Anyone who has read my posts knows that I'm pretty upbeat and positive about weight loss surgery in general, and the sleeve in particular. That's why it pains me to share the results of a new study that is not terribly optimistic (links below). With that being said, I think what this means is that we need to be put even more energy into getting all the way to goal weight, and then be even more diligent about maintaining it for the rest of our life. Otherwise, some of the weight will come back and bring co-morbidities along for the ride – especially diabetes. So hard as it may be, my suggestion to myself and everyone else is to remember that there is no finish line! We have to stay ultra-focused on our healthy eating programs forever. Of course we already knew that, but this study really brings it home. So let's use that as extra motivation to succeed!!!

Washington Post Synopsis

JAMA abstract of the study results

I agree with Folly. There are many reasons people don't report in. Moving, weight gain, AND weight loss. When you've lost your weight and kept it off, why bother returning to the doc with no complaints. That's another more positive reason than just weight gain. Also co pays, forgetting, and procrastination are more reasons. Keep your glass half full is my attitude!

I'm 21 months out and have been at (or near) goal for 1 year.

My appetite has definitely increased and its a constant battle to maintain. I am about 10 pounds higher than my lowest weight and have been fighting hard lately to lose 2 pounds.

Increased my workouts (still 6 days per week but increased intensity) and decreased calories but it just wouldn't come off.

Finally lost 2 but I really miss the days when the weight was flying off ...

I agree with Folly. There are many reasons people don't report in. Moving, weight gain, AND weight loss. When you've lost your weight and kept it off, why bother returning to the doc with no complaints. That's another more positive reason than just weight gain. Also co pays, forgetting, and procrastination are more reasons. Keep your glass half full is my attitude!

My doc wants you to get annual checkups, both to check on Vitamin levels and to see how you're doing. I realize that he has a financial incentive for this. But if you make it an annual requirement, it's one more accountability check on yourself. And as long as insurance covers it – why not? It's also an opportunity to talk about any issues you may be having. My doc says he also wants to see you if you're struggling, because they have ideas and suggestions to help get back on track. And if you're okay, it's a chance to show off how well you're doing to someone who really cares about your continued success.

I'm 21 months out and have been at (or near) goal for 1 year.

My appetite has definitely increased and its a constant battle to maintain. I am about 10 pounds higher than my lowest weight and have been fighting hard lately to lose 2 pounds.

Increased my workouts (still 6 days per week but increased intensity) and decreased calories but it just wouldn't come off.

Finally lost 2 but I really miss the days when the weight was flying off ...

Thanks, Andrew! These are the things we need to keep hearing. Oddly, other peoples struggles help us remember that we need to continue putting in the effort, even/especially in maintenance. Hope you get your arms around the beast soon! Try a few days of ketosis by eating only Protein. That might give you a quick start.

I agree with you Rogofulm! My previous comment was not meant as a reason not to see your doc, but was a reason why some people weren't participating in the aforementioned study. I feel you should see your doc regularly. She/he is as much a tool in your weight loss as your WLS is.

I'm 21 months out and have been at (or near) goal for 1 year.

My appetite has definitely increased and its a constant battle to maintain. I am about 10 pounds higher than my lowest weight and have been fighting hard lately to lose 2 pounds.

Increased my workouts (still 6 days per week but increased intensity) and decreased calories but it just wouldn't come off.

Finally lost 2 but I really miss the days when the weight was flying off ...

Thanks, Andrew! These are the things we need to keep hearing. Oddly, other peoples struggles help us remember that we need to continue putting in the effort, even/especially in maintenance. Hope you get your arms around the beast soon! Try a few days of ketosis by eating only Protein. That might give you a quick start.

I have to avoid high protein diets as that lead to my getting kidney stones a while back.

Lowering my calories/carbs and increasing exercise is making a difference, but of course that's always easier said than done.

@@jess9395

I wouldn't be considered a failure but I also changed my whole health care team and insurance coverage when I relocated in Feb. I'm still losing and my 2-year date is 23rd of this month. When they don't reach me for follow-up it means they just can't reach me. I wonder how often that happens and how much it has affected statistical assumptions on what to report?

I'm sure that happens a lot, it does in all medical studies, but the dropout rates on this are much higher than most studies. If it were only people relocating then the numbers would be similar. I have an advanced degree in statistics, it's the higher than normal/accepted attrition rates that worry me.

I agree with Folly. There are many reasons people don't report in. Moving, weight gain, AND weight loss. When you've lost your weight and kept it off, why bother returning to the doc with no complaints. That's another more positive reason than just weight gain. Also co pays, forgetting, and procrastination are more reasons. Keep your glass half full is my attitude!

Yup, but again those are all reasons for attrition in any medical study, but the numbers in this one are significantly higher and that makes the statistician in me look for an explanation. Believe me I'm as optimistic as the next guy, but I'm looking for a logical reason a WLS follow up would have higher attrition rates than a study on, say, knee replacement.

Yup, but again those are all reasons for attrition in any medical study, but the numbers in this one are significantly higher and that makes the statistician in me look for an explanation. Believe me I'm as optimistic as the next guy, but I'm looking for a logical reason a WLS follow up would have higher attrition rates than a study on, say, knee replacement.

Yep. I think we all know what the reason is. As it has been stated previously on this thread. Unfortunately, it's the same reason people disappear from Weight Watchers, Jenny Craig, AA, the gym, or any other voluntary addiction or behavior modification program. I have a dear friend who was very active in her bariatric support group for a couple of years, until a period of stress led her to revert to old habits. Now, much of the weight has come back on and she can never find time to go to support group meetings [sigh]. And THAT'S why we need to keep talking about this stuff here!

I have to avoid high Protein diets as that lead to my getting kidney stones a while back.

Lowering my calories/carbs and increasing exercise is making a difference, but of course that's always easier said than done.

And that just goes to show that solutions are not one-size-fits-all. We all have our individual issues to deal with. I wish you great success!!!

I was only pondering reasons other than "failure" people are unaccounted for. (By the way, being unreachable to my original team doesn't mean I'm not getting appropriate Healthcare and checkups. I would use all the powers of pursuasion I could muster to talk anyone who has had WLS to continue appropriate healthcare)

@@Andrew0929 I could have written your post. I had my surgery same timeframe you did and am experiencing something similar. I am changing up my exercise starting this week. Nothing more wants to come off and I've even gained a little. Scares the heck out of me. I had a bodpod assessment done in July (helpful tool by the way) and it confirmed what I thought - my resting metabolic rate is lower than it should be and I have very little muscle mass. Kettleball classes are starting tonight!

And if they come up with a fecal transplant of skinnyfying gut flora that will make my job easier, I'm getting that, too.

hahahahahaha

@@Andrew0929 I could have written your post. I had my surgery same timeframe you did and am experiencing something similar. I am changing up my exercise starting this week. Nothing more wants to come off and I've even gained a little. Scares the heck out of me. I had a bodpod assessment done in July (helpful tool by the way) and it confirmed what I thought - my resting metabolic rate is lower than it should be and I have very little muscle mass. Kettleball classes are starting tonight!

Perhaps this is a normal stage of the process for us, but I am having trouble dealing with even the small weight gain.

My workouts are more stringent than ever, but my snacking has definitely increased. I'm snacking on Cereal, but still logging/counting calories. Carbs definitely higher, but still not too bad.

I'm thinking of just stopping the cereal, though, as that seems to be a trigger for more eating ....

Edited September 4, 201510 yr by Andrew0929

I say, stop with the Cereal.