Surgery vs. Dr. supervised medical weight loss via medication

Hello all. I am new to this forum and starting to consider weight loss surgery, but I am wondering if I am just a lost cause. I have spent the last 8 years losing and gaining the same 80-ish pounds. Over the last 3 1/2 years I have been working with the same weight loss specialist trying various combinations of medications (phentermine, metformin, glyxambi, topamax etc etc) to control hunger, insulin etc in combination, eventually, with low-carb diet. I always seem to hit about the same number and the weight creeps back up, I get frustrated and lose some diligence with the diet portion and the cycle starts again. During my last visit, my Dr asked me if I would want to consider surgery and I am honestly not sure. I am worried that it would have the same effect--I would lose initially, but end up back at the same place.

Welcome to the forum here.

You're right to be worried. Many can and do regain all of their weight loss and more. Regardless of surgery type.

Anecdotally, it appears that while some folks regain due to legitimate medical problems most regain is self-inflicted. As a pre-op it behooves you to be aware and recognize that as a factor in your decision. I'd maintain the vast majority of us here have re-gained and re-lost large amounts of weight more than once in our lifetimes. But it wasn't until after surgery that we've had success with keeping off those numbers.

The factors in succeeding long term post WLS are many and varied by both surgery type and individual. Others failing doesn't guarantee that you will. I'd encourage you to spend a lot of time reading both these boards and other sources. Maybe make a post asking for success stories AND stories from post ops who don't feel successful right now or something similar.

I have a feeling you'll find your way.

I think many of us here have been where you are regarding the vicious lose/gain cycle. After discussing surgery options with my PCP I decided to make an appt with the WLS center and see what might be different with surgery vs. "dieting". It is important to understand that WLS is just another "tool" in our toolbelt and it will do the work if we put in the effort. Typically, it seems the first 18-24 months (sometimes referred to as the honeymoon period) the weight will come off without having to put much effort out. A great poster here always says act like a machine during this time and allow your body to get as much weight off as possible. After those first few years you'll most likely be able to eat more and sometimes different things that you weren't "daring" enough to try earlier so setting the stage early on is best. I think after about 2 ½ years was when it got hard for me and I had to realize that I will always have to weigh/measure/track my food and know when to reign things in. I am by far a "vet" around here but I do know that I must stay vigilant and stay the course as regain is always possible. Coming here and posting helps keep me accountable. In a nut shell, my opinion is that regain is something I can control. I choose to be active, eat protein first and foremost, take my vitamins, drink al least 100 oz water daily, not drink 30 mins before, /during, and for 30 mins after a meal, and find ways to cope with feelings/emotions/boredom that aren't food. I am not perfect and will always be a work in progress.

I suggest reading and absorbing as much information as you can from this site - you will find knowledge and support on a continuous basis from awesome caring people. Best of luck to you on your journey wherever it may lead you.

Erin it took me years to make the decision. Any WLS is simply a tool. You personally have to be ready to embrace WLS. For me personally once I made that decision I was committed 100%. I literally changed my life once I had WLS.

For me WLS was life changing. I had been obese my entire adult life (I was in my mid-40's when I had my surgery). Once I made the decision on the DS and had my surgery, I became somewhat obsessed with reaching goal. Once I did (took about 18 months to lose 175 pounds) I was all in. Worked out 4-5 times a week, weighed and measured my food to learn how to eat properly, attended regular support meetings with a great group of people who I still consider friends (as well as private therapy), and had some plastics along the way. I'm 15 years post-op and still within 10 pounds of my goal weight.

Research all the types of WLS. Don't rely on one doctor's opinion. Learn as much as you can so you can make the right decision for you. Look at things like what type of eater are you and what habits need to be broken.

Welcome to the boards and we're here to answer your questions.

The odds are better. Without surgery the odds of keeping it off are 5%.

With surgery your odds of keeping it off go to 50%.

Both are after five years.

Many of us have been down your same path, losing and regaining over and over. Thats what brought us to wls. Its not a perfect option but does give you a "leg up" on the problem. You have to be totally willing to change your relationship with food for life. But wls, in my case vsg, does indeed reduce the hunger hormone ghrelin so that I didn't feel hungry at all for a couple of years. Plus with my restriction it was impossible to overeat and I learned to focus on protein and skip carbs and sweets. Now at nearly 9 years out I have regained about 20 of 125 pounds lost. I am still far better off and have formed much better eating habits than I had before. So I would consider it but go at it with the resolve that you are going to change habits for life. You can start now working on those habits - eating more protein, more veggies and fewer carbs - and changing your mindset plus a little exercise. So do your research as I did for nearly a year. GL Diane S

I have essentially the same reservation (my initial consultation appointment is tomorrow). I'm cautiously optimistic though. I think the disruption in my relationship with food (6 month pre-op diet, post-op time where I have to follow the plan, year or so honeymoon where it shouldn't be too difficult, etc.) should be enough to make the breakup permanent, so to speak, and lead to a healthier new relationship.

Reduced hunger is also going to help, though currently I'm getting that from Topamax.

My story is a lot like yours. WLS increases your odds of success. One thing that made me finally take the leap is when I came to terms with all the research around long-term weight loss through diet and exercise alone---Depending on which study you read, only 1-5% of people who lose weight through diet and exercise are able to keep it off. Our bodies are like a thermostat. WLS is a chance to try to reset that thermostat. It's also a force multiplier---during the first 6-18months post-surgery, all your efforts (clean eating, exercise) are amplified. Also, with VSG, the surgery reduces your hunger hormones--again, increasing odds of success.

Out of curiosity, did you try medication to assist weight loss before surgery? Have you had surgery yet? If so, would you be willing to share your general experience with each?

Erin,

Welcome to the forum.

Like others have said, I think we've all been where you are. In the decade before I had my surgery (18 years ago this past April) I gained and lost the same 150 pounds at least three times. After my surgery, I lost the 150 pounds again -- and it hasn't come back. My weight fluctuates within about a five-pound range.

I will always remember what my surgeon told me at my first appointment with him. I realize, of course, that back in 2000 there was a lot fewer hoops to jump through. I met my surgeon on the 31st of March and had my surgery on April 17 -- no pre-op diet, no Opti, no psych evaluation beyond whether I thought the surgery was a magic cure or a tool -- which is amazing, particularly in Canada where there weren't all that many bariatric surgeons at the time.

In any case, what he told me was this: If you took 100 randomly-selected morbidly obese (those needing to lose 100 pounds or more) people and put them on a supervised diet and exercise program, every single blessed one of them would lose the weight. The operative word here is "supervised". We can't do this by ourselves.

However (and this is the mother of all howevers, in my book) if you went back a year later, only three of the 100 would have kept the weight off; ergo, for morbidly obese people, diet and exercise has a 97% failure rate.

Many of us on this site, prior to our surgery, were on the same diet treadmill as you have been -- lose 50 pounds, gain back 75, lose the 75, gain back 90, etc., etc., world without end, amen. I don't think I ever gained back less weight than I lost at any time during the thirty-odd years I was continually falling off the dieting bandwagon -- it was just up and up and up and up. No matter what diet I was on, and over time let me tell you I was on some real doozies.

Only you can decide if weight loss surgery is right for you. Some of us -- myself included -- needed therapy both before and after to work out the twisted relationship we had (and continue to have, it's only a tool after all and not the magic cure-all) with food. But I'd do it again in a heartbeat, and wish I'd not waited as long as I did. The only thing in my life that I wish I'd done even faster than that was having my knee replaced -- I just had it done on April 20 (what is it with me, April and surgeries?) and I'm like a kid with a new toy, walking around pain-free.

Best of luck, wherever your journey takes you.