Eastern Caribbean or Western Caribbean, lounging on the ship or island hopping, Julie Pulmano's love language is "any vacation on a boat." The 60-year-old nurse has been on more than two dozen cruises in her life — including the one where she met her husband, Sherman.

Of all the cruises she's taken, though, one stands out in Julie's mind.

"I was going up the stairs on a ship, and I was having chest pain and was short of breath," she says. "My husband said to me, 'You really need to go to the doctor. You promised me 90 years together.' That was a promise we made to each other, that we'd be married for 90-plus years. I didn't want to let him or our kids down. I went and had my heart checked out. It wasn't my heart, though. It was my weight."

Julie wasn't surprised by the news. She'd always battled her weight.

"I was that person who would be getting ready to go somewhere and I'd be in the closet, trying to find something that would fit," she says. "But nothing looked good on me, so I wouldn’t go. I'd tell my husband that I wasn't going and would just cry in the closet instead.

"I'd plan amazing cruises for six months out and buy cute outfits and start trying to lose weight, but I'd never lose it, and I'd be so sad. I'd go buy big-girl clothes instead and still go on the cruise, but the whole time I'd be so jealous of all the thin people around me. So, I'd promise myself that, next time, I was going to be one of those thin people. But then I'd book another cruise, and the same pattern would just repeat every year."

It took learning her weight was harming her health — and could potentially shorten her life — to encourage Julie to take additional action.

"That was what made me realize I needed to do something," she says. "I've never looked back."

Turning to Mayo Clinic

At the time, Julie was working as a nurse on the surgical floor of Mayo Clinic. Mayo had opened its Bariatric Center in Florida in 2007, and ever since, Julie had been struck by the success stories she heard from patients who'd gone through the program.

In 2012, Julie entered the program as a candidate for weight-loss surgery. While Sherman and her kids supported her, Julie felt judged by other family members and friends, and she left the program.

Dr. Steven Bowers, a surgeon in the Bariatric Center, says the response Julie received isn't uncommon. "Some people may view surgery as extreme," he says. "But they're often not thinking about the long-term toll obesity has on health. They also may not recognize that if you have a lot of weight to lose, you're unlikely to get there through diet alone."

In 2014, Julie realized she needed help if she was going to meet her weight-loss goals. She reentered the program, determined to complete it successfully this time.

Second time's the charm

The Bariatric Center at Mayo Clinic in Florida offers surgical and non surgical options for patients. To be cleared for bariatric surgery, patients must undergo certain evaluations, including blood and imaging tests, as well as behavioral, heart and lung assessments to reduce the risk of complications.

"I went through the evaluations," Julie says. "I met with the dietitians and nurses. I met with the bariatrician, who determined I was a great candidate for surgery. And I went to the classes to learn how to eat properly and exercise. Everyone in the program was wonderful."

Julie credits the lifestyle changes she learned before her gastric bypass surgery with the outcome she achieved afterward — losing 125 pounds and keeping it off for 10 years and counting. The behavior modifications she maintains, like focusing on portion size, not plate size, and learning how to meal prep, have been the most important factor, she says.

"Buying into the behavior aspects of the program is what leads to success with bariatric surgery," says Dr. Bowers, who was Julie's surgeon. "Julie is a great example of someone who took to heart the importance of changing your diet and changing your lifestyle, and she's done extremely well."

Although Julie acknowledges she's biased because she works for Mayo Clinic, she says she'll never go anywhere else for her health.

"Mayo Clinic has the highest standards," Julie says. "They're so comprehensive. They truly walk alongside you, from start to finish."

In addition to the help and encouragement Julie received from the bariatric program team, she also drew inspiration and motivation from her peers through the program's support groups.

A (role) model nurse

In May 2023, Julie switched roles, moving from the surgical floor to work as a nurse in the Bariatric Center. She now serves as a "standard bearer" for bariatric patients coming behind her, Dr. Bowers says. She shares her story with patients, as well as before-and-after photos, and tells them how much the program has helped her.

"This is the perfect job for me," Julie says. "I feel like I'm able to inspire patients. I tell them it's not easy, but it's worth it. And it will bring them longevity and happiness."

Julie stresses to patients that deciding to go through the bariatric program and have weight-loss surgery is something they must choose for themselves.

"It took me two tries," Julie says. "The second time was the right time for me, and it has to be the right time for them. But helping to overcome the judgment patients may feel from others is one of the reasons I want to share my own experiences now."

Julie says she also explains to patients that weight-loss surgery is about much more than appearance.

"Obviously, it gives your confidence a boost, but it also benefits your health and gives you a better quality of life," she says. "You just feel better. Your whole attitude toward life is better."

With her next cruise coming up in September, Julie says she no longer wonders if she'll be able to fit into her clothes by the time she boards.

"Now, I go into the closet and pull out an outfit and know it's going to fit," she says. "It's such an amazing feeling to hold my head high and not hide in a corner. Going through the bariatric program is the best decision I've ever made. My one regret is that I didn't do it sooner."

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