In the war on obesity, Jessica, Katie and Megan Lyerly are a true triple threat.

The 25-year-old nurses at Novant Health Rowan Medical Center in Salisbury, North Carolina, are identical triplets who have battled identical weight issues since childhood. Now, thanks to one another and bariatric surgery, they're winning that fight.

“Everybody in my family has struggled with their weight,” said Jessica, who dieted for the first time in fifth grade with her mom. “As long as I can remember, I have been overweight. And for as long as I remember, I loved food.”

Over the years, the sisters caromed from one diet to another – Weight Watchers, keto, paleo, clean eating and more. Some pounds came off. But more came back. Underactive thyroids made slimming even harder. By the time they entered nursing, all three had BMIs over 60 – twice the level considered obese. (BMI stands for body mass index and is a measure of body fat based on height and weight. Find a BMI calculator here.)

“I remember thinking this is insane. I was 22, and I was taking blood pressure medicine and had developed sleep apnea,” Jessica said. “As nurses, we see this day in and day out. People who don't control their weight and their chronic illnesses, and they are like a revolving door in and out of the hospital. I knew I did not want to be that person.”

Packing 400 pounds – 255 more than the normal weight for a woman 5-feet, 4-inches tall – she was the first of the three to turn to bariatric surgeon Dr. Eric Mallico for help. Mallico performs about 100 weight-loss operations a year at Rowan Medical Center.

Dr. Eric Mallico

So far, he has operated on Jessica, who is down about 200 pounds from her peak weight and 120 since her March 2017 surgery, and on Katie, who has shed about 100 pounds since her operation last February.

Both chose a minimally invasive operation called sleeve gastrectomy. It's the nation's most popular weight-loss surgery and takes about an hour under general anesthesia. Through a small incision, doctors remove 80 percent of a patient's stomach, leaving a banana-shaped pouch that holds just 4 ounces of food.

But that's just the beginning. The surgery isn't a cure for obesity, just a powerful weapon in a battle that requires permanent lifestyle changes.

After surgery, patients still have to watch what they eat, but their stomach holds less food so they feel full faster. They must also move more: A brisk 30-minute walk on most days of the week is what Mallico suggests.

“No matter how great my surgery is,” he said, “If they aren't bought in, they're going to fail. These young women are doing better than typical. They're hitting goals that not everyone hits.” 

But he's not surprised. When family members or close friends get weight-loss surgery together or in tandem and then support each other afterward, they lose up to 20 percent more, studies show.

The Lyerlys are a close-knit family that loves to have Sunday dinner together. Everyone is on board with the lifestyle changes the triplets have made.

Jessica and Katie also share a townhouse. Katie, who does most of the cooking, adapted fast to her sister's high-protein, low-carb bariatric diet. She also noticed something else as Jessica's excess weight began to disappear.

“I saw she could do things physically that she couldn't have done before – exercising and just generally being more active. She wasn't being held back by her weight,” Katie said.

That was just the spark she needed. Katie decided to go for surgery too.

From 295 to 208

Following Jessica's diet gave her a head start. Before surgery, all patients begin the bariatric diet and meet with nutritionists. A psychologist screens each one for underlying emotional issues that could affect their success. But that's not all.

“Ultimately, you need to be losing weight so we know you're making a change in lifestyle,” Mallico said. “Then we do the surgery. If anyone is gaining weight, we'll keep them in the program, but they're not having surgery. Once they realize you're serious, they get on the ship and turn it around.”

Like her sister, Katie aced the tests.

“My fear was I was going to drive myself into an early grave, and I wasn't going to be here to live my life the way I wanted to,” she said. “I also knew that in order to take care of patients the best way I wanted to, I needed to take care of myself first.”

From the start, her weight came off fast. In less than a year, Katie dropped from 295 to 208 and from a size 28-30 to a 14-16. Her goal: “To live under 180.”

“Last February, if you'd told me I'd be almost 100 pounds lighter today, I don't know if I'd believe you,” she said. “And I just didn't know how different my life would be.” 

Though both sisters' weight loss has slowed, it hasn't stopped. And their lives have changed in surprising ways.

“At 350 pounds, you worry am I going to fit into the booth at the restaurant? If I sit down in this chair, is it going to hold me? Those thoughts don't cross my mind anymore,” Katie said.

Last summer, she, Jessica and their mother celebrated with a trip to Alaska, where they enjoyed climbing, rafting and even zip lining. They can't wait for their next adventure.

“Now, I feel like I am the girl on the outside who has always felt trapped on the inside of somebody else's body,” said Jessica, who continues toward her ultimate goal: under 200 pounds. “I feel like I'm who I was meant to be all along.”

The triplets' story doesn't end here.

Fitting into her wedding dress

Inspired by her sisters' example, Megan, who weighed 403 at her first appointment, is preparing for the same life-changing surgery. She hopes to have hers in April – plenty of time to heal and slim before her Oct. 5 wedding.

“I have already bought a dress, but if it’s too big I will cross that bridge if needed later,” Megan said. “I will be able to enjoy my wedding day and my honeymoon even more with losing weight and living a healthy lifestyle.” 

While they'll always have to work at weight control, the Lyerlys have every reason to be optimistic.

Five years after weight-loss surgery, 7 out of 10 patients have kept their excess weight off, according to Mallico. His goal is for every patient to have a BMI below 30.

“You might still be overweight by some definition, but you're not obese. When you lose 15 BMI points, you pretty much gain 10 years of life expectancy. That's real,” he said.

When people ask about her weight loss, Jessica tells them surgery was “hands-down the best decision I've ever made.” 

“I was willing to do whatever it took to lose the weight and get healthy,” she said. “Whatever road you take to get there, the point is getting there.”

Weight-loss surgery Q&A

Novant Health's bariatric centers offer surgical and nonsurgical treatment of obesity in the Charlotte and Triad areas.

Q: Is weight-loss surgery right for me?

A: You're a candidate if your BMI is above 40 – or if it's between 35 and 40 and you have other obesity-related health problems, such as diabetes, sleep apnea, high blood pressure or high cholesterol.

Q: How long does the surgery take?

A: Nationwide, the two most popular procedures are sleeve gastrectomy, which takes 45 to 60 minutes, and gastric bypass, a 90-minute procedure. Both are laproscopic, or minimally invasive, surgeries and are done under general anesthetic. Most patients go home the next day.

Q: What are the risks?

A: Infection and blood clots are the major ones, affecting fewer than 1 percent of patients. Long-term, patients who don't follow diet recommendations can suffer nutritional deficiencies.

Q: Surgery scares me. Is there any alternative?

A: Look into one of Novant Health's medical weight-loss programs. You'll learn about diet and exercise, how to shop for healthy foods and to understand your eating habits. One of six FDA-approved medications can help you shed pounds and keep them off.

Another alternative is a gastric balloon, which helps take up space in the stomach as you learn to control your portions. Put into place without surgery, it's removed after six months.

Q: Does Novant Health have a stamp of approval from recognized medical associations?

A: Absolutely. The American College of Surgeons and American Society for Metabolic and Bariatric Surgery have recognized Novant Health bariatric surgery centers in Charlotte, Salisbury, Matthews and Kernersville for meeting national quality and safety standards.

Q: Where can I learn more?

A: Take an online quiz, and then get more details at a free seminar in your area. Sign up here.

Photo, from left: Megan Lylerly, Jessica and Katie. 

Photo credit: Wendy Yang, Wendy Yang Photograpy