How can you be successful long-term with WLS if you’ve always failed

[meggs353 118]

I’ve read over and over again that WLS is not a magic bullet. It takes dedicated, sustained lifestyle changes. But, if we can’t maintain those changes (eliminate carbs, low calorie diet, avoid trigger foods) before surgery, how can we expect to maintain them after surgery? I’m thinking long term here: 5, 10, 15 years after surgery when the magic of weight loss is gone and it’s just daily life. If I can’t stop eating now, how could I expect that to change in 10 years?

Really looking for help here. I had lap band surgery in 2014 and I weigh 15lbs more than my highest pre-surgery weight. I gained back all weight I lost and more, and have the same bad habits.

I’m thinking of revising to gastric bypass, but I’m wondering if I’ll just fail again.

BUT, if I can theoretically make a sustained life-style change post-surgery, why can’t I actually just do that now? (I try, every single day, and I fail week after week).

I feel like it’s possible or impossible. If surgery doesn’t make it easy, what benefit does it have beyond short term (1-3 year) weight loss?

[NovaLuna 710]

I think everyone is different. I had no issues giving up carbs or eating healthier, as long as I get results it keeps me on track. But everyone is different. I have a co-workers who had WLS and are strict about their diet years out and the results speak for themselves. I have co-workers who had WLS who aren't as strict, but don't have terrible habits, just the occasional 'bad' habit that still have good to decent results. Then I have co-workers who are years out and have gained back half their weight AT LEAST because they've gone back to their bad habits. (My place of employment has over 250 employees and weight loss surgery is fairly common there... I can think of more than a dozen people off the top of my head who've had it...). Personally, if you know that you have food addictions, then you should DEFINITELY see a psyche doctor regularly and they can help you work through it. I know if I start to struggle, I won't hesitate to make an appointment for myself if I feel I need it.

[catwoman7 11,215]

you do have to change your eating habits. If you don't, you'll be right back where you started. As everyone says, WLS is just a tool. I think of it as a strong tail wind to get you where you want to go - BUT....you have to change your eating habits, or you're either not going to get there - or you'll end up gaining it back.

My RNY still helps to control my eating to some extent. When my husband and I used to go out for pizza, we'd order a large and each eat half of it. I physically could not do that anymore because of the restriction. I can manage about two pieces. BUT....that's at one sitting. There's nothing stopping me from eating two pieces then...and then another two pieces an hour or two later.....and then another two pieces an hour or two after that. So I could definitely eat the same amount as I did before - only not at one sitting.

you theoretically could lose all that weight and keep it off if you just changed your eating habits and didn't have the WLS as an aide, but supposedly fewer than 5% of people are able do that. Your chances are much higher (although certainly not 100%) with the restriction from WLS.

the first year you have some strong advantages - hunger goes away for a few months for a majority of us, RNY people have the malabsorption component, your stomach is much smaller than it will ultimately be due to the swelling from the surgery, metabolism, supposedly, is "reset" - but after the first year or so, a lot of that goes away and what the surgery mainly seems to do is just control how much food you eat at one sitting. The rest of it is all on you.

[ms.sss 15,664]

26 minutes ago, catwoman7 said:

The rest of it is all on you.

+1

[summerset 5,265]

3 hours ago, meggs353 said:

I’ve read over and over again that WLS is not a magic bullet.

In my opinion WLS is a magic bullet. It is the game changer when it comes to losing excess weight and maintaining the new weight.

Quote

I’m thinking of revising to gastric bypass, but I’m wondering if I’ll just fail again.

We don't always succeed on the first try. Sometimes people need a second try or maybe even a third. Inadequate weight loss after lap band is quite common, revision to bypass also and many patients do quite good after revision. Maybe you want to do a quick medline search about this.

You're now a few years older and more experienced. Maybe you're now being able to handle problematic things in your life differently. You might also be more disciplined now when it comes to certain things. Think about your younger self and compare it to your now-self. I'm sure you're able to handle things way smoother than you did e. g. 10 years ago. The same can be true for this whole weight loss thing.

Of course there is the chance that you might fail again. There is always the chance of failing, doesn't matter if it's weight loss, learning a new language or performing at your job.

Quote

BUT, if I can theoretically make a sustained life-style change post-surgery, why can’t I actually just do that now? (I try, every single day, and I fail week after week).

If we couldn't make these changes before any WLS at all, why is it possible for so many people after they had WLS? It just is because WLS is the game changer. Lapband is different. It doesn't provide the same hormonal changes a bypass does.

Quote

It takes dedicated, sustained lifestyle changes. But, if we can’t maintain those changes (eliminate carbs, low calorie diet, avoid trigger foods) before surgery, how can we expect to maintain them after surgery? I’m thinking long term here: 5, 10, 15 years after surgery when the magic of weight loss is gone and it’s just daily life.

I always cringe when I read or hear this. "Dedicated". "Eliminate". "Avoid". Same with "struggling", "fighting" or "food is the enemy" etc. - being at war is so damn exhausting. Make peace with food. It's easier in the long run.

If you don't white-knuckle things you might discover something interesting: not all lifestyle changes are a struggle or need dedication in the long run. You might indeed discover (or re-discover if you were into sports in younger years) that exercise can be fun and fulfilling. Or that healthier food doesn't taste that bad. Or the opposite around, that this junk food is actually not as tasty as you always thought it is. You might discover, that when you feel more comfortable in your body and with yourself that you don't feel that need to eat in the same strong and overwhelming way. You might notice that you say "No, thanks but I don't want it now" when you get offered French fries or chocolate or whatever and really mean it.

However, there are many people who aren't able to maintain their "new lifestyle". I have no idea what makes or breaks this. I sometimes have thoughts in the back of my head that maybe some people are just lucky in reacting very good to WLS and don't actually need to watch their intake that much. They also don't live in the gym. When you browse around the board you're going to notice that maintenance calorie intake is very different in different people, even though their stats are quite similar.

Quote

I feel like it’s possible or impossible. If surgery doesn’t make it easy, what benefit does it have beyond short term (1-3 year) weight loss?

Nobody can tell if WLS/revision to bypass is making it easy (or less hard) for you or not. I sometimes feel it's like playing the lottery. You won't know to what group of patients you will belong before you got the revision.

Short term weight loss doesn't really bring some benefits (someone correct me if I'm wrong please), however, one doesn't have to get to a normal weight to reap the benefit of weight loss. So many patients feel like "failures" because they don't get to a normal BMI. Yet, when you look at the studies actually not that much patients ever get down to a normal BMI.

And sh*t on "eliminating carbs". Like really take a big dump on it. (Years ago we should eliminate all fats, now it's carbs. I wonder what the future will bring.)

Edited May 8, 2020 by summerset

[Lily66 425]

This book really addresses the issue you’re concerned with. Dr. Weiner helps you work through whether you have the burning desire to succeed at WLS, and if not, it’s best to wait a bit and try to get it right the first time.

I respect your fears, it shows you’re aware of the pitfalls and are taking it seriously. For $13 something on Amazon, and an afternoon easy read at 150pgs, I believe you’ll gain valuable information and perspective from his bariatric surgeon with 2 decades of experience, determining which ones were ready, which ones were not. Be gentle with yourself...we’re walking the same journey with you!

[summerset 5,265]

Does it provide any valuable additional information if one has already read pound of cure?

[Lily66 425]

1 hour ago, summerset said:

Does it provide any valuable additional information if one has already read pound of cure?

Yes it does, particularly for those still considering WLS. He goes in depth on each type of procedure to help determine which one may be best for a person. He also goes in depth re: head issues, and life issues. I would sum it up that this book is more about the science/mechanism of the surgery and the psychological state of the individual, where as Pound of Cure is about our eating and lifestyle choice after the procedure.

One particular point he talks about in this book is the difference in how he counsels clients based upon age in an effort to maximize their success rate. For example, he talks about the increased challenges a younger candidate faces in having WLS say in their 20’s and thus having to potentially deal with pregnancy, career stresses, financial stresses ahead of them, while maintaining the weight loss for potentially 50+ years, vs. a 50 year old who has those major life stresses behind them and has maybe 20+ years to focus on managing their health and maintaining their weight loss. He’s not saying don’t have the surgery while younger, just realize the challenges ahead that can stress and derail you and try to plan WLS accordingly. He says it better than I, but you get my drift... lots of food for thought (pun intended)😉

[summerset 5,265]

Sounds kind of interesting. Maybe if it's available on kindle unlimited one day (as pound of cure is currently) I'm going to look into it out of curiosity.

[New&Improved 1,780]

My surgery was bypass and it has been amazing.

I know for a fact it has changed my metabolism and the way my body processes food it's like I struggle to gain weight now..

Within 8 months I'm now below my goal weight and maintaining very well and still some days I'm not even hungry other days I'll have a craving and I'll have a treat here and there but it has not affected my progress at all.

But yes there's alot of mental preparation needed and commitment and willpower to follow the rules and not be influenced by others around you...

[meggs353 118]

Thank you so much for the thoughtful replies. Helps give me some context and some new things to think about.

[A1220M 101]

On 5/8/2020 at 11:40 AM, summerset said:

I always cringe when I read or hear this. "Dedicated". "Eliminate". "Avoid". Same with "struggling", "fighting" or "food is the enemy" etc. - being at war is so damn exhausting. Make peace with food. It's easier in the long run.

If you don't white-knuckle things you might discover something interesting: not all lifestyle changes are a struggle or need dedication in the long run. You might indeed discover (or re-discover if you were into sports in younger years) that exercise can be fun and fulfilling. Or that healthier food doesn't taste that bad. Or the opposite around, that this junk food is actually not as tasty as you always thought it is. You might discover, that when you feel more comfortable in your body and with yourself that you don't feel that need to eat in the same strong and overwhelming way. You might notice that you say "No, thanks but I don't want it now" when you get offered French fries or chocolate or whatever and really mean it.

However, there are many people who aren't able to maintain their "new lifestyle". I have no idea what makes or breaks this. I sometimes have thoughts in the back of my head that maybe some people are just lucky in reacting very good to WLS and don't actually need to watch their intake that much. They also don't live in the gym. When you browse around the board you're going to notice that maintenance calorie intake is very different in different people, even though their stats are quite similar.

Saving this gem, good stuff here ↑

[Jay453 5]

Had sleeve oct 2016 weighed 278. got down to 160! It was too easy. I wasn’t paying attention cause I would lose no matter what I did. After Covid and bad habits I’m back to 215. Feel like an absolute failure. This was my worst nightmare. I’ve hunkered down the past few weeks without any drop in weight. Like all the magic is gone. Take advantage of the honeymoon period, learn better habits. It’s horrible gaining it back especially when people know you had the surgery. Hope for a better 2021. And back under 180(my original goal). Good luck every one

[A1220M 101]

6 minutes ago, Jay453 said:

Had sleeve oct 2016 weighed 278. got down to 160! It was too easy. I wasn’t paying attention cause I would lose no matter what I did. After Covid and bad habits I’m back to 215. Feel like an absolute failure. This was my worst nightmare. I’ve hunkered down the past few weeks without any drop in weight. Like all the magic is gone. Take advantage of the honeymoon period, learn better habits. It’s horrible gaining it back especially when people know you had the surgery. Hope for a better 2021. And back under 180(my original goal). Good luck every one

First: Yay you and good luck!

I'm sure this has been rough to go through. Thanks for sharing this. As a pre-op person, it's extremely helpful to hear about everyone's experiences after the honeymoon period.

[Jay453 5]

Thank you. Good luck