What is the real point of this surgery?

[powaqqatsi 12]

The more I research this, it seems that most weight lost is due to the extreme pre-op and post-op calorie-restricted diets. I have read many people on these forums talk about appetite coming back (I thought the ghrelin-producing cells were removed!), ability to eat large volumes of food still, and generally weight loss stalling or at least slowing to 1-2 pounds a week. I can lose 1-2 pounds a week just exercising and grinding a program like Weight Watchers.

I got interested in this procedure when I heard about the appetite reducing properties and thought that, coupled with the inability to eat large volumes of food, would help me not just lose my 100 pounds of extra weight, but KEEP it off. I see so many people talk about regaining half or nearly half of what they lost, or the hyper-vigilance needed to watch what you eat, not drink during meals, make sure enough Protein is ingested, and vitamins/minerals too.

It sounds to me like I'll have to be just as careful about watching what I eat and exercising as I would be if I lost weight the traditional way.

It's all got me wondering what is the point of the surgery? Is it just to lose part of it faster?

Is there something I'm missing here?

Hoping for guidance, and thank you!

[mi75 1,235]

you will find that most of the people here 'watched what i ate and exercised' so many times in our lives we lost count.

when i had joined weight watchers for the 29th time i finally got a clue that it wasn't working for me...

there is no secret to surgery, it is simply a TOOL to aid us. this tool DOES eliminate a majority of the grelin producing section of the stomach (it is also still produced in the brain) AND limits capacity.

My surgeon told me that right now my stomach at capacity is probably around 76-90 oz. full, it's the size of a football. post-op, my new filled tummy will be around 6 oz., the size of a smallish banana. obviously if it can only hold that small amount, i have less calories to both burn and utilize.

i am simply trying to put myself on a level playing field so that i have a chance to be in control.

[powaqqatsi 12]

You say you are trying to put yourself on a level playing field. That is exactly how I was thinking of the surgery when I first learned about it. But is seems like I've heard of so many people who end up the same...craving bad foods, eating too much. It's disheartening. I just don't want to go to the expense and possible risks of the surgery to end up where I am now, which is....food cravings, eating too much, being hypervigilent....

Trying to really understand what to expect, long term really.

[BladeFox 235]

For over eaters anonymous! HA!!!

[Kissifur 244]

Per my Nut it takes 3-4 months to develop a habit. So for me the point of the surgery is to take the next 6 months of restrictions to learn new habits. Granted I am only one week out but I have learned that I have more control of what I eat then I ever thought before. Just because I crave it doesn't mean I have to eat it. My hope and plan is to emerge from this as someone who can sample a decadence and not eat every drop until it is a distance memory. I love your question because it made me really think. Success for me is not to diet the rest of my life but to develop a healthy, normal relationship with food.< /p>

[pjpanda 129]

Honestly it depends on each individual person, and this surgery may not be for you. I'm still a "newbie" to this procedure only 3 weeks out but I can tell you this. For me, this is the only way I've been able to lose more then 10 lbs due to a very sluggish, practically dead metabolism. It's not some quick weight loss scheme, It is very much a lifestyle change and really only a tool to help you make the change to a healthier lifestyle. Do I still want bad food? Yes, however it's changed. My body no longer tolerates sweet stuff and I get full very fast but for me, this was one of the best decisions of my life.

[BMWSistah 31]

The real question is "How bad do you want your new life?" Some people want it bad enough to do whatever it takes to succeed. The surgery is a tool but we have to work the tool. They operate on your stomach but not your brain. One of my pre-surgery requirements was to see a psychiatrist for them to determine whether I'd be compliant, among other things. At my monthly weigh-ins I saw a nutritionist who gave me a list of things I'd do differently after surgery (e.g. eating and drinking at least 30 minutes apart, not drinking with straws.) My surgery was November 2013. I've lost 80 lbs. since them and have 30 lbs. to goal. I exercise 4-5 times a week, follow doctor's directions, take Vitamins, eat or drink until I'm satisfied. I don't count calories. You're right Ghrelin producing cells are removed. These people may be "head hungry"; eating when not physically hungry or continuing old habits. Consuming the correct amount of Protein, vitamins and Water became easy after the first week. I can say this is the best thing I've ever done for myself. I never want to endanger my health again, go back to feeling and looking the way I did or have wasted my time or the insurance company's money.

[familyguy 147]

Powaqqatsi,

This is a great topic. You primary point -- that these surgeries are NOT a panacea or magic wand of weight loss is totally correct. If you can lose weight on your own and keep it off, then I wouldn't consider this surgery. For me, I just couldn't and wanted to extra help.

You can still gain weight by eating the wrong foods, not exercising, etc. I'm six months post opp and sugar drinks, alcohol, Cookies, ice cream, and chips basically go down just as easily post surgery as they did pre surgery for me. So, if those are your big weaknesses, then I'd tell you it's not going to help. Fortunately, for me, those weren't my problem. My thing was that I ate way too much and had a ridiculous appetite all the time and this surgery does help tremendously for that. For example, in the past, I'd eat a large rack of baby back ribs with fries and slaw and then wonder about desert. Now, I eat 2 or 3 ribs (no fries, no slaw) and feel completely stuffed and satisfied. That kind of help has allowed me to get back to my high school weight and has been totally life changing.

Anyhow, going in "eyes wide open" is super smart. Loosing a bunch of weight can make folks feel exuberant about their decision and your right to set expectations properly.

[fuzzymonkey 38]

According to my Dr. 2/3 of Grehlin is in the stomach ( which is removed with surgery) and the other 1/3 is is the bowel with this surgery there is less chance of failure as complied to the band ( which at some point they won't even offer that as an option) and RNY has a higher risk of stretching out the stomach and as far as I know the RNY does not remove the hormone.

[Jenny L 45]

At the end of the day, you are still the SAME PERSON. I am the same person that got morbidly obese, and so is everybody else here. We've all had inappropriate/unhealthy relationships with food. If we only ate when truly hungry, nobody would need theses extreme interventions! And after surgery and recovery, that same person is still inside you. You still have to face your overeating triggers like stress, depression, etc. and cravings, too. Just because my tummy got tiny, chocolate did not become less delicious. Just because I got the sleeve, exercise didn't become something I don't rolls eyes about. It's a tool, and you still have to put in work. Otherwise youre not ready for this so don't waste your time.

I'm sorry if I sound bitchy, but this is the cold truth.

[playlikeworldchamps 595]

The ghrelin is reduced but not eliminated. Most people will not feel hunger at all for 1-2 months post surgery or even longer. But hunger will come back. However unlike losing significant weight without surgery the ghrelin won't increase back to higher than pre diet values. That's one of the main reasons people gain the weight back when doing a weight watchers type diet. Because the gherkin goes higher than it was before you dieted. Your body is fighting you to gain it back. With surgery ghrelin is much more stable and you have a fighting chance. You can go ogle ghrelin levels for the sleeve or bypass and find a lot of studies on this.

Another stat is that without surgery if you are vigilant you have about a 3-5% chance to keep significant weight off.

With surgery and if you are vigilant I believe you have a 80% chance to keep the weight off. I like those odds better.

Also you use the honeymoon period to build the habits you will need for a lifetime. Sure I could eat every 30 minutes and gain my weight back. But i spent 8-9 months during the easier phase building good habits that are now embedded. I also learned what worked and what did not. Now I also exercise to get off the rest of my weight.

This is a disease that needs constant vigilance. The difference is that now I have a fighting chance. I did not want to lose 100 lbs and gain it back again. The thought was just too depressing. When I had cancer I went all out and chose chemo and the most treatment I could. I wanted to do the same for this disease too. Obesity also kills. It just takes longer.

[beeteroo 166]

At the end of the day, you are still the SAME PERSON. I am the same person that got morbidly obese, and so is everybody else here. We've all had inappropriate/unhealthy relationships with food. If we only ate when truly hungry, nobody would need theses extreme interventions! And after surgery and recovery, that same person is still inside you. You still have to face your overeating triggers like stress, depression, etc. and cravings, too. Just because my tummy got tiny, chocolate did not become less delicious. Just because I got the sleeve, exercise didn't become something I don't rolls eyes about. It's a tool, and you still have to put in work. Otherwise youre not ready for this so don't waste your time. I'm sorry if I sound bitchy, but this is the cold truth.

I don't think you sound bitchy! It's exactly correct! I had the surgery because I've spent the past 30 years as an over weight or morbidly obese person. I've tried so many diets and exercise plans. Nothing worked long term. I'm done being obese. The sleeve is a tool only. I still want chocolate cake and donuts but not enough to eat it often. I think my physical cravings have diminished but my head hunger has continued. I'm still the same person! I love food!

[powaqqatsi 12]

To Jenny above,

You don't sound bitchy. I was actually scared to ask this question in the first place, thinking I might offend someone. But the honest truth is that I'm torn over whether to do this or not. I am terribly addicted to food and thought this surgery would be the answer. Now I'm not so sure. You say that after surgery, you are the same person inside who must still face triggers. Then my question is, if those addictions must be managed and triggers avoided after surgery, why not just face them INSTEAD of surgery, and lose the weight a little more slowly?

I'm so very happy for all of you who, for perhaps the first time ever, have finally achieved meaningful weight loss. I hope to achieve it too. I've had ups and downs with my weight since I was little and I gained all of my 100 pounds of excess weight in 4 years of graduate school. Well, 3 kids later, and I still haven't faced down this weight and won. I'm really feeling desperate, but just don't want to do something drastic, just because "everyone's doing it" and the happy shiny people on the TV commercials make it seem so great.

I want something that will be a tool for a lifetime, not just for a few months to a year. I wish I could post this same question in the veteran's forum, but it won't let me. I would love to hear from people who are 5 or more years out. The trouble is, because of human nature, I may not hear from many people for whom this hasn't worked that great for that far out.

Thank you all for your input and again, I am very happy for you and wish you continued success.

[McButterpants 2,846]

I'll be honest - I had similar thoughts pre-surgery. And, I failed at so many diets that I wondered "will I fail at this, too?"

First, I wasn't prepared for the emotional / mental part of this process. I read and researched so much about the physical part - how the surgery is performed. I didn't think much about the reasons I got to 256 pounds - I didn't think about my binge eating, my eating in secret, emotional eating, etc. I wish I had been more mentally/emotionally prepared - it would have made things easier in the beginning. Instead, I had to address my emotional issues while I was learning how to eat with my new tiny tummy.

Second, the sleeve doesn't stop you from making bad decisions. I have a sleeve of steel...The only thing that bothers my stomach to the point of getting sick is my bariatric Vitamins. I haven't found a food that my stomach doesn't like. That's a double edged sword. I can eat anything - that's not necessarily a good thing for an overeater. So, I have to CHOOSE to make good food decisions. I can eat ice cream before I go to bed...I have to choose not to do that. I can eat a bag of tortilla chips because that's a slider food for me - I have to choose to not have them in my house. The sleeve will only stop you from eating copious amounts of food in one sitting. It doesn't stop you from going back to the bag of chips 30 minutes later when you can fit more into your sleeve. The sleeve is simply one tool in your tool box.

Thirdly, the sleeve doesn't drive you to the gym or make you put on your tennis shoes to go for a walk. That's you. You are responsible for that.

As far as being able to lose 2-3 pounds a week - you're right. I could lose 2-3 pounds per week up to about 20-30 pounds. Then the weight loss would stop and I'd fall off the wagon. What you're doing on the pre-op diet and immediately after surgery isn't sustainable for the long-term. My husband said it best right before surgery...."This is going to force your hand." It has. My weight loss at 7 months out is moving at a snail's pace...I log 80-100 miles in a month at the gym and I focus on getting my Protein in. I get discouraged because I'm not losing at the same rate I was 5 months ago, but I'm still fighting the good fight - and you know what? It's easier to fight knowing I have this tool in my tool box.

[JeanZ_RN 378]

McButterpants says it very well, especially this: "The sleeve will only stop you from eating copious amounts of food in one sitting. It doesn't stop you from going back to the bag of chips 30 minutes later when you can fit more into your sleeve. The sleeve is simply one tool in your tool box.."

Here's my added 2 cents...

I was very fortunate in that I was not hungry at all for 2-3 months post op. I ate because I knew I should. When my hunger returned it wasn't as intense as before, and by then I had established my new eating habits which helped a LOT. Now I eat every 4 hours (8a, 12n, 4p and 8p), and I keep my carb intake as low as humanly possible. Both factors contribute to my never being hungry for very long at a time.

What keeps me on track when I could never stick to a diet before:

1. The feeling of satisfaction / fullness after each meal, plus the decreased hunger, is the main thing that makes it possible for me to stick to the plan. I do get head hunger sometimes, and when I can't ignore it I have a SF popsicle or some SF Crystal Light. If those don't work and I indulge in a cookie, I can now stop with one - which I could never do before.
2. I've lost a significant amount of weight doing this, so I KNOW it works. I've been able to stick to the plan for 7 months now, which is way longer than diets I tried before surgery.
3. I will be da**ed if I'm going to throw away the $12,500 I paid out of my pocket to have this done, not to mention all the work I've done (and the goodies I've resisted eating) to get to this point. Sometimes I just repeat to myself, as many times as necessary "I'm not going to eat that. Not gonna do it. There will be goodies available when I'm at my goal." And I walk away from the temptation.
4. The support available on this site and on the Facebook group I belong to is PHENOMINAL. It helps SO much, especially at those times when family/friends would probably beat me to death if I mention one more thing about the trials and tribulations -- or the NSVs -- related to being sleeved.

Hope that helps. Best wishes.