Okay here is my rant:

I somehow lost my long rant

. Will try again tomorrow.

Edited August 12, 201411 yr by I will what I want

Love your rant, and I 100% agree!!!

I agree with the metabolic factor. My gastroenterologist told me that both the RNY and sleeve essentially reset the metabolism. He told me that years of obesity alter your metabolism significantly. For me, 30 years at more than 250 lbs meant that I would do weight watchers, etc, eating about 1400 calories a day and starving, and I would lose 40 lbs in two or three months and then lose nothing more and start the regain. I regained all the way to 291 lbs in dec 2012. My RNY was 2/28/13 and I am down 125 lbs. I eat 1200 calories a day-- some days 1400. Still losing and I don't feel controlled by food.

Found this interesting study about the effects of the sleeve on bile acids, and bile acid signalling's role in weight loss:

Abstract

Bariatric surgical procedures, such as vertical sleeve gastrectomy (VSG), are at present the most effective therapy for the treatment of obesity, and are associated with considerable improvements in co-morbidities, including type-2 diabetes mellitus. The underlying molecular mechanisms contributing to these benefits remain largely undetermined, despite offering the potential to reveal new targets for therapeutic intervention. Substantial changes in circulating total bile acids are known to occur after VSG. Moreover, bile acids are known to regulate metabolism by binding to the nuclear receptor FXR (farsenoid-X receptor, also known as NR1H4). We therefore examined the results of VSG surgery applied to mice with diet-induced obesity and targeted genetic disruption of FXR. Here we demonstrate that the therapeutic value of VSG does not result from mechanical restriction imposed by a smaller stomach. Rather, VSG is associated with increased circulating bile acids, and associated changes to gut microbial communities. Moreover, in the absence of FXR, the ability of VSG to reduce body weight and improve glucose tolerance is substantially reduced. These results point to bile acids and FXR signalling as an important molecular underpinning for the beneficial effects of this weight-loss surgery.

http://www.ncbi.nlm.nih.gov/pubmed/24670636

Edited August 12, 201411 yr by larkspur

I was surprised to hear from my sister who is considering WLS that they are testing her metabolic rate to see why she did not lose weight on a carefully monitored diet. What the nurse and nut told her was that if it is off then it would make no difference if she had the surgery or not. That that had to be fixed for her to lose weight either way.

I thought wow, they can fix that!

Just a die note I love the nut work you use in the states to describe your primary local dr. We call them gps in Australia, as in, general practioner.

One thing that people should be aware of is that different types of WLS will not work for everyone. The band works great for some and not others, same as sleeve and bypass. When I originally went to my surgeon we discussed my reflux and how it could disappear with the sleeve but maybe not and then I would need to think of other options. As he discribed it the sleeve is a high pressure environment so I will be revising to a RNY next week. I also have another issues. Glad I got my sleeve as it did help me lose some original weight.

All I can say is what I always say do your research about all wls and decided what YOU think is best for YOU and YOU only , I have friends and family that have had many of the different wls and I knew what was best for me .

Lin - NUT refers to nutritionalist. PCP is primary care physician. Or maybe I misunderstood your down under accent?

Edited August 13, 201411 yr by CowgirlJane

Here in Canada we call them GP's General Practitioners. And NUTS are nutritionists. Like the USA

You all crack me up! Here is the rant I tried to post last night: Please people, read the research papers that abound on this crazy thing called the internet about WLS. You know the vitriolic, name calling arguments that ya'll have been having over carbs, band vs vsg, vsg vs RnY? There are recent and good scientific studies about the pluses and minuses. (Good, meaning not funded by a medical company and peer reviewed, etc) And those questions and statements that vsg is mostly restrictive (it's not, actually)? A couple of new studies have shown it's mostly metabolic... I could go on and on with examples but you get the idea. Why do I care, you ask? Here's why: When one understands fully how and why each procedure works, you can make proper choices. If you understand that vsg is mostly metabolic and you basically get a reset then you can make choices to keep that reset. If you read that new studies show the size of sleeve (ie 34 to 40 ish) makes no difference in weight loss but does in reflux...you can have a serious conversation with your doc. How much supplementation do you .really. need if you have had RnY? It's in a study... It's your body and health. Don't count on a surgeon you see occasionally (or nut. Or strangers on the internet) to know it all. Know it all for yourself. There is a lot of research happening with WLS these days because the results are phenomenal. Drug companies and institutions are performing basic research because they are looking for new drugs to produce. That's good news for us! One last note: some of the studies are dense and even with a science background I can't follow the details. However, I can follow the basic argument and conclusions. I can decide if it's a well designed study. So don't let the 20 character long molecule names stop you! Get reading people! Rant over. And now you can proceed to tell me why I'm wrong (isn't that what comes next with strangers on the internet?)

Hey wait back to your rant ....

If I read it why would I be here

And that we remove me from the easy part of just asking. Again and again and again

And hey did you change your name on here?

I did change my name. It was basically my real name and after dealing with some scary trolls on Facebook I realized I needed to be more careful in general. Nothing happened here on BP.

Yes. It's soooo much easier to have others think for me too. :-).

argh, thanks for clearly up the jargon

argh, thanks for clearly up the jargon

Sorry to leave you confused with the jargon. Glad you spoke up and got your questions answered!

Yes. It's soooo much easier to have others think for me too. :-).

Ouch!

I did change my name. It was basically my real name and after dealing with some scary trolls on Facebook I realized I needed to be more careful in general. Nothing happened here on BP. Yes. It's soooo much easier to have others think for me too. :-).

I like the new name.

Yes if people read research there would be no new blogs here. I mean do they not know how to use the search function.

Guess not.

You all crack me up!

Here is the rant I tried to post last night:

Please people, read the research papers that abound on this crazy thing called the internet about WLS. You know the vitriolic, name calling arguments that ya'll have been having over carbs, band vs vsg, vsg vs RnY? There are recent and good scientific studies about the pluses and minuses. (Good, meaning not funded by a medical company and peer reviewed, etc) And those questions and statements that vsg is mostly restrictive (it's not, actually)? A couple of new studies have shown it's mostly metabolic...

I could go on and on with examples but you get the idea. Why do I care, you ask? Here's why:

When one understands fully how and why each procedure works, you can make proper choices.

If you understand that vsg is mostly metabolic and you basically get a reset then you can make choices to keep that reset. If you read that new studies show the size of sleeve (ie 34 to 40 ish) makes no difference in weight loss but does in reflux...you can have a serious conversation with your doc. How much supplementation do you .really. need if you have had RnY? It's in a study...

It's your body and health. Don't count on a surgeon you see occasionally (or nut. Or strangers on the internet) to know it all. Know it all for yourself.

There is a lot of research happening with WLS these days because the results are phenomenal. Drug companies and institutions are performing basic research because they are looking for new drugs to produce. That's good news for us!

One last note: some of the studies are dense and even with a science background I can't follow the details. However, I can follow the basic argument and conclusions. I can decide if it's a well designed study. So don't let the 20 character long molecule names stop you!

Get reading people!

Rant over.

And now you can proceed to tell me why I'm wrong (isn't that what comes next with strangers on the internet?)

Common sense. I did all my own research by reading everything I could find on the internet, watching videos, talking to the few I knew who had WLS (one lap band, 2 RNY's), talking to my endocrinologist and my PCP, then attending the informational seminar. I made my decision to do RNY based on my particular needs.

This site was invaluable for those little tips from people a few months ahead of me in my progress that were not covered in my own research or program education workshops. Just talking to a peer group who understood everything I was experiencing was comforting, too. I like sharing personal experiences, getting encouragement and sometimes sympathy (and giving it). And where else can you find someone who understands the joy you felt when you could finally paint your own toes? :-)