Surgeon says I should only focus on losing 50-70% of excess weight -Boo!

[Omieliz 213]

I was sleeved on 08/31/16, and have had a relatively smooth recovery. A few bouts of Constipation and fear that there wasn't enough of my stomach removed since I have not felt any restriction, but nonetheless, an uneventful time. I had my follow up appointment with my surgeon on Friday and he said a couple of things (which I now have in writing), that really bothered me.

First, when I told him that I did not feel any restriction, he told me that "the staple line affects about 2/3 of the stomach and the remaining "untouched" part of the stomach, is about the size of a fist. 5-6 cm wide. In every single patient. Every time." Really? I never learned this in my Options class, in my Bariatric Support meetings, or just in general doing the research I did before having the surgery. I originally wanted the RNY, but because I have a huge hernia, my surgeon said the risks outweighed the benefits and he would only do the sleeve. I really have no complaints about the sleeve - I've already lost 36 pounds which is pretty significant, but I'm scared that I don't feel a restriction. I'm weighing and measuring all my food to ensure I don't over eat, but it's still a concern I have. I didn't get severely morbidly obese overnight, and I didn't take this surgery lightly. I'm so scared that when my hunger finally comes back, the lack of restriction is going to make it easy to overeat. I never want to overeat again.

Second, I asked him what his goal weight is for me since it's something that was never discussed. He told me that he will be satisfied if I lose 50-70% of my excess body weight. He said that anything more than that is a "bonus." I told him that I wanted to lose 100% of my excess body weight and get to a normal BMI (50-70% doesn't even get me close to it). His excact words are, "Losing 100% of your excess body weight is unrealistic and not a healthy goal, mentally."

I feel rather discouraged right now. I am very greatul that I had the surgery and for the ease of my healing, but I'm concerned now that I went into this with unrealistic expectations. I feel no restriction, apparently 1/3 of my stomach remains untouched, and apparently, a goal of losing 100% of my excess weight is unrealistic...Booo!!!!!!

[KristenLe 5,979]

@@Omieliz I think you have unrealistic expectations to some extent but it doesn't mean you can't lose more than 50-70% of your excess weight. Your surgeon is going to tell you the norm - some lose less - some lose more! I would love to lose 100% of my excess weight but I'm not setting myself up to be disappointed. I have realistic goals and if I can surpass them - bonus! He's not going to set you up to feel like a failure. Try not looking that far ahead - have smaller goals leading up to a bigger goal. You have done great so far - just keep it up! Measure your food - Protein first and avoid foods like Pasta, bread, rice, cake, Cookies, crackers, etc. You are the one in control!

[SilentBotts 138]

I don't feel 100% excess is unrealistic, though it's certainly going to be a challenge. My goal 220 and my surgeon actually thinks I can probably push it a little.

50-70% excess weight is pretty much what you are going to loose during the first six months to a year after surgery without doing much else. Building better habits and relationships with food and exercise get you the rest of the way.

Just go into it with the understand that as that initial honeymoon perioid weight loss starts to slow down it will become more challenging to loose and you wont loose as quickly, but as long as you maintain good behaviors as far as food and exercise you should have a good shot of getting well past that 50-70%. Stalls are also normal, and you may have change things up from time to time, the important thing is to not get frustrated and slip back into old bad habits.

[theantichick 2,204]

I agree that 100% EBW is unrealistic for most people.

I am 5'9". Apparently, I'm supposed to weigh about 160lbs. I started out at just over 300, which makes my EBW 140 lbs.

I can look back to my late teen/early 20's which was the last time I weighed in that range. I was able to maintain 165 with a teenager's metabolism ONLY by watching EVERY calorie I put in my mouth and running about 2 miles 3-5 times a week.

I'm 46 now, with an auto-immune disorder that makes exercise difficult, and I have to ramp up exercise VERY carefully to avoid a flare. I personally think it would be crazy to try for 165 as a goal weight.

In my mid-20's I was ranging between 175 and 190 and felt really good. I was active and watched my diet but not obsessively. It would be amazing, and my ultimate goal to get back in that range, so I've set 185 as my goal weight. That's 121 to lose, a bit over 85% EBW.

I don't know if it will happen, and if it does if it'll happen in this first year. The statistics say it won't, but statistics don't tell the whole story. So far, I'm doing really well. 46 lbs down at a little over 7 weeks, and weight loss has slowed to about 2 lbs/week. If that rate stays constant, it'll be about 38 weeks to lose the rest.

But even if I stall out permanently at 236 which is 50% EBW, I'll be thrilled. I don't want to set my goal there, because I want to try and stretch for the 185 if I can.

I think having stretch goals is a good thing, and my doc hasn't been discouraging at all when I've discussed it with her. She thinks I can get below 200 at least which will be about 75% EBW.

Every 10% of your total body weight you lose (at least down to the ideal weight) improves your health drastically. I consider every bit lost movement in the right direction and toward my health.

I will say I don't understand the "1/3 untouched" part of your doc's statement, doesn't jibe with what I know of the surgery. Some people have more restriction up front, others less. Doesn't mean the sleeve isn't working for you. Just stay the course, you'll do fine.

Edited October 11, 2016 by theantichick

[LipstickLady 25,682]

There is no reason you can't lose 100% of your excess weight. It may be a challenge, but MANY people do it. Now, I will say that shooting for a "normal" BMI could be BS because the BMI chart is ridiculous. MANY athletes are categorized as "obese" simply because of their height/weight. BMI does not take body fat into account at all, which is ridiculous.

There is no reason to expect that you will only lose 50% of your excess weight either.

YOU WILL DO WHAT YOU WORK FOR. YOUR ACHIEVEMENTS WILL DIRECTLY EQUAL YOUR EFFORTS.

That's really the bottom line.

[Rosey posey 176]

And so the latest from the my Posey patch.< /p>

Edited October 11, 2016 by Rosey posey

[rolosmom7 740]

I agree that 100% EBW is unrealistic for most people.

I am 5'9". Apparently, I'm supposed to weigh about 160lbs. I started out at just over 300, which makes my EBW 140 lbs.

I can look back to my late teen/early 20's which was the last time I weighed in that range. I was able to maintain 165 with a teenager's metabolism ONLY by watching EVERY calorie I put in my mouth and running about 2 miles 3-5 times a week.

I'm 46 now, with an auto-immune disorder that makes exercise difficult, and I have to ramp up exercise VERY carefully to avoid a flare. I personally think it would be crazy to try for 165 as a goal weight.

In my mid-20's I was ranging between 175 and 190 and felt really good. I was active and watched my diet but not obsessively. It would be amazing, and my ultimate goal to get back in that range, so I've set 185 as my goal weight. That's 121 to lose, a bit over 85% EBW.

I don't know if it will happen, and if it does if it'll happen in this first year. The statistics say it won't, but statistics don't tell the whole story. So far, I'm doing really well. 46 lbs down at a little over 7 weeks, and weight loss has slowed to about 2 lbs/week. If that rate stays constant, it'll be about 38 weeks to lose the rest.

But even if I stall out permanently at 236 which is 50% EBW, I'll be thrilled. I don't want to set my goal there, because I want to try and stretch for the 185 if I can.

I think having stretch goals is a good thing, and my doc hasn't been discouraging at all when I've discussed it with her. She thinks I can get below 200 at least which will be about 75% EBW.

Every 10% of your total body weight you lose (at least down to the ideal weight) improves your health drastically. I consider every bit lost movement in the right direction and toward my health.

I will say I don't understand the "1/3 untouched" part of your doc's statement, doesn't jibe with what I know of the surgery. Some people have more restriction up front, others less. Doesn't mean the sleeve isn't working for you. Just stay the course, you'll do fine.

I am also tall - 5'10. When I think of times I was a happy, fit weight it was 185-190. I feel like the BMI calculation gets off the taller you are. I cannot imagine weighing 140. 180 is my stretch goal. But that's still "overweight" which I find odd. Do any other tall people (females) feel this way?

[LipstickLady 25,682]

I'm short and athletic. I should weigh 140. At 155, I am at a very low body fat and while I would love to be 149, 135 would be weird for my build. No, I am NOT "big boned" but I am strong. I refuse to lose muscle for a BMI scale that does not take muscle and body fat in account.

Instead of looking at BMI, consider your pants size. It's much more reflective.

[Omieliz 213]

I'm 5'2. 130 pounds is what I would like to weigh. I haven't weighed 130 pounds since the late 90s. I wasn't skinny by any means - just healthy and fit.

Thank you for all of your advice, I really do appreciate it!

Sent from my iPhone using the BariatricPal App

[OutsideMatchInside 10,166]

@@Omieliz

I think your Dr is right about the 50-70% being a better goal, at least at first. Just because once people have been morbidly obese for so long they have more muscle mass, so they are going weigh more.

I weigh more than I did in college, but I am smaller than I was in college, because I have a lot of muscle mass. I am smaller than I was in HS, but I weight a good 20-30 pounds more, but I am physically smaller.

I have exceed my 60% excess weight loss in a year (the amount for a sleever, bypass is 70%, band is 50%), that amount was 143 pounds. Now I am working towards my goal of 85-88%. I am at 72% right now, which is 156 pounds.

When you look the pounds beyond just percentages, it makes more sense.

If I lost 143 pounds and never lost another pound, no one would consider me a failure. I'm at 72% which is 156 pounds lost, no one would consider that a failure. Yeah I guess 215 pounds lost would be awesome to lose all of my excess weight, but the 86% I want to lose puts me are 185 pounds lost. No one is going to consider 185 pounds loss a failure either.

So honestly once you get past a certain amount in excess, getting to 100% is just gravy. All of my health issues are solved. Other issues I didn't even know I had are solved. I don't even want to hit 100%, but I might just accidentally slowly over time just because of how I eat and live. If you really make a lifestyle change, you can easily lose all the weight you want.

Edited October 12, 2016 by OutsideMatchInside

[Thucydides 250]

The first surgeon that I met flat out told me that I would "never be normal." That kind of irritated me, but pushed me to think differently about my goals.

I know it sounds crazy, but over time my goal became less and less connected to how much weight I lost. Instead, my daily goal was to just stick with my exercise and food plan. Beyond that, my only other goal was to be able to be more active and to be able to buy clothes off of the rack. By just following that, the weight loss came on its own but I wasn't obsessed with my weekly weigh-ins or my total weight loss. That helped me avoid being frustrated if I lost too little weight in an individual week or avoid getting overconfident if I lost a lot of weight during a week. At 11 months out, I am happy that I am down 257 lbs, but more happy at how different I feel, move, and act.

[higher 966]

My surgeon told me he thought I would get to the 140s, which is still overweight BMI for my height. I told him I was in the 120s in college and would love to be back there and he said "if you really stick to it and work hard, you can get there!"

But in the 140s I would still be a success. And honestly, I'm in the upper 160s now and I feel ten trillion times better that it's all gravy from here. I know I will keep losing and just feel better and better no matter where I end up.

[LipstickLady 25,682]

Y'all focus on 50-70% if you care to. I'm an overachiever so no one will ever limit me BUT me.

[reree6898 1,164]

At my one year check up a few weeks ago I had lost 71% of my excess weight. I'm not planning on stopping till I hit my goal of getting to 140-145 pound range. I had the sleeve so my doctor already counts me as a success.

[higher 966]

I'm only 3 months out and already at 55% so I'll keep working it.