Hello out there somewhere near of around Rome NY

Does anyone know of a support group for us that had the

Surgery ? I am 2 years out didnt make my goal and now gained 40lbs I need the support of a group or someone in my shoes. I recently moved from Texas and dont know anyone I desperatly need help PLEASE
Thanks Carol

Hi Carol,
I'm sorry I don't have any immediate information for you regarding the Rome NY area, but I just wanted to let you know that I feel for you. I am 2.5 years out, and have gained 10 pounds back and am desperately trying to keep more from coming back, and trying to lose the 10 I've gained. Whether it's 10 or 40, the feeling of loss of control is the same. The surgery helped us move away from total abandon of control to a bit more control, but there are still a lot of hurdles ahead.
In my estimation, this is a very long battle. A life long battle. By asking for help, you have made a very important step on the road to regaining control. I hope you find the support you are looking for. This is sure a tough haul.

Wishing you the best,
Amy

Thank you so much Amy
Maybe someone will know of a support group for me to go to and eventually will find a Dr. I am on Medicare and none close will take it but need the follow up of a Dr havent been to one in over a year.
Again thank you so much for the help and hope you get things under control it is so easy to gain I have found out . I know what my problem is but for some reason cant stop When I was in tx I went to a therapist for my depression but not since being here. Trying to get back in to see one well thanks again hope to hear from you again you take care
Carol

Online join this group perhaps, email me off list I can hook you up with someone in Utica area I think......
[email protected]

http://health.groups.yahoo.com/group/OSSG_Off_track/

Here is a lot of info I posted on being off track etc......

 

REALISTIC EXPECTATIONS

WHERE IT ALL STARTS!

The surgical community considers anyone a success when they have lost 50% of their excess weight.  Right here we have a problem. MANY approach this surgery expecting to lose 100% of our excess weight.  And if we don’t, then we consider ourselves failures even though our surgeon is adding our name to their success column. The first month or two after the surgery makes matters worse.  You are losing 20 pounds  +/- a month and believing that this will go on forever.  I know I had my calculator out and was trying to figure out how long it would be before I hit my goal (excess pounds divided by 20). But life isn’t like that for most of us. We hit plateaus.  We come to the end of our widow of opportunity before we reach our goal and we stop losing.  Or we stop losing and regain some of our weight. Why do surgeons consider 50% as a success?  It is because there is no other method that you could use that would result in that much weight loss on a permanent basis (think 5, 10, 15 years). Remember back to your old diet days?  Yes, you lost weight, but regained it plus additional weight. The best you can attain with dieting is a 5% weight loss. Before surgery, have your eyes wide open.  Although most people lose 70% to 80% of their excess weight, you may lose only 50%.  Figure out what 50% is, and be sure to rejoice when you hit that mark.  ANYTHING ELSE IS A BONUS!

 

WT LOSS DIFFERENCES

There are so many factors to consider, heights, starting weights, men vs. women, individual metabolisms, age, and most importantly if you have any other medical conditions or are on medications!!! Remember the heavier people are the more they will lose (but the farther away one will be from an ideal bodywt..) and the lighter one is the closer to an ideal bodywt you will get, but the less they will loose overall!

 

EXAMPLE: After RNY surgery research states most people can/will loose 50-78% of their excess bodywt...lets say both of these "hypothetical" people lose 75% of their excess bodyweight....

1. A 400lb person at 5'6'' (a bmi of 64) who has 250# of excess wt (ideal is 150#) will lose 187.5# and weigh 212.5# and have a BMI of 34.5, 1 1/2-2 years after surgery.
2. A 300# person of 5'6'' (a bmi of 48) who has 150# of excess bodywt. (ideal also 150#) will loose 112.5# and weigh 187.5# and have a bmi of 30,  1 1/2-2 years after surgery.

 

 THE TRUTH ABOUT REGAIN *THAT NO ONE WANTS TO HEAR!

 

WLS is a tool, if you eat the wrong foods (carbs/sugar we NEVER EVER malabsorb, digestion/absorbtion of these substances happens starting in the MOUTH!), overfill pouch, graze all day, don’t exercise, drink calories, eat and drink together then we can/will regain wt.  IT IS still about calories and you can regain wt. WLS is the tool to help us lose wt, PSYCHOLOGY is the tool to help us maintain that loss!

WLS is a tool that should lead us to a LIFESTYLE CHANGE…

 

Ø      How we see & use food. FUEL or SELF SOOTHING

Ø      How we keep our bodies active. EXERCISE or INACTIVITY

Ø      How we use our brain. EATING TO LIVE VS. LIVING TO EAT

 

WLS IS NOT MAGIC, IT IS NOT A GET OUT OF MORBID OBESITY JAIL FREE CARD…NO MATTER WHAT THE HONEYMOON HAD US FOOLED INTO BELIEVING! IT IS HARD WORK! PERIOD.

 

 

THIS IS ABOUT PERSONAL ACCOUNTABILITY!!!

 

JAMIE’S BACK ON TRACK TIPS

Your surgery hasn't failed; you are just not using your tool to its potential that is all. It is there still; you need to get back to basics though. Remember it isn't the surgery alone that makes us lose weight it is the lifelong lifestyle & behavioral changes we make that enable us to lose weight and keep it off. Dumping isn't guaranteed (~ 50% will dump early on only!) after surgery and may decrease the farther we get post-op....with that said:

 

You know the rules of the tool & what you aren't doing.

So how to get back to basics? You have to just take one step at a time; it doesn't have to be all or nothing that is old thinking! What do you feel you can conquer first?

 

Write down your goal for the week, then work on it, once you have one goal under your belt start on another, be patient and kind to yourself, no one said this was easy! It is hard and no one is perfect! But you can change. The negative habits didn't happen overnight so neither will positive ones! But they wont happen if you don't start somewhere! Asking for help and admitting the problem is a great first step! Get to a local support group at least monthly if available, this keeps you focused on what you are doing and accountable to yourself...Life will always be busy but you need to reprioritize health as a higher priority and taking care of yourself has to be more important than anything else!

 

DO NOT RETURN TO DIETS! THEY DIDN’T WORK PREOP AND WON’T POSTOP!

MY 3 FAVORITE MANTRAS:

 

1. IF YOUR LIFE IS TOO BUSY TO EXERCISE OR TAKE CARE OF YOURSELF THAN YOUR LIFE HAS TO CHANGE! THIS IS NOT SELFISHNESS!
2. PROGRESS NOT PERFECTION!
3. IT IS WHAT WE DO 90% OF THE TIME THAT MATTERS, THINK CONSISTENCY!

 

What works for me is the PHILOSOPHY of the South Beach Diet….It is a good marriage between healthy lifestyle and postop WLS needs! I must stress it is not a diet but a way of life for me! I am carb sensitive, when I eat more refined carbs I am hungry sooner and crave more carbs, it is a vicious cycle, but when I eat better carbs, getter fats, healthy lean proteins the way the pouch rules dictate I do well and maintain

SAMPLE GOALS:

 

1. Fluid: Resolve to drink AT LEAST 64 ounces (This will keep you full longer and tension on the pouch) of NON-carbonated-NON-calorie fluid a day. (Water, Crystal Lite, diet Kool-Aid) In other words don't drink your calories! DO NOT DRINK WITH MEALS and WAIT 1-2 HOURS AFTER MEALS TO START DRINKING....(OR YOU WILL JUST MAKE YOURSELF HUNGRY AGAIN...SOONER!).
2. Vitamins: Resolve to take 1-2 multivitamin(s) a day, calcium as citrate form ~1,500mg a day (some may need more), & ~1,000mcg B12 liquid/tablets sublingually daily (some may need intramuscular shots). Other vitamins are based on labs/dexascans: some will need extra iron/vit C (pills/shots/infusions), vitamin A, D, E, K, Zinc, Magnesium, Thiamine (B1), Folate, B6, selenium….This is a reason we need to follow up for life with our healthcare providers, deficiencies can happen not just early postop but anytime postop!
3. Protein: Resolve to get in ~65 grams a day (this will vary due to age/ht/wt/medical comorbidities) either in the food you eat or by supplementing with shakes *this is controlversial. EAT PROTEIN FIRST!!! IT fills the pouch!(less room for carbs)
4. MEALS: Resolve to eat no more than 3-5 small meals a day, NO GRAZING! Take 15-20 minutes for a meal no less/more, pay attention to the food, not a TV, radio, newspaper! Composition of meals: ~50% protein leaving 25% of meal for veggies/fruit and 25% carbs (whole/multigrain/low glycemic index/.load).
5. Exercise: Resolve to exercise 30 min 3x a week, then increase to 60 min 3x a week or 30 min 6x a wee****il you are exercising 30 min MOST DAYS OF THE WEEK (or more)! It helps you cope with stress, so you don't turn to food, it will help the wt loss and also give you energy! You will feel better about yourself and be less apt to go for the carbs. NOTHING revs the metabolism better! START SOMEWHERE! VARIETY IS KEY!
6. SUPPORT: Resolve to either get involved in a local support group monthly (weekly would be better but at least 1x a month), online support is also helpful and/or get into therapy to deal with your food issues and look at why you are sabotaging your happiness. We all have food issues/demons and we all need to face them eventually the surgery is a great help but the brain is a hard organ to change and unfortunately they didn't operate it when they shrunk our tummy! Be around those  whom can support and not sabotage your success, this may mean making new friends and giving up old/unhealthy ones!

 

I am glad you are looking at the issues and wanting to deal with them! Be proud of yourself for that and you can do it. Now is a great time to start, holidays and parties are always going to happen, we can always find an excuse to wait or a reason why we can't, search within yourself and find a reason why you can and do it (nothing tastes as good as health and thin feel!)!

 

OR LOOK AT IT THIS WAY!!!!!!!!!!!!!! (*MEANT TO BE HUMOROUS*)

You can beat this or any weight loss surgery. If you want to regain weight then I
would suggest you do the following:

(a) Eat a diet rich in high carbohydrates with a high glycemic index--
such as donuts, cookies, cakes, ice cream

(b) Do not start an exercise program, instead spend more time watching
television and increase time in front of the computer

(c) Eat your food rapidly so that you don't get that full feeling. Remember, feeling full
-- or satiety -- takes a while to register, so if you eat rapidly you can stuff a lot more
in then if you eat a bit slower and feel full with less

(d) When you feel full, eat just a bit more-- this will help stretch that pouch out to a
normal sized stomach

(e) Graze throughout the day, especially those calorie dense foods -- eat a little bit all the time and you will find that no matter what operation, even a duodenal switch -- you can gain weight.

(f) Gulp down liquids before/during/after you eat, don't sip-- but gulp them down -- it will force the food out of a pouch (for RNY, lap band, VBG) and you can eat more.

 

(g) Drink alcohol, soda or any caloried/carbonated beverage you will absorb lll the calories, not feel full, hungry sooner and the bubbles may help stretch that stoma/pouch!.

--- I am certain there are other ways to beat the system, but these are some of the
more popular ones.

 

We have to change our negative self talk, we have to adopt a positive outlook, and accept that it takes A LOT of effort and time to maintain, even a wt loss less than 100%! This is unknown territory for us, no one knows what it takes to maintain, so enjoy the journey and arm yourself with all the knowledge you can!

 

The bottom line is this: YOU HAVE TO HAVE THE THOUGHT BEFORE YOU CAN CREATE THE ACTION. When all is said and done, change begins with the thoughts you think. So, what do you think? It only takes 100 calories a day to gain 10# in a year, or visaversa 100# calories less a day and we could lose 10# in a year! 

 

CHANGE IS INEVITABLE

STRUGGLE IS OPTIONAL! 

 

AUTOBIOGRAPHY IN 5 SHORT CHAPTERS

By Portia Nelson

I

I walk down the street.

There is a deep hole in the sidewalk.

I fall in.

I am lost…I am helpless.

It isn’t my fault.

It takes me forever to find a way out.

II

I walk down the same street.

There is a deep hole in the sidewalk.

I pretend I don’t see it.

I fall in again.

I can’t believe I am in the same place.

But, it isn’t my fault.

It still takes a long time to get out.

III

I walk down the same street.

There is a deep hole in the sidewalk.

I see it there.

I still fall in…it’s a habit.

My eyes are open.

I know where I am.

It is my fault.

I get out immediately.

IV

 

I walk down the same street.

There is a deep hole in the sidewalk.

I walk around it.

V

I walk down another street.

********************************************************************************

 Info on emotional eating old post I saved..mayhelp

Glad you posted your challenges. It is the first step in many toward recovery I believe. OH YES HVE I EXPERIENCED THIS! (as a RNYer it happened at 7mo out and came back with a vengeance yrs 3-4!)

 

I hear your wounded child cries, who is attempting to find happiness/peace/safety/control by using food as a way to soothe emotions such as: fear, loneliness, sadness, anger, shame, guilt, hurt. When this happens for me I look within myself asking what am I FEELING and why? I just know for myself the road of my destructive emotional eating as a dangerous and unhealthy/unfulfilling one that leads me further down a path of self-destruction/hate. We know the bypass lessens in its support of my lifestyle by 6-7 months, leaving me a small window of opportunity to build my foundation for health. The choice now for me is to build on the foundation I laid all that time ago w/ habits, as well as reinforce it with healthy choices and positive self-talk. I decided I needed to stop hating my body and love it as it is today and know I am loveable at this moment....Happiness and success will NEVER EVER come from an external source (person, object, number on the scale). It can and will ONLY come from internal self-discovery and love. Listening to my BODY is key, my natural physical hunger, my body knows and will not let me down....When I take on the helpless victim personality and have overwhelming feelings of guilt, shame, helpless and out of control I learned that I am trying to control an external thing (i.e. food) as a means to control my inner turmoil.. For me these feelings spill over into an addiction food (could be alcohol, drugs, sex etc for others). Either in a way that is restricting (counting calories, carbs, watching the scale daily) or permitting (like the overeating out of control binge eating you have described).

 

I am wrapping my brain around: ’DIETS NEVER WORK’, they always lead to a binge....Over/under/controlled eating is a symptom of the internal out of control feelings we have...We want to be happy and healthy yet we can not if we continue to punish ourselves w/ food (by restricting or permitting)..We can move out of the victim role, and heal and thrive! It takes work to look within, feel our feelings, see how we are involved in areas of our lives that reinforce our victim personality, healing the inner child, seeing how that hurt has permeated our current lives/personality and relationships w/ food and others. Having the healthy adult in us allow balance and growth and protection for the hurt child, so we can be safe and not need to control our food or have those emotions spill over into an external control that will never fix the internal out of control feeling. Only working on the internal self-talk, emotions can do that. This is my current journey as years 3-4 for me have been quite different than years 1-3. So for me it is time to look at the deep inner child work I never have done, the emotional issues because it is my choice and I choose no longer to be a victim and I choose today to love me as I am. This is what a good therapist who understands WLS and eating disorders can help, as can reading, support groups, etc.

 

NOW I am not perfect, for me to see things in others is far easier for me than seeing it in myself. I am on a personal journey for wellness and I am only offering what is working for me, diets never worked because they were an external control that could never heal my internal self...I hope this makes sense and it not taken negatively. It is my way of letting u know what is working for ME and maybe it can reframe your thoughts and work for you!

 

Sometimes we consume our lives with food, thinking about what we can and can not have, when we can eat or should eat, how much, how often, how it should be cooked, when to buy it, how much, etc that we occupy so much time and do not even realize that we have no time left to feel (the point) in an addiction, it takes over us so we can forget us and what we are scared/fearful of feeling/being.

 

Think of today as just another NEEDED step in your million mile journey to health and long-term success; which WLS is one of the million as well *it is not the destination*! Which we mourn long after we have it! Those that have goals that are health focused and functionally focused do the best (vs. those that are scale or weight/number focused). I am such a firm believer in not allowing the scale (or hunkametal that it is) to rule or dictate ones life/thoughts/feelings any longer, I agree we want to lose wt but gaining our health and ability to function in life are far more important than any number the scale can read; otherwise if it never reads the number we think, others say, a chart suggests we fail and that is simply not true!!! Most of our lives we have set RIGID, UNREALISTIC WEIGHT LOSS GOALS for ourselves that are BOTH UNATTAINABLE and CHRONICALLY DISAPPOINTING and lead to DEVASTATION & the slippery slope of self-sabotage...Review the UNDERLYING lifestyle change such as exercise, food choices, self-awareness/monitoring, avoidance of emotional eating, adherence to living self responsibly in a CONSISTENT way that is the foundation to our long-term success. For me I keep telling myself daily that***THE GOAL SHOULD NEVER BE A NUMBER*** These choices are what makes WLS work long-term and not be another failed diet attempt (and believe me it is for MANY! So I use that fear to keep plugging along)...It is a wonderful tool to build the foundation and sadly one that has ways to be defeated/broken down as we all can discover (grazing etc). Consider writing all the 'supports' of diet/exercise/lifestyle changes, coping skills etc for non-emotional eating (i.e through individual therapy, support groups) you have worked on, now where do you need to add reinforcements? You now are seeing it can collapse and the WLS tool if not used properly/consistently can be defeated w/o the extra supporting structures...Like having only one wall of your basement in place before putting the house on top.. what happens? it can crumble w/ the weight of the house (your life/the worlds challenges), but if you have the 4 walls in place (food choices/planning/healthy and consistent choices, exercise, self awareness/monitoring, support); then the WLS tool can just reinforce that foundation and make the house stand strong for a long long time! :-) Your tool will be back soon, but the tool to work on now may be the brain! For me it is anyways!

 

I have been taking some much VERY NEEDED time for myself and wellness. I have needed to take care of me and stop avoiding that as I have when I take care of everyone else! I am understanding and learning that loving ourselves is not selfish, that I need to feel loved inside so I have love to give others; if I continued not taking care of me and only having self hate and anger then that is all I would have to give others....We are all learning and growing, keep growing and learning with us here!

 

I have been using mediation, positive affirmations, reading, groups, individual work to work on my recovery, and accepting my imperfections!

Here are a few references for you if interested....

These are guidelines i am working on fitting into my life..not rules which are rigid, but guidelines which are flexible! I have 3X5 cards I take w/ me and place at different strategic spots such as fridge, computer to remind me!

 

EATING GUIDELINES

(*To avoid emotional or unconscious eating)

 

1. Eat when you are hungry

2. Eat sitting down in a calm environment *NOT THE CAR!

3. Eat w/o distractions, including radio, TV, newspapers, books, magazines, intense anxiety producing conversations or music.

4. Eat only what your body wants.

5. Eat until satisfied.

6. Eat (with the intention of being) in full view of others.

7. Eat with enjoyment, gusto and pleasure.

© Geneen Roth

http://www.geneenroth.com/

~~~~~~~~~~~~~~~~

 

Daily Affirmations for Compulsive Eaters (Paperback)

by Susan Ward List Price: $7.95  ISBN: 1558740767  (*Avail on amazon and probably any bookstore!) I have used this yr after yr!

 

''It's Not about Food: Change Your Mind; Change Your Life; End Your Obsession with Food and Weight'' By: Carol Emery Normandi, Laurelee Roark $9.72 ISBN: 0399525025

 

''Life Is Hard, Food Is Easy : The 5-Step Plan to Overcome Emotional Eating and Lose Weight on Any Diet'' By: Linda Spangle $9.72 ISBN: 0895260573

 

''Choices: Taking Control of Your Life and Making It Matter'' (Paperback)

by Melody Beattie $10.17 ISBN: 0060507225

 

''The Language of Letting Go'' (Hazelden Meditation Series) (Paperback)

by Melody Beattie "This is a book of meditations..." ISBN: 0894866370 $11.53

 

''Codependent No More: How to Stop Controlling Others and Start Caring for Yourself'' (Paperback) by Melody Beattie ISBN: 0894864025 $10.85

 

~~~~~~~~~~~~~~~~

http://www.centerforholisticoptions.com/products.htm

I bought the Stress management, Body Image and self esteem CDs all are short and can be done even during lunch!

 

~~~~~~~~~~~~~~~~

Elaine Simione has 2 great CD's that are self hypnosis for emotional eating 2/$25

CD1 Track 1 Affirmations, Hunger Level & Stomach awareness, Track 2 Being present in your body, your physical routine: CD 2 Track 1 The emotional aspects of eating, medicating the inner child’s emotions, track 2 your story and the underlying feelings, embracing your feelings.

 

http://holisticcounselingcenter.com/

 

~~~~~~~~~~~~~~~

Breaking Free from the Victim Trap $9.95

https://store.wellness-institute.org/Details.cfm?ProdID=36&category=6

An easy-to-read book on Healing Codependency by Diane Zimberoff, newly revised in 2004. (Softcover)

~~~~~~~~~~~~~~

Consider CODA meetings *if this is an issues for you* www.coda.org  for a meeting near you, of OA www.OA.org both can be great supports and are free for your recovery journey! Or if spiritual many larger churches may have groups, such as in my area the Pine Knolls church http://pineknolls.net/support_groups.htm has great support groups (Codependent, depression/anxiety, Women’s/Men’s, wt loss, etc)

 

~~~~~~~~~~~~~~~~~~~

AND I am journaling almost daily my EMOTIONS...I guess my point is we al need a toolbox, and our success may be based on how many tools we have! Not any one thing works for recovery (the band, the RNY) therapy, support groups, meditation, journaling, exercise etc it is a combo of any one/all that assists and eases the journey I guess! Or at least that is HOW I SEE it! :-) Be well.

 

YOU most certainly are not alone!!! Consider the definition below for addiction and how it may for you *looking at the price you were willing to pay for a number on the scale * Consider seeing the food addiction is getting a strong grip on you...,I know it is what I needed to read in black and white to help me make different choices...

http://www.hms.harvard.edu/doa/html/whatisaddiction.htm

One simple model for understanding addiction is to apply the three Cs:

·Behavior that is motivated by emotions ranging along the Craving to Compulsion spectrum

·Continued use in spite of adverse consequences

·Loss of Control.

 

Feel free to write me off list if you have any other ??!

 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Bariatric Surgery: A “Tool” in the Treatment of the Disease of Obesity

How much weight do you estimate that you lost in your life from diets or anti-obesity drugs? More importantly, how much weight do you estimate you have regained following weight loss programs? Did the weight stay off for less than a year? For two years? Is there anyone who suffered from morbid obesity who was able to maintain their weight loss for more than five years?

Long-term studies have found that approximately 2/3 of people who lose weight on a diet program will regain all of their weight within 2 years. Approximately 99% of individuals will regain all of their weight by 5 years post-diet.

With diet drugs, weight loss is generally around 5% to 10%, which represents a weight loss of only 10 to 20 pounds for someone who is 100 pounds overweight. Weight regain is unusually rapid when the drug is discontinued. And, long-term studies have shown that, even if the anti-obesity medication is continued, weight gain occurs over time.

Weight loss success for the morbidly obese is even more difficult. Most individuals who are morbidly obese not only regain all of their weight loss following conventional therapies (diet, exercise, behavioral modification, or anti-obesity drugs) but, generally, gain even more.

Why are conventional therapies not successful in treating obesity long-term? Conventional therapies fail because obesity is a disease – a progressive and life-threatening disease –not unlike cancer.

Once an individual has the disease of obesity, it progresses rapidly, affecting all body functions, often with fatal consequences. And, similar to cancer, obesity stubbornly responds to treatment. Even when the disease appears to be arrested, the reprise is generally temporary; the disease often returning with vengeance, causing even greater fat tissue proliferation and weight gain.

Studies have found that most individuals who are morbidly obese are not eating thousands upon thousands of calories each day. In fact, several studies have found that the individual with morbid obesity eats fewer calories more than someone who is normal weight but, even so, continues to gain substantial amounts of weight. Why?

The morbidly obese are essentially trapped in a series of fat-promoting biological cycles that cause a greater proportion of calories consumed to be stored as fat. What are some of these fat-promoting cycles responsible for the progression of the disease of obesity?

For one, obesity causes hormone changes, such as an increase in insulin, defects in sex hormone production, low growth hormone, and elevated cortisol. These hormone changes increase fat storage and/or prevent the breakdown of fat, thereby, causing even more weight gain and obesity.

The disease of obesity also alters activities of various enzymes that control fat metabolism, causing less fat to be burned for energy and more to be taken up into fat cells and stored, increasing fat cell size and total body weight. Furthermore, serious obesity (as well as childhood obesity) may not only increase fat cell size but also increase fat cell number. An increase in fat cell number, according to several reports, significantly reduces an individual’s chance for successful and sustained weight loss.

Weight gain further enhances the spread of fat tissue by altering the production or actions of several important regulators of eating behavior. By altering these regulators, the disease of obesity may cause an increase in appetite, food cravings, or reduced satiety (feelings of fullness). These defects, in turn, are likely to promote further weight gain and progression of the disease.

To make matters worse, obesity causes numerous health problems that may reduce an individual’s desire for physical activity, lowering the numbers of calories the body burns for fuel and increasing those stored as fat. And, ironically, obesity-associated health problems, including diabetes, hypertension, depression, and arthritis are often treated with medications that cause further weight gain.

Bariatric surgery helps to ‘break’ many of these obesity-promoting cycles, improving the need for medication, normalizing hormones and some of the weight-promoting eating behavior regulators, increasing physical activity and calories burned, improving metabolism, and resolving disease and the need for medications that can cause weight gain. The interruption of these vicious weight gain cycles with bariatric surgery, coupled with the restriction that the surgery imposes on nutrient intake, induces massive weight reduction.

With gastric bypass, as well as the biliopancreatic diversion and duodenal switch, weight loss is rapid and substantial. Excess weight loss one year after surgery is generally 70% or more. Studies have found that 5 years after gastric bypass surgery most individuals will have maintained 48 to 74% of their excess weight loss. One study found that even 14 years after surgery, average excess weight loss for over 600 gastric bypass patients exceeded 50%.

Bariatric surgery, therefore, is effective in inducing massive weight loss in individuals suffering from the disease of morbid obesity and in helping to maintain much of the weight loss for years and years. Still, the surgery is not a ‘cure’ for the disease of obesity.

Although it is extremely rare for an individual to ever regain all of their weight loss following surgery, some weight regain generally occurs. As discussed above, an individual may lose 70% or more of their excess weight loss with gastric bypass surgery and maintain a 50% or more weight reduction long-term. Although such a high degree of weight maintenance is considered exceedingly successful for the disease of morbid obesity, some weight regain does occur, evidence that the disease is not arrested.

Longitudinal studies of large groups of gastric bypass patients have shown that around the second post-surgical year there is generally a weight regain of approximately 5% to 10%. This increase in body weight tends to happen about the same time that many individuals complain of a ‘reawakening’ of some of the symptoms of the disease, such as an increase in appetite, food cravings, and a loss of satiety.

How, then, can an individual maintain all their weight loss after surgery? For continued maximal weight loss success, the bariatric patient must realize that their surgery is not a ‘cure’ for obesity but rather a ‘tool’ that can assist in keeping the disease ‘suppressed’. The surgical ‘tool’ is effective in inducing and helping to maintain weight loss by substantially reducing total calorie intake. And, as mentioned earlier, the surgical ‘tool’ breaks those obesity-promoting biological cycles that contribute to the progression of the disease and prevent the afflicted individual from gaining control over their body weight.

The pioneers of obesity surgery recognized years ago that the surgery was not a ‘cure’ for obesity but rather a highly effective ‘tool’ that assists in halting the progression of the disease. These individuals worked diligently to see that the morbidly obese patient would have every opportunity for life-long weight loss success. Through their efforts, the National Institute of Health, the National Heart, Lung and Blood Institute, the American College of Surgeons, as well as the national and international societies representing bariatric surgery, all recommend that patients who have bariatric surgery be followed by a multidisciplinary team of obesity healthcare professionals.

The multidisciplinary team of professionals aids the bariatric surgical patient in making lifestyle changes that, with the assistance of the surgical ‘tool’, helps to keep their disease under control. The multidisciplinary team generally includes (in addition to the surgeon and clinical staff) a nutritionist or dietitian with knowledge of the specific nutrient needs of the bariatric patient, a mental healthcare professional who understands obesity and the psychosocial consequences of the disease, and an exercise physiologist or trainer who can prescribe physical activities that help to promote maximal weight loss success and long-term weight loss maintenance.

There are now several studies reporting the effectiveness of the multidisciplinary approach to the surgical treatment of obesity. The early findings of these studies clearly show that individuals who participate in such programs have greater weight loss success and long-term weight loss maintenance than do those who do not take advantage of the multidisciplinary program.

What can you as the bariatric patient do to keep you disease under control? First, recognize obesity for what it is – a progressive and malignant disease. Second, know that your surgery is a ‘tool’, rather than a ‘cure’ for your disease that can enable you to lose massive amounts of body weight. Third, recognize that the surgical ‘tool’ can help you to keep your disease suppressed and enjoy long-term weight loss maintenance, provided you are willing to make lifestyle changes necessary for long-term weight loss success including: 1) regular physical activity, 2) good nutrition and appropriate vitamin/mineral supplementation, 3) assistance in improving emotional status, and 4) continued involvement in a bariatric support group and in your clinical program.

Take Care,
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current)  5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005  Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"