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Round Two

By GREG HARDESTY
The Orange County Register

ANAHEIM - Ramona Galindo has two big strikes against her in her fight against obesity. She says she's lazy. And she loves to cook.

"There are a lot of people out there like me without the willpower of a Lance Armstrong," said Galindo, 43, overweight since the sixth grade - and among the one-third of American adults who are obese. The Anaheim woman, a rental car agent at John Wayne Airport, isn't shy about her appearance. Her black hair highlighted with burgundy streaks, she goes out in shorts and spaghetti-strap tops, and she lifts up her T-shirt to show a visitor a scar on her stomach. But Galindo, about 100 pounds overweight by her own account, wants to feel more energetic. Diagnosed with diabetes six months ago, she wants to avoid other weight-related diseases. And she wants to meet a man, but first wants to feel better about her appearance - like most of the 60 million Americans who are obese.

Five feet, 2 -1/2 inches and 230 pounds doesn't cut it, she feels. So she's poised to try, for the second time in about 4 -1/2 years, surgery that is far less invasive than gastric bypass, in which a stomach is permanently reconfigured to hold less food. In December 2000, Galindo became the first person in California and one of the first in the country to get a stomach implant that uses electrical pulses to curb a person's desire to overeat. The medical trial lasted through October 2003 and Galindo dropped about 80 pounds, to 200, before recently gaining 30 back. Later this month, Galindo will become part of a growing number of people to try out a LAP-BANDŽ, an adjustable and removable prosthesis placed around the stomach to make the patient feel full after eating a small amount of food. Galindo sees the LAP-BANDŽ as her last chance to drop weight and keep it off for good without having to resort to more invasive surgery.

"I'd do anything just to get in the 100s," she said. Currently a size 22, Galindo's near-term goal is to fit into a 16. So, Galindo is asked, why not just exercise more? Why not just eat less? Like any obese person, Galindo can launch into a litany: an odd work schedule (3 p.m. to 11:30 p.m.) where the closest options are fast food; a love of cooking she acquired as the oldest of five children in a Latino family; the death of her mother; a bout with depression.

Promises. Progress. Failure. Galindo knows the cycle well, having been on about 25 diets since high school. "When you're on these diets, you think of ways to cheat yourself," she said. Galindo realizes she just isn't equipped to go out and run a 10K or give up unhealthy food. Her relationship with eating is too strong and complex for her to make drastic changes on her own. She knows she can balloon up to 300 or 400 pounds if she isn't careful - that it's frighteningly simple to drive through a McDonald's and order two Big Macs with fries.

Sitting in an Anaheim condominium she shares with her sister and nephew, a three-pound hunk of ground beef chuck defrosting in the kitchen sink, Galindo laughs about how her young relatives used to tease her about her

belly. "I told them I ate a lot of Jell-O when I was a kid," Galindo said. She can joke about her weight, but the sadness and shame her body has caused is real. "I used to lie to flight attendants about wearing a seat belt," said Galindo, who grew up in Garden Grove and graduated from Rancho Alamitos High School. "I'd hide the (unfastened) straps under my shirt." Relatives, too, are concerned about her health. "I don't like seeing her too heavy," her father, Norberto, 71, said.

Dr. Milt Owens, who practices at Chapman Medical Center in Orange and Alvarado Hospital Medical Center in San Diego, implanted the stimulator in Galindo as part of a national study. To thank her for being part of that testing base, Owens will perform the LAP-BANDŽ surgery for free. Galindo knows no surgery will magically make her thinner; that any meaningful improvement will require a drastic change in eating habits. She learned some good habits from her first surgery. Her gastric pacemaker sent painless pulses to her stomach that counteracted her digestive tract's natural rhythms and slowed digestion. Although the device has been turned off for a couple of years, Galindo said, she's learned to eat more slowly and to stop when she feels full. When her co-workers go out for Chinese fast-food or Del Taco, Galindo will order but not scarf it all down. Being on her feet most of the time at work helps. Still, she said, the only real exercise she gets is walking up and down the 14-step staircase inside her condominium. "I could join a gym, but ...'' Galindo said. "I really need someone to push me. It's hard to make time for myself."

Pause.

"I'm lazy," she admitted with a laugh. "It seems I can make time for everyone else, but not myself." Best friend Geraldine Leon said Galindo's role as caregiver makes it tougher for her to lose weight. "She kind of loses herself," said Leon, who in 1998 had gastric bypass surgery, losing about 100 pounds. Obese people need to realize surgery isn't a cop-out, said Leon, 43, a travel consultant. "Even the most disciplined people struggle with trying to lose weight on their own," Leon said.

Galindo looks forward to the day she can buy a scale. Right now, she doesn't want to know how much she weighs. She estimates by how her clothes fit. "I want to be comfortable with my body," Galindo said. "In my dreams, I always see myself smaller."