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3+years out milestone?



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Im finding people who struggle to maintain weight after passing a 3 year mark. The first 3 years seem like magic in comparison. What do other long term sleevers experience?

Several of us have been discussing this issue on "wt gained after sleeve" but people who are recently sleeved are writing about stalls. What we are experiencing is NOT a stall but an actual trend of weight gained. Sometimes in spite of sticking to same regimen (diet and exercise ) and sometimes because of physical difficulties interfering.

Words of wisdom, anyone? We dont want to face total failure.

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So I don't want to be debby downer here but this is what I heard. My surgeon is one of the surgeons who was involved in the multi-center study "LABS" or longitudal assessment of bariatric surgery. They have found with most surgeries at the three year mark there is a lot of regain. I don't think they know why. I do know that your body will always "want" to gain weight. It will try to go back to your highest weight. One reason is that you never lose the fat cells that are created when you gain weight - they simply deflate so it will be much easier for us to "re-infflate" those cells. This is a huge fear for me since I lost all of my excess weight with the lap band and then regained when the band stopped working. I regained incredibly fast. I was told that this is something we will almost all face and that it will be a lifelong battle. Almost nobody is "fixed" by this surgery. I don't have an answer but I was told that if I felt the hunger coming back strongly at the 2-3 year mark I could see a specialist for a medication that would help with that. This has been very successful for bariatric patients. I apologize in advance - I know my answer isn't precise or maybe correct but I am not in the medical profession!

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I wonder if people who regain is because they have slip back into old habits? I understand that the fat cells are still present in our body but I don't see how we can gain back all of our weight if we are eating right and exercising.

Edited by Slimsoon1988

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Here's the LABS Web site. They'll be releasing longitudinal study results later in 2015:

http://www.edc.gsph.pitt.edu/labs/Public/index.html

So far, it appears they've found that through Year Three RNY and lapband patients do pretty well, on average -- although there's considerable variation in outcomes.

http://www.ncbi.nlm.nih.gov/pubmed/24189773

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I second the comments of @@Bndtoslv but would like to add the good news that even though people who have had bariatric surgery are prone to regain at the three year mark, most of us will not regain all that we lost, plus a little more as had happened to most of us in the past.

My unprofessional theories about the prevalence of regain are that 1) habits are difficult to overcome and many of us slowly return to our previous eating styles and levels of activitity; 2) our bodies seem to have a memory (those lurking, deflated fat cells?) and a preference for our former high weight and through hormones and hunger encourage us to eat more; 3) our bodies adapt to the surgical changes and restriction gradually diminishes in both RNY and VSG patients, and malabsorption of macronutrients diminishes or disappears for RNY patients.

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On the regain issues ... my shrink works with a number of bariatric patients and has seen many people go through this process. Back in January 2015 I asked him, "What issues do you see patients struggling with who regain weight? And by that I don't mean that they're eating too much. I'm really asking what's going on inside them that leads them to regain?"



After thinking a moment, he said: "What I mostly see is that they're struggling to find new reasons and new motivations to focus on their weight and fitness.



"After they hit their goal weights, many of the rewards they got while losing weight go away. They're no longer motivated by seeing the scale move down. After a while, their family and friends get used to what they look like and stop commenting on their weight loss or weight. Even people who were their strongest supporters during the weight loss phase no longer offer supportive comments. And when this positive reinforcement disappears, that has a negative effect on the patients.



"So then they must find new goals and new motivations to maintain their weight and to be fit. And for some folks that's not easy."



So that's one shrink's brief observations about the psychological (not medical or physiological) causes of WLS patients' weight regain. Maybe that will ring some bells for other readers.



Interestingly, over a year ago I committed to see my shrink for three years during:



* The year of losing weight


* The year of maintaining weight


* The year of boring real life

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I don't mean to sound like all hope is lost! I personally regained because 1) my band had problems and 2) I had 2 young children and a lot of family drama and didn't make good food decisions. I learned my lesson for sure and I take full responsibility for my regain. What I meant to express was that we need to be constantly vigilant and keep up with the latest data that can help us stay healthy.

@vsgann201 I know that the published LABS studies don't reflect a 3 year gain but what I heard was based on the research coordinator at my center who came in to chat with me at my last appointment. She is giving ANECDOTAL observations based on her experience with patients. I myself was a LABS subject with my lap band and she said I was the #1 most successful patient from my center.

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On the regain issues ... my shrink works with a number of bariatric patients and has seen many people go through this process. Back in January 2015 I asked him, "What issues do you see patients struggling with who regain weight? And by that I don't mean that they're eating too much. I'm really asking what's going on inside them that leads them to regain?"

After thinking a moment, he said: "What I mostly see is that they're struggling to find new reasons and new motivations to focus on their weight and fitness.

"After they hit their goal weights, many of the rewards they got while losing weight go away. They're no longer motivated by seeing the scale move down. After a while, their family and friends get used to what they look like and stop commenting on their weight loss or weight. Even people who were their strongest supporters during the weight loss phase no longer offer supportive comments. And when this positive reinforcement disappears, that has a negative effect on the patients.

"So then they must find new goals and new motivations to maintain their weight and to be fit. And for some folks that's not easy."

So that's one shrink's brief observations about the psychological (not medical or physiological) causes of WLS patients' weight regain. Maybe that will ring some bells for other readers.

Interestingly, over a year ago I committed to see my shrink for three years during:

* The year of losing weight

* The year of maintaining weight

* The year of boring real life

All what you said makes a ton of sense. You have a great therapist. I do think I was incredibly motivated by the scale going down and as long I was able to stay in my routine I did great and maintained. Re-losing the re-gained weight was less motivating since I was feeling so bad about it to begin with. Also the 2 small children made my austere exercise-centric lifestyle hard to manage.

Edited by Bndtoslv

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Wow. Did not expect these in depth informational replies. Thanks to all. Immediately, either i am in denial or i honestly do not eat the "wrong" food. My diet has not changed and my exercise regimen has not decreased. But the amt of "good" food i eat HAS increased and my sense of hunger after a meal is NOT satisfied. The fat cells, i knew about from long ago. The shrink thinking its because nobody says snything? Meh! I never wanted to be noticed in the first place. No, i been with shrinks since i am 17 years old maybe thats an issue for some, but not me.

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This makes me feel regrets and fear. I feel like I'm going to be a ticking time bomb to balloon back up at 3 years

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Sassy the thing is you DON'T feel that way at all. And you,DON'T balloon up. It starts out with one or two lbs up and the down . I became confident i could manage that. It always came off agsin. Now im 202. Yesterday 1 was nearer 204. Im trying to get down to 199. 188 was my goal...and i made that last year...but its so much more difficult now.

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I "ballooned" because my lap band wasn't working = zero restriction. This won't happen to you with the sleeve - it is a totally different experience.

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