Julie Schwartz, RD, Director of Nutritional Services, Emory University.

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Video Transcript

: Dr. Palmer: You look fantastic. Christine: Thank you, I feel it.

Narrator: Christine lost 150 pounds through diet and sheer will power. Michael lost 140 pounds when he combined exercise and meal planning with his lap band surgery. And Josh lost 180 pounds with the help of gastric bypass surgery. All that hard work and dedication can pay off handsomely.

Josh Jarvis : I was taking medicine for high blood pressure, medicine for cholesterol, started taking diabetes medicine. I was off all three medicines two weeks after my surgery.

Michael Kay: I certainly notice people who smile or flirt, or express kind of an interest that maybe hadn't before. That's different for me, I'm not used to that.

Christine Judy: I'm happy with what I've done, where I'm at now, and I'm excited to go on.

Narrator: Despite their success, each knows that if they revert back to old habits, the weight could easily return.

Michael Kay: Some people think that weight loss surgery is the easy way out. They look at me and see all this weight that I've lost, but they don't see the effort that I've put into it.

Narrator: Michael has reached his goal weight, yet still works closely with his dietitian and attends regular support groups.

Julie Schwartz, RD: It's not a magic bullet. It’s not going to do this for you. With the lap band,if you don't make behavior changes as a patient, you probably won't see weight loss, or you'll see very minimal weight loss. With the bypass, you're going to see weight loss, but you may see all of your weight come back if you don't make behavior changes.

Narrator: For Josh and Michael, that means carefully chosen meals of no more than a cup of food, eaten slowly and cautiously chewed into mush. Doing otherwise can stretch those small stomachs and lead to weight gain, or worse.

Michael Kay: If it can't fit through that opening, it's got to come back up.

Josh Jarvis: it just comes back up itself, like I ain't got nowhere to go that way, here I come so. it does make some situations awkward.

Narrator: About as awkward as Christine felt about her now "saggy" skin. It's a common but often overlooked result of losing a vast amount of weight that can be devastating, medically and emotionally.

Christine Judy: It kind of holds you back, because you want to be so proud of yourself. But then to have all of that stare back, it's kind of like haha, you really didn't get rid of me.

Josh Jarvis : Yea, so that's pretty much all skin. I got lucky in my face, I mean I've kind of got a little bit of excess but it shrank back

Michael Kay: I have it where I carried the bulk of weight, so I feel like I have some excess skin in my abdomen, I have excess skin in my thighs. It's not a big issue for me

Narrator: It was a big issue for Christine. She's undergone several surgeries to remove skin off her arms, thighs, and tummy, even her face.

Christine Judy: And now, anytime I pass the mirror, it's like, there I am again, and I didn't know that it was going to make me feel so much more confident, like my old self again

Narrator: Old self, meet new self. For many who have lost 100 pounds or more, coping with the way the world now views them is challenging.

Josh Jarvis : It was kind of depressing, really at the moment. I'm the same exact guy that I was, just in a smaller body.

Michael Kay: People didn't look at me because I was attractive. They looked at me just because of my physical appearance. And I like just blending in. To the woodwork, you know I like just being an average person.

Christine Judy: I feel like me for the first time, like I feel like me, this is who I am. I couldn't go back.

Narrator: For WebMD, I'm Sandee LaMotte.