Sandra, a 31-year-old woman living in Barcelona, has been overweight since childhood. But, as an adult, she developed morbid obesity. "From my 124 kilograms [273 pounds] I managed several times to drop to 100-105 kilograms [220-230 pounds], but I never managed to remain at that weight," she told photographer Alessandro Vincenzi. Ultimately, Sandra decided to undergo gastric bypass surgery — and invited Vincenzi to document her life before, during, and after the procedure. The result is an honest, often melancholy photo series Vincenzi titled Metamorphosis.
Vincenzi, a self-trained documentary photographer also based in Barcelona, first met Sandra while visiting the Hospital del Mar at the recommendation of a friend who worked there as a radiologist. The hospital's obesity program offers gastric bypass surgery to select morbidly obese patients who have already completed a year of nutritional and psychiatric counselling. Patients do not choose to undergo the surgery lightly.
The procedure typically involves dividing the stomach into a small upper section and larger bottom section; then, the small intestine is connected to both sections, restricting the amount of food patients can eat and the calories the body absorbs. "When I asked Sandra why she [chose to have the surgery], she told me that she didn’t want to have health problems in the future and also, she wanted to be accepted by society," Vincenzi writes on his website. Sandra told Vincenzi that she didn't have a "complex" about her looks, but that she feared for her future.
Sandra lost nearly 120 pounds over two years, and now, at 154 pounds, she is "on her way to a new life, though she is still in the process," Vincenzi writes. That process will be lifelong: While recovery from the gastric bypass surgery itself is painful, the regimented schedule of eating many small, nutrient-rich meals each day exacts a greater toll on patients. Still, Sandra "looks at these pictures with a smile," Vincenzi says of his subject's reaction to Metamorphosis.
Click through to view the 29 poignant photographs — including intimate moments with family as well as scenes in the operating room itself — with commentary from Vincenzi.