I've been big all my life from the time I was a little kid.. I hit 310+ in my very early 20's and dieted and exercised my way all the way down to 155lbs a few years later..
I thought at the time, Never Again! I have this thing BEAT!
As with the vast majority of the human population, I couldn't hold onto that type of a loss and slowly regained most of it over the next 10 years. Just by the fact I stayed within a healthy weight range for 5+ years, I technically beat the odds.. but I had the rest of my life still ahead of me, and I was morbidly obese again, not a good present to live or future to look forward to..
I may be smart, I may be stubborn, and I have the ability to lose like gang busters when I set my mind to it.. but I realized I am not super-human, and I couldn't fight against a biology that was flinging everything possible at me to regain. I had dieted myself fatter, and the depressing fact is, that's exactly what serial dieting does..
It's been years of reading nutrition, reading about obesity research, and exactly how much of an "organ" fat becomes once you have enough of it on your body. It's also very enlightening in a sad way to see how much ignorance is out there on the subject as well.. people still see it as a moral failing, despite the information available to anyone that cares to read... Intentional ignorance at it's highest, but it makes people feel better to pigeon-hole things, and so it happens and will likely never change.
I thought I knew a lot about the subject prior, but much of what I learned the last couple years surprised even me, and it finally drove home the realization I could not win this (read: maintain a healthy weight) without medical intervention... this isn't a stubborn 15lbs that would come off and stay off with minor permanent shifts in eating or even have little to no impact on overall health if just maintained. We're talking 140lbs+ excess fat on my frame. Let that sink in. They don't call it morbid without reason. Fat in that amount of excess kills, slowly.. while taking away quality of life bit by bit till the end. I was no longer mobile, couldn't hike in the woods at all, and was living on anti-inflammatory meds to function.. the decline was well under way, and I was only 37.
I decided to have surgery a year and a half ago, specifically the VSG.. which removes 85% of the stomach, the stretchy part in fact. Everything else remains the same, fully functional just as before.. but my capacity is that of a 5yr old. I am now less than half the weight I was when I decided to have this operation. I have lost more than 100% of my excess weight, and my bodyfat is finally in a moderately lean and healthy range, my BMI being square in the middle of normal. Am I a "bariatric success?" Ask me in 5 years, better make that 10 or more...
Does this mean I am "cured?" Hell no. All it does is give me a fighting chance.. a literal odds evener when I had none before.. that is all any bariatric surgery does. I will take that help. Where I had no chance to ever maintain a healthy weight, now I have a more level playing field.. still completely up to me, but what was impossible, now is possible but hard.. and I am very very thankful for the assistance.
Is it easier? That's complicated depending on how you mean the question.. easier on one hand if you are talking just about the initial loss: yes of course, how could it not be? It also means I needed to change everything about how I interacted with food, the world, me and my relationships with people. That isn't easy. Maintaining, that isn't easy no matter what.. smaller capacity for some types of food or not, choices matter in a big way and always will, no surgery negates this fact. Regain can happen with or without it.. there's no free ride regardless of anatomical alterations.
I can eat a couple ounces of meat and a little veggies and feel satisfied for a couple hours.. this is repeated several times a day. If I choose to eat something junky like chips or breads, it gives little feeling of satisfaction/restriction- meaning I could eat a ton of it, so choices are on me entirely just as they were before. Good, better, best.. poor.. every day choices.
The differences however are many-fold: the logical part of my brain tells me I have limited real estate- and nutritional needs that have to be fulfilled to keep me healthy, so choosing wisely the majority of the time is necessary. I understand now what effects different foods have on the body, and that information helps steer my choices as well. I measure and log my intake daily, usually before I eat (often the night before) and will for life as this is the single biggest thing that helps keep regain in check for anyone that has lost any amount of weight. I cannot trust my body to stay in balance just because I look like I'm a normal weight now. I am not cured, and never will be.. My body has no sense of homeostasis, it is constant vigilance only that will keep things in the favor of health. Do I have a non-nutritional treat now and then, yes of course.. but I have to stay aware of them like anyone that is trying to stay healthy and keep them very infrequent.
I also feel satisfied most of the time- this is a big deal to me.. I had what I refer to as a broken satiety switch.. Since I was little, I could eat, and never feel satisfied.. Likely multifaceted causes from being raised with parents who insisted on the clean-plate, and the lovely hormonal cues from accumulating fat (ghrelin and leptin among the dozen or so identified satiety hormones all work together to keep us healthy, unless something is out of balance, like having too much hormonally active tissue (fat) hanging around!) Once things are out of balance, they tend to get further out.. unless something intercedes to correct the situation. Removing most of the fundus cuts down on ghrelin production, and decreasing bodyfat as well as shifting foods away from carbohydrates all effect the hormonal balance and sensitivity for the better as well. Meaning, it takes far more than just "eating less and moving more" to lose any significant weight and keep it off. If it were really that simple.. it's just not.
If you've read through my brain-dump, thanks. These thoughts have been rattling for some time, and will continue to shift and mature as I live my life.. I have moments of being amazed at the way my body functions now.. I can walk all day without pain most of the time, move and play, and just "be" without having to appraise situations like chair stability, how many stairs may be waiting, or if I can even fit through certain places.. and that I do not "stand out" now unless I want to. I get overwhelmed by a feeling of gratefulness and joy at times that I can only smile. It was a hard and tough decision to make, financially, emotionally and physically.. the recovery was long and tiring. But, I would go through it all over again to experience what I finally have now.. a small sense of normalcy and a chance to live a healthy active life.