I was reading another forum last night and a woman just got back from a seminar with her bariatric doctors they told the people that the sleeve is great, but also said that after about the five year mark the restriction goes away and hunger is back all the way and most need to be re-sleeved!! Thoughts?

So I've been thinking about it all day, and have done some poking about a bit and some reading..

http://www.medpagetoday.com/Endocrinology/Obesity/40490

And I found this an interesting statement coming from a doctor at a bariatric conference...

“Doctors are constantly concerned with durability. The gastric sleeve gained instant popularity because it is quick and easy to master, and is a less difficult operation than a bypass,” said Dr. Coon. However, he stressed the need for surgeons to learn all of the facts, perform extensive prep work, and communicate effectively with each patient before deciding whether the sleeve gastrectomy is appropriate.

“With new surgeries, outcome is always hard to predict,” he said. “If five years from now it still seems to be a good operation, then it probably will continue — and then again it might fail. Regardless, people will continue to promote it or disagree with it.”

Or did they mean 60% of excess weight?

That is how I would translate that. Pretty crappy way of saying it though. They should just stick with excess weight, IMO.

Ok so I'm still reading but someone explain to me what this means without using the metric system or calculus.

"However' date=' 34.3% of patients who had sleeve gastrectomy as their primary procedure and 50% of those who'd had it after a failed gastric banding still had a BMI above 35 kg/m2 after 5 years."[/quote']

What they mean is a third of sleevers and at least half of all the revisions from bands didn't lose all the excess weight after 5 years.

So you're saying that's just a BMI of 35? Shoot they threw me off with that other stuff.

Yes, that is how my brain unscrambled their damn medical code. LOL! I just like to "gloss" over things that include mathmatical equations, or something that would require me to look up a conversion chart. So I just read it as BMI of 35....

Well' date=' what I should have asked was....what the hell does "35kg/m2" mean?[/quote']

Kilograms divided by meters squared, which is how BMi is calculated. A little flourish of jargon for no useful purpose whatsoever

Ok...so my 2 take home points from that article are....the patients didn't lose much BMI on average (barely 12 BMI points dropped) but did maintain said loss over 5 years. So that's kind of a good news/bad news article.

Ok...so my 2 take home points from that article are....the patients didn't lose much BMI on average (barely 12 BMI points dropped) but did maintain said loss over 5 years. So that's kind of a good news/bad news article.

My take on is that 70% of the people lost ALL the weight they should have. About 30% didn't lose all of it, but even they lost more than half their excess weight. And they all had fewer comorbidities, and none of them gained enough to need the DS. Also that if your band fails, you might should consider RNY not the sleeve.

Good news, good news I think. I'd take 70-30 odds and the worst cast being I only lost 60% of my excess weight.

Aaaand I posted in the vets forum again, dang it! Sorry guys not easy to see on the app

"Over 5 years of follow-up, 77.9% of patients developed Vitamin D deficiency, 41.2% had Iron deficiency, 39.7% had zinc deficiency, 39.7% had a vitamin B12 deficiency, 25% had a folic acid deficiency, and 10.3% developed anemia.

These deficiencies occurred "despite routine supplementation, in a higher rate than we had expected," the researchers wrote."

That is a little disturbing. I'm wondering how consistent supplementation was? And if they were deficient before surgery or it developed strictly after?

Bah, not loving the article I must say. But, LV, I didn't read anything about hunger level. Did I miss something?

Is re-sleeving really an option? I know you can do a RNY after the sleeve (and of course you can to the DS after the sleeve) but I was under the general impression that re-sleeving is super-tricky. The place where you have been cut' date=' stapled, and some of us oversewn, that would be considered a weak spot in the stomach. So what do they do, take the remaining 15% of your stomach and cut another 5%? Or would it have to be more like 10% and then you are left with 5% of stomach? I just don't think this seems feasible.[/quote']

Good question! So being re sleeved.

Im looking for information on it...

The only re sleeves I've heard of so far are for ones that are not done "right" the first time..

LV- JUST re-read your OP. Sorry...the hunger thing was from the bariatric surgeon's office...sorry!

.........And they all had fewer comorbidities' date=' and none of them gained enough to need the DS. .....

[/quote']

"They also found that re-operation due to insufficient weight loss was needed in eight patients, or 11.8% of the study population."

Doesn't say what surgery they had....could have been RNY or DS.

Good question! So being re sleeved.

Im looking for information on it...

The only re sleeves I've heard of so far are for ones that are not done "right" the first time..

Exactly what I have seen/heard before also. There was someone here who was left with basically a large sleeve (can't remember exact details but like 60% or something of their orig. stomach) and she was looking to be re-sleeved.

I know of another blogger who described having a "malformation" of her sleeve and was looking to be re-sleeved but as far as I know she hasn't gone through with it.

"Over 5 years of follow-up' date=' 77.9% of patients developed Vitamin D deficiency, 41.2% had Iron deficiency, 39.7% had zinc deficiency, 39.7% had a vitamin B12 deficiency, 25% had a folic acid deficiency, and 10.3% developed anemia.

These deficiencies occurred "despite routine supplementation, in a higher rate than we had expected," the researchers wrote."

That is a little disturbing. I'm wondering how consistent supplementation was? And if they were deficient before surgery or it developed strictly after?

Bah, not loving the article I must say. But, LV, I didn't read anything about hunger level. Did I miss something?[/quote']

Yeah those vitamin deficiencies worry me as well. That's fairly severe it seems for people taking supplements. But an easy thing to monitor with yearly blood work. My PCP will check for all that as part of my annual physical.

"Over 5 years of follow-up' date=' 77.9% of patients developed Vitamin D deficiency, 41.2% had Iron deficiency, 39.7% had zinc deficiency, 39.7% had a vitamin B12 deficiency, 25% had a folic acid deficiency, and 10.3% developed anemia.

These deficiencies occurred "despite routine supplementation, in a higher rate than we had expected," the researchers wrote."

That is a little disturbing. I'm wondering how consistent supplementation was? And if they were deficient before surgery or it developed strictly after?

Bah, not loving the article I must say. But, LV, I didn't read anything about hunger level. Did I miss something?[/quote']

The deficiencies didn't surprise me at all really..

I see a lot of that here and with people taking all of their prescribed supplements (me included)

Hunger?

Nothing there about that.

LV- JUST re-read your OP. Sorry...the hunger thing was from the bariatric surgeon's office...sorry!

In your OP I thought you were saying the article talked about hunger but I was confused. The hunger coming back came from a diff. source than the article...