Hello. I am new to this forum. I am booked to have my Vertical Sleeve in Manchester, England, on 12th August.

I am concerned about complications, however, my greatest concern is that I will fail at keeping any weight loss off in the long term (life time).

I am 5 foot 9 inches and weigh 21 1/2 stone (about 300 lbs). This is the biggest I have ever been. However, over the past 15 years I have lost 70-85lbs and then regained it all at least 4 times! It takes me 6 months to lose the weight and 4 months to put it all back on.

Experience tells me I don't have the ability to lose weight and keep it off. I just don't have the will power. I use food as a comfort for even the minor daily difficulties we all face.

I know that I will lose weight after the operation, but don't know if it will keep my weight reasonable for the rest of my life. We are paying for the operation at £10,000 and my husband has begun to ask me if I should actually have the Gastric Bypass operation instead to give my weight loss a long term fighting chance.

I am supposed to be 170lbs but I would settle for 200lbs. I'm tall and can carry the weight and know that at that weight I can still do all the things that I would like to do in life.

Have any of you considered the ByPass over the Sleeve on the basis of long term success?

First off, there are just as many bypass patients that have significant regain because ALL of the weight loss surgery choices can be cheated. The malabsoprtion of calories/carbs/fats only lasts about 2 years, and then intestinal adaptation takes over, and all you'll have is the restriction of a stretchy pouch. So, if you're going to cheat, any of the surgeries will fail. If you do not address the emotional/mental aspect of making better food choices, none of the surgeries will work long term.

Hate to be "debbie downer", but there's way too many stories of people getting surgery, and then regaining in 3-5 years out because they never worked on their relationship with food. You can check out the revision forum on obesityhelp.com and see just how many RNY patients are looking for revision because they've gained back hoards of weight, and can't lose it again even with diet and exercise.

I removed the word "cheat" from my vocabulary when it comes to what I eat now. I just have to decide if the food I'm choosing to put in my mouth is nutrient dense or junk food. If I want to have junk, have I compensated it by ensuring I've eaten or will eat my Protein that day?

Long term results with bypass and sleeve patients are only about 3-5% higher weight loss numbers for bypass patients. So, long term, you're looking at the same issue if you choose to not address your mental tie to food.

My recommendation is to not have surgery until you are ready with other coping mechanisms in place to deal with food. Finding a support group, counselor that has experience with weight loss surgery patients are your best bets. They operate on our stomach, the rest of it is up to us because our brains are in control. You have to make the effort and constant choice on what to put in your body. I can still suck down a huge milkshake every day without issue, and so can my dearest friend that had bypass about 4 years ago. The big difference is, I choose to NOT do it, she does, and she's gained back 50 of her 150lb loss.

As I am a while away from the operation I have not had the neutricianist speak to me about what I can and can't eat on the diet and the importance of Protein etc. I eat rubbish now, but I eat healty food too. I love both in equal measure. I would be just as happy with a punnet of strawberries or blueberries as with a bag of crisps or chocolate bar. Shame the fruit is far more expensive than the junk food!

I guess I am hoping that if I get the urge (mentally) to eat, that I can eat the healthier option first which will hopefully fill me up and then I won't want to eat the junk as I will be full.

I have no idea if it works that way or not though.

Welcome;

Yes - the sleeve will work. You don't have to "diet" for the rest of your life. I eat what I want but choose healthy foods first and then have some Snacks too. At 8 months out I am at goal weight loss and do not fear regaining weight. Our stories are similar - I too was a self payer since in the US, I was not severly obese so insurance would not pay - at 75+ poungs overwieght I did not qualify, so I paid for the sleeve totally out of my own pocketbook. Lost and gained back weight more often than I can recall, without the ability to keep weight off long term. What I received was a permanent restriction, so I eat and enjoy all foods just in moderation. I eat meat, fish, vegetables, fast food, pizza, fruit, pastas, choosing among the best in smaller quantities.

Why choose the sleeve vs. bypass? My friends here will give you other reasons than what I list.

• No malabsorption issues like with bypass - ie Vitamin deficiencies
• Less supplements to take for the rest of my life
• My intestines were not rerouted, just part of my stomach taken. I have a normal functioning digestive system, unlike bypass.
• I don't experience hunger, really I don't. Head hunger but not the mantra of "I am hungry" that my body used to scream all the time
• Can take NSAIDS - over the counter pain meds, unlike bypass
• No dumping syndrome, which can be quite scary to those who experience it
• Long term weight loss is similar for both surgeries
• I can eat what I want...but am restricted to how much always. Bypass you have foods that will always be no no's. A single piece of good dark chocolate is enough to satisfy me and it tastes so good!
• Complications are less. I don't get diarrhea, gas pains when eating some treats.

I love my sleeve and made the best choice for me. Never will I regain my weight as long as I do not feast on just milkshakes and chips. I am free from me and am able to no longer "diet" and fail over and over. I have won. Best wishes!

I appologise if I am going on about this. It is just such a massive operation for me - I have never had a general anasthetic in my life. Also a huge amount of money!

I am not one for fast food like MacDonalds or Kentucky, I am not even one for chips (US call them fries) or crisps (US call them chips). However, I may as well take shares out in Harebo or other jelly sweeties. I love chocolate too.

I mainly eat very frequently and have lots of it. So I would have 4 slices of jam on toast for Breakfast, Harebo sweets for snack (big packet) mid morning, 2 cheese sandwiches for lunch plus a cake, more Harebo sweets, I will have high fat yoghurts for a snack and then have a cottage pie or curry (lots of mash potatoe adn rice) for dinner - plus eating chocolate with my husband whilst we watch TV at night.

Acutally I just love love love bread and stodgy English dinners - love chili con carne too.

Will the sleeve mean I can't eat the volume and stay fuller for longer. That way I should lose weight.

Stay full longer? Hon - you don't experience hunger. So even on empty I have to REMIND myself to eat. Without my DH around, sometimes I skip meals which is not good nutritionally. So - you can enjoy just about everything...just in much smaller amounts. Chili con carne-YUM. Not much of a jelly pastry lover but you could have a few bites and be happy. Not recommended to have this daily. Breads yes, but they are only fillers. Nothing like a good sourdough toast with some jam. Half a slice is perfect. I now just add eggs on top and am completely satisfied. My relationship with food has changed, I still think about food, prepare food but am not obsessed by food anymore. The sleeve means you have restriction...that full feeling all the time. Yes you can still have bangers and mash if desired in much smaller quanities. I eat off of smaller plates now.

Caution - during weight loss with sleeve, you will need to watch your carbs and learn to make better choices. The sleeve is a tool for weight loss. You can not eat crap and lose weight. Are you prepared to make a major change in your life?

I appologise if I am going on about this. It is just such a massive operation for me - I have never had a general anasthetic in my life. Also a huge amount of money!

I am not one for fast food like MacDonalds or Kentucky, I am not even one for chips (US call them fries) or crisps (US call them chips). However, I may as well take shares out in Harebo or other jelly sweeties. I love chocolate too.

I mainly eat very frequently and have lots of it. So I would have 4 slices of jam on toast for breakfast, Harebo sweets for snack (big packet) mid morning, 2 cheese sandwiches for lunch plus a cake, more Harebo sweets, I will have high fat yoghurts for a snack and then have a cottage pie or curry (lots of mash potatoe adn rice) for dinner - plus eating chocolate with my husband whilst we watch TV at night.

Acutally I just love love love bread and stodgy English dinners - love chili con carne too.

Will the sleeve mean I can't eat the volume and stay fuller for longer. That way I should lose weight.

Not all sleeve patients lose their hunger so you can't count on that aspect. But, if you choose the right foods, you will stay satisfied longer. If you eat mushy, carb-laden foods that slide through you can eat more and more often. All the junk food you listed, the cakes the Haribo Snacks will not stay with you long, and will allow to continue to eat well over the suggested caloric intake for optimum weight loss success.

You can have all the foods you listed. It's about moderation on what you put on your mouth. Not every person can just eat what they want and lose weight. If you continue to do the same thing you've always done, you will get the same results.

The sleeve gives you restriction, 100% correct, but if you eat to just eat, and eat junk food, lots of carbs, then your weight loss might not be what you want. You can eat what you want, but you also can't expect fabulous results by not following a more nutrient dense, balanced, and planned food plan. You do not have to diet, but you can't just eat whatever you want and have fabulous weight loss. If that were the case, you wouldn't be considering surgery.

Losing weight is easy in the beginning. I can tell you at 2 years out, that gaining weight is easy as well. There are plenty of us that are further out than 12 months that have seen gains. I saw a gain over the holidays because I ate just whatever I wanted, drank lots of alcoholic beverages, partied for 3 months straight. Well, that behavior gave me about a 7lb gain. So, again, everyone that thinks "Oh I'll never gain the weight back, I can eat whatever I want, and not worry about regain, or I'll never gain again." don't be surprised if/when regain happens when we allow ourselves to forget how we got fat in the first place.

It's naive to think that surgery will fix everything, and that just because we're eating smaller amounts, we won't gain weight. It is easier with the sleeve to make the best choice (fruit over chips), but making those choices, and breaking bad habits is the really tough part of this journey. It's a lot easier said than done in my opinion.

I appologise if I am going on about this. It is just such a massive operation for me - I have never had a general anasthetic in my life. Also a huge amount of money!

I am not one for fast food like MacDonalds or Kentucky, I am not even one for chips (US call them fries) or crisps (US call them chips). However, I may as well take shares out in Harebo or other jelly sweeties. I love chocolate too.

I mainly eat very frequently and have lots of it. So I would have 4 slices of jam on toast for breakfast, Harebo sweets for snack (big packet) mid morning, 2 cheese sandwiches for lunch plus a cake, more Harebo sweets, I will have high fat yoghurts for a snack and then have a cottage pie or curry (lots of mash potatoe adn rice) for dinner - plus eating chocolate with my husband whilst we watch TV at night.

Acutally I just love love love bread and stodgy English dinners - love chili con carne too.

Will the sleeve mean I can't eat the volume and stay fuller for longer. That way I should lose weight.

I think an important step for you would to keep track of EVERYTHING you put in your mouth. Use fitday.com or an other on line service. Those calories really add up, and mindless eating will get you in the end with or without surgery. Those little Haribo bears, are 50 calories for 15 gms. In the beginning you can only eat 300 calories a day! And most of that must be Protein. I see you don't eat much protein now... I didn't before surgery either. If you can keep your protein first, you will probably be OK. This will be a big change in eating habits. Something I do is include (2) gummy Fiber every other day or so... a couple really help the old fiber intake and are a treat.

http://www.cvs.com/CVSApp/catalog/shop_product_detail.jsp?skuId=789277&productId=789277&WT.mc_id=Shopping_Feed_Products_Google_Free_Listing

They do have calories, so only a couple!

I think, too, that you aren't really going to know how the surgery will affect your mind until you have it. I know that I had a terrible fear of busting my stitches and vomitting after my surgery. Because of that, I have always measured every single thing I put in my mouth. The surgery keeps my hunger at bay so that I can actually think for a minute before I eat and that helps me to make the good choice. Also, I was terrified of starving because of the small amounts of food that I could eat - this got me to alsways choose Protein first and make sure that what I am eating is good for me because I have very limited opportunity to eat.

I could not have predicted that I would react that way, but the end result has been a very healthy, nutritionally dense diet. I am not at all interested in junk food or sweets - at all.

However, I am still in the early stages and I can't say what will happen in a year ot 10 years. I know that I have honestly developed new habits at this point. It's as if the sleeve has bought me time and sanity when it comes to my food. I am more mindful of what I am doing, so I eat better.

Make sure you have a support group to go to and a nutritionist to work with. Also, make sure you have a very clear set of post-op eating instructions so you know exactly what you can eat and when. THat will help you get on track with your new habits. There is a big emotional component to not being able to eat in situations where you used to eat a lot. This passes, but the first month or so is hard emotionally. Set yourself up with some support to help you out.

Your sleeve will only work for you as much as you let it. I worked AGAINST mine, through overeating and loading up on carbs and junk, and have regained half of the weight I'd lost.

I'd definitely recommend, as others have said, working on your mental and emotional relationship with food. Because it is possible you will still feel hungry (I do) and it's possible you will stretch out your sleeve (I did).

Things like chili, cottage pie, you are better off just eating the meat part with vegies and leaving the potato or rice alone. Someone somewhere wrote "no white foods", which is great advice.

I was a self-payer too, in Australia, and don't regret my decision to have the sleeve, just some of my decisions afterwards. Don't make my mistakes and you'll do great!

Thank you! I have been weighing the sleeve vs. bypass and this puts it all in context ! Exactly what I've been looking for!

Welcome;

Yes - the sleeve will work. You don't have to "diet" for the rest of your life. I eat what I want but choose healthy foods first and then have some Snacks too. At 8 months out I am at goal weight loss and do not fear regaining weight. Our stories are similar - I too was a self payer since in the US, I was not severly obese so insurance would not pay - at 75+ poungs overwieght I did not qualify, so I paid for the sleeve totally out of my own pocketbook. Lost and gained back weight more often than I can recall, without the ability to keep weight off long term. What I received was a permanent restriction, so I eat and enjoy all foods just in moderation. I eat meat, fish, vegetables, fast food, pizza, fruit, pastas, choosing among the best in smaller quantities.

Why choose the sleeve vs. bypass? My friends here will give you other reasons than what I list.

• No malabsorption issues like with bypass - ie Vitamin deficiencies
• Less supplements to take for the rest of my life
• My intestines were not rerouted, just part of my stomach taken. I have a normal functioning digestive system, unlike bypass.
• I don't experience hunger, really I don't. Head hunger but not the mantra of "I am hungry" that my body used to scream all the time
• Can take NSAIDS - over the counter pain meds, unlike bypass
• No dumping syndrome, which can be quite scary to those who experience it
• Long term weight loss is similar for both surgeries
• I can eat what I want...but am restricted to how much always. Bypass you have foods that will always be no no's. A single piece of good dark chocolate is enough to satisfy me and it tastes so good!
• Complications are less. I don't get diarrhea, gas pains when eating some treats.

I love my sleeve and made the best choice for me. Never will I regain my weight as long as I do not feast on just milkshakes and chips. I am free from me and am able to no longer "diet" and fail over and over. I have won. Best wishes!

I think every person has a different reaction to the sleeve. I had almost no hunger the first few months, but I am now experiencing it. It is nothing like presurgery. I just have to be careful not to snack on carbs when I do feel hunger between meals. I do get full very quickly, especially if I eat protein. There are slider foods that I can eat lots of such as popcorn or chips. I stay away from those foods and I now have my husband hide any microwave popcorn we buy for the kids so I can't eat it. There have been a couple of times I felt stressed and there I was eating half a bag of popcorn. I had to stop this old habit so it did not get out of hand. There are foods I have trouble eating: hamburger meat, breads, and fried foods. I get a sick feeling (close to the dumping syndrome) when I eat them. I have found that the more carbs I eat, the more I want. I try to limit carbs I eat and make sure to drink all the required water. I really feel it you are ready for this, you will succeed. At first, the weight loss will be easy because you physically can't eat. Over time, you are able to eat more, and you have to make the decision to stick with the plan. The sleeve does give you restriction and it you follow the rules, that restriction will get you to your goal. Good luck!

The part of the stomach when you have gastric sleeve surgery is a completely different part of the stomach than the pouch that is made the gastric bypass surgery. Our stomachs after surgery are from the muscular part of stomach which is the least stretchy part of the stomach so it does not stretch nearly as much as the gastric bypass pouch.

I am now 2 yrs 3 months post op and I can tell you that bread fills me up to the point that if I choose to eat it, I can count on not being able to fit anything else in.

I don't have the desire to eat all day long like I did before surgery. There are definitely emotional days when I do have cravings, but really, the sleeve stops me from eating as much I would really like to.

I am sure it's possible to gain a lot of the weight back by eating candy and sweets constantly. The scale is my best friend. I weigh every day and it's pretty easy for me to grab control back when I see a gain of a couple of lbs. I did gain 8 lbs this last holiday season, but I do know how to diet. After the holidays, I made up my mind to take it off and since then, I go up and down a couple of lbs from my goal. Honestly, there are days when I just don't feel like eating so it's not hard to stay at goal.

In my opinion, your best chance in not gaining the weight back is with the sleeve surgery over any other option that is available.