New study about the long-term effectiveness of the sleeve

[Babbs 14,680]

@@CowgirlJane

I have heard that before. Why do you suppose the body gets so resistant to losing after a few years? Any ideas?

[OKCPirate 5,323]

It looks like "they are not sure" http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4284080/

http://theweightofthenation.hbo.com/watch/bonus-shorts/the-quest-to-understand-the-biology-of-weight-loss

Leptin, ghrelin, both affect the bodies set point and our weight loss...and keeping it off, but some people's "set point" seems to get reset and others do not. Why? Who knows. But it is an ongoing struggle. We have to find our max calorie level, exersise level etc. Dang we are complicated critters.

[CowgirlJane 14,259]

I have read many people describe what fat pig over-eaters they were pre-surgery. I definately overate... but in my judgement NOT THAT MUCH. It is like once I was obese, it didn't take much to "maintain it" (or gain more). I suspect a similiar mystery involved.

i also think the fact that I simply cannot workout like I could 1-2 years ago (due to physical problems) has a big impact. Exercising isn't just about the calories burned during the workout, it is about a muscle mass it builds that takes more calories to maintain. I look muscular now due to my body type, but i do NOT have the muscle that I did a year ago.

When you think about it, it isn't a big swing in terms of calories/carbs between losing, maintaining or gaining...

just a fairly small change - in either intake or output - makes all the difference.

@@CowgirlJane

I have heard that before. Why do you suppose the body gets so resistant to losing after a few years? Any ideas?

[Babbs 14,680]

@@CowgirlJane

Totally makes sense! Go look at Ann's thread she started. You just TOTALLY backed up what her follow up said!

[CowgirlJane 14,259]

I am the analytical type... so I tend to want to know the "why" - but when it comes to managing obesity I am over it. At this point, it is just "how"

I was committed when I revised from band to sleeve... and I remain committed to the "fight". I love life as a normal sized person too much to consider any other path.

[Babbs 14,680]

I am the analytical type... so I tend to want to know the "why" - but when it comes to managing obesity I am over it. At this point, it is just "how"

I was committed when I revised from band to sleeve... and I remain committed to the "fight". I love life as a normal sized person too much to consider any other path.

All I know is you are an inspiration to me! I have always looked up to you and what you've accomplished!

[ProudGrammy 8,322]

you are hungrier? volume of food - you can consume more? restriction?

@@Babbs

man oh man bud

you are always so nosey!!!!

short and sweet answer

yes, yes, no

you know i MUST talk/write more

can't help myself

"sometimes" i am hungrier than i used to be

fight "head hunger"

about a year PO (reached goal)

i realized i could eat more than before

common saying on the board is

"just because you can doesn't mean you should"

i don't feel that i have as "much" restriction as i did the first year+ PO

sliders like popcorn and Protein bars will always be my down fall

i try not to eat them, but easier said than done

also maybe ate "some" unmentionable treats that i won't mention

that's where those extra calories and weight came from

grazing at times too

eating/knowing when to stop???

easier said than done sometimes

its more a "mental" thing for me, that i had my proper portion and just stop

again, easier said than done

i have a problem with my hands recently

they frequently want to move around til they can find food to eat

i "usually" am able to control those nasty hands/bad old habits

but, as i said, "confessed" earlier post - i gained almost 10 lbs recently because of those hands!! (lost 5)

and grazing

so i gotta continue and work with those hands, get them to co-operate with me

doc told me pre-op

"eat til you are full, then stop 2 bites earlier"

old joke, guy asks someone on the bus

"where do i get off for "sleeve rd"

man tells him to watch when "he" gets off bus, and get off two stops earlier

talk to me anytime - calling me a guinea pig (i've been called worse )

at least no one can call me a PIGGY anymore

you are sooooo close to GOAL

maintenance is right around the corner

it might/will/can be hard

continue to follow all the rules like you learned this past year

you will be/do great!!!

you will be following this new lifestyle for the rest of your healthier, happier, longer life

staying successful

see you around the neighborhood

let's meet for drinks

i'm buying

Water of course

take care

kathy

[MichiganChic 3,262]

Even so - sleeve HAS BEEN a miracle for me. It has done it's job and now the maintenance is up to me.

I am STILL a normal sized person, after a lifetime of morbid obesity, it is a miracle. I still say that I worked harder to stay under 300# then I do now to stay "normal".

Yes, this!!!!

Although I am finding I am working harder and harder to not gain these days...

[Alex Brecher 10,484]

Rogofulm,

Thanks for posting this. Even if it has been posted before, this is a good reminder, as you said. The only way any weight loss technique, and any type of weight loss surgery, will work long-term is if you follow the diet long-term.

There is still not that much information on long-term effectiveness of the sleeve. What little research there is isn’t necessarily what I’d call “long-term:” like the article you posted, a lot of the studies only follow patients for 5 years. What about the next 30 or 40 or 50 years?

And some of the studies show positive results: for example, the study talked about here found 57% excess weight lost after 5 years – pretty good! But I bet those patients put in a lot of hard work in addition to just getting the sleeve.

http://www.medpagetoday.com/Endocrinology/Obesity/40490

And also that above study says one-third of patients still had BMI over 35 after 5 years.

On another positive note, the study you posted says blood pressure stayed lower!

Anyway, I guess we’ll find out over time how well the sleeve does on average. For all of us who are WLS patients, it’s up to each of us to do our best to meet or beat the average with our healthy lifestyles and hard work.

[katybelle7 65]

I thought the JAMA article was interesting in that they did over 440 surgeries, but really only had about 50%feedback at 1,3, and 5 years. I'm not sure how scientific that research is at that rate. Did I miss read the numbers?

[IncredibleShrinkingMan 437]

All the sleeve is before weight loss is a tool with which to do it. Once you enter maintenance, all the sleeve is after weight loss is a better opportunity to stay there. Nobody fails, including the sleeve itself. It's just not a guarantee of anything, it's just better odds of a lot of things. If you experience weight gain a year or two out, then just get back in the game. The sleeve should still be helping you do that at that point. For everybody who talks about how stats are unreliable because of re-gainers not reporting or following up, I'd point out those studies also don't point to weight "re-loss." The most important thing to me out there is that it appears that our set points definitely change, which is more important than the loss or gain of any particular pound.

[VSGAnn2014 12,992]

Yeah ... the non-response bias in that study is shocking!

[Folly 308]

The studies are depressing but people are looking at this as a physiological issue without really understanding that the rate of relapse from ANY recovery from addiction/addictive behavior is extremely high. We are not exempt from having to find our way out of those things that brought us to needing WLS any more than any other addict must to assure lifelong health and recovery.

I stopped reading them when I hit my statistical "plateau" a few months ago. I find it sobering and helpful to understand that WLS isn't a cure but one of the tools we employ but I also find it very discouraging to dwell on the probably of relapse/regain. I know the probability is high, I am an addict however, I am not a f**cking statistic. I have a say in what happens to me now and every day for the rest of my life. Staying the course seems to be my main tool. When I "mess up" (not doing what I believe is correct - not always food related) I acknowledge it, make a course correction and let it go.

AWESOME THREAD!

[CowgirlJane 14,259]

Well, Stats are important, but not as important as your own results!

I have shared repeatedly that I am finding maintenance MUCH harder this year than previous....HOWEVER - I AM MAINTAINING!

[jess9395 5,448]

Yeah ... the non-response bias in that study is shocking!

And of course my fear is the people who dropped out had more weight struggles and wanted to disappear-- typically the less successful a person the more they want to hide the fact.