Joan Salt, a school bus driver, has been overweight most of her life. Weighing more than 450 lbs., she couldn't walk stairs without stopping nor drive certain buses. Home with an inflammation of her blood vessels, she found inspiration from a TV show profiling Al Roker's dramatic weight loss, and knew she had a choice.

Above: Mrs. Salt with her daughter and husband, who backed her every step of the way. Below: Mrs. Salt (right) and her sister, Karla, at a family birthday party.

Quietly researching the option for several months, she got "the good, the bad and the ugly" and found others in the same boat. She then discussed surgery with her doctor and husband, who were behind her 100 percent. In the fall of 2003, she was referred to WinthropUniversity Hospital to meet with bariatric surgeon, Siva Vithiananthan.

"He told me 'I am not telling you to do this surgery, but I do know that if you don't do something soon, you won't live long,'" she explained. "I hit a point of no return."

At 42, Mrs. Salt felt she'd spent too much time not doing what she wanted in life. "I was really ready, and I knew this is what I wanted to do." In early 2004, Dr. Vithiananthan performed gastric bypass on Mrs. Salt. A minimally invasive procedure, it reduces stomach size and restructures the intestinal tract to restrict appetite, limiting the calories absorbed.

"A week later, everything was heavenly," she explained. "I lost more than 20 pounds in a few weeks. I made a schedule to exercise 3-4 times a week and followed it to a 'T' because I was not going back."

That summer, after losing more than 100 pounds, she attended her high school's 25th reunion, participated in a four-mile march and went to an amusement park where she was able to walk around and ride roller coasters and water slides.

Today, at 240 lbs., she's amazed at how strange it is to feel full. And, she no longer suffers from sleep apnea and asthma, a long-life battle she has fought until now.

"I believe that if I had the choice today, I would make the same decision," she explained. "I am enjoying my life, I'm a kid again."

Anthony LaFerrera, a volunteer firefighter, watched his weight balloon. Standing five-foot four, his waist inched past size 68. When other weight-loss options failed him, Mr. LaFerrera began researching gastric bypass, which his friend had found to be successful. However, his family was dead set against it. When his weight edged to 400 in 2002, he knew his health was suffering.

Mr. LaFerrera, a volunteer firefighter, also found hope when he met Dr. Vithiananthan. After losing nearly 200 lbs., he no longer has high-blood pressure and he's down to a size 44 waist.

"I was diagnosed with borderline hypertension and showed the beginning stages of diabetes, and I was very inactive," he explained. "The weight kept piling on. The only thing I had going for me was that my cholesterol was low."

Mr. LaFerrera's general practitioner referred him to Dr. Vithiananthan, and in January of 2003, he too found hope.

"Dr. Vithiananthan gave me options and told me the pros and cons," he explained. "It was great that he met with my family to make sure they were all on board."

In February, after he concluded all the pre-testing required, Mr. LaFerrera went in for the six-hour procedure. Discharged after three days, he was urged to walk every day. By April, he was a new person.

"What a change! I am not carrying an extra 180 pounds," he said. "I can travel more now. I can get on a plane and use the seat belt. I can drive without my stomach hitting the steering wheel. And most importantly, I no longer have high-blood pressure. The only pills I take are vitamins."

Three years since his operation, he's down to a size 44. It was a gradual change supported by a strict threeday-per-week gym regimen. His eating habits also have drastically changed. Before the surgery, eating an entire steak was satisfying. Today, he eats one-fourth of the steak and he's full.

"Dr. Vithiananthan does the surgery, and his staff supports you, but you have to do your part. He only gives you the jumpstart. If you believe in him, you will have no problem losing weight."

The Bariatric Surgery Program's support group is a valued resource. Participants learn from each other and help each other psychologically. Dr. Vithiananthan (front row, left) and his staff attend every session.

For more information about Winthrop's Bariatric Surgery Program, call Karen Norowski at (516) 663-3300.

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