CoffeeGrinDR

Just an update...
SouthernSoul was spot on here. We ended up talking about EVERYTHING. I didn't get to see her before she left the country but we will when she gets back.
She called me on Christmas to tell me she has feelings for me and that she totally supports my goals and plans for self-care.
Turns out she loves me just as I am.
This surgery has always been for me and me alone but it was an incredible experience to have prior to losing weight and means a lot.

When I read the original post on this thread I thought, wow, do you get it. I have to think we each, in our own way, understand the depths and lasting impact of some wounds we have experienced early on.
I grew up in an abusive household and I've done a lot of work with a therapist to get through anger issues but I haven't resolved my weight problems.
I've gone through periods of losing. I have a cycle. I lose weight, I feel better, I meet someone, I get "comfortable", I gain weight, I get upset, I feel worse, I gain weight, the relationship gets rocky, I gain weight, I feel worse, I go through a break up. Repeat.
I'm successful in my career but I have no doubt that I have faced "fat" prejudice in job interviews or with colleagues. I have no doubt that it has held me back in living my life; I have spent so much time getting out of potentially embarrassing situations its what I've lived my life knowing and excelling at: avoiding living.
But when you are the weight I am you worry, you stress, you know that you might not fit in the chair, you worry that you'll bring the wrong seat belt extension; you know it will wind you to have to walk up the hill for the sightseeing, you avoid beach vacations, you would love to sky dive or ride horseback or even run, but you can't; you try to get to meetings early because you worry about having to squeeze into a row for a seat; you don't like being out of breath just from going up two floors with your colleagues when you walk back from lunch; you live in a state where people ski most of the year and you have no ski weekend stories because the thought of even walking in snow is exhausting.
It is so tiring, so exhausting not living.
And so when it is quiet and lonely but safe you are happy but not quite, so you grab that box of swiss rolls and the sugar and the pleasant set of movies make you forget about all the painful moments of being so aware of being the biggest one in the room but being invisible. But the temporary reprieve keeps us caught up where we are.
I don't think I've wrapped my mind around what my life looks like "thin" it's more of: what is my life like? I have no idea. I have been on the sidelines. Yes, I got places, I do things, but everything is always buried in these extra 130 pounds and it is tiring. I've lived in three different countries, I've traveled around the world, I go out and yet I do so always aware of my size.
So, it's time to start thinking differently. Or rather, to stop thinking "fat" and start thinking "worthy" or maybe just to not have to plan everything, control the environment, avoid embarrassment. It's not a secret but we never talk about it. It's the most obvious thing but it creates so many walls that make us invisible.
I'm choosing to live. I think I am afraid of what that will bring. No more sidelines. And there will still be difficult days and tough times and lonely Sunday evenings. And then what do I do? Without the food to soothe and the weight to blame, what does my narrative become?
It's time to start a new story of my life...

(ok, I shouldn't say the band stinks - it just doesn't always work - so don't feel bad if it hasn't worked for you!)



Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

(ok, I shouldn't say the band stinks - it just doesn't always work - so don't feel bad if it hasn't worked for you!)



Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Steamy, it did. Psycho-social research tends to be much more difficult to draw clear correlations from due to the sensitive nature of things. What I found were some interesting (and at times confounding) outcomes. I'm happy to do another summary.
Basically, overall quality of life for WLS patients goes WAY up but there DOES tend to be higher instances of depression amongst WLS patients than the control population...
Here's where this gets "noisy" in statistical terms...we know that the reasons for our obesity/problems with weight are attributable to a confluence of factors, and none of them will be exactly the same for two people. The advice from what I've seen in the medical journals mirrors that of what many wise vets here say: the work is not just about the body, but the mind, and the heart.
I often think there needs to be a lot more done in terms of social and mental (and perhaps spiritual if that's your cuppa) support for healing than anyone in Western/modern medicine would ever want to admit. Some psychologists are finally wading into this difficult area. I read a book by Sara Stein, MD, that discusses her own personal struggle with weight (as a psychologist) and it is reassuring. That book is called "Obese From The Heart" and it is helpful but it is a beginning to a much LONGER conversation. There are a few other books out there -- workbooks on emotional eating, self-soothing without food - but I haven't gotten into them yet. I believe in books that help you see into yourself but for some reason these sorts of works don't tend to resonate strongly with me (and yet I KNOW I am an emotional eater).
My plan is to see my therapist weekly and journal my experience and keep talking to you all. The one structured thing I plan to do is to document how I am feeling - how i would have responded before - and what my NEW response is. Classic cognitive behavioural therapy work...make the implicit habits explicit until you change them I guess.
I'll be back with a psych-lit summary later.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

True, I think Geneen Roth's work is good because it speaks to these issues but (forgive me, this is my humble opinion) she does a lot of pitying of the victim. And that just doesn't work for me. I want a structured recovery plan.
She is mostly repetitive in her books and I appreciate it takes a lot for most of us to open up to soft parts of our insides that have led us to this point but where is the next step?
I think that's why I find the forum here so helpful, these are people actively living the next step and living to tell about it from a place of strength.
Much love to everyone in their journey.

Steamy, it did. Psycho-social research tends to be much more difficult to draw clear correlations from due to the sensitive nature of things. What I found were some interesting (and at times confounding) outcomes. I'm happy to do another summary.
Basically, overall quality of life for WLS patients goes WAY up but there DOES tend to be higher instances of depression amongst WLS patients than the control population...
Here's where this gets "noisy" in statistical terms...we know that the reasons for our obesity/problems with weight are attributable to a confluence of factors, and none of them will be exactly the same for two people. The advice from what I've seen in the medical journals mirrors that of what many wise vets here say: the work is not just about the body, but the mind, and the heart.
I often think there needs to be a lot more done in terms of social and mental (and perhaps spiritual if that's your cuppa) support for healing than anyone in Western/modern medicine would ever want to admit. Some psychologists are finally wading into this difficult area. I read a book by Sara Stein, MD, that discusses her own personal struggle with weight (as a psychologist) and it is reassuring. That book is called "Obese From The Heart" and it is helpful but it is a beginning to a much LONGER conversation. There are a few other books out there -- workbooks on emotional eating, self-soothing without food - but I haven't gotten into them yet. I believe in books that help you see into yourself but for some reason these sorts of works don't tend to resonate strongly with me (and yet I KNOW I am an emotional eater).
My plan is to see my therapist weekly and journal my experience and keep talking to you all. The one structured thing I plan to do is to document how I am feeling - how i would have responded before - and what my NEW response is. Classic cognitive behavioural therapy work...make the implicit habits explicit until you change them I guess.
I'll be back with a psych-lit summary later.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

No probs, Arts. Research is kind of my thing, citations are just habit.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

Steamy, it did. Psycho-social research tends to be much more difficult to draw clear correlations from due to the sensitive nature of things. What I found were some interesting (and at times confounding) outcomes. I'm happy to do another summary.
Basically, overall quality of life for WLS patients goes WAY up but there DOES tend to be higher instances of depression amongst WLS patients than the control population...
Here's where this gets "noisy" in statistical terms...we know that the reasons for our obesity/problems with weight are attributable to a confluence of factors, and none of them will be exactly the same for two people. The advice from what I've seen in the medical journals mirrors that of what many wise vets here say: the work is not just about the body, but the mind, and the heart.
I often think there needs to be a lot more done in terms of social and mental (and perhaps spiritual if that's your cuppa) support for healing than anyone in Western/modern medicine would ever want to admit. Some psychologists are finally wading into this difficult area. I read a book by Sara Stein, MD, that discusses her own personal struggle with weight (as a psychologist) and it is reassuring. That book is called "Obese From The Heart" and it is helpful but it is a beginning to a much LONGER conversation. There are a few other books out there -- workbooks on emotional eating, self-soothing without food - but I haven't gotten into them yet. I believe in books that help you see into yourself but for some reason these sorts of works don't tend to resonate strongly with me (and yet I KNOW I am an emotional eater).
My plan is to see my therapist weekly and journal my experience and keep talking to you all. The one structured thing I plan to do is to document how I am feeling - how i would have responded before - and what my NEW response is. Classic cognitive behavioural therapy work...make the implicit habits explicit until you change them I guess.
I'll be back with a psych-lit summary later.

Mostly I wanted to see what the medical literature has to say about VSG and dying. Turns out, it's pretty darn safe - but don't take my word for it, I'm not a medical doctor. Just sharing some research.







KEY FINDING: LAP-BAND FAILS 44% OF THE TIME.



This study finds that the LAGB failed as a primary bariatric procedure for 44% of patients due to either inadequate weight loss or adequate weight loss with unmanageable symptoms. This suggests that the LAGB [lapband] should be abandoned as a primary bariatric procedure for the majority of morbidly obese patients due to its high failure rate.



Kindel, T., Martin, E., Hungness, E., & Nagle, A. (2013). High failure rate of the laparoscopic-adjustable gastric band as a primary bariatric procedure. Surgery for Obesity and Related Diseases.





KEY FINDING: SLEEVE REDUCES GHRELIN AND IS MORE SUCCESSFUL THAN GASTRIC BANDING.



As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after LSG but not after LAGB. This reduction remains stable at a follow-up 6 months postoperatively, which may contribute to the superior weight loss when compared with LAGB.



Langer, F. B., Hoda, M. R., Bohdjalian, A., Felberbauer, F. X., Zacherl, J., Wenzl, E., ... & Prager, G. (2005). Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obesity surgery, 15(7), 1024-1029.





KEY FINDING: LSG IS SAFE AND EFFECTIVE (as far as we know in the short-term).



Results: Of the 62 patients who underwent LSG performed by two surgeons, the data of 30 patients (7 males and 23 females) were further analyzed. Mean preoperative BMI was 41.4 (33-59) kg/m2. Mean operative time was 80 min (range 65-130). Mean hospital stay was 3.2 days (range 2 to 25). Mean weight loss at 3 and 6 months following the procedure was 22.7 kg and 30.5 kg respectively, and mean % excess weight loss (EWL) was 40.7 and 52.8, respectively. Three patients were considered to have mild complications, and one patient had a major complication that necessitated surgical intervention. There was no mortality. Conclusions: In the short-term, LSG is a safe and effective treatment option.



Roa, P. E., Kaidar-Person, O., Pinto, D., & Rosenthal, R. J. (2006). Laparoscopic sleeve gastrectomy as treatment for morbid obesity: technique and short-term outcome. Obesity surgery, 16(10), 1323-1326.





KEY FINDING: Even 5 years out sleeve gastrectomy is effective to fight obesity.



Five years after performance of SG, weight loss was satisfactory, few complications were observed, the reduction of co-morbidities was significant, but there was an increase in the frequency of GERD.



Fuks, D., Verhaeghe, P., Brehant, O., Sabbagh, C., Dumont, F., Riboulot, M., ... & Regimbeau, J. M. (2009). Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery, 145(1), 106-113. (Conducted in France)







KEY FINDING: Gastric sleeve works on its own, the weight stays off, and the ghrelin doesn’t come back in the first 5 years.



At 5-year follow-up, a mean EWL of 55.0 ± 6.8% was achieved, indicating that SG leads to stable weight loss. Beside significant weight regain, severe reflux might necessitate conversion to gastric bypass or duodenal switch. After an immediate reduction postoperatively, plasma ghrelin levels remained low for the first 5 years postoperatively.



Bohdjalian, A., Langer, F. B., Shakeri-Leidenmühler, S., Gfrerer, L., Ludvik, B., Zacherl, J., & Prager, G. (2010). Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obesity surgery, 20(5), 535-540.







KEY FINDING: Meta-analyses indicate that while there are a small number of complications (mainly fistulas for BMI<60) people don’t die from sleeve surgery. (Canada, Korea, France, Israel, USA)



Behrens, C., Tang, B. Q., & Amson, B. J. (2011). Early results of a Canadian laparoscopic sleeve gastrectomy experience. Canadian Journal of Surgery, 54(2), 138.



Han, S. M. (2005). Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obesity Surgery, 15(10), 1469-1475.



Nocca, D., Krawczykowsky, D., Bomans, B., Noël, P., Picot, M. C., Blanc, P. M., ... & Fabre, J. M. (2008). A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obesity surgery, 18(5), 560-565.



Rubin, M., Yehoshua, R. T., Stein, M., Lederfein, D., Fichman, S., Bernstine, H., & Eidelman, L. A. (2008). Laparoscopic sleeve gastrectomy with minimal morbidity early results in 120 morbidly obese patients. Obesity surgery, 18(12), 1567-1570.



Hutter, M. M., Schirmer, B. D., Jones, D. B., Ko, C. Y., Cohen, M. E., Merkow, R. P., & Nguyen, N. T. (2011). First Report from the American College of Surgeons--Bariatric Surgery Center Network: Laparoscopic Sleeve Gastrectomy has Morbidity and Effectiveness Positioned Between the Band and the Bypass. Annals of surgery, 254(3), 410.

I will echo a lot of what lipstick lady says. I am embarrassed by what I looked like when I started. It doesn't mean I judged what anyone else looked like. How I feel about me has nothing to do with how I think about anyone else. We are always nice to other people than we are to ourselves anyway aren't we?

Maybe she is just being a real friend and being respectful?
Could be she is taking it as none of her business if you aren't the one opening up the conversation. I wouldn't get bent out of shape having unnamed expectations of someone.
Congrats on your progress.

As sometimes data on rates of loss are sometimes thin on the ground, I thought I'd share mine for you all.
I am 5ft 10. I started at 250lbs. Day of surgery, I was 243.83. BMI 35.3
I am 6 months and 8 days out (including today) since surgery.
As you will see (and I hope it brings a little reassurance to some), that although my scale is a little on the slow side in comparison to others, that the numbers (on the scale and on my body) are moving in the right direction. Stalls and all!




I am trying to reach 173lbs. This will give me (for the first time since I was 18) a normal BMI of 24.8.

As it stands of today and based on the above figures:

250lbs Starting

192lbs Current - Loss 58lbs BMI 27.8

173lbs Goal - 77lbs total loss required

58lbs / 77lbs = 75.3% of Excess weight lost

19lbs to go! (31lbs if I want to get to my lowest weight ever, although I'll re-evaluate this when I hit 'normal' )

Now, I'm just hoping that my window of opportunity isn't about to slam shut!

Would really appreciate any viewpoints on rates of loss during the 6 months- 1 year mark?

Hope the above has allayed some fears and provided a bit of confidence in your own rates of loss, all you sleeve-superstars out there!

Revs x

My routine is usually the same everyday. AM: Protein shake. I have over 15 different flavors and have added fruit to several for a change. I try to add fruit 3 times a week.
Lunch: 1/2 cup of "food" Protein first (min 25 gms) and then add veggies. Usually a Soup or stew. Occasionally a salad with meat, egg and cheese.
3 PM: snack of yogurt with cottage cheese or a cheese stick.
Dinner: Protein Shake.
I usually get 900 calories, 65 gm of protein.

I am a creature of habit. I eat the same thing every day (with the exception of dinner) because that works for me. It makes shopping pretty straight forward as well.
Here is my typical food distribution throughout the day:
6 am- premier shake and 1 cup Fiber one
9 am: 4 oz chicken and 1/2 cup red bell pepper
12 pm: 4 oz chicken and 1/2 cup red bell pepper
2 pm: 1/2 cup steel oats, 1 scoop chocolate Protein powder and 1/2 cup Fiber one - all mixed together. It is yummy!
4 pm : work out
5:30 pm: 2 scoops Protein Powder mixed with scoop super food powder (green vibrance). Sort of nasty, but it helps nutritionally.
7:30 pm: wife prepares. Usually a chicken dish like chicken garlic, or chicken picatta, etc and 2 oz of cooked brocolli.
9:30: 3 scoop casein powder (I like it thick like pudding).
And that is it. I do not include dairy products, bread products, sweets, and most of the time, fruit, in my diet. Sometimes I will make a Protein Shake with a banana. There may be some exceptions if we eat out or are otherwise not at home, but habits are easiest to stick to.

Every Sunday I go to the store buying what I need for a large batch of something nutritious and delicious. I try to buy local ingredients and keep the recipes very simple. I detail my plan here in this thread:
http://www.bariatricpal.com/topic/300695-discouraged-with-planning-meals/?p=3397701
Mason jars are the key to my success.

You can wear your knickers - don't worry. Just your bra will have to be removed.
If you tell them, they'll be cool about it.

Wt is 181.6 lbs!

Maybe she is just being a real friend and being respectful?
Could be she is taking it as none of her business if you aren't the one opening up the conversation. I wouldn't get bent out of shape having unnamed expectations of someone.
Congrats on your progress.