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

Hello everyone,

Haven't been here in a while. Oh man can I relate to the hunger coming back! I sure hope that Grehlin monster isn't back!!!! That slimy SOB caused me years and years of misery. Some is head hunger but some is genuine hunger. I have to ask myself every time--OK are you physically hungry? Or-do you just want to stuff food in your mouth because your brain thinks you should? I do feel rather proud of myself when I resist temptation and God knows it's EVERYWHERE.

I've gained some of my weight back but I realize it's a daily battle I must engage in to keep the majority of the weight off. I am a compulsive over-eater--sleeve or no sleeve. One Day At A Time, (ODAAT) is how I will have to live my life. I remember from Over-eater's Anonymous, (OA) meetings. The compulsive over-eater monster is outside doing push-ups to battle you while you are successful at keeping it at bay. It just waits for the chance to pounce on you. The program works when I WORK IT--and I AM WORTH IT!

It whispers seductively in your ear--"You deserve to eat that" , "One little bite" , "You know you want it" . All those phrases it whispered in your ear before the sleeve and even more so now.

I just have to keep up the fight--no different than any other addict.

Blessings,

Kathleen

My surgeon told me from day one that weight loss was not guaranteed and this was merely a tool. You have to use it as such. It does not give you license to eat whatever you want. I am only 4.5 months out from surgery but I think there is a shift once you hit your goal weight. You forget what you have been through. You forget your limitations. You really just want to feel "normal" again. I don't know.

It's a good reminder that the surgery is only what we make it. If I didn't deal with the emotional eating issues (totally not directly related to the sleeve) I can specifically look at a point around 7 or 8 months post op where I know I would have started regaining. But you have to deal with the underlying issues.

@@Rogofulm ... that's how I talk all the time. Love it!

BTW, would you expound a bit on this: "At support group last night our surgical coordinator/nurse was talking about how after 18 months we lose the metabolic advantage."

What is the "metabolic advantage" she/he was referring to?

Did she/he mean that 18 months is how long it takes for the body to figure out how and where to produce and release ghrelin elsewhere in our bodies (other than in the stomach fundus that was removed during VSG)?

A.

He didn't specifically mention the return of the ghrelin gremlin, although he did impress upon us that hunger returns in spite of the restriction, and our healthy eating habits need to be well-established so as to avoid falling into old patterns. I think the point he was making is that our metabolism stays "confused", for want of a better word, for about 18 months. After which, it recognizes that this is the new "normal" and settles-in for the long haul. I'm extrapolating now , but it may be that whether our metabolism settles-in at a faster or slower rate may depend on our nutritional and exercise patterns. I could expand that to include our muscle mass as well, since that contributes to our metabolic rate, right? So in my case, at 14 months out, I have about 4 months to build up additional muscle mass to support a faster metabolism. I doubt that it's quite so cut-and-dried, but it may be worth using 18 months as a target time-frame to have all our ducks lined up, whether they be eating/drinking habits, exercise routines, or muscle mass development. That last piece is an "aha moment" I'm having even as I write this. Thanks for the question, @@VSGAnn2014, it caused me to think more deeply about the topic, and may encourage some needed changes; specifically, the urgency to add strength training to my routine. Okay, I'm tired now....

l