Okay, this has been on my mind big time lately, as I'm sure it was on many others pre-op. I've been trying to decide if I want to do this. I've been fat ALL my life, always. I never knew anything else except for a brief period of time in high school when I was biking all the time and hardly ate anything. Otherwise, yeah, I was the fat gal everywhere I went. My weight is currently 250 and I'm 44 years old. Sooo, tired of it.

When I read about people on here really struggling with keeping weight off a couple of years out and more, I keep wondering, what was the point, then? If you have to watch your food like a hawk, get on the scale a great deal, fuss and worry about weight gain...why not just do all those same things with all of your stomach intact? If you're willing to do it now that you've had the surgery, why don't we just do all those things NOW and keep our stomachs?

So what I'm not hearing in the posts is WHY having had the sleeve done was beneficial for you. Do you feel you are living the same way afterwards as you did before it? Does it help you keep your weight in line, even years later? People keep calling it a "tool", how is it assisting you later on when the weight gain becomes a worry?

Before I do something this drastic, I would want to know that even when weight gain became an issue a few years out, the sleeve was still helping me in some way while I exercised and ate right. If you start to gain some weight, is it easier to get back off because of the sleeve? Because if all I'm looking at is this dramatic weight loss for the first couple of years and then I'm back to white-knuckling my existence with food, then what were the expense, pain, and possible risks for?

I hope this makes sense. I'm tired of being tired, being the fat lady in the group, losing and regaining, and watching my weight issues get worse over time. I don't want to waddle my way through the rest of my life. I want to feel good and look good and avoid diabetes and other issues. I'm a nurse and know what I'm looking at if I stay at this weight. Sigh!

Thanks!

Cara

Well for the most part you answered why you should do it - I'm tired of being tired, being the fat lady in the group, losing and regaining, and watching my weight issues get worse over time. I don't want to waddle my way through the rest of my life. I was to feel good and look good and avoid diabetes and other issues.

Here is how I feel it has helped me ( I am 11 mos out) - I no longer have the stomach size that is capable of eating lbs of food at a time.. Prior to the surgery i failed at weight loss because I had no self control. My tummy would scream at me and I would respond by shoving tons of food in to it. It was torture trying to diet and fight the signals that my tummy and head were always sending..

Now, when I get the signals, it is much easier to maintain control.. It doesnt take much to silence the screams. The main thing I must do is ensure my choices are good.. You can still shove all the slider foods down and slow your progess and even gain.. There is no magic pill but this has helped me tremondousl.. I dont regret my decision. I am 56 and just wish I had done it years ago.. The only thing that is happening now after approx 100 lbs of loss is I am dealing with excess skin.. But even that is worth it.. I feel better than I have in years.. And yes, I did get type 2 diabetes in the 80's.. I was about to have to go insulin per the Dr.. I am now down to one med where I was on 4 for Diabetes.. That in itself has made it worth it for me..

I understand your doubts but you have to be realistic with yourself.. If you truly think you can acomplish what you need to with diet and exercise, then dont do surgery.. I am thinking you are at this crossroads for the same reason we all were,, We were not succesful with diet and exercise.

Good luck!

Hi healthygal,

I just wanted to answer one part of the question, "why not just do all those same things with all of your stomach intact?"

I did all these things with my stomach in tact, and lost no weight. I did 8 months of boot camp, whilst having my diet monitored by a personal trainer, numerous attempts of diets did not work for me.

Unfortunately, nothing changed. I did not go into this halfheartedly, this was a chance for me to regain life - confidence, health and happiness. I am only 7 days post op - But I needed this as a tool to assist me with my weight loss journey.

You answered one thing for yourself here "I'm a nurse and know what I'm looking at if I stay at this weight."

Good luck with everything, whatever you decide, you will make the right choice for you. Everyone is different.

Hi Cara:

I absolutely asked myself the same questions, and had the same concerns prior to surgery. I also have had a life long weight issue. I have successfully gained and lost and gained again the same hundred + pounds at different times.

Going on a diet was never the problem. Not being able to sustain it was, for me at least.

I did weight watchers, and was "successful" Until after a year, I was tired of being hungry all the time and the bad habits kicked back in. Which for me, was always a portion size thing.

I had a big appetite and could pack it in. Throw in some bad food choices and emotional eating and POOF.. back on went the weight.

I always wished it could be a little easier, for me the feeling of being full and satisfied was always a comfort. With the sleeve in place for about 9 months now, I get that feeling, and keep my portions in check. I was never one to graze all day, so for me that hasn't been an issue.

Like most things, this is not a one size fits all solution. Depending on what our individual issues are - portion, grazing, bad food choices, binging etc; - we all have to alter some aspect of what got us this way. The emotional eating aspect did not change overnight. But what I keep in the house has. And yes, this has changed before too.

All any of us can do is make the best decisions we can. The sleeve is a tool, not a cure.

There have been struggles, no weight loss is easy. But sometimes we find the one thing that does help. We don't always know what that is initially, so we keep trying.

For me, the decision to get sleeved was a last resort. I tried EVERYTHING short of surgery. pills, WW, nutri-system, fasts, cleanses... the whole lot. The only thing that took was Weight Watchers. It wasnt' the plan that failed, it was me. I needed the tool that would help me. The sleeve has been that for me.

Ideally, I want to eat the things I enjoy (in moderation) Thanks to my built in restriction, moderation comes much easier these days. I believe there are many factors that go into long-term obesity. We have to tackle these things one at a time, and try to understand the why behind it, at least that is what works for me.

Not being hungry, and getting full faster is a part of it, but I still have to make the decisions on what to put in my mouth. I don't know what will come in two years, but I'm committed now and plan on sticking to it. True, I always planned on sticking to it, this time truly feels different- I feel very much in control. I know I cannot sit in front of a big bowl of Pasta and chow down. I physically can't. This time around, having the benefit of a nutritionist is extremely helpful. It makes sense to me that because of the lower calories Im taking in, they need to count. So yeah, I get my Protein in first. I plan my meals, and I portion my food, but I'm enjoying the food I'm taking in and it is physically satisfying me.

We cannot predict what struggles we will encounter. Like any other weight loss try, we have to do our best, form better habits and hope when push comes to shove we can stick to it. When we struggle, we are now in the midst of like minded people in the forum who walk the same path. We know how the others feel and having that support is also a huge benefit this time around.

Best of luck to you!!

_{I'm six months out and yes it's a struggle even this early on, but for the first time in my life it's MANAGEABLE. I had gotten up to 360 pounds and managed to lose 20 and just stayed there even when I was putting in effort. I don't MIND making effort to lose weight as long as I don't feel like it's insurmountable. Having the surgery didn't make things easy for me.. but it did make it less hard!}

Your last sentence is the key. You know what you are looking at in the future. I am 66 and went thru this 10 months ago. I already have all those future things but I am not in a wheelchair like my mother was for 15 yrs. and did not want to end up there either. Diabetes was out of control, 150 units of insulin a day, 4 shots a day a human pin cushion. Now I only test once a day and 2 shots 15 units each. If I had done RNY back 15 yrs ago insulin and many other of my problems would be non existent. You are so lucky to live in an age where you have this choice so young. The point is to live on 1600 cal for maintence, the amount for me. This is a fair amount of food especially if you don't have the hunger. I am down 83 lbs with 23 to go to where I want to be. I will never be a bathing beauty or off all medications but maybe I will be able to care for myself and enjoy the rest of my life. This is my goal even if I have to struggle. It's your call!

I'm very interested to see others' responses to this. For me, I could no longer lose weight on my own, despite severe calorie restriction. And when I did, I always put it back on and it comes back on with several of its friends. Always. My metabolism is severely jacked up and on very low calorie diets, it would slow down to a crawl.

I'm very early out, I'm losing very slowly. But for the first time, I feel like I'm in control and that this might work.

I've always had to be vigilant about food, calories, and carbs. So if I still have to do that--but this time it WORKS--then I'll happily do it.

I am exactly lik you sleeve master, well done for the weight loss .

This is from a post I made a few weeks ago, it does not answer everything you asked about but it fall into the "tool" part (with an additional comment to follow):

"It was asked of me last weekend if I could clarify one thing about WLS, if I could make one notable point that has not been mentioned what it would be. So I thought, hmmmm….

We are constantly reminded that after WLS our stomachs have gone from being a sources of distress, these large cavernous things that CAUSED us to be overweight, FORCED us into eating poorly, etc. to valuable tools we use to lose weight. We have changed our stomachs to be sure. What, however did we change them to? VGS is generally a laparoscopic procedure that removed most of the body of the stomach. Starting generally below the pylorus, the suture/staple/cauterizing procedure extended along the length of the body of the stomach and removed the greater chamber, and may or may not have removed the fundus. So now what, what does that mean?

Now we have our tool. We eat less, we have to. The weight comes off. It may drop like a rock or progress slower. Different body types, health issues, meds, and still the foods we choose to consume will help determine this. So we have a tool for weight LOSS.

Then we maintain. Now we just eat less and it stays off, right? If you have been on the forum for even a little while you will see it is not always that easy. There are still many questions, lots of issues and answers still to be figured out, each in our own way and time. Many questions are about how to use the tool in maintenance.

BUT this post is not about maintenance; it is about the in-between, one of the less mentioned but in my opinion more profound things we do with this tool that affects our success. I define success not by an ideal size or shape but ability - ability to be a size that allows me to be active, and healthy, and off at least some medication, to name a few things. These are not the only goals I have, but they are the achievements I have that I now use to have a far superior lifestyle to the one I had before.

A big shift I have undergone is that I recognized that my tummy did something I did not expect. It provided a way to eat less and it has definite, defined physical ways it has assisted me, no doubt. Mentally it has assisted and even raised more questions! Beyond that, however, there is something more, and whether or not I embrace it I think is the true test of how successful this will be for me. I am talking about the “gap”. I have tried to find any reference to it in the articles and such that I spend a bit of time reading but so far I have not found that many.

The gap I refer to is that space that we never met successfully when we dieted. The ‘ –‘ in yo-yo. That point where the adulation of successful weight loss, and health and compliments began to lose momentum. It lagged with stress of home life, maybe. It was the burger and fries when, honestly, even if it had been a lackluster salad one could have ordered that instead, heck ordered TWO, whatever to be full – but did not. It is the sinking feeling one get when 50 lbs. of weight loss did not make the ailing marriage better, or the bills did not pay themselves. Maybe the issues that were under those layers were still there and still hurt. food was there, with food came feelings of comfort and simultaneous guilt, and a yo-yo began before the weight even crept back on.

Here is the “gap” the ‘ –‘ in yo-yo, and here is where our new friends, our new tummies, kick in. I think it is much underrated in the WLS journey. Our sleeves fill the “gap”. In between that space that we could not overcome, that ‘– ‘ in the yo-yo. We do not eat the burger and fries, we cannot overindulge by volume. We have a means to bridge that gap, if we want it. I think our longest terms of success can be affected by how we choose to take advantage of this bridge over the gap. Better habits, educating ourselves on food choices, understanding what got us here, learning to forgive and set vanity aside. Repairing the mental damage from being in the shells we were in, this is something our sleeves offer us that we did not have before. Much more important than just eating less and as vital as exercise - we have time. Time to recover before we even stumble, time to get equanimity from our minds and bodies at the same time we do not regress to bad habits and start that journey back up the scale.

We have time to make time – days and months and years to in turn create space to enjoy those days and months and years. If we did not gain a day from this, we gain quality. You know the sayings about rather have quality of years over a lot of years? We get an opportunity for both!!! From VGS and the bridge it gave over the “gap”."

Now, as far as everyone struggling years later, that is falling back into habits, and eating foods that they ate before. No one wants to hear this but you are undergoing a permanent, life altering event. To enjoy a long-term success, you will need to permanently alter your choices of foods, exercise as you can, get control of emotional triggers and I would seriously recommend reading “The Power of Habit” by Dughil.

If you are asking why incorporate this, and make the struggle easier, and yet still struggle – but say struggle at 250 lbs rather than 400, or 180 rather than 250. Well, that is your answer.

I got the sleeve for all the same reasons listed above, but also this was my chance at a fresh start. A redo. Forced portion control. It doesn't come without struggle though. I didn't have the surgery to eat like I used to. I've studied nutrition and prepared myself to make life changes.

Sure, I have days or even weeks where I fall back into old habits but now it's easier for me to get back on track. Instead of gaining all the weight back, I may gain 2-3 pounds, get back on track, a continue on with my weight loss. I think those who gain the weight back have given up completely. Your outcome is still up to you but the sleeve helps tremendously! Good luck on your journey.

I chose this surgery because all other diets failed me and I was so tired and depressed about my weight. I intuitively knew that I needed this surgery for my health. Yes, the sleeve is just a tool and it does help with reminding me that I need to eat healthy and cut out the sugars as much as possible. It has helped me learn more about the addictive things that are put into our food that makes us want more. I can eat a ton of candy if I choose to and I always feel like I let myself down and it shows by an increase in weight. So I jump back on the wagon and cut out all sugars and the weight decreases. I am a food addict and the sleeve reminds me the toxic relationship I have with sugar......I eat mostly paleo and cut out the majority of processed foods. I don't eat anything with corn in it except on rare occasions and I love eating small portions now.

OP: If you are questioning this, then perhaps your not ready for the surgery yet. It is ok to wait because this is a permanent procedure that in non reversable....

I love my new journey with my skinniness and feel so much more healthier too. It is still work and I'm learning to deal with the struggles of healthy eating....... This is the life I have chosen.........

Pookeyism has pretty much said it all in her post. Everyone has a "why". Why did I do it? Why couldn't I do it on my own? I am not sleeved, yet. And that being said I have no long term advice I can give. But I can give you what my heart believes. The sleeve makes it possible. If it were possible to a healthy weight without the sleeve, then all of us who have been here would not be. Obesity is not a choice anyone wants. I truly believe the sleeve, as a tool, makes us stay true to what needs to be. Weight loss is just as much of a mental battle as it is a physical one. I feel the sleeve gives you a break on the physical fight, so that we can spend our energies on the mental one. The struggle is redefining our relationships with food. What it means in our lives. The sleeve covers the physical aspect of hunger and over indulging. We have to work on the "why" we are eating and "why" we are choosing what to eat. And as far as struggles with gaining back weight... I believe that, once a healthy weight is obtained, we are much more likely to want to keep it than let it slip. I think most people who write about struggling to keep the weight off long term mean in excess. Even naturally thin people struggle to keep off the pesky extra 10-15lbs. But people who fight obesity have never had to worry about such low amounts, it is all new. I honestly cannot imagine at this point what struggling to just lose 10lbs to be a healthy weight would be like! I think long term sleevers are describing that, not the amounts of weight we face pre op. I do not believe I will EVER be able to get as heavy as I am now once I have the sleeve. I have no intent of it. Because at the end of the day we do go through a LOT of pain, money and possible side effects to get where we need to be. It should serve as a reminder and a testament. I have surrendered myself to the fact I cannot do it alone. It is all about personal choice, and this is mine.

Thanks for starting this thread & also for all the great replies. Off the top of my head, I was thinking about that hormone or neurotransmitter, Gherelin? It is produced in one area of the stomach and is essentially removed from the equation once that section of your stomach is removed. This was an added benefit and a surprise to doctors after the fact. It's my understanding that Gherelin levels are high in people with obesity because it sends hunger signals to the brain. So chemically and physiologically, we should be less hungry... Having my surgery on October 15th... Excited for my future and wish the best for you regarding yours!

These are great responses! No, I wasn't looking at the sleeve to be a "cure". I know better than that! What I wanted, and have gotten some of in these responses, was to know HOW the sleeve made things easier as a tool, or if the struggles were exactly the same as they would have been when I've had my whole stomach and was struggling with dieting. I know for certain doing this will require paying attention to my eating issues, making smart choices, and exercising. That's okay with me. I wanted to know exactly what part the sleeve was playing in helping the process. I didn't want to think I'd have this surgery and then it would stretch out in a couple of years and I'd be right back where I was before. It is a super-big decision and I wanted to know what the sleeve was going to be offering me later on as a tool, or if the effects diminished.

I am a food addict, too, and feeling full seems to be a big thing with me. It's a comfort. Also, hiding behind being BIG has given me a feeling of being more physically imposing and stronger, that people couldn't just push me over. That's one emotional issue I'll have to work through, because it actually scares me a little to think of being smaller. I've never been the smaller one in the group! I'm learning to find strengths inside myself that I can make shine, rather than thinking I have to physically be the BIG ONE who can't be pushed and manipulated.

All of my diets failed because I got sick of being hungry and feeling like I was restricted all the time. When I did allow myself some of the good things, because I seem to want quantity over quality, I would invariably eat a WHOLE BUNCH and then I'd be back where I started in short order. Maybe part of the issue was also that, as I said above, I'm not mentally used to be smaller. That's going to require some work to get that worked out. I also have social anxiety, so having MORE attention paid to me would be, well, nerve-wracking.

So yeah, there are lots of issues that will need work and attention. What I wanted to know was that having the sleeve done will continue to be an asset in my weight loss into the future and realy help me out, not just cause a lot of weight loss at first and then stretch and put me back to where I was at the start.

I do not believe I will EVER be able to get as heavy as I am now once I have the sleeve. I have no intent of it. Because at the end of the day we do go through a LOT of pain, money and possible side effects to get where we need to be. It should serve as a reminder and a testament. I have surrendered myself to the fact I cannot do it alone. It is all about personal choice, and this is mine.

I so resonate with what you are saying. I think reading these posts is helping me get a clearer picture of what the sleeve does for people post-surgery. That's what I was truly asking about. I wasn't saying, "Well, if it's work afterwards, why bother?" I knew there would be work on the causes of the overeating, and choosing good foods, etc. But some of the posts sounded like they were really struggling with not gaining back. Some of the studies I read said that at 6 years out the excess weight loss was at a median 50% of what was lost initially. So I thought, hmmm, does the sleeve start to fail people? Does it stretch and they eat too much again? Do they still crave the bad stuff and just give up? I guess what I would hope is that when I reached that stage and COULD eat more, I would have learned enough about my eating issues and choose good foods that I wouldn't pack it back on again. But when considering such a drastic move as surgery, I wanted to find out how the sleeve was aiding people after a couple of years, how they felt it was still helping.

I guess in the end, it's always still up to us to make it work. I just want to know that for the investment in so many ways, it will continue to help me permanently and make things simpler.

The reality is that in the beginning, we all lose weight due to the physical restriction of the sleeve. However, there comes a point where the sleeve will no longer be as effective at weight loss or maintenance as diet and exercise is. I have put significant effort into changing my relationship with food and embracing exercise. I still have work to do- my old habits still creep up every now and then and I find myself repeating old behaviors that I am trying so hard to replace with better choices. I understand and accept that the sleeve is basically temporary but my lifestyle is what is going to make the permanent and life-long change that I am looking for in my life. I understand and accept that I might struggle with my food addiction for the rest of my life, as any alcoholic does. But I also knew that I only had a 5% chance of loosing more than 100 pounds on my own, so for me, the surgery was necessary. Now, as I continue to struggle, I only have to deal with the food issues and temptations, and not the constant shame and guilt I felt at being 340 pounds. So even though I might always struggle, I won't struggle with as many things, if that makes sense.