Tess Boehm weighed 443 pounds before her surgery. ((Submitted by Tess Boehm))

A Saskatchewan woman who has spent thousands of dollars in the last several years on surgical treatment for obesity has undergone another round in the operating room as doctors removed sagging folds of skin.

Tess Boehm has shared her experience in the hopes of helping others who face serious health issues with obesity.

Four years ago, Boehm became the first person from Saskatchewan to undergo bariatric weight-loss surgery offered in Brazil. In the procedure, doctors surgically limit the amount of food the stomach can hold in order to restrict food intake. The patients become full after eating less food, and weight loss results.

Since the operation was performed on her, Boehm has shed some 200 pounds, reducing her weight from 443 pounds. The latest operation, also performed in Brazil, was to remove large folds of skin that were unsightly and a potential medical problem.

After doctors cut away 22 pounds of loose skin from her stomach area, Boehm said the transformation astounded her.

"[The skin] would hang down to my knees sometimes," Boehm told CBC News. "So you are always wearing things that will hold everything in. And for me to look down and not have that stomach is amazing."

Boehm has paid for all the procedures and the associated costs out of her own pocket, draining the family's resources.

"I would not be alive today if I didn't go for the original weight-loss surgery," Boehm said when asked if the expense and painful recovery has been worth it. "There's no doubt in my mind that I would have died."

Aside from the improvement in her health, Boehm said the surgery has also changed her self-image, albeit slowly.

"I'm finding it difficult," Boehm said. "When I look in the mirror, until I came back this last time, I look in the mirror and I still see that fat person."

Boehm said that she is planning more surgery, procedures she described as more for her ego's sake, than anything else.

"This is just the end of the journey," Boehm said. "You look in the mirror and your skin is all over the place and you just feel like you need to make a change. Some things like my face, I'm just doing them for me, just to make me feel better about who I am."

Boehm has started raising money to return to Brazil for her final plastic surgery in a year and a half.