Sunshine Kuhia Smith lives up to her name. This is a pretty woman with a ready smile and a shock of bright bronze hair neatly cropped around her face. Tall-ish and fit, she has an easy laugh and a pleasant demeanor; quite fitting for a Youth Program director at the YMCA’s Kailua branch.
Newly into her 39th year, she’s cautiously sunny about what the future brings. It has not been an easy road to today.
Just over two years ago, she came to a breaking point in her life, brought about by her lifelong struggle with her weight. “In September of 2014, I was 259 pounds on a five foot six frame, and I had a lot of health problems brought on by having diabetes.”
Kuhia Smith says her doctor diagnosed her with Type II diabetes in 2006, and immediately put her on insulin shots. She says she had high blood pressure, failing eyesight, and dental problems (“My body was shutting down”), all caused by diabetes, which in turn, largely stemmed from her food and lifestyle choices.
Changing her habits meant changing patterns formed over a lifetime. “I was always a big girl – the biggest in my classes in school. In 1999 when I got pregnant with my first son, I didn’t even know I was pregnant until I was four months along,” she recounts.
She doesn’t even know how much weight she gained from her first pregnancy. After Jalen was born, Kuhia Smith lost 100 pounds, and kept that off for six years, until she became pregnant with her second son in 2005. “With Peyton, I went on bed rest for two months, and I gained the 100 pounds back.”
She says she also developed gestational diabetes in both pregnancies, and preeclampsia in the second pregnancy. The warning signs were starting. “Because I had gestational diabetes, doctors told me it was a matter of time before I developed diabetes. It wasn’t if, but when,” she says.
Kuhia Smith heard this, but didn’t heed it. She admits that for nine more years, she continued unhealthy eating habits (“sweets, snacks, and large meal portions”) paired with no physical activity.
“I couldn’t even play with my children because I would get tired so fast,” she says. “And once at an amusement park, I had to get off the ride because I couldn’t fit in the car. The safety bar wouldn’t close around me.”
Kuhia Smith had attempted for years to lose weight through traditional means of diet and exercise. “I worked so closely with my doctor, Marti Taba. I tried everything – every weight loss program and diet – and she monitored me throughout. It just was never enough. My weight went up and down,” she says.
Then came her 35th birthday. Kuhia Smith explains one critical moment of change. “Thirty-five just seemed to be that number when everything could go downhill. It made me think about my grandfather, who died at age 42 of a heart attack and diabetes. I was the only one in my family with diabetes, and I had high blood pressure. I felt like I was following his footsteps, and I didn’t want that.”
That summer, she was on a family vacation. “My right foot was tingling, and I felt so, so tired. When I got home, I saw my doctor, who told me, ‘This is it. This is diabetic neuropathy.’” That’s nerve damage that can lead to painful, disabling, or even fatal complications.
“I thought, ‘I can’t lose my foot!” she recalls. “My doctor had encouraged me to get gastric bypass surgery for years, and now, I finally considered it.” This is a weight-loss procedure that surgically alters the stomach and small intestine so a person eats less food.
Kuhia Smith says in September of 2014, she attended a gastric bypass informational meeting at Pali Momi Medical Center and “decided right there I would do it.” It was a fragile time, and a path she needed to walk alone.
“I told no one, not even my husband. I just didn’t want to be asked questions about it, or be told more information about it. I thought, if I heard more information about it, I would freak out,” she explains.
She didn’t even reveal this to her husband until a couple weeks later. “I just didn’t want to hear anything. I was also ashamed of what I thought was a stigma around this surgery. It seemed like the easy way out, like I had failed at losing the weight by myself,” she says.
Her husband, Alika Smith, was and is entirely supportive. “As a family, we are glad she did it. She was on the highest dosage of insulin for her diabetes and it seemed like there was just no other option anymore. It was hard for all of us, and our lives have changed, but it’s good. She’s healthy now,” he says.
Kuhia Smith says on December 2, 2014, she went in for the procedure. As she describes it, there was nothing easy about this process.
She says she developed an infection in her wound that didn’t heal for six weeks, compounded by an allergy to the surgical tape used to cover her wound. She says she also couldn’t eat “anything for weeks. I threw up all the time.”
Her friend and YMCA coworker, Wendy Tupper, has been sitting in the office during this interview. Tupper chimes in, “Sunshine worked out like crazy.” Kuhia Smith had taken six months off work to recover, and in that time, worked with a YMCA personal trainer to hasten her physical fitness.
She also continued working, she says, with Dr. Taba, on portion control and nutritious choices. It worked. Before a year had passed, Kuhia Smith had lost 100 pounds. “October 29, 2015 was the day,” she beams proudly.
Numbers are so important to her. Dates, pounds, calories, grams, clothing sizes, cups per meal. “Haven’t you noticed she’s all about numbers?” jokes Tupper, who weaves in and out of our interview, providing insight and humor.
Tupper and Kuhia Smith have been friends for 20 years, as long as they’ve worked at the Y together. When asked to describe their relationship, they answer simultaneously, “She’s the sister I never had,” then break out in laughter.
“Numbers are what I can control,” explains Kuhia Smith. “I haven’t been able to control my weight, and after surgery, I couldn’t control a lot of things about my body. So I was obsessed with numbers.”
She would get sick from eating – due to the kind of food, or the amount of food. She still cannot eat a meal and drink water at the same time. “Heart palpitations, sweating, nausea. I’d have a few bites of rice or chicken and feel like I needed to lie down for 20 minutes.”
“She would,” confirms Tupper. “She’d lie right there in the middle of our office and complain, ‘Why did I do this?’”
Once, a couple bites of butter cake made Kuhia Smith so ill, her husband had to carry her up the stairs to their bedroom. “I thought I needed to go to the emergency room, it was so bad,” she says. This was her body adjusting to the smaller stomach and the shorter digestive tract.
Kuhia Smith also worked with a behavioral therapist for about two years, starting right before she went into surgery. “I was so frustrated. I couldn’t eat. I didn’t know if I’d ever be normal again. Would I ever be able to eat what I wanted? Could I ever eat more than just a tablespoon of food for a meal?”
Then there was the issue of her relationship with her body. “I was never satisfied. When I was a size ten, I wanted to be a size eight. Then I still wasn’t happy. When I got to size eight, I thought, Maybe I’ll be happy if I drop another size.”
Therapy taught her she had an eating disorder. “I was 250 pounds and had anorexic-bulimic tendencies. I didn’t realize you could be that weight and have an eating disorder. I thought it was only skinny people. I had and still have high anxiety.”
It’s a matter of creating new thought patterns. “I thought I’d be happy with myself if I lost a certain amount of weight, but that’s a fallacy. People think I’m fine because I lost all this weight and I look good on the outside now, but it’s still a struggle. They just don’t see that.”
All of this – the eating, exercising, and attitude adjustment – has been extremely difficult. “I never thought it would be this hard,” admits Kuhia Smith. She’s gone from asking herself “Why did I do this?” to “I’m OK, and I’m glad I did this.”
She’s kept the 100 pounds off, and has seen other success stemming from that. “Six months after the surgery, I had an eye doctor appointment. I hadn’t told him I had gastric bypass, though he might have figured it out since I was 82 pounds lighter. He told me, ‘I don’t know what you did, but you saved your life. You made an amazing recovery,’” she tells me, saying her eyesight restored to perfect vision.
Doctors also took her off insulin (which she says was at a whopping 220 units a day at its peak.) They reclassified her as in remission, with normal A1C (blood sugar) levels. She reports that her teeth are better.
Kuhia Smith exercises an hour a day and now “loves it.” She accepts that she will always have to eat more protein, fewer carbs, and even fewer sweets.
She has gone from shame and secrecy about her surgery, to pride. She is an advocate for it – with conditions.
“It saved my life. Maybe I’d be on dialysis by now, if I hadn’t. But people should know how hard it is, and how it’s a never-ending effort to keep the weight off. Don’t expect everything is perfect just because you lose all the weight,” she warns.
Husband Alika sees all this and is understanding. “It’s a work in progress,” he agrees. “We help her by avoiding junk food and sugar. We’re actually all healthier as a family.”
Kuhia Smith is also grateful she tried many other weight loss methods before having surgery. “To other people trying to lose weight, I say, try everything. It’s how I learned about healthy food choices and healthy lifestyle choices. It helped me succeed in my current path.”
Today, she’s a size eight. I ask her what her future goals are. She hesitates.
She seems like she’s about to reel off another numerical goal, when Tupper – ever the counterbalance – interjects. “I think you should just aim to be healthy,” Tupper reminds her friend.
Slight pause for consideration, then, “Yes… Yes, that,” nods Kuhia Smith. “Doctors say I’m fine with where I am. There’s always room to improve, but I like my lifestyle now.”