ELKHART CO. — Imagine being 20 pant sizes smaller than you once were. That is happening to some local bariatric surgery patients. WSBT talked with one local couple who's lost 290 pounds in just 15 months.

After a lifetime of morbid obesity, Bruce and Patty Nowlin knew they had to do something.

"Getting your mind and your body around the physical challenge is daunting when you're looking at having to lose 150 plus pounds," explained Bruce.

He said he could feel his body shutting down.

"My knees hurt, my back hurt, I wasn't able to move very easily."

The couple said goodbye to those pains about 15 months ago. Today they're healthier, more energetic and much thinner.

Patty chose gastric bypass surgery — the more popular option.

"You actually create a very small stomach ermenant out of a larger stomach," explained their surgeon Dr. Greg Credi. "[The smaller stomach is] about the size of your fist."

Bruce opted for the adjustable lap band.

Credi said the lap band procedure is similar to a noose around the upper portion of the stomach. It also creates a smaller stomach and can be adjusted over time.

Both operations led to quick results. Still, Bruce and Patty struggle with other people's reactions.

"You're recognized by people at a different level," explained Bruce. "People at church, people at work. They'll interact with you more when you're skinnier and you're pretty much left alone when you're obese."

But the biggest challenge has been recognizing themselves.

Bruce said he still sees himself as the obese person he's been all his life, and that makes it difficult to perceive how different he looks.

"When you see pictures and you see these kind of visual representations of what your body is, there's just a disconnect there," said Patty.

Doctors call that disconnect Mirror Image Syndrome.

Dr. Credi told WSBT the syndrome is common in people who experience a dramatic weight loss.

"They've judged themselves not often on how they look, but how much they weigh," he said. "As that begins to change, then they again struggle with not knowing who they are."

Even through their struggles, the couple knows how far they've come.

"It's not a magic bullet," said Patty. "The weight doesn't just fall off. You still work like crazy."

So far, Patty has shed 165 pounds and Bruce has lost 125. The lap band procedure takes a little longer than gastric bypass.

Both say they're still losing weight. Another interesting thing about Patty and Bruce's surgeries — when they had them done they weren't sure if insurance would cover the $60,000 procedure.

Their insurance did, in fact, agree to pay for it. It's also covering their cosmetic surgeries to help get rid of some of the excess skin. Bruce and Patty hope to have the surgeries done this summer.

In their own 12-week medical weight loss program, Kirk Mason, Cari Peugeot and Kelli Cheatham keep losing weight as well.

At the end of week 7, they have lost a combined total of 39.5 pounds. Kirk is leading the pack. He's lost 8.7 percent of his body weight. Kelli is up to 6.5 percent and Cari has lost 5.4 percent.

For more on the competition between Kirk, Cari, and Kelli, plus tips and resources for getting healthy, go to WSBT.com's Why Weight section.