So I’ve been in preop phase for 8 months in prep for bypass. Long story short I switched doctors after 6 months with old doc. I love the new doctor and almost ready for surgery, just took some time to get all records from old dr. Now my husband is on board and he’s seeing new doctor to go through WLS as well. We went to our first support group meeting last night and now I’m very confused and I think he is too. We now have this mindset that “we can do this”. He hasn’t been one to read or research much as I do, and he was amazed at all the lifestyle changes and tools you use to rewire your head and to be successful. He says well if we can learn that now I think we can totally do this! He bragged on how far I had already come and changes I’d made and he said I really think we can do this. I’ve kinda had that feeling all along but then again here I am 8 months in and only 25lbs down. Tell me this is normal or tell me something, anything? Isn’t it only like 3-5% of people can actually lose the weight and keep it off without surgery? I’m just so at a loss on what to do now….

I can only speak from my experience.

I had several of those "I can do this without surgery" moments throughout my life. I first started down the path of surgery in 2013/14. I was doing the Tim Ferriss Slow Carb Diet (6 days/wk, eat only beans/meats/veggies, 7th day is cheat day) and having great success. I explained what I was doing to the bariatric surgery coordinator and her response (paraphrased) was, "That's nice, but you won't be able to do that post-surgery." I didn't want to hear that, figuring that I had already lost 40+ pounds this way and cancelled my appointments. I ended up losing roughly 150 pounds on that diet, but gained it all back. Why? It reinforced binge eating habits and didn't set me up for future success.

Like a lot of overweight people, I thought my next lifestyle change (clean eating! intermittent fasting! keto!) would be the one that allowed me to lose the weight and keep it off. I finally realized that I was only fooling myself. It takes an incredible amount of discipline to lose weight and keep it off without surgery. You have to commit to eating a certain way for the rest of your life; I have yet to meet someone who did a diet for 6 months, lost the weight, went off the diet and kept the weight off. I reached a mental state where I had two choices: 1) continue living my life as I had been or 2) making a truly radical change, the change most likely to keep the weight off. I chose Option 2, because I owed it to myself, my wife and my kids to be the healthiest person I could be. I do not regret my choice.

But while I do not regret my choice, I don't go around telling other people to do it. I don't think I would have succeeded in 2013 the way I have today with the surgery. In 2013, I would have seen it as "I do a surgery, I eat less, I lose weight, winner, winner, smaller chicken dinner." That is a set up for long-term failure. Now, I see it as "I have been given a great chance to live a healthy life and I need to take advantage of it." Until you reach that mental state, you are not ready to succeed with this surgery.

I'll speak for myself, but I think it applies to many of us. First off, many of us can do this - until we can't. I flat out rejected the idea of surgery for years, thinking exactly what you did in your post. And sure, I would have successes - the best time, I lost 75 lbs. Another time, probably about 50 lb. But then, it got harder and harder to do it, no matter how much I knew what I needed to do. And keeping it off? Forget it. Gained all those back and with friends. The reality is what you said, only a tiny percentage of people can keep it off successfully. It's not a moral failing. Our bodies make it hard, and it gets harder every time we lose weight. Compared to people who have never dieted, our metabolisms are affected in the long term by the yo-yo.

The surgery doesn't guarantee success, but it gives you another tool to use toward getting there. This experience is just so different than every other time I've tried to lose weight. It's not easy, but it feels attainable. It doesn't feel like a a long, losing battle where my body is conspiring against me. And, the surgeries can have major, positive impacts on metabolism that dieting alone will not accomplish.

Thank you both for the replies! I feel like my mind was settled and then my husband started down this journey more with me and he says things like “well that doctor said you can gain it all back anyway so what’s the point” or he says “ these changes you have to make after surgery will make you lose weight anyway, just make the changes without surgery”. I honestly know with PCOS and as many diets as I’ve ever been on I think I need the surgery for true long term success. I am a different person now, already after 8 months in. I exercise regularly and have gained so much endurance and cardiovascular fitness doing CrossFit exercises. I do eat better and don’t see the “quick fast diet” mentality in my life anymore. I’ve made changes that I could’ve never imagined. At the end of the day I do fear the outcomes-what if I’m weak and malnourished or sickly? Or have complications? But then I remember I’ve been in this 8 months with only lost 25lbs AND I’ve never lost more than 40 on my own and never kept it off. My husbands rebuttals say but you’ve never changed your life like this before for this long. I think he keeps dragging me back to the fence lol!

It is a difficult decision, and I can understand going back and forth. I certainly did, and I was very worried about all the things that could go wrong. Honestly, I wish I did this years ago now. The time I spent telling myself I could do it on my own could have been spent losing weight and living life happier. Having said that, I wasn't in the right place mentally before, and I certainly wouldn't have been ready to have success. I'm still in the honeymoon period right now, and I know things will get harder as time goes on, but I feel a sense of hopefulness which I rarely felt any other time I've been losing weight. I don't obsess about food, other than worrying if I will get to my calorie goal or not (when have I ever had to work to eat more, vs less?)

It is also ok for you to be ready to do the surgery, and for your husband to not be ready. He may still be in the "I'm not sure stage." That's fine, but you are different people. You have to do what's right for you, whether that is doing it now or waiting and seeing what happens.

2 minutes ago, mrsjo said:

Thank you both for the replies! I feel like my mind was settled and then my husband started down this journey more with me and he says things like “well that doctor said you can gain it all back anyway so what’s the point” or he says “ these changes you have to make after surgery will make you lose weight anyway, just make the changes without surgery”. I honestly know with PCOS and as many diets as I’ve ever been on I think I need the surgery for true long term success. I am a different person now, already after 8 months in. I exercise regularly and have gained so much endurance and cardiovascular fitness doing CrossFit exercises. I do eat better and don’t see the “quick fast diet” mentality in my life anymore. I’ve made changes that I could’ve never imagined. At the end of the day I do fear the outcomes-what if I’m weak and malnourished or sickly? Or have complications? But then I remember I’ve been in this 8 months with only lost 25lbs AND I’ve never lost more than 40 on my own and never kept it off. My husbands rebuttals say but you’ve never changed your life like this before for this long. I think he keeps dragging me back to the fence lol!

I don't know your age, situation, weight, other health problems, etc. If you think you can do this without surgery, then do it without surgery. I am not being sarcastic. It is a huge, life-altering decision and if I could do it without surgery, I would.

But the surgery isn't just another way of saying, "Eat right and exercise." I understand what your husband is saying: with or without surgery, you will have to watch what you eat and stay active. But I struggle to explain to people how the surgery changed me, in terms of my relationship with food. Bypass/sleeve doesn't just make your stomach physically smaller; it changes the hormones from your stomach. My cravings for food are so much weaker and different; I don't crave rich foods (I am much more likely to crave saltines than cake). More than any time in my life, I see food simply as fuel rather than a source of pleasure/joy. I choose foods as much for how they will make my stomach feel than how they taste (my stomach will find it much easier to digest fish than steak, so I am much more likely to order salmon at a restaurant than sirloin). It's easier to stay disciplined when you don't even feel the same tug toward the foods that destroyed your old diets.

1 minute ago, Splenda said:

But the surgery isn't just another way of saying, "Eat right and exercise." I understand what your husband is saying: with or without surgery, you will have to watch what you eat and stay active. But I struggle to explain to people how the surgery changed me, in terms of my relationship with food. Bypass/sleeve doesn't just make your stomach physically smaller; it changes the hormones from your stomach. My cravings for food are so much weaker and different; I don't crave rich foods (I am much more likely to crave saltines than cake). More than any time in my life, I see food simply as fuel rather than a source of pleasure/joy. I choose foods as much for how they will make my stomach feel than how they taste (my stomach will find it much easier to digest fish than steak, so I am much more likely to order salmon at a restaurant than sirloin). It's easier to stay disciplined when you don't even feel the same tug toward the foods that destroyed your old diets.

All of this, right here. My relationship with food is so different. I can walk away from things I never could have resisted before. Again, I'm still in the honeymoon period, but it has been so liberating for me.

Also, I just realized @Splenda is my surgery twin. ?

1 hour ago, mrsjo said:

Isn’t it only like 3-5% of people can actually lose the weight and keep it of

It's much less, unfortunately. Even the new obesity drugs don't work once you stop taking them.

https://www.cuimc.columbia.edu/news/complicated-reality-weight-gain-weight-loss-and-weight-stigma

1 hour ago, Splenda said:

it changes the hormones from your stomach

This. People think about bariatric surgery in a way that's nowhere near close to reality.

Surgery won't change your dieting behavior. Sure, it will in the short term, but if I wanted to gain weight at 15 months out, I probably could.

Surgery will change your body's response to the diet behavior. It will stop fighting you. You'll need both the mindset of 'we can do this!' and surgery to make it happen. I hate to push surgery like this, but there's no real data to support any other way of thinking about this:

1. Find out why you're obese. If disordered eating, fix that first.
2. Make a plan. (This is the We Can Do This! phase)
3. Choose a surgery carefully. Look at the data, lifestyle requirements, cost, recovery etc.
4. Make plan for how you'll get the surgery and for how you'll recover.
5. Start path and new lifestyle.

Note: it's not about what you weigh now. Most bodies will want to get to their highest weight without surgery. We all know the high from having lost 20 lbs on our own. And we all know the "wtf happened?!!" when you gained it all back. The body is really that powerful. It will make you eat, eventually.

That's why surgery works. It's not a behavior modification. It's a hormonal intervention to give you a second chance to be a healthy weight (whatever that may be for you).

Hey. I'm about 16 days post op from gastric bypass so I have yet to know how this will turn out long term but to be honest, with this post op stomach, my hopes are high. Someone made a good point in the thread, with the surgery, you don't feel like your body is conspiring against you while trying to lose weight. The pre op diet was so hard because of my actual old anatomy and physiology.

Now post op, I first off haven't felt real hunger since my surgery and when I do eat, I can actually hear myself and my body. It tells me when to stop or take a break. Obviously we have the ability to gain weight back but you have to also have faith and discipline, like everyone says it's just a tool.

Mental health counseling has really helped me understand why I binged so much in the past. I don't think I'd be where am I today without my psychologist and psychiatrist.

I had a lot of moments in my life where I thought I can just do it on my own, but every single time I was still binging when I was having off days. I lost about 70 lbs naturally in the past and then gained 100 lbs back because I never worked on the important part, listening to my body and finding healthy coping mechanisms. The rest of the time was spent miserably losing 10-15 lbs at a time on unstable crash routines. When I reached my highest weight and injured my knee, I knew I needed medical help.

I saw a psychiatrist who was able to diagnose me and get me medicated then did 8 intensive months of counseling with a psychologist on my eating behaviors in order to prepare for surgery. I only lost 25 lbs before my pre op diet (that was a 8 month time span) and that didn't matter because the weight comes off post op. I'm now down 45 lbs total and have about 70lbs more to go until I'm in my ideal range.

As long as you feel ready, you've followed your surgeon's orders, and you understand the commitment that this takes then do it. It's seriously an amazing tool and a privilege to be on the journey. I wish you luck with it and sending love to you and your husband on your journey.

On 03/02/2022 at 16:01, MiniGastricBypassDude said:

This. People think about bariatric surgery in a way that's nowhere near close to reality.

Surgery won't change your dieting behavior. Sure, it will in the short term, but if I wanted to gain weight at 15 months out, I probably could.

Surgery will change your body's response to the diet behavior. It will stop fighting you. You'll need both the mindset of 'we can do this!' and surgery to make it happen. I hate to push surgery like this, but there's no real data to support any other way of thinking about this:

1. 
   Find out why you're obese. If disordered eating, fix that first.
   


2. 
   Make a plan. (This is the We Can Do This! phase)
   


3. 
   Choose a surgery carefully. Look at the data, lifestyle requirements, cost, recovery etc.
   


4. 
   Make plan for how you'll get the surgery and for how you'll recover.
   


5. 
   Start path and new lifestyle.
   

Note: it's not about what you weigh now. Most bodies will want to get to their highest weight without surgery. We all know the high from having lost 20 lbs on our own. And we all know the "wtf happened?!!" when you gained it all back. The body is really that powerful. It will make you eat, eventually.

That's why surgery works. It's not a behavior modification. It's a hormonal intervention to give you a second chance to be a healthy weight (whatever that may be for you).

Thanks for this. It’s like I knew this, but I was listening to other people, even if it was my spouse. I’ve researched and planned for this for a long time and I know the hormone thing cannot be down played like he seems to be thinking of it. That’s the tool we all need to get over the hump and actually be successful long term.

5 minutes ago, mrsjo said:

That’s the tool we all need to get over the hump and actually be successful long term.

You're very welcome. Honestly, bariatric surgery - even just being a person who needs that - was such a big thing pre-op, and it's such a minor thing in my life 15 months out.

Do some digging into obesity studies. You won't doubt it afterwards.

Check out (citing from memory, but it's a start for your googling):

• Harvard Health Biggest Loser study (shockingly, people's metabolism slows and is still much slower even after regaining all the lost weight)
• Studies on rat populations that have their calorie pool reduced (lowest social hierarchy rats do not starve as predicted, they get fatter!)
• Studies on how childhood stress and trauma alter your body's idea of a weight set point (trauma or stress = your body stops wanting to maintain a healthy weight, but wants to add weight constantly)
• Overfeeding studies (it turns out feeding people 1000 calories per day in a 100% controlled environment does not, at all, mean a similar weight increase - so calories in, calories out is dead as an absolute concept.

Obesity is a chronic disease. It's one we have tools to manage. But we need to get rid of the idea that bariatric surgery is capitulation, an easy way out, or for losers. You two's feeling of We Can Do This! is spot on - but why do it without using the tools we know work?

Best of luck.

My last thought before surgery was the two women I have met who had surgery and kept the 200 lbs off 10+ years. All those years at WW and I never met people who lost and maintained a 200lb weight loss the “natural way.” Even the “before” pictures at the gym didn’t compare to the amount I need(ed) to loose and keep off.

I thought this exact thought for literally decades (I'm in my 60s). I can't even tell you how many times I lost weight - sometimes as much as 50 or 60 lbs - just to gain it all back again a few months later. And I had over 200 lbs to lose. How on earth was I ever going to lose 200 lbs if I couldn't even keep 50 lbs off? Yet I'd try again...and again...and again.

And yes - that 3-5% figure you heard is what I've read as well. Without surgical intervention, supposedly only about 3-5% of people can lose a lot of weight - and keep it off (although honestly, I'm surprised it's that high). Unfortunately, I wasn't one of the 3-5%. It took me 40 years to come to that conclusion.

yes - you absolutely can regain all of your weight after having weight loss surgery. But your odds of losing a ton of weight and keeping it off are MUCH better than they are without surgery. I never, ever, in a million years could have lost those 200 lbs without surgery. And I wouldn't be sitting here almost seven years later, still managing to keep almost all of it off (like many of us, I did have a rebound during year 3. Most people seem to regain 10-20 lbs after hitting their lowest weight). This surgery has honestly been a miracle for me. It's not that I didn't have to work at it - I did - hard - but I never could have done this without surgery.

I tried every diet I could for more than 10 years before I did the surgery route. It would take me an entire year prior to surgery to lose 20-30 pounds and if I went off track I would gain back what a lost with interest within a very short period of time. It was ridiculous and disheartening. Surgery has been the only thing that has helped me take the weight off and keep it off. It's not impossible to do it without surgery, it's just unlikely. My mom was one of the rare ones who was able to lose a significant amount of weight on her own and keep it off because due to all her allergies she can't have WLS (she's allergic to vitamin supplements. seriously, they give her hives). My mom was over 400 pounds and at her lowest weight she got down to 180 on her own. She's maintained in the 230's for the last 20+ years. I tried the diet route, but my weight would barely budge and then I'd get upset and go off track and gain what I lost and extra and so at my heaviest I was 392 pounds. I took the WLS route when my niece was born in 2019 and it hit me that if I didn't DO something that I wouldn't be around to watch her grow up. Now my weight bounces around 175-185 and I just lose and gain back the same 10-11 pounds since I hit maintenance back in September. I'm much happier now and wish I had just done this for myself years sooner.

I think it's only natural to question why we can't "do this on our own" at various times in our lives and even during pre-op WLS appointments. Only you know the answer to that question.