The problem is extra skin.
Pam Pelletier said her life has been changed by gastric bypass surgery.
The surgery helped her lose 145 pounds in less than a year.
"It came off quickly," she said. "My youngest daughter weighs around 140 pounds, so I lost her, plus five pounds. That's what I tell everybody."
Doctors told Pelletier that for the first time in her life, she is at a healthy weight.
But the weight loss left about eight inches of sagging skin behind.
"It's hard to be small for the first time in your life and then not be able to wear what you want to wear," Pelletier said.
Dr. Michael Zenn, a plastic surgeon at Duke University Medical Center, said removing the extra skin is often the only way to get rid of it.
"We do see a lot of patients who have lost a significant amount of weight," Zenn said. "We're talking 50 pounds or more."
But the procedure is safe only when a patient is at his or her ideal weight.
"What will happen is, we'll take some tissue out, " Zenn said, "make them look nice and flat, and then they'll lose 25 more pounds, and then, guess what? There's extra skin again."
Two months ago, Zenn removed excess skin from Pelletier's arms.
"He took about a pound out of each arm," Pelletier said.
She said the procedure was an early Christmas present. But now she is focusing on exercise and toning.
Surgeons said sometimes patients mistakenly request skin removal when all they really need is muscle toning and exercise.
Pelletier said she is happy with how she looks and feels, which was her inspiration all along.
"I'm doing this for me," she said. "I'm not doing it for my husband or my kids or anyone else. This is for me. This is something I want."
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