Hey friends!

I often read that people are regaining weight a few years after having the gastric sleeve. Mostly after 2 years or so (roughly).
Mostly the people blame themselves for regaining the weight. They think it's the emotional eating/head hunger, or bad food choices, or grazing and eating more often.
While I 100% agree that these things might not be the "healthiest" way of eating, I do not think that these are the cause of the regain. Before presenting what I have found out, I want to say, I have NO IDEA if what I'm saying might be true or not, I'd rather just start a discussion with you guys on this, so please hear me out.

I just registerted a few days ago and started a thread already and had gotten great input, thanks for that! Since that I have been researchin the gastric sleeve day in day out (I'm off work for a few weeks haha).

Like I said,I have been researching the gastric sleeve surgery quite a bit for the past week and especially looked for studies, and luckily I could find quite a few great studies on it! Even long term studies ranging from 5-13 years post op (on request I will post these here)!
What almost all these studies have in common (I think, I'm not a pro at reading studies, but they put a comprehensive conclusion at the end, which really helps understanding it), after 2, 3 or 5 years people regained weight compared to after 1! The overall weight loss got less! So for example, year 1 people lost 70% of excess weight, in year 2 that dropped down to being only 60% and by year 5 it was down to 50% (these numbers are close-ish to the ones in the study).

So after 2 or 3 years the MAJORITY, if not all, are regaining weight. Ain't that something? Do they all decide to give in to emotional eating and bad food choices right at the same time? I do not think so. I rather think, that after 2 or 3 years the body naturally WANTS to regain weight and sends us more signals to consume more food. Just because we lost all that weight after 1 year, does not mean our body wants to stay at that weight happily ever after.

So what I'm trying to say is, it might just be a natural part of the gastric sleeve to regain some of the weight and it has nothing to do with personal "errors", its just the weight our body wants to be. Most of the studies show, after 10 years, people will still have lost around 50% of their excess weight. I know, it's not perfect, but hey, that is pretty damn good!
I know the "It must be my fault, that's why I'm regaining, I did something wrong"-mentality is the go to for a lot of people . Did we not learn exactly that by calorie restriction and then "failing", because we started to eat more? Thinking WE messed up, but in reality it was just our body not wanting to put up with any of this dieting and restriction.

These are just my thoughts, I might be totally off, but I had to atleast write it down. I would love to start a discussion on this and appreciate any input, I also hope the point I was trying to make came across rightly (english is not my first language).

Cheers!

Edited December 29, 20178 yr by setoo

Quote

Think twice about labeling food as "bad". Rice is not bad, bread is not bad, potatoes are not bad either.

Eating all of these foods daily in place of lean meats and vegetables is absolutely not a healthy diet and is precisely the cause of my weight gain. When I lost over 60lbs in the past, I could still occassionally eat these, but not to near the extent as I am now. I was simply explaining my reasons for regaining which was replacing my whole foods diet with a high carb/starch diet out of convenience.

Edited December 30, 20178 yr by Xerox

11 minutes ago, Xerox said:

Eating all of these foods daily in place of lean meats and vegetables is absolutely not a healthy diet and is precisely the cause of my weight gain. When I lost over 60lbs in the past, I could still occassionally eat these, but not to near the extent as I am now. I was simply explaining my reasons for regaining which was replacing my whole foods diet with a high carb/starch diet our of convenience.

/edit misread something

Sorry, but I think it is ridiculous to say that said foods are the cause of weiht gain or even calling them "absolutely not healthy". They are completely fine and healthy foods and have been a staple for hundreds of years, so yeah, I have to disagree.
Which does not mean one should not add veggies or meat to them, that would be even better. But said foods are not inherently bad, even though people love to make some foods the "enemy". Sorry if that comes off as being a bit harsh, but I really think that advice like this is dangerous.

P.S.
I made long post adressing other posts on the site before, just at the end, in case that has gotten under the radar. Thanks everyone for chiming in! It's a great discussion!

Edited December 30, 20178 yr by setoo

Quote

I feel like you lean heavily towards people making "bad choices" or not forming "healthy habits" to be main reason for the weight regain. I do not think that's true. While I agree that healthy choices and awareness in general does help, it does not justify the regain in my opinion.
Let's apply your logic to some person that had no WLS surgery at all:
They are starting to eat "healthy" aka protein and veggies (this seems to be definition of healthy around WLS surgergies forums). They lose tons of weight, but say, after a year, they just can't do this anymore. They are not happy with this, their body is also fighting this. So they give up, because they simply do not feel good doing this.
So you could say these people have failed, because they have decided to go back to "bad choices". If that is the case, then everybody who does not maintain a great weight loss via eating a rigid diet (which is 99% of the population) is just making bad choices? That does not sound reasonable to me , at all and I think many of us can agree, by having experienced the said scenario.

Yes, absolutely. There are many reasons you fall off the wagon, usually falling off the wagon isnt introducing a bit more lean meat, vegetables and legumes in to your diet to ward off hunger, its going off the rails and eating high calorie and nutritionally void foods too frequently. Nobody gets obese eating comforting portions of lean meats, vegetables and legumes most of the time and treating themselves occassionaly.
If you dont feel good eating filling portions of nutritionally dense food then you have a phycological issue, you arent suffering physically from this.
Its difficult to gain weight by over indulging in lean protein and vegetables, but you can by over indulging in potatoes or high calorie processed foods.
So I dismiss the idea that people stop eating nutritionally dense low calorie foods because? What? they're starving? What is the pressure that makes them not able to do it anymore? How is it not sustainable? Are they low on energy?
If you are saying they dont feel good because they crave high calorie foods too often and want to give in to temptations often enough that it causes weight gain then that is phycological and can be changed with persistance its like an addiction. You wouldnt be saying this to an alcoholic.
I felt like I wasnt getting anywhere on wholefoods after a while, but in hindsight if I kept going I would have broke the plateu eventually, even if I didnt it would be a better place than I am at now. I take full responsibility for mucking things up for me.

Edited December 30, 20178 yr by Xerox

I want to know why the most fit people in the world...who live the longest, and have the fewest health problems...have diets based around rice, potatoes, fruits, veggies, legumes, whole grain breads, nuts and seeds....and eat meat very rarely. (when we're told by the diet industry to eat animal protein constantly...and high animal protein diets are statistically correlated to really awful health outcomes)

Diet is such a paradox.

Makes for some fascinating study, though:)

Edited December 30, 20178 yr by Creekimp13

Quote

Sorry, but I think it is ridiculous to say that said foods are the cause of weiht gain or even calling them "absolutely not healthy". They are completely fine and healthy foods and have been a staple for hundreds of years, so yeah, I have to disagree.

I said

Quote

Eating all of these foods daily in place of lean meats and vegetables is absolutely not a healthy diet

If I thought they were inherently bad I wouldnt say

Quote

When I lost over 60lbs in the past, I could still occassionally eat these, but not to near the extent as I am now

In both of these quotes I identified that I am eating these items in place of more nutritionally dense and less calorie heavy foods. This isnt healthy.
What is and is not healthy eating depends on the individual circumstances. If I were an athelete maybe It would be beneficial to eat something that will skyrocket my blood sugar before a workout but I am not.

Please understand peoples arguments and understand the context in which words are being used rather than assume that we are painting a food as objectively bad for you.

40 minutes ago, Xerox said:

If you dont feel good eating filling portions of nutritionally dense food then you have a phycological issue, you arent suffering physically from this.

So are you saying that overweight people who lose tons of weight and then at one point start eating higher calorie food again and also start regaining weight do have a psychological problem? They eat again because their "addiction" suddenly arises again? Again, that would mean 99% of the people who lose weight and can't keep it off are regaining, it BECAUSE of psychological issues regarding food? Please think about this statement. I feel like you are dismissing human biology and according to your logic, one would not even need the gastric sleeve, because it's psychological.

My take on this is, that the body wants to be at a certain bodyweight (mostly unhealthy) in overweight people. So being overweight creates a unhealthy bodyweight set-point. You can google for "set-point theory" on this, there is tons of legit data on this.
So our body gravitates in the direction of that weight, which makes it so hard to lose weight in the first place and that is why the gastric sleeve helps in changing that set-point. That's all what it does, the mechanisms behind this are still not clear, it's quite the fascinating thing. But it's certain that the gastric sleeve is changing our bodyweight set-point, again, lots of data on that.

I know where you are coming from and I used to think that way too. "bad foods" "bad choices" "psychological issues" and so on. It's easy to adapt that mindset given the current state of the general opinion on obesity, but more and more evidence is emerging which shows us that it's not true.

Edited December 30, 20178 yr by setoo

21 minutes ago, Creekimp13 said:

I want to know why the most fit people in the world...who live the longest, and have the fewest health problems...have diets based around rice, potatoes, fruits, veggies, legumes, whole grain breads, nuts and seeds....and eat meat very rarely. (when we're told by the diet industry to eat animal Protein constantly...and high animal protein diets are statistically correlated to really awful health outcomes)

Profit?

Can't think of another reason.

Btw, I think we need to post more in the Proteinoholic thread I guess.

14 minutes ago, Xerox said:

I said

Quote

Eating all of these foods daily in place of lean meats and vegetables is absolutely not a healthy diet

If I thought they were inherently bad I wouldnt say

Alright, and that is also simply not true. As @Creekimp13 pointed out, the most healthy and lean people on earth thrive on exactly that kind of diet! They are doing absolutely wonderful. That's a fact which one can look up. So that dismisses your argument, no?

And sorry if I did not get your initial statement 100% right, it happens. But in the end it did not really change that much.

Edited December 30, 20178 yr by setoo

Quote

So are you saying that overweight people who lose tons of weight and then at one point start eating higher calorie food again and also start regaining weight do have a psychological problem?

Erm, no? How on earth did you get that Idea? I just said people fall off the wagon for thousands of reasons. They might have just decided they prefer eating more than being slimmer.

Im saying if you cant maintain a diet where you are over indulging in low calorie nutrient dense foods, but cant keep it up because you just really want to eat junk food every day, then that is phycological, not physical. There is no physical barrier stopping you from eating an abundence of low calorie, nutritionally dense foods which is what your body wants.

Quote

I know where you are coming from

Clearly you dont, I never said a food was objectively bad, Im using casual language, you just fail to understand these words in context.

On 12/29/2017 at 10:57 AM, setoo said:

Hey friends!

I often read that people are regaining weight a few years after having the gastric sleeve. Mostly after 2 years or so (roughly).
Mostly the people blame themselves for regaining the weight. They think it's the emotional eating/head hunger, or bad food choices, or grazing and eating more often.
While I 100% agree that these things might not be the "healthiest" way of eating, I do not think that these are the cause of the regain. Before presenting what I have found out, I want to say, I have NO IDEA if what I'm saying might be true or not, I'd rather just start a discussion with you guys on this, so please hear me out.

I just registerted a few days ago and started a thread already and had gotten great input, thanks for that! Since that I have been researchin the gastric sleeve day in day out (I'm off work for a few weeks haha).

Like I said,I have been researching the gastric sleeve surgery quite a bit for the past week and especially looked for studies, and luckily I could find quite a few great studies on it! Even long term studies ranging from 5-13 years post op (on request I will post these here)!
What almost all these studies have in common (I think, I'm not a pro at reading studies, but they put a comprehensive conclusion at the end, which really helps understanding it), after 2, 3 or 5 years people regained weight compared to after 1! The overall weight loss got less! So for example, year 1 people lost 70% of excess weight, in year 2 that dropped down to being only 60% and by year 5 it was down to 50% (these numbers are close-ish to the ones in the study).

So after 2 or 3 years the MAJORITY, if not all, are regaining weight. Ain't that something? Do they all decide to give in to emotional eating and bad food choices right at the same time? I do not think so. I rather think, that after 2 or 3 years the body naturally WANTS to regain weight and sends us more signals to consume more food. Just because we lost all that weight after 1 year, does not mean our body wants to stay at that weight happily ever after.

So what I'm trying to say is, it might just be a natural part of the gastric sleeve to regain some of the weight and it has nothing to do with personal "errors", its just the weight our body wants to be. Most of the studies show, after 10 years, people will still have lost around 50% of their excess weight. I know, it's not perfect, but hey, that is pretty damn good!
I know the "It must be my fault, that's why I'm regaining, I did something wrong"-mentality is the go to for a lot of people . Did we not learn exactly that by calorie restriction and then "failing", because we started to eat more? Thinking WE messed up, but in reality it was just our body not wanting to put up with any of this dieting and restriction.

These are just my thoughts, I might be totally off, but I had to atleast write it down. I would love to start a discussion on this and appreciate any input, I also hope the point I was trying to make came across rightly (english is not my first language).

Cheers!

The goal should be healthy at whatever that weight might be for you.

Here is my issue with statistics.

Per my surgeon's office : St Luke's for the state Idaho follow patients for five years at each check up. The problem is that many bariatric patients stop coming to follow up appointments. Surgeons offices see a drop off of participants in the first to second year. St. Luke's is still required to send in the statistic even when they know for fact they are not accurate. These are factored into the national average.

St lukes also says its normal to gain around fifteen after goal. Your body naturally wants to settle at a certain weight.

I don't judge people that have lost 100% of weight, Lost below the norm or have weight gain. I also don't judge " if your body does not want to put up with a diet and calorie restriction"

Things that I see when I talk to local patient in my area: (not saying all these issues will cause weight gain either)

Gains can be small or a major for many reasons...Healthy issues, wrong type of surgery for the individual, not properly screened by the mental health process, muscle mass gain, eating/exercise disorders, mobility issues, hormone issues, Pregnancies, complications from surgery and going back to poor choices/behaviors (I'm sure I missed more examples)

Personally, I never wanted to be considered a statist in this process. Each of us have different goals. it's a choice of what weight makes you comfortable for goal and maintenance.

I hate the word failure.

• It might be you cannot lose weight due to the examples listed above.
• Could be a set back gain.

What my life looks like at 3.7 years out for life

I live on protein, sugar substitute, dairy,vegetables, healthy carbs and fruit.( I eat all food groups) At goal I indulge once in a while. When I have a weight gain. I go back to basics and get back down to where I am comfortable. Maintaining for me is chasing the same 10 to 15 pounds.Weight loss is slow.

3 minutes ago, setoo said:

Alright, and that is also simply not true. As @Creekimp13 pointed out, the most healthy and lean people on earth thrive on exactly that kind of diet! They are doing absolutely wonderful. That's a fact which one can look up. So that dismisses your argument, no?

No, I dont eat that diet, they dont eat my diet, they might eat a component of my diet but not in the way that I do or to the extent that I do, Our diets are not the same, if they were I would be the most healthy lean person on earth, but im not.

48 minutes ago, Xerox said:

If you are saying they dont feel good because they crave high calorie foods too often and want to give in to temptations often enough that it causes weight gain then that is phycological and can be changed with persistance its like an addiction. You wouldnt be saying this to an alcoholic.

Of course there are people beating addiction. But there are more of them that lose the battle. Look up the relapse rates when it comes to addiction. They're devastating.

The one take-away that I find most exciting about this thread...is reading multiple studies that most people only regain about 4-5% of their first 12 month weight loss....5 years after surgery.

I find that spectacularly encouraging:)

13 minutes ago, Xerox said:

Quote

So are you saying that overweight people who lose tons of weight and then at one point start eating higher calorie food again and also start regaining weight do have a psychological problem?

Erm, no? How on earth did you get that Idea? I just said people fall off the wagon for thousands of reasons. They might have just decided they prefer eating more than being slimmer.

Im saying if you cant maintain a diet where you are over indulging in low calorie nutrient dense foods, but cant keep it up because you just really want to eat junk food every day, then that is phycological, not physical. There is no physical barrier stopping you from eating an abundence of low calorie, nutritionally dense foods which is what your body wants.

So people who can't maintain their weight loss after eating just protein and veggies, as much as they want, all have psychological problems? That's what you are saying.

The body is not stupid, it will send urges to eat higher calorie foods if it demands it. That's the base of so many scenarios where people lose weight but the body pushes them to eat more. And once again and I can't say this enough, that would be 99% of the people who lost weight.

In the end I feel like I'm correct with my interpretation of what you are saying. You are just chaning it a bit, but at the core it's the same.

Edited December 30, 20178 yr by setoo

Quote

So people who can't maintain their weight loss after eating just Protein and veggies, as much as they want, all have psychological problems? That's what you are saying.

No it is not what I am saying. What a ridiculous statement to make. Im saying if you want to lose weight but you feel like you cant sustain a diet that is enriching your body with all the calories, vitamins and minerals your body wants, soley because you cant resist eating foods that you know will cause you to gain weight if eaten regularly and in excess, but you do it anyway, thats phycological, not physical, you arent physically hungry or starving, its in your head.
Its the inability to resist which is a psychological issue which you can work on.

You said

Quote

they simply do not feel good doing this

I responded

Quote

Because? What? they're starving? What is the pressure that makes them not able to do it anymore? How is it not sustainable? Are they low on energy?

Followed by

Quote

If you are saying they dont feel good because they crave high calorie foods too often and want to give in to temptations often enough that it causes weight gain then that is psychological and can be changed with persistance its like an addiction

I was very specific about what I am talking about. Im not saying anyone who gains weight for any reason has a psychological issue. Im saying a very specific behaviour is a phycological issue.

Edited December 30, 20178 yr by Xerox