I love you.  Such a good example and inspiration.

I am on a diet and will be for life.  There is no magic in the surgery.  The only way to maintain weight loss for me is to count calories.  If I eat too many, I gain. 

I am only 3 years out.  I was initially 316, BMI 46.6.  I have been between 161-168 with a day here and a day there at 170 before I hit danger zone button and pulled myself from the brink.  I have not had a single significant complication although my iron is still normal but trending down.  I am 5'9" and I wear size 6 in jeans and dresses and size S-M shirts depending on the store.

I work at this every single day.  I am not perfect and I get carried away sometimes with poor choices and sometimes a 1-2 ****tails a week can become 5-6 if I am not paying attention.  I never truly realized how hard i work at this until my husband tried to eat the way I do.  He simply can't do it.  Too much thinking, too many meals a day, too specific in the food choices and amount of food that I eat.  I also do yoga 2-3 times a week and run a 5K twice a week.

Surgery just helped me get here.  I have to do the work to stay here although my restriction is still very good.  Anyone who figures out how to eat around their restriction will regain and it is incredibly easy to do.  That is how I got up to 168 which is unacceptable to me.  That is also why I am in therapy.  I initially went twice a month right after surgery and am down to once every 6-8 weeks.

KB

MY BMI was a 63 to begin with. It's currently a 24 but I'm only 21 months out so I'm way early. 

However if after 5 year I'm at 35 BMI (ok I'm going to be pissed at myself) BUT when I started this a 35 WAS A SUCCESS to me. So in complete honestly I saved my damn life with this surgery. 35 BMI or 25 is lightyears from a 63. 

As an aside we make of the surgery what we can. Each person succeeds or fails on their own. WLS is not cancer - there you can do all the right things and still be screwed. Here not so much. 

I've been able to maintain my weight loss. I never got down below a BMI of 25. I actually could have gone much lower, and my fastest, I was still losing weight at a rate of 2 lbs a week (even at almost 1 1/2 years out). I tried stopping at 200 lbs (i'm 6'1'') because people started to think I had cancer....yes, I was 200 lbs...but I had a lot of skin hanging of my body from a 300 lbs weight loss.



I started eating every carb known to man! I finally stopped my weight loss at 180 post plastics and tried to regain a bit...at 180 I was in a size small shirt. I would have been in smaller pants, but my waiste never shrunk past a size 32...I do have bones!



Anyway...I was able to maintain my weight for almost 10 years eating whatever I wanted...I do have to "low carb" about once every couple of years to take off any creep...but I'm talking about 10 lbs....I waited a bit longer this time around and had to take off 20...but it came off.



I've actually decided that I'm going to set a new low weight...and try to get back down to 185. I think when you are initially losing, you still have "heavy" bones from years and years of being SMO. But I'm now 10 years out, I am sure that I've lost some bone mass. So I really haven't changed my diet...but I did give up daily Large McDonalds fries.. my daily sleeve of oreos and pint of ice cream. Not much of a sacrifice, but the weight is coming off now at about .25 to .5 lbs a week without any other diet changes...I did add exercise too. I haven't been in a gym in years.....was I sore the first few weeks!

Good luck to you!!!





Scott

Perhaps you should read some of the medical studies.  WLS is the only method with long term results - most people take off 2/3 of the excess body weight and keep of 1/2 of it.  25% of people gain it all back within 5 years.  ~25% stay around about 25-30 BMI.  This is not perfect and keeps on-going effort, but it beats the 3-5% who can keep it off without WLS.

 

 

Obes Surg. 2012 Oct;22(10):1586-93. doi: 10.1007/s11695-012-0707-z.

Long-term results of laparoscopic Roux-en-Y Gastric bypass: evaluation after 9 years.

Himpens J¹, Verbrugghe A, Cadière GB, Everaerts W, Greve JW.

Author information

 

Abstract

This retrospective study aimed to evaluate the long-term results of the laparoscopic Roux-en-Y gastric bypass (LRYGB) procedure performed at our department of bariatric surgery. The 126 consecutive patients treated by LRYGB between January 1, 2001 and December 31, 2002 were analyzed in August 2011. Seventy-seven patients (61.1 %), including 18 who had had previous bariatric surgery, were available for evaluation after 9.4?±?0.6 years (range, 8.7-10.9 years). Eight patients (10.4 %) suffered from type 2 diabetes mellitus (DMII) at the time of surgery. Initial body mass index (BMI) was 40.3?±?7.5 kg/m(2) (range, 24.5-66.1 kg/m(2)). There was no postoperative mortality, but two patients died of causes unrelated to the surgery. Some 9 % of the patients suffered from internal herniation, despite the closure of potential hernia sites. With time, the patients had the tendency to experience weight regain: percentage of excess BMI lost was 56.2?±?29.3 % (range, -78.8 to 117.9 %), down from a maximum of 88.0?±?29.6 % (range, -19.7 to 197.1 %), that had been obtained after a median of 2.0 years (range, 1-8 years). LRYGB was effective for diabetes control in 85.7 % of the affected patients, but, surprisingly, 27.9 % developed new-onset diabetes. The weight regain in this latter patient group was statistically not different from the nondiabetic group. Conversely, four patients required hospitalization for hypoglycemic syndrome. Two patients underwent reversal of their bypass for problems linked to glucose metabolism (one hypoglycemia, one DMII). Patient quality of life was fair. The patient satisfaction remained good in 76 % of the cases.

The quick answer: yes, because insurance companies do not pay for treatments that are ineffective.  Even if they base this on short term data that winds out being crappy later (see: lap bands) they will not compensate providers for non-evidence based treatments.  That means that what clinicians and physicians do as interventions must have a positive effect.

Having said that, consider that 50% of EWL is considered successful where surgery is concerned.  A BMI of 25 dealing with ongoing negative consequences post-op?  Not...really?  Most of the people I know who are there were lightweights, and/or have a malabsorptive procedure, and/or typically are higher functioning, and have/had fewer comorbidities.  There are also some incredibly motivated people who don't meet those criteria, too!  Social science has done lots of research.  Typically, if someone has more money, less stress, no mental illness, and better resources, you will have a lower BMI even without WLS.  Much of the success has nothing to do with surgery.  It all comes down to 1) habit and 2) environment. That is why we do assessments pre-op. :)  But, there's a lot to be said for environment and availability of resources.

My highest BMI was 130.  My current BMI is... I'm not sure what I weigh.  Find out Friday.  However it's around 50.  I'll take my success even though I may never see BMI 25.  I have no doubt extended my life drastically, and my weight loss will continue.

I have seen dozens of bariatric post-op cases at this point, not counting support groups.  The factor that makes the most difference?  The willingness to step aside from their own baggage, examine their behavior, and get over it.  The most successful people are unflinchingly honest with themselves.  This goes for DS, RNY, VSG, etc, all WLS patients.  I've seen DS patients *****gained 150 pounds, so... that is the power of habit and pathology.

Although I do not want to be the person in this case study, my surgeon's partner posed this scenario: 

What if we do surgery, the person loses 200 pounds, and then over the course of 10-15 years gains it all back?  Can we still consider this surgery a success?

Yes, he said.

Because if we had not done the surgery, that person likely would have gained 100-200 pounds over the course of those 10-15 years anyway, being even more heavy.

He said we do not fully understand all the reasons behind weight gain, especially in some people.  Especially in the SMO.  Definitely there are many factors--which I don't have to list for this reading audience! 

In a case like the scenario he offered, he said he would think of the surgery as creating a kind of remission of symptoms.  Almost like a cancer doctor doing surgery to gain a person an additional 6 mos-10 years of life.  During this time, the person would do better than they had done with all the extra weight.  Overall, a better quality of life during that person's overall lifetime.

When I decided to have WLS, I made a promise to myself to do whatever it takes to lose the weight and keep it off. I realized every step of the way that WLS is only a tool and that I had to work hard at this.

I am 8 years out from RNY. My highest recorded weight was 339 and I maintain around 140. I have gone from a BMI of 53 to 22. I am not perfect, but when I do gain, I track every bite and cut back on my calories until I lose it again. I plan to stay diligent which is why I believe I will be successful in the long run. 

Thank you for being such a great example of tenacity, and for continuing to post regularly on this site.  I always appreciate your comments.