Now that Carmen “Deedie” Deal’s stomach is about the size of an egg, it’s fitting that she eats like a bird.

The 48-year-old woman, who has Charcot-Marie-Tooth disease (CMT), underwent gastric bypass surgery in October 2003, and in six months dropped more than 75 pounds from her 5-foot-6-inch frame.

Deal, of Myrtle Beach, S.C., ate her way up to 330 pounds “feeding the stress” of family and financial responsibilities.

“When you’re carrying all that weight, you’re tired all the time,” she notes. Obesity also caused high blood pressure, high cholesterol, impaired sleep, reflux, hiatal hernias and “just not being able to get around a lot.”

Deal was pessimistic about losing weight through diet and exercise. “I just loved to eat all the time. I knew any type of diet wouldn’t help me because I’m not strong enough to do it.”

Then she attended a free seminar about bariatric (obesity) surgery. Basically, this surgery forces a person to live on an extremely low-calorie diet by creating a tiny stomach pocket that regurgitates (throws up) if it receives too much food.

Two types of bariatric surgery predominate:

• Gastric bypass (also called Roux-en-Y) permanently creates a small pouch by sewing or stapling off part of the stomach. The pouch is connected directly to the small intestine, further cutting down on calorie absorption.
• Gastric banding places a band around the upper end of the stomach, creating a small pouch with a narrow opening to the rest of the stomach. Some bands can be tightened or loosened as needed.

Gastric bypass results in greater and longer-term weight loss than banding, as well as better reversal of medical problems associated with obesity, experts say.

But the surgery can cause a number of serious complications, including death. It’s typically reserved for people whose weight is causing serious medical complications — at least 100 pounds overweight for men and 80 pounds for women. It’s a last resort when diet and exercise have failed and obesity threatens survival.

Costs range from $15,000 to $50,000. Medicare covered most of Deal’s Roux-en-Y, because it was deemed medically necessary.

Before her surgery Deal consulted a lung specialist and Jeffrey Rosenfeld, director of the MDA clinic at Carolinas Medical Center in Charlotte, N.C.

“The clearance for gastric bypass is the same as for any major surgery,” Rosenfeld says. “In neuromuscular patients we are generally concerned about cardiac and pulmonary status.” In people with severe weakness, immobility after surgery could lead to pulmonary complications without proper postoperative physical therapy, he cautioned.

Rosenfeld says little is known about the effects of this technique upon a person’s neuromuscular disease. Poor nutrition can cause some gastric bypass patients to develop neuropathy (nerve disease) if they don’t take adequate vitamin supplementation.

In any surgery, some people with NMDs are prone to malignant hyperthermia, a dangerous condition that can be triggered by anesthetics. Make sure your MDA doctor and surgeon are talking to each other.

Deal had “no problems whatsoever” after surgery. Her biggest challenge was learning how much food she could eat. Breakfast shrank to half an egg with cheese; lunch and dinner to 2 or 3 ounces of meat and a tiny portion of vegetable or salad. Bread is off the menu entirely. She takes vitamin supplements and works out at the gym three times a week.

“I’m not hungry, I don’t crave sweets or anything. It’s a miracle,” says the former self-described sweets addict.

“My dresses just hang on me,” she added. “I have more energy. I sleep so much better at night. My health has been wonderful.”