I am using Dr Pilcher in San Antonio. I am trying to decide between the sleeve and RNY. My biggest problem is that I am always hungry. Also, I really like food. I can diet and exercise and just not lose much because the hunger always takes over. I can usually do about 2 months and stick to a strict diet, then after that, I just get really exausted of always being hungry, and I cheat. I work out, and I love lifting weights. I like feeling strong. But I am 350 and I need to be closer to 200. I am 6 feet tall. I am worried that the sleeve will not kick the hunger. Then again, I worry about the rny and the lifelong issues it brings with supplements and the inability to eat some of my favorite foods again. i am more concerned with the long term success and quality of life, than the immediate weight loss. I have been reading up, and seen a lot of people that had the sleeve that are still hungry, and that scares me, because to go through all the prep with insurance, and the surgery, and to still be hungry... would suck. Has anyone else used Dr Pilcher in Texas?

Regardless of what surgery you have, you have to work at it. My best friend's mother had bypass @ almost 400 lbs, got down to about 180 and is back over 300. The surgery will only work if you stick to the plan. I got the sleeve because I didn't want my intestines rerouted, I can only get down 4 oz at a time, and have lost 51 lbs in 7 weeks. I'm happy with my decision. My Dr's goal for me is 195 lbs, my goal is 170. You should do lots of research on both surgeries before making a concrete decision. As far as hunger, you still feel hunger with any surgery, but you do get full with a small amount of food. Best of luck on your journey!

Thanks. My problem is, that even after I eat, I am hungry. There is never any full. I would love to be able to sit down and eat, and 30 minutes later, not feel like I haven't eaten all day. I did Medifast for 3 months, along with exercise, and was sick the whole time because the hunger made me nearly throw up. So I added more Protein to my meals and upped my caloric intake to 1500, and then I lost nothing. A month of that and I was completely frustrated. It's like, I can stick to the diets, but the frustration with the constant hunger drives me to quitting. I usually end up depressed and hating myself for not being strong enough to overcome the hunger. I am really hoping that I can feel full after meals with one of these surgeries so I can stick to the healthy eating. I have heard of bypass patients pouches stretching out after several years, but I don't know any sleeve patients. I wonder what the rate of stretching back out is on them?

Doctor Pilcher is my surgeon. I had an RNY on Tuesday Feb. 10th. I was leaning towards sleeve in the beginning, but we sat down and discussed my co-morbidities, the facts around sleeve success with women, and lot of other details. In the end, I felt comfortable with his recommendation to have the RNY and I am so glad I did. Off all diabetic meds and my sugars are consistently under 100. My BP meds have been reduced and those numbers are getting better every day also. He came highly recommended, so I went with him. I am in turn recommending him to everyone - he's amazing and I am so pleased. No pain meds after I was released from the hospital and I only had to stay overnight.

I did a LOT of research, and met with a few other surgeons, and none of them made me feel that "we are meant to be" feeling. So I waited. Then I ran across Dr Pilcher and after talking to him via email, I had more of a comfort feeling with him, than I ever did the others I met. So I am glad you recommend him so highly. I am excited to get this all underway. His office is about 2 hours from me, but even my PCP is 75 miles from me in downtown Austin, so driving down I-10 to SA isn't that big of a deal really.

I completely understand. I was what we call a bottomless barrel! Lol I could eat all day without feeling full, which is how I got up to my highest weight of 368 lbs =/ I can no longer eat anywhere near as much as I used to. 4 oz and I'm stuffed! There are days I forget to eat and have to drink a quick protein shake before bed to make sure I get in my protein for the day. The majority of the hunger hormone, gherlin, is cut out during surgery, making you feel less hunger instantly. I thought I was going to wake up hungry being that I hadn't eaten anything since the night before, and nope! I was drinking fluids because I had to, I didn't want to end up back in the hospital due to dehydration. Same goes with food! I even set alarms to remind me to eat, because I can go all day with my morning protein, but I wouldn't meet my requirements for the day. Sometimes I'm busy and silence my alarm, only to realize after I put the kids to bed, and I'm about to catch a show on TV that I forgot to eat. Both surgeries ate great, both will help you lose the weight you need to lose, but ultimately your success will be all on you. With either you can stretch your stomach beck out. The sleeve had only been around 5-6 years and I have heard of people gaining back 5-20 lbs, but haven't seen anyone gain back drastically. Do searcheson this site, it's very informative! There actually is a thread where someone asks if you gain back weight after the sleeve. Do the same search for bypass. This site helped me choose between the two surgeries also. There are many ups and downs for both, and it's not the easiest decision to make. Best of luck!

Honestly, I would not worry so much about the hunger issue. I did not feel hungry until I was about 10 weeks post op and the good news is, I just need to eat a small portion of Protein heavy food and I am full again for hours.

The thing you really have to pay attention to is eating the right foods. If you eat heavier carbs you will find it does not stay with you very long.

Having weight loss surgery takes a lot of work and requires you to change the way you eat. The good news is the surgery helps you to be able to build those habits as it restricts your intake. If you follow the eating plan with either surgery you will be successful. The surgery definitely assists with hunger and portion control but it is up to you to make sure you eat the right foods to curb that hunger, give you the right nutrients.

Also no drinking 30 minutes before and after makes a huge difference. It allows you to eat the right portion size so you are full. Not drinking for at least 30 minutes or more ensures you do not flush your meal through before you absorb all the nutrients and of course get hungry again.

Also, milk becomes important. It is a great healthy snack, has plenty of protein and turns to solid making you full.

Good luck in whatever your choice is!