I know Alex and B-52 and others have had success with lap-bands, but I also keep hearing about people who have had them and the initial restriction helped them lose weight, they eventually gained it back. And that makes sense to me as more and more evidence comes out showing sleeves and gastric-bypass are much more than restrictions. At some point, they might figure out that it is hormonal surgery. There are diabetics who are off their meds more quickly than people who were losing the equivalent amount of weight.

Well, how long this hormonal effect last? The Cleveland Clinic Study is showing it works for at least five years...https://www.sciencedaily.com/releases/2016/04/160404152903.htm

I am going to make a hypothesis based on this study: just because your honeymoon period (the first 6-8 months post surgery) is over, you can still get the benefits of WLS a couple of years out. I keep wondering if the reason I was losing so quick up front is because I was really mindful for the first few months. And yes I was really excited too. But like many, I slacked off. The very real restrictions in my stomach/sleeve have made it easier to maintain, but I can restart my weight loss.

I posted about how my view of how I see my body has changed over the last 18 months (http://www.bariatricpal.com/topic/386931-who-dat/), and I'm about ready to start a rather intense six-week program this week designed to jump start weight loss. It should be interesting because the diet looks like what I was eating on week five following my surgery, only this time with more intense exercise. In short, I'm really excited, but also I'm looking at this as a follow-up experiment. I feel like I did when my post-surgery restrictions ended and the weight loss journey really began.

I've sort of beat myself up mentally for not being as diligent as I could have been, but I've been putting some of the techniques from this article into practice: http://www.nytimes.com/2017/01/03/well/mind/the-year-of-conquering-negative-thinking.html?ribbon-ad-idx=5&rref=health&module=Ribbon&version=origin&region=Header&action=click&contentCollection=Health&pgtype=article. I embraced what I did and didn't do. I believe it is possible to have multiple second chances.

If I'm right, my sleeve is still a great tool, even 2.2 years out. I'd love to hear from others who lost their focus but came back years later to finish what they started when they had their surgery.

The lapband is not the best one they say its much riskier than the other two and if something gose wrong with it they have to go back in and fix and do more stuff with it

Sent from my 5054N using the BariatricPal App

I think your ability to lose weight a couple years out from WLS is completely dependent upon what you did to your metabolism immediately post-op. Some people have *clearly* wrecked their metabolism by restricting calories WAY too much. I have seen people on these forums who claim to gain weight if they eat any more than 850 or 1000 calories a day a couple years post-op. I would accuse them of inaccurately tracking their calories, but there have been too many of them to ignore.

Meanwhile, if you lost more slowly, ate enough to keep your metabolism up, and did some exercise to help keep your metabolism working, there is no reason you shouldn't be able to lose weight a couple years out, because your metabolism should still be intact. You should still be able to lose weight through a simple caloric deficit created by restricting calories and increasing activity.

For example, I am maintaining now. I am a pretty serious runner, but haven't run for the past two months, because I have had literally NO time as I have moved into and am renovating my new home. Back when I was running regularly, I had to eat 2200 to 2400 calories a day in order to NOT lose weight. Now that I haven't been running regularly, I have gained a few pounds, which is to be expected, since I haven't really cut back on my eating. I fully anticipate that I will be able to lose those pounds when I begin training for my next half marathon later this month.

I am a pretty serious runner, but haven't run for the past two months, because I have had literally NO time as I have moved into and am renovating my new home. Back when I was running regularly, I had to eat 2200 to 2400 calories a day in order to NOT lose weight. Now that I haven't been running regularly, I have gained a few pounds, which is to be expected,

EVERY TIME I cut back on my exercise, even a little, I gain. I agree with you. I think our metabolisms get into a "groove", and any little change will cause gains.

So see? Maintenance is simple, really. Just keep doing what we've been doing to keep the weight off.

Too bad life gets in the way of that sometimes

I think your ability to lose weight a couple years out from WLS is completely dependent upon what you did to your metabolism immediately post-op. Some people have *clearly* wrecked their metabolism by restricting calories WAY too much. I have seen people on these forums who claim to gain weight if they eat any more than 850 or 1000 calories a day a couple years post-op. I would accuse them of inaccurately tracking their calories, but there have been too many of them to ignore.

This is why I keep advising people to progress their calories, but it seems like so many people are terrified to do so.

They don't realize what it means to be stuck on those low low calories for the rest of their life. It makes maintenance so much harder. It is like dooming yourself to regaining.

Hi guys,

I'm following your conversation. I understand what you are saying about reduced metabolic rates. But I'm not sure what specifics to put into action. Looking back, what would you recommend for caloric intake during honeymoon to avoid problems later?

I recommend having your RMR tested and pegging your calories to that instead of guessing. DEXA scans also help with determining calories because it can determine you lean mass.

In general though, people should try to get to 1100-1200 calories as soon as possible.

First month, the best you can, 600-800

2nd month 800-1000

3rd month and beyond 1100/1200 min plus more calories depending on your activity level and lean mass..

Still it is better to work with some professionals on determining these goals, instead of just guessing.

RMR and DEXA scans can be obtained in most places in the US. If you have a local research university nearby it might be more affordable than you think.

Edited January 5, 20179 yr by OutsideMatchInside

Thanks for advice. I appreciate it.

I went over 1000 yesterday and was admonishing myself. sounds like I was on the right track!

I had RMR done pre-surgery in October. I'm sure it has changed since then. I will get it re-run.

@@deeveg

keep having you RMR tested quarterly at least

@@OutsideMatchInside - This is interesting...I understand the physics of RMR and DEXA scans, but has this been tested with WLS vs non-WLS? I think there a hormonal component which seems to break down the math. @@JamieLogical has a very good point about what many of us have done to our metabolism via yo-yo dieting. It doesn't seem to always be simple math. But you may have some info I'm not aware of.

@@OKCPirate

I'm not sure what you mean about the hormonal part in relation to scientific testing.

When I have had my RMR tested it is exactly where it should be for my age height and weight, leaning to higher than normal. Most WLS patients have lower than normal RMR.

The Professor and team I use for my DEXA and RMR tests have no idea I had the sleeve. They aren't with my surgery program at all. They are at a local university. They treat me and know of me just like any other person losing weight.

I don't eat or plan my food as a WLS patient. I eat keto, like anyone else and have for months, which is why I think I am still losing weight with basically no effort, when most people that had surgery when I did stopped losing weight months ago.

@@OutsideMatchInside - You might ask them if WLS changes the numbers.

It really gets odd: http://theweightofthenation.hbo.com/films/main-films/Choices

Oh well, I'm not going to because I like how the treat me. I'm not into disclosing my surgery. Actually let me take that back, I think they do know I had the sleeve. Now I can't remember if I told them the last time or not.

My point is, and has been, that my metabolism is normal, and has been all along after surgery, because I don't eat like a typical weight loss surgery patient. I increased my calories, I eat a high fat diet. I also look easily 10 years younger than my age, when a lot of people age horribly after losing a lot of weight.

I knew all that research about WLS changing peoples numbers which is why I had my numbers tested to begin with. People who have WLS for the most have diminished metabolisms. Having surgery gives people a chance to reset it, but instead of doing that, they stay on starvation calories forever and ruin their reset.

We have had several conversations on this forum since the Biggest Loser "study" (I say "study" because the number of people involved is so small it isn't really a study imo).

While WLS initially helps people with resetting their set point and helping them with weight loss. Most patients don't eat a normal-ish diet and tank their metabolism, so they have to eat near immediate post-op calories for the rest of their life. Which is part of why so many people regain as soon as they start introducing more foods and eating normally. Not to mention all the people that stick to 60g or Protein and lose a lot of lean muscle mass which helps keep your calories higher.

I have watched that weight of a nation series so many times. That is part of what made me decide on surgery. I realized finally it wasn't a matter of will power, it was basically impossible for someone my weight to lose weight on their own.

Edited January 5, 20179 yr by OutsideMatchInside

Hi guys,

I'm following your conversation. I understand what you are saying about reduced metabolic rates. But I'm not sure what specifics to put into action. Looking back, what would you recommend for caloric intake during honeymoon to avoid problems later?

I mean, everyone is going to be a little different depending on their activity level. When I was post-op, the first thing I did was try to push up over 800-850 calories ASAP, before starting ANY kind of real exercise (besides walking). Then I pushed to get up over 1100 so I could start running. I would say through most of my weight loss phase, I was around 1400-1500 calories a day, while running and biking about 5 days a week. Then, once I got to maintenance, I needed about 1900 a day to maintain while not doing intense cardio and closer to 2400 a day while training for my half marathon and marathon.

The thing is, you really really don't want to be below 1000 calories a day for long. You will have to be in the very beginning, because it'll be too hard to get above that. But I'd say by about 2 months post-op, there is no reason you can't get above 1000 by eating some calorie-dense high-Protein foods like nuts and cheeses. Shoot for a minimum of 1000 calories and then make sure to eat back calories you burn via cardio. So if you are burning 400-500 calories 5-6 days a week through exercise, aim more for the 1400-1500 range.

Not to mention all the people that stick to 60g or Protein and lose a lot of lean muscle mass which helps keep your calories higher.

Oh, don't even get me started on that! People who don't keep their protein up and don't exercise are completely dooming themselves. By the time I reached my goal weight I had GAINED seven pounds of muscle. That is definitely key to helping keep metabolism strong. By the numbers, you would think I was a slow loser (and I was), but one of the reasons those fast losers lose so fast is they are losing precious precious muscle.

This is everything my nutritionist preaches. She already wants me at 1050 calories and that was at 2 weeks out. I haven't gotten there yet but I make the effort every day,