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Why will this be different?



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I am considering RNY and am in the last stages of approval. Of course I have questions and am seeking input. I am a male and 53. As a kid I was rail thin (having graduated high school weighing 140 lbs). Over the years the weight slowly accumulated.

One year and eight months ago I started on a medically supervised low carb diet and lost 65 pounds in six months. It was Protein Shakes and as I transitioned off I gained back about half. I have so many co- morbidities (Diabetes, sleep apnea, high BP, high cholesterol) I feel I have to do something drastic. For me it is a health issue, plain and simple. A family member had great success several years ago (and is still doing great) with a sleeve so I am considering surgery.

For me I am pretty much decided on RNY, my logic is that if I get the sleeve and it doesn't get me where I want to be, I can't change it. I have known my medical team (nurses, endocrinologist, nutritionist, exercise person) this entire time. The surgeon and psychologist were just added. They are all very confident that I will be successful....me not so much. My BMI is 38ish so I have some weight to lose (maybe 50 or 60 lbs) which I know is not as much as others. I think I am, at least, a semi intelligent person. I have researched the procedures, the pluses and minus, the risks, and life after surgery. Nothing is like actually having gone through it but at least I think I understand what I am getting into (as best as I can).

I guess the question is "WHY IS THIS DIFFERENT"? Let's face it, if I was that good at following a directed diet, I wouldn't be looking at surgery. If I was motivated get up and exercise I would be doing it. So what makes me think that altering by body will change my mind and life.

The teams feedback is that because I have lost weight in the past (not just last year but multiple times in my history) that I have proven I can make changes. The surgery will help the changes stick. I am not sure I understand this. The only things I can think of are Volume, Dumping and Relationship.

V - I get that I will eat less volume and that makes a difference, but I also know that this alone won't be enough long term. The pouch can stretch and you can sabotage the volume thing with bad choices. I am not to worried about volume but, again, if I was any good at making good choices I wouldn't be here.

D - I think dumping can give you immediate feedback when eating the wrong volume or type. I am not sure this is a valid tool but it is there.

R - I know that for the first year or so you are not physically hungry. I also know that this disappears and that most of my eating is NOT driven by hunger. I guess my thought is that if I am not driven by hunger for a year I can focus on recognizing and controlling eating for other reasons (boredom being the biggest). The psychologist also mentioned that my energy would be higher and I would be more active, hence less bored.

I would appreciate input, not only to the central question, "Why is this different?" but also if you have any insight into my thinking. Is my mind in the right place? Does the VDR logic make sense to those that have gone through it? Really any input would be great.

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Though I am fairly young (23) I think your heart is definitely in the right place. Though only about 30% of bypass patients dump I believe the thought of eating something that can cause physical pain, sickness, and down right miserableness, is not something that sounds appealing to me. I am going into this situation thinking that I may never eat a piece of cake, fried chicken, etc. like that again... And since that is what helped get me into this situation in the first place, I am okay with that. I am also a "am I bored or am I hungry" person, often times, getting the two mixed up and never really knowing what actually being hungry for me was/is. I would overeat Snacks, or not enough and binge at meals... both in which have gotten me to the weight I am today.

For me, this will be different because my heart and mind is in the right place. I have dieted and it has only gotten me so far. I often would diet, get to a certain point, and then decide "okay, this is good. I can handle it from here" and life happened causing me to put my "diet" on the back burner. Let's be real here, this is a lifestyle change, this isn't something that if I don't want to do it anymore, I can just quit. This is commitment, and I have always worked better when this it comes to something I HAVE to do. Another reason why it is different for me, is because of my children. My girls are my world, and will be 3 in April. To me this is my way of letting them know that it is NEVER too late to change the situation you are in. "Impossible" is not something that I want them to have in their vocabulary because everything is possible with the right (positive) mindset.

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For me the restriction and feeling full way sooner than before seems to do the trick. It is a difference how much you eat, even when you eat high quality nutrition only. You can overeat on high quality food and eat too much calories as a result (though this seems to be a concept many people out there obviously don't get)

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My surgeon is a big believer in the set point theory. He said your body has a weight it wants to be and the more you weigh and the longer you've been at that weight, the higher it is. When you lose weight on a normal diet and/or exercise program, your body will do whatever it can including increasing your hunger and lowering your metabolism to get you back to your set point. He said currently the only tool medical science can offer to reset your set point to a lower weight is WLS. He refers to it as a one time do-over. If you eat too much and regain, you'll raise your set point again, but if you protect it through good eating habits, you can maintain your weight with much more ease than with diet and exercise alone.

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Thanks for the advice. I've heard of the set point theory but I don't know much about it. More research!

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The biggest change for me, in addition to the food restriction and lack of hunger, is the hormonal change that comes with RNY. Your tastes for certain foods actually changes with RNY. I am completely grossed out by anything sweet: Cookies, cakes, baked goods, candy, sweet drinks -- anything. In addition, I am grossed out by high-fat and heavy foods. What I crave is clean and fresh food. This change in cravings due to hormonal changes was totally unexpected, but it has been FANTASTIC. We went husband's family Xmas part last December, which is a feast of Desserts. NOTHING appealed to me. In fact, I had to stay out of the dessert room because it grossed me out so much.

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That would be awesome. I have a bad sweet tooth and that would be welcome!! Is this a normal thing?

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I totally agree with the set point making this different. Also, like you said, you know what to do or you wouldn't be in this spot...I completely understand that feeling. But for me (I've gone up and down my whole life, more up than down unfortunately), it's been the combination of the mental willpower to change, as well as the physical restriction...if you use your tool, really listen to it, allow it to tell you to slow down, to stop eating, to not put whatever in your mouth...respect the tool, and it will serve you.

I had my rny 6/2016, and for me, going through the preop process, and surgery, I made it such a huge deal in my mind so as to never, EVER forget what I actually was willing to put my body through...to keep it alive. Without wls, you only have your mind to tell you what to do or don't do....but when you add in your body to dictate as well....it's a powerful combo if you let it be. Makes sense too....after all, the brain and the body...they both need each other to survive.

Best of luck, and I'm glad you're searching for an answer to a really good question.



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I am 4 months postop RNY 10/24. Down 80 pounds today!! What shocked me was how drastic my tastes changed. I am not craving foods I used. I don't even want it. It doesn't even sound good. It's hard to explain but the hunger not being an issue and cravings being gone are a game changer for me. It has made this so much easier.

Good luck!!

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Erin and Shar, thanks a ton. Everyone's advice and comments really helped. I was at a support group meeting last night and they said the same thing. This has really made a difference. I know people say that all the time but it is true. Thanks.

Ed

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Until you experience it, it probably will sound too good to be true. So many people have been absolutely amazed by this when I told them. I think it happens only with RNY because the part of your stomach that generates the hunger hormones is disconnected from your esophagus. I'd be interested to hear if people who had other types of WLS also have experienced such a dramatic change in taste buds and cravings.

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Lifestyle changes matter more than the surgery. If you don't make the necessary changes to diet and exercise then you're going to pull a Roseanne, have a bypass, and you beat it. And that's not a good thing.



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