setoo

Hey everyone! After 10 years of dieting and losing tons of weight, just to put it back on, I'm finally considering gastric sleeve now. I'm about 300lbs. While I hear lots of great things about it, there is one thing that's quite scary to me: People are complaining that they feel hungry all the time afterwards in the long run. I'm scared I'll just ditch calorie counting + feeling hungry for surgery + feeling hungry. And I know that hunger makes me not function properly and can have negative effects on my mental well being and the body. I started to think about this because of a lot of negative feedback on this topic here https://www.bariatric-surgery-source.com/how-i-eat-at-two-years-post-op-vertical-sleeve-gastrectomy.html It seems to me that a lot people gain a bit of weight back (which is expected) and are afraid to gain even more, because their appetite is so high. They even talk about the fear of the stomach stretching to they can eat a lot more. Can anyone chip in on this? While I might be obese, I feel like a mentally stable person, by not starving/not being hungry anymore. So I would not want to end up losing that. And the other thing (which is not that scary to me): Can I ever eat "normal" again? Going out with friends for a burger or a pizza? Basically having a regular sized meal? Like I said, this is just a minor point compared to the benefits of the surgery, but the first point really makes me think. I know being obese is a serious situation and gastric sleeve is probably going to help me a lot in that regard, but I still want to make sure I'll be on a good way mentally too afterwards, I hope you understand. I would be so very thankful for some of your honest opinions on this, please don't hold back. Much appreciated and merry christmas!

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!

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.

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.

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.

/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!

@Creekimp13 You make great points and I could not agree more! I too see the danger in putting post-op folks on these rigidly low calorie and protein dominant diets, which just don't seem like a good idea to me. Doctors have put obese people on exactly the same diets already(who had no surgery), there is tons of studies on that. While all of these obese people lost weight, they mostly regained it back and it did do no good things for their metabolism. (google for "very low calorie diets" or "vlcd", and you will find a lot of information, for anyone interested). So why would one think it is a good idea to put people who had a gastric sleeve on that diet? They might do fine for some time, also lose weight at a fast pace. But really looking at it, this can't be healthy no? And I also do not think this is a "healthy, normal" diet, not at all. Just to emphasize your point! I also agree that people who lost 100% EWL are the minority. There seems to be no data that shows these people are in any way common or the norm. @Introversion Your post regarding people regaining weight after the "hooneymoon phase" because they did not adopt healthy habits does seem quite speculative. The parts with the genetics also. Could you provide some data or information on that? I'm curious! Regarding the studies, like @Creekimp13 pointed out, they do not cluster everyone together. So yes, most people are actually at those numbers of regain or EWL for example. @Xerox 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. @summerset You speak my mind! Thank you for your wonderful posts on this topic, everything you said resonates with me and I also learned new things. Like you said, one should strive for the sustainable middle ground. It often seems to me that people get kind of fanatic after these surgeries, because they HAVE to make them work. Meaning they will adhere to rigid restrictive diets and exercise, just to make it work. Guys, did we not go through all of this already via dieting, workouts and suffering because of these? This does not seem to be the way to a content life, nor to a happy and normal relationship with eating and exercise. Awesome to have your insight on this, after 17 years (damn!), that's a long time and I really appreciate you chiming in on this topic. ______ What I'm proposing: The gastric sleeve surgery does indeed work for weight loss, but with having the expectation to lose 100% of the excess weight, you will set yourself up for quite some disappointment. It's more realistic to have lost around 50 or 60% of excess weight. Pretty much every study confirms this. In my opinion this is still a wonderful thing. Why not use this tool that was given to us and work with it, instead of trying to force some result which the body is not agreeing with? Rather just have the surgery and eat the way your body signals you to. Think twice about labeling food as "bad". Rice is not bad, bread is not bad, potatoes are not bad either. These are staple foods of humanity, with which most people are doing wonderfully on. I would go as far as saying that just eating lean protein and veggies is actually unhealthy. I know, it's healthier than the food that is eaten when one is obese, but why go from one extreme to the other? I just want to provoke some thought regarding all of this "I have to eat like that and exercise like this, eat that many calories and not more". Why should we do that? Why not actually LISTEN to what our body is telling us, accepting and working with that? Because everything else seems to be unsustainable in the long term.

@Introversion Thanks for the input, this is what I was hoping for! Would you mind sharing your activity level and what your diet looks like? I think that would be very interesting, especially since you are so good on maintaining your weight loss (good job on that, btw!). I agree that not everyone regains weight, but I think it is safe to say that the majority is regaining weight to some extent. It is true what you are saying, one can decide which food to use to satisfy the hunger. What I'm just wondering, does there come a point where the body is craving something highly caloric, because it wants to be at a higher weight or more calories to feel good? So regarding that I think you could offer more experience than me! Do you feel that with eating lean protein and vegetables as the majority of your food (if I understod right?), your body is truly satisfied after all that weight loss? By that I don't mean it just fights off the hunger and you feel ok-ish, I really mean being satisfied and content with the food eaten and energized and ready to be productive. If one is not satisfied, I would see the same danger as in calorie restriction. Low caloric food is eaten to keep hunger at bay, but mostly it does not create a good overall well-being, because the body demands more. What I should clarify, I don't support eating junk food all the time after the sleeve, that's not what I'm getting at at all. I'm just wondering if all those people that are saying their change in lifestyle/food choice is the cause of the regain, might actually be driven by underlying urges from the body, which does want them to eat more. This reminds me of regular dieting in some way, you restrict, you get hungry because of the restriction, you eat high caloric food as a consequence, you blame it on yourself and your bad food choices/self control, while it's actually just your body demanding food, but one interprets this as making dietary "mistakes" or "giving in". /edit What I forgot to add, if the choice of eating lean protein and veggies and not fast food is what makes a success or maybe a failure regarding the maintenance, what exactly did gastric sleeve do then? One could skip the gastric sleeve and make those changes, no? But that does not work. So the gastric sleeve changes the weight our body wants to be at and it really makes me wonder how one has to be so very rigid with the diet, to maintain that weight, if the gastric sleeve should do a big part in that? The reason that comes to mind is, that the body does not really want to stay at that low of a weight. Maybe eating a less rigid diet will lead to a higher weight (still a great weight loss I'd say, for example 50% excess weight lost), but at least one gives the body the chance to settle. But I'm just rambling now hah