With 65 percent of Americans either overweight or obese, according to the federal Centers for Disease Control, it's not surprising that many people are electing to have this procedure done.

After all, post-procedure weight losses range from 60 to 80 percent of excess body weight in patients with a body mass index of 35 to 60, over the first two years. That could roughly equal a loss of 80 to 150 pounds, depending on your original weight.

Undoubtedly, weight-loss surgery guarantees permanent weight loss, right?

Well, perhaps . . .

Melissa Blanco, 32, once carried a whopping 274 pounds on her 5-foot-4-inch frame. But the Philly native shed 130 pounds after having the gastric bypass procedure.

"I did Weight Watchers, Jenny Craig, and the weight-loss program at the University of Pennsylvania, and had some success to some degree, but could not maintain it. I started feeling tired and wobbly. I knew something had to change," Blanco said.

So, in the winter of 2005, after doing some research, she decided to have gastric bypass surgery that reduced her stomach to the size of an egg.

"For the first six to eight weeks I was eating clear liquids, solid liquids and pureed foods," she said. "You can't go back."

After the first eight weeks, she began slowly to reintroduce solid foods in her diet. But it was a challenge.

"Before, I would eat whenever I wanted to, whether I was hungry or not. I had to learn to recognize the signs of hunger and to eat when I was truly hungry - and learn not to eat when I was bored, sad or depressed.

"I was miserable that first month. I had lost my best friend. Food was my best friend, and I could no longer eat that way."

When you're struggling with your weight, losing pounds seems like the solution to all your problems. But nothing could be further from the truth.

Besides learning how to eat significantly smaller portions, Blanco also had to learn to manage her mental health.

She sought out counseling to discover what was eating her - and making her eat. The psychological part, she now says, was the most important aspect of her journey to physical fitness.

"Initially, I blew them [counselors] off, thinking I didn't need it. But I really did. I had to discover why I was eating to mask other things."

Maintaining weight loss is a bear; without proper maintenance, you can regain most if not all of your pre-surgery weight. In addition, not following doctor's orders can lead to "dumping syndrome," a common side effect after gastric bypass.

When the shrunken stomach empties rapidly into the small intestine (especially if you eat concentrated sweets or carbohydrates), you may experience a combination of profuse sweating, nausea, dizziness and weakness.

Your weight loss will invariably plateau, so exercise and portion control have to become a permanent way of life.

Blanco learned this lesson when she regained five pounds. That was enough to get her jump-started on a daily half-hour of exercise, which she plans on increasing over time to include weight training for toning.

"Exercise was not a big thing for me, but that five pounds dashed the illusion that I'm never going to gain that weight back again," she said.

The surgery has been a life-saving success for Blanco because she took the necessary steps to make it so. This once-shy woman has not only licked her weight problem, but she has also blossomed into a courageous and confident woman who has created a life she loves.

The Fat Trainer weighs in

Trainer Damali Mason is down 30 pounds and just 15 pounds away from her goal. Way to go, Damali! Keep up the good work.

To follow her progress, go to www.girlfriendslockerroom

.com. *

Kimberly Garrison is a certified personal trainer and owner of One on One Ultimate Fitness in Philadelphia (www.1on1ultimatefitness.com).

E-mail her at

kimberly@1on1ultimatefitness.com. Her column appears each Thursday in Yo! Chat with her on her Daily News weblog, the Girlfriends' Locker Room, at www.girlfriendslockerroom.com. Her new podcast, "Philly Fitness and Health," is available for download every Thursday at www.philly.com.