Understanding the phrase "honeymoon period"

[clk 3,519]

As it pertains to the sleeve, there really isn't one. I'm seeing some posts here that say things like, "I really need to make the first six months count because my surgeon told me loss slows after that," or "My surgeon told me I won't lose after a year and will be in maintenance at that point."

This causes a panic and pressures patients to lose the weight as quickly as possible. It also causes a lot of people to feel frustrated or like they've made a poor decision with the sleeve if they aren't dropping five pounds a week!

With every WLS the patient is going to lose the most weight in the first few months post op. It's purely logical. We go from eating far too many calories a day to eating almost nothing. We go weeks on a liquid diet. Even once we're on solid food, our capacity is so limited that it's laughable. In addition, almost everyone is diligent about diet and exercise at first. OF COURSE we see rapid results when we're in this stage!

Many people see a slower loss from months six onward. OF COURSE they do. It doesn't mean the sleeve has stopped working and we need to panic because we're not at goal yet. It means that we're closer to goal and our bodies are losing at a slower pace. It's also our bodies compensating and adjusting because we lost so much in the earlier phase of life post op.

Does loss slow from one year onward? OF COURSE it does! At one year out most people are close to or more than one hundred pounds lighter. We have less weight to lose, and yes, once we're at that point it does come off more slowly. If you're a lightweight and had less than 100 pounds to lose, expect this slowing sooner. Again, the closer you are to goal, the harder to get those final pounds off.

That does not mean the sleeve works any differently. In fact, it's the same from day one. The sleeve is restrictive and that's what it does: it restricts the quantity of food you can eat in a sitting. It does NOT cause malabsorption which is going to speed up your weight loss. I've seen the study that was posted about dumping with the sleeve, but even that is not going to majorly affect your loss pattern. Your sleeve does not stretch like a bypass pouch, either. Your capacity will vary, but in my case, at about nine months post op I was double what I could fit at first with solids, and at around two years that doubled again. Sounds scary...until you realize that I'm talking about fitting in roughly 6-12 ounces of food at a time, depending on what I'm eating. That's FAR less than a pre-op stomach.

So this idea of a "honeymoon" is misleading.

In some respects, yes, there is an easier period of loss. But this is not due to the sleeve working more effectively. Our bodies do not look at a calendar and say, "Oh, wow, we're closing in on one year post op and so let's just transition to maintenance and stop losing now." It simply doesn't work that way.

Your sleeve will work as long as you work your sleeve. When you give up and slide into maintenance or worse, into bad habits, is when you'll see the loss stop. Outside of your body's own limits on loss, there is nothing stopping anyone from achieving goal at any point post op.

I just wanted to post this because we really do see a lot of questions about this and a lot of panicked posts because people aren't losing as rapidly as they want. We put on the weight over the course of many years - we cannot expect it to fall off in less than one year. Some people will fly to goal in a short period of time, but they are the lucky minority. The rest of us need to work at it and it's a longer process than a few short months.

Good luck!

~Cheri

[Diamondeyed 399]

Thanks

[NurseGrace 509]

I don't even really seem to be experiencing this "honeymoon period" because honestly, besides the huge drop right before sugery that was basically induced by more or less fasting, I am now about two weeks out and am losing at a rate of about 3-6 pounds a week. Now I do realize that being only two weeks out its a little soon to start declaring that I am losing "too slowly" or whatever and frankly, I am not overly concerned. If it dropped below 2 pounds a week I would be a little concerned that my math was bad or something but I think people buy into these grandiose picture perfect success stories of people losing 30 pounds a month for 6 months or whatever and BAM! they are cured of their weight problems FOR-EV-ER.

That's just NOT how it happens for most people, but I think its what people secretly wish for. I understand it I suppose but here is what I know from my medical training - you can only metabolize so much fat per week, you did not a medically significant amount of weight every single month of your life and you are not going to lose it like that more than likely unless you are some kind of rule-following superstar.

I am constantly telling myself and reminding myself that my expectations need to be in line with reality. I don't need to be frantic about my weight loss, what I need is to be focused. Every choice needs to be deliberate, not frantic. The two things are very different and produce vastly different results.

[NurseGrace 509]

But all of that being said in my previous comment, I think they tell people that to get their asses into gear. I think what they are trying to do is create a sort of "now or never" mentality in hopes that it will shock people into action. Because I do think that if you cannot make some significant headway while the surgery is still fresh and new, the thinking is that you never will.

If your stalling at 4 months out, throwing the rules to the wind and frequenting the local fast food joints and have not made any significant headway or have completely hit the brakes on weight loss, chances are you probably will never get with the program again. Its a sad but true assessment of bariatric patients. Of course that does not apply to everyone and its obviously a generalizations but where there is smoke there is fire and there is a reason why its a general assumption.... GENERALLY it's true.

[clk 3,519]

I don't even really seem to be experiencing this "honeymoon period" because honestly, besides the huge drop right before sugery that was basically induced by more or less fasting, I am now about two weeks out and am losing at a rate of about 3-6 pounds a week.

Lady, I am WITH you on this. I had a big loss exactly TWO months out of the seventeen it took me to get to goal. I never experienced the "honeymoon" either. But I did lose more in the first six months and it slowed down again after one year.

And I completely agree with aligning expectations with reality. We all read it and we've all heard it and it's a completely tired line but the sleeve is NOT A MAGIC WAND. It's a tool, and one we have to utilize properly for long term maintenance.

I'd also add that I think the idea of a honeymoon period is bad for some people because they'll pretty much lose weight no matter how awful their food choices immediately post op. They then think that they can eat whatever they like, just in smaller portions, and get to goal (and stay there for-ev-er) but they inevitably wind up horribly disappointed when their stomachs heal and they find that they can still graze an entire bag of Oreos in a day and they aren't going to lose weight doing it!

In any case, I think the more people stumble across this PRIOR to surgery the better.

~Cheri

[NurseGrace 509]

In any case, I think the more people stumble across this PRIOR to surgery the better.

~Cheri

YEP I am knew with the sleeve but unfortunately not to weight loss surgery as a whole. I was one that had a lapband thinking it was going to help me a hell of a lot more than it really did so none of this is new, and I'm also older now and have seen some **** lol.

I wish people slowed down a little more and considered this. I wonder how many people would still have the sleeve if they knew that they might not be losing any more than say 3 pounds a week? I bet it would be a lot less, but even then, my doctor tells me that is what I should expect and anything more than that is gravy. Expectations are too high and people underestimate how much they will give up for those three pounds.

[deedeemuffin 346]

Cheri,

Thanks for posting this. What you said makes perfect sense. I think what makes it hard sometimes is that more people post about their successes than their struggling. OF COURSE! Honestly, though, people who drop like 150 or 200 lbs in a year (or if they have less to lose and made goal in 6 months) their posts get a lot of attention. They keep getting bumped up to the top because people look at & respond to those posts. I'm bot saying that we shouldn't recognize accomplishments like that, but we should give equal time to those people who are "normal" or "slow" losers. Yes, I will continue to post good or bad, but I have decided to change my mind set. I will not be perfect all the time. I know that I will have genuine stalls. I refuse to compare myself to others, though. This is my body & it is not going to work exactly the same as someone else. I will stay on my program & the weight will follow.

[Teddy bear 42]

As it pertains to the sleeve, there really isn't one. I'm seeing some posts here that say things like, "I really need to make the first six months count because my surgeon told me loss slows after that," or "My surgeon told me I won't lose after a year and will be in maintenance at that point."

This causes a panic and pressures patients to lose the weight as quickly as possible. It also causes a lot of people to feel frustrated or like they've made a poor decision with the sleeve if they aren't dropping five pounds a week!

With every WLS the patient is going to lose the most weight in the first few months post op. It's purely logical. We go from eating far too many calories a day to eating almost nothing. We go weeks on a liquid diet. Even once we're on solid food, our capacity is so limited that it's laughable. In addition, almost everyone is diligent about diet and exercise at first. OF COURSE we see rapid results when we're in this stage!

Many people see a slower loss from months six onward. OF COURSE they do. It doesn't mean the sleeve has stopped working and we need to panic because we're not at goal yet. It means that we're closer to goal and our bodies are losing at a slower pace. It's also our bodies compensating and adjusting because we lost so much in the earlier phase of life post op.

Does loss slow from one year onward? OF COURSE it does! At one year out most people are close to or more than one hundred pounds lighter. We have less weight to lose, and yes, once we're at that point it does come off more slowly. If you're a lightweight and had less than 100 pounds to lose, expect this slowing sooner. Again, the closer you are to goal, the harder to get those final pounds off.

That does not mean the sleeve works any differently. In fact, it's the same from day one. The sleeve is restrictive and that's what it does: it restricts the quantity of food you can eat in a sitting. It does NOT cause malabsorption which is going to speed up your weight loss. I've seen the study that was posted about dumping with the sleeve, but even that is not going to majorly affect your loss pattern. Your sleeve does not stretch like a bypass pouch, either. Your capacity will vary, but in my case, at about nine months post op I was double what I could fit at first with solids, and at around two years that doubled again. Sounds scary...until you realize that I'm talking about fitting in roughly 6-12 ounces of food at a time, depending on what I'm eating. That's FAR less than a pre-op stomach.

So this idea of a "honeymoon" is misleading.

In some respects, yes, there is an easier period of loss. But this is not due to the sleeve working more effectively. Our bodies do not look at a calendar and say, "Oh, wow, we're closing in on one year post op and so let's just transition to maintenance and stop losing now." It simply doesn't work that way.

Your sleeve will work as long as you work your sleeve. When you give up and slide into maintenance or worse, into bad habits, is when you'll see the loss stop. Outside of your body's own limits on loss, there is nothing stopping anyone from achieving goal at any point post op.

I just wanted to post this because we really do see a lot of questions about this and a lot of panicked posts because people aren't losing as rapidly as they want. We put on the weight over the course of many years - we cannot expect it to fall off in less than one year. Some people will fly to goal in a short period of time, but they are the lucky minority. The rest of us need to work at it and it's a longer process than a few short months.

Good luck!

~Cheri

thank u Cheri..... this is relieving

[Butterthebean 8,146]

...... They then think that they can eat whatever they like, just in smaller portions, and get to goal (and stay there for-ev-er) but they inevitably wind up horribly disappointed when their stomachs heal and they find that they can still graze an entire bag of Oreos in a day and they aren't going to lose weight doing it!

In any case, I think the more people stumble across this PRIOR to surgery the better.

~Cheri

Ha....I remember when I first came here, I read a post by PDXman that said something to the affect of ...."you can't eat Taco Bell every day after surgery and expect the sleeve to limit your portions and still lose weight"....and I thought...YOU CAN'T??? I was hoping it worked that way. I was so naive. So once I did more reading, I found post after post of people not making it to goal, or not losing weight, or gaining weight..and many of them had a common theme....eating crap on a regular basis. I made up my mind that I was going to learn a healthier way to eat so that when my capacity increases (as it has) I would be eating the right things. I guess it's working cause I've lost a little weight. Best of all, I've found that there is a happy medium. I'm not eating twinkies and big macs, but I am eating in a way that I can sustain indefinitely. I am not depriving myself, so I am not going to break down and binge.

[Lorraine Freeman 47]

Totally agree with you Cheri, I lost 16 pounds in the first 2 weeks and thought I would lose the weight at the same pace no probs (duh) The reality is I lose 3 pounds a week now (3 months out) After reasons lots of your posts Cheri, I have come to accept this weight loss every week and actually be content with it. So I would like to thank those that take time to post threads like these, which give people the confidence and realisation that this ox totally normal and that they will still get there if they follow plan. Xxx

[MichiganChic 3,262]

Great topic. I agree with clk, and I think there is a lot at play with the honeymoon period, the least of which is statistics. My doc presents stats that show a 25% loss of excess weight at 1 month. However, this includes his RNY patients, and I believe they are rolling pre-op losses into that number too. And again, the STATISTIC is showing an average, not necessarily a median or even a mode. The average is all the percentages divided by the number of people, as opposed to a mode, which would be the percentage most people acheive by a certain time frame. Cheri's point about losing faster with more to lose directly influences this, as well.

I also wonder if physicians/offices are used to the first 6 months being critical with RNY, and just transfer that teaching accross the board. I spoke to my NUT last week, and she said most people consume 400-800 calories the first 6 months, and then 800-1000 after 6 months, then around 1200 for maintenace. So, that would also contribute to the statistical rates of loss, and slowing down at 6 months.

I do think there is value in the honeymoon period, though. Not in believing you are failing if you don't meet those statistics, but in using it to establish better habits. Its the time to evaluate how we eat and exercise, and see a direct correlation between that and the scale. Having a realistic expectation is paramount to success. I track my calories and exercise, and as little as I'm eating, my fitbit dashboard shows my weekly deficit, and guess what? It shows about a caloric deficit that translates into about 3 pounds per week - pretty spot on at this point. As I lose more weight, that number will naturally decrease because I'll have less to lose and my basic caloric requirements will decrease.

The thing I love about the sleeve is that it gives my will power the support it needed. I always had it, but had physiologic things working against me, such as increased capacity and hunger. Now that those things are gone, I can optimize MY influence on my body. Also, the restriction reminds me every day that I can't just give up like I used to....and that I don't want to.

[MichiganChic 3,262]

I think people buy into these grandiose picture perfect success stories of people losing 30 pounds a month for 6 months or whatever and BAM! they are cured of their weight problems FOR-EV-ER.

That's just NOT how it happens for most people, but I think its what people secretly wish for.

I'm not secretly wishing for it, I am wishing for it right out loud, lol!! But I think "graniose" was the key word here

[Fallenangel2904 494]

This is a great thread! Thanks Cheri!!