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Do I need surgery still? A reality check



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Brief background, all my dieting failed, I loved nutrisystem, but just could stay on it past 6 months.

Now, I am in a pre-op situation. I was to stop the nutrisystem, and eat regular meals. It took a while, but now I am building my own meals. Never spiced or rubbed s chicken before in my life, until now. I can pass fast food joints, even when I am hungry. Grabbing an apple is second nature, and I push for better Fiber count. I actually watch cooking shows for ideas of what I could cook up. Two months, I lost 15 lbs of my starting 394. I haven't felt better. Normally, if I lost 15 lbs, I'd hit a pizza as a "celebration.". No desire for that now, just want to tick off another 2 lbs. My only problem is perhaps not enough vegetables, and need better meal scheduling.

So, I feel like I could keep doing this, and maybe won't need surgery. Or am I falling into a trap?

Sent from my XT1609 using BariatricPal mobile app

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I am having the exact same thoughts. I’m doing very well on my pre op diet, and am wondering if I could just keep doing this.

Maybe I could, but I never have before. One reason I am have been successful on the pre op diet is because I know I have to see my surgeon once a month. And if I gain weight, i’m out of the program.

One reason I have decided to continue with the surgery is because i’m not a young chick anymore. I believe I will lose the weight faster by having the surgery.

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YOU are the only one that can answer that ?. I would for sure take a reality check about my past endeavors. I also had been on almost every diet trend that came along. But...I couldn't get to maintenance. Once I got down to 135#'s which I had lost only due to me being sicker than a dog!! But it didn't take me long to regain it all plus some extra pounds. I am 4 years out and I can say with everything within me that I AM SO GLAD I did this. Yes, it is hard but it will get better. NOTHING taste or feels as great as reaching your goal weight and being able to maintain your weight. Hang in there and KEEP ON KEEPING ON!!!

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2 hours ago, wjgo said:

So, I feel like I could keep doing this, and maybe won't need surgery. Or am I falling into a trap?

Without knowing you, I'd say you're falling into a delusional trap.

Here's the deal. The vast majority of us can lose weight just fine without the help of surgery. However, most of us cannot keep the weight off without bariatric surgery.

After losing the weight on your own without surgery, there's a 5% chance of maintaining a massive weight loss. There's a 95% probability you'll regain it all plus more.

When we lose weight on our own, a few months pass before the body fights like hell to regain. You become tired, hungry, and develop cravings that overwhelm your capacity for willpower.

With the neurohormal changes prompted by surgery, you'll actually have a fighting chance of keeping the weight off for life.

Bariatric surgery is the only proven method that helps formerly obese people maintain whatever weight they lose. Without surgery, you'll climb an uphill battle for life.

Good luck to you.

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A long time poster on here used to say something I have adopted. She says she considers this weight MAINTENANCE surgery and I agree.

I've lost 50-100 pounds more times than I can count. This is the first time I have EVER kept it off. 135 lbs for three years now.


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Even though it's true that 95% can't keep it off... what if you are in the 5%? After all, you haven't taken THIS path before.

I say give this lifestyle change a real chance at avoiding surgery. If it works, that's perfect! If it doesn't, surgery can always be a backup plan.

Surgery should always be a last resort.

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Everyone is so different, this is a hard question to answer. I know that when I was *on* and had last 100 pounds, was very into my nutrition, macros, workouts and with a complete restructure of my routines, I was SO thankful that I had chosen natural weight loss rather than a bariatric surgery as a tool. I still thought that when I gained it back and lost 100 pounds again. Now 14 years as passed and each time I've gained weight it's been harder to loose it while following the same nutrition and exercise framework and my body is really starting to hurt. I need to do something quickly because even loosing 100 pounds means I still had about 100 more to loose and I'm not sure I can do that AND maintain it.

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It works for about 5% of the population. It never worked for me. I'd lose 50-60 lbs, hit a wall, and then it would gradually come back on. This happened dozens of times...

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As Introversion said, anyone can lose weight. Keeping it off long term is another story. I was more successful with my pre-op diet (21 pounds lost in 21 days) than I have post-op; however, my weight has continued to go down, however slowly, over the past 8 months, and that's something that has never happened before. I already know from going off-plan a bit this summer that I will have to be smart about food for the rest of my life. But without the surgery I wouldn't have a chance to keep it off.

A lot of people feel the way you do pre-op, but I think it's like pre-wedding jitters - you're just trying to find something to convince you not to do the thing you're worried about, even though you've been working towards that goal for months (if not years). But really what you want to do is have the surgery. It's helped so many people to not only lose weight, but to keep it off for good.

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17 hours ago, wjgo said:

Brief background, all my dieting failed, I loved nutrisystem, but just could stay on it past 6 months.

Now, I am in a pre-op situation. I was to stop the nutrisystem, and eat regular meals. It took a while, but now I am building my own meals. Never spiced or rubbed s chicken before in my life, until now. I can pass fast food joints, even when I am hungry. Grabbing an apple is second nature, and I push for better Fiber count. I actually watch cooking shows for ideas of what I could cook up. Two months, I lost 15 lbs of my starting 394. I haven't felt better. Normally, if I lost 15 lbs, I'd hit a pizza as a "celebration.". No desire for that now, just want to tick off another 2 lbs. My only problem is perhaps not enough vegetables, and need better meal scheduling.

So, I feel like I could keep doing this, and maybe won't need surgery. Or am I falling into a trap?

Sent from my XT1609 using BariatricPal mobile app

It's no trap and this one is all on you! If you like the ideal weight and will continue the new healthy life style then do not do the surgery remember the surgery is just a tool and you have found another tool that helps you. Just keep maintaining keep using the tool for help and guidance and if you do not feel you need the surgery DON'T. Remember you have found another tool to replace the main tool. Good luck to you

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1 hour ago, biginjapan said:

As Introversion said, anyone can lose weight. Keeping it off long term is another story. I was more successful with my pre-op diet (21 pounds lost in 21 days) than I have post-op; however, my weight has continued to go down, however slowly, over the past 8 months, and that's something that has never happened before. I already know from going off-plan a bit this summer that I will have to be smart about food for the rest of my life. But without the surgery I wouldn't have a chance to keep it off.

A lot of people feel the way you do pre-op, but I think it's like pre-wedding jitters - you're just trying to find something to convince you not to do the thing you're worried about, even though you've been working towards that goal for months (if not years). But really what you want to do is have the surgery. It's helped so many people to not only lose weight, but to keep it off for good.

This is a great analogy! You should really listen to @biginjapan.

And I understand where you're coming from, OP, but remember, the mind is a terrible thing to lose. :) ;) And the reality is, that our fat brains would say or make us do just about anything to keep us from "starving" it to death. Like a coyote caught in a trap, we will chew our own leg off to escape.

Not sayin that getting right with the diet isn't important. To me, it's the diff between success and failure. We simply must create new and better relationships and choices with the food we put in our mouths. You're making great advances by learning to cook and making better food choices. (And I second the getting in more veggies and upping fiber...), but I agree with these smart vets who caution you with reality.

The numbers are dismal--even after weight loss surgery. In the first seminar, my surgeon cautioned the surgery was only a tool, and that even a new anatomy still only yields about a lifetime 50% reduction in additional weight. But, the ones (the vets) who stick around and really work their program have a much better success rate. I see so many here who are maintaining the original losses.

I think @jess9395 said it best with the quote from the vet who called this Weight Loss Maintenance surgery. That's what I know I'm really going to need. I am reasonably confident I could lose "almost" all my weight "this time," but keeping it off is just a whole other story. *sigh* Sadly, once you've put those fat cells on your body, the body wants to keep that number of fat cells. You can lose weight and empty the cells...the body wants to force you to refill them. You can cut and suck the fat out of your body...and the body will seek to replace the lost cells until they number the same as they were before your procedure. So from my perspective as morbidly and super morbidly obese people who already have a thriving fat cell community going strong, we must adapt a slash-n-burn approach to weight loss and weight maintenance--and for most of us, that's going to involve surgery, maybe multiple types of surgery along with lifelong dietary intervention.

Edited by FluffyChix

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19 hours ago, wjgo said:

I feel like I could keep doing this, and maybe won't need surgery. Or am I falling into a trap?

It is up to you entirely.

IANAD ... so, this is just my thoughts as a 23-25 year yo-yo dieter.

If you feel you are really ON TRACK ... as opposed to all your other dieting regimes of many years ... then, by all means, stick with it. But will you be okay if you hit a plateau or setback?

The bariatric surgery route will give you the opportunity to push into an area where weight control and, eventually, weight maintenance will be more within your control.

None of this is set in stone. Only you will know what your perseverance and resilience limits are. The balance of probabilities say I have a better chance with my layman's assessment.

Ultimately, it's your say. Your risks. Best wishes, whatever you choose.

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I know - I had the same thoughts. I would lose the same 30-50 pounds and I can't tell you how many times. I think I was so up and down with my weight that I actually messed my metabolism up and got type 2 diabetes at 35 years old after losing weigh on Atkins and gaining it back. I am sure I was pre-destined to get the diabetes (thanks for the genes, Mom) and stress during that time of my life did not help. I think if you are doing so well that considering surgery is a good tool. You can continue the healthy eating and then have a good tool with your weight loss surgery to help you keep your weight off. Of course, nobody can answer that but you but I am glad you came here to hash it out and think about it with some of us who have been there.

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WJGO, only you can make this decision for yourself. If you feel that you can truly be successful without surgery, then you owe it to yourself to try to do that. Surgery should be a last resort, and it is truly life-changing. We all struggle with the decision. We all think that we can do it on our own...until we realize that we can't. It is when we realize that we can't, that we are finally ready for surgery.

I lost 25 pounds during my 2 week pre-op diet, and was really scared about going through with the surgery. I thought that I should be able to do this by myself. I had never lost that amount of weight so quickly before. I then remembered what I was consuming....Protein shakes, Soups and broths, veggie smoothies and sugar free popsicles. This was not going to be sustainable. I knew it. This was the most restricted diet that I had ever tried before, and there is no way that it would be sustainable long-term. So I had the surgery anyway. Best decision of my life by far.

So give yourself a date. See if you can do this on your own. If you do, great. If not, then surgery will be there for you. I decided when I was 40 that I was going to be in the best shape of my life by the time I reached 45. I worked and dieted, but never made it there. I am 45 now and wear the same waist size that I wore in 8th grade. I am still working on being in shape though. Got a two pack and going for four now. I'll take that over a keg any day.

Good luck in your decision and the rest of your journey.

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There is nothing wrong with proceeding as you are and see how far you can take it, and most particularly if you can stick with it. It is certainly a long shot to lose to a normal weight range and keep it off - as others have mentioned, there's about a 5% success rate in doing so. But that doesn't mean that you can't get part way to your goal and learn a lot in the process.

I started out on this WLS venture some 14 years ago when my wife and I got serious about our weight problem, and after doing some investigating on procedures and surgeons, started going to our surgeon's support group meetings. Long story shortened, it took a couple of years to get my wife on the table (she was #1 on the runway with her weight and comorbidities) but in the meantime, starting to comply with insurance requirements, started out 6 month diet/exrecise program. As I would probably taking more time, and was disinclined to play with fad diets, took a very strict no-fad-diet approach to this. Most of us know what we need to do - lower calories, minimize/eliminate junk food, more fruits/veg, whole grains in place of refined white grains, leaner meats, etc. etc. etc. Ultimate weight loss was not the primary goal as much as learning sustainable dietary/lifestyle habits consistent with long term weight control. If i could be amongst that lucky 5%, so much the better, but at least it should make the surgery and subsequent life easier and more stable.

I wound up losing a net of about 50 lb, or about a third of what I needed to lose. As we were still working to get my wife on the table, (eventually self paid) I just let it ride and kept going to see where I could go. Ultimately I couldn't lose any more sustainably, but continued in what eventually was a WLS maintenance life along with my wife after her surgery - I didn't lose any more, but didn't gain any back, either. After about six years our insurance started covering the sleeve, and as I wasn't going to lose any great amount more without surgical intervention, went ahead and restarted the process.

While this did delay things a few years, it also helped make some decisions. As I had developed a modicum of weight control, that helped move my decision toward the sleeve; had I regained my loss or more, as often happens, that would have moved me toward the DS (duodenal switch), which offers better regain resistance than the other mainstream WLS procedures. Also, the fundamentally good dietary habits that I had established (not perfect by any book's standards, but sustainable for me,) made the surgery and subsequent post op loss phase much easier as it helped me resist falling for any of the quickie fad diets many do to "improve" their WLS performance, but also have to unlearn to maintain the loss in the long term.

6+ years later and the weight is still stable.

So, if you are not in a hurry to get surgery, by timing of insurance coverage, or intolerable comorbidities, it can be worth it to wait and experiment with the diet/lifestyle habits. It seems that you are already well on your way.

Really short answer - there's no need to make a yes/no, surgery or diet, type of decision; rather one can easily take an evolutionary plan A/plan B approach and decide, or change decisions, later.

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