If I lose a lot of weight during the 6-month pre-op, how do I know if I should still have surgery?

[Fitted T 3]

First time posting!

Hi everyone, I'm currently in month 2 of my 6-month pre-program for a sleeve. In the first month I somehow lost 20 lbs. If I keep losing weight this well it makes me wonder whether or not I should actually have the surgery.

About 6 years ago, I was able to lose 100+ pounds, but then as soon as I went back to my old ways (poor eating/not exercising) I gained it all plus some back taking me to 350 lbs at the start of the year. I feel confident I can lose the weight again, but I don't feel confident I can maintain it. That's what I was thinking surgery would be a tool to help with. But I'm very nervous about changing my anatomy when I'm only in my 30s. What if I have buyers remorse in 5 years and can't do anything about it?

Any advice or personal experiences you can share would be much appreciated. Thank you!

[GreenTealael 25,609]

That's a hard question that ONLY you can answer. I felt the same for about a month pre surgery and almost said never mind ill do it without surgery. I changed my mind because while I thought I was losing steadily, I was actually gaining . I was eating according to the nutritionists recommendations but no progress. I said screw it stop fighting a battle you can't win alone.
Took a leap of faith and not one day goes by that I regret it.

[Creekimp13 5,841]

I think many many people can identify with what you're saying here.

Because it's true...regardless of how you do it...you still have to watch your diet, and make lifelong lifestyle changes.

For me....getting the sleeve made sense because it helps with with volume, and with encouraging better food choices. (I can have a bite or two of sugary stuff and enjoy it, but if I try to eat a full serving of refined sugar...yuck...I feel nauseated for a while and it's a good reminder) Not a huge bread fan anymore. I still love the stuff emotionally...but eating it isn't as satisfying.

At the end of the day....I'd lost and gained hundreds of pounds. Over and over and over.

The definition of insanity is doing the same thing over and over and expecting a new result.

Will my sleeve work forever? There are no guarantees. But I'm feeling really really encouraged by how it's effected my food preferences. I LIKE my forever diet. I LIKE my exercise routine. And I'm not blowing smoke here...and pretending I do (which I have in the past). There is very honestly no other diet I'd rather be eating. I love how my new exercise routine makes me feel.

Working a supervised program has been supportive, too. Seeing my health improve...has inspired me.

Edited February 15, 2018 by Creekimp13

[kakatlady612 1,053]

Hey Tealael and Creek Imp have their act together, I'm starting on an equal weight footing with you, I've lost and gained over the years that fabled 100 lbs, Now I'm seeking surgery too. They both had the sleeve, age and comorbities dictate a RnY for me. I am more at this point concerned about not having the surgery than having it. I am 72, if something isn't done I'm looking at shortening my lifespan seriously, with GERD arthritis and apnea my quality of life is not great. I am sick and tired of being sick and tired. If I can set my mind to doing it, I know YOU can. Buck up buckaroo--- we are in this together.

Sent from my VS880PP using BariatricPal mobile app

[Down South Aussie 65]

I agree with What Creekimp said.

When it comes down to it the surgery is not going to be the silver bullet and it is about the changes you make now and after the surgery in-conjunction with the surgery that will make the long term success.

I am right there with you in that i am on the supervised diet right now and have lost a little over 20lbs in in the last month. Someone even said to me at my meeting this week "Oh so you dont even need the surgery, you can do it on your own" than answer to that is that no not really otherwise i wouldn't be where i am now. I have done the High Protein low carb diet and had success, then gained it back. I have dont the eat 6 times a day diet and had success, then gained it all back. I have the do exercise until you drop and had success (even got my second degree black belt in Tae Kwon Do) but i still gained it all back.

Personally im looking to add this new tool to my quiver. This time around i am also eating 6 times a day High protein, low carbs but i am also logging EVERYTHING that goes in my mouth, which i was suprised by but it is really helping me look at what it is im eating. For instance it may be high in protein, but also super high in fat, something i may not have noticed previously.

[Fitted T 3]

33 minutes ago, Creekimp13 said:

The definition of insanity is doing the same thing over and over and expecting a new result.

That is such a good point! I should remember that yeah, I lost it before, but I also gained it all back. And you're right that if you don't change any of the variables in the equation why should you expect a different result.

Thanks for the support from everyone.

[kakatlady612 1,053]

Another definition for you---' Tact is telling someone to go to h*** and have them actually look forward to the trip.

Sent from my VS880PP using BariatricPal mobile app

[RickM 1,753]

Why not give it a try and see how far you can go? Assuming that you are not in a big hurry for surgery Healthwise, see what you can do by changing your habits for the long term (as opposed to a quickie weight loss diet)?

When I started in this game close to 15 years ago when my wife and I started looking seriously at WLS (she was number 1 on the runway with her higher BMI and comorbidities) I went along for the ride on the 6 month insurance diet, with the intent of following her once she had recovered. We basically worked on learning nutrition and changing our diet toward what we could live with in the long term rather than one of the fad or "book" diets promising miracle weight loss. We joined the Y and I got back into swimming as I had done when younger and learned to kinda like strength training, which I had never done. The key here was to find things that you can stick with in the long term (still going there most every weekday for swimming or a weight circuit), and now have a couple of high energy hunting dogs that need regular running (they run, I hike)

The upshot of this all was that I lost about 50lb, or about a third of my excess, in the six months and while it took another couple of years to get my wife on the table (insurance problems) I stuck with it, though was not able to permanently lose much more than that 50, I did keep it off over the years and fell into a WLS maintenance lifestyle with my wife after she got her WLS, though I generally ate about twice as much as she did. The weight remained stable for several more years; when our insurance started covering the sleeve, it seemed to be time to go for it as I was not going to lose more permanently on my own.

Nearly seven years later, and things are still maintaining in the 190ish goal range. The dietary adjustment and waiting exercise was well worth it in my case, as it helped to seriously prepare me for the road ahead (not just a quickie pre-op diet and then try to figure out the maintenance thing later). I successfully avoided all of the calls from the various forum "experts" that this, that, or the other fad diet was absolutely essential to WLS success, as I already knew what was working for me. Further, it also gave me better insight as to what procedure would be best for me - had I gained back all (or more, as often happens) of what I had lost, that was a good indicator that I needed something stronger than the VSG, and I would have gone with the DS instead, as that procedure has better regain resistance than the other mainstream WLS like the RNY or VSG. Also, since I was tracking what I was doing, I had a good insight as to what my actual metabolism really was (not just based on some flakey online calculator) so I had a better handle on what type of diet I really needed to use to lose the weight - how many calories gave me the appropriate deficit rather than just guessing or going with what others do (600 calories? 800? 1000? 1200?)

In short, while it is a longshot to get to a normal weight without WLS (typically about a 5% success rate) there can be a lot of things to learn by trying, if you put your mind to it, and think long term and not just strictly how much weight can I lose how quickly.

[Jerseygirl4523 44]

On 2/15/2018 at 9:51 AM, Fitted T said:

First time posting!

Hi everyone, I'm currently in month 2 of my 6-month pre-program for a sleeve. In the first month I somehow lost 20 lbs. If I keep losing weight this well it makes me wonder whether or not I should actually have the surgery.

About 6 years ago, I was able to lose 100+ pounds, but then as soon as I went back to my old ways (poor eating/not exercising) I gained it all plus some back taking me to 350 lbs at the start of the year. I feel confident I can lose the weight again, but I don't feel confident I can maintain it. That's what I was thinking surgery would be a tool to help with. But I'm very nervous about changing my anatomy when I'm only in my 30s. What if I have buyers remorse in 5 years and can't do anything about it?

Any advice or personal experiences you can share would be much appreciated. Thank you!

Look at it this way, it’s february. You’re going to hit your deductible this year and probably out of pocket max during pre op. Stick with it as if you plan on getting the surgery. And then if at the end of the six months you decide you don’t need it and you’re happy doing what you’re doing, no harm no foul. The tools during pre op can only help you and will probably keep you on track when you know you have an appointment to get weighed next month.

[QueenMab89 6]

A New York Times article came out in 2016 that talked about what happened to the metabolisms of The Biggest Loser contestants after their weight loss. One of the things they found was that their metabolisms slowed significantly, making it harder to maintain weight loss. Reeger Cortell's weight loss surgery podcast had an episode where they talked about that and referred to a concept of a set point for your weight. Your body fights to return to a set point. Apparently WLS helps to lower that set point. Doing some reading on this notion of a set point helped me solidify my decision to have surgery. Without surgery, if I managed to lose all of the weight, it would be very very hard to maintain my weight loss.