I'm frightened after reading some of these posts. Stalling made me give up losing weight in...

I like to look at WLS as something of a "do-over" - it allows us to get back to a normal-ish weight and gives us a second chance a keeping it there, but it doesn't allow us to make the same mistakes that got us MO (morbidly obese) in the first place. We need to learn how to maintain ourselves as a "normal" person does (and/or to compensate for whatever metabolic deficiencies we may have that has helped keep us MO.) One of the problems is that maintaining our weight, while related to, is not the same as losing it in the first place - that's why diets alone don't work in the long term (about a 5% success rate beyond a year; WLS is more on the order of 50% after 5+ years.) Also, those who do lose a lot on a diet program alone tend to snap back and regain that weight fairly quickly, usually within the next year; with WLS, the regain process, if it happens, tends to be slower as there is still restriction at work, so there is more time to catch it and make corrections.

Another way to look at it is that this is a team effort - neither we, alone, nor the WLS alone will do the job - it is a combined effort; we need to learn how to use our WLS to maintain our weight and health in the long term after it has helped us lose the weight over that first year or so.

You mention discipline, and to me, in this realm, this implies sticking to some prescribed diet - certain calorie or macro counts or ratios - whatever the diet promotes - which tends to work OK as long as one has the positive feedback of the weight coming off. Once that stops, there is little incentive to stick to the diet and the weight starts coming back - this is why diets fail 95% of the time. You speak of having a hard time sticking to an eating style before surgery - whose eating style are you trying to stick to. To me, this is something that we have to make our own (much like a tailored suit, versus a borrowed one - it has to fit us, not someone else.)

When I started this game some fifteen years or so ago, when my wife was getting serious about WLS and I was going along for the ride with her, we needed to do the typical six month insurance diet/exercise program. My philosophy on it, as long as we had to spend the time on it, was to work on what my diet and lifestyle should look like in 5-10 years, rather than some quickie weight loss fad diet. I studied nutrition and worked to drive my tastes toward that goal of a sustainable healthy diet that would help control my weight. It wasn't perfect by any standards (most particularly whatever the fad diet of the day was) but was getting as close to the ideals of nutrition science as I could get, and it was (and is) a work in progress. But it was "good enough". I lost around 50 lb, or about a third of my excess, over those months and it felt good. It wasn't quite a "I've got this nailed, I don't need surgery..." moment, but more of a "if I can be one of those lucky 5%, that's great, but I'm not counting on it - just yet." That was about what I could lose on that basis - a few more here or there, but nothing that stuck. I became more of a test of maintenance - can I maintain this loss? As it turned out, yes I could over the next several years, as my habits had evolved enough to do that, but ultimately I did need the WLS to finish the job (I probably could have jumped onto one of those fad diets to lost more, but that would most likely have resulted in the total regain that is typical of them.) This exercise did teach me a lot about myself and what I needed to get the job done, and helped drive the decision as to what procedure was appropriate for me. I went with the VSG as I seemed to have developed a reasonable level of weight control; had I gone the total regain route as so often happens, that would have pointed me more towards the DS, as that offers better regain resistance than the other mainstream procedures like the VSG or RNY

A good RD (nutritionist or dietician) can work within your tastes and preferences to adjust your diet in the right direction, and help you evolve your tastes, making it more sustainable effort than some packaged or fad diet. Some bariatric programs are more flexible than others - some can be quite cookie cutter, which is great if you fit their mold, but counterproductive if you don't. It may be appropriate to take a step back and really evaluate your needs, and what the program you have chosen provides in that area - a delay or change might be appropriate.

Good luck!

Stalls are natural and even necessary. I was upset when they happened to me but then the scale starts moving again and my unhappiness is relieved. I think its kind of like a breather for your body. It catches its breath and begins losing weight once more.

I saw that you have attended AA meetings. They have all sorts of slogans like, if you're not working on you're recovery then you're working on your relapse. The same goes for WLS. If your not measuring your intake and you don't exercise the weight will surely come back.

It's definitely not an easy journey but I know for me its been incredible. I probably never would have been able to lose this much without surgery. I've been able to keep up with things I've needed and wanted to do.

Surgery fixes your stomach, NOT your head.

Being successful after WLS requires constant vigilance and a completely new relationship with food. The folks who slide into old habits, like emotional eating and binging, tend to be the ones *****gain.

The people here who've been successful at losing and maintaining for 5, 10, or more years continue to weigh, measure, and log their food, and stay accountable for everything they eat and drink. Surgery is not magic and it requires a lifetime of hard work.

If you don't think you can commit to that, spare yourself and don't have surgery until you're ready to commit and follow-through.

Let me go ahead and give you the spoiler. You're going to stall. Your body's metabolism acts like a system, combined with appetite. As you lose weight at a rapid pace, your body freezes and says "oh sh&*!" It thinks you're starving, so it slows the metabolism way down while increasing your appetite. It's used to you being a certain way (eating large portions of terrible choices of food and not exercising). Once your body realizes that everything is normal where it's at, it "lines out" and goes back to normal again. Of course, everybody is a separate case and not all body mechanisms are the exact same.

The thing I personally learned about stalls is I hit a big one at six months for over a month. I learned that I was so crazy about avoiding carbs that I wasn't eating enough. I just happened to fall onto this by mistake. I went on vacation with the family to Disney and honestly had a few cheats. I came home and realized that all the walking and eating more carbs into my diet actually made me not only break the stall but lose 5 more pounds. After sharing this with my nutritionist (which she confirmed), started adding just a few more carbs into each meal, and started committing myself to 3-4 times of week of either cardio or going to the gym and doing a light full body/cardio. I haven't looked back since. I still hit little teeny tiny stalls, but nowhere close to that big 6 month one. And with eating carbs, there is a razor fine line of eating "enough" carbs and eating "too many" carbs.

The bottomline is this buddy: I agree with those who say this has to be a lifestyle change. Just as with sobriety, you have to take the mindset that failure is not an option. Just as we can't just have "1 beer", we also can't afford to go back to where we were pre-surgery. So this has to be a marathon (and not a foot race) that you make work for you, for the rest of your life. And not just a fad that lasts for one or two years. Nothing that I was doing was working for me: the portion size, the speed that I ate, the food choices I made, and the lack of any exercise. Since the surgery, I have had several moments of clarity regarding all of this, and did a complete 180. I am more proud of that, than the actual weight I'm losing (if that makes sense).

I had RNY GB in 2003. And years after my surgery I began having problems with iron-deficiency anemia, constipation, SIBO (small intestine bacterial overgrowth), and IBS (irritable bowel syndrome). These are all directly related to the GB. I have spoken with several very knowledgeable gastroenterologists and they feel that the GB caused Blind Loop Syndrome in my case. And I have to laugh because on another WLS forum a bariatric surgeon told me that GB does not create a blind loop -- it most certainly does.

Worse, these conditions have caused or contributed to downstream serious health conditions of chronic fatigue syndrome and other comorbid conditions. It is extremely difficult to eradicate SIBO and balance the gut microbiome. And, in fact, the imbalance that it causes predisposes the patient to weight gain.

Thusly, I favor the sleeve over the gastric bypass. The sleeve does not have a malabsorption component so the risk of nutritional deficiencies is decreased. It does not create a blind loop so SIBO and IBS are less of a risk. It is a far less complex surgery and therefore there is less that can go wrong.

I am certain the gastric bypass saved my life. And I do not regret the surgery. The sleeve was not available at the time but it is likely I would have chosen the bypass anyway since it is statistically results in greater weight loss. I would like to see statistics on weight regain between the two surgeries. I would like to see short-term and long-term statistics on complications between the two surgeries. My i is there is greater weight regain with the bypass than the sleeve.

Best of luck to you. It is scary to go through surgery. I know! I cancelled my first surgery date. But I am so glad that I finally did it. It provided me with many years of a quality of life that I would never have had if I were morbidly obese. And I honestly believe I would be dead now. Despite the setback, I am working to regain my health over SIBO and IBS and CFS. The future looks bright!

My surgeon recommended one type surgery over another based upon the hormonal/metabolic effect the RNY procedure had on diabetes so that is the one I chose. I have gone from having to take shots to not having to take any diabetes meds. He was right. Have an honest discussion with your surgeon and listen to the pros and cons of each procedure. Keep in mind that comments in this forum are not a substitute for your nutritionist or your surgeon. It will be a hard path, but a VERY rewarding one when you see the life changes this can make happen for you. Question is whether or not you want it and want it badly. If you do, the discipline and the perseverance will come. If you need help along the way, get involved in a local support group or arrange for counseling. I am two years out next month and I still call in for our telephonic support group. It keeps me focused. All the best.