2011, and she was his driving motivation.

“I wanted to see my kid grow up,” Hare said. “And things were starting to hurt all the time that shouldn’t have been hurting. My blood pressure was starting to get out of control. Things like that. … But having a kid really is what put me over the hump.”

Making the decision to attend his first bariatric surgery informational meeting at the Adirondack Medical Center in Saranac Lake was Hare’s first difficult step, but it wouldn’t be his last. Aside from the surgery and the following years of maintaining a new diet regime, Hare would face deep psychological and physical challenges in the face of a society that many times scoffs at bariatric surgery patients.

“A lot of people will discriminate against you for it because they think you’re taking the easy way out,” Hare said. “They don’t realize that, yes, it may be physically easier, but it’s a lot harder mentally. People will react to you a different way. They think that if you didn’t take 10 years to lose the weight and bust your butt in a gym every single day that you took the easy way out. It’s not easy, and there’s a lot of maintenance afterward. It’s a complete lifestyle change.”

Whether you have bariatric surgery or not, you have to change your lifestyle if you’re going to lose a lot of weight. And that’s exactly what Hare has done.

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Types of surgery

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The Bariatric Program at AMC gives patients several surgical options. There’s the roux-en-y gastric bypass, duodenal switch, sleeve gastrectomy and adjustable gastric banding (Lap-Band).

AMC provides the following descriptions of the surgeries:

-Gastric bypass and the duodenal switch reduce the size of the stomach, making you feel full more quickly. The procedures also bypass a segment of the intestine, meaning not all food eaten will be absorbed.

-The sleeve gastrectomy reduces the size of your stomach but does not bypass the intestine.

-The Lap-Band is a less-invasive weight loss surgical procedure that reduces the stomach’s capacity and restricts the amount of food that can be consumed at one time. The procedure does not require surgical reduction of the stomach, stapling or gastrointestinal re-routing to bypass normal digestion.

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Hare’s surgery

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Hare’s decision to get bariatric surgery was already made by time he attended his first informational meeting. He wanted the Lap-Band because it’s the least invasive and seemed like the simplest procedure. But after learning more, he changed his mind.

“The more I listened, the more it didn’t fit my personality because it was too easy to cheat, to screw it up if you’re not careful,” Hare said.

The duodenal switch was the way to go.

“Because it was lifelong,” Hare said. “It’s really hard to screw it up.”

Hare soon began a six-month-long pre-surgical program which included classes a couple of times a month to help change his mindset and provide more information to readjust his lifestyle. It also gave him time to lose weight before the surgery.

“They want to see you lose a certain amount before your surgery because they want to be able to see that kind of commitment, to know that you’re not going to fall back into your old ways afterward,” Hare said. “And some insurance companies, some of them will want you to lose a certain percentage before they OK the surgery.”

Hare lost 15 pounds before Dr. Michael Hill performed the duodenal switch on him Sept. 6, 2011, in Saranac Lake. It was laparoscopic surgery with five small incisions, and he was in the hospital for five days.

Admittedly, there were concerns going into the surgery. The duodenal switch was the riskiest of his choices and has the highest chances for complications.

“Because not only is your stomach shrunk, but your digestive track is rerouted,” Hare said. “So there are more chances for things to go wrong. … Anytime you get put under and have anything major done, there’s always a concern.”

Hare hasn’t had any complications after losing 120 pounds.

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Weight loss

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Hare’s weight loss was quick and dramatic, and he lost some muscle in the process.

“Your body needs to get fuel from somewhere, and in the early stages, you can eat so little that you can’t always get enough nutrition for what your body needs,” Hare said.

When the duodenal switch is complete, the stomach is only about 4 ounces.

“Your stomach goes from being the size of a football down to maybe a golf ball,” Hare said.

He likens the digestive tract to a fork in the road.

“Instead of your digestive juices and your food meeting at the bottom of your stomach and passing through your whole digestive tract, they split,” Hare said. “The food goes one way, and the fluids go the other way, and they only meet at a very small section of your intestine before they’re passed out of your system.”

Hare essentially lost weight by malabsorption. But he can still eat a relatively normal-sized meal. At dinner, for example, he might eat a chicken breast, 3/4 cup potatoes and a vegetable portion.

“When you go to the classes, they tell you to make sure you eat your protein first,” Hare said. “Then, if you still have room, eat your other stuff after because the protein is the most important thing for you to intake. The vitamin regimen they put you on after the surgery kind of takes care of a lot of your vegetable needs, your vitamins and minerals.”

Hare takes a long list of vitamins and consumes between 90 and 110 grams of protein every day.

“You’re kind of overloading your system in order to get the amount that you really need,” Hare said.

Maintenance

Hare looks at food differently than he did three years ago, when he was a binge eater.

“That used to be my biggest downfall,” Hare said. “I was an emotional eater, and I would eat until I just couldn’t eat anymore. … Now the pain of overeating controls that because if you eat too much, there’s going to be a lot of pain involved. You’ll throw up because you can only hold so much.”

Now he tries to stay away from greasy food because his body is not absorbing the fats.

“So if you eat something that’s really greasy or fatty, there’s a good chance that you might have an accident,” Hare said.

Hare also looks at clothing differently than he did three years ago, when he was wearing size 4X shirts and size 50 pants. Now he’s down to large shirts and size 36 pants.

“I still have a closet full of clothes that don’t fit anymore, but I can’t bring myself to give them away,” Hare said. “I had a bunch of clothes that I couldn’t wait to fit into, but I dropped right through those sizes and never got a chance to wear them.”

At 210 pounds, Hare makes sure to eat enough calories to maintain his weight because he doesn’t want to lose anymore. He’s already surpassed his original goal of 220 pounds.

“I think if I went down much lower, I wouldn’t feel healthy and I wouldn’t look healthy,” Hare said.

Any temptation of bingeing is checked by the pain of overeating and the risk of embarrassing accidents. Yet Hare still eats most of the food he ate before the surgery.

“They’re just in moderation now,” he said.

Asked if there are things he can do now that he couldn’t do three years ago, Hare said, “Absolutely.” He can now play with his daughter in the park, and he can work a whole day without limping home. His energy level is higher.

“If I take my daughter to an amusement park now, I don’t have to worry about not being able to fit on the ride,” Hare said.

As for drawbacks, Hare was struck by the lack of internal long underwear and its benefits during a long, cold Adirondack winter.

“I definitely get cold a lot easier,” Hare said. “I always used to think that the whole insulation thing was just a wives’ tale, but during the last couple of winters, I’ve froze to death.”

That’s a small price to pay for getting his life back.

“I definitely think it was worth it,” Hare said.

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Ongoing challenges

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Before the surgery, patients are required to undergo a psychological evaluation to see if they are well enough to handle the physical changes.

“It happens so fast that some people have an issue with their personal image,” Hare said. “You look in the mirror and don’t recognize who you are anymore.”

Hare is still readjusting to his new look. Those self-esteem issues that haunted him as an obese person have carried over into his new life.

“You may walk into a room and think that people are still judging you,” Hare said. “I have a big issue with that. I still haven’t fully adjusted to the way that I look now because, in my mind, I still feel like I’m the same person I was three years ago.”

And when he goes to buy clothing in a store, he still walks to the bigger racks.

“I’m so used to having only two racks to shop from instead of 20,” Hare said.

Eating, especially in social situations, can be challenging.

“Thanksgiving definitely isn’t the same,” Hare said.

What advice does Hare have for others thinking about bariatric surgery?

“Do the research,” he said. “Make sure you weigh the pros and the cons; it isn’t for everybody.”

If you can’t live with the excess skin after weight loss, for example, bariatric surgery may not be for you. Hare is living with it because his health insurance company won’t pay to have the excess skin removed. They deem it cosmetic surgery.

“If you can deal with it, the health benefits are definitely worth it,” Hare said.