Debate topic: Does having RNY actually make it HARDER to lose weight down the line?

 Nik:

We can absolutely take the weight off.  I am living proof of it after almost six years.  We all know that if we do not follow the rules in the beginning the weight is still going to come off.  But, after malabsorption is gone, it's just you and if you have not learn the basics like I did not, then weight gain will happen.  I put on 70 lbs. in about a 2 year span and last May said enough is enough.  I went back to basics, journaled everything and started exercising.  Did not exercise before.  In 9 months, I have lost 68 lbs.  I am back into all my size 10's and loving every minute.  My original goal was to weigh 145 which I never made, but I am now back at 158.  I am 13 lbs. away from this goal and I am going to make it this time for sure.  So, if you want to kick start again, you can, our pouch never stops working, we just do.

Wow, how encouraging.  Keep up the great work.  I have gained about 5 pounds back but have still maintained a 100 pound loss - but I must keep it in check, kick up the exercise and get back to the very basic way of WLS eating.  Thanks for the kick in the rear, so to speak!

That is very encouraging.

I always did exercise. And I gained MOST of my bounce while still in the gym five days a week. Well...half. I've regained 20 and at least 10 came back while I was still working out.

I haven't gained any weight since that bounce but I haven't lost any either. Today was my weigh day at the gym. I've been going at it hard trying to get my endurance and weights back into gear.

My losses? NOTHING! But I'm ok with that. These days my activity is more for personal satisfaction but I would SO love to get back to my low weight and just keep on going...

I sure hope that we are not at a disadvantage, as I would like to see 170 something SOMEDAY! I never got to goal, and even if I did and bounced back, it would be nice to say I got there. Instead of being in this perpetual state of trying to lead my normal life and lose weight.

I do, however, focus more on the activities that I can do now! Life is pretty sweet, and I've got loads of time to work on getting to goal, getting more fit and healthy. It really is a journey!

:Danni

 Yes, for some people the severe caloric restriction during the 6-9 months after surgery causes a permanent drop in metabolism, making it more difficult to lose weight (and easier to regain) down the road.  (My PCP gave me a copy of a medical study on it right before I had surgery and then I found another study via a Google search, so I would assume that a search now would still lead you to the study.  Unfortunately, after 5 years, I don't remember what is was called or who did it.)

Lora

Nik I think we are at a disadvantage, if we don't weight train!  We tend to loose a lot of muscle with our initial weight loss so we have to work extra hard to build some muscle mass.  Muscle burns more calories all day long.  I was a cardio freak up until this year.  I hired a trainer to make me do weights as I refused to do it on my own.  I'm only a couple of weeks into it but I am hopeful it will help me get to goal.  I love the way I feel pumping iron, too bad I'm such a weakling right now!  Add a good solid weight training program to your program if you are not already.

I don't know that it's WLS specific people, but more likely MO people who have lost substantial weight. The body's homeostatic response is to try to get back up to it's highest weight. A person who was 400 lbs and is now 150 lbs needs to take in less calories to maintain at that 150 lbs than a person who never went higher than 150 lbs and needs fewer calories to gain a pound.

We are built that way because only a very short time ago scarcity was the norm, and drought, blight, shortage etc was an inevitable thing. There would come a day when you would starve, and fight your environment to keep enough nutrient to stay alive. The body stores fat for just that eventuality, and once you have acquired fat, it resets the internal mechanism of your body to say: "Hey I didn't realize we could achieve that much, let's make that what we shoot for for now on." Once the body's set weight point goes up, it never comes down again.

The problem being, of course, that scarcity is not what it used to be. Low cost, high caloric density food is widely and cheaply available... we're basting in it, culturally speaking. So much higher weight achievement is now possible, and the mechanism that used to keep us alive is starting to kill us because it has happened faster than the body's evolution can keep up with.

I've been reading here and there about this for a long time - it was this knowledge that finally convinced me to go forward with surgery, knowing that I would never be able to permanently reduce my caloric intake without restriction of some kind. They recently they published an interesting article in the NY Times about it. (http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope- fat-trap.html?pagewanted=all )

Dr Sharma's talked about it too: http://www.drsharma.ca/how-the-hedonic-system-ratchets-up-yo ur-weight-obesity.html , http://www.drsharma.ca/obesity-your-body-is-happy-to-wait-fo r-your-weight-to-come-back.html , http://www.drsharma.ca/does-neuronal-scarring-determine-the- body-weight-set-point.html , http://www.drsharma.ca/obesity-why-diet-and-exercise-is-not- a-treatment-for-obesity.html

I'd love to see some comprehensive longitudinal study that compares MO folks who lost weight with / without WLS and the long term ability to loose and maintain. I would guess that our ability to maintain is easier, but our ability to lose is is of similar difficulty.

I've had health problems and a lot of meds along the way, so I can say I've had more than a little bounce back.  I've had 70 lbs now of bounce back, to be exact.  I'm now down 42 lbs, with 28 left to go.  I'm pretty proud of that.  I'm back in the 150's again =D!  I'm not going to kill myself to lose it, but I'm not slacking either.  I admit it's a lot harder to lose it the 2nd (or 18th, with all the diets pre-op) time around that it was to lose it as a new post-op.  I'm not giving up and I'll be happy just to hit 138-143 lbs again =D. 

Renae

== Now at 158 lbs, instead of 130, but still happy and not giving up==