Considering WLS - Concerns about my ability to be successful post-op

Hello! 

First post here - just beginning to consider whether WLS could be a viable option for me.  Thanks so much for any thoughts, advice, support you could offer! I know my questions may come off as naive - I hope not offensive in any way.

I have lost weight significantly 3 times through diet and some exercise and each time gained back even more.  Each time, I regained when I hit a weight loss plateau, got discouraged and then quit trying all together.  I see this as a lack of self-control for myself.  Since I see my obesity as a consequence of my lack of self-control, I can only assume that this is the case for at least some others who are obese as well.  

I'd like to ask: If you had (like me) trouble controlling your food intake pre-WLS, causing you to be obese in the first place, how is it different post-op?  I can only imagine becoming physically ill from eating too much will be a motivator...  What else?  As I'm reading more about WLS I understand that there are huge lifestyle/diet/exercise changes necessary post-op, and honestly, I know right now that I should make those huge lifestyle/diet/exercise changes, even without the surgery.  Somehow my own personal comfort, the risks to my own health, my inability to interact with my children as physically as I'd like and the thought of not being around as long as I'd like are not motivators enough for me to make the changes I need to and KEEP UP with the changes.  Why should I expect any of that to change post-WLS?  I understand these are questions to bring up with my doctor and I will, but I'd love to hear from people first-hand, who may have struggled like I have.   

Any thoughts you have on why people can be successful keeping weight off post-WLS, vs. their trouble to keep it off pre-WLS would be greatly appreciated!  Thanks in advance!

Megan

The difference between diets and WLS is... your eating habits after surgery are no longer a "diet."   It is a lifestyle change.  Diets fail because you reach some arbitrary number (or not), then go back to eating the way you did before the diet.  WLS restricts what you can eat and how much.  But, it's only one part of the entire experience.  Unless you're ready to commit to changing how you feel and think about food, it's not going to give you the results you want.  

They operate on your stomach, not your head.  Trite, but true.  Deal with whatever issues made you fat before, during and after surgery through therapy, support groups, OA - whatever works for you. 

I can't speak for keeping the weight off since I'm still in loss mode, but the vets I see who are successful accept that this is a life long commitment and do not let their eating get out of control again.  If you're not motivated to change, then maybe you're not ready yet.  All I can say is that most people wish they had done the surgery years earlier, including myself.

Good luck with whatever path you choose.

There are four major forms of WLS: LapBand, VSG/Sleeve, RNY/gastric bypass, and DS/duodenal switch. The Band is the least effective, the DS is the most effective, and the VSG and the RNY fall in the middle (and have similar long-term results.) You need to research them ALL, so you can choose the form best suited for YOUR needs.

Like you, I had lost significant amounts of weight, but always regained more than I'd lost. At 45, I'd been on one diet or another for about 35 years, and I was tired of 'dieting'. It wasn't something I could do long-term, and it just did not work for me.

Yes, having WLS does require you make some permanent changes, and no, having surgery doesn't make this magically easy. Each form of WLS has different changes it requires, so it's VERY important that you choose the form whose changes you can best live with. Like a diet, WLS only works as long s you can stick with it.

I chose the DS for many, many reasons, and I won't go into all of them here. The biggest reason I chose the DS was because the things it asked me to change were things I was comfortable changing---like taking vitamins and minerals 4 times a day. For me, that's a LOT easier than resisting temptation all day every day.

The DS actually made a dramatic, permanent change in the way my body metabolizes food. It gave me permanent malabsorption of a significant per centage of the calories I eat, especially calories from fat. With my DS, my 'diet' is a high-protein, high-fat, moderate-carb 3000+ calories every day. (Due to my DS, I only absorb about half of these calories.)

At 10+ years post-op, I still have restriction. this means that I feel full and satisfied on MUCH less food than pre-op, and because of caloric malabsorption, I don't really count calories any more---I eat what I like. My food preferences are for foods that are high-protein and high-fat, and as long as I'm mindful of the carbs I eat, I can eat pretty much all of those I want, too.

What I'm trying to say is that for ME, WLS isn't like a 'diet' at all. I eat like 'normal' people do, and now, that works for me.

Wls gives you an edge! I think most of us have lost and regained in the past, you often see people posting they were serial or yo-yo dieters. I certainly was.

surgery makes it that bit easier. Not easy! Easier! Some make you malabsorb foods ( bypass and DS), others allow you to feel less hunger while eating less (band and sleeve). You say feeling physically ill would be a great motivator- we can't rely on that! Bypass is the one people assume will make them ill if they eat sugars but in fact under 40% of bypassed people dump. With the band and the sleeve, over-eating or fast eating can cause pain but not with nice slippery, high calorie foods like chocolate or icecream! 

You can eat round any surgery. You still need willpower. Just a little bit less! 

Thank you so much, everyone!  I appreciate you taking your time to share with me.  You are helpful and inspiring!

I have lost large amounts of weight before and gained back more quite a few times. This made wls a hard decision-especially since everyone said I could do it "on my own" since I've done it before. 

First-I don't think it is ONLY willpower. It is part of it-but I think this is a disease-both physically in that it is harder for obese people to maintain a weight loss-and psychological factors also. I think I had to finally accept this and give up the ideas that I had to fix it on my own will. I have a problem/disease that I need help with. We need to become ok with asking for help. 

Second- I did research on the stats. People that have wls have a much better chance of maintaining than those that lose through diet and exercise alone. Since I've failed at maintaining (or staying consistent through a stall as you described), why wouldn't I use something that gives me a better chance of being successful? 

Third-for me, this surgery only serves as an extra tool to use. It kind of works to keep you from straying too far (as long as you follow some of the rules). I picture it like bowling-it is like bumpers in the gutters. As long as I throw the ball in the right direction, I have a good chance of knocking down pins-maybe just 1 or 2, but something. If I don't follow any rules and throw it ion the opposite direction, then I still could get way off track. 

I had the VSG and I already know it would be very easy to gain back weight if I don't use it properly. It limits what I can eat as long as I focus on protein. I'm certain that I could easily pack on donuts, bread, cake and consume just as many calories as got me super morbidly obese. 

Just my thoughts. Hope they make some sense. Good luck!

I hate it when people throw at my face I choose the easy way out for weight loss!! Are you kidding me!! I will be 10 years out in August have had two babies in between and still have managed to keep it off. Start out weight 264 lbs 1 year out at 147 lbs and got preggo which terrified me because I didnt want to gain any weight and I didnt. Currently Im at 140 lbs and have been for the last 8 yrs and recently had a baby she will be two this friday and I dis gajn way too much 35lba but lost it in 3 months back to 140lbs. My " SECRET" a scale!!! I weigh mh seld religiously!! Every morning after I do my daily duties in the potty strip down and step on the acale. If I weight more that day lots and lots of water no fried foods or processed foods. Honestly I cant lie, I have done absolutely no exercise in 10 years other than walking at work. But being on that scale makes me consious of my gain. But ultimately is your MIND that will carry you threw. I couldnt see myself fail at my last attempt to be healthy, soecially when my 4 year old girl had asked me " Oh mommy why are you so fat?". its been a long journey w daily struggles and constant choices to do and pick the right foods. Best of luck!! 

Many people, and I would bet the far majority of those who do WLS, have tried repeatedly to lose weight and have experienced the exact scenario you describe: a plateau followed by weight regain + extra weight. I understand this seems like a personal failing, but honestly, it is a species failing. The statistics on long term weight loss doing it the "old fashioned" way are dismal. In clinical trials, only something like 5% of dieters are able to keep the weight off after they lose. Bariatric surgery is the only clinically proven way for a morbidly obese person to lose weight long term. In other words, it works for much more than the tiny sample of people that are able to keep weight loss going with diet and exercise alone.

I'm not a doctor, but my general understanding is that when you lose weight, your body starts fighting back in many ways such as reduced metabolism, hormonal changes, etc. It does not want to lose weight. I don't know if there is a solid, complete scientific explanation for why it is easier to minimize your body "fighting back" after weight loss surgery, but it is.

Personally, I had given up on weight loss after so many attempts to lose weight. The past 8 or so years I mostly just tried to accept my body the way it was, which is a lovely attitude that I recommend, but unfortunately I was starting to develop major health problems because of my weight such as hypertension and pre-diabetes. Once I realized that bariatric surgery would make it possible to lose weight and more importantly, keep it off, I was extremely motivated. I'm having surgery on Monday and I'm not going back to 350 pounds.

I had an RNY done 3¾ years ago, and chose RNY because of my severe GERD and tanking physical health. I did my surgery primarily for my health, and that motivation has worked for me in maintaining my loss.

At this point I am very grateful for my surgery- my health is excellent now, and I am able to keep up with my grandchildren at age 63. I'm also a lot smaller- I have been able to maintain at goal since losing the weight.

The surgery helps take the weight off, which for me was very helpful because I had so much trouble losing on my own. It does require tremendous changes in habit with diet and exercise, but the work has been so worth it for me. To be successful in the long term has made me confront my demons of eating for comfort and avoiding exercise, but the weight loss has made that a lot easier. I eat healthy now, and I exercise pretty much daily. I feel much better about myself and like living with me, and am doing things I could only dream of before my surgery.

The following might be helpful for you in starting out your research to see if weight loss surgery makes sense for you:

There is no perfect weight loss surgery, they all have varying benefits and costs as well as risk factors for complications. They also have varying levels of body invasiveness from the lapband which is the least invasive but has a high rate of complications ranging through to the DS, which is the most invasive in terms of innards rearranging, requires the highest skill levels from the surgeon, and carries the highest risk factors for complications. There are also different levels of frequency performed for the surgeries, with the RNY still performed the most frequently, the sleeve catching up, the lapband losing popularity, and the DS performed the least frequently by a wide margin.

A link with pros and cons of weight loss surgery: http://www.webmd.com/diet/guide/is-weight-loss-surgery-right-for-you

A useful link for comparison of types of surgery: http://www.thinnertimes.com/weight-loss-surgery/wls-basics/w eight-loss-surgery-comparison.html

Another link re: the realities of weight loss surgery: http://beariatric.com/2013/12/16/10-cold-hard-facts-about-we ight-loss-surgery/

 All of the surgeries require a high level of personal responsibility with lifelong major lifestyle and ha*****ange re: diet and exercise and vitamins and minerals. They aren't a magic fix. They don't operate on our brains or emotions or cravings. Eating around them with weight regain is possible for all of them if habits aren't changed no matter what kind of surgery a person goes for, both for the first year or so, and especially when a person hits maintenance and you are pretty much on your own again.

It's great to ask here regarding people's experience and opinions, but they are only that- personal, amateur, stranger on the internet experiences and opinions shared with you, another stranger on the internet. We can't know your situation and we aren't professionals.

Also people here will often tend to strongly promote the kind of surgery they themselves have had, which may not fit you and your particular requirements.

Please make your choice of weight loss surgery that will work best for you in consultation with your Bariatric surgeon because he/she will know your medical history and unique needs based on considerations of weight, comorbidities, reliability and compliance with lifestyle modifications and follow-up.

Oh, and research a lot, here- look under the "MORE" tab on the top of the page and check out the different forums, internet, and info sessions with Bariatric surgeons.

Thanks for your thoughts, everyone!  I appreciate you!  I'm continuing on in my journey, about to ask my primary care physician for a referral to a bariatric surgery center!