This topic comes up all the time, both on BP and in real life, for many of us. There seems to be a general belief that having weight loss surgery is somehow easy, or "less than" traditional, non-surgical weight loss methods. I read thread after thread from BP members having to deal with yet another judgment around their weight and approach to managing their health. They report feeling judged, and express a sense of dismay, sorrow, or outrage. We discuss whether to tell or not.

So, I've been thinking about this. First - I don't care what people think. Don't judge me until you've walked in my shoes. But, when I compare my attempts at weight loss pre-sleeve, I have to say, having a sleeve is WAY easier!!

So before anyone gets riled up, I am not saying its easy. It's a major surgery, and all of the associated procedures and hoops you deal with just to get the surgery make it a challenge. You have to deal with post op pain, and if you are not one of the lucky ones, there are complications of varying degrees. Once you get through all of that, there is being FORCED to change what you eat, and how you eat. It's forever, and there is no break from it. You have it all day, everyday. So no, not easy.

But when it comes to weight loss, it's been easier for me. I still had to do the work, but at least the work paid off for once. I used to be on weight watchers for years, and I'd be lucky to lose 50 pounds in a year, and I'd be more miserable and hungry than I've ever been with the sleeve. I did medically supervised diets, and have the same outcome. At the end of the day, I always gained the weight back, and felt miserable for the time, effort, and money I put in, only to fail. Yep, the sleeve has been much easier for me, and I do not feel the need to defend it. It's just the way it is, and I'm grateful for it.

What about you - has it been easier for you?

I am new to the sleeve only having mine less than a month. I did do many diets before the sleeve... actually when I come to think of it, it was more like an endless stream of one diet or another but the one thing in each case that fell short was the tools. Please follow me here. We are or were all quite a bit bigger and our drive to lose was there, we followed in a large part the diet restrictions but there was always a huge stomach and by only putting a few hundred calories into it made us perpetually hungry. Day and night everyday screaming hunger. Your body was saying help me I need food. And when we slipped because we just couldnt take it a moment longer we felt guilty and tried a different diet. Sound familiar anyone? I hated myself when I failed. My kids would see me eat a diet meal and listen to my stomach growl for hours... all day long and say hey dad I think you need to eat something. They say it out of concern because thats what you do when your hungry. You hear your stomach growling and they know your hungry... or starving actually. You are set up to fail way before you begin. I will use a simple analogy, pretend our body is a car. You have a huge gas tank but your only putting in a quarter of a tank or less and expecting to go just as far. And as like with a car it will not run right. It will sputter and all the idiot lights will come on. Eventually you will give in and fill up the tank to get it to run like normal. Our bodies as we would diet would act similarly. You can have all that will power, determination and drive. Eventually somewhere it would all break down because your stomach wants some volume. We all finally give in and fail. It is not easy.

Now someone who only had 10-20 lbs to lose has a smaller stomach. They are very close to their goal. Altering their daily intake a small amount will get them the weight loss that they want without the agony we go thru to lose 100- 200 or more. And we do lose lots of weight. Way more than those 10-20 lbs. So for the rest of the population losing a bit is not a major life changing event, it is not agony, it doesnt feel like starvation. But at that point we are doing it without the proper tools.

These procedures, whether it be the lap band, the sleeve or a gastric bypass, they all give each one of us a tool we did not have before. Real portion control and a real chance to succeed permanatly. This is a lifestyle change. We are now not just changing our diet! We have the tool we absolutely needed and did not have on any previous attempt at any other diet. I can speak about my sleeve and that it is a lot smaller. I do not have the agony from hunger but some still do but that might be head hunger. But the portion control is now there. We have to all embrace a completely new lifestyle that encompasses a healthy way to eat, exercise and proper planning. There will be some of us who will not see the tool for what it is and push it beyond its capability and fail. The large majority of us will not because of everything we had to go thru to get us here.

I will say between multiple hospital stays, the pain and healing, the dehydration and beginning this journey as we all have has been a lot harder. Before a diet was only that. Eating less. Or eating based on points or whichever of a hundred different diets. This is so much more and as of right now so much more involved. I for one know and feel this is so much more difficult. Think of every hoop we had to go thru just to get approved, then everything we had to do to get ready for the procedure. Then there was the procedure itself and the recovery and the hospital stay! Maybe even multiple hospital stays and complications! If this was the easy way out, what would anyone call all of that in addition to the post op dietary plans and restrictions! This is not the easy way out. I can see down the road when we acclimate to this new lifestyle and it becomes second nature and a normal way to think, some may think it is then easy or easier. They would not be seeing the bigger picture. We have to look at everything we did and went thru to get to this point which is a lot.

This is the last resort. This is the mountain at the end of the course.

This is the hardest way to lose. Eventually and hopefully it will get easier down the road as this lifestyle change becomes our everyday normal but it will always be the most difficult way to lose weight in my opinion.

Also just a side note, there will always be people out there to rain on someone elses parade or to make you feel bad. That is life. Dont let that negativity into your life. This is hard enough without the haters and hecklers. Those people do not know what you have been thru, what you had to do and what you go thru on a daily basis or what your life is like. Surround yourself with positivity, mentors and people who care. Focus on your goals and ignore the ignorant.

I appreciate your comments and observations, and will use them to fortify myself for the journey ahead of me. I have been mulling over how I plan on addressing comments, and the more I do, the angrier I become. Weight loss in our society is like some kind of twisted blood sport: If I do well...it must come at the expense of someone else's success. The sleeve is a tool that haters consider to be an advantage. Nothing could be further from the truth! Others may want to discredit your success loosing weight once they learn how you have chosen to go about doing so, but I believe that is only because they are not willing to go through the process, or even understand the process. What's more, I am not going to waste my time explaining it.

Edited February 21, 201511 yr by MsAlaineus

No, having the sleeve has not been easier for me. I lost 60 pounds in the 6 months leading up to surgery. I pretty much embraced everything my Dr., nutritionist & psychologist told me. I adjusted to eating a less than 1200 calorie diet, exercised 5xs a week for an hour, followed all the various rules of a bariatric patient...and I think it was easier to do emotionally and physically than PostOp. PostOp I've lost 30 pounds. I have way more stalls PostOp. It takes a lot of effort to get 60-70g of Protein, and all my fluids in. There are days when I get full super quickly and days when eating 4ounces is easy. So yep, I'd say PreOp was way easier for me personally. Don't get me wrong...I don't regret my sleeve one bit. Just believe if one thinks PostOp will be easier than PreOp they could be in for a rude awakening if not mentally & emotionally prepared.

Granted, I am only 9 weeks PostOp & my viewpoints may change after a year or two

Edited February 21, 201511 yr by ProjectMe

Has it been easier to control my over eating with the sleeve? Absolutely! Has losing weight been easier with the sleeve? Yes and no. The first few months, when the weight just "falls" off with little or no effort at all is where I believe we as WLS patients have the advantage. After that, at least in my case, I have to work just as hard on my weight loss as a non surgery person. Also in my case, I am averaging less weight loss at this point than I was using conventional dieting methods. So yes, at first the weight loss is easy, but there is such a short window of time where that happens, we are working just as hard as any other person on a conventional "diet". In my case at least. I know there are a few that have a much easier time of it losing the weight, but I see more who are in my boat who fight for every single pound lost.

I have said it before...not the easy way out, the ONLY way out.

One of the main reasons it is easier for me is because I had to eat 900 calories to lost weight. With a whole stomach and hunger hormones raging, I could not do that, and didn't even know that it would take that sort of deficit. So, in that respect, it sort of IS the only way out for some of us.

I never said it didn't require extreme effort, but at least for me, the efforts are helped along with decreased capacity and controllable hunger, and those efforts are rewarded with weight loss. So I still work very hard, but that's new for me.

I am going on record stating, "There is NOTHING easy about this post op life"... PERIOD!!!

Here is a statement that was passed on to me regarding the "easy way out" reference. So, it is my turn to pass this on. Enjoy.

Why surgery is the "easy way out" for weight loss!

Yep, you heard that right. I've decided that I agree with the myriad non-surgical, gym-loving, overwhelming weight loss successes that feel strongly (and vocally) that surgery is the easy way out. They really are correct. We all should be ashamed of ourselves for taking the shortcut approach and racking up an "un-earned win".

Just think about it. To successfully lose weight without surgery, all you have to do is two things:

1. eat less

2. exercise often

With surgery, you only have to do one thing:

1. pay a surgeon to make you lose weight

Well, perhaps that's a minor oversimplification. There are a few other steps, but they are tiny and insignificant. Not everyone has to do them either! But, just for the sake of objectivity I’ll list most of them that I can think of. (I might miss a couple, but since surgery is the easy way out who cares really.) Let’s see, there is:

1. Convince yourself that you want to do this. This is much more complicated than it seems, so take your time. Don’t get sick before you make a decision.

2. Convince your doctor that this is medically necessary. Convince him/her that you really do want this and you aren’t just someone unwilling to sweat a little. Convince them that you won’t die on the table. Convince them that you aren’t doing this so you can keep eating cake for Breakfast. And lunch. And dinner. Because that’s the only reason big people are big people.

3. Spend anywhere between 3 months and a year working with your PCP to make a preliminary run at losing weight. This should include:

   1. A special diet

   2. Exercise

   3. Constant office visits to measure progress

   4. Significant expense to participate in the diet (Nutrisystem, Medifast, and Jenny Craig, I’m looking at you!)

   5. Lots of documentation

   6. Likely (if not anticipated) painful, humiliating failure (PS, this is a requirement!)

4. Spend hours to days or more working with your insurance company website, phone reps, and via letter to determine if weight loss surgery is covered at all, assuming they will admit to it.

5. Once you find out it is covered, find out what exactly is covered. Type of surgery, location, type of doctors required, pre-op programs necessary, pre-op medical requirements, pre-op diet requirements, and documentation. Make sure you understand it all clearly because…

6. Meet with your PCP to go over all of the above. Explain to them what most of it means, because they don’t understand. Make sure your work so far will meet the needs of the insurance company. Convince him/her to do the work to get the approval. If not, return to step 1 and try again. (Note: make sure you do all of this quickly- most of these rules are subject to change on January 1, even if you have a 12 month diet requirement. You’ll need to find a way to violate the laws of space and time on your own.)

7. Get a psych evaluation. People who want this surgery are invariably crazy, so we need to confirm that. Don’t use a doc you know. Go somewhere you’ve never been so that they can get that first-blush, cover of the book impression of your particular brand of crazy in the 45 minutes you get with them. Let them write their report confirming your “crazy flavor” to your docs and insurance. They will approve you anyway.

8. Take an online class that confirms the crazy diagnosis.

9. Take another online class that basically tells you if you have the surgery you will likely die horribly on the table, if you’re lucky. You might just become a vegetable and be a possibly fabulous looking skinny burden on everyone you know and love!

10. Find a surgeon that can both perform the surgery (practically, legally, and allowable by the insurance) as well as doing so without causing

    1. Errors

    2. Infections

    3. Hernias

    4. Leaks

    5. Death

11. Make sure that doc can take your insurance. Not just yoru insurance, but your exact insurance. This may require them to check at least a dozen contracts.

12. Do the same for the hospital.

13. Make sure that hospital you’ll have the surgery in isn’t a festering wound itself. The surgeon can only do so much if when you get to the floor you’re placed in the same bed last used by an Ebola patient with a cold and cleaned by “Blind Larry”. Fortunately there are many websites sponsored by government agencies to help you with this. They will all disagree with each other.

14. Get insurance authorization to have the surgery. Fortunately this process starts the weight loss, as one arm and one leg weigh a surprising amount when removed and given to them. This should take no more than a day or two, tops.

15. Have a discussion with your employer. Let them know that you’ll need a full week off from work in the near future. You know, when you aren’t busy and won’t be missed. Again, if you’re lucky you’ll have vacation and can use that. If not, think of how much extra weight you’ll lose when you can’t afford to eat for lack of a paycheck! OH, you may need more than a week. If you come out healthy. If not, it’ll be more. A lot more.

16. Have a discussion with your family, if you haven’t yet. If you haven’t yet, shame on you for your discretion, personal space, and recognition of the gravity of this decision. Make sure that you convince them that you won’t die, runaway with David Beckham or Eva Longoria (or both if you’re flexible), or otherwise ruin the home.

17. Get answers to all of the questions you have. Fortunately ObesityHelp is a great place for that. You will get no less than 10 answers to every question. Some may actually agree. ☺

18. Make sure that this is really what you want. This isn’t like buying a car or getting married. This is permanent and there is no going back. Still confident this is the right choice? Now you know your flavor of crazy from item 7.

19. Go on a liquid diet. You may not have anything that you cannot “read a newspaper through”, is solid, has calories, has carbs, has Protein, has flavor, or is made of a natural substance. This will last anywhere from two days to a month. Your surgeon will tell you how long.

20. While on the clear liquid diet, please try not to cheat on the diet. More importantly, please try not to defecate on yourself. Here’s a mantra for you: “Never trust a fart!”

21. Have the surgery. This will include:

    1. Large, but not quite large enough gowns with special butt exposing panels

    2. Freezing rooms

    3. Needle fears

    4. Vein scavenger hunts

    5. Panic attacks

    6. Several other fun moments no one will spoil for you to discover

22. Recover from the surgery. This will include:

    1. Amazing drugs that will make you fear for the poor 110lb nurse that will help you walk at first. Please don’t fall during this time or you will crush her. You’ll fear this, but only briefly (great drugs remember). Just don’t fall.

    2. Walking. Yes, you’ve just had your entire insides rearranged and have more stitching in you than a rented tuxedo, but hey, let’s go for a walk. Every hour.

    3. Eating. This is really a game. You have a 3ish ounce container that replaces your stomach. It is swollen, but you don’t really know how much. If you over fill it, you will be in serious pain, and may hurt yourself severely. Here’s the fun part- you’ll be given a selection of hald a dozen Clear liquids to choose from. Some will make you retch. Some will taste like heaven. All are more than 3 oz. You- the person who’s complained that Mickey D’s quarter pounders have never once been a quarter pound – now get to determine what 3 oz looks like. Don’t forget two very important things.

       1. You are stoned on anesthesia. Your judgment aint what it should be.

       2. So is your stomach. It’s not going to help you by saying “I’m full” for about 2 weeks to a month.

    4. Going to a bathroom. The author of this article is a male, so with that perspective in mind, consider the male stereotype of urinating. Now imagine that sharpshooter in the hands of someone who cannot see straight, or single vision, is falling asleep on their feet, whose prostate is not yet awake from surgery but whose bladder most definitely is, and who is currently on their 4th IV bag of saline with lactated ringers running wide open. Don’t forget to measure your output!

23. Go home! This is the easy part. Stuff your swollen and now anesthesia free self into a car and try to avoid potholes, cough, sneeze, or breathe too hard.

24. Continue the clear liquid diet for a few more days

25. Progress to Protein drinks. These are a joy. There are few if any samples, so make sure you get the 5lb bottle to be sure you love it.

26. Progress to pureed or baby food

27. Progress to cat food or tuna

28. Progress to gourmet cat food or flavored tuna / canned chicken

29. Progress to dog food or chunky Soups / heavily cooked soft and unflavored chicken

30. Progress to human food. During this time you will need to learn a few things. These will include:

    1. How to eat. Remember you’ve been doing it wrong all your life so this should be easy.

    2. You may only have dense protein.

    3. You must take in no more than 3-4 oz.

    4. You must take an entire 30 minutes in which to do so.

    5. You may not drink before, during, or after the meal.

    6. You may not have anything spicy.

    7. You may not have anything with carbs.

    8. No alcohol for at least 6 months, or maybe forever.

    9. Nothing liquid.

    10. Carbonated anything is permanently off the menu for the rest of your life.

    11. Nothing with caffeine.

    12. Nothing with less than a 10:1 ratio of protein to carbs

    13. Keep calories as low as possible.

    14. Learn to keep something that meets all of your dietary needs handy. If you need to eat, not every place can meet your “special needs”.

    15. Make sure that you understand that you need to do this for the rest of your life. You can’t change this. Non Surgical people can indulge once and awhile. They can cheat. We rupture.

31. Please remember to keep your intake to levels that would make Ethiopians send you food. This is generally 800 calories, less than 40 carbs, and more than 80 grams of protein per day. You must do all of this in 3 meals with no Snacks.

32. Take your supplements:

    1. Calcium. Note that it isn’t the same calcium that you can get for a dime on any gas station shelf (Calcium Carbonate). This is a highly refined form of easily absorbable calcium (Calcium Citrate). It will come in three forms: A disgusting snot textured liquid found at Wal-Mart for $11 per week, a myriad of chewable pills that all taste like flavored drywall and cost about $20 per month, and delicious chewable candies that cost $40 per month.

    2. Multivitamin. You’ll be doing double doses. Get the adult gummy ones. Find the ones with no carbs.

    3. Fiber. Get the adult gummy ones. Find the ones with no carbs.

    4. Iron. Some people will take iron. Get chewables.

    5. B12. You can do pills under your tongue that taste like yesterday’s fish for $10/month, injections at the doc’s office every 3 weeks, or a nasal spray that costs $350/month.

    6. Do all of the above for the rest of your life. Don’t stop or you’ll die.

33. Start to exercise! What, you thought that you didn’t have to exercise? Yep, here’s the trick. You are going to lose weight even if you don’t. Here’s the other trick. It’s easier to take that weight from your bones and muscles if you don’t exercise, so if you don’t work out, all that’s left will be fat!

34. No really, you have to exercise.

35. Yes, that means sweating.

36. Make sure that while you’re going through this easy time in which every hormone you have is at full tilt, every part of your body looks and feels funny, nothing fits, and you generally are proud that you’re losing while also being weirded out by how different everything feels you also take into account everyone else. Remember, this is about them and how they perceive you. You can’t be the popular kid. The healthy person without diabetes, hypertension, edema, or apnea. The more confident employee. The more confident lover. The physically stronger person. The person who wants attention. The person with self-esteem. You need to apologize frequently for these failures and must work hard to gently help these people along to where they can think of you as a lesser person for altogether different reasons than they did before, to preserve their psyche. Stop making your weight loss about you.

See? Even with these minor things, it’s obvious. Surgery is the easy way out. Don’t be a sucker. Be strong, and just eat less, and exercise more. It’s that simple!