Pamela Stokes considers herself “full-figured” and feels at ease with her appearance.

“I have grown into my body,” she said in a recent interview. “I wear it well. I dress well and take care of myself. It’s part of my personality.”

And it’s true; Stokes looks terrific, so it isn’t vanity that has got her thinking about weight loss surgery. At about 100 pounds over her recommended weight and with a body mass index of 42, she qualifies as morbidly obese in the medical world.

With a strong family history of cancer and the recent emergence of diabetes, high blood pressure and joint problems, the 44-year-old working mother is considering the surgical route seriously.

“It’s becoming increasingly clear that I’m not fine anymore,” she said.

Stokes lives in Bangor and has two children – a 19-year-old daughter preparing for a medical career at the University of Maine and a 9-year-old son with long-term special needs.

Her son’s likely dependence on her as he matures has her thinking hard about the need to stay active in his life. Getting her weight down is key to regaining her good health.

Of course, she has tried dieting, tried exercise. A few years ago she dropped 40 pounds using the popular diet aid fen-phen before its health risks had been identified. Any weight she has lost always has come right back and brought its friends along.

Five women at her church have had surgery to help them lose weight, and some have been very successful.

“At first it seemed like an easy way out, but the more I looked at it, the more I realized that this is a major step,” Stokes said. “There is a risk of death either way, and a lifelong commitment afterward. I ask myself ‘Have you truly exercised and dieted to the best of your ability?'”

It’s ironic, but Stokes’ positive self-image may complicate her decision. Many people want to lose weight to look better, but Stokes likes the way she looks now. She dreads the possibility of shedding so much weight that she’ll have excess skin – a very real side effect of significant weight loss.

While her insurance will pay for the laparoscopic banding she’s considering, it won’t pick up the tab for the cosmetic surgery to make her trim afterwards.

Stokes praises Eastern Maine Medical Center’s comprehensive approach to preparing and selecting weight loss surgery patients.

“They walk you through it. They make sure you’re completely aware at every level. They know your success depends on how well you’re prepared,” she said.

“That’s really very empowering.”

So far, Stokes has been to a preoperative class, met with a physical therapist and a nutritionist and had a psychological evaluation.

Now it’s just a question of scheduling the procedure. “I’m still thinking about it,” she said.