What is the real point of this surgery?

[CowgirlJane 14,261]

I think you got some great answers. I tried and tried and tried to lose and keep ANY weight off for years. I considered it wonderful if I could be under 250# - at 5'5" not exactly svelte.

I was hungry 24/7 - I had a drive to eat that was at times overwhelming. I would try different programs and have temporary success and then regain. I reached a point where I wasn't even having temporary success anymore - yikes!

So, for me the point of the sleeve was to give me a forced restriction of food, and a true hunger reduction to give me a chance to get off the eating/obesity hamster wheel. A chance to learn new behaviors. A chance to understand the physical drives and how to control them. Oh, and Portion Control.< /p>

What I started to realize is how carb sensitive I am. That processed foods have something in them that just isn't good for me, makes me want to consume compulsively. I realized that something about being obese itself actually triggers hunger - like a chemical imbalance or something.

My hunger did start to return about 8 months out and I worried... My NUT pointed out I was eating Protein bars like candy. Two things there 1. too many carbs and 2. Behavior. Knowledge is power and you can be sure my favorite Protein Bars no longer live in my house. Same with Peanut Butter and other trigger type foods. This didn't happen overnight, but I eat small portions, I keep trigger foods out of the house and I have good strategies for situations.

I am 2.5 year out, I have lost about 160 pounds (currently weigh 140). My hunger is under very good control. I work at it, but not nearly as hard as I previously worked to stay under 300#.

I treat my obesity like a disease in remission... my condition is still there, but I am currently managing it's primary symptom - excess weight, very well. I must remain focused or it could very easily creep back... although frankly right now, it is not a problem at all.

[fuzzymonkey 38]

Behavior changes is the biggest component to a successful weight loss.... Even after surgery people think that they can just eat the bad or unhealthy in moderation... Isn't that what got us in this predicament in the first place? Sleevers need to remember that just because you can eat something and " it goes down ok" you need to ask yourself: Do I NEED this ( piece of cake, bite of cracker...) because just because you CAN EAT IT without issues, doesn't mean you should.

[NothingUpMySleeve 244]

I still get hungry, but it's different. Before, after two weeks on an 800 cal diet, I'd be hungry and craving anything just to fill me up a little more.

Before, It was like the minute I went back to eating like "a normal person" the weight would just plop back on. Well, since the sleeve, I have easily eaten 600-800 calories a day and it's ok.

Now, my hunger message is like someone writing "Hey, I'm kinda hungry" on a post it note. Before it was like a marching band playing a hungry song and flying a banner saying "EAT NOW DAMMIT" while throwing Cheetos to the crowd.

[moonlitestarbrite 902]

cowgirljane, new research supports this, that being fat leads to overeating... a hormone given off by fat cells themselves.

one of the things i experienced was exercise made me ravenous. this really sabotaged my weight loss efforts. i would work and work at losing weight and actually gain a pound! it was infuriating!

[LivingFree! 478]

I want something that will be a tool for a lifetime, not just for a few months to a year. I wish I could post this same question in the veteran's forum, but it won't let me. I would love to hear from people who are 5 or more years out. The trouble is, because of human nature, I may not hear from many people for whom this hasn't worked that great for that far out.

Thank you all for your input and again, I am very happy for you and wish you continued success.

Hi powaqqatsi,

A Veterans Forum member here--I'm not 5 years as you asked for, but I am 3 years post-surgery and I am so glad you asked this question. My sleeve will be "working" just as well at 5, 10, 20 years as it is working now because I AM THE ONE who makes it work; IT DOESN'T WORK BY ITSELF just because I had the operation.

Please don't take this as a rude or flip answer--your question really is what a lot of people who are just begining to look into weight loss surgery believe to be true--You have the surgery, and then you lose the weight, and then you're not hungry any more, yet you can eat all the same unhealthy stuff you always ate (that got you into the trouble you're in in the first place), and you live happily ever after. As so many people say--weight loss surgery is the "easy way out." Nothing could be further from the truth!

There are two distinctive parts to WLS: 1) the operation 2) a FOREVER new eating plan & physical/emotional lifestyle

Any weight loss surgery is about personal CHOICES, ACCOUNTABILITY, POSITIVE ATTITUDE, and CHANGING YOUR RELATIONSHIP WITH food that you have had for your entire life. It is a lot of hard work every day, but among the most life-changing events you will ever experience. I love eating healthy now. I use food as medicine for my body and don't like putting junk food in it any more. Can you believe that a formerly morbidly obese person can change their way of thinking THAT MUCH? Sometimes I still have to pinch myself that that's ME talking!

I was morbidly obese since puberty. At age 59 and 252 lbs I was sleeved. I have maintained my 105 lb weight loss with a peace and joy I have never known. I CHOSE to make my adventure FUN, not DRUDGERY. I was diabetic, on 4 BP meds, 2 chol meds. No more of any of that. Healthy body, healthy mind, healthy life--who could ask for more? Please feel free to send me a private message if you have any questions I could help you with.

[CowgirlJane 14,261]

LivingFree has it 100% right

[MichiganChic 3,262]

Probably like a normal person, something many of us have never known. And, even with an increased capacity, it's NOTHING like it was before.

Michigan Chic,

This statement right here is what I keep coming back to. My husband, who loves food and loves to eat, but can easily turn food away, just doesn't really understand what I go through day in and day out. I heard one person call it "brain chatter". That constant nagging in our heads about wanting to eat, thinking about food, etc. I have read where people talk about what you say...feeling more "normal." That's how I felt, back in the 90's when the "real" Accutrim was out there. I would take one of those on days that felt stressful or like I might have a problem watching my intake and for that day, I felt like my relationship with food was...normal. I ate when hungry, stopped when no longer hungry. I wish there was something that would give me that feeling all the time. I just want a normal relationship with food.

I know what you mean about the brain chatter. I never thought of it that way, but that's what it is. I hate to tell you, I still have that. I don't know if it will ever go away. However, it does not have the power or frequency that it used to. I can resist it, and I can easily be distracted from it. A lot of the time, it's not there at all. I do get hungry, but it's not this overwhelming DRIVE TO EAT that it used to be. It used to feel like I HAD to keep putting food in my mouth, much like breathing, even when I was not hungry (though I truly was hungry a lot of the time). Now normal to small size portions satisfy the mild to moderate hunger I experience, and the chatter subsides. If I'm stressed and not otherwise occupied, the chatter is there. However, if I am busy, there's no chatter! And, when I'm physically hungry, I get what I suspect is a normal urge to eat. Anything will satisfy it, so it allows me to choose the right foods instead of some crazy drive to eat cake.

I could not have begun to realize how life changing this would be for me. I really wondered if I would be a good candidate for surgery that did not involve malabsorption, because I could not lose weight at all, the older I got. I figured if I couldn't lose it myself, what on earth would make it come off after surgery? Answer: It's the ability to drastically decrease calories and maintain that reduction over time.

Some people get inflamed when others accuse us of "taking the easy way out", but for me, it was definitely easier. I don't mean to imply that I don't work for it every day, all day. I just mean that if you compare the scenarios, this is much easier. You still have to do the work, but the difference is that the surgery gave me a fighting chance. Hunger and capacity are decreased enough to let my willpower do what normal people do - manage my weight through diet and exercise.

[beachgurl84 456]

The more I research this, it seems that most weight lost is due to the extreme pre-op and post-op calorie-restricted diets. I have read many people on these forums talk about appetite coming back (I thought the ghrelin-producing cells were removed!), ability to eat large volumes of food still, and generally weight loss stalling or at least slowing to 1-2 pounds a week. I can lose 1-2 pounds a week just exercising and grinding a program like Weight Watchers.

I got interested in this procedure when I heard about the appetite reducing properties and thought that, coupled with the inability to eat large volumes of food, would help me not just lose my 100 pounds of extra weight, but KEEP it off. I see so many people talk about regaining half or nearly half of what they lost, or the hyper-vigilance needed to watch what you eat, not drink during meals, make sure enough Protein is ingested, and vitamins/minerals too.

It sounds to me like I'll have to be just as careful about watching what I eat and exercising as I would be if I lost weight the traditional way.

It's all got me wondering what is the point of the surgery? Is it just to lose part of it faster?

Is there something I'm missing here?

Hoping for guidance, and thank you!

powaqqatsi,

Before I give my input, please understand I am in the same position as you are. I am just now starting my 6 month program and I have my first "Lifestyle Class" next week. I asked myself the same question you are asking...."what's the point if I still have to diet and exercise?"

If you notice, every single diet plan/weight loss program out there comes with the instructions "diet and exercise". So what makes this any different? If you can diet and exercise on your own without the surgery the same as you would with the surgery, what's the point?

The question that I finally asked myself provided me with the answer that made me start this journey. That is "if I can get the weight off on my own, why haven't I".

So, I can't give you any answers about post op or even preop really as I'm just starting myself. I've read everyone's responses and they are only encouraging me more. We are all responsible for our own actions. I CHOOSE to put the unhealthy food in my mouth. I CHOOSE to buy the junk food at the grocery store KNOWING I will eat it. That's why I'm really looking forward to the LIFESTYLE change that is required with surgery. It will be the most helpful tool I have to change my lifestyle. For someone like me that grew up in the south where eating is our way of celebrating (weddings, funerals, homecoming, church, holidays, birthdays), this is going to be tough. But I look at it this way.......

1. I KNOW I can learn to turn away from unhealthy food if I have the hunger under control. I need a tool to help with hunger. I need to LEARN to turn away from those foods.

2. The surgery is not going to keep my mother from making a sausage and rice casserole after church that's so greasy you don't even need to chew it because it slides right down your throat. It won't stop everyone around me from eating unhealthy. It will HELP me CHOOSE not to join them.

3. I haven't been able to get the weight off on my own for one reason or another. No matter how many diets I try, I have failed (I failed, not the diet) to get my weight off. I have to take responsibility and reflect on things I need to change. The surgery will be my tool to do that. Many people are very successful with the available diets out there like weight watchers, HCG, adkins, Jenny Craig, etc. I am not one of them.

I know I haven't answered your question because I am not even close to my surgery. I hope I haven't sounded offensive in any of my thoughts. I just wanted to share with you the reasons I am starting this journey. If you are seriously considering it, but have doubts, ask yourself this.....if you can get the weight off on your own without surgery, why haven't you?

I wish you luck in whatever you decide. If you decide the surgery is right for you, I hope to see you around on these forums as we get through this journey. It's going to be tough, but having such a wonderful support group available, and seeing all the successful stories will make it much easier. I KNOW I CAN DO THIS!

[patrice1 81]

My surgery date is in 6 days for the gastric sleeve. I have asked myself these same questions, and had other people say the same to me: "If you have to watch what you eat and exercise anyway, just do it without the surgery." Well, if I had been able to do that before, I would never have contemplated surgery. However, your question is one that everyone must answer for themselves, that I know. I have lost (and regained) significant amounts of weight repeatedly throughout my life. The sorry statistic of 3-5% of those who are successful at keeping it off (without surgery) is dismal.

As my nurse said to me in my last pre-surgery appointment: "We all know we don't just eat when we are hungry." I have been in therapy ever since I decided to get weight loss surgery, and I have learned a lot about myself. I was on the fence until I took a long hard look at the type of eater I am. I eat very well until my binges. Overeating and binging (I never purged, thankfully) is considered an eating disorder (as my therapist told me). I need to have the tool that will keep me from overeating in a frenzy during times of emotional stress. Sure, I could force more food down my soon to be tiny stomach every 30 minutes as another person said earlier in this thread, but that 30 minute delay (which I didn't have before) is usually a good space to get myself together.

With a large stomach, I go until I am sick. Someone else may not need this restriction, I do. This gives me a tool, "a slap in the face"if you will, if I do get out of control. I also know I am going to stay in therapy as I get used to my new lifestyle. Can I still beat the system later? Sure. People do. It's personal choice, just like everything is: We have to make the choice to do what is best for us long-term. For me, this gives me a sense of security knowing that restriction is there. I need it. I know I do.

I also spoke with people who have had WLS and had the same issue I did. While they ate healthily, exercised, much of the time, they also had these severe binges that caused them to gain weight back, and thus were never successful in permanently keeping it off. I followed their advice: get therapy, work your program, do what your doctor says, exercise, keep track of everything that goes into your mouth, join a support group, get therapy if you need it, and stay in touch with your NUT (all the things we know)... However, all of them said that their taste buds changed after surgery, that they no longer craved the foods they did before surgery, and the sense of fullness after a small portion kept them on track. THAT is what the surgery gave them in addition to the usual smart things we all know to do and couldn't do permanently before WLS.

That makes me hopeful, and at the same time knowing that this is up to me.... but whatever you choose, you know what is right for you. I have a suggestion - look at why you eat and your patterns that led to gaining weight. You might have a different solution than I did, or someone else does. If you can do it without WLS, and keep it off on a permanent basis, wonderful, wonderful. You are right to ask yourself all these questions. Go on a program that fits your lifestyle and see if you can keep it off. Give yourself a timeline. If you reach that timeline and still aren't satisfied that you were able to get your weight under control, despite everything, you can reconsider the surgery.

That's exactly what I did. I reached that time, and realized that WLS was necessary. But I went into it with the peace of knowing I had done everything else I could.

Best of luck and grace to you on your journey!

Patrice

Edited June 14, 2014 by patrice1

[BMWSistah 31]

I want something that will be a tool for a lifetime, not just for a few months to a year. I wish I could post this same question in the veteran's forum, but it won't let me. I would love to hear from people who are 5 or more years out. The trouble is, because of human nature, I may not hear from many people for whom this hasn't worked that great for that far out. Thank you all for your input and again, I am very happy for you and wish you continued success. Hi powaqqatsi, A Veterans Forum member here--I'm not 5 years as you asked for, but I am 3 years post-surgery and I am so glad you asked this question. My sleeve will be "working" just as well at 5, 10, 20 years as it is working now because I AM THE ONE who makes it work; IT DOESN'T WORK BY ITSELF just because I had the operation. Please don't take this as a rude or flip answer--your question really is what a lot of people who are just begining to look into weight loss surgery believe to be true--You have the surgery, and then you lose the weight, and then you're not hungry any more, yet you can eat all the same unhealthy stuff you always ate (that got you into the trouble you're in in the first place), and you live happily ever after. As so many people say--weight loss surgery is the "easy way out." Nothing could be further from the truth! There are two distinctive parts to WLS: 1) the operation 2) a FOREVER new eating plan & physical/emotional lifestyle Any weight loss surgery is about personal CHOICES, ACCOUNTABILITY, POSITIVE ATTITUDE, and CHANGING YOUR RELATIONSHIP WITH food that you have had for your entire life. It is a lot of hard work every day, but among the most life-changing events you will ever experience. I love eating healthy now. I use food as medicine for my body and don't like putting junk food in it any more. Can you believe that a formerly morbidly obese person can change their way of thinking THAT MUCH? Sometimes I still have to pinch myself that that's ME talking! I was morbidly obese since puberty. At age 59 and 252 lbs I was sleeved. I have maintained my 105 lb weight loss with a peace and joy I have never known. I CHOSE to make my adventure FUN, not DRUDGERY. I was diabetic, on 4 BP meds, 2 chol meds. No more of any of that. Healthy body, healthy mind, healthy life--who could ask for more? Please feel free to send me a private message if you have any questions I could help you with.

LivingFree!

Great testimony! Thanks for sharing.

[carstanger 346]

I'm on Veteran's forum too , 67, and only one and half years out!! I too still track my food, weigh every day and like having the smaller stomach!! I actually had to add back nuts, fruit, Peanut Butter per my nut. My doctor follows me rest if my life!! This forum really helps me as my doctor and his support groups are 2 hours away! I had surgery in early April got a prolapse due to how I carried my kids when pregnant.. Was able to continue my 4 pound leeway U give myself. This is a personal choice.

Healthiest I've been in over twenty years!! Ordered half a portion last night at a favorite hometown restaurant and it was still two meals for me!! I still supplement as I have a hard time eating enough Protein. Good luck on your decisions!!! Keep asking questions!

[VSGAnn2014 12,992]

I asked my surgeon last week, "What are the patient factors associated with very long-term (10 years plus) success in maintaining their weight loss?"

He immediately said, with considerable gusto: "Follow-up! Those who stay connected to our program -- who come to the support group, who keep coming to their quarterly appointments, who take advantage of our nutritional consultations when they need them, who keep doing their lab tests to make sure their nutritional and blood chemistry is in balance -- those people are guaranteed of long-term success." He was so enthusiastic in his answer that it rang very true for me.

(In the last 15 years, this guy has done over 5,000 weight loss surgeries.)

Edited June 14, 2014 by VSGAnn2014

[LivingFree! 478]

I asked my surgeon last week, "What are the patient factors associated with very long-term (10 years plus) success in maintaining their weight loss?"

He immediately said, with considerable gusto: "Follow-up! Those who stay connected to our program -- who come to the support group, who keep coming to their quarterly appointments, who take advantage of our nutritional consultations when they need them, who keep doing their lab tests to make sure their nutritional and blood chemistry is in balance -- those people are guaranteed of long-term success." He was so enthusiastic in his answer that it rang very true for me.

(In the last 15 years, this guy has done over 5,000 weight loss surgeries.)

Excellent point, VSGAnn2014! What a wise and awesome surgeon you have.

We all know the stark reality--when we sign on for WLS, we sign on FOR LIFE. It's easy after a year or two (or more), for some of us to "forget" that. In the big picture, it really isn't that hard to stay compliant with the medical follow-up as recommended by our particular bari programs as trade for the amazing life benefits we get in return! Thanks for sharing this important point!

[swimbikerun 1,048]

Amen to everything said above. The tool helped me to get down and keep it down. Unfortunately its all the other whoo haaa that is getting me LOL.

It is worth getting. I tell everyone and would basically expand the ability for insurance to do surgery for a great many. I just want them to be CAREFUL and investigate who you get so they don't get the experience I had. The problem is aftercare and the surgeon's attitude (ok yes, there are a few things that appear to have been missed) but the greatest problem I have is a lot of the residual effects of how he managed me, etc.

[swimbikerun 1,048]

Amen to everything said above. The tool helped me to get down and keep it down. Unfortunately its all the other whoo haaa that is getting me LOL.

It is worth getting. I tell everyone and would basically expand the ability for insurance to do surgery for a great many. I just want them to be CAREFUL and investigate who you get so they don't get the experience I had. The problem is aftercare and the surgeon's attitude (ok yes, there are a few things that appear to have been missed) but the greatest problem I have is a lot of the residual effects of how he managed me, etc.