In reading through several of the posts here, it sounds like people are perpetually hungry

Good luck to you when you have your surgery! I would do it again in a heartbeat!

This is exceptionally rare after the first few months, so don't count on it; do the emotional work to prepare your mental game for coping with hunger.

And honestly, having to eat by the clock can be incredibly stressful for some folks!

I currently eat by the clock, it is actual stress. There is more worrying about food than when I was heavy. We need this nutrition in our bodies and if I don't plan it out I just won't get it. Every day has to come with a plan. Thankfully I honestly don't mind cooking ahead and making my meal plans the night before.

I recommend you do some research into the metabolic effects of surgery. The restriction of having a small stomach is clear cut, the metabolic benefits are more complex. For example, if an obese person loses weight through calorie restriction alone their resting metabolic rate drops significantly as the body makes an effort to regain the lost fat cells. This does not happen to the same extent after losing weight with wls and calorie restriction. This means our bodies aren't fighting against the weight loss, which is a huge benefit.

Initially I felt some pretty insatiable hunger, but when I posted about the hunger-like feelings I was experiencing some of the sleeve veterans assured me this was due to acid production. Apparently when 1st sleeved your stomach can produce too much acid as it is used to compensating for a much larger stomach. The hunger is ?acid gnawing hunger? (google it). From my experience it dies down. I very rarely have those hunger like feelings anymore at a little over 4 mnths out. My sleeve works by restricting my portions, so regardless if I feel hunger, I can?t eat the quantity I once did. I could graze my way to failure this is true. The sleeve certainly won?t do it all, but it sure helps.

Yes, the sleeve limits intake-- but primarily for dense protein. Liquids and carbs are known as "slider foods," and we do not experience the same type of restriction. At four years post-op, I can only eat about 3oz of chicken, but I could probably eat an entire sleeve of crackers, especially if I drank something at the same time.

The hunger-reduction aspect of VSG is way overblown, IMO. Yes, ghrelin production is reduced, but it's not eliminated completely. Additionally, many of us deal with "head hunger" and emotional eating, which is a completely separate issue from physical hunger that surgery does NOT address.

The good news is that when you stick to the appropriate post-op diet, which is almost exclusively dense protein, there really isn't a feeling of deprivation. When it becomes your normal, and you've got the emotional tools to address food-related emotions, the diet is not "very difficult."

And yes, you're correct to note that these forums are a skewed sample. People seldom post about how amazing things are going, how they're still maintaining, etc. That would be boring :)

My surgeon is a believer in the idea of WLS resetting your setpoint - the weight your body works so hard to maintain. When we lose weight on our own, the body has metabolic tricks up its sleeve to get you back to what it considers your setpoint weight. So increased hunger and decreased metabolism help lead to the dismally small percentage of people who can keep weight offfor 5 years (2-4%).

With WLS, your body's setpoint "resets" to a lower weight so you don't have to work quite so hard to stay at a lower weight. It's still not super easy as we're human and can still make crappy choices and are still influenced by pizza ads and party buffets, but it's not as hard as it would have been otherwise.

And ditto to what Julie said. Yes, the forums give a skewed sample. People pre-op seeking information, people post-op with concerns. But lots of people with concerns don't come to the forums and lots of people drift away once they start "living life."

For what it's worth - I'm 4 years post-op and doing awesomely. It would just be boring if I posted a daily update to say that ;)

FWIW (because I am not a sleever).

You've gotten great responses. Just wanted to add that, for me, hunger wasn't the big issue. I didn't get up to 347 pounds because I was physically hungry.

I was told that one of the biggest benefits to surgery is that first 12-24 months when most of us lose probably 90% or more of our excess weight. A huge challenge when dieting is the lack of constant and timely visible results as we make proper choices day in and day out. A SMO person like me has to pack in innumerable days to be able to recognize some positive feedback. That can be daunting. It's definitely a factor in the difficulty that non-ops deal with.

The surgeries give us a huge shot in the arm while we are in weight loss mode because we lose so very quickly that we can literally see it. Once you're down to your goal or close to it, it's easier to keep eating on the plan that got you there - so that we don't have to start buying bigger clothes again if for nothing else.

Lots of us regain,( I had huge ones twice) , but we can lose the regain by reverting back to what got us smaller to begin with. The mirror can become an incentive and so can the scale. It takes more work than those first glorious months but it can be done. And I believe it can be done without being miserable.

The nature of the forum kind of dictates that a share of the posts will be asking for advice. Sometimes when we get a problem "solved" or we are in a good space, we don't stick around. I'm almost ten years out and there are several of us who make a personal commitment to regularly log on and help others as we were helped. Others wander in on surgery anniversaries only. Some are regular posters for years and then just stop coming back. Those of us who've been around a bit don't often post threads about how much better things are now than what they used to be. So you've got a skewed representation that looks like there aren't very many long-term, not constantly hungry, members. And that just isn't the case.

Good luck in whatever you decide. Keep asking all the questions you have; also searching old threads can give some valuable information.

I can only offer my personal experience, FWIW.

I do see posts here with people having hunger almost immediately after surgery. That was not my experience, at all. I struggled for the first few weeks to get enough fluid intake, including protein shakes. I wasn't particularly hungry, though there were times where I had a lot of discomfort that was probably due to my sleeve being completely empty and so it was driven by hunger, but it didn't feel like hunger at all. It passed, and by 2 weeks out my "hunger" was more about being bored stiff by the liquid diet, and I couldn't WAIT to have "real" food when I was finally released to have soft foods at 2 weeks. (Those refried beans were ambrosia to me that day...)

Anyway, when I started in soft foods, I found the biggest benefit the surgery has given me. For decades, I have been driven by cravings that had nothing to do with physical hunger. I started therapy with a wonderful therapist who specializes in eating disorders and body image issues months before my surgery, so we were already working on emotional eating and overeating on the verge of being binges. I first noticed during the soft food stage that I would have old tapes in my head saying I should eat Little Debbies or other foods that were NOT in my eating plan. Because of the combination of therapy and the physical changes the VSG made, I could identify those as being emotionally driven cravings instead of true hunger. Therapy gave me the tools to quiet or counter those tapes in my head.

By the time I was released to a full diet by about 6 weeks, I'd had a month to practice separating the cravings that were not physical from those that were. I did start having hunger after a few months, but it wasn't that driving craving I'd had before. There were days where I had a LOT of hunger, and I fed my body appropriate foods but didn't limit how much and then it would be followed by days where I hardly felt hungry at all. On the low hunger days I focused on getting enough fluids in and supplemented my solid food with protein shakes where needed to keep my protein up.

Now that I'm a little over 18 months out, and had a bunch of health problems that stalled me out over the winter, I can tell you where I'm at. I have more hunger than I did in the first few months post-op. I also still have a tendency to respond to stress by wanting foods that don't advance my health goals. Sometimes I give in, but with the practice over the first year post-op I feel like it's a choice I'm making instead of something I'm feeling driven to do.

My sleeve was very well built from everything I can tell. At 18 months I still have significant restriction. I can only eat 1 to 1-1/2 cups of food depending on density and how long I let my meals run. If I go back to the basic rules of eating only at planned mealtimes, only eating for 20 minutes, and restricting fluid during my meal, the physical restriction is enough to keep me from eating too much even if I am not making the absolute best food choices.

Now, I can easily see where if I were driven to do so, I could easily eat around my sleeve and put back on the 110-115# I've taken off. Letting meal times stretch allows the sleeve to partially empty and pack more food in. Making food choices that "slide" through the sleeve easily and quickly makes more room faster for more food. Choosing high sugar and refined carbs lets you pack more empty calories into food. I knew a couple who both had the band years ago, and didn't address their food issues. They deliberately drank sugared sodas, ate ice cream, chose cream-based soups, and the like... just so they could fill their emotional needs with food. They also became functional bulemics so they could eat the volume they wanted. Needless to say, the band was not helpful for them. Having seen how easy it is to thwart any tool, I chose to get into therapy early so I could address my emotional eating and develop a better relationship with food. I'm not 100% there, but I'm miles from where I was.

I've maintained within 5# of my lowest weight for 6 months, with a brief period where I went 9# over my lowest weight. But since I now weigh myself regularly I caught the regain early, and tightened my eating up and took it back off within a matter of a couple of weeks.

I'm nowhere near far enough out to declare myself a success. I'm right at the point where a lot of people end up with some regain. But now that the weather is clearing up and some of my health issues improving with the weather, I'm actually planning to tighten up again and make a push for my initial goal, which means another 10-20# loss. Wherever I end up, I will work to maintain that weight.

I believe that the VSG in combination with therapy will continue to be useful tools to that end.

Sorry for the long-winded response, but I hope it helps some. :)