Eagles guard Jean-Gilles losing weight after lap-band surgery

NO ONE DARED utter the "W" word in the presence of Max Jean-Gilles. For as long as he was old enough to step on a scale, it seemed as if he had been a prisoner of what could only be called an All-Pro appetite. As his weight ballooned to close to 400 pounds, he became so annoyed with his inability to shed the extra pounds he had accumulated that he banned it as a topic of conversation in his household. No one could ask him what he weighed, give him casual recommendations on how to reduce, or even express concern that he was placing not just his career but his life in jeopardy. The Eagles guard had heard enough of it.

But his wife Maggie had become concerned. Jean-Gilles had told her last year that he had experienced shortness of breath and even chest pains. The possibility that he could have a stroke scared her. In fact, it scared Jean-Gilles, who says that he "prayed every day that I would wake up breathing." In the 8 years they had been a couple, Maggie had understood how trying it had been for her husband to overcome his weight problem, why it had been so hard for him to address it with her. But it was not just the two of them anymore. They now had a 2-year old son, Marcus. Maggie began searching for solutions on the Internet and sat down with Max to share her findings. Initially, he was less than receptive.

"There is a procedure . . . " she began.

"No," Max interrupted.

" . . . called lap-band surgery."

"No," he said.

"It has been around for a while . . . "

"No."

But "no" became "yes" as she pressed on and acquainted him with lap-band surgery: A band is placed around the upper part of the stomach, which reduces its size to the point where it is only able to hold an ounce or so of food. Consequently, the patient will eat less, feel full sooner and thus lose weight. Jean-Gilles and Maggie consulted with Dr. Vishal Mehta in New Brunswick, N.J., who showed them photographs of people he had operated on who weighed 500 pounds. Ultimately, it was not until Jean-Gilles sat down with a psychiatrist as part of the insurance protocol that he agreed. The psychiatrist looked at his age (26), weight (then 388 pounds) and height (6-3), and told him he should be 270 to 280 pounds.

"I would look sick," Jean-Gilles told her. "Me? 270?"

But instead of using the "W" word, the woman looked him in the eye and used the "O" word: "You are obese."

Some 3 weeks after he is believed to have become the first active NFL player to undergo lap-band surgery, Jean-Gilles sat with Maggie on a quiet Friday at a rear table at Dave & Buster's on Delaware Avenue. As a waitress whirled by with a tray of something oozing with calories, he appeared oblivious to the culinary temptations that surrounded him, including the always savory and completely irresistible mac and cheese. But there would be none of that today, given the dietary constraints he has been under since the procedure was performed in April: clear broth or soup; pureed skinless fish or chicken; mashed potatoes and low-fat yogurt or pudding. Down 30 pounds from his starting weight, Jean-Gilles still has to drop another 38 pounds to reach his goal: 320.

"Weight is not going to be an issue for me this year," says Jean-Gilles, who indicates he has experienced few of the side effects that can be associated with the surgery. "The psychiatrist slammed it on me: 'You are obese.' I told her, 'You have to understand, I play football.' But she just said for your age, height and weight, you are obese."

Maggie leans forward and smiles. "Saying 'I play football' is no longer an excuse," she says. "Because one day football will be over and what will you say? I 'used to play football?' By then it may be too late."

Obesity has become an alarming problem in the NFL, particularly for offensive and defensive linemen. Generally weighing at upwards of 300 pounds, they tend to encounter a myriad of health problems once they leave the game, including diabetes, sleep apnea and cardiovascular disease. When 310-pound former NFL defensive tackle Norman Hand passed away on May 14 of a heart attack at age 37, it was just the latest example of what has become a sad litany of ex-players who have died too young of weight-related issues: Steve Trapilo, dead at 39; Frank Warren, dead at 39; Tony Elliot, dead at 48; and so on. A 2006 Scripps Howard News Service study found that players over the last century who were obese were more than twice as likely to die before their 50th birthday as their teammates. The NFL dismissed the findings. NFL analyst and former center Jamie Dukes says that he had five former teammates die before the age of 50 and includes in that count 6-5, 300-pound Eagles legend Reggie White, whom he played with at Green Bay and who died in 2004 of a heart condition in combination with sleep apnea at age 43.

"The cause of death is never identified as obesity but something else," says Dukes, 45, who played 10 years in the league before retiring in 1996. "But the reality is the excess weight is the problem. Certain players need help beyond exercise and diet."

No one knows that better than Dukes, who had the lap-band surgery in July 2008. While he had played at 6-1, 290 pounds, he says his weight climbed to an astonishing 395 pounds in retirement, a victim of reduced activity and what he calls a genetic predisposition to gain weight. "I would look at a cookie and gain a pound-and-a-half," says Dukes, who adds that he would be up 5 pounds once he finished the box. Whenever he would hear people say "just push away from the table," he would explain to them that it is not that easy, that the craving for food "can drive you crazy." The lap-band surgery has allowed him to drop 110 pounds and he has become a proponent for the procedure as a way for former players to get down to a healthy weight. But he says that Jean-Gilles having the surgery could "open the door for some other [active] guys who need help." Says Dukes: "We are in uncharted territory insofar as active players go."

Uncharted until the underlying question is answered: Can Jean-Gilles now go out on the field and prove that it has allowed him to become a better player?

Selected by the Eagles in the fourth round out of Georgia in the 2006 draft - ahead of Jahri Evans, who has emerged as an All-Pro guard for Super Bowl champion New Orleans - Jean-Gilles has blocked well but has problems with his agility and endurance. Ankle surgery in 2008 hampered his ability to work out, which allowed his weight to surge upwards and became even more of a problem. While the Eagles did not recommend that Jean-Gilles explore the possibility of the lap band surgery, team trainer Rick Burkholder told the Daily News on May 1: "He came up with the idea, went and saw the doctors, they had a plan laid out, we looked at the plan and then we agreed with it." Burkholder added, "You wish he would have done it in a traditional way, but some people struggle."

Mehta echoes that. "For people who are extremely overweight, it has been proven that the effects of diet and exercise are temporary, that you lose only 10 percent of your weight," says Mehta, who works out of the Mehta Obesity Center in New Brunswick. "For someone 400 pounds then, he can expect to lose 35 to 40 pounds and maintain that. To lose 100 pounds or more, just diet and exercise is very ineffective for 99 percent of people."

But while Jean-Gilles was concerned with his long-term health, he was also concerned with his career. Burkholder told the Daily News that he understood that Jean-Gilles was of the belief that he was at "a break point" in his career. Jean-Gilles acknowledged that worry. He has started 15 games since 2008 as a replacement for injured teammates, but he seems to wear down the more he plays. In search of what to do but not sure what that could be, he did not want to inadvertently use any substances banned by the league, something that could only deepen his problems. Jean-Gilles adds that he and his fellow linemen discuss the weight-management issues continually, especially since jobs in the league are so scarce. The 6-6, 320-pound Eagles tackle Winston Justice has joined into those conversations and says the key is "making an investment in your body" by eating properly.

Jean-Gilles agrees. Now.

"The No. 1 thing is to stay healthy," he says. "So you can compete at your fullest potential."

To hear Jean-Gilles explain it, eating always had been a haphazard undertaking. Going through a typical day, he says he would seldom eat breakfast, except on the weekend, when he would scarf down six eggs, five pieces of bacon and sausage. Lunch used to be a problem for him, especially if it happened to be Italian food. "Love Italian food," he says. He would get a heaping plate of lasagna or whatever else caught his admiring eye.

Dinner?

Neither he nor Maggie says he would eat voraciously at the dinner table.

The big problem came later: Snacks.

"Mostly chips," he concedes sadly. "I loved chips."

But a large part of it came down to portion control. Instead of ordering five chicken wings if he happened to be out, he would order 20 or more. He would eat until he was full and then some. While you would be tempted to guess that he developed an affinity for the cuisine at Burger King, Maggie says that "we never eat that stuff," that the problem had more to do with sitting down at the table and not leaving. Insofar as beverages were concerned, Jean-Gilles says he developed a fondness for "Red Bull and tequila," which he says "lifts you up and lets you down at the same time." On a typical day, Maggie estimates Jean-Gilles would consume 3,500 or more calories.

Hunger would always leave Jean-Gilles "short and agitated," according to Maggie. Wherever they happened to be, or whatever they happened to be doing, Maggie says they would have to stop and feed him. And it could not just be something on the go. They would have to sit down, order, have a drink and an hour or so later Maggie says "a smile would come on his face." But until he had his appetite satisfied, she says he would be "very cranky," hurrying the waitress along to bring his food.

"I have to say it became annoying," says Maggie. "Whenever he ordered soup, he would just pick up the bowl and slurp it down. He would not even use a spoon."

Jean-Gilles smiles sheepishly and says, "The spoon was always too small. When I would get hungry, you better not even talk to me. I had to get food in my belly."

Seeing her husband in the condition he was in was a source of ongoing anxiety for Maggie. Her husband did not sleep well and seemed to become increasingly sluggish. Well aware of what the statistics were regarding the life expectancy of NFL linemen - that essentially "it was not good" - she had been thinking of what life would be like if something awful happened, not just for herself but for their small son. But whenever she would bring up the subject of what to do, Jean-Gilles would sigh and say he was "tired of dealing with it." Jean-Gilles says, "Every year she would bring something new to the table."

But Maggie did not back down or give up. For part of her youth, she had lived amid the abject poverty of Haiti (and still does relief work there in the wake of the earthquake that claimed 300,000 lives). She knew how to overcome obstacles, even if it happened to be a 388-pound man she so dearly loved. Upon hearing of the lap-band surgery, she began doing her homework on the Internet and found that the pros outweighed the cons: such as ulceration, band slippage, difficulty swallowing, constipation and bloating. She searched for a doctor in New Jersey with the hope that the surgery could be done without drawing attention from the press (which both she and Jean-Gilles now welcome if only that it can help others). She set up an appointment with Mehta and persuaded Jean-Gilles to attend by reminding him that he had a family and saying, "The last thing I want to become is a widow."

Jean-Gilles was in surgery for less than an hour. Mehta inserted a band around the top of the stomach and explains that "under the muscle is a port that is accessible with a needle." By injecting saline solution via the port and into the band - and thus tightening it - Mehta says "you can control the amount of weight a person loses." Mehta says that in the case of Jean-Gilles, "I would have to add saline or he would not lose much weight." But Mehta told him that he would also have to change his eating habits for the better. Initially, he has been eating soft foods, although he did try to force down some meat.

"And he did just what they said he would do: He threw it up," says Maggie. "Eventually, they said you are going to get tired of throwing up and stick to the plan. But even when he is able to eat more foods, he is going to have to eat smaller portions. And he has to learn how to breathe when he eats, and actually smell the food as he is taking it in."

Jean-Gilles chuckles and says, "The big thing is I am not hungry all the time."

But he has been somewhat sluggish since the surgery, which Mehta says "can be expected in the early weeks." Jean-Gilles returned to the field last week for Eagles organized team activities. Mehta adds that Jean-Gilles should be in good shape by the beginning of training camp in July and recommends that the Eagles keep an eye on his food intake and see that he supplements his diet with protein shakes.

Told that Dukes is of the belief that Jean-Gilles could pave the way for other active players to undergo the surgery, Mehta says he has "already heard from a few of them" but none has committed to having it done. The doctor says "they are waiting to see how it goes with Max."

Jean-Gilles says, "I should have done this long ago."

Maggie is beaming these days. She cannot help herself. Gone is the worry that once consumed her, as week-by-week the weight falls off her husband. Neither of them had had a lot in life - Jean-Gilles grew up in Miami with Haitian-born parents who each worked two jobs. In the years that have passed since she caught his eye in the weight room at North Miami Beach High School, Maggie says that the struggles Jean-Gilles endured with his weight "just made me love him more," if only because each day it reminded her again that he was doing it for her - and now Marcus. A smile flashes across her face as she says, "Where there is a will, there is a way."

Jean-Gilles says he plans to keep the band on for a year or so (unlike Dukes, who says he plans to keep it on "forever - why take the chance?"). He says he would like to play in the NFL for "as long as God allows," yet knows that the NFL is not forever, that a day will come when he will have to leave the game either by choice or involuntarily. When that day comes, he wants to have a healthy life, one that will allow him to see Marcus grow up into manhood. Because the way he looks it at now, he has a lot more than weight to lose.