Growing up, Candace Neely stoked her competitive fires playing basketball, volleyball and softball. Now, every so often, in the driveway of her High Point home, Neely lets that side of her personality flicker back to life playing basketball with her three kids.
Neely, 40, acknowledges that her basketball skills aren't what they used to be, but five years ago, she couldn't have imagined playing at all. As a newly widowed mother, her life was overwhelmed with stress and little time for herself, causing her physical well-being to take a backseat. Her weight eventually reached 320 pounds.
"I knew I had to get healthier so that my kids wouldn't be orphans," said Neely, a Pediatric Ambulatory Nurse at Duke Children's Specialty Services of Greensboro. "I was their only parent."
In 2020, Neely underwent bariatric surgery at Duke Regional Hospital, which was covered after a $2,500 copay by her Duke employee health insurance. Since then, she has lost over 160 pounds.
Meant for severely obese patients who haven't been able lose weight effectively through diet and exercise, bariatric surgery refers to surgical procedures that alter the digestive system to limit the amount of food it can handle and reduce the amount of fat and calories the body can absorb. Duke surgeons perform around 800 bariatric surgeries each year.
According to data from the American Society for Metabolic & Bariatric Surgery , 96% of patients who have bariatric surgery experience remission in obstructive sleep apnea, 92% see remission in type-2 diabetes, 75% experience remission of hypertension and 58% see remission of cardiovascular disease. Bariatric surgery may also reduce patients' risk of premature death by 30 to 50%.
Bariatric surgery is available for benefits-eligible Duke employees with at least two continuous years of service, or their covered spouse, on Duke Select, Blue Care or Duke Options plans. Patients must cover a $2,500 copay, meet medical requirements and complete three months of the Pathways to Change health coaching program offered through LIVE FOR LIFE , Duke's employee wellness program.
For employees residing in North Carolina, the procedure is only available at Duke Regional Hospital. For employees outside of North Carolina, procedures are available from approved providers with prior authorization.
Duke employee insurance plans have covered around 30-35 bariatric surgeries each year with interest in the procedure increasing among plan members.
"By the time people are entertaining the idea of having weight loss surgery, they have had their share of struggles with weight and have tried many different things, and are quite often feeling discouraged," said LIVE FOR LIFE Health Coach Sally Neve, who operates the Pathways to Change program and works closely with bariatric surgery patients. "This sort of change can give them hope that there's something they haven't tried. It's nice to see them go through this journey and get to the other side. That's what I love."
When Neely was eligible for the benefit, she contacted the Duke Center for Metabolic and Weight Loss Surgery to begin her weight loss journey. Working with Physician Assistant Annie Ward, she underwent medical and psychological counseling and received instruction about the diet restrictions that would be part of her post-surgery life.
In October 2020, Neely had the surgery, and in the months that followed, she stuck to her carefully regulated nutritional routines such as ensuring enough protein and electrolytes and eating small 2-ounce meals every few hours.
"She's really been on top of things and super adherent," said Ward, who has continued to consult with Neely since the surgery. "She's a nurse, so that's to be expected. But it's wonderful to see her change physically as well as emotionally and psychologically."
In the more than four years since the surgery, Neely has experienced plenty of change. Her new diet, which is built around eating small, 2-ounce snacks of protein-rich nuts or yogurt throughout the day, has become second nature. She has a cupboard filled with plastic food containers perfectly sized for her smaller meals and she knows what area restaurants serve food that fits her diet.
She now weighs around 158 pounds and has gone from clothes that were as large as size 4XL to wearing smalls and mediums. Her body mass index is now 25.5, which is about half a point above the range for a normal weight and less than half of what it was five years ago.
"It's a complete lifestyle change," Neely said. "The surgery is part of it. It's a tool. But it's really a complete lifestyle change. You have to put forth the effort, it's not an easy fix. You have to follow the rules."
Her new physical health has helped her find joy in other areas of her life. Not long after the surgery, Neely met James, a single father of two sons. She enjoyed spending time with James, who created an instant rapport with her boys. They got married in 2021 and now enjoy a life filled with baseball, soccer and basketball games and practices and new happy memories.
"It has made my whole quality of life better," Neely said. "I have my confidence back. I have a husband. And I can be more present for my kids. Instead of sitting on the front porch watching my boys play, I can get up and play with them."
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