Bariatric surgery - long term

[vpsdub 0]

Good afternoon

Have diabetes 2 and obesity for many years, now endocrinologist consultant recommends bariatric surgery, most likely Gastric bypass.
Since 2015 keeping balanced diet and Portion Control, doing walking, swimming, lost 20kg in 2018-2020 but unfortunately not much weight loss recently.

It would be interesting to hear from people of similar age and health profile who had bariatric surgery 4-5 years ago - is weight loss sustainable in long term? Any side effects - short and long term?

Male in early 60s with sleep apnea and high blood pressure. BMI 49. Angiogram found no cardiac blockages but chest tightness happens often especially in warm humid weather. Physical activity is mainly walking, average 5-6 K steps daily, also swimming, outdoor stretching and breathing exercises

Thanks

[catwoman7 10,867]

I had surgery eight years ago at age 55. No diabetes, though - just obesity. SUPER obesity. Also, borderline sleep apnea that I didn't know about until I did a sleep test for surgery. I lost 235 lbs and gained back about 20 lbs in year 3 post op (a 10-20 lb rebound weight gain after you hit your lowest weight is very common). Maintained ever since, but it's work. On the other hand, before I had surgery, the most I could lose was about 50-60 lbs, and every ounce of it would come back. Happened dozens of times. So yes - weight loss is sustainable after bariatric surgery as long as you monitor yourself.

I had strictures at two months out and four months out. Very easy fix. The PA at our bariatric clinic told me it was the most common complication, and that they happen to 5% of gastric bypass patients (and if they're going to happen, it'll be during the first three months post-surgery - they're very rare after that). I personally wouldn't call something that happens to 5% of people "common", but that does give you an idea of how common complications are. Basically - they're not very common.

about 30% of bypass patients have dumping syndrome. I've never had it and most of the people I know haven't had it, but some of us do. It's caused by eating too much sugar at one sitting (or for some, too much fat at one sitting seems to set it off). It's because food passes through to your small intestine much more quickly once you've had bypass, and your intestines go into overdrive trying to deal with the sugar (or...fat). It can be prevented by limiting the amount of sugar you eat at one sitting (which we should be doing regardless, even us non-dumpers).

good luck in your decision. Honestly, I should have done it years ago. My only regret is that I waited that long to have it done. My life has changed dramatically for the good. I'd go back and have the surgery done every year if I had to - it's been terrific!

[Arabesque 6,481]

I had my sleeve four years ago at almost 54 so a little younger & also female. Also no diabetes or other co morbidities. I lost all my weight & more & have basically kept it off (apart from a slight hiccup with a medication absorption issue). My fluctuation weight initially was 48.5-49.5kg & is now about 49.5-50.1kgs - maybe my weight settling.

I am careful with what & how much I eat. Which you would be already doing a lot with managing your diabetes. I mostly eat whole foods that are low or no processed. I’m not really active: just stretches & resistance bands - wouldn’t burn 30 calories. The changes I made to what & how I eat were sustainable & easy to manage. I don’t feel like I’m missing out or making sacrifices to maintain my weight. I also feel my choices aren’t negatively impacting how I want to live & enjoy my life. If the opposite was true & I felt I was missing out or couldn’t enjoy my life I would not be able to maintain & would have been gaining weight .

But yes things do happen in life that throw a lot of that out the window: personal & professional stress, emotional traumas, health issues, etc. Our weight can resettle into its new set point (where it’s most happy) which is higher. Our initial way of eating may have been too restrictive & unsustainable to maintain a lower weight. Or we simply become a little complacent.

I didn’t have any complications or issues post surgery but my tummy can be a bit fussy - quirky - & I have random episodes of the foamies for often unknown reasons. There are certain foods I can’t eat (like breads, Pasta & rice sit heavily in my tummy) but it doesn’t bother me. There were foods I couldn’t tolerate before surgery or avoided because my tummy was always a bit fussy, had some sensitivities & to manage my reflux. So no big change really.

[Tomo 1,137]

Had vsg in my fifties, had vsg to rny revision recently (almost 2 yrs ago) in my 60s (gerd related). It's been great. Maintained 100+ weightloss over the years. My weightloss rate was on par with others much younger than myself. I had no complications, recovery was very easy for me.

As far as long term success, after the honeymoon period, and hunger returns, long term weightloss requires some discipline in following your plan. But since you are already practicing good habits since 2015, you are ahead in the game, and I think you will be very successful.

[vpsdub 0]

Thanks for your replies, very helpful, much appreciated!

Here are my main concerns with surgery, just trying to achieve risk/benefit balance:
1) anesthesia - recently had minor dental surgery with local anesthesia (tooth extraction), for 3 days afterwards had more frequent than usual shortness of breath and chest tightness. Bariatric anesthesia will be much heavier - it would be good to hear from someone 60+ with pre-surgery cardio vascular issues
2) my friend post-surgery has to take loads of supplements and Vitamins as necessary nutrients not absorbed properly after surgery causing fatigue. Also other surgeries might be needed - to fix stricture, excessive skin etc. It seems like a lot of risk taking into account my heart issues. Are supplements for life? Would prefer natural nutrients as any chemical/medication has side effects

Another question - would appreciate views/experiences on non surgical ways. Tried diets - lost weight and gained back. Heard about microbiom changes, faecal transplanting - any experience of those?

Thanks again

Edited June 19, 2023 by vpsdub

[catwoman7 10,867]

yes - supplements for life. But they become old hat after a while. I honestly don't really think about it at all anymore. I take a small handful when I get up in the morning, and another small handful in the late afternoon. Then Iron & Vitamin C before I go to bed.

no surgery required to fix strictures. They do it via upper endoscopy. They give you "twilight" anesthesia - which is different from general anesthesia. You're awake but unaware and you don't remember anything once you snap out of it. Easy peasy.

yes plastic surgery is a pain and it's costly (two (of the three) of my plastic surgeries were much more difficult than my RNY), but I think only a small percentage of people actually have plastic surgery. No one could tell I had excess skin except, obviously, me, my husband, and my doctor, but I eventually had it taken off regardless. But when it was there, it was very easy to hide in clothes.

I think microbiome changes and faecal transplanting aren't commonly done at this point - but maybe in the future. They do seem promising.

here's a photo of me BEFORE I had my excessive skin removed. See any of it? I can assure you after a 235 lb loss, I had a ton of it...but as you can see, my clothes hide it.

[Danpaul 42]

Had the sleeve at 60. HAD type 2 diabetes, high blood pressure, gout, gerd, sleep apnea and mostly everything else associated with obesity. Since my WLS they have all been a thing of the past. It takes work to maintain the good health that the surgery gives you.

[Arabesque 6,481]

Structures aren’t that common & not everyone has plastic surgery. I didn’t have a stricture & neither did my three friends (one also in her 50s, one in her 40s & one in her 20s) who had surgery. Only one of us has had plastic surgery - the younger one. She lost more weight than the rest of us. She had it because it was affecting the activity she wanted to do & she was having to buy larger size clothes simply because of the excess skin.

They will do cardiac testing before your surgery but make sure you tell your team about your breathing difficulties especially after anaesthetic & maybe ask for some respiratory testing to be done as well.

[MarisAthena 58]

On 6/19/2023 at 6:24 AM, vpsdub said:

Thanks for your replies, very helpful, much appreciated!

Here are my main concerns with surgery, just trying to achieve risk/benefit balance:
1) anesthesia - recently had minor dental surgery with local anesthesia (tooth extraction), for 3 days afterwards had more frequent than usual shortness of breath and chest tightness. Bariatric anesthesia will be much heavier - it would be good to hear from someone 60+ with pre-surgery cardio vascular issues
2) my friend post-surgery has to take loads of supplements and Vitamins as necessary nutrients not absorbed properly after surgery causing fatigue. Also other surgeries might be needed - to fix stricture, excessive skin etc. It seems like a lot of risk taking into account my heart issues. Are supplements for life? Would prefer natural nutrients as any chemical/medication has side effects

Another question - would appreciate views/experiences on non surgical ways. Tried diets - lost weight and gained back. Heard about microbiom changes, faecal transplanting - any experience of those?

Thanks again

I am 58 years old and I have Afib, I also had rheumatic fever when I was a teenager and I have some valve issues. I am a diabetic ( or was ), and wear a CPAP. I had my surgery on 6/5/23. Within a day from the surgery I stopped taking the diabetes medication (after 15 years). I keep checking my blood sugar, and everything is perfect. I have no idea why and how this happened. My CPAP pressure decreased, they told me at the hospital that eventually I will no longer need the CPAP machine. I had no Afib episodes since the surgery. The gastric bypass requires a lifelong commitment of Multivitamins, minerals and nutrients due to malabsorption. I tried about 8 separate diets prior to committing to this surgery and I always gained back the weight. The education I received prior to the gastric bypass at mayo Clinic explained why we always gain the weight back when dieting. I have no issues with the microbiome, I take pre and Probiotics daily. I think that this surgery is the best decision of my life and the best thing I could have done for my heart. I knew that this will be so when a doctor told me the same thing years ago, that he got the gastric bypass and it was the best thing he did for himself in his entire life. It is a tough decision and a life commitment but the benefits exceed the struggles. I was like you, I doubted my decision until the morning of the surgery. I am really happy that I went through with it!