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Is weight loss surgery more effective long term than dieting?



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I've been thinking for some time about having wls and finally took the plunge to see a Consultant. I've since had dietitian/psych consultations and have been "passed" for a gastric bypass though I don't have a date yet for the op. I have just over 4 stone to lose which has crept up on me over the last decade due to stressful situations/comfort eating. Having spoken to the dietitian and looking through the various topics and posts on bariatricpal I can see that in order to successfully maintain the weight loss which is achieved after the bypass, it's necessary to limit eating forever, say by calorie counting, and if this isn't done then it's likely that I would regain weight, despite the smaller stomach. I had (obviously stupidly) assumed that with a smaller stomach it would simply not be physically possible to eat as much and that this would keep the weight off.

In the past I've been a bit of a yo-yo dieter and have lost weight successfully at Slimming World; the problem for me is that I find it hard not to go back to old eating habits and gradually the weight goes back on.

So my question is: why is having the weight loss surgery more effective than losing the weight by dieting in terms of keeping the weight off long term? Am I just as likely to put the weight back on after wls as I would if I lost weight following a diet? I have to self-fund the wls and thinking about that, as well as the fact that it's major surgery plus the various potential issues such as Hair loss etc is freaking me out a bit.

Any thoughts? Thanks!

Edited by Deb9386
Didn't make sense!

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Hi! A very valid question. Statistically, the evidence shows that WLS is the most effective way to lose a significant amount of weight and to reach a more healthy BMI. Yes, you have to make lifestyle changes. It is not a quick fix. What its been for me is a very effective tool that is helping me to have a new relationship with food.

I'll have to work at this for the rest of my life. This tool (I had the sleeve) helps me in a way that a the diets I've done in the past did not - i think partly bc for me, I feel like this is my last, best chance to be healthy. You will likely still be hungry or crave things - some people don't, but I for sure do. But this tool helps me with that.

My only regret is that I didn't do this sooner. I've lost 140 lbs since December and am healthier than I've been in years. Good luck on your decision!

Sent from my SM-G975U using BariatricPal mobile app

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Thanks for your reply which is very interesting - I think that I would also see wls as my 'last chance' to turn my weight issues around, particularly as I'm 58 now. So it might well be more effective in helping to keep the weight off.

Thanks again and congratulations on your amazing weight loss!

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Study after study has shown that dieting alone is not effective for long-term weight loss. Roughly 95% of people gain back all the weight they lose from dieting, and often more. Most bariatric surgery patients, on the other hand, maintain weight loss of at least 50% of their excess weight long-term. Many bariatric surgery patients do regain some weight, sometimes a significant amount, but typically still maintain some amount of weight loss (whereas without surgery, they’d most likely be gaining steadily over the years).

The amount you can eat after weight loss surgery gradually increases, but usually not to the point that you can eat as much as you used to. People call the first couple of years the “honeymoon period” because that’s when it’s easy to lose weight, since the restriction is strongest. WLS also changes the hormones in your body that cause hunger, so at least for a while, you don’t feel hungry. They say it’s important to take advantage of the honeymoon period to change your eating habits so they become permanent even when the effects of the surgery weaken. Some people experience changes in taste after surgery and come to dislike sugary or fried foods (and these foods can even make you sick after WLS, which creates a strong disincentive to eat them).

So yes, it still takes work and lifestyle changes to lose weight and maintain weight loss after WLS, but WLS makes it easier than dieting. Many, many people who have repeatedly failed at weight loss through dieting alone have been able to succeed with WLS. (FYI, I’m only 7 weeks out from surgery, so I don’t have personal experience to back this up, but I’ve read a lot and watched a lot of videos from people who have been through it. There a lot of people on this forum with amazing success stories.)

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yes, you do have to work at it or you'll gain back a significant amount of weight. The surgery acts more like a strong tail wind - you still do the work, but it gives you a huge boost.

I started off MUCH heavier than you - I had about 15 stone to lose. I am 60 years old. I spent DECADES losing and gaining weight. Four stone would have been one of my more successful attempts - and I would always ALWAYS gain it back. And I had 15 stone to lose. I knew there was no way I would EVER be able to do that on my own, if I couldn't even keep four stone off for more than a few months.

as for Hair loss, some people lose a lot, some lose very little, some don't lose any at all (I lost hardly any). But for most of us, we're the only ones who notice it. And it grows back. I think most "vets" on here will tell you that in retrospect, we wonder why we wasted even one brain cell worrying about hair loss. In the grand scheme of things, the hair loss was just a minor (and temporary) annoyance. I would take the hair loss any day over almost 400 lbs again. ANY DAY!

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15 hours ago, BigSue said:

Study after study has shown that dieting alone is not effective for long-term weight loss. Roughly 95% of people gain back all the weight they lose from dieting, and often more. Most bariatric surgery patients, on the other hand, maintain weight loss of at least 50% of their excess weight long-term. Many bariatric surgery patients do regain some weight, sometimes a significant amount, but typically still maintain some amount of weight loss (whereas without surgery, they’d most likely be gaining steadily over the years).

The amount you can eat after weight loss surgery gradually increases, but usually not to the point that you can eat as much as you used to. People call the first couple of years the “honeymoon period” because that’s when it’s easy to lose weight, since the restriction is strongest. WLS also changes the hormones in your body that cause hunger, so at least for a while, you don’t feel hungry. They say it’s important to take advantage of the honeymoon period to change your eating habits so they become permanent even when the effects of the surgery weaken. Some people experience changes in taste after surgery and come to dislike sugary or fried foods (and these foods can even make you sick after WLS, which creates a strong disincentive to eat them).

So yes, it still takes work and lifestyle changes to lose weight and maintain weight loss after WLS, but WLS makes it easier than dieting. Many, many people who have repeatedly failed at weight loss through dieting alone have been able to succeed with WLS. (FYI, I’m only 7 weeks out from surgery, so I don’t have personal experience to back this up, but I’ve read a lot and watched a lot of videos from people who have been through it. There a lot of people on this forum with amazing success stories.)

Thank you for your reply - it's very helpful!

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11 hours ago, catwoman7 said:

yes, you do have to work at it or you'll gain back a significant amount of weight. The surgery acts more like a strong tail wind - you still do the work, but it gives you a huge boost.

I started off MUCH heavier than you - I had about 15 stone to lose. I am 60 years old. I spent DECADES losing and gaining weight. Four stone would have been one of my more successful attempts - and I would always ALWAYS gain it back. And I had 15 stone to lose. I knew there was no way I would EVER be able to do that on my own, if I couldn't even keep four stone off for more than a few months.

as for Hair loss, some people lose a lot, some lose very little, some don't lose any at all (I lost hardly any). But for most of us, we're the only ones who notice it. And it grows back. I think most "vets" on here will tell you that in retrospect, we wonder why we wasted even one brain cell worrying about hair loss. In the grand scheme of things, the Hair loss was just a minor (and temporary) annoyance. I would take the hair loss any day over almost 400 lbs again. ANY DAY!

Thank you, and congratulations on your weight loss!

I've also spent the last 3 decades gaining and losing weight and it gets to the point where I have no confidence in myself to be able to keep it off even if I do manage to lose it, so in a way I'm condemning the diet as I start it. If it would make it easier for me to keep the weight off then I think it would be worth my doing it. Thanks again!

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Just also like to mention how helpful I'm finding the forum on this site. It's be a bit daunting to see the topics where people are having problems after surgery, but it's much better to go into it knowing what to expect and with so many helpful comments as to how to overcome/deal with the problems. 😄

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1 hour ago, Deb9386 said:

It's be a bit daunting to see the topics where people are having problems after surgery, but it's much better to go into it knowing what to expect and with so many helpful comments as to how to overcome/deal with the problems.

The people without problems don't tend to hang around for very long so there definitely is major selection bias at work and some of the problems you might have read about are just your typical issues after abdominal surgery that usually resolve itself within the first few weeks, e. g. gas pain, potty issues, fatigue.

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2 hours ago, summerset said:

The people without problems don't tend to hang around for very long so there definitely is major selection bias at work and some of the problems you might have read about are just your typical issues after abdominal surgery that usually resolve itself within the first few weeks, e. g. gas pain, potty issues, fatigue.

Thanks - that's reassuring to know.

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9 hours ago, Deb9386 said:

Just also like to mention how helpful I'm finding the forum on this site. It's be a bit daunting to see the topics where people are having problems after surgery, but it's much better to go into it knowing what to expect and with so many helpful comments as to how to overcome/deal with the problems. 😄

Yeah, this forum is really helpful for preparing. I do not like surprises, so I wanted to make sure I knew what I was getting into -- the good, the bad, and the ugly -- before I committed to surgery. I also watched a ton of YouTube videos and found those helpful as well. Some of the ones I watched are Kimberly H, Minnie Me in TN, My Level 10 Life, Clusie L, Timetodeflate, and Foodie Turned Sleevie. There are many more (which you'll see on your recommended videos once you start watching WLS channels), but a lot of people just have a couple of videos about WLS.

Like so many things in life, WLS is a tradeoff. You have to make big sacrifices, but there can be big rewards. It was important to me to understand going into it what I would be sacrificing and what benefits I would get. It was daunting to think of what I would have to give up for WLS, but when I looked at what I hoped to get out it -- to get my health back, get my mobility back, and so many other things that I have missed out on in my life because of my weight -- it was a lot easier to accept those sacrifices.

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10 hours ago, BigSue said:

Like so many things in life, WLS is a tradeoff.

Absolutely. Everything in life has some kind of price tag on it and sometimes only time will tell you if the price you paid was worth it.

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19 hours ago, BigSue said:

Some of the ones I watched are Kimberly H, Minnie Me in TN, My Level 10 Life, Clusie L, Timetodeflate, and Foodie Turned Sleevie

Thank you for the recommendations - I'll definitely watch those.

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For me, I could never lose much weight, and definitely couldn't keep it off. I would give up because I never saw good results. I ate mostly healthy, but still too much food,
obviously. WLS is just the tool I needed to learn to control my portions. Now I am seeing results for my efforts and losing like I never could before. There's no way I could do this without surgery.

Sent from my moto g(6) using BariatricPal mobile app

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Same story as many of you. Years of dieting, losing weight & gaining more than I lost. I know it hasn’t been a long time compared to others & I’m in the golden time, but I have never been able to maintain as I have for the last 7 months since I hit my current weight.

Almost 40yrs of skipping meals & dieting killed my metabolism. (And don’t get me started on the 15kg I put on with menopause.) Even though I ate home cooked, generally healthy food 80+% of the time, I’d always put on weight. Now I eat very regularly: smaller portions, reduced carbs & sugar, low fat, limited alcohol. It’s working so far & I haven’t had to compromise my lifestyle.

The surgery isn’t an easy fix but it gave me a helping hand & made me examine how & why I ate. I know I’ll have to continue to work at my diet & develop strategies to survive the challenges life throws my way so I don’t sacrifice what I’ve achieved by having the surgery.

Is it worth the effort? You bet. Every single day I’m glad I chose to do this.

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