Hey guys! I'm about to start my pre op week for my sleeve on Aug. 28th. I've been reading lots of threads here and notice that some people lose much more in the first three or four months than others. Can I get some advice on maintaining a higher rate of loss early on in the process? I know myself and I'm afraid if I drag it out I'll become disenchanted and start a bad cycle again. Thanks!!!

No magic trick or hack exists to increase the rate of weight loss in the first 3 months, though some folks may certainly disagree. Adopt permanent lifestyle changes and you'll be fine.

Bariatric surgeons hesitate to admit this so as to not discourage prospective patients, but genetics run the show regarding speed of weight loss with surgery in the first year.

People with two favorable markers on chromosome 15 are rapid losers; these genetically blessed people can eat a dozen of Krispy Kreme donuts daily and still lose weight like a house on fire.

People with one favorable marker on chromosome 15 lose at an average to slow rate, and those without any favorable markers on chromosome 15 are non-responders who usually lose less than 30 lbs.

In addition, men, the super-morbidly obese (BMI 50+), and males/females under 35 years of age are normally the rapid losers.

The usual slower losers are older females, 'lightweights' who've got less than 100 pounds to lose, menopausal/postmenopausal women, racial/ethnic minorities, and those with stubborn metabolic afflictions (PCOS, hypothyroidism, diabetes, metabolic syndrome, insulin resistance).

What she said.

Our bodies do what they do, and no input from us can really change it. Now if you asked what can you do after the first 6 months.. then there IS something.. keep to the program with diet and exercise.

You have some head work to do if you demand rapid weight loss as a prerequisite to you "staying the course". Surgery only does 20% of the work. 80% comes from you.

After surgery, if you hope to keep off your losses, you have to watch what you eat forever. It is physically easier than preop, but you still have to do it.

33 minutes ago, Introversion said:

No magic trick or hack exists to increase the rate of weight loss in the first 3 months, though some folks may certainly disagree. Adopt permanent lifestyle changes and you'll be fine.

Bariatric surgeons hesitate to admit this so as to not discourage prospective patients, but genetics run the show regarding speed of weight loss with surgery in the first year.

People with two favorable markers on chromosome 15 are rapid losers; these genetically blessed people can eat a dozen of Krispy Kreme donuts daily and still lose weight like a house on fire.

People with one favorable marker on chromosome 15 lose at an average to slow rate, and those without any favorable markers on chromosome 15 are non-responders who usually lose less than 30 lbs.

In addition, men, the super-morbidly obese (BMI 50+), and males/females under 35 years of age are normally the rapid losers.

The usual slower losers are older females, 'lightweights' who've got less than 100 pounds to lose, menopausal/postmenopausal women, racial/ethnic minorities, and those with stubborn metabolic afflictions (PCOS, hypothyroidism, diabetes, metabolic syndrome, insulin resistance).

How do you know whether or not you have "favorable markers"

Ok that all being said, and this is a serious question, what's the point in the surgery?

8 minutes ago, Half-Tum said:

How do you know whether or not you have "favorable markers"

You don't know unless you get professionally tested, which is outside the realm of most people.

Dr. Matthew Weiner, a bariatric surgeon with a bunch of YouTube videos, explained that people with first degree relatives who underwent weight loss surgery and lost rapidly probably have two copies of the favorable gene.

The point of the surgery is to reset our "weight set points" the body helps us drop weight until that new set point is reached.

We help the process by keeping our calories low (now possible since we aren't horribly hungry). Then, when we reach our new weight, it will be much easier to maintain than if we had just dieted off the pounds without surgery.

BUT, gains are still possible like they have always been. (I wasnt born 300lbs).

25 minutes ago, MagnoliaGirl said:

Ok that all being said, and this is a serious question, what's the point in the surgery?

The point in surgery is restoring our health with a powerful tool that offers us the chance to keep the weight off. Anybody can lose weight without surgery via diet and exercise, but it's unlikely we'll keep it off for life if we lose it the old fashioned way.

People who were/are obese have permanently altered biochemistries compared to our naturally thin counterparts. So once a person has been obese, his/her body fights like a gladiator to defend the higher set point weight if/when weight loss via old-fashioned diet and exercise happens.

Have you ever lost a significant amount of weight by cutting back and exercising? I assume the answer is "yes." Were you ever able to keep the weight off? I assume the answer is "no." Correct me if I'm incorrect.

Bariatric surgery is the only proven method to drive the body's set point downward. When we have surgery, the body fights to lose enough weight to get to a lower set point due to favorable hormonal alterations.

Also, obesity is a time-dependent problem...so the longer a person has been fat, the less likely he/she'll keep weight off after dieting down to a normal body weight.

Pretend there's two 40-year-old females. Both are 5'6" and weigh 250 pounds with the same body fat percentage, but one lady has been obese since early adolescence whereas our other woman was normal-weight all her life until gaining weight with back to back pregnancies in her 30s.

The one who has had a weight problem since her teens is unlikely to ever keep weight off without surgery. Her body's had nearly 30 years to hormonally adopt obesity as its default state. If/when she enters a weight-reduced state with diet/exercise, her body fights (and succeeds) to return to 300 pounds.

Likewise, the woman who has had a weight problem for only a couple of years has a fighting chance of losing and keeping weight off. Her body simply hasn't had sufficient time to adapt to the potent neurohormonal influences of obesity.

Diane Carbonell was normal-weight all her life until she gained massive weight (300+ pounds) after several pregnancies. She lost weight the old-fashioned way via diet/exercise and has kept it off since the late 1990s. I suspect her body never had a chance to become acclimated to obesity since she wasn't fat for that long:

http://www.dianecarbonell.com/

If you wish, click on the link below to read the thoughts of obesity specialist Dr. Arya Sharma.

http://www.drsharma.ca/arguments-for-calling-obesity-a-disease-4-limited-response-to-lifestyle-treatments

Quote

It is not that diet and exercise are useless – they absolutely remain a cornerstone of treatment. But, by themselves, they are simply not effective enough to control obesity in the vast majority of people who have it.

This is because, diet and exercise do not alter the biology that drives and sustains obesity. If anything, diet and exercise work against the body’s biology, which is working hard to defend body weight at all costs.

Thus, it is time we accept this reality and recognise that without pharmacological and/or surgical treatments that interfere with this innate biology, we will not be able to control obesity in the majority of patients.

Edited August 17, 20179 yr by Introversion

Thank you so much for that great answer. It helped to answer some of the questions that I've been asking myself as I come up quickly to me surgery date. Thank you, thank you!!

15 hours ago, Introversion said:

You don't know unless you get professionally tested, which is outside the realm of most people.

Dr. Matthew Weiner, a bariatric surgeon with a bunch of YouTube videos, explained that people with first degree relatives who underwent weight loss surgery and lost rapidly probably have two copies of the favorable gene.

I actually have that

No magic trick or hack exists to increase the rate of weight loss in the first 3 months, though some folks may certainly disagree. Adopt permanent lifestyle changes and you'll be fine.

Bariatric surgeons hesitate to admit this so as to not discourage prospective patients, but genetics run the show regarding speed of weight loss with surgery in the first year.

People with two favorable markers on chromosome 15 are rapid losers; these genetically blessed people can eat a dozen of Krispy Kreme donuts daily and still lose weight like a house on fire.
People with one favorable marker on chromosome 15 lose at an average to slow rate, and those without any favorable markers on chromosome 15 are non-responders who usually lose less than 30 lbs.

In addition, men, the super-morbidly obese (BMI 50+), and males/females under 35 years of age are normally the rapid losers.
The usual slower losers are older females, 'lightweights' who've got less than 100 pounds to lose, menopausal/postmenopausal women, racial/ethnic minorities, and those with stubborn metabolic afflictions (PCOS, hypothyroidism, diabetes, metabolic syndrome, insulin resistance).

They told me to use the first year you make important lifestyle changes with diet and exercise. So this makes sense.

I'm considered a "fast responder". My consultation was October 2016, Surgery February 2017, and currently 6 months post op (August 2017) and has lost 77 lbs altogether (I always calculate it via my consultation date since that determined if I qualified or not).

There wasn't any secret, I followed my dietitian's plan to a T. And with what the other poster said about genetics, I was not fat all my life. My weight now is the same weight I was 12 - 13 years ago. Until I got obese in 2008, I weighed an averaged of about 120 -130 lbs.


Height: 5'0"
Weight for WLS consultation: 216 lbs.
Surgery date: 2/13/17
Goal: -71 lbs for healthy BMI (about 145 lbs).
Current weight: 140 lbs, now ready to lose 15 more past goal.
My profile picture is not me. It's my "FITspiration" body.