I'm leaning toward the sleeve because it's less invasive and less vitamin deficiency. But I'm terrified to lose so slowly. I'd be pissed if I only lost 5-10 lbs

Month!! I know all loss is good but I'm afraid I'd be discouraged if I didn't see results faster. Thoughts? Cw 220

Gw 145

With the usual disclaimer: I am not a doctor, I am not an expert--but it seems that if your current weight is 220 you are not going to see the big losses that much heavier people do (such as I may see). But even for those who lose a lot the first month or two, ongoing losses of ten pounds a month seem typical. The questions I'd ask myself are these: 1) how much weight can I lose each month without the surgery? and 2) how likely am I to keep the weight off for the long term?

Just realize that this isn't magic surgery--it's a tool to help in a longer journey in your life. It's not easy any way you choose, but there's a lot of evidence that it's worth it.

29 minutes ago, Yettid said:

But I'm terrified to lose so slowly. I'd be pissed if I only lost 5-10 lbs Month!!

Why would you be upset at 10 pounds lost per month? Have you ever lost that kind of weight that quickly without surgery via old-fashioned diet/exercise? My guess is that the answer is "No."

10 pounds a month is a whopping 120 pounds a year. Realistic expectations are important throughout your weight loss journey.

Since you're a lightweight who is starting out at 220 pounds, I guarantee you'll never be one of those rapid losers who drops 30+ pounds a month, or even 20+ pounds a month.

My starting weight was 218 pounds on surgery day. Most of my monthly losses were single digit (1 to 7 pounds lost each month). It took me 17 months to lose 100 pounds and reach my goal weight.

And you know what? I'm dancing on a cloud, but not because of the weight loss. I'm happy because this is the most realistic opportunity I have to keep the weight off for life.

Good luck to you.

@Yettid

If your start weight is 220, it doesn't matter what surgery you have, you are not going to lose more than 5 to 10 pounds a month. You will be lucky to lose 10 pounds the first month and 5 each month after.

You are not going to have rapid massive weight loss with WLS you are not big enough starting out.

I have to disagree, the amount of weight lost has nothing to do with how much you weigh. Everybody is different. For instance, my mother was 270 before her gastric bypass, at 5'7" her goal weight is 170. So that's 100 pounds. The fact that you are only 5' your suggested goal weight would be 115 to 130. So technically you need to lose the same amount as her. I don't see how that would make you any different than her. She had gastric bypass in March and she has already lost 80". On the other hand, I have friends who have had gastric sleeve that have lost as much weight and at the same rate. Whatever surgery you choose, it's gonna be hard, but there's no way of knowing how much or how fast you will lose weight. That all depends on how much effort you put in, but you could be just as successful as anyone else. Most people do lose the majority of their weight the first year, but honestly you would have less saggy skin if you did only lose 10 pounds a month. So it's a win either way, lol!

Starting as a lightweight, you can expect slower loss no matter your surgery. That doesn't mean you won't reach your goal quickly; some still do. But expecting double-digit returns every month just isn't realistic. I'm 5'1", sleeved, SW 242, lost 6 pounds a month, got to 116 pounds.

You should be basing your surgery choice on physiological factors - do you have reflux, want malabsorption? Rate of loss is something mostly beyond your control.

Both surgeries lead to success for a lot of people.

Good luck.

Cheri

Thanks for your replies. Obviously, I can't keep any weight off long term without surgery. I can lose about 5lbs a month on my own, but can't maintain. I am going to choose the wls option that is safest for me. But, given the option, I think we all would take the option that loses fastest. I do have Gerd, but in the past, it goes away when I lose weight. I want success no matter which surgery I get. And I want to gather as much info as possible to avoid surprises:)

Based on the posts on this board there are a surprising number of people who have odd and unrealistic expectations of weight loss surgery

While calorie deficit is not the only thing that impacts the rate of weight loss it is at least a place to start to give you a sense of what might be possible for you. You can get a reasonable estimation of your BMR and adjust for your activity level and then estimate your calorie intake post surgery and see what you get in terms of monthly loss

I am someone who never had difficulty taking weight off, the issue was unbelievable hunger once I lost about 50 lbs. the best thing for me about the surgery is using the absence of hunger to build new patterns (both in my brain and my daily routines).

My weight loss rate is on the high end of the scale. If you take the first week out where I dropped 16 pounds, I am averaging about 3 lbs a week on a daily calorie average of about 800

That matches pretty solidly with an estimate of my calorie deficit.

Anecdotally it seems that people's bodies work differently. You will not be able to control how quickly you lose and you will be able to impact it by following a plan and using your metrics to experiment and adjust.

I watch the people on this board who have long term success because at the end of the day that is what I am interested in.

They take the long view, they work their plan, they establish new patterns, they do not obsess over stalls, they deal with what got them obese in the first place.

You may be one of those people who looses weight quickly. If not, what then?

With a history of GERD, if you choose the sleeve, be sure you are willing to entertain the notion of a revision if the GERD doesn't improve or gets worse. If you would prefer a "one and done" operation, go with the bypass the first time.

Something I have noticed.. which may or may not be accurate in your case.

Our bodies tend to lose at the same rate post-op as preop.

When the typical person first starts a diet (take the first 2 weeks for example).. 10lbs drops off almost immediately. I refer to this 10lbs as a free "sign on bonus". Take that out of the equation. The losses above the 10lbs indicates your base rate of weight loss.

So for me, I lost 16lbs in the 2 week preop diet. 16-10=6lbs in 2 weeks.. so 3 pounds a week. I could expect to lose an average of 3 pounds a week for the first 3-6 months postop.. and so far that is actually very accurate. (keep in mind I started 150lbs overweight).

One caveat.. if your diet is already very restricted for a period of time before starting the "diet".. then you may not HAVE the 10lb sign on bonus, since you've already been on a diet. That weight is lost by those that have been eating whatever, whenever.. in a non-diet format.

A relatively minor change in the preop losses, equates to a dramatically different result postop. For example 14lbs = 2 pounds a week, which is only 8-9 pounds a month instead of my 12-13lbs/month.

27 minutes ago, Berry78 said:

With a history of GERD, if you choose the sleeve, be sure you are willing to entertain the notion of a revision if the GERD doesn't improve or gets worse. If you would prefer a "one and done" operation, go with the bypass the first time.

This!!!

I'm 7 years out, sleeved. My reflux is now out of control. I'm on both Protonix and omeprazole. I still have acid rumbling all night, burning in my chest and vomit burps. I'm following up early next month, but of course GI is the next step. My reflux is purely due to my sleeve. I truly feel they're going to recommend revision to bypass. If not now, at some point over the next year.

Some people have resolution of GERD with sleeve but overwhelmingly you'll see a worsening of symptoms. Surgeons often recommend bypass to these patients for a reason. The sleeve's biggest side effect is reflux - even in people that didn't have it previously. Weigh your decision carefully.

Best to you! It's a lot to consider.

Cheri

7 hours ago, AmylouRouxEnY said:

I have to disagree, the amount of weight lost has nothing to do with how much you weigh. Everybody is different. For instance, my mother was 270 before her gastric bypass, at 5'7" her goal weight is 170. So that's 100 pounds. The fact that you are only 5' your suggested goal weight would be 115 to 130. So technically you need to lose the same amount as her. I don't see how that would make you any different than her. She had gastric bypass in March and she has already lost 80". On the other hand, I have friends who have had gastric sleeve that have lost as much weight and at the same rate. Whatever surgery you choose, it's gonna be hard, but there's no way of knowing how much or how fast you will lose weight. That all depends on how much effort you put in, but you could be just as successful as anyone else. Most people do lose the majority of their weight the first year, but honestly you would have less saggy skin if you did only lose 10 pounds a month. So it's a win either way, lol!

Your starting weight definitely has some impact on your rate of weight loss (and it is not the only thing that has an impact).

It takes more calories to maintain a 300 lb body than a 200 lb body.

It is simple physics.

I'm leaning toward the sleeve because it's less invasive and less vitamin deficiency. But I'm terrified to lose so slowly. I'd be pissed if I only lost 5-10 lbs

Month!! I know all loss is good but I'm afraid I'd be discouraged if I didn't see results faster. Thoughts? Cw 220

Gw 145

Lol prepare to be pissed of some months[emoji23] Maybe your not ready for surgery yet. High expectations can be emotionally damaging.( in my experience any way)

Sent from my Swift 2 using BariatricPal mobile app

I've lost 105 lbs over about 7 months, so about 3.5 lbs per week. But it hasn't actually been 3.5 lbs per week, some weeks I'm up 5, some weeks I'm down 10. My loss has slowed down a lot now that I'm around 200 pounds. You will probably loose at a slower rate since you're already pretty small. But hey, slow is better than nothing! And for me, this was about KEEPING the weight off. I've lost hundreds of pounds before, but never kept it off. This should be a tool to help with that.

10 hours ago, AmylouRouxEnY said:

my mother was 270 before her gastric bypass, at 5'7" her goal weight is 170. So that's 100 pounds. The fact that you are only 5' your suggested goal weight would be 115 to 130. So technically you need to lose the same amount as her. I don't see how that would make you any different than her.

There's definitely a remarkable difference in metabolic rate between a tall 270-pound woman and a short 220-pound woman that cannot be ignored.

Per common TDEE (total daily energy expenditure) calculators, a middle-aged 270-pound woman who stands 5'7" tall burns an average of nearly 2700 calories daily, whereas a woman who stands 5'0" and weighs 220 pounds burns about 2300 calories a day.

Taller people have a metabolic advantage: http://bradpilon.com/weight-loss/weight-loss-science/the-unfair-metabolic-advantage-of-being-tall/

Also, heavier people have a metabolic advantage because more caloric energy is utilized to move a 300-pound body than a 200-pound body, and bigger people generally have larger mass/organs that increase their metabolisms: https://fitfolk.com/what-is-tdee-total-daily-energy-expenditure/

So, yes, there's a huge difference between lightweights in the low 200s and their heavier counterparts. Starting weight makes a notable difference.

Also, genetics plays a major role. People with two beneficial markers on chromosome 15 are rapid responders to bariatric surgery and lose quickly. Those with one beneficial chromosome 15 marker lose at a slow to average rate, and those with no beneficial markers are nonresponders who lose less than 30 pounds.

And I'll chime in on weight loss averages... vs. weight STAYING off.
That , in my opinion is the long Term goal!
Even if all your excess weight doesn't come off or completely stay off .... you may have an easier time keeping at a lower weight. Long term!! Thankfully