For generations, the Southerland family have lived and died in the tiny town of Washburn, Tennessee. The rural community, nestled in the Clinch Valley, has barely over 2,500 residents. There’s no police station or even a red light. The closest city, Rutledge, is over Clinch Mountain, some 15 miles away.

“It’s very rural country,” said Karen Cullom. “My mother’s family, the Southerlands, have probably been in Washburn over a hundred years. Going back from my mother, Pauline Southerland, her mother, and mother before them.”

Karen also raised her daughter, Laken Bailey, in Washburn. The Southerland women are close knit and share many family traits and traditions. However, one family tradition the women have fought to break is the cycle of obesity.

Food and family go hand-in-hand, especially in the south. Families share meals and pass along favorite recipes. Unfortunately, they often pass along unhealthy ways of cooking and eating.

“Good country cooking with lots of butter and lard,” explained Karen. “My Granny couldn’t fix green beans without adding a spoonful of lard. That’s what we ate.”

And with a diet that included lots of fat, sugar, and salt, Karen, her mother Pauline, and daughter Laken, packed on the pounds. The turning point came when Karen needed knee surgery at age 39.

“The doctor said to have the knee replacement, I had to lose a lot of weight first,” said Karen. “He recommended bariatric surgery.”

Karen attended one of our Foothills Weight Loss Specialists’ surgical seminars and started the process of becoming a bariatric surgery patient. I performed a gastric bypass on her in February of 2010. In this procedure, the small intestine is rerouted to a smaller stomach pouch, thereby limiting the amount of food a person can eat and reducing calorie absorption.

The surgery was life-changing for Karen. “My quality of life was better. I lost over 100 pounds and could breathe better, and had more endurance,” said Karen. “Just walking across the parking lot or up the stairs, my knees felt better.”

Karen wanted the same success for her mother and daughter. “My Mom was my support person, and I encouraged her to do the surgery. I knew it could also help Laken. She was so young, and I think she was scared to acknowledge she had a weight problem.”

Twenty-year-old Laken was reluctant about the procedure. “I had been overweight my whole life and gained more after I had a baby,” said Laken. “I was scared to do surgery, but I saw how much it helped my Mom.”

Laken and her Grandmother, Pauline, attended a seminar at Foothills Weight Loss Specialists to learn more about bariatric surgery.

“I wanted to get off my cholesterol and blood pressure medicine,” said Pauline. “Laken and I decided to do the surgery process together.”

Grandmother and granddaughter became teammates, with Karen cheering them on. Laken underwent gastric-bypass in December of 2011 and Pauline had the same procedure a month later. Adjusting to the surgery and a new way of eating wasn’t easy.

“I had my surgery right before Christmas, and it was terrible lying there drinking protein shakes, while everyone ate casseroles and cake,” remembered Laken.

But, as the weight came off, Laken, her mother, and grandmother encouraged each other to exercise and to stick to their healthier diets. “We realized we all did best when we fix and eat our food together,” said Laken.

Foothills Weight Loss Specialists’ dietician taught the women new ways to cook.

“We learned how to fix food better,” said Karen. “We get fresh vegetables from our garden. Instead of frying with lots of butter or lard, now things are steamed or baked.”

And, the women eat differently. “I can’t eat ice cream at night anymore,” said Pauline. “I carry little 100 calorie snacks with me and avoid the foods I can’t eat.”

At a follow-up visit at our office in August, Laken had lost 60 pounds and Pauline nearly 50 pounds. Both enjoy being able to move more easily with their new, lighter bodies.

“At Myrtle Beach, I parked and walked six blocks to play putt-putt with my great-grandson,” smiled Pauline.

And Laken is determined that a healthy lifestyle, not obesity, is the family tradition she passes on to her young son.

Jonathan H. Ray, MD, FACS, FASMBS, is a bariatric surgeon for Foothills Weight Loss Specialists, a division of Premier Surgical Associates. Ray is board certified by the American Board of Surgery. He is a fellow of the American College of Surgeons and the American Society of Metabolic and Bariatric Surgery. He is a member of the Society of American Gastrointestinal and Endoscopic Surgeons. For more information, visit