Nancy Kurtz lost 109 pounds after traveling to India for gastric bypass surgery. (CBC)

Nancy Kurtz was told she'd probably have to wait five years to undergo gastric bypass surgery and she might have to travel from her home in Kenora, Ontario to Alberta to get it. The 46-year-old retail worker didn't have immediate health problems, so the chances that a doctor would approve her for the procedure right away were slim. But she was worried that sitting on a waiting list for three to five years might be long enough to allow problems like diabetes, cardiovascular illness and painful joints to develop.

Instead, she decided to travel to India, where the procedure would cost her approximately $13,000 — and there would be no wait.

She's still trying to get the Ontario Health Insurance Plan to pick up the cost of the surgery. OHIP will pay the cost of gastric bypass surgery, but only if a doctor decides it's medically necessary. That hadn't happened before Kurtz decided to get the surgery in India.

CBC News talked with Kurtz to find out about her struggle with weight and how the surgery has affected her:

Nancy, can you just start by talking about your lifelong battle with your weight?

Kurtz: I was overweight from about 2½ years of age, most of my life, with small interruptions of starvation diets or something that was successful short-term to keep my weight down — at a great cost to my happiness in many ways. Like I would feel deprived all the time or I would smoke instead of having a meal or I would drink Diet Coke instead of having a meal. So it was not very healthy.

I've probably gained and lost the same 30 or 35 pounds probably a couple hundred times. Because I would hear about the newest diet or I would try something I tried before or they would reintroduce another take on one plan or another, and I would get very excited about it or a product would come out or sometimes it was a new pill. Or maybe it was a new exercise or something, whatever got attention. And I tried them all.

I think there are some really good programs out there and there are some that probably aren't and I think they all can be successful as long as you stick with them. And I could never stick with them long enough to get down to what I should have been on my BMI [body mass index] or what would be considered a healthy weight for my height.

Why do you think that nothing you tried worked for you?

Kurtz: Because eventually I would get too hungry to stick to it. I would feel really hungry and after my surgery, when I first started to go on soft food, I started to get a feeling of pressure in my sternum. I thought that there was something wrong, the surgery had gone wrong, that I was sick or maybe it was a hard problem, so I quickly contacted my surgeon in India.

He suspected that I was mistaking that discomfort for fullness.

And that's exactly what it is. And I had never felt that ever in my life, felt that feeling of fullness, you know, and it was a revelation to me. I thought, well, no wonder the rest of the world stopped eating, when you feel like this: if you know what causes it, you certainly wouldn't eat anymore to feel worse. And all the times in my life that I thought I was full before that, I just wasn't starving. I was never really full, I'd never had that feeling. And I get that feeling now with the very small amount of food.

What kind of effect was the weight having before you had the surgery? What effect, if any, was it having on your health?

Kurtz: I had high blood pressure and I actually still do so probably it wasn't a weight issue. But it runs in the family. When I arrived in India, I had high blood sugar for the first time ever which was very terrifying to me because diabetes is so prevalent and so many other health things go along with it — heart disease and some cancers and stuff.

I was pretty lucky to have escaped many of the conditions that go along with obesity. So far my knees were still good and my hips were okay. But I really felt that it was only a matter of time before I would be struck with all of those things.

How did you come to consider gastric bypass surgery?

Kurtz: I did do a great deal of research because I was frustrated at everything I had tried that wasn't successful for me. I thought if I could control my appetite, I could be successful. Because I knew what I should be eating. It was all about portion control.

When I read about it, online primarily, it just made so much sense to me.

I thought it makes sense and that it seems more of a tool than just a magic bullet. It was going to make you feel satisfied on a small amount of food and you would be responsible yourself for having nutrition and not making the wrong choices, which wasn't my problem anyway. I was discouraged by my doctor to do it. He suggested I try other means and I thought I felt I was pretty sure I had exhausted other means. It was not through lack of trying. I tried almost everything.

How long were you told it would take to get the surgery?

Kurtz: Out West, the waiting list was three years if you had all kinds of complications. And more like five, if you didn't have an immediate health issue. And, of course, I think priority would still be given to people in Alberta over myself coming from Ontario. So I thought in three to five years, I could have a heart attack or a stroke or just simply die. You know, I wouldn't even have lived through those things. Or need new knees and maybe I couldn't exercise anymore. It was just going to be a downhill trip for me. I just really felt lucky to have gotten that far in life and still maintained quite good health with all that extra weight.

I wasn't naive enough to think that it would all be all right and that they would take care of me in time. I just didn't have that level of faith in our system. I see people all the time even in my small town that are much larger and much unhealthier than I was before I had bariatric [weight-loss] surgery. I don't know what their personal stories are, if they are waiting for surgery, if they are considering it. But I'm thinking if I had to be so sick to have this done, what about all those people that I can see are less healthy than me?

Why did you decide not to wait and go to India?

Kurtz: I could go when I wanted, almost pick the date that I wanted my surgery. None of this waiting around and trip after trip after trip. And my research led me to believe that it was going to be very, very good care and state-of-the-art equipment. So I just felt that I had to make that decision for my health. You know it was that time to do it.

How much did it cost you in total and why can't you get it back from the Ontario Health Insurance Program?

Kurtz: It cost me just over $13,000. And I'm in the appeal process right now to try and get some of this recovered from OHIP because I feel that I should be entitled to it. I don't believe that it's a cosmetic issue. I believe it's a health issue and as a taxpayer in Ontario, I think I should be entitled to it. But I didn't pre-apply for out of country expenses. I just decided on my own that I would go to India and that it would be the right thing and the best thing for me to do at that time.

What kind of impact did the surgery have on you?

Kurtz: As a result of the surgery, I instantly had a very small appetite. In fact, I had to force myself to take in food. And I could no longer eat anything that was processed.

My weight almost fell off of me. I changed sizes so quickly sometimes in pants that I completely missed a whole size because I barely had something for a couple of weeks and I'd have to go down two sizes from that. My blood sugar was never high again after that.

I was within a healthy BMI in less than six months after surgery. From being morbidly obese I fell into the healthy range of my BMI. That was six months ahead of where they guaranteed me I would be at that state.

How much did you weigh before and what was the amount you lost?

Kurtz: I weighed 270 pounds the day before surgery in India. I weighed myself this morning and I weigh 161 pounds. I have spoken to a plastic surgeon and he estimates a minimum of 20 pounds in excess tissue that has to be removed so my true weight actually at this time would be about 141 pounds or less.

What kind of followup care have you received?

Kurtz: My doctor has been very supportive. There can be absorbed shin problems after this surgery and I have had a little bit of a struggle keeping my iron levels up, so he's been keeping an eye on that closely with some regular blood work.

What do you say to people who say this is cosmetic surgery and not necessary?

Kurtz: I think it'll be a huge burden on the health-care system over the long-term to have so many people suffering from obesity because of all the other things it brings with it — things that are on the rise right now, actually.

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