ouroborous

I wasn't aware that I would have to be catheterized... ugh.

"you know most people gain all their weight back plus some" "why take the dangerous road...just eat right and exercise" "if you've never lost more than 20 lbs on a diet, then YOU are the reason why...not the diet...what makes you think you can stick to this?" This is just dead wrong. They are right about one aspect: most people who lose weight with diet and exercise alone gain it back, and more. But the whole point of weight loss surgery is durable weight loss. It is MORE of a "dangerous road" to just eat right and exercise, because the odds are 95% that you'll fail with that route, and the dangers of obesity are FAR greater than the dangers of the lap sleeve (when performed by a competent surgeon, and with patient compliance). The reason you'll be able to "stick with" this is that the sleeve is specifically designed to limit the amount you can eat at one sitting, and to limit your hunger. Thus, it is a tool designed to augment your "willpower." I think you should realize that your family is afraid for you; be touched by their concern, but still be aware that you are making the right choice.

Excellent points. I also wonder if the sleeve wouldn't help alcoholics as well -- from what I understand, you'd be hard pressed to consume enough volume of alcohol to get really blotto. Two birds (addictions) with one stone, for those who are addicted to both?

I don't usually get into belief vs. non-belief arguments. Having a mother who's fairly devout has taught me that when I answer that my non-belief is as heartfelt as her belief, I only get blank stares. So I've learned to just live and let live and accept that 95% of the rest of the population doesn't share my beliefs (errrr, non-beliefs ) and, that's perfectly okay.

Does anyone know what the mean excess weight loss percentage is for VSG as a primary procedure? The ASMBS paper shows a 60% mean EWL, but from what I can tell, that's for the Magenstrasse and Mill procedure, which does not include the resection that removes the ghrelin-secreting fundus of the stomach. So it's possible that the "real" mean EWL for lap sleeve is higher than 60%, but I can't find hard figures on it. Anyone know?

Indeed. One fact that most people overlook is that losing weight is EASY. I can lose 10-30 pounds without even working too hard. A lot of it is switching to lower carbs and watching what I eat. The problem is that keeping the weight off is next to impossible. That's what's so great about the sleeve; not only do you lose an amazing amount of weight amazingly fast (although TBH, I'd be very happy to lose it slower), the sleeve gives you a great set of tools for keeping the weight off. By changing your hormonal chemistry, by producing a restrictive (but not malabsorptive) anorexia, and by avoiding all of the foreign body complications of the lap band, the VSG provides a near-ideal tool for losing the weight and keeping it off long-term. It's still too new to tell for sure, but many bariatric surgeons are calling the lap sleeve the new "gold standard" for weight loss surgery. Honestly, I wish the "weight loss industry" would go away, and be replaced by the "avoiding weight regain" industry. That would be more honest, and more healthy for all of us.

That's a great story! Just one thing... I wish we were all more willing to say "I had surgery" when people asked us how we lost the weight. If we could all have the courage to say that, it might start to take the stigma away from WLS. As long as we hide the fact, I think we're still buying into the idea that weight loss is a matter of courage and determination, and not what it really is -- a medical issue.

For those debating whether or not to pursue weight loss surgery, or which procedure is right for you, I highly recommend reading studies and peer-reviewed publications on the topic. They can be daunting since they're all in medicalese and science jargon, but they are (or attempt to be) an unbiased view of the subject. I did my own research, and quickly came to the conclusion that just trying to "do it the old fashioned way" was likely a recipe for failure, and that my risks of doing nothing and remaining obese were much higher than my tiny risks from weight loss surgery. For those committed to WLS and the VSG in specific and trying to choose a doctor, that's more difficult. Even here in the States, I've had a really hard time finding concrete stats on my surgeon. I BELIEVE that his stats are really good, but I don't have access to any hard data on him. I can only imagine how difficult that would be if he were in another country with different reporting standards. This is not an attempt to slander non-US doctors, but I would believe that doing "hard numbers" type research might be more challenging. Of course, you can just call the doctor and ASK, but if you don't trust them to begin with (and of course, they'll all say "trust me!"), why would you trust their statistics? Ultimately I wish there were publicly-available statistics on morbidity and mortality for all licensed medical practitioners. Not everyone has the time or money (or knowledge) to track this down on their own.

I strongly, STRONGLY recommend that people follow the doctor's guidelines to the letter. This is a major surgery; just read the stories of those with leaks (or worse), and you'll realize that the potential consequences of not doing what you're supposed to do far outweigh the little surge of pride from "I'm tough! I can eat a whole loaf of bread 2 days post-op!" Bottom line is, you've only got one body. Treat it right -- do what the doctor says!

I think that stretching (medicalese: "redilatation") is an "unknown" for VSG. However, it's less likely than things like bypass, where it is basically just a matter of when it happens, not if.

Weird question, since people keep mentioning the gas post-op. Since that's in your abdominal cavity (right?) and not your digestive tract... how does it... er... get out?

Interesting. This doesn't sound like my experience at all. I have consumed various things in my life -- food, alcohol, drugs -- that were very unhealthy for me, but there was nothing that I couldn't "put down" and nothing that I ever "obsessed over." Mostly I have bad habits and get into trouble when I'm bored! Thanks for the input. It's always interesting to me to understand how other people "experience life" (if that makes any sense).

So, atheists and other "nonbelievers" make up, I believe, five percent of the population. And sleevers are, what, 1% of the population? Less? So agnostic/atheist sleevers like me are literally one in a million! I KNEW my momma was right when she said I was "special!"

These are all great ideas! To inject one small word of caution into the narrative though, please be careful to use correct form, especially when dealing with heavy weights. I don't want to imagine what it would be like to get a sleeve and be all excited about getting fit and muscular, and then getting a hernia or a ruptured disk. Otherwise, exercise safe, and (most important) have FUN!

Well, you're not really supposed to have carbonated beverages due to the carbonation. I haven't heard anything about avoiding acid. As Dr. Jossert (sp?) said, this is not a procedure that leads to ulcers. Things might be a little different for band-to-sleeve revisions, but my doc has said I can have pretty much whatever I want, once my sleeve is healed. Just in smaller portions.

Thanks for the replies. The followup from my EGD is that it looks like I won't need to have ANYTHING done aside from the sleeve itself (which, on a virgin stomach, should be a breeze). As long as I can follow the pre-op diet rigorously and shrink my fatty liver, the odds are that I should be in good shape!

Guys, cravings are NORMAL. You have to stop beating yourself up for them, or letting them rule your life. The idea of the sleeve is that it puts YOU back in charge; by limiting the portions you can eat without physical discomfort, it makes it very difficult to "cheat" unless you're TRYING to sabotage yourself. Plus, the ghrelin changes supposedly make real hunger (as opposed to head hunger) much more manageable. You can beat head hunger, if you substitute healthy new habits (say, exercise) for your bad old habits. Believe the numbers: as opposed to diet and exercise, where the vast, vast, VAST majority of people fail to lose the weight and keep it off, most WLS patients (particularly sleevers) manage to lose the weight AND keep it off for at least two years (it's still new enough for there to not be much long-term data, but the weight isn't showing an upwards trajectory like it always does with diet and exercise). So, if you can't trust yourself, trust science and statistics -- they say you've made the right choice... the one with the most chance of success. It's not a work-free solution, but you can make it work!

I am curious how prevalent depression post-VSG is. I've struggled with depression before, but it's always been tied to sleep deprivation (my sleep apnea is barely treated, but when I got on CPAP, I was able to quit all psych meds). I wonder how much of it is due to body image changes, and how much of it is due to the (very normal) physiological response to the trauma of surgery?

From what I know, weight regain is a concern with EVERY weight loss method. However, from what I understand, weight regain is much less of a concern with lap sleeve than with other surgeries (due to the hormonal/ghrelin changes), and also weight regain is much less with WLS in general than with diet and exercise. Sorry it's not a simple "don't worry, it won't happen," but I think it's safe to say that if you're willing to do what you're supposed to do, your odds are pretty good.

Anyone know if martial arts are safe for sleeve patients (after the stomach has healed)? I'm trying to find less boring, more "fun" kinds of exercise I can participate in after my sleeve has healed, since I don't tend to succeed at things I find boring, and standing on an elliptical trainer at the gym is boring as hell. I'm just not sure what the effects of a full on sparring blow to the midriff would be post-sleeve! Thanks for any info.

Thanks for that, I'll take a peek at it.

This isn't about success rates, but interestingly one WLS (RnX) showed a greater positive effect than diet and exercise:

Here's one study showing "greater than 20%" able to lose 10% of their body weight and keep it off for one year or more. SUCCESSFUL WEIGHT LOSS MAINTENANCE - Annual Review of Nutrition, 21(1):323 - Abstract I'm really curious where the 5% figure comes from.

Hi, I've heard quoted a few times now, from different sources, that "only five percent of obese people are able to lose weight and keep it off with diet and exercise alone." Of course, this is a great -- perhaps the strongest -- motivation for seeking weight loss surgery. But, is it true? So, in the spirit of being scientific, I'd like to ask if anyone has ever seen a study corroborating the five percent figure. Obviously, if the number is 80% instead of 5%, that's going to significantly change how I think about WLS. To be specific, I'm only interested in peer-reviewed research here.

I can't find any studies showing an uptick in gastric cancer due to weight loss surgeries (I am not a doctor, but I'm pretty good at doing medical research). Do you have a source that indicates that WLS leads to gastric cancer? By the way, when considering risks and complications of WLS, remember to consider the risks and complications of remaining overweight/obese, and also the percentage of people (3-5% is the number I keep seeing) who are successful at losing weight and keeping it off WITHOUT some sort of surgical intervention. I looked at the numbers long and hard before committing to WLS, and I ultimately decided that the risks of NOT having the surgery were higher than the risks of having it.