Band to Sleeve (Ghrelin and Leptin Responses)

[susieq321 31]

Long time member but i haven't posted anywhere in ages, but I used to be on the Lapband board.

I was a long time very successful band patient i was orginally banded in Jan 02 (in Canada, pre FDC approval) lost weight at a great rate. My first band (Innamed) slipped a total of 3 times before it came out for six months, I also had surgeries to move my port and another because my tubing disconnect. Next we went to the J&J band and it was great until it slipped badly, I had it for about 6-7 years and it worked like a charm, restriction was great most of the time, lost to my goal size and then it self tightened and i left it there because of travel, personal stress etc and i thought it would release on its own when i went for a defill it completely slipped around my esophagus and it was horrible. With the J&J I had a port revision surgery in there too.

Then we tried a 3rd band it never worked right, I couldn't get restriction because if we did more than i had instant reflux etc.

I revised to the sleeve last week with a new surgeon in Philadelphia who told me the band was basically around my esophagus and i had no pouch which is why I had no restriction and why I could not be tightened any more.

But I lost about 150 lbs in 12-16 months and maintained that loss for 10 years plus, with little to no effort.

In the meantime because of the band with no restriction, some prescribed evil steroids that I had to take that put 30lbs on me in a matter of 8 days... (they change your brain chemistry in weird ways) hashimoto's disease (hypo thyroid) fluctuations for the last few years and a few other things I gained about 70-80 lbs that I could not lose weight I tried. I went gluten free and dairy free, nada, I tried the HCG diet lost 20 lbs gained it back and generally I don't eat more than 1500-1700 calories per day including when I am drinking wine, eating out 3 meals a day etc. I hired a trainer, almost went paleo not quite.

Now in talking to my surgeon he has said there are new studies showing band patients 9-12 years out who suddenly gain weight they can't lose for love nor money. They try everything and it won't come off more restriction, calories restriction etc. So we made a joint strategic decision to go to the sleeve since I knew the risk, what type of lifestyle change I was in for, Portion Control etc. wouldn't be a problem since i had it already.

In our conversations we talked a lot about Ghrelin which is produced in the stomach and it makes you hungry, when you are feeling that craving to overeat or binge typically it is ghrelin and obese people produce more ghrelin than non obese people typically with some exceptions. We also talked about leptin which makes you feel satiated and is produced in the brain.

With the sleeve, about 70-90% of the ghrelin produced is surgically removed with the part of the stomach they remove.

i am curious have you noticed a difference in how hungry you get, cravings and the satiation of cravings ie: I can eat two bites of cake vs. I want the whole cake now? Have you also noticed the full feelings getting different than before from the leptin.

My surgeon has said in his conversations with his patients they noticed their cravings reduced which helps them with portion control and in making better choices which helps a number of other things. In other words the brain and stomach don't conspire to make cheetos seem like a great dinner choice or ben and jerry your best friend.

Overall I eat very healthy without a ton of junk food in my life we cook at home, we make our own stocks and Soups etc. to help get me through the liquids phase. But we do eat well and drink wine, we might be foodies (we are told we are, I just like trying new things). I have never eaten out of control even with the last band and no restriction just trying to lose weight has been terrible, depressing and frustrating. Especially after my first experiences which was I lost well, ate well, exercised and it worked like it was supposed too.

I am a consultant and I travel for my job excessively so hence the eat out three meals a day most of the time I don't have a choice in that, but you can make healthy choices even in eating out and I do. I look at fats and calories along with Proteins and make good choices.

Any thoughts you have I would appreciate and any advice you have I would love to read. Thanks for reading and good luck

[thesuse2000 698]

I'm a band to sleever too. For that brief period of about 6 months when the band was working well for me it did curb my hunger and help me feel satisfied with less food - but for me the sleeve is SO much better!

I just don't have those out of control cravings anymore - and I can eat a little bit of a treat without difficulty. A few weeks ago I went out with a small group for a friend's birthday. For dessert we went to the birthday girl's favorite cupcake bakery (one of my fave's as well). I had decided to just have a cupcake for this occasion, but after eating half (they're not huge either) I just felt like it was enough. I haven't been eating much sweets, so just half a cupcake felt like a lot. Could I have eaten the whole thing? Sure. But it was not hard to stop. In the past I would have gobbled the one and then bought a few to bring home (with the excuse of sharing with my husband) and eaten another one - or three...

One more story - this past week I took a train home from a client and as I came out of the train into Penn station I ran right into a Cinnabon. I hardly ever pass those, but it's always been a HUGE temptation for me. I felt compelled to go look at the goods (fighting in my head about whether to do that) but when I looked at it all I realized that it didn't actually appeal to me at all. Just looked overwhelmingly fatty and just junky. It was sort of an awesome surreal feeling walking away from that realizing that I really have changed! I have to think that the whole metabolic reset with the sleeve (vs the band) has made that change happen.

Honestly I still feel so cautious about trusting that this will last. It's just hard for me to imagine that my relationship with food is forever different now. But I am cautiously optimistic that longterm things will be at least a bit better than they used to be. I wish you the best with your new sleeved life! I am loving it so much.