Problems after VBG

I had my original VBG about 17 years ago.  I did lose a little weight, but only about 40 pounds of the 200 I needed to lose to be at my optimal weight.  Over the next few years, that weight came back.  I've continued, in the ensuing years, to try other programs such as Jenny Craig, Weigh****chers, etc.  I actually lost about 50 pounds on Jenny Craig, but again reached a point where it just stopped working for me, and eventually gained the weight back.

Now I'm in a situation where I am still experiencing severe restrictions on how much food I can eat, as well as what kinds of foods my stomach can digest.  I have severe osteoarthritis in my knees, to where I use a wheelchair at work because of excruciating pain.  I did consult with a surgeon who told me he would be willing to operate, even at my weight, because the fact that I had WLS indicates I have made an honest effort to lose weight.  But he did tell me that the results from the surgery are going to be limited, because the stressors that caused the damage to the joints in the first place are still going to be there.

I don't really want to go through revision surgery, unless it would be to have the staples removed.  To me, that just sounds like trying one more diet or one more exercise program.  What happens if this next surgery doesn't work?  Do I have still more surgery, and then more?  What I would like is for some doctor to actually believe me when I tell him/her that I burn up more calories than I eat, and yet can't lose weight. (Or get seriously ill when I try.)  I'd like for some doctor to even try to figure out why I have this problem.  How can I try a treatment, when I don't know what caused the disease in the first place?  It seems that they do one test, or a couple of tests, and then when those tests turn up negative, they just shrug their shoulders and tell me I need to "try harder," instead of looking further.

This is why you're not losing, even though you're barely eating:

Our bodies are hard-wired to defeat “diets."  You’ve seen the weight-loss charts of some individuals that look like an upward-trending stock market chart? We lose 20, and regain 23. Lose 80 and regain 89. Maybe your weight-loss chart is similar. 

Our bodies are actually programmed to do this. Back when our ancestors lived in caves, our bodies developed the necessary ability to react to the conditions in which we lived. Food was plentiful at times, and then at others, not. When our bodies would go for a period of time with limited food, our metabolism would slow down. This served two purposes: to conserve energy for the current famine, and (once food became plentiful, again) to prepare for the next famine by storing as much of that newly available energy as possible. 

The more frequent these no- or low-food periods were, the more efficient our bodies needed to become in order to survive. Likewise, the greater the change to our weight (remember, back then, the more weight we lost, the more severe or the longer the famine was), the more efficient our bodies needed to become. Those whose bodies were unable to adapt like this were quickly eliminated from the gene pool. 

Now that food is plentiful, this trait isn’t useful any longer, but back when we lived in caves, it was essential to our survival.  

Just like then, when we lose weight quickly now, it signals a “famine," and our bodies react as they always have – our metabolism slows in order to get by on less fuel. Once we’ve lost the weight we want to lose, and begin to eat more normally, that slow metabolism doesn’t go away. Our bodies go into “storage" mode, and we put weight on more easily, and our bodies will fight to add even more stored energy (fat) than we had to begin with, in order to be better prepared for the next famine. 

When a person lives their life obese, continually losing weight in relatively large chunks, their bodies will fight harder and harder against them. Their bodies become very efficient metabolic machines. This used to be a good thing. Now, given the fact that obesity has been directly linked to diabetes, heart disease, sleep apnea, hypertension and cancer … it can be deadly. 

Losing weight quickly is the worst possible way to go about lowering your Body Mass Index. Unfortunately, it’s the way most people tend to do it.

Thanks for the input.  I really do appreciate it.  However,

"Losing weight quickly is the worst possible way to go about lowering your Body Mass Index. Unfortunately, it’s the way most people tend to do it."

I'd settle for losing it slowly.  I'd settle for losing it any way it would come off, and stay off.  I've been on probably 50 or so weight loss programs in the last 40 years, ever since my mother drove me to my first TOPS meeting at the age of 11.  I've consulted with a myriad of nutritionists and doctors.  The end result is that I've ended up fatter and sicker.

I'm sorry. I should have expanded on that.

This article was talking about how folks screw up their metabolism by dieting. For us, it's already a done deal.

I'll give you an example. My friend, Mary, was never overweight in her life. She had her son about the same time her marriage was breaking up, and gained about 150 pounds over the course of the next two years.

She's lost that weight over a long period of time ... over the course of four years, by making very small changes in her diet. SHE will likely be successful in keeping it off for two reasons. 1. She hasn't spent a lifetime yo-yo dieting, and 2. She lost her weight without throwing her body into "feast and famine" survival mode.

For me, because I didn't have this infomration back in 2nd grade when i became obese, my life has been spent yo-yo dieting. My body is ALREADY in that dreaded "feast and famine" survival mode.

Yes, losing the weight fast is the worst way you can do it. BUT, once you've gone that route (whether it's atkins, weigh****chers, the grapefriut diet, or WLS), your body will remain in feast and famine mode. That's why no matter how much you try, your body is giong to fight you every step of the way ... where as Mary's body may accept the change without triggering that metobolic monster that you and I suffer with.

I'm not sure if I've made that clear. This article was addressing someone who was overweight and trying to do something about it for the first time. In that case, losing slowly is DEFINITELY the way to go. However, I've trained my body (just like you have yours) to store everything you give it.

In our case, losing will be significantly more difficult than it will be for someone like Mary.

A surgery like the DS will defeat your damaged metabolism. Your body simply doesn't absorb all that you feed it. It acts as a sort of artificially induced metabolism. A surgically altered metabolism.

Good luck

All that is to say that if you were to simply remove your staples, you'd gain weight very rapidly.

You've posted this elsewhere, I know ... but I'd like to add it here, in case others see this:

Please consider the DS. Read, read, read, of course, and make your own decision. But I am right where you are, now ... down to the arthritic knees. The arthritis isn't going to go away and will only get worse unless you get the weight off. I KNOW what a drag it is to think about another surgery. I know you think you'll fail... like you did, last time.

I know, because I felt the same way. But after reading my eyes blurry, I believe I can succeed with the DS. There is enough mal-absorption to kick my efficient metabolism in the ass. I've seen many successful revisions on the DS board, and I've drunk the koolaide.

Lurk the board, and ask lots of questions. There very well may be an answer for you, and reason to hope.

~hug~

Kathy

Thanks again for the support.  But any kind of surgery is out right now, unless it could be done on an out-patient basis and I could be back to work the next day.  And that includes getting my knees done.  I do contract work, and have no sick days.  I have insurance, but the day I can't work my coverage ends.  And my husband isn't working.

I haven't completely ruled out the prospect of further surgery.  But, I'm at the point where I've tried so many different things, only to have failed each time, that I just don't have the heart to try anything else.  And that includes surgical and non-surgical methods.  I am hoping, however, to find someone who can at least tell me why I am this way.

I understand.

And hopefully, I've given you some insight into why you are the way you are. Your body is an incredibly efficient machine. It will react quickly and surely against a famine ... and it doesn't distinguish between "natural" famines and "self-imposed" famines like diets.

It's doing exactly what it's supposed to be doing, as much as we'd like it to knock it the hell off

Why I am the way I am?  No.  I know you mean well, but I know about how the body is supposed to react to food.  And my body's not doing it. 

I can't say my body is doing what it's supposed to be doing.  If it was, I wouldn't need to be here.  But, thanks for your support anyway.

I'm sorry I've failed to word this so you can understand. You're eating very little and not losing weight, because you've spent your life training your body to hold onto everything you give it. By dieting and losing lots of weight over and over, you've triggered a "famine" response in your body.

Just like I have. Just like any of us have who have spent a lifetime on yo-yo diets. I can't make it any clearer than that. I don't mean to pester you. This will be my last post.

Good luck.

I do understand, very clearly.  I work as a speech therapist in nursing homes, and good part of my work involves working with dementia patients who show what you describe as a famine response.  I can't tell you how many times I've tried to explain it to worried family members who are trying to understand why their loved one doesn't want to eat. 

I want to eat.  I can't.  I gain weight anyway.  I can't make it any simpler than that.

I do appreciate your efforts, and your support.