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Science of why and how the pouch / sleeve works



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Thanks for posting! :)

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Thank you thank you thank you for sharing. Great information that I wish I had four months ago. I only have 2 months left on the dramaitc weight loss curve so I need to step up my excercise from 3 to 5 days a week. I was slacking because I thought the restrictive eating was enought. WOW!! I wonder if anhyone has the weight loss curve???

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Don't worry yet! I do not believe the "weight loss curve" is mandatory...

Just read, and research. I find that I will need to have a long term focus on:

Protein

Hydration

and a forever avoidance of sugars, processed carbs

and if so, I'll be OK. My favorite quote from the article is:

If adequate satiety is achieved, our patients are successful. . . And they fail if that satiety is not achieved.

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Thank you thank you thank you for sharing. Great information that I wish I had four months ago. I only have 2 months left on the dramaitc weight loss curve so I need to step up my excercise from 3 to 5 days a week. I was slacking because I thought the restrictive eating was enought. WOW!! I wonder if anhyone has the weight loss curve???

Yeah I think you are misinterpreting the article. It talks about the maximum size of the sleeve and talks about hunger returning but not about weight loss stopping. As long as you use the tool properly you should keep losing. That means eat dense Protein and dense veggies, do Water loading, and don't drink your calories or rely on soft calories. You can do it!

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I thought it was a great article, much better then much of the fluff written.

I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

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I thought it was a great article, much better then much of the fluff written. I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

There's not enough historical data to do such studies yet, I would think. But this is one of those things I really don't need a study to prove. I'm going to find a little faith for a change.

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I thought it was a great article, much better then much of the fluff written.

I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

I'll see If I can find a medical study paper I just read in the last week... showing how changing BMI can predict longevity... the longest lived people are overweight, with their BMI staying the same. The shortest lived are the most obese whos BMI is going up, and the underweight who BMI is going down. (I think that was the order)

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I'll see If I can find a medical study paper I just read in the last week... showing how changing BMI can predict longevity... the longest lived people are overweight, with their BMI staying the same. The shortest lived are the most obese whos BMI is going up, and the underweight who BMI is going down. (I think that was the order)

I thought it was a great article, much better then much of the fluff written.

I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

Dr. Sharma recently had an article on that. I think I posted a redacted version or a summary somewhere.

I think the basics of the reasoning are thus: Losing weight changes certain health-related outcomes. Other research has shown that these health-related outcomes are strongly linked to premature death. While the relationship between losing weight and a direct reduction in premature death have not been established, I think from a lay person's perspective, looking at diabetes, Metabolic syndrome etc. as the proverbial "canary in the coal mine" that precedes premature death, it's a reasonable enough extrapolation to think WLS helps you delay premature death.

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Then there are the calorie deprivation studies from worms to apes. Effectively starve living things but make sure the nutrients to live are barely maintained and every living thing tested lived from 15-80% longer of a lifespan. This surgery will possibly help us eat a LOT less calories than average folks. The studies (and they are voluminous) back up longevity should follow.

Dr. Sharma recently had an article on that. I think I posted a redacted version or a summary somewhere.

I'll see If I can find a medical study paper I just read in the last week... showing how changing BMI can predict longevity... the longest lived people are overweight, with their BMI staying the same. The shortest lived are the most obese whos BMI is going up, and the underweight who BMI is going down. (I think that was the order)

I thought it was a great article, much better then much of the fluff written.

I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

I think the basics of the reasoning are thus: Losing weight changes certain health-related outcomes. Other research has shown that these health-related outcomes are strongly linked to premature death. While the relationship between losing weight and a direct reduction in premature death have not been established, I think from a lay person's perspective, looking at diabetes, Metabolic syndrome etc. as the proverbial "canary in the coal mine" that precedes premature death, it's a reasonable enough extrapolation to think WLS helps you delay premature death.

Edited by bearman99

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Here it is.

Obesity and Mortality Risk New Findings From Body Mass Index Trajectories

I signed up for this site, its free and quite interesting. You can get notices on any topic you want.

http://www.medscape.com/viewarticle/815335_1

Here is a tantalizing two paragraphs from a LONG DRY article.

Introduction

The rising prevalence of obesity has emerged as a potential threat to overall life expectancy in the future. The extent of this threat, however, is still uncertain, and estimates of the percentage of total deaths due to obesity vary widely, from 5%[1] to 13%.[2–4] Although these estimates are all based on measuring the mortality consequences of body mass index (BMI) assessed at baseline (i.e., at 1 point in time), other studies have found that a dynamic measure of weight status (weight or BMI change) is more predictive of mortality than is a static measure of weight status (i.e., baseline BMI), especially among older adults.[5, 6] We might expect obesity to increase the risk of death more profoundly when it persists over the life course. Therefore, in order to better assess the rising threat of obesity, it is essential to examine the mortality consequences of BMI trajectories.

Prior studies based on dynamic measures have yielded mixed findings about the mortality consequences of weight change.[5–21] Several factors contribute to the mixed findings. First, the association of weight change with mortality depends on baseline BMI status. Weight gain leads to excess death among overweight/obese individuals but lowers the mortality risk among underweight or normal weight people.[8] Second, the association differs by the magnitude of weight change. Modest weight gains are associated with a decreased mortality risk, but excessive weight gains predict an increased mortality risk.[7, 13] When both initial weight and the magnitude of change are taken into account, small weight gains (1.0–2.9 BMI units) are not associated with excess mortality risk among 50–70-year-old Americans, regardless of their initial BMI levels, whereas large weight gains (3.0–5.0 units) increase the risk of death only when the initial BMI is greater than 35. Moreover, both small weight losses (1.0–2.9 units) and large weight losses (3.0–5.0 units) are associated with an increase in the risk of death among people who are normal, overweight, or mildly obese at baseline.[22]

What!??? 8o

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Then there are the calorie deprivation studies from worms to apes. Effectively starve living things but make sure the nutrients to live are barely maintained and every living thing tested lived from 15-80% longer of a lifespan. This surgery will possibly help us eat a LOT less calories than average folks. The studies (and they are voluminous) back up longevity should follow.

Bear, I follow a version of the 5:2, that is a longevity protocol that involves two days of semi fasting every week. It has helped me to lose some regain and finally get to goal and maintain. Not too hard to follow. In fact I enjoy how it makes me feel. I have thought how the enforced calorie reduction involved in WLS seems like it would cause life extension to me too...

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I thought it was a great article, much better then much of the fluff written. I clicked on a link to find a bunch of other articles... some of them quite concerning really. Basically, challenging the premise that we will live longer due to obesity related illnesses being under control. Turns out that is more an "idea" that hasn't apparently been studied. Conclusion, WLS should be thought of as a quality of life improvement, jury is still out if we will actually love longer.

There's not enough historical data to do such studies yet, I would think. But this is one of those things I really don't need a study to prove. I'm going to find a little faith for a change.

I agree with you butter - and besides it is too late to worry about it now... as frequently pointed out, there is no "going back" from being sleeved.

It is disturbing to me though that even with the gastric bypass, there are not good published studies answering the question "do you live longer with WLS or without?"

In the end, quality of life was the main motivator for me. I felt I was heading for becoming wheelchair bound on my old trajectory. Now, I feel like I have a good chance of maintaining a reasonably active life for a long time which counts for alot.

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Feed your eyes,

Thanks for the good info, this DOES make sense and I appreciate that your postings are so well researched.

It makes sense because there appears to be a "sweet spot" for BMI. Too high - obese - and you have all the problems associated with metabolic syndrome, DM, CV disease, arthritis, etc. Too low, and you are in malnutrition or are catchetic (sp). Some very recent work suggests that BMI drops as a predictor in the "aged" but that the quality of life suffers with obesity...

So much to think about!

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I'm am so glad to have found this article. Finally, and I'm nearly 6 months out. I had a sugar slip since Christmas and while all of my post op instructions are in line with this article, understanding the rationale for the education seems to be essential to my compliance. I seemed to be missing this. It's all good, it's not too late. I'm 9 lbs from goal, feel great and certainly "honeymooning". This article is a good push to get me back on track which will also give me peace of mind and freedom from food/diet obsession that has slipped in a bit since my healthy eating has fallen off a bit. It just is a good reminder that I need to ask "Why?"and then pursue until I get a reasonable response. Complacency is not my friend, and the discomfort of it can be so subtle. Action, and more action. Thanks again!

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 2 replies
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
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