Tough Love: What You Really Need to Do to Lose Weight

I saw this article online.  In a few short statements it underscores what we already know about losing weight and thought it was helpful.

http://www.foxnews.com/imag/Wellness/Tough+Love%3A+What+You+Really+Need+to+Do+to+Lose+Weight

Great article!

Excellent information, basic facts, GOOD REMINDERS!  Thanks for sharing!

Here's your tough love: 98% of people who try to lose weight and keep it off by diet and exercise fail.  They may lose weight, even a lot of weight, but they will inevitably gain it all back and end up weighing more than they did when the started.  For the serioulsy overweight, following the advice in the Fox News article is a bad idea, maybe a very bad idea.

The cold, hard reality is that once you are obese or overweight, apart from a game-changer like RNY, you will lever lose weight and keep it off.  Any attempt to do so will result in more weight gain.

Here's an article with links to the latest science on the subject:

http://seekingalpha.com/article/490531-handicapping-the-obes ity-race

If you are overweight or obese, unless you are going to have WLS, you would be better off staying at your current level than trying to lose by diet and exercise, and then ending up even worse off than when you started.

The reason is that the body appears to go into "starvation, food-seeking mode" AND IT STAYS THERE until the weight is regained.   The effect appears to last for YEARS and may NEVER GO AWAY until the weight is regained.  RNY changes things on a hormonal level in a way that is not yet completely understood.  This may be even more important than the restrictions created by the small pouch.

This is the latest research and it shows why our approach to food is all wrong.

I hate to break this to you but RNY does not exempt us from having our bodies do the "must gain back more" syndrome. It helps fight the process.

But I don't think it's a given that a person will gain all their weight back if they are obese. I know a girl who was well over 400 lbs and lost weight without surgery and she's still smaller. Like us, she did not stay at her low weight but she has maintained an over 200 lb. loss. I know a few folks like that. Bigger than their smallest but way smaller than their biggest. If you have the will to do something, you can do it.

I didn't say "exempt".  None the less, RNY does change the game.  While some percentage of RNY patients regain some or all of their weight, it is a much, much smaller percentage than those who use diet and exercise alone.  RNY is far more effective for permanent weight loss than lifestyle change alone.

At four years out, "lifestyle change alone" and my current life don't look that different. If you truly change your lifestyle, whether you have surgery or not, you are more likely to maintain weight loss. And yes, I know you can regain - but I don't see RNY being a big game changer in that. And I've had the pleasure of meeting lots and lots and lots of post-ops as well as folks who lost weight traditionally. The lifestyle change, not the surgery, seems to be the key to long term success from what I've seen.

There may be individual examples of people who are exceptions to the rule, but this article from the New York Times sheds some light as to why it is almost impossible to keep weight off:

http://www.nytimes.com/2011/10/27/health/biological-changes-thwart-weight-loss-efforts-study-finds.html?_r=1

The lead researcher in the peer-reviewed study mentioned does not recommend RNY, as he considers it "draconian", but he does admit it works to keep weight off:

http://healthread.net/why-dieters-regain-leibel.htm

I'll take "draconian" if it helps me!

The point is that from a scientific perspective, attempted lifestyle change without some sort of other help is a failure for most people who try.  The question is: what else can be done to help?  Maybe someday there will be a drug that will have the benefits of RNY without the other problems it can and does cause, which will help people make their lifestyle change sucessful.

 The statistics with RNY are so much more positive than the satistics without that I think it was a correct statement to say that it is a "game changer."  It is also true that regain is possible, even probable without lifestyle changes... but I question whether those lifestyle changes are possible without RNY.

Personally, I've committed to a low carb lifestyle with a vitamin regime.  I also intend to include weight lifting in my fitness regime, something that was entirely impossible before I lost weight.

Committing to these lifestyle changes without RNY would have been nearly impossible.  Not only would the metabolic disorder I had fought me every step of the way, but exercise was becoming downright dangerous.  My psychiatrist advised against a low carb diet, because low carb eating releases less dopamine and combined with my already high estrogen levels (from endometriosis and obesity), exacerbated my depression and anxiety. 

Then, there is the ghrelin, which is the hormone that creates the "yo-yo" cycle.  RNY "deactivates" the part of the stomach that is primarily responsible for producing this hunger hormone.  So, after RNY, it is much easier to dedicate yourself to a healthier diet, AND it is possible to maintain the calorie deficit through exercise that is key to weight maintenance.  Scientists believe that post WLS bodies probably are capable of producing ghrelin from alternative locations in the body, but they also believe the ghrelin levels are overall lower in WLS patients than in the general dieting public.

So, yes, RNY is a gamechanger.  It makes it possible to commit to lifestyle changes.   So, change your body... change your reality.  I'm not pretending that it's not possible to fail with this... I've seen too much evidence of failure to discount the possibility... but we're talking statistics here.

I still disagree. RNY is not the game changer. Your mentality is the game changer. I've met hundreds of veteran post-ops who I THOUGHT were pre-ops to back this up. The RNY doesn't change you. YOU change you. The RNY helps the first few years. After that, it's basically on you.

So far as the other stuffy ou listed, I am well aware. But your body compensates. Your body learns to start producing ghrelin with your new system in time. That's not permanent. Your intestines grow longer villia capable of absorbing more fat and carbs. That is not permanent. So in the first year I'll agree RNY is a game changer but in the long term I think it is our minds that carry us to long-term success. And what I am saying is simply that this is the SAME factor that propels any other person to maintain weight loss. The physical challenges are not insurmountable. They are simply challenges, just like the challenges I, as a four year post-op, face every day.

There is nothing magical about RNY that makes it any easier for us to maintain weight loss. You do the head work and you have a good shot, though.

Just my opinion.