Interested in input from sleeve vets

Wow, that is a lot of weight lost in 4 months!  Congrats to you!  If you don't mind my asking, what size bougie did you have?

Honestly I don't really know. I never heard about it until after the surgery and then didn't bother asking. I suspect one that wasn't too small because I never had any trouble with liquids, foods or excess restriction.

Basically, I eat a very compliant diet and drink only water, at least 100 ounces. Yes, per your original post, my calories are small, around 650, but I really don't care or even miss what I not getting. And my diet before surgery was terrible so that's a monster change.

Is sleeve is a perfect tool IMAO.

I have lost over 150 pounds, and have been maintaining for for over a year now.  Maintaining has been no problem at all, and I do not eat low calories.  I do eat nutritional food consistently, around 1600 calories or so for a daily target.  Some days I go over, other days under.  I did not find it difficult at all to lose the weight, but I was very careful to surround myself with support (family, attend support groups) and exercise.  I have slacked off on the exercise- down to 2-3 times a week now compared to 6 days during weight loss. 

The DS is a terrific procedure.  In my specific case, I know I am terrible about consistently taking medicine/supplements so that was a deal breaker for me.  No issues with the sleeve and nutritionally deficiencies other that a stint of low iron, but I was like that before surgery.  Totally off my meds, and comorbidities are gone, baby gone!

Wow!  You have done a fantastic job!!  Congratulations!  I think support is key in success...I'm glad to hear that it wasn't a difficult ride downward and that you have been able to maintain with 1600 cals or so a day. Sounds like a good surgery fit for you and so glad your comorbidities are gone..YAY!

What INgirl said.  I'm a bit over 3 years out, and maintain around 135-140.  I'm 63 (age 60 at time of surgery).  I have no idea what my calorie count is these days, but I too follow a fairly high-fat/moderate protein plan, with very low carbs.  I also gave up journaling my food a few months ago, but up until then I was pretty rigorous about it.  These days I find that the sleeve restriction and the low-carb food plan pretty much keep me where I want to be, weight-wise.

However, you have hit on the major mystery of my experience - why on earth I can do this now, when I couldn't put together two minutes of "clean" eating pre-surgery.  One thing, I think, that helped was all the research I did on here - reading back posts, and following what the vets said - about the importance to my health of a protein-forward food plan, since we eat so little and since protein (and fat) are the only macro nutrients the body MUST have.  (That said, some people have found they don't feel well on a very low carb plan, but I'm not one of them.)  So I guess I got it, right down to my bone marrow, about how important it is to eat this way.

I'm still a major foodie, and since my surgery have done a lot of research on food and nutrition, the damage done by the traditional food pyramid, the value of good fats, grass fed/locally sourced beef, free range (truly free range) chickens and their eggs, natural probiotics from fermented food, and on and on.  The "just eat real food" movement (blogs like Food Renegade and Nourished Kitchen), the Weston A Price foundation, the value of paleo style eating, good fats, etc etc.  I've become a convert!  And that helps me stay on plan too.  If a little nutty-sounding to most people, LOL.

I have absolutely no doubt that you can lose all your excess weight with the sleeve; however, the DS is a very powerful tool, and it would serve you well also.  If, between the two, you're leaning towards the DS I would do it.  The intestinal rerouting of the DS can be done as Part 2, down the road, since the DS uses a sleeve for the stomach part.  But if you're leaning that way anyway, it makes sense to do it all in the same surgery.  Just my $.02.

Good luck! 

Not a vet yet but am one year post op. So far I have lost 85% of my excess weight and I think I inadvertently slipped into maintenance some months ago. I still intend to get to 100% but it has me a bit stumped at this point. It is really easy for me to eat my weight in some things...like cheese or nuts. It would be super easy to eat gallons of ice cream. Milkshakes would have no problem going down so yes, I could and know how to eat around my sleeve at this stage. 

I don't (yet!) because the effects of that koolaid I drank right before surgery are still with me and I hope they stay with me forever. No way to tell though. I just hope someone gives me another dose if what I have wears off. 

I started the process at 222 lbs at 5 ft 0. I want to get to 120 lbs so 102 lbs to lose.  I initially asked my surgeon about the DS and he is a vetted and excellent DS surgeon and does some complex revisions so he knows it and would not NOT recommend it if he felt this was the best option for me. He said that in my case it would be overkill and that I would lose too much weight and become malnourished. I insisted for a while because I read on the DS and the lightweights boards and saw many DSers who started out with low BMIs (under 40) and were doing very well. Then I went with my surgeon's recommendation and had the sleeve.

I don't know if I will regret not getting the DS but I certainly don't regret getting the sleeve. It is a fabulous tool. I have had no issues at all in recovery and in eating and drinking. I have no vitamin and mineral deficiencies and I am not the most compliant in terms of taking vitamins regularly. I am off of all my meds for previous co morbs now in remission.

there is no magic bullet however. I still read on the DS board a lot coz there are a lot of very smart DSers and I learn tons there. But they also speak of regain...and not just 3 lbs...so even the DS can be beaten if you put your mind to it. 

My bottom line is that you gotta drink that Koolaid and keep drinking it. If the brain ain't in it, no surgery will do the trick.

Pretty much, carbs are the bane of anyone imo, unless you are burning a lot of fuel in long-endurance/high intensity work. I find it kinda funny (not ha-ha) that for DSers, high fat/high protein is the best way to eat. At least for me, with just the VSG, high fat 60-70% of my caloric intake and moderate protein (sub 100g, 70+)  keeps me in the zone. My carbs are about the same as most DSers in maintenance. From reading here and other boards, regain happens with the DS as well, IF you start eating crap-carby pseudo-foods..  I live a fairly "primal" lifestyle.. had no idea as I gravitated to it before finding Mark Sisson and the like.. it fits. It works. I feel good, I move well, I have muscles.. I eat amazing foods, and maintain. I don't worry, or spend a heck of a lot of time working out (5 mins a day seems to work for me.) 

I still don't consider myself a vet, but I lost all of my excess weight - all 225 pounds. I went from 375 to 150 and have been maintaining within 5 pounds since June. It's not been hard, nor easy. It's about changing your mindset. I knew I could "upgrade" to the DS if I needed it, but I really really didn't want all the bad that comes with the DS, so I decided to give the VSG a good try. Has been wonderful for me :)

For comparison... my doc's goal was 250. My pie in the sky goal was 175 and then I revised to 150. I have about 10 pounds of skin that will eventually be removed, putting me at 140, which is right near the middle of my BMI range.

Honestly? The surgery and the food plan is the easy part. It's about your brain if you're SMO - with a few exceptions, I'm sure. Most of us didn't get to SMO because we were hungry for food. Getting a therapist has been the single most important thing I've done for my weight loss.

Congrats on your amazing weight loss!!!  What challenges have you faced with the sleeve-if any? What makes it easier to lose the weight once you have the sleeve? Is it the smaller stomach size; do you lack an appetite; etc?  What is the interplay of the head with the small stomach like? For example, if your head says eat and then you overeat do you throw up..what happens?

Okay, that's a lot of questions... read, read, read and read here. Just go back through old threads. You'll learn a lot. Read sleever's blogs here at OH.

Dealing with my mental stuff has been the hardest part. Once I started working on that, the rest fell into place - that's not to say it's all been roses - quite the opposite, frankly. It's been hard work. I cannot drink anything carbonated, it doesn't sit well with me (I seem to be the minority). I'm VERY limited on pasta, bread and rice - they sit too heavy. Your mileage may vary.

Obviously, the smaller stomach size helps. I rarely get hungry. Like this morning, I realized at 11 when I was out that I hadn't eaten and was feeling bad. We were near a Starbucks, so I had a blueberry muffin and a coffee. Better planning would have prevented that choice, but that was the first blueberry muffin I'd had in 2.5 years and I made the choice. I'm in maintenance, so I just adjusted my day.

As far as hunger, the stretchy part of your stomach is what is removed, that is where the hunger hormone, grehlin, is stored. That's not to say that everyone is never hunger. Most folks that DO think they have hunger have head hunger or acid reflux, from most of what I've seen.

I have overeaten a few times, but I still measure stuff (mostly eyeball it and check myself now and then to make sure I'm not getting off the path too far). For me, I've only thrown up once from overeating. Usually you know right away and there's a lot of pressure/pain in your chest. It passes, but it's not fun. Again, that's only happen a few times, I try to pay attention.

HTH