I'm just wondering if any of you might have thought or wondered if we are jumping into this sleeve surgery too soon? i mean, it hasn't been around that long so the long term stats are still unknown. i mean isn't this what we did when the band came out and now we say to ourselves if we only knew then what we know now we would have made different choices. i don't want to be in the same situation a few years down the road with the sleeve as i was with the band. does this make any sense to anyone?

Pshaw, they make tongs for that.

How do I know? A RNYer at a support group years ago brought hers and put them on the table next to my drink (that I promptly threw away) to show us.

GRROOOOSSSSSS

Ya, that's where I draw the line apparently. When my fat requires equipment... no no...not gonna happen.

Whew! I was worried there about my guys ...

"Uhhh ... Doctor ... there's something you didn't tell me you were going to do ..."

I was thinking...That's some serious re-routing!!!! hahaha

I read this the other day, but wanted to think a little before responding. I think the OP and the discussion raises some enormously important points.

I am a project manager, I make "risk based" decisions everyday. That means, weighing the possible outcomes, trying to judge the probabilty and impact of those outcomes - and making a decision. I basically did that when I got the sleeve, and it took me a long time. I am not a medical expert, but i listened to them. I read as much pros and cons as I could and threw some grains of salt into the glowing pros because early euphoria is not really what I was looking for - I want long term success at weight management with minimal risk of bad side effects or consequences. I had EXACTLY the same reservations that are expressed here.

I was banded in 2001, right before it was FDA approved. I thought I had reseached it, but I was fooled by a group like this one, (it was a yahoo group called Bandsters). At that time, there was a lot of peer pressure - people who weren't having big success simply didn't reveal. There were a couple of dominant personalities in that group and basically, anybody who wasn't successful had "compliance" issues.

I did okay at first, but I was never super successful with the band. Worse then that, the reflux was a nightmare. I can go on and on. Anyway, I had the Fluid out about 2003/early 2004 due to uncontrolled reflux and lived with the band until 2011. I didn't feel shame for being fat, I felt shame for FAILING at a WLS that I thought pretty much everybody else succeeded with. It made me very skeptical of all the claims about WLS, it made me skeptical of myself. I was convinced that I had a "compliance issue" and would surely fail with the gastric bypass or anything else too. In hindsight, I realize I was pretty hard on myself.

I lost weight on weight watchers - kept that off for quite awhile, but then in recent years tried everything and couldn't keep weight off for more a few monhts... the regain was always so fast. I couldn't figure out what was wrong with me, I saw counselors to find and hopefully cure my "eating disorders". They kept asking me how I felt when I wanted to eat... they didn't think "hungry" was a legitimate answer.. I really didn't make progress on that front either.

I was pushed hard by my sleep apnea doctor to get some weight off. The doctor that looked at my arthritic kneed and told me it needs replacing soon, practically begged me to get weight off. They were both compassionate, but very firm. I could always say "I am healthy" but in truth, I at 47 I was starting to have physical issues. They shared with me real stories of patients, and in the case of the surgeon, about his mother. They painted a picture of the road I was on... 300+ at 47; what is life going to be like at 57, 67... if I made it that long. They shook me up.

The sleep doctor convinced me to meet with a surgeon that he knew. Great guy, great reputation but he felt strongly I would fail with a restrictive procedure (oh, the non compliance thing again) so steered me toward the gastric bypass. I started the process, but at some point decided that I was just too scared and would rather die young then do that procedure. This may not be rational, but it is where my head was at.

I came across another place that advertised "weight management" services that required a two year commitment to their program and as I read about their program and thought... I need to try again. I got lucky and the director/founder of that business is who I talked to. She listened to my story and said... have you considered the gastric sleeve? I told her about me failing at the band etc etc and she said, please, before you do anything - talk to these guys and referred me to the surgeons they work with. (they have a weight management program that is non surgical but she identified that I was not a good candidate for that due to lifelong obesity and high BMI at the time. The stats don't lie - deck is stacked against people in that situation). She said something that stuck with me.... as much as the deck was stacked against me, a lifetime of obesity, one failed surgery she said I had going for me one very important thing - I never gave up. That little comment gave me some hope.

I met Dr Billing and he spent the time to really talk to me about obesity and theories, research and surgeries. He spent such a long time with me, I am so grateful for that. He gave a sobering assessment too about risks of revisions - things can happen. He agreed that the revision to the gastric bypass was riskier and stongly recommended the sleeve. One of the docs in their practice has had the sleeve, and another one's wife has had it done - they really believe in this procedure. He also referred me to a bariatric doctor (non surgeon) to work with. She, combined with Dr Billing changed my view of the whole thing.

There are physical reasons I am hungry all the freaking time!!!! I am not denying personal responsibility, i realize it is lifestyle and choices, but, I was swimming upstream trying to overcome the obesity cycle I had been deeply caught up in my whole life! He told me that it is possible to break free without surgery, but the odds aren't good.

He also told me my band needed to come OUT as it had slipped, I had pouch dialiation - it needed to go. I was not mentally ready for it, but I went ahead with the band removal surgery... still deciding about the sleeve.

About 2 days after the band came out, I was hungry hungry hungry even more! I couldn't believe it, even my failed band had been helping somewhat. My gosh, wonder if I would have weighed 400# if I hadn't had that crapband in there - maybe I should give it some credit.

I went to the bariatric doc (not the surgeon) and followed her program which kept me from gaining 50# but I was becoming frantic and even depressed over what was happening. The drive to eat was out of control. I am not sure what clicked, but at some point, I could no longer deny that I needed a tool to help me. I could not deny that my life was being negatively impacted by my obesity. I could not deny that I was starting to not be able to do the things I love and that everything was such an effort. (I could still wipe my butt, but I know what she meant, everything just gets so hard when you are that heavy). And I was miserable always feeling like food was the most important thing in my life since I just had a drive to eat.

I am reminded of the quote "I was going downhill faster then I could lower my standards"

So, because i had one foot in the door on this whole deal, I had some of the presurgery things taken care of including insurance approval. Then, in November 2011, I found out my insurance was changing. The new insurance specifically excluded the Gastric Sleeve, but still covered the gastric bypass. I did some soul searching and then booked it for December before the new insurance kicked in. At the time, I didn't like that pressure, but in hindsight, it was the kick in the butt I needed after dallying with this whole subject for a year.

I wound up with a different surgeon (who is also amazing) in the same practice because my doc was on vacation in December.

It was a huge leap of faith. I still don't really know what problems, or weight regain I might have in 5 years, 10 years. I have risked being "fooled again" by the hype - I know that.

For me, the risk was worth taking because I just could not keep gaining weight. I could not remain in that high BMI catagory - that wasn't me and wasn't the life I want.

Anyway, I am only 5 months out, but my success has already surpassed anything I achieved with the band. It has also been easier so far, and so far, I don't experience hunger all the time. My whole relationship with food is changing. I am not claiming the war is over, but I have been winning many battles. I have heard it said on this forum "the sleeve is everything the band promised but didn't deliver" - I agree with that statement.

My blood work is the envy of the medical and nutritionalist staff (like wow, fasting blood sugar of 77 for example and I was pre-diabetic, triglicerides all that are in the outstanding excellent catagory). I feel like a million bucks. I am doing stuff with my horses again and loving on it. I am so active, I have so many choices of what to do, where to go, where to shop - all that. I no longer feel like the morbidly obese person who has no business doing horse things. I no longer feel the constant drive to EAT. I feel more like ME. I still have lots of weight to lose (I am still obese even, but in a whole different weight class now), but I am so happy with how this is going I can't even express it adequately.

My life is becoming a life I want to live.

So, back to the original point. Yeah, I am skeptical. I still wonder sometimes when the shoe will drop and I suddenly have "mental issues" with food. There is a part of me that still believes this whole situation is a character flaw on my part, even though I fight that. Seems to me that my issues with food have pretty much gone away since I am not starving 24/7, but time will tell. My docs openly disclosed the limited data on long term results of this exact procedure, based on the stomach size they are currently using. I just couldn't wait another 10 years to see how the studies turned out, so for me the risks as I understand them now, are totally worth the benefits, as I understand them now.

Here's to a great next 10 years - I am determined to be one of the good statistics!

(my signature shows I still have 66# to lose, but I have lost over 80# in the 5 months and am much closer to normal sized person now)

CowgirlJane: wow. What a great response! I don't think anyone could make the case for the decision to get the VSG better than that. Thanks !

Great post CowgirlJane.

All of these issues have been on my mind too. I don't know what the long-term effects will be but I think that the basics make sense. A smaller stomach and less ghrelin to trigger hunger makes sense. I don't expect miracles but am hoping that it will help to level the playing field.

Something is wrong with my metabolism and always has been. I gained weight too fast as in infant. I have craved carbs as long as I can remember. When I was a very small child I swiped a cake mix from the kitchen and hid it in my room, eating it a spoonful at a time. I don't believe for a moment that as a pre-school child I had a complex neurosis that made me crave sweets, i was a happy kid with a wicked sweet tooth,I believe that I craved sweets for physical reasons.

When I had my appendix out I lost my cravings spontaneously and lost forty pounds. It took effort, but at least it wasn't like scaling a shear rock face. For sixteen years I had fairly good control over my weight. My BMI was 26 most of the time with one excursion to 30. Then, at the age of 32 the weight started coming back and the same eating habits that had worked for 16 years were putting weight on me. Twenty five years hence my BMI is 36.3 and I'm having other problems. A year of low carb couldn't reverse the trend. My choices are three: give up and be a diabetic in another year or two, starve myself brutally or have WLS. For today the sleeve seems the way to go. Even if it only buys me ten good years that's better than nothing but I'm guessing that I'll make the most of it.

CowGirl Jane, That was an amazing post!! I am in awe of your journey!

I read this the other day, but wanted to think a little before responding. I think the OP and the discussion raises some enormously important points.

I am a project manager, I make "risk based" decisions everyday. That means, weighing the possible outcomes, trying to judge the probabilty and impact of those outcomes - and making a decision. I basically did that when I got the sleeve, and it took me a long time. I am not a medical expert, but i listened to them. I read as much pros and cons as I could and threw some grains of salt into the glowing pros because early euphoria is not really what I was looking for - I want long term success at weight management with minimal risk of bad side effects or consequences. I had EXACTLY the same reservations that are expressed here.

I was banded in 2001, right before it was FDA approved. I thought I had reseached it, but I was fooled by a group like this one, (it was a yahoo group called Bandsters). At that time, there was a lot of peer pressure - people who weren't having big success simply didn't reveal. There were a couple of dominant personalities in that group and basically, anybody who wasn't successful had "compliance" issues.

I did okay at first, but I was never super successful with the band. Worse then that, the reflux was a nightmare. I can go on and on. Anyway, I had the Fluid out about 2003/early 2004 due to uncontrolled reflux and lived with the band until 2011. I didn't feel shame for being fat, I felt shame for FAILING at a WLS that I thought pretty much everybody else succeeded with. It made me very skeptical of all the claims about WLS, it made me skeptical of myself. I was convinced that I had a "compliance issue" and would surely fail with the gastric bypass or anything else too. In hindsight, I realize I was pretty hard on myself.

I lost weight on weight watchers - kept that off for quite awhile, but then in recent years tried everything and couldn't keep weight off for more a few monhts... the regain was always so fast. I couldn't figure out what was wrong with me, I saw counselors to find and hopefully cure my "eating disorders". They kept asking me how I felt when I wanted to eat... they didn't think "hungry" was a legitimate answer.. I really didn't make progress on that front either.

I was pushed hard by my sleep apnea doctor to get some weight off. The doctor that looked at my arthritic kneed and told me it needs replacing soon, practically begged me to get weight off. They were both compassionate, but very firm. I could always say "I am healthy" but in truth, I at 47 I was starting to have physical issues. They shared with me real stories of patients, and in the case of the surgeon, about his mother. They painted a picture of the road I was on... 300+ at 47; what is life going to be like at 57, 67... if I made it that long. They shook me up.

The sleep doctor convinced me to meet with a surgeon that he knew. Great guy, great reputation but he felt strongly I would fail with a restrictive procedure (oh, the non compliance thing again) so steered me toward the gastric bypass. I started the process, but at some point decided that I was just too scared and would rather die young then do that procedure. This may not be rational, but it is where my head was at.

I came across another place that advertised "weight management" services that required a two year commitment to their program and as I read about their program and thought... I need to try again. I got lucky and the director/founder of that business is who I talked to. She listened to my story and said... have you considered the gastric sleeve? I told her about me failing at the band etc etc and she said, please, before you do anything - talk to these guys and referred me to the surgeons they work with. (they have a weight management program that is non surgical but she identified that I was not a good candidate for that due to lifelong obesity and high BMI at the time. The stats don't lie - deck is stacked against people in that situation). She said something that stuck with me.... as much as the deck was stacked against me, a lifetime of obesity, one failed surgery she said I had going for me one very important thing - I never gave up. That little comment gave me some hope.

I met Dr Billing and he spent the time to really talk to me about obesity and theories, research and surgeries. He spent such a long time with me, I am so grateful for that. He gave a sobering assessment too about risks of revisions - things can happen. He agreed that the revision to the gastric bypass was riskier and stongly recommended the sleeve. One of the docs in their practice has had the sleeve, and another one's wife has had it done - they really believe in this procedure. He also referred me to a bariatric doctor (non surgeon) to work with. She, combined with Dr Billing changed my view of the whole thing.

There are physical reasons I am hungry all the freaking time!!!! I am not denying personal responsibility, i realize it is lifestyle and choices, but, I was swimming upstream trying to overcome the obesity cycle I had been deeply caught up in my whole life! He told me that it is possible to break free without surgery, but the odds aren't good.

He also told me my band needed to come OUT as it had slipped, I had pouch dialiation - it needed to go. I was not mentally ready for it, but I went ahead with the band removal surgery... still deciding about the sleeve.

About 2 days after the band came out, I was hungry hungry hungry even more! I couldn't believe it, even my failed band had been helping somewhat. My gosh, wonder if I would have weighed 400# if I hadn't had that crapband in there - maybe I should give it some credit.

I went to the bariatric doc (not the surgeon) and followed her program which kept me from gaining 50# but I was becoming frantic and even depressed over what was happening. The drive to eat was out of control. I am not sure what clicked, but at some point, I could no longer deny that I needed a tool to help me. I could not deny that my life was being negatively impacted by my obesity. I could not deny that I was starting to not be able to do the things I love and that everything was such an effort. (I could still wipe my butt, but I know what she meant, everything just gets so hard when you are that heavy). And I was miserable always feeling like food was the most important thing in my life since I just had a drive to eat.

I am reminded of the quote "I was going downhill faster then I could lower my standards"

So, because i had one foot in the door on this whole deal, I had some of the presurgery things taken care of including insurance approval. Then, in November 2011, I found out my insurance was changing. The new insurance specifically excluded the Gastric Sleeve, but still covered the gastric bypass. I did some soul searching and then booked it for December before the new insurance kicked in. At the time, I didn't like that pressure, but in hindsight, it was the kick in the butt I needed after dallying with this whole subject for a year.

I wound up with a different surgeon (who is also amazing) in the same practice because my doc was on vacation in December.

It was a huge leap of faith. I still don't really know what problems, or weight regain I might have in 5 years, 10 years. I have risked being "fooled again" by the hype - I know that.

For me, the risk was worth taking because I just could not keep gaining weight. I could not remain in that high BMI catagory - that wasn't me and wasn't the life I want.

Anyway, I am only 5 months out, but my success has already surpassed anything I achieved with the band. It has also been easier so far, and so far, I don't experience hunger all the time. My whole relationship with food is changing. I am not claiming the war is over, but I have been winning many battles. I have heard it said on this forum "the sleeve is everything the band promised but didn't deliver" - I agree with that statement.

My blood work is the envy of the medical and nutritionalist staff (like wow, fasting blood sugar of 77 for example and I was pre-diabetic, triglicerides all that are in the outstanding excellent catagory). I feel like a million bucks. I am doing stuff with my horses again and loving on it. I am so active, I have so many choices of what to do, where to go, where to shop - all that. I no longer feel like the morbidly obese person who has no business doing horse things. I no longer feel the constant drive to EAT. I feel more like ME. I still have lots of weight to lose (I am still obese even, but in a whole different weight class now), but I am so happy with how this is going I can't even express it adequately.

My life is becoming a life I want to live.

So, back to the original point. Yeah, I am skeptical. I still wonder sometimes when the shoe will drop and I suddenly have "mental issues" with food. There is a part of me that still believes this whole situation is a character flaw on my part, even though I fight that. Seems to me that my issues with food have pretty much gone away since I am not starving 24/7, but time will tell. My docs openly disclosed the limited data on long term results of this exact procedure, based on the stomach size they are currently using. I just couldn't wait another 10 years to see how the studies turned out, so for me the risks as I understand them now, are totally worth the benefits, as I understand them now.

Here's to a great next 10 years - I am determined to be one of the good statistics!

(my signature shows I still have 66# to lose, but I have lost over 80# in the 5 months and am much closer to normal sized person now)

Wow, CowGirlJane,

That was very inspiring! You are a strong and determined person! After reading that, I just want to give you a hug. What a nightmare we all live in when we struggle with obesity. Unfortunately, I am the first in my immediate and extended family (parents, siblings, grandparents, aunts, uncles and cousins) who has struggled with obesity. It really is hard having a thin or "average sized" family, and husband--then there's me, 5'3", 26 years old, and 240lbs. They don't know what to do with me. :/

I chose the lap band two years ago, (had it placed on my golden birthday! 25th), and thought I would see the end of my weight struggles. I, too felt like a complete and total failure after losing 20-30lbs and gaining all of it back after being drained when my band got so tight I couldn't eat or drink.

Thank you for giving me hope! I also hope that we all will not be a part of a fading fad that only works for a given time. Thank you for your post and congratulations on your success! May it never end!

Thank you again!!

Erika

Thank you CowGirlJane.

I also hope that we all will not be a part of a fading fad that only works for a given time.

Erika

I've had the same thought. I think that there are valid reasons to believe that the sleeve will be more effective in the long term than bands. Probably the best evidence is the fact that failed Lapband patients succeed when revised to the sleeve.

Here's my thinking on this. The shock of abdominal surgery, in and of itself, is enough to trigger weight loss. I quit eating after my appendectomy, probably because my digestive system was in shock from the trauma of a burst appendix, a complex operation to remove my appendix and clean out the peritoneum and the fact that I was deathly ill for the first few days afterward. I would imagine that a Lapband being installed also alters the operation of the digestive system for a time just because of the shock. That could easily be the tipping point for weight loss.

But restrictive bands have little or no effect on hormones and the sleeve is said to have a serious effect on ghrelin. This would only make sense in view of the fact that the part of the stomach removed is responsible for a significant proportion of ghrelin production. I've also read that ghrelin is thought to be related to depression. Just a crazy guesstimate by a medical layman but, IMHO, it seems to fit nicely; depression, cravings for carbs, high insulin levels in response to a high-carb diet and a body hungry for proper nutrients secreting ghrelin which triggers more depression and cravings for carbs . . . It would certainly explain why my hunger seems almost constant much of the time.

If the sleeve can reduce hunger to some extent and the restricted capacity of the stomach slows down eating it should work and be durable. It's not foolproof but I think it's probably the best bet out there for permanent weight loss. Even of my permanent results were only 50% EWL that would probably mean the difference between a healthy future and a diabetic future. If I can achieve and maintain 100% EWL I'll become the world's oldest Chippendale dancer and get rich on tips.

DesertRat, some interesting ideas, but I have a simpler theory. When I had the band they made me do a liquid diet 30 days post op. That is the time when I lost that initial 30 pounds. That isn't so terribly different then the first 30 days post sleeve.

I do think that over time, support and guidance got better, but I really didn't understand how to eat with the band. My surgery was done when I lived overseas and was performed in Germany. Good surgeon, lousy followup. I was told, small portions, but never specifics. i was told no sweets or alcohol, but not told what to eat. I was told to not snack, but was never advised to eat the small 5-6 meals a day so I was really hungry a lot of the time which made it much harder to control my eating at meal time.

Honestly, 1/4, 1/2 cup of food is pretty small and that is why I now eat with miniature plate, bowl and use appetizer eating utinsils. I really didn't understand how small was small enough when I was banded. I could have done better with my initial losses with the band had I been better educated on how to really work it, I still don't think it would have made a lot of difference in the overall outcome though, once that reflux hit it was a nightmare.

I am not sure about the whole hunger hormone thing. From what I understand, there are multiple hormones at work in the hunger response so I am curious to see how the science/research develops on that front. Like, over the long run, is the hunger reduced that much or is it just satisfied faster with a smaller stomach? What I can say is that my hunger and cravings are nearly completely under control. I know that may change with time, and I do sometimes crave or desire to eat things that are unplanned, but the sleeve gives me the help I need to manage it in a reasonable way.

What I do know is that my whole (remaining) stomach is "satisfied" now after eating a small meal and stays satisfied until it is time to eat again. It is just a whole different situation compared to feeling pain/discomfort "stuck feeling" without ever feeling any satiation which was my experience with the band. With the sleeve, I have only overdone it a very small number of times - generally speaking I am able to stop eating well before max capacity because I am not hungry.

So, here is my theory about success rates with revision patients. I am basing this on the bariatric doc (not surgeon) who cares for 4 revision patients + me. Basically, the 3 have been wildly successful and the 4th has never lost much even with the sleeve. Her feeling is that the person who didn't lose with the sleeve is one of the people that just can't get over the idea of food (as comfort, as pleasure as central to her life story) and so eats small amounts all day long. Bandsters are notorious for learning how to "eat around" the restriction and I am guessing that SOME apply those same techniques to the sleeve and therefore don't lose as well.

It can happen, it is possible to "fail" with ANY weight loss surgery. I just believe your odds are much better with the sleeve (and DS and RNY) over the band. I feel truly grateful and blessed to have found this help that I needed.

I meet with a NUT monthly. She told me that my progress is right in line with/or better then a typical sleeve patient - revision or no.

I spend a lot of time visualizing my long term success because I know that the real battle for me is the long haul. I have lost 85# before (my total loss as of this morning!!!) but it is the keeping losing and keeping it off that eluded me in the past. I am giving away too big clothes as soon as I "grow" out of them. I am closing the door on letting myself get so big again and am determined to make it stick. My knees thank me and frankly the stakes are higher now.

Yesterday, I met with a friend for a horseback ride. I haven't seen her since last summer and she did about a triple take. She knew I had the surgery and lost weight, but 85# makes a big difference!

I am not sure about the whole hunger hormone thing. From what I understand' date=' there are multiple hormones at work in the hunger response so I am curious to see how the science/research develops on that front. Like, over the long run, is the hunger reduced that much or is it just satisfied faster with a smaller stomach? What I can say is that my hunger and cravings are nearly completely under control. I know that may change with time, and I do sometimes crave or desire to eat things that are unplanned, but the sleeve gives me the help I need to manage it in a reasonable way.

What I do know is that my whole (remaining) stomach is "satisfied" now after eating a small meal and stays satisfied until it is time to eat again. It is just a whole different situation compared to feeling pain/discomfort "stuck feeling" without ever feeling any satiation which was my experience with the band. With the sleeve, I have only overdone it a very small number of times - generally speaking I am able to stop eating well before max capacity because I am not hungry.

So, here is my theory about success rates with revision patients. I am basing this on the bariatric doc (not surgeon) who cares for 4 revision patients + me. Basically, the 3 have been wildly successful and the 4th has never lost much even with the sleeve. Her feeling is that the person who didn't lose with the sleeve is one of the people that just can't get over the idea of food (as comfort, as pleasure as central to her life story) and so eats small amounts all day long. Bandsters are notorious for learning how to "eat around" the restriction and I am guessing that SOME apply those same techniques to the sleeve and therefore don't lose as well.

[/quote']

I agree with what you are saying but I still think that the hunger hormones are a factor. If they weren't the success rate for sleeve patients would probably not be nearly s high as it is. Food only stays in the stomach for an hour or so. If the sensation of hunger was determined only by the absence of food in the stomach then everyone would get hungry every hour or so. I know that it's not simply ghrelin that determines hunger, there are blood sugar signals, habits and emotions involved. The role of leptin is a part of satiety and the idea of leptin resistance is gaining favor. Nonetheless I think that removing a large portion of the stomach is going to reduce the source of much ghrelin and reduce hunger.

So, yesterday, I had my annual physical. I had to do the fasting blood test. Had nothing to eat since 8:00 the night before. Had the Dr appt and went down to get the blood draw around 10:00 am, about 14 hours since I had anything to eat. While I was sitting there, I did a little self assessment.

Was I hungry?

In the conventional, pre-sleeve sense, I could honestly answer: No.

Did I need food?

Yes

So, what was I feeling? Pre-sleeve, the hunger, after 14 hours, would be intense. The craving for anything would be huge. It would have been all I could think about.

I was no where near that. What I felt was a lack of nutrition. My body felt drained. Now, was that a sugar low? Probably. I don't know for sure, but I do know I could have gone several more hours without eating. It wouldn't have been healthy, but 11 months ago, I would have torn down walls to get to the cafeteria. How much of that is mental vs physical? I don't know. But what I do know is I don't have those feelings anymore.

Also know that I am a very active sleever who pretty much eats and drinks all day long to get the calories and nutrition in my body needs to maintain this level. I was able to cut my intake out for 14 hours and mentally, I was fine.

So, yesterday, I had my annual physical. I had to do the fasting blood test. Had nothing to eat since 8:00 the night before. Had the Dr appt and went down to get the blood draw around 10:00 am, about 14 hours since I had anything to eat. While I was sitting there, I did a little self assessment.

Was I hungry?

In the conventional, pre-sleeve sense, I could honestly answer: No.

Did I need food?

Yes

So, what was I feeling? Pre-sleeve, the hunger, after 14 hours, would be intense. The craving for anything would be huge. It would have been all I could think about.

I was no where near that. What I felt was a lack of nutrition. My body felt drained. Now, was that a sugar low? Probably. I don't know for sure, but I do know I could have gone several more hours without eating. It wouldn't have been healthy, but 11 months ago, I would have torn down walls to get to the cafeteria. How much of that is mental vs physical? I don't know. But what I do know is I don't have those feelings anymore.

Also know that I am a very active sleever who pretty much eats and drinks all day long to get the calories and nutrition in my body needs to maintain this level. I was able to cut my intake out for 14 hours and mentally, I was fine.

That's quite reassuring to hear. For me hunger exists on two levels; the continuous hunger that always exists, even when I am physically feeling full and the hunger I would feel after great exertion such as when I come in from mowing my yard on a hot day. I've long since learned to say no to the continuous hunger which is probably the only reason I am at a BMI of 36 as opposed to a BMI of 46.

I had my pre-op endoscopy yesterday and fasting for 12 hours was no problem although I would have given $1,000.00 for a cup of coffee. As it was, I had the procedure and was able to get coffee for less than $2.00 at a restaurant near the surgery center when the procedure was over. I guess tha the $998.00 saved was worth waiting an extra two hours for my morning coffee.

As I see it, the question of sustainability comes into play. I can lose 20 pounds in the next month without surgery, all I have to do is starve myself, be in a lousy mood, and live miserably. I've done it before . . . but it's not sustainable as a lifestyle. No one wants to live starving, walk around with blood sugar in the 70s and in a bad mood and such a thing can really hurt one's employability.

If weight control was easy, if diets actually worked, if we all had nothing else to do but exercise, cook healthful foods, etc, we would probably all be near ideal weight and there would be no such thing as a VSG but we live in the real world where nothing is ever that simple. In reading your blog PdxMan, I see a man that has changed his life, taken control of matters and set couse for a positive future. Thanks for posting, I found it quite an encouragement.