LEHI -- A little more than a year ago Phil Garrett, of Lehi, weighed nearly 400 pounds -- at 32 the father of three tipped the scale at 390 pounds. He says he had high blood pressure and sleep apnea and knew that something needed to change. Last March Garrett underwent gastric bypass surgery to help get his weight under control.

"Basically it was have the surgery or buy a burial plot because that is the path I was on," Garrett said.

Gastric bypass is the most effective and most invasive type of weight loss surgery available. During the surgery doctors detach 95 percent of the stomach and bypass a section of the intestines, leaving a functional stomach that can hold roughly two tablespoons of food at a time.

"Patients who have gastric bypass surgery can lose 70 to 80 percent of their excess body weight over a year," said Dr. David Watts, medical director of the Utah Valley surgical weight loss program. "Of all the bariatric surgeries it is the most successful with weight loss."

But getting approved for the surgery isn't easy. Patients need to have a BMI of more than 40 or more than 35 if they have other metabolic disease like high blood pressure and diabetes. There is also a rigorous approval process to go through.

"It was brutal," Garrett said. "You have to meet with a whole team of people, a dietician, exercise physiologist, psychologist, so they can make sure you are really ready for the process."

The weight loss program at Utah Valley Regional Medical Center focuses on teaching patients about their new lifestyle long before they have the surgery.

"After the surgery patients will only be able to eat about two tablespoons of food at a time and they have to take 30 minutes to do it," said Ginny Duncan, bariatric coordinator at UVRMC. "They can't drink soda pop or eat sugar and highly processed foods. It is really intense."

Garrett says he learned quickly which foods his new stomach could tolerate and which ones it couldn't. He says he can't eat steak anymore or his body goes into dumping syndrome.

"It is like the worst flu you have ever had times 10 and it lasts for 24 hours," Garrett said. "Your body just rejects some things and for me steak is one of those things."

Patients also are required to drink 64 ounces of water a day but that water can't be ingested during meals. Watts says they want patients to fill up on food in order to get the nutrients they need rather than just filling up on water. He says most patients eat between 600 to 800 calories a day in the year after the surgery but that eventually they will be able to eat between 1,500 and 2,000 calories per day once they reach maintenance phase.

Watts says that studies have shown that among people who have had gastric bypass surgery nearly 20 percent end up gaining the weight back.

"It is a failure to follow up and a failure to follow the diet recommendations," Watts said. "We try to teach people that the surgery is just a tool that if used in conjunction with eating smaller amounts of the right foods and exercise can help successfully control their weight. These are lifestyle changes that need to be sustained in order for people to be successful."

Garrett says despite the lifestyle changes he has had to make the only regret he has is not having the surgery sooner.

"I can go to a store and pick a shirt off the rack and not have to pay $3 more because it's a 3x," Garrett said. "I don't have to ask for a seat belt extension when I fly. The surgery has given me a whole new outlook on life. I never want to go back to where I was. I am happier now than I ever was."

Garrett will celebrate his one-year anniversary since the surgery on Thursday; in that time he has lost 170 pounds weighing in at 220. He says the past year hasn't been easy but it has been worth it.

"My kids say 'We got our dad back.' I thought I was a good dad but I wasn't," Garrett said. "Now I will be around for them, I will get to walk my daughter down the aisle. I get to play around with them without feeling like I am going to have a heart attack. The surgery changed me and it changed our family dynamic. We are a healthier family now."

Garrett says his advice for anyone considering the surgery: Do it.

"Don't let the hoops you have to jump through scare you, let them be stepping stones to get you onto a path of a happier, healthier life," he said. "It isn't a fix-all, take one pill and get thin; you have to be committed and put forth the work but it will be worth it in the end."