Does VSG just not work for some people?

I think too once they stop logging if they ever did the weight can creep on so much easier. I will admit I am not always diligent about logging and some days I just don't. For most of the days I do and know exaclt how many calories I consume. Half a sandwich (or not, which I do eat ) I can see where I need to be for each meal. Logging is so important and weighing myself. So many people like the once a week way, but if I feel more accountable if I weigh every morning despite what the number reads.

I have known people who have had each type of WLS and were never able to reach goal or lost it all and then regained (including the DS). It's absolutely possible, and 99.999% of the time it's not because of the surgery. Sorry but the tool just doesn't stop working. A lifestyle change is required.

There are more than you think because their metabolism is just shot. I even met a DSer who lost 85 lbs and still had another 60 to go but just stopped. Some blame a lifetime of yo-yo dieting, some blame genetics. Some admit they did it to themselves and couldn't stick to a diet. You'll find them in the forums here for wls regrets, wls failures and revisions. Most go to either RNY or DS.

It's a hard question to answer. I struggle with this myself, because I have lost over 461 pounds at this point and stalled horribly a year after surgery. Saxenda rebooted it, but I can't take it forever. I am fiercely honest when I struggle because, well, you have to be. I still need to lose about 100 pounds. I always ask myself why, and why is a good question to ask, because at the end of the day it's more often user error than the surgery which fails.

In my case, again I will be brutally honest, I "only" lost 150 pounds since surgery because 1) I have a severe eating disorder, 2) I have a horrible and stressful job and work 80+ hours a week between two jobs, and 3) I have three chronic autoimmune diseases, two of which are severely metabolic. I also have chronic pain and other crap that I don't take anything for because I am stubborn and also don't want to take pain killers.

At any rate, I have zero illusions I have made bad decisions since surgery. However, on the other hand, I have still lost that 150ish pounds while having many conditions whi*****lude: binge eating disorder, ADHD, Celiac disease, Hashimoto's thyroiditis (thyroid at super low function), RA, etc. The list goes on. Despite these, I still lost 150 pounds. If I didn't have any of those things I would doubtlessly have hit goal.

My point is that, yes, many of us have damaged metabolisms. The main reason I struggle now is that it's psychologically hard for me to eat under 500 calories and work like I do. And, I absolutely lose weight eating 500 or less. With BED it's...really freaking hard, even with weekly therapy and medication. I stress out and can't handle it for more than a few weeks at a time.

The "rules" also tell people to eat 130g of carbs a day or less, and tell people to eat a balanced diet which doesn't work for people. I eat nearly zero carb to avoid regain because, literally, if I eat 4-5 sushi rolls I will gain 10-15 pounds immediately. Literally overnight. And yes, it's water weight, and yes, it goes away, however my body, due to the disordered fat, likely, is extremely carb intolerant. The closer we get to 500 pounds and the older we are when we fix our obesity, the less likely that we will retain insulin sensitivity.

Enter an intestinal bypass - an intestinal bypass basically nukes insulin resistant (the primary reason we get obese) into orbit. The sleeve absolutely has a permanent (sort of) metabolic effect and boost to nuking IR, but any intestine stuff, even non-WLS procedures, have the same effect.

To be honest, most of us overeat more than we imagine. Almost always people with regain are eating too many carbs, too much food not being tracked, drinking calories, or really just have a metabolism that needs a low carb diet.

We are very attached to food, especially when we've used it as comfort. I had a literal nervous breakdown in my 750 pound days, and many temper tantrums I am afraid to say, about not being able to eat whole pies anymore. Yes....seriously.

Food is a part of culture and heritage and tradition for all of us. Rewriting that cultural script is not easy. And yet, that is what we must do as WLS patients, regardless of surgery.

So, I guess my answer is: it's complicated. Isn't it always? Heh.

You are always a fountain of knowledge and inspiration to me, Donna. I love reading any replies you make to just about anything. You have come so far with everything you have on your shoulders, you are an amazing person and so very strong!

One thing I want to make so sure of in my future is to never stop tracking my meals. I laxed for a couple days and when I would go back AFTER the day was over and tracked it after I had eaten it, I would be 100-200 more calories than I thought. I am glad that a higher carb diet doesn't hurt me, I still say around 50, which I guess is very low carb in most people's standards. It's let me put a slice of bread into my diet, or oatmeal which I adore.

My question is, since you mentioned it, eating under 500 calories a day. At a year out, is that a successful and healthy strategy? Those of us with WLS like RNY and VSG, is it viable to eat 500 calories or a bit less for the remainder of our lives and be health? My assumption was our calorie intake would continue to come up until we find our maintenance levels.

I appreciate it...I actually am only successful after surgery because of many of the vets here who helped me a lot. Hala helped me tremendously in particular...I was having many bad GERD issues and her advice basically saved me from being miserable.

50g of carbs is considered low carb, yep! Actually, for nutritionists, it's about 100-130 or less. Most people eat around 200-300 or more, actually. If you can handle a slice of bread or oatmeal and not overconsume it, I say go for it. One slice of bread for me turns into way too many, or did before surgery, so I avoid it. That's part of why cookie cutter nutrition can be dangerous...we all have to work with our habits.

As for 500 calories, that's just my body for weight loss. In my case I can't sustain it because I was getting severely depressed and not hitting my protein as easily. If my diet drops too low in fat I get depressed (actually common with very low fat diets in some cases). Calories in maintenance-wise, the average patient is advised, I think, to hover around 1000, however this really depends on the program. In theory it should come up when you hit maintenance, mostly because we tend to eat more when we are more active and have less fat storage, and also because the further out from surgery we are more comfortable eating. All of us are different, though, and I have spoken to people *****gain at 900-1000. Some people can eat more and some people have to eat less - we have to experiment and tweak depending.

The unavoidable truth with WLS patients though, is that very few of us return to a normal body fat percentage. So, we always have surplus energy even after we are slimmer. Raising calories and carbs both means your body is less inclined to use the stores you have.

With regards to the RNY and DS vs. VSG, there is far more calorie latitude the longer the intestinal bypass. Having said that as well, the biggest reason those two surgeries work versus the VSG is actually the metabolic changes to the cells of the intestines. The malabsorption is a factor sure, however it's the expression of stuff like GLP-1, omentin, etc, that actually provides the boost to weight loss.

We store food or use it depending on what hormones are in circulation to a large degree. Eating low carb maximizes this phenomenon. Eating higher carb diets can make keeping weight off harder because often the higher cars are processed stuff like bread, wheat, etc, that we digest and absorb rapidly. It also boosts insulin to do this, which boosts the potential for weight gain. Now, if you're an athlete, I could see where you'd use most, or even if athletic to varying degrees, but most of us hold on to fat very tightly if we have been previously obese.

My sister went to Mexico for a VSG. Her friend advised her on diet afterwards. Drink Ensure so that you get in enough calories. 220 Calories, 9 grams of protein and four to six cans a day.

I told her that was crazy, but she already had bought cases of Ensure and did not want to waste the money. So she followed that plan. Her loss has been minimal.

Jeez! What horrific advice!

That's more calories than I can eat now and she is getting it just from ensure. That's horrible. What terrible advice.