Tuesday, May 25, 2010

gastric sleeve story


If you look at this blog, you will see the glowing report from a new op on the gastric sleeve. She didn't want the gastric bypass (admits she was 'barely qualified' for WLS by US standards) because she felt it was "too drastic". But although things are rearranged in the gastric bypass, nothing is taken out of the body.

Not true of the sleeve - this drastic surgery calls for the removal of 90 percent or more of the stomach, creating a Frankensteinian pouch which holds only a couple of ounces of food.

The new op goes on to credit her normal weight to the sleeve and the reduction of ghrelin in her blood not realizing that her lack of hunger now, is simply that her stomach is going through a healing process. Human appetite is NOT controlled by one hormone, scientists will tell us and I would ask, how many people are fat because they only eat when hungry anyway?

That ghrelin has anything to do with appetite is merely a theory however, there is a body of evidence suggesting that those with less ghrelin in the system also have less growth hormone and this can cause premature aging. That, they don't tell you in WLS seminars.

Back to the new op, she runs a couple of hours a day and has done a triathlon or two. Since she is working out like those on the "Biggest Loser" she has lost weight like they do. But when she's all healed and finds her lack of a stomach to be more of a liability than an asset, like when eating healthy food like veggies with bulk is difficult which makes many tend toward foods which go down more comfortably like milkshakes, then she will likely leave her glowing testimonials up and not warn newbies of the other side of the story which she has regrettably discovered - all too late.

Some of us call this the "conspiracy of silence", the lack of negative information about weight loss surgery which leads 200,000 people a year to get cut without really knowing what the repercussions might be.

Sadly, the sleeve is viewed as less invasive than the gastric bypass and this is so not true. Since most folks know someone who has had a gastric bypass with a bad result (the least of which was regain), many are now choosing the new guy on the block, the sleeve, as the weight loss surgery panacea.

Still looking for the easy way out. But like the perfect solution, the easy way out doesn't exist and grabbing of something which is being sold like used cars, might make things a lot worse.

CAVEAT EMPTOR.

Remember even the surgeons admit, and most older op WLS patients will tell you that....

"Success with weight loss surgery is 10 percent the surgery, 90 percent the patient" (Dr Terry Simpson, MD and WLS surgeon)

51 comments:

Anonymous said...

Um... so she's putting all this weight loss and energy down to the surgery.

She seems to not really be connecting it to the very large increase in her activity levels.

I wonder, if she had just decided that she was going to do a Triathlon, even in the "Athena" category, if she would have seen all the similar health improvements, with or without corresponding weight loss.

It just seems to me from reading that all that OTHER stuff she did wasn't really from the surgery, it's just stuff she decided to do.

Are they going to start selling this surgery with the caveat that "Oh yeah, if you want it to work you also have to start doing triathlons?" Probably not... They will use her before and after and say "Look! look! it was ALL the surgery... if you have it, this can be YOU!"

wriggles said...

Human appetite is NOT controlled by one hormone,

And even if it was, that would be the thing to control/adjust, directly.

Aggression should not be the first and only resort.

Unknown said...

Ive had the surgery 6 years ago and I havent age one bit.. In fact because of the weightloss I look 10 years younger, I also feel 20 years younger. I think for most it has been a successful operation. I know for me it has been and I have no regrets. After 6 years my hunger drive before I had the operation has not returned. However my weight loss did slow down after the first year. But like thousands of others , I am pleased with the results.

Sue Joan said...

Lee, I appreciate your comment but 6 years isn't far post op in the grand scheme of things. I'm sure there are folks who do well with the surgery but I'm wondering how many and how long. I'm afraid it's incorrect to make a conclusion that "most folks" are happy campers especially after 10 or more years ... I have yet to meet a happy camper with a gastrectomy of any kind at the 15 year post op point - most have not only regained the weight but also have many repercussions like post gastrectomy syndrome. I sure hear A LOT of horror stories though - many folks get to feeling so altering their digestive systems has ruined their lives - especially with a procedure like the sleeve which is so not reversible. I'm sure you work hard and have a willing body and that's good. ("Success with weight loss surgery is 10 percent the surgery, 90 percent the patient" Dr Terry Simpson, WLS surgeon) Will you post comments if you start getting repercussions from it or will you add to the "conspiracy of silence" about this surgery, I'm wondering.

Regina said...

"Will you post comments if you start getting repercussions from it or will you add to the "conspiracy of silence" about this surgery, I'm wondering."

This "conspiracy of silence" is what is ticking me off most regarding WLS. I am a 400lber. I'm a walking dead person, to most who believe the hype. The shame of being this fat makes me hyper sensitive to the stares, giggles, and tongue clucking of the non-fat. I have even gone to two weight loss seminars and come within a stone's throw of having the Gastric Banding. The one thing that stops me? The damn silence from the WLS patients who are 10 yrs out from their surgery. There is something in my logical brain that tells me that if I undergo surgery that restricts my body's ability to absorb or intake nutrients necessary to survive---IM GOING TO GET SICK~. I want to live a long, healthy life. At 44, I have only sleep apnea and GERD to contend with at my weight. I have had 3 non-weight related surgeries (uterine fibroid/tubal ligation-vertical abdominal incision, appendectomy, and uterine ablation). Post surgical office visits ALWAYS end with the dr. saying "You're healing well and ahead of schedule!". Hmmm...do you think that might have something to do with my energy reserves??? Hmmm?
Anyway, back to my initial comment....I think shame is the underlying factor here. Shame due to the WLS not producing the results, natural hunger causing the pouch to stretch (and keep the patient alive), fear of being seen as a failure...all of those shame factors whose silence COST LIVES. Shame that's encouraged by big pharma and the medical community because continue to blame the patient for everything instead of re-examining the methodology and fully researching outcomes beyond the standard 2 yr mark. Silence, in this respect, truly IS deadly!

vesta44 said...

This is why I wasn't silent about the failure of my WLS or the fact that it killed my best friend. I'm 11, almost 12, years out from mine and let me tell you, if I had it to do all over again - I would tell my nurse practitioner (who recommended the VBG) to put a sock in it, no way no how would I do this (in fact, the social security doctor I saw who said I should have an RnY got told they had their one chance to kill me, they weren't getting another one).
At that, I'm lucky - I don't have many of the complications from WLS that a lot of people do. Probably because a VBG isn't as drastic as RnY or gastric bypass, and my pouch either stretched or came partially unstapled. I do have fibromyalgia and IBS, and I take a multivitamin, along with additional B12 and vitamin D, just in case. Still, I'm 30 to 40 lbs heavier than I would have been if I had never had the surgery, so ultimately, with the complications, I'm worse off now than I was before the surgery (oh, and my mobility issues are much worse now than they were 12 years ago). WLS is not the cure it's touted to be, that's for sure.

Michelle said...

I am one of the success stories of bariatric surgery. I had the bilio pancreatic diversion, mainly due to 3 basic reasons: 1. it is partly reversible if things went south (I am a skeptic by nature) 2. It has the best long term success and 3. it best suited my eating/social habits - my family are big on entertaining & dining out - though I do eat less than I used to it is still the same types of foods as everyone else after about 12 months post op.
I was 144kg or 317.5pds and now I am 78kg or 172pd. After 6 years I am only 2 kg heavier than I was at my lowest weight post op and I do not diet! Yes there are some concessions. I must take multivitamins for the rest of my life (costly) My bowel motions stink to high heaven. And I feel rotten if I stuff myself - hence I eat smaller portions but it is only smaller compared to what I ate before - I still eat larger portions than my slim adult daughter. My sister had the gastric bypass 18 months earlier and has a similar success story though she does have more flatulence problems and has discovered she is lactose intolerant though it is unconfirmed if this is due to her op.

Sue Joan said...

@stampnMichelle, Congrats on your success! Good job on the weight loss! That being said, since you are less than 3 years post op, medical information states that it is unknown how your body will eventually react to the surgery. Most new ops are quite happy with their surgery - that's why they call the first year or so, the "honeymoon stage". As time wears on, it will make a difference how careful you are about getting in your protein and taking your vitamins (in the second year or so, the body depletes itself of its stored up vitamins and must rely on what you can digest which is much less with a long intestinal bypass as is connected with the BPD). Also keep on the lookout for anemia - that seems to be a problem with (some doctors opine) about 50% of BPDs. If you get this, you will need iron infusion. That is what can be so misleading about this surgery - early results are good for most folks but few are prepared for the possible long term repercussions. As Dr Mason, inventor of the gastric bypass has written, the digestive tract was probably made the way it was for a reason and changing that can have devastating side effects. All the so called "fixes" for obesity assume that we only eat when we are hungry and so if the appetite is changed or the digestive system re-plumbed to work less well, that will solve the problem. And for a few folks (about as many as make it with a non surgical program) it can work but for many, they find their appetite returns with a vengeance in the 2nd or 3rd year and then, they are faced with the same dieting and exercise dilemma they couldn't handle before surgery. Everyone researching this surgery should seek patients who are more than 10 years post op to chat with before making their choices. Most 10 and more year post ops, even if they have remained slim, do not recommend the surgery. One of them who is a great success with the surgery (same procedure you had, the BPD), says it's so much work to keep healthy and fit that there are days she wishes she'd never heard of weight loss surgery.

Michelle said...

I am 7 years post op and I have NO regrets whatsoever. Of course I tried all manner of dieting and exercise before the operation and either it didn't suit my lifestyle or I was unable to maintain the diet etc which ever way I tried over the years I just ended up being more frustrated and more overweight. If I could have done it 'naturally' then terrific but I couldn't. I needed drastic help and I am NOT ashamed of it.

Sue Joan said...

@StampnMichelle: oh duh, I re-read your first comment and you did say "after 6 years". So I don't know where I got the "3 years post op" idea. :( Anyway, I guess I feel the need to comment. Bottom line, none of us could do it until we did it. This was my fourth time on Weight Watchers and that's not counting all the other programs I was on (except cabbage soup... was too lazy to make the d---n soup!). At the age of 66, I'm sure I've tried (and failed) more programs than you. But you know we musicians have a saying "never play when you are hungry". In other words, decisions made in desperation are often, not the best decisions. Bottom line, you keep trying and eventually you find a way. With or without surgery. You can see my weight loss story here:
Sue's weight loss video

Another bottom line, it's a trade-off. And I find that successful WLS patients do the same things I'm doing - they exercise and eat healthy (if they don't they WILL get very sick by and by). My trade-off, I log my food daily. BUT I do not have to deal with feces which smell so bad that people complain, nor anemia nor blood work every six months and stuff like that. IMHO, WLS is much more of a trade-off than my 3 minutes of logging my food each day. You see what you are doing by keeping off your weight is about 90 percent YOUR work and not the surgery i.e. "success with WLS is 10 percent the surgery and 90 percent the patient". Thus says WLS surgeon, Terry Simpson. Additionally, and this may not happen to you, I hope it doesn't but I've known surgeons who no longer do the BPD because of the vitamin deficiencies that many patients get on the long term (and I mean in 10-15 years post op). Fact remains, since you are doing most of it without surgery, you COULD have eventually done it totally, without surgery and so that begs the question of whether surgery is a real good idea for most folks. (Any surgery has its place but often not enough of a place to make a good living for the surgeon unless they sell it to more people than it's good for.) I truly decided being fat and fit was the lesser evil than having surgery and I did enjoy life that way for 42 years. But in the long run when I discovered, quite by accident, that mild calorie restriction made my severe GERD go away, then THAT became the lesser evil and that's how I lost all my weight and have kept it off for over a year now. 112 lbs off. Hubby has found that mild calorie restriction keeps him off insulin (he has diabetes). "We only make a change when the pain of changing is less than the pain of staying the same". Human nature. Wishing you continued success and health! Thanks for your interest in my blog!
Best,Sue

Unknown said...

Hello I just need help I am having my sleeve in 5 days and I have one hundred million scenario's in my head. I have tried everything from Jenny Craig to Weight watchers to store bought diet pills I cut my diet down to 1200 calories and my fiancee did the same thing how ever he lost 75 lbs and I gain 11. I need to know the truth is it hard to adapt to the concept of no regular food and pop again. I have been doing is drinking protein shakes and h20 for about 9 days now and I find myself dreaming about food is this a sign? please anyone with advice I will welcome it.

Sue Joan said...

@Michelle, the sleeve is very drastic because it calls for the removal of 90 percent of your stomach and therefore if you do not like it or something goes wrong, you cannot have it reversed. Yet, the sleeve has not been proven any more effective than the gastric bypass and the bottom line is, after the initial weight loss, you will have to do the same things that you have to do on Jenny Craig or Weight Watchers or any of those. You will have to exercise and count your calories. I would suggest holding off the surgery until you have better researched things. You can ask someone whether it was so hard and they can say "Oh it was so easy for me" and maybe it was, but we are all different. For most folks, keeping off the weight with ANY program is extremely difficult for one reason or another - and that is why so few people can do it. Only 5% can keep off the weight without surgery but with surgery, any surgery, even a drastic one including an intestinal bypass and removal of most of the stomach, only SEVEN PERCENT can keep off the weight that way. If you are dreaming about food, it means you are very hungry and this isn't necessarily going to change with having weight loss surgery. Many patients who have any type of weight loss surgery, suffer not only repercussions on the long term but also regain the weight so now they have the co-morbidities of weight loss surgery plus fighting the same obesity problem they had before and they are STILL stuck with finding something like weight watchers or jenny if they want to lose the weight again.

Whatever the case, I think most patients will tell you, if you are not very very sure this is what you want, hold off until you are very very sure because there is no going back on something like the sleeve - once 90 percent of your stomach has been removed, you are stuck with it for life!

You might want to consult a doctor to help with metabolic problems if you really gain weight on 1200 calories a day.. surgery to make your digestive tract into an unnatural state is not going to help metabolic problems but there are medications etc which might help.

HOLD OFF until you have better researched and you are very sure because there is NO GOING BACK with the gastric sleeve! No chance for reversal if it is not for you!

cd70 said...

it seems to me that unless everyone agrees with you suew that your going to have a negative comment to come back with , so tell us sue how much weight did you lose ? how did you lose it ? Cmon tell us please ??? or are YOU going to be silent some people have very few options and this is theyre last hope why don't you try to be supportive and not such a lil whiney b ,,,,

Sue Joan said...

CD70 (who probably won't check back to see this) I'm glad you asked how much weight I lost. I lost 112 lbs (to a BMI of 25) - no surgery or pills and have kept it off for over a year now. I just kept trying until it worked. Here's my video... take a look! :)

Sue's weight loss video

The sad thing about WLS (any procedure) is they appeal to folks looking for the "easy way out" but the bottom line is no matter how a person loses the weight, they have to do the same things. Log their food every day, exercise and calorie restrict, only if you have a WLS then you have to deal with medical issues as well - doctor visits, blood work, vitamin deficiencies. Americans are always looking for a "free ride" and marketeers love to take advantage of this but "there is no easy road to a place worth going!" (Beverly Sills, opera singer)

Now ... whom did you call a whiney b? *LOL*

love4my3kids said...

Hi i am about a month away from sleeve gastrectomy surgery and i am sooooo scared i cant believe im actually cutting off what god gave me for substitance formy body! I was going to get the surgery last year and i backed up 3 days before the surgery because i wanted to do it on my own but i lost 18 lbs only and regained 30 ! Im so depressed dont want to have this. Surgery in my heart i know im hurting my body by doing so but i weigh 241 lbs and im 5ft2 i have high blood pressure pre diabetes sleep apnea and my self esteem is so low, allmy bones hurt im always extremely tired i dont know what to do sometimes i thnk if god sent to get me it would b thebest thing! If you have any feed back for me please email me. At: odiluvsr@hotmail.com thank you so much for this blog and congrats on your sucess

Navypride said...

I am 31 years old and had my Gastric Sleeve done June 10, 2009, and after 2 years I am sad to say I wish I could go back and decide not to have it done. I am slowly withering away painfully. I am now on iron infusions weekly, vitamin shots weekly, and am so neasouse all the time that i can hardly eat now. I am labeled a fall risk because every time i stand up my blood pressure drops so far so fast that i almost pass out and sometimes do because this has effected my heart. My organs are slowly failing and there is nothing I can do about it. I wish that I knew about these types of complications before the surgery. So here I am a Navy wife and a mother to 2 special needs children ages 11 and 8, and I wake up every day sad because I know that my dream of being healthier to be able to watch my children grow up may now be cut a lot shorter then it was before my surgery.

Sue Joan said...

Navypride, I am so sorry to hear about your illness with the gastric sleeve. I think you are not alone and thank you so much for posting your experience - it may save a life! Sending a hug!

Landons Mommy said...

Navypride, I am 31 as well getting ready to have this surgery next month. What does your surgeon say is the reason for these complications? I have been reading so many stories both good and bad, and now I am worried about my health after surgery. I thought the only things I had to worry about were potential leaks and hair loss. =(

Sue Joan said...

Landons Mommy, Losing hair is not a big deal and probably not true with the sleeve and leaks are pretty uncommon after the first week or so. Nutritional deficiencies, food getting stuck, lots of food which doesn't go down right and esophagal distention (stretching of the esophagus even in compliant patients) are common after all WLS procedures.

Some surgeons will typically blame complications on the patient (in order to avoid shedding a bad light on the surgery).

Fact is when you cut and remove 90% of the stomach from the body, yes, it's going to cause a lot of repercussions because the stomach is a key digestive organ where most proteins and fats are digested and where many vitamins are digested like B12. Removing the stomach which is essentially what they are doing with the sleeve, is like removing the central organ of the digestive tract (the "main office" etc). And sadly, although the remnant left (about as thick around as your thumb and twice as long) doesn't digest much, it will stretch in time to allow more food intake.

"There are no shortcuts to a place worth going." If you want to lose the weight, you are going to have to count calories or points whether you have surgery or not and probably do some exercise also and if you don't want to cut down the food, you still can get healthy by trying to make mostly healthy food choices and exercise 3 times a week like take a 30 minute walk or something like that 3 times a week. Many people choose surgery because they think they won't have to diet and exercise to lose weight. That's so not true and most surgeons will tell you that you still end up counting calories or points and exercising to lose weight. Yes, there is a small percentage who do well with surgery (and most of them, whether they admit or not, are counting calories or points or by some other method restricting food intake - remember you can drink endless milkshakes and eat lots of ice cream with any weight loss surgery) but that's like 7% who are keeping all their weight off and staying healthy after weight loss surgery which is only 2% higher than those who keep off the weight without surgery.

Some folks who are not having a good journey with their surgeries, stay silent for fear of being blamed (although it is seldom if ever, the patient's fault).

Bottom line - can you lose weight after surgery and keep it off? Definitely. Will YOU be doing most of the work? Also very true.

"Success with weight loss surgery is 10% the surgery and 90% the patient!" (Dr Terry Simpson, MD and weight loss surgery surgeon)

Thyla said...

Ghrelin is also produced in the hypothalamic arcuate nucleus where it stimulates the secretion of growth hormone from the anterior pituitary gland.

HGH is not produced in the stomach, and the stomach is not the only place where ghrelin is produced.

New research findings to be presented at the upcoming annual meeting of the Society for the Study of Ingestive Behavior (SSIB), the foremost society for research into all aspects of eating and drinking behavior, finds that ghrelin, a natural gut hormone that stimulates feeding, also modulates the ability of tasty food and food-related cues to alter dopamine levels within the striatum, a critical component of the brain's reward system.

Also wanted to add:

"Scientists measured dopamine in 'real-time' while rats ate sugar, a highly rewarding food. Administering ghrelin to rats while they ate sugar increased peak dopamine "spikes" within the striatum, whereas administering a drug that blocks ghrelin's actions significantly reduced dopamine levels during sugar intake. Study author Dr. Mitch Roitman (University of Illinois at Chicago) says, "The modulation of brain dopamine reward signals by a gut hormone that regulates appetite strongly supports this interaction as a way to direct the organism's behavior towards further intake, perhaps by making food more rewarding. The results shed light on how peripheral body signals in general can shape brain-directed behavior."

Source: Society for the Study of Ingestive Behavior

Linda Sherwood said...

The "conspiracy of silence" I have a problem with is how my father decided not to have weight loss surgery, and he died at the age of 69 after decades of serious health issues that could have been improved or eliminated with weight loss.

My dad was over 400 pounds most of my life. He did lose 100 pounds after a strict 5-year diet, but he gained it back.

He had a pacemaker, multiple heart attacks, diabetes, high blood pressure, shortness of breath, etc. His weight caused problems with his joints. He did not go to my school events.

My children (those that do remember him) remember him in a wheelchair. He sat through most of my life watching rather than participating. That isn't living.

Even if weight loss surgery isn't successful long-term, it improves the quality of life.

I am too young to have a dead father.

Research shows most people who lose weight without surgery gain it back. For surgeries like by-pass, there is also a high risk of gaining back the weight.

Living a life while morbidly obese is a conspiracy of silence that needs to stop.

Sue Joan said...

Linda Sherwood, I would like to point out that your clinically obese father died at the age of 69 but my normal sized father died of a massive heart attack and stroke when he was 63! On the other hand, my clinically obese mother was still going strong at the age of 68 when she decided to end her own life (she was bipolar). So much for the dangers of clinical obesity. Want more examples? My husband has a cousin who is 75, and has a very high BMI (higher than my mother had) and she's still going strong! No study ever found that clinical obesity killed you. What the studies all have found is that lifestyle factors like lack of exercise and poor food choices can greatly raise the risk of an earlier death. Er... How many 69 year old weight loss surgery patients do you see walking around? You really think crippling the digestive tract would have prolonged your Dad's life? If you do, I'd suggest you read some of the study instead of listening to the hype on TV or in the media... Would you like to know how many folks in their 30's and 40's I've known who died FROM weight loss surgery? Be thankful your dad DID NOT have it!!!

Christy Farneth-Kerr said...

Wow!! I find this blog topic very interesting and all of the responses great. It's one side of many and I can respect your opinion Sue. WLS has been a complete success for my entire family. I was 8 years old when my mother had her gastric bypass. I remember how she would get looked at in the grocery stores and how difficult it was for her to be around a crowd of people. She never got on the floor and played with me or went swimming for that matter. She is now 67 years old and in a size 12 and sure she has to take a b12 shot once a month but in the grand scam of things that's nothing. Her highest weight was 395 I don't think I would have a mother today had she not made that decision. The amount of joy I get out of seeing her with my children. Well there is no greater gift she could have given them. I also have an auntie who is 80 had her surg in the 80's and recently 4 of my cousins had wls in the last 3 years all are doing very well. You definitely get out what you put into it. Its not healthy to yoyo either. You have to change your life style. I am going to have my wls in October :) and I cant wait
Thank You

Sue Joan said...

Christy, undoubtedly, there are successful patients who have this surgery, however, as you pointed out, the successful patients are the ones who make lifestyle changes and that can be done without surgery. On the other hand, those who do not make the lifestyle changes, end up not doing well to lose weight and can get sick also. Undoubtedly, surgeries which cause vitamin deficiencies like gastric bypass will cut some years off the lifespan because there are over 100 vitamins and nutrients we need on a daily basis, only a small percentage which can be supplemented. If your Mom had her surgery several years ago as it sounds, she likely has a lot more of her stomach remaining than the pouch they do these days. She also may have the thing where the food drops from the pouch into the stomach. Finally even if not, a larger remnant stomach will produce more enzymes etc. Truth be known, they didn't know much about digestion when the gastric bypass was invented or what a key organ the stomach is, in the process. Bottom line, no weight loss surgery is much of a help in keeping off the weight...even with the tiniest pouch, liquids and milkshakes slip easily down. Which is why the success rate of people who can keep off the weight, is only slightly higher than among non surgical losers, that is... 7% of Weight loss surgery patients can keep off all of their excess weight and 5% of non weight loss surgery people can keep off all the weight. The extra 2% of surgical patients keeping off weight, can probably be accounted for in those who become ill and cannot eat. Bottom line is it's just as much work to keep off weight, with or without surgery, so taking those kind of risks may not be necessary for many folks, although you mentioned your Mom started out at close to 400 lbs so it may have worked for her where lighter weight persons may not need such drastic intervention. Any surgery is not for everyone. And should not be sold as such however, if only folks of very high BMI got these procedures, it would not keep many providers in business! Which is, of course, the downside of a medical system run under a profit making system. Modern procedures like the sleeve, and the lap band, are less invasive than the older procedures... If you are not as large as your Mom was, you might consider making a commitment to something like Weight Watchers which has worked well for me to keep off 110 lbs for over 2 years. Whatever the case, I wish you well with your procedure.

Sue Joan said...

Christy, it also should be mentioned that several studies have found that fat people who exercise have about the same risk of early death as thin people who exercise regularly and both fat and skim couch potatoes have the same risks of illness and early death ... Weight has been found in several studies to not be much if any, of a factor in health. Healthy food choices and regular cardio exercise seems to be the key regardless of weight. So just going to healthy food choices and exercise 5 times a week or so, is a very viable option without losing weight! That type of program is called HAES or "health at every size". I lived healthy on HAES even being clinically obese, (BMI 40-44) for 38 years and only ended up on calorie restriction to control a very nasty case of GERD. There are many options some of which you might not hear from your PCP's!

Chris said...

You've ONLY kept it off for a year? Come back and talk to us after you've kept it off for over 10 years. PULEEZE!

Sue Joan said...

Chris, uh, you didn't look at the date of the blog, nor my post. I've kept the 110 lbs off for over 2 years now... No surgery. How about you?

annk73 said...

Suew, I took off over 100 lbs and kept it off for almost four years, but it eventually slowly crept back on, which it does for almost everyone. You keep saying that its the easy way out......yet you also state that the same things have to be done as you would without surgery. Which is true? So it might be less insulting to others if you dropped the "easy way out"comments. And truly, you have not kept your weight off nearly long enough to be considered a long term success...... Certainly no more than the VBGs you have been dogging. Also you really can't compare one type of surgery to another when they do not work the same. The VGB is relatively young so its impossible for you or anyone to accurately predict the long term outlook yet.

Sue Joan said...

Annk73, I have NEVER said weight loss surgery is the easy way out. I think it's a rather HARD way out. Not sure where you think I wrote that. Best to read more carefully.

Jane said...

Wow, all this is interesting! I am 2 1/2 years post op sleeve. 35 kgs lost, no blood works every 6 months, healthy as. Eat really well, no side effects at all. I have heaps if friends who have had the sleeve an no one has any side effects. I am just reading a book which states that virtually zero percent keep weight off 5 years on for non surgical weight loss. I could not have achieved my weight loss without the sleeve, however it is a tool, but what a great tool it is. I am no different than I was before I had my sleeve except I am satisfied with a much smaller amount and tend to et protein and salad a lot. Will wait and see what the future brings but I am fairly confident I will be OK! Cheers Janelou x

Jane said...

Wow, all this is interesting! I am 2 1/2 years post op sleeve. 35 kgs lost, no blood works every 6 months, healthy as. Eat really well, no side effects at all. I have heaps if friends who have had the sleeve an no one has any side effects. I am just reading a book which states that virtually zero percent keep weight off 5 years on for non surgical weight loss. I could not have achieved my weight loss without the sleeve, however it is a tool, but what a great tool it is. I am no different than I was before I had my sleeve except I am satisfied with a much smaller amount and tend to et protein and salad a lot. Will wait and see what the future brings but I am fairly confident I will be OK! Cheers Janelou x

Sue Joan said...

Jane (Janelou) Congrats on your success in losing 77 lbs and thanks for your comment. I lost 110 lbs 3 years ago and am also keeping it off - without surgery. With surgeries like the sleeve, the stomach expands after a while so if the patient does not watch their calories and food choices, the long term success rate is low, however, most of the surgeons are favoring this new surgery because gastric bypass has been observed to have too many long term complications. Sadly, since so much of the stomach has been removed in the sleeve, it is doubtful how much protein is digested and sleeve patients should be warned to take supplemental protein powder to make sure they do not suffer a long term protein deficiency. (If you start getting sore muscles, you may be suffering from that - you can get that even on a long term calorie restriction program without surgery - I know that from personal experience!) It's not zero percent who can keep weight off without surgery. Weight Watchers records of those lifetime members who weigh in once a month show that 80 percent of them keep most of their excess weight off. That is, I'm glad you had success with surgery but many of us can have success without surgery also - one does what works for them - I would not want to surgically mess with my GI tract! I did not get fat because my digestive system worked so it stands to reason that breaking it through surgery may not be a long term solution for obesity (which it's not in the majority of folks). The lifetime cure, is daily vigilance and lifestyle changes which are kept up. If your sleeve encourages you to make those right choices even after it stops being very effective, then, you will be a lifetime success. I wish you the best!

Unknown said...

Sue oi appreciate that you are strongly opposed to wls. I also appreciate your passion to share that with others. As a 40 year old wife, and mother of 4 beautiful girls I've tried the last 20 years to lose weight only to yo yo right back heavier than before. I weigh 274 lbs and I'm 5'7" tall. I have made up my mind to have the sleeve. I know if I keep on this path I'll end up 300 or more pounds. I have no ability to do this on mmyown. In my opinion I will use this as a tool to help me finally overcome.

slimmerkim64 said...

I'm 2 years post gastric sleeve. I was overweight most of my life and tried numerous ways to lose the weight. I was 47 suffering from high bp, sleep apnea, arthritis, depression and just overall felt like crap. I chose gastric sleeve surgery over the lap-band. Now I'm a month away from my 50th birthday, I weight 135 lbs. I'm in better shape now than I was at 30 and I feel great! I exercise, I eat right and my quality of life has improved immensely. I take a mult-vitamin, b-12, and citracel with vitamin D. My bp averages 90/60, my labs are all perfect, no more sleep apnea and I look forward to living a long healthy life!

Sue Joan said...

slimmerkim64, that's nice but two years post is still pretty new op... gastrectomies don't bite the way gastric bypasses can but they can bite also. I think you should be taking protein supplements since a stomach the size of a thumb is not going to digest much if anything, and a protein shortage by the time you feel symptoms has already gone too far. As for "good labs", terminal cancer patients also have "good labs". You should be doing a lot more supplements than merely a mult-vite which is probably just passing right through. Eating healthy and exercising will not only take weight off anyone (without surgery) but is the way to stay healthy... do consider protein supplements though please... you do NOT have a normal stomach.... and need to eat accordingly or you WILL get sick - it's just a matter of time... Good luck and thanks for reading my blog! (I using the Weight Watchers program, have now kept off 94 lbs for 4 years!) No surgery.... Weight Watchers works!

texasdaveinla said...

OK! Enough, fellow fatties. Here's how it works. If you've been fat your whole life, a couch potatoe, secretly consume food like heroin in the dark, don't do the surgery, you'll be the one with all the complications. But if your lucky like me:)--- a former model skinny most of their life until mid, late 20's because of age, Then do it!! We're you a former athlete or gym goer for at least a decade, living on salad happily??? I was. Then my age and a little depression put 60 ibs on me. I stretched my formerly small stomach. The doctor shrunk it back with the sleeve. The new diet was actually nothing new to me I had previously eaten and lived that way for over a decade. Shakes, lean meats, ect. I went 4 yrs once without pizza my fav food. I was a model. I fucked up stomach stretched it out, because I was in a slump, then the surgery took me back to normal. It also cured my IBS I've had since birth. All these horror stories come from old surgeries not usually the sleeve. And if it is a horror story, it's from someone who probably broke the rules and secretly tried to stuff a whole pizza down, then lied and said, I don't know what happened, bullshit. This surgery saved me. I look 25 again. 250lbs to 160. 5'9 male.

Sue Joan said...

TexasDave... First of all, as a young male, you have a much easier time losing than women...even non couch potatos like me...secondly, gastrectomies tend to bite after a few years so not a good idea.... Why didn't you join Weight Watchers ? That works with anyone without surgery... I know...I have kept off 94 lbs for 4 years on WW and I am NOT a young male... I am an elderly 70 year old with a tanked metabolism....

Unknown said...

You are full of shit - the surgery saved my life. Gastric sleeve is wonderful and I have not had any complications, but I also followed the doctors orders about diet, some do not. Please don't talk about something you know nothing about (since you never had the surgery). Stats are only 5% of dieters lose and keep off their weigh for 5 yrs, WLS patients have an 80% chance of keeping off their weight for 5 yrs. Stats speak for themselves... to all that are thinking about it, go to youtube.com and here it live from people who have had it. By the way, the surgery 10 years ago was totally different from the surgeries today (open surgery with much higher complication rates)- look it up.

Sue Joan said...

Heather, just because the sleeve is working for you now doesn't mean it's going to work in years to come and doesn't mean it works for everyone. Anyone who keeps weight off anyway, has to work at it. I've now kept off 100 lbs for 4 years and everyone I meet who is keeping off weight is doing just what I'm doing...logging or journaling food and exercising. The WLS surgeons say "success with surgery is 10% the surgery and 90% the patient!" And if you are telling folks anything else, you are misrepresenting the truth. It's invasive surgery and yes, even gastrectomies have long term repercussions. People should know BEFORE surgery what they might be in for in the future...your angry comment leads me to believe you wonder if there is some truth to what I wrote! :)

Finnegan said...

My good friend weighed over 400lbs. He wanted the sleeve but it was too expensive in Missouri unless have welfare or on group ins plan. He was terrified of a Mexican trip to Tijuana but his health was poor and he saved money to do it but was struggling with fears of surgery. He felt he needed the sleeve to help boost his motivation to lose weight, exercise and keep it off. His doctors were hopeful he would do it soon. ...he was not soon enough with the choice as he died of heart attack last month related to obesity associated metabolic syndrome as evidenced by enlarged liver, type 2 diabetes, hypothyroidism, heart disease, family history of obesity, and depression... I believe his life could've been prolonged even if only for ten years .... The sleeve would have most likely helped his chances of reaching weight goals. Weight watchers would be appropriate post op in his case as he needed drastic discipline to get him started.

Sue Joan said...

Finnigan... According to the huge Cooper Institute Studies spanning over 30 years and including (and following) 40,000 people, health was contingent on lifestyle...including cardio exercise at least 5x a week and healthy food choices and regardless of girth or weight....before I was successful on Weight Watchers ...lifetime membership in 2009...have kept off over 100 lbs for almost 5 years now...I was over 100 lbs overweight for 38 years, but exercised cardio daily and resistance 3-4 times a week... This did keep me healthy...I'm living proof that the Cooper Institute studies were valid... There is no quick fix to either health OR obesity! Like my friend surgeon Terry Simpson says "success with weight loss surgery is 10% the surgery and 90% the patient!"

Finnegan said...

Great, I agree with you Sue, just wish my friend had listened to you in time. If only he had done the gastric sleeve earlier that year (10%) and followed up with your advice to follow weight watchers (90%), he would have been alive today. Did I mention he was engaged to be married this month? Yes, the gastric sleeve would have given him the time to follow a permanent change forever such as with your recommended diet and lifestyle with weight watchers. Thank you for clearing this up.

Sue Joan said...

Actually, Finnigan, you do not agree with me...my point was since 90% of success with weight loss surgery is the patient's diligence on a daily basis, my point was your friend DID NOT need to take the risks of invasive surgery to lose weight....part of that risk with surgery, is a 2% chance of dying within a month of surgery! And since 90% of it is the patient's work, why not just do the 90% and skip the risks and expense of surgery? Furthermore, I pointed out that the Cooper Institute studies of several thousand people over 30 years, found that exercise and healthy food choices, are key to health REGARDLESS of weight...so your friend did not even need to lose weight to become healthy! Hope that is more clear now...

Unknown said...

I had my sleeve in July of 2014. I am down 103 lbs so far - from a size 24 to a size 12 at the moment. I am married to a bariatric FA / Educator. I know all of the surgeries, inside and out. Some of what I'm reading here is untrue and based on patients who clearly have GAD and other issues. Bottom line, if a person is obese AND has comorbidities, their life expectancy IS already shortened compared to a person of normal weight without comorbidities. Patients who need WLS are ALREADY high risk patients for complications, and often the ones that die do NOT die from WLS!!!!!!!! They die from complications from their obesity. Is it too soon to statistically know how a sleeve will compare? YES. It is a fairly new procedure. It is restrictive ONLY; no malabsorbtion b/c nothing is reworked. Simply, a large portion of the stomach is stapled off and removed. In essence, it is a subtotal gastrectomy. Lap Band, another "restrictive" procedure has proven that weight loss IS less and can easily be gained. That avenue of thought stated, we can assume the same long term results MAY happen with a sleeve. Presumably, this will happen because patients fail to comply with the diet, fail to follow up with their bariatric Team, or just plain fail - mostly b/c of unresolved psychological issues. If a person is obese/sick enough to need bariatric surgery, then they are sick enough to die without surgery. I can't stand reading comments made without research and/or knowledge of WLS. It is NOT a decision that should be made quickly. People need to research and understand EACH of the surgeries, and choose the one that best fits their need(s). These forums are NOT the place to get educated on these matters. Seek professional guidance if you feel you are in need! Know the facts and make only informed, intelligent decisions. Email me if you need real solid information. My friend has a whole online program in the works that can assist people in gaining knowledge. Personally, I think the jury is out on discussing ANY long term effects of a VSG. Plainly, it is way to soon to see what long term outcomes can be expected. No, a VSG can not be reversed BUT it can be converted (in some appropriate cases) to a Roux en Y Bypass. I absolutely regretted my decision to have a sleeve for the first 5 weeks postop. I absolutely LOVE my decision now, 1 year out! I run, fit into clothes I only once dreamed of fitting in, am healthy, lowered my blood pressure and I am only getting stronger! Yes, food is my nemesis each and every day, but I am in charge of my weight loss and my diet. I choose to eat healthy, low fat/low carb foods to fuel my body. This is the best thing anyone who suffers from the disease of obesity can do for themselves and their loved ones. It is easy??????? NOOOOOOOOOOOOOOOOOOOOO. But, nothing worth it usually is. Good luck.

Sue Joan said...

Marie, congrats on your success with the sleeve ... Most post ops love their weight loss surgery for a year or two but it is when the complications set in, that they have second thoughts...also..to keep off the weight requires daily vigilance and that works without surgery.... Something which people almost never hear in seminars...I am keeping off 106 lbs using the Weight Watchers program and have kept it off for five years...I know that weight loss surgery isn't a free ride and everyone I know who is keeping off the weight, is doing exactly like I am doing...counting points, calories or "macros" and exercising ...

Unknown said...

I see people posting that they take out 90% of the stomach but my dr only takes 70% out. It's a scary thing. My husband and I are doing it together in the next 2 weeks. Did you ever go thru it? I'm not sure when this was posted.

Sue Joan said...

To J. Rod, how much of the stomach is removed, is up to the doctor... Removing 70% of the stomach is less risky than removing more but some surgeons remove more because removing less sometimes is less effective than removing more. Bottom line is the appetite center is in the brain, not the stomach so controlling weight has a lot more to do with the person working with their brain than surgery to make the stomach smaller. Which is why the recidivism rate on weight loss surgery (unless the patient becomes ill) is rather often. I have now kept off 106 lbs for almost 6 years, doing exactly as you will have to do... Count calories, weigh and measure portions and become able to say "no" to things like fast food, junk food and so forth...when they first started doing weight loss surgery, they thought the stomach controlled the feeling of satiety...but now they know the appetite and satiety center is totally in the brain...we've come a long way in understanding the GI tract since the 1960's when they started doing these procedures... Al Roker, a gastric bypass patient does exactly what I do without surgery, to keep off the weight (guy on the Today Show on NBC). Took me 38 years despite reading umpteen books, articles etc, to figure out weight control! So why do they still DO these procedures? The average weight loss surgery surgeon makes $1.5 million dollars a year...people have done strange things for much less money! :)

Sue Joan said...

Tommy 4 tonable posted the following: To those espousing WLS: you are or were unhealthy simply due to either lifestyle choice, lack of discipline, or some other issue you're failing to overcome. Now, that's not to say that there isn't some contributing underlying factor (i.e. emotional, special case, other medical symptom leading to the need of a special diet or something that doesn't allow you to exercise and be healthy). But, isolating those issues from the weight issue is simple. For example: Sally is overweight because she's depressed and is eating more than normal or lacking motivation to exercise. The problem here is the emotional issue and it's toll; the solution is get help/therapy to overcome that. There is no fundamental reason why exercise and diet AND discipline won't cure the overweight symptom. In fact, even if you CANNOT exercise, you can still manage caloric balance through proper diet and maintain and/or lose weight. Using the example above, Sally doesn't need surgery to gain her confidence back; she needs to find her source of self confidence in an effort to gain the motivation to do what is necessary to lose the weight and not EVER sacrifice a healthy lifestyle. That is the true meaning of succeeding at weight loss. Stop BSing yourselves and those contributing to this blog. Think WLS can save you from certain death? SO CAN A CHANGE IN LIFESTYLE, AT A MUCH LESSER COST AND A FAR GREATER BENEFIT!!!

Sue Joan said...

To Tommy, basically I agree with you but your approach is very judgmental. Size is 60% genetic, physical with possibly some 40 genes involved according to obesity scientist (who is slim) Rudy Leibel. And I find that folks who are judgmental of the obese (while stuffing their pie-holes with pizza and cake) are often naturally NOT obese and so, a simple "Watching what you eat" is enough to keep you slim. I am genetically obese due to pituitary damage from my toncillectomy, and after fighting for years to keep off weight, have lost 106 lbs and kept it off since 2010 (6 years) but I don't JUST "watch what I eat". I live on a strict diet regime of low fat (eat nothing over 20% fat), mostly veggies with small amounts of meat combined with daily cardio exercise. Additionally, I journal everything I eat, not only in Weight Watchers but also in My Fitness Pal. Yes, sir, that's what it takes when you are genetically obese. That I am in the 5% who can keep off a significant amount of weight suggests that it's very difficult to do this and perhaps something that you, if not blessed with better genetics, might not be able to do. People having WLS must do exactly what I do and that's what I'd like them to know - bottom line is a major lifestyle change and sadly many find out after surgery, that WLS isn't any kind of a cure and after they go through the expense and pain of WLS, they still have to journal their food, and exercise.

Unknown said...

Hi, I am 3 months post of sleeve on dec 1. It has been tough from the beginning but I anticipated that. At 2 months post of I started not being able to get anything down besides water and thin liquids. Even with th these liquids I had discomfort as soon as they hit my pouch. Had an endoscopy and apparently my sleeve has a curve in it where stuff was getting stuck and piled up so they attempted to stretch the area. Since then about a week and half ago I have felt no diff except the first day or two. I don't know how much more I can take. Calling my surgeon back tomorrow. Is there anyone who has had similar issues? Yes, I have eaten slow, tiny bites. I could only get 2 -3 bites max and one sip of water before feeling an electrify going through my pouch.

Sue Joan said...

Hi Colleen, sadly your experience is quite common with the sleeve and the procedure is not reversible. Perhaps a gastroenterologist can help you, though. I suggest you visit a gastroenterologist soon.