Help! No Weight Loss - Over 1 Year Out Gastric Sleeve Surgery

[Finally! 0]

I had the sleeve 3 years ago and lost all of my weight. My brother, best friend, and uncle also had it and lost most of their weight.

But my poor mom had it over a year and a half ago and has only lost 20 pounds. (She has about 80 to go.)

She eats small portions, doesn't make terrible choices, etc. I don't understand.

Her doctor doesn't seem to care. He just said to get some blood work done (it was all normal). I get the feeling that it's just a mystery to him and he's more interested in getting more patients sleeved than in figuring out what's wrong with my mom.

She got her thyroid tested and it's on the low/normal side - but nothing that would explain this.

I haven't found anyone else with this issue on any of the forums.

If anyone has an idea about what to do, what to research, PLEASE PLEASE PLEASE let me know.

It's heartbreaking.

If anyone has a doctor to recommend that would be able to figure this out, she's located in Austin, Texas. Her doctor was in Dallas. I honestly wish she had gone to my doctor (Aceves in Mexico) because I know he would never rest until he knew what was wrong with her.

[PdxMan 4,292]

As I understand it, 3,500 calories makes up a pound. So, if you burn 3,500 calories more than you take in, you will lose a pound. Injest 3,500 more than you burn, you will gain a pound. Yes, there are other factors that can make your body burn less calories than another person of the same stature, but over the long haul, I believe what I stated above to be true. So then, how can you not lose weight? By taking in the same amount of calories that you naturally burn. So, to lose weight, you need to create a deficit, whether that be to take in less calories burning the same amount or burn more calories taking in the same amount. I am currently burning an average of 2,500 calories / day according to my BodyBugg. (Google it) I am taking in around 1,700 a day. So, I lose about a pound every 5 days, which, for the most part is right on.

As you know, the sleeve restricts the amount of food to the stomach. But it does not alter the quality of the food to the stomach. I could easily eat 4,000 calories a day with my sleeve. How? Drinking Water with my meals would allow me to eat more at a sitting. I could eat chips, Cookies, (more) ice cream and other foods high in calories. How many calories are in some of those Starbuck's drinks? Huge.

A sleeve doesn't make you lose weight. It is a tool to help you feel restriction so you stop eating. If you bend the rules, it is not going to work.

Congratulations to you and your family members who have worked the sleeve, but I'm guessing your mother needs to track everything she puts in her mouth and, of course, exercise. Do you know what she is doing in that category?

[Paola 62]

I agree that to lose weight you need to create a deficit, and 3500 less is a pound. Taking into account that I am no doctor, this is just a suggestion, I would calculate her BMR, that is going to tell you how much calories her body needs a day, as you grow older you need less calories. Track what she eats in a food diary like myfitnesspal.com and if she is consuming less calories than her BMR then hypothetically she should lose weight. If she does exercise compare her net calories (food calories-exercise calories) to her BMR.

Example:

Food calories= 800

Exercise calories= 350

BMR= 1400

Net Calories= (800-350)=450

To make it simple, lets say this is what her calories intake looks like every day Monday- Friday (7 days)

All week calories is then 450*7= 3150

What the body needed those 7 days was 1400*7= 9800

All week deficit = 9800-3150 = 6650 calories

6650/3500= 1.9 lbs lost in 7 days

Like I said before, I am not a doctor, I am actually testing my theory this week. This is an estimate, and should give you an idea of how much she should lose in a week. Myfitnesspal.com tracks food calories, exercise calories and has a BMR calculator.

Hope this helps!

PS: Please don’t judge me for all those number, I can’t help it I like numbers

[Finally! 0]

Yes, I agree with all of the numbers - but I'm telling you - I know it SEEMS impossible - but that's not the issue with her. She's active and is consuming very few calories. I was just with her for a solid week and saw everything she ate. She's not sneaking in shakes or high-calorie foods or crazy amounts of carbs or anything. She eats Protein, drinks Water - everything.

She has kept track of her intake and it just doesn't make any sense. In the beginning I assumed that she was probably taking in too many calories or that her sleeve wasn't actually restricting her food intake or that she was grazing all the time.

She's NOT. Something else is amiss here. Does anyone else have any experience with this - beyond the basics of calories in, calories out?

[MegInNOLA 531]

I might respectfully suggest that your mother go to another doctor for a complete physical. If your mom is indeed operating at a calorie deficit, weight loss should be happening. Is she dropping sizes at all, or just nothing? I wouldn't panic, but I would suggest to her that she see another doctor, report all her information, and see what that doctor can help her discover. Low thyroid can, indeed, keep weight loss from occurring as quickly by slowing the body's metabolism (my doctor said my very underactive thyroid would have meant absolutely no weight loss with even bare minimum caloric intake, for example), but after a year, I believe I'd be looking for other answers.

Best wishes to y'all. A complete physical exam, plus knowing if she's losing sizes but not losing weight, would help in figuring out the mystery, I think.

[fern 195]

What about getting a hold of YOUR surgeon to see if he could give some suggestions? He might be willing to help....

[feedyoureye 3,087]

That must be so frustrating for her!

[Finally! 0]

What about getting a hold of YOUR surgeon to see if he could give some suggestions? He might be willing to help....

Fern, I did get in touch with him. Unfortunately, he's in Mexico and the steps he wants to start with (giving her an eating plan, checking on her sleeve size) are multi-step and would require a few visits. He's so great but I really would love to at least know what to start researching in terms of her condition.

I'm just trying to find some similar cases and see what they did.

Thanks for your reply!

[Finally! 0]

I might respectfully suggest that your mother go to another doctor for a complete physical. If your mom is indeed operating at a calorie deficit, weight loss should be happening. Is she dropping sizes at all, or just nothing? I wouldn't panic, but I would suggest to her that she see another doctor, report all her information, and see what that doctor can help her discover. Low thyroid can, indeed, keep weight loss from occurring as quickly by slowing the body's metabolism (my doctor said my very underactive thyroid would have meant absolutely no weight loss with even bare minimum caloric intake, for example), but after a year, I believe I'd be looking for other answers.

Best wishes to y'all. A complete physical exam, plus knowing if she's losing sizes but not losing weight, would help in figuring out the mystery, I think.

She isn't dropping sizes. She isn't gaining weight, which is good - but it's so frustrating to not be eating, to have had surgery, and to not be losing.

She has had a complete physical recently with her main physician and a full panel of blood tests. I'm hoping to find similar cases to see if I can figure out what is going on and then find a specialist who can help her.

[Foxbins 625]

Unfortunately, there is a failure rate with this surgery that has nothing to do with patient compliance. When I was reading some of the studies I seem to recall that about 5% of patients have little to no weight loss despite reporting diet and exercise regimens that would normally result in weight loss. Nobody seems to know why some patients have a good result and others don't but it's probably some unknown metabolic pathway. Did your mom ever lose her hunger? I ask only because it might be easier to ignore food if she's not hungry. Small comfort, I know...

[sasicas 194]

Is she taking in enough calories? I know MANY people who hit a point where they HAVE to eat more to lose weight, especially if they are active. My non-medical suggestion would be for her to up her calories with healthy items, add in more fat for a week or two and see how her body reacts. I know for me, at 9 months post op, if I take in more than I normally do, I almost always lose.

[longer-life 139]

Did she do a pre-op diet and lose weight? How about before that? Did she ever do Weight Watchers or any other program and lost weight?

[Finally! 0]

Unfortunately, there is a failure rate with this surgery that has nothing to do with patient compliance. When I was reading some of the studies I seem to recall that about 5% of patients have little to no weight loss despite reporting diet and exercise regimens that would normally result in weight loss. Nobody seems to know why some patients have a good result and others don't but it's probably some unknown metabolic pathway. Did your mom ever lose her hunger? I ask only because it might be easier to ignore food if she's not hungry. Small comfort, I know...

I am really concerned this may be the case. Do you happen to remember where you found those studies that reference the failure cases?

She doesn't really get hungry - about the same as me.

Thanks for the reply!

[Finally! 0]

Did she do a pre-op diet and lose weight? How about before that? Did she ever do Weight Watchers or any other program and lost weight?

She did do a brief pre-op diet and did drop some initial weight. She's lost about 20 pounds total - but that includes the pre-op diet. She has done Weight Watchers, etc (every diet on the planet) and has lost weight before - but hasn't lost more than 20-30 pounds in quite a few years. If she completely restricts all carbs, she lost weight in the past, but that's unsustainable.

I feel awful because I talked her into the sleeve - and even though I know that there's no way I could have known it wouldn't work, it makes me so sad to know how excited she was for the surgery and heartbroken that it just isn't working for her. It seems so bizarre. I can't imagine how you can NOT eat and still not lose weight.

[longer-life 139]

I would be heartbroken too. I hope she is also actively looking for answers and not just you though. Was her primary doctor out of ideas after the thyroid and blood panel come back. I wonder if a visit to an endocrinologist (or a phone call first) and a consultation with a bariatric surgeon that normally takes difficult cases would help. You might also want to read the studies Foxbins was referring to. Best of luck!