WLS and metabolism

I posted this somewhere on here yesterday, but don't see it on the forum. I was reading around on some of the other  forums and there was a discussion where some people said their primary care doctors told them that having wieghtloss surgery slows your metabolism over the long run b/c our bodies get used to living on so little food. Their point was being discussed under regain and trying to lose it. Anyone heard of that?

WLS that simply is just eating less - that would be true.  There are some endocrine changes with the sleeve, for instance, that may give a boost, but not a huge one.  Being more active and exercising increases metabolism, too.  There are procedures like the RNY and DS that combine the restrictive eating with malabsorption that does impact metabolism more aggressively.  Some people definitely benefit from that, but it may be overkill for others.  The key is understanding that wls isn't one-size-fits-all, you need to understand your own physiology and take the time to learn how each of the procedures will affect it.  Its worth it to do this analysis yourself and not depend on a doc knowing you better than you know yourself from a 10 min consult.

This discussion is scaring me. I don't want to slow my metabolism! I feel one of the reasons I'm in this shape to begin with is a slow metabolism. No doctor has ever mentioned a change in metabolism. Could you elaborate?

Seriously - I lived the slow metabolism thing, which is why I got the duodenal switch (it has a sleeve stomach, which is why I respond to posts here).  The DS did change my metabolism in a way I never imagined, and 9 years later, I"m still going strong.  The RNY also does so for at least a couple of years before the body starts to compensate. 

For restrictive surgeries like the sleeve or lapband, if you were to be sedentary and simply eat less, then yeah - your metabolism will slow down.  If you become more active as your weight goes, then your metabolism will reflect that active lifestyle. 

Maybe you need more than restriction.  If that's the case, start learning more about the restriction/malabsorption procedures like the RNY and the DS.  WLS is not one-size-fits-all.

Do I eat less calories now (maintaining over 2 years with a vsg)? Yes. BUT I no longer weigh over 320 pounds, so of course I need less calories- I am no longer carrying around an extra 150 pounds every minute of the day. My maintenance average is 1600 (no exercising). Some days higher, some lower. With exercise up to 2,000. Nothing wrong with that. More importantly, I can feel very satisfied on 800 calories if I eat smart. It is plenty of calories for a day. Now if head hunger is an issue, then no- when I fall off the wagon I am entirely capable of putting down 3,000 calories. The sleeve does slow me down though, so when I screw my head back on correctly less damage was done and it is a little easier to reign it in. I do not regret getting surgery, returning to a normal bmi, and perhaps yes eating less calories than when I weighed 320 pounds. 

I can only tell you my experience -- and my experience does not bear out that doctor's opinion.  And it is just his opinion because I haven't seen any evidence-based research that proves that resting metabolic rate (RMR) went down after WLS.  There are research buffs on here who may be able to find that.  But it would have required someone to get their RMR tested prior to surgery and then at different points after surgery.  I've never heard of that study.  

I've had my RMR tested and it has actually increased in the last year since I reached maintenance.  Part of that is likely due to my increased activity level.  But my food intake has at least doubled in the last year too...and I've been able to maintain my goal weight.  So I personally don't see any evidence that surgery "wrecked" my metabolism.  

Kairk had a great post on here a couple days ago about the "naked truth behind regain".  Search for it and read it.  People regain weight because they go back to old, bad habits and stop doing all the things that made them successful in the early post-op days.  I don't believe for a second that people have significant regain because of slowed down metabolisms. 

Here's your previous post -- http://www.obesityhelp.com/forums/vsg/5276250/Does-WLS-chang e-your-metabolism/

I answered this on the other thread, but WLS does not decrease your metabolism, it increases it. Several studies have demonstrated this. In fact, it is these metabolic changes that have the most significant impact on weight loss, not restriction. If restriction was all that important, the band would work much better.

You will not damage your metabolim with WLS, you will boost it.

Eating less food slows your metabolism down.  I don't understand the impact of the actual surgery so can't answer that, but dieting - especially for a long time, and even more especially on very low calories slows down your metabolism.

when you go on a diet, not only do you burn less calories, because you actually have less body mass to keep alive, your body goes through what is technically called adaptive thermogenesis (or what some people who diet and then stall for a very long time call "starvation mode") your metabolism drops much lower than it would if it was just based on your weight loss.  [Please note starvation mode does not mean that people can't starve themselves to death.]

the longer you diet and the bigger the difference between what your current body mass needs to eat to maintain weight and your daily intake the more drastic the decrease.

Why do doctors then recommend VLCD and do WLS
because when you are very overweight the risks of all sorts of yucky things happening to you is so high due to your weight that they don't actually care how you lose the weight, just that you lose it.
In other words you can save your metabolism by staying extremely overweight, but what on earth is the point of that?

Any metabolic slow down that is diet related, is reversible and there are tricks to convincing your body not to do this. (The decrease based on your weight is inevitable though, so is the drop due to your age and menopause).

To me not having surgery or not going on a diet to save your metabolism from decreasing is like not putting on sunscreen because you will use up the tube and staying out in the sun and getting skin cancer instead.

I was concerned that living on very few calories would "reset" my metabolism to a hard to manage low after surgery, but that has not been the case.  Once I got the first 30 pounds off and felt well enough to exercise, I started a good 5 day per week habit that I believe keeps my metabolism in a manageable place. During my loss phase, I worked my way up to 1000-1200 calories per day with 75+g of protein. In maintenance it's closer to 1300 (still 75+g) PLUS whatever I earn from exercise, usually 300-500 5 days per week. That's A LOT for my tiny tummy some days. So some days I'm over, some days I'm under. I've maintained within 5 pounds of goal. If it creeps up, I cut out some snacks and all alcohol until I'm back where I belong. I feel like I'm in a very manageable place now!