Does WLS ruin your metabolism?

Any time you go on a diet, WLS or not, your metabolism slows down. It's natures way of keeping you from starvation during a famine. (Your body interprets dieting as living through a famine and does what it can to force you to hunt down food and eat it.) Once you go off the diet, your metabolism recovers to some extent. How well it recovers depends a lot of facotrs including how much you lost.

In general, a 130 pound person who used to be obese has a calorie requirement of a 120 pound person who was never obese instead of the calorie requirements of a 130 pound person who had never been obese. So there is not necessarily a complete 100% recovery of metabolism. OTOH, the base calorie requirements of a 120 pound person and a 130 pound person are only different by about 100 calories a day.

This is not a gap that can not be overcome. It's a bummer that you have to over come it, but a little extra walking or with slightly less eating is all it takes. It's not some impossible task.

Plus, individuals vary. In my case, my metabolism is better than it was pre-op. Before all those online calculators would tell me I should be losing 2 pounds a week when I was only losing 1 pound or that I should eat XXXX calories a day but eating that much would make me gain weight. Now, they are usually spot on and some of them underestimate my calorie needs. This is beause my basic caloric needs are higher than average instead of lower than average.

I believe the reason for this is that I didn't just cut calories but also exercised and, in particular, I did a lot of strength training. The more muscle mass you have, the more calories you burn at rest. The fitter you are, the more calories you burn at rest too.

For example, Lance Armstrong has a VO2Max of 65. (This is a measure of how much oxygen you burn at peak energy expenditure.) Most unfit women have a VO2Max of 30-ish. Therefore, if you weigh as much as Lance, but have a lower VO2Max, if you do the same workout, he burns more calories than you do.

But, even if it were true that WLS "ruined" your metabolism, the cool thing about WLS is that it gives you hunger control. So you are satisfied eating that smaller amount of calories that your body needs to maintain itself. That is the difference between dieting without WLS and with.

When you diet without, your body fights you to stop and fights you to get back up to your old weight. But WLS fixes things that are broken in our homeostatic system (the system that controls how much we eat) so that our bodies don't fight us to get back up to our old weights again. Some people's bodies fight them to be a higher weight than they'd like. But we're talking about maybe 10-20 pound overweight, not 100-200 for most people.

This is really interesting, I feel like I still have so much to learn!

My metabolism was destroyed. Diet and exercise only kept me from going from MO to SMO.

The DS fixed that and I now have the metabolism of a normal person without dieting or exercise.

But, the DS does allow me to eat much more than all the other surgeries allow.

I think you ask a very wise question.  Who wants to go through the trouble, expense and discomfort of surgery only to lose a lot of weight and then in a few years have it all come back?  Not me!!  I had done that quite well all on my own thankyouverymuch.

That is why when I learned about the Duodenal Switch and started really studying the science and studies about it I became sold on it.  Here is a surgery that will LAST.  For the first time in my life I can count on NOT regaining if I comply with a low carb (not low calorie and not a restrictive starvation diet) diet.

The gastric bypass is known to stop working after 2-3 years.  That is why you hear so much about "learning to use your tool."   You have to learn how to eat very low calorie and exercise so that once the malabsorption ENDS you can keep the weight off.  Many people regain with the RnY and revise to get the DS.  I didn't want a surgery that might mean a SECOND surgery.  I wanted to get it right the FIRST TIME.

Here's some info for you:

www.obesityhelp.com/forums/amos/4391498/RNY-insulin-carbs-we ight-regain-Articles/#36305662

www.lenoxhillhospital.org/press_releases.aspx

www.dssurgery.com/procedures/compare-surgical-procedures.php

www.obesityhelp.com/forums/ds/4416755/Must-Read-Transcript-o f-Dr-Roslins-Presentation-to-ASMBS-on/

The DS not only does not ruin your metabolism it actually FIXES it.  That is why people with Type II Diabetes come out of the HOSPITAL OFF their diabetes medications.  Yes, off their medications BEFORE they even lose any weight.

The DS is the surgery of choice for anyone with a broken metabolism, for anyone who wants the best surgery for LONG TERM maintenance of weight loss.

But it comes with some serious self care requirements.  You have to take vitamins and you have to get labs done and you can't rely on your surgeon or PCP to advise you about those.  You have to be pro-active and take care of your own health.

Here's a great thread if you are interested in the DS:

www.obesityhelp.com/forums/ds/4280788/Repost-Request-Advice- for-Pre-Ops-with-Links/

And here's the DS website with tons of info including a list of surgeons who do the DS:

www.DSFacts.com

~Becky

I wondered the same thing before I had surgery, and got the DS after doing much reading. Years of yo-yo dieting, and probably genetics too, left me with a super efficient system and messed up metabolism.

Becky above already provided the links to the info that you should look at, and I agree with her 100% here. 

I like the sleeve, which is a restriction only procedure, but knew my metabolism was too shot for it to work for me. Same for RNY, since it only keeps the malabsorbtion or calories for most people for about 2 years. I needed metabolic help forever, and by the time I left the hospital after my DS, some of the stuff related to the metabolic issues were already ready resolving like insulin resistance and PCOS stuff. 

I think I agree with the premiss that our metabolisms were ruined before we had any WLS, largely through all the yo-yo dieting.  I've got hyperinsulinism, reactive hypoglycemia and dumping syndrome now.  They've put me on phentermine to give me some semblance of a metabolism.  All in all, life isn't too bad.  I do fine if I eat healthy food, and I've been sick enough times from eating junk that I don't bother to eat junky food anymore.

I think it depends on the procedure, on how long you'd been obese prior to surgery, on how long you severely restrict your intake after your surgery...lots of factors. I intentionally got myself back up to eating 2000+ calories per day as soon as I could after my surgery (was probably back up to that by about 6 months) because I didn't want my body to get used to living on 1000 calories or less per day, or else I'd essentially be doomed to eat at that level for the rest of my life, and I wasn't okay with that.

By 2 years out, I could maintain my weight eating pretty much whatever I wanted (though I will say lots of starchy carbs would give me gas, but sugar was oddly non-problematic!). I was eating out every single day for both lunch and dinner, we would stop at the frozen custard place a few times a week, I would join in the celebrations at the office (cake, cupcakes, whatever junk they had on hand), etc., and my weight stayed within the same range of about 182-187. Never got down to my randomly-selected goal of 150, but when I'd previously weighed as much as 324 pounds, 180s was just fine, especially considering managing my type 2 diabetes was a thing of the past.

Today, I am about 13.5 weeks pregnant, and I've LOST more weight since I've been pregnant even though I did NOT have morning sickness. I'm now holding pretty steady at 175. I don't count calories, but I did change from eating whatever to making much healthier (NOT low-calorie or low-fat, but more natural) choices. I now no longer consume artificial sweeteners or soy, and I still focus on protein first. I just finished a little bowl of uncured nitrate-free smoked sausage with sauerkraut and all-natural barbecue sauce. Lunch will be a burger (either at home or out, depending on if I decide to go out for lunch today) with lots of cheese, possibly some nitrate-free bacon, and barbecue sauce mixed with mayo for dipping. This weekend, I plan to hit up Loghorn steakhouse for their fabulous crab-stuffed filet. No deprived eating here! Metabolisn be damned, I'm doing well eating delicious foods and never counting my calories.

Hi Jill,

Wanted to wish you congrats on your pregnancy! And, also share that pre WLS when I was pregnant I LOST about 35 pounds during the pregnancy.

And my docs had me eating a TON of calories (3500 / dayt - and being required to get up in the middle of the night and eat!) because they were worried that I was shedding ketones like crazy. Although my blood sugars never made it to the point of gestational diabetes, I was on a diabetes diet, because I had been pre-diabetic earlier in my life.

Wierd - and points to something having to do with hormones as a contributor to or reason for my weight gain - I told my husband that if we just had 5 or so kids, I could be a supermodel (never mind that the weight found its way back to my ass after I stopped breastfeeding!)

Best wishes for an easy pregnancy!
Margo