To Pre Ops

 
Do you want this to be your one and only WLS ??????

Than educate yourself and pick the correct surgeon.

I am noticing a lot of new surgeon names recently.


Not all VSG's are the same. It's not standardized !!!!

Some of the things I believe to be truths based on observations here on OH and my own support groups.

- Pick an experienced VSG surgeon that has a high success rate in.....

* Weight loss (60% of EW is not a good number....look for a number closer to 80%)
* Low percentage of regain.
* Low complication rate. For instance my surgeon has a .3% when the national average is close to 2% for WLS.
* Making a small sleeve. 32f being the most successful currently. A number in the 40's is like 5 years ago.
* Up to date eating plan..... not just notes from nutritional plans for normies.
* Total number of VSG's should be in the hundreds if not the thousands. Don't assume just cause they do other bariatric procedures that they would be good at a VSG. A DS surgeon can physically make a good staple line....but is it a properly shaped/size sleeve?

Some of you are stuck with a rookie in your insurance network. Look into travel and/or self pay if getting the most correct procedure is important to you. Or take the chance....your choice. 

You have to understand (generally speaking) the larger and improperly shape sleeves tend to have a higher re-gain weight. Don't listen to the person 3 months out telling you they have a 46f and they are losing weight just fine. Talk to the people with large sleeves that are 2-3 years out and find out how much they eat and if re-gain is an issue.

You will find a few success stories from folks with larger sleeves.....but you will find out they are very compliant and eat fixed amounts of food under their sleeves capacity.

Just puttin it out there..... As there has been an increased number of people on this board coming up with some pretty questionable procedures and eating plans.

frisco

You made some very good points, but the bottom line, is that if people do not make the necessary lifestyle changes, the weight will come back on, regardless of the skill of the surgeon and sleeve size. WLS is only a tool, a very powerful one, but it is up to the individual to follow through with maintaing the behaviors that helped to lose the weight. The further out from surgery that I get, it is more about the choices I make, than the surgery itself. ANY weight loss surgery can be eaten around, despite a wonderful surgeon and tiny sleeve size.

Weight regain is a complex issue and I believe is mostly related to people returning to old behaviors and habits. Whenever, I read about people regaining, it is because they stopped exercising, returned to simple carbs, and are eating junk. Following the rules will work long term, if one follows them. I don;t see too many people having problems with regain, if they stick to protein first, limit simple carbs (if any at all), and continue to exercise.

Gail

Gail, I basically agree with you that the patients long term choices make the ultimate difference in maintenance.  Without a lifetime commitment to following YOUR maintenance plan, and watching the scale, the person with regain to matter how wonderful the surgeon and how small the sleeve.  Having said this, I have witnessed a number of sleevers who are a few years out that can eat two to three times what I can eat.  We have gone out to dinner at a restaurant and the difference was astounding to me.  So while it is true that I still have to watch what I eat, it is also true that at two years out my tool is totally different than their tool.  My difficulty with weight loss was always in maintaining my weight long term, so for me the efficacy of the tool in the long run can be the difference between success and failure.  I couldn't do it without the sleeve but now I feel like I have a fighting chance to be successful long term.  There are those that have maintained with a larger sleeve but statistics are not with them.  I wanted as powerful a tool as I could get, because I will never be perfect and because I am a food addict and always will be one.