What if it just...doesn’t work?

[brooketw 6]

I have a surgery date of April 12th and I’ve been struck by this intense fear of it just not working.

What if I wake up from surgery craving a cheeseburger? What if I don’t feel any different and I’m just a bottomless pit? I feel like my willpower wavers as the day goes on so I am really hoping for a drastic shift in my hormones and cravings after surgery. Does the desire for junk food and urges to binge just go away?

I know what to do, I have the food prepped, and I have already completed so many of these hurdles. But just...WHAT IF IT DOESN’T WORK? (Not yelling—just freaking out!)

[nightowl1971 3]

The hunger hormon is in the stomache you are about to remove. So as long as you are not using food to anything other than eating, I think it will work out just fine.

[Jaelzion 1,127]

I had this fear as well. After a lifetime of being heavy and not being able to permanently lose weight, I wasn't convinced the surgery would work for me. That fear was compounded by the fact that for medical reasons I was forced to have the sleeve rather than the bypass. The surgery doesn't correct the psychological factors that lead to emotional eating or binging. That takes self-reflection or therapy and finding new ways to cope.

However, it does address the physical aspects. The surgery will reduce the amount of ghrelin your body produces (one of the hormones responsible for making you hungry). For most people, this results in a reduced appetite (at least for a while). It will drastically reduce the amount you can eat before feeling full and make it physically difficult to overeat. In my case, the surgery even blunted the intensity of my cravings. I may want something I shouldn't have, but it's much easier to just tell myself no post-surgery.

In the end, the surgery worked for me just like it does for most people. I lost all my excess weight and so far, I am maintaining the loss. It will work for you too (just be willing to put in the work of figuring out WHY you overeat and addressing those feelings).

[catwoman7 11,216]

as usual, I totally agree with Jaelzion.

the first year or so most people do have lowered hunger and most of us are pretty gung-ho about following our programs, and as long as you do that, the surgery WILL work. You have to really monitor yourself for life, though. After a year or two, you're dealing with the hunger monster again (although for some, it's not as intense as it was pre-surgery), and you're not always as committed as you were that first year ("diet fatigue"), so weight gain is easy if you don't watch yourself.

if you find yourself dealing with the urge to binge eat again, then like Jaelzion said, work with a therapist. The surgery won't cure that. A lot of us work with therapists and find it helpful.

[Officially Not Fatty Matty 462]

Reality check: it is possible for it to not work. Ask my wife. She always ate light and right and while I thought and still think she’s perfect and didn’t need surgery she got it done in early July 2020. She’s lost six pounds. Six. She is NOT cheating or eating the wrong things. She stuck to the plan, was at 400cal for months and seriously has done everything by the book, Proteins, exercise, Water intake all of it. We kind of worried about it before because prior she was working out several hours a day with a personal trainer, and as I said she has always been a very healthy eater, most days (pre surgery) logging (yes she logs food and has for years) around 1200-1500 healthy cals. She works a physically demanding job and is constantly busy around the house. I don’t share a lot of my milestones with her because it makes her sad. She’s obviously happy for me and what I’ve been able to do but it just amplifies her feelings of failing. We’ve spent a lot of time with various doctors trying to figure out what’s going on. One even told her “well if society collapses you will outlive us all.” Currently she’s getting Iron infusions several times a week due to pretty severe anemia so there is a possibility that is related (lack of o2 to the cells reducing energy expenditure). Time will tell. I don’t say this to scare you, the vast vast majority of people are successful. Me? I feel like this is cheating it’s been so easy. Most people are somewhere in the middle though. While I don’t think you should worry (what will happen will happen and worrying will accomplish nothing) I think it’s power to know all possible outcomes.
And if anyone has had similar experiences as my wife and you’ve discovered a solution please pm me or reply. It’s disheartening to see her like this knowing she’s done everything right. Something is wrong and we just need to find it. Most doctors seem to have the attitude that “oh patients lie or don’t really know how much they eat so she too must be lying or misjudging her intake” when she most definitely is not.

[mweiss1998 79]

I am 25 days PO and am currently afraid it isn't going to work. I dropped 20 lbs in the first 10 days and haven't lost a pound since. I am measuring and tracking everything, following my program and getting my fluids. I am hoping things start moving soon.

[catwoman7 11,216]

1 minute ago, mweiss1998 said:

I am 25 days PO and am currently afraid it isn't going to work. I dropped 20 lbs in the first 10 days and haven't lost a pound since. I am measuring and tracking everything, following my program and getting my fluids. I am hoping things start moving soon.

it's the infamous three-week stall. Happens to almost all of us. If you do a search on this site for it, you'll find literally thousands of posts on it. Lasts 1-3 weeks. Just stick to your program and stay off the scale. Your weight loss WILL start up again.

[mweiss1998 79]

12 minutes ago, catwoman7 said:

it's the infamous three-week stall. Happens to almost all of us. If you do a search on this site for it, you'll find literally thousands of posts on it. Lasts 1-3 weeks. Just stick to your program and stay off the scale. Your weight loss WILL start up again.

I've read all about it I just didn't think it would last this long. I go for my 1 month check up on Wednesday and I am going to weight the same as I did on my 10 day. Just disappointing.

[catwoman7 11,216]

4 hours ago, mweiss1998 said:

I've read all about it I just didn't think it would last this long. I go for my 1 month check up on Wednesday and I am going to weight the same as I did on my 10 day. Just disappointing.

they'll know what's going on. Pretty much everyone has that stall. It's frustrating, but...it's part of the process.

[Creekimp13 5,840]

One thing we don't talk about here....because it's negative and not motivational....is that for lots of people, this surgery DOESN'T work.

Not because it doesn't do precisely what it's said to do....but because people who have it are sometimes not yet ready to change their habits and address the causes of their poor choices and what drives them.

The surgeries are a tool. They absolutely help. But they are not the cure. They fix your stomach, not your head. If you don't fix your head and your habits, the weight loss won't last.

The surgeries will NOT prevent you from regaining weight. It's not even that hard to regain. Go to the veterans page...notice that not a lot of people hang out there....and that most of the posts are about...OMG, i'm regaining everything!

Most folks don't reach goal. Most folks lose about 50% of their excess weight. This is STILL a really good thing, and WORTH having the surgery. Tons of health benefits in that 50%....and that 50% gets you that much closer to your goal weight when your head is ready to do the work and get disciplined enough to get there.

https://www.mdedge.com/diabeteshub/article/150969/obesity/weight-recidivism-after-bariatric-surgery-what-constitutes?sso=true

[summerset 5,265]

7 hours ago, Creekimp13 said:

https://www.mdedge.com/diabeteshub/article/150969/obesity/weight-recidivism-after-bariatric-surgery-what-constitutes?sso=true

Interesting read. I can't help though but think about how much weight people gain during a time period of 11 years who never were obese in their whole life, maybe not even overweight. I just need to look at colleagues and friends. Weight gain (sometimes really significant) between the age of 35-50 seems to be quite common.

So while I definitely don't want to dismiss weight regain over a time span that long, one should maybe also take a look outside the realm of the bariatric world and be careful what to label as "failure" or not (though this usually seems to be more of a patient-problem than a doctor-problem).

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Most folks don't reach goal.

If "goal" is BMI 24.9 or less you're definitely right.

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If you don't fix your head and your habits, the weight loss won't last.

Now I'm going to talk about something that is really rarely talked about in the WLS community (we seem to have exactly one moderately active thread about this): eating disorders or disordered eating.

When one takes a look at "failure rates" of treatment of patients suffering from eating disorders like anorexia or bulimia, bariatric patients don't seem to have worse outcomes so we don't seem to be exceptionally "bad patients".

Too many patients seem to only change gear and develop overly restrictive eating habits, starve themselves and compulsively exercise, all too often encouraged not only by the scales showing less weight, but also by their environment and even their treatment teams.

[catwoman7 11,216]

6 hours ago, summerset said:

Too many patients seem to only change gear and develop overly restrictive eating habits, starve themselves and compulsively exercise, all too often encouraged not only by the scales showing less weight, but also by their environment and even their treatment teams.

I wonder about that when I read posts from people who are a ways out (like a year or more) and still eating something like 800 kcal a day and training for marathons - or otherwise exercising compulsively. Are they really going to be able to keep this up long term? And what happens when they settle into a more "normal" life?

[catwoman7 11,216]

6 hours ago, summerset said:

If "goal" is BMI 24.9 or less you're definitely right.

my surgeon said only about 10-15% of his patients make it to a normal BMI. The research I've read backs that up. A lot of people don't want to believe that, but....

[summerset 5,265]

21 minutes ago, catwoman7 said:

Are they really going to be able to keep this up long term? And what happens when they settle into a more "normal" life?

I wonder how people maintain their weight with tons of exercise and on that little calories. And we're not talking about a BMI of 16 here. Do they really track their calories accurately?

Please note, that I'm not implying these patients are not telling the truth on purpose. But somewhere something simply doesn't match.

[catwoman7 11,216]

3 minutes ago, summerset said:

I wonder how people maintain their weight with tons of exercise and on that little calories. And we're not talking about a BMI of 16 here. Do they really track their calories accurately?

Please note, that I'm not implying these patients are not telling the truth on purpose. But somewhere something simply doesn't match.

yea I've wondered that as well.