WESTBROOK — After years of trying weight-loss pills and diets, including a steak-and-water combination, a weary Veronica Bates sat in front of her computer and tapped out an e-mail.

"I have decided to have a gastric bypass," the 33-year-old told her friends and relatives. Having high blood pressure and pre-diabetes, being unable to chase after her young daughter in the park ´ this was no longer tolerable. She scheduled the surgery for June.

"I do this for my family, yes," Bates wrote. "But above all I will do it for me. .ï.ï. I want my life back."

She knows there is a chance of infection, even death, with stomach-shrinking. But Bates, who is 5 feet tall and weighs 283 pounds, is joining the thousands of Mainers who've decided that rapid weight loss outweighs the risk involved with the procedures.

Many patients can expect to shed two-thirds of their excess weight in the first year, and will see the easing, even reversal, of debilitating health conditions such as diabetes, joint pain and sleep apnea.

At a time when obesity is being blamed for billions of dollars spent on health care in America each year, supporters of bariatric surgery say the procedures are cost-savers because they prevent and cure chronic illnesses.

"It takes three to 3.5 years to recoup the cost of the operation, and the patient becomes (profitable) because of his lowered medical expenditures," said Dr. Neal Hutcher, president of the American Society of Bariatric Surgery.

The society estimates that more than 800 weight-loss procedures are performed annually in Maine, most of them on women. Procedures vary, but all severely limit the intake of food.

Bates will undergo a procedure called Roux-en-Y. A pouch is created in her stomach ´ unable to hold more than one-eighth of a cup of food ´ and connected to the middle part of the small intestine.

Food passes through the body faster because it will bypass most of the stomach and the top part of the small intestine, allowing less time for nutrients to be absorbed. To compensate, Bates will have to take multi-vitamins and other supplements every day for the rest of her life.

In preparation for the surgery, Bates has overhauled her lifestyle. No more being self-conscious about her body; Bates makes a point to swim every other day because exercise has been shown to optimize the surgery's outcomes.

Out went the red meat and fries, in came the salad and fat-free croutons. That the change is benefiting more than just Bates was evident before a recent dinner.

"I love spinach!" yelped 3-year-old daughter Marissa as she helped her mother shred greens for a salad on a recent evening.

Bates has lost a pound or two in the last several months, but it is not at a rate fast enough for her to abandon her plans for surgery.

Bates needs the weight to come off soon because of a car accident-related back injury. The pain forced her to take time off from her job as a customer service representative at the disability insurer UnumProvident Corp.

When she failed to get better after several months, her doctor sat her down for a talk last November. There's nothing we can do, she recalled him saying; your body is crushing itself.

Bates, who had put off surgery so she could have her daughter, felt now she had no choice.

"I realized I needed to go with a more drastic route to get on with my life and back to work," Bates said.

She was referred to the bariatric surgery center at Maine Medical Center in Portland. In a marathon first appointment, she was screened for the surgery in separate interviews with a dietitian, a counselor and a surgeon.

She also attended a class at which she learned about the different types of surgery, the diets that patients must follow and the mortality rates ´ about 1 in 200 people for gastric bypass.

"There were three or four people who got up and left who decided they didn't want to do it," Bates said.

After the medical team, led by surgeon Dr. Roy Cobean, agreed she was a good candidate for surgery, it was time to contact her insurance company.

With surgery costing upward of $15,000 and more people seeking the surgery in the last decade, many insurance companies have cut out the surgery from their benefits or enforced rules on who qualifies. Most require that patients are at least 100 pounds overweight or at least 75 pounds overweight with a significant health problem, such as diabetes or heart disease.

"There was a reason to believe that a lot of people being proposed for the surgery did not meet guidelines," said Susan Pisano, a spokeswoman for the American Association of Health Plans.

Some health plans also require pre-operation weight-loss programs that last up to a year, a point of frustration for Lynn Bolduc, coordinator of the state's largest and oldest surgical weight-loss program, at Eastern Maine Medical Center in Bangor.

"Most of these people have really given it all in terms of dieting," Bolduc said. "They haven't woke up morbidly obese. Clearly, they've been there, done that."

As a result of insurer mandates, Bolduc said her program has seen a dip in procedures, from 708 in 2004 to 672 in 2005.

Bates said her health plan from Harvard Pilgrim is covering all of the surgery and hospital stay ´ she only owes a $100 co-payment ´ allowing her to focus on the surgery. Husband Kanji hopes to take a month off from his computer programming job to help with her recovery.

He is nervous about the procedure's safety, but also what will happen if the surgery succeeds. What if his wife's personality changes with her new-found shape?

"I don't know if we're going to grow into different people," he said. "I don't know if I'll resent the weight change."

Bates tries to assure her husband, whom she met online while studying at the University of Maine, that everything will be the same.

"Physical appearance was never an issue for us," she said, pointing out that they fell in love without setting eyes on one another.

Another bariatric surgery patient, Hannah Dickinson of Brunswick, said her relationship with her husband did not change after the surgery, but it seems as though everything else has.

Dickinson, also 33, underwent a type of surgery known as Lap-Band, which involves putting a band around the stomach, through which food settles slowly, like sand in an hourglass.

The surgery is less invasive than gastric bypass, and weight loss is much more gradual. Still, Dickinson has managed to go from 310 pounds to 155 pounds in the two years since the operation.

"I can focus on everything else that is important in my life," Dickinson said. "I have to say, I have a lot more time to do things with my daughter and to find where I can improve on my job" as a Sagadahoc County deputy registrar of probate.

The future is full of unknowns for Bates, but she said she feels excited.

"I don't care if I ever get in a size 8 jeans," Bates said. "I just want to be able to say, 'No, I don't have diabetes. No, I don't have high blood pressure. Yes, I can go for a walk.'ï"

Staff Writer Josie Huang can be contacted at 791-6364 or at: jhuang@pressherald.com