My surgeon and Bounce Back!

My surgeon and "Bounce Back" Okay - this is going to be LONG, but I want to make sure I explain myself as best as I can. Keep in mind, I like my surgeon, absolutely have complete faith in his skills, his opinions, his expertise and the fact that he's been performing weight loss surgery for 20+ years is a huge plus. I saw my surgeon for the first time in almost 3 years, this past January. He was very pleased with my current weight loss, health, attitude, etc, but pretty much warned/predicted that I would have a "bounce back" and NOT to see it as the surgery failing me, or me failing the surgery, it was just a reality of the surgery. Let me back track a bit - my INITIAL appointment with my surgeon, way before a surgery date had even been set, he asked me what "my" goal weight was. At 5'9", I told him I wanted to get down to 165 - 170 and I'd be thrilled. At that point, Dr. Weber flat out told me.... "This surgery will settle in at 200 lbs, don't expect any more from it. If you do, you'll set yourself up for major disappointment and forget to enjoy, celebrate and enjoy the new health that comes with dropping 200 lbs." Yes - Im paraphrasing, it's been almost 4 years since my first visit. When I left his office that day, I was VERY disappointed with our conversation and was determined to prove him wrong. I didn't want to go through all this pain, trouble, risk, etc just to still be considered "obese" and be in the 200's. Fast forward 20 months, I've SURPASSED my surgeons goal, and YES, in a childish sorta way, I was very SMUG about it. "Don't tell Lei.... blah blah blah, cause you can damn well bet, I'll prove you wrong". Soooooooooooooo - now let me bring you current. I'm to the point of walking into my surgeons office for the first time in 3 years. Dr. Weber was thrilled to see me, actually remembered me (it helps to have a big mouth) and took me and my husband into the back so we could play catch up. He pulls my files - takes a look at me, takes a look at his notes, asks me a few questions about my weight loss, how quickly, the maintenance aspect and then pretty much tells me. TO EXPECT a 10% "bounce back" which is NOT the same as "weight gain" and it's better that I'm armed with that knowledge so I don't self sabotage any additional gain. You know, based on all those decades of "giving up" when you struggle so hard to eat freakn rabbit food just to have the scales still go UP? His data is based on 25+ years of surgery (10+ which are RNY) and several thousand patients coming through his office. The data on file dictated the average bounce to be 10% of the total loss, which was then maintained for at least a year, with no additional gain. Per Dr. Weber (and yes, it's all hearsay at this point, since you're only getting MY side of the conversation) but he says, "It's "expected" that our bodies will overshoot it's healthy resting place and there's ALWAYS a slight rebound. In other words, based on my situation and my total weight loss, I can EXPECT to bounce back 25 pounds!?!?!?! IF I take that one step further, a 25 lb bounce would put me at the 200 lb "resting weight" that my surgeon predicted 4 years ago, I would end up at, long term. On ANY given day, Im dealing with a 10 lb increase. Some days, it's as high as 15, but I fully believe fluid retention can claim 5. I eat between 1500 and 1800 calories a day, I'm 5'9" and am "moderately" active. Not the gym rat that I should be, but I stay busy. Based on online body and calorie sites, I should be averaging 2100 calories a day to MAINTAIN. I've brought that number down approximately 500, just because my metabolism is all mucked up from decades of obesity. I'm not even sure why I brought all this up, or why I'm rambling nonstop in a new thread. Fear? Concern? Hell, even a feeling of DEFEAT? Im dealing with a lot of MIXED emotions, although I normally think "knowledge is power" ...I can't help but wonder if this kind of knowledge is just ammo for SELF SABATOGE? I mean c'mon - would AA tell their members "You WILL drink 10% of what you used to have daily, so expect it and don't beat yourself up"? I've never been to an AA meeting so maybe they DO, but I kinda' doubt it. I just can't help but wonder if this kind of information is good or bad? Good - because then I don't feel like a failure, when the scales do go up slightly. Which as of this morning, they're up 8 lbs since September of last year. (Hey Jay? Did you notice after we shared that Crunchy Bagel in Tulsa, we both started to "bounce"?) Based on the conversation with my surgeon, these 8 lbs of mine are to be expected. I'm not a failure and there will be 17 more of his/her friends showing up. Bad - because supposedly there is NOTHING I can do about it, even after bringing my calories DOWN from the National Average. It's a done deal, based on my age, years of dieting and being SMO for decades. How final is that? I'm going to bounce, it was predicted way before I even went under the damn knife and my future INCLUDES weighing 200 lbs again. Just wheel my butt to the head of the buffet, might as well enjoy myself. NORMALLY, for me - knowledge is power, I truly believe that statement, it's served me well over the years. I read, absorb, research, participate, lurk on a dozen weight loss boards and you know what??? I DON'T LIKE WHAT I'M SEEING with my own eyes. Many many many long term post-ops ARE dealing with an increase. Is it a bounce back or weight gain? Who knows. How do you fight something you "supposedly" can't control?!? ~ Lei [Sorry this is so long, Im too lazy to proof read this beast and scale it down some. Hopefully, I didn't let the "emotions" overshadow the points I was trying to share]

Well, I believe death and taxes to be the only two absolutes, that I have no control over. Everything else, I take responsibility. Don't take this doctor's word for gospel. Believe in yourself and enjoy your new life. You are a true success and a wonderful inspiration !!! Karen G

You continue to have the faith you have always had and fight to keep it under control. You might be that 1% that actually doesn't bounce back. You did good with the points, sweetie! Now, you just keep on keepin on!

Lei, my surgeon and our group support leader have both said expect some regain, is it bounce back or weight gain, I don't know. Their experience also is that within 2 years most will have about 8-12% regain. I hate to even think this is a possibility but it appears based on your surgeon and my surgeon's experience it happens. Can we avoid it? I'm not sure but I won't give up fighting the good fight. I've surpassed my surgeons goal of 130 lbs and there is no way in he(( I want to get above that. Soo the fight continues to maintain at some level that I am happy with. Dana

Lei Thank you so very much for sharing this very VALUABLE information.....As I sat here reading your post I had a flash back to me sitting in my surgeons office and he was explaining the entire procedure....I gotta admit 2 things....First off Dr Quillici is an extreamly good looking french doctor with a beautiful sexy french accent.....HEY Im human..I kind of was just euphoric listening to his soft voice telling me how healthy I will eventually be and how beautiful and sexy I will look one day...it was like listening to a fairy tale...I remember being very distracted during his little sermon...2nd I slightly remember him describing LIFE AFTER the surgery and what to expect...He did mention "BOUNCE BACK" and what he has seen through the years with other patience and what to do when maintance comes into play...MAINTANCE...hahahahahaha I wanted to just get to the operating room without a sever panic attack....so I wasnt really listening to his enlightenment...shame on me!!!!!!!!! This is possessing me to go back for my 3 year check up in a few months and ask the Handsome Doc to re-enlighten me about what I can expect for the future....There has got to be a way to FIGHT THIS!!!!!!!! I will give my body a 5 maybe 10 pound cushion but thats it..... God help us all on this lifelong struggle to battle our demons and to stay healthy with love,peace and alot of HOPE stacey

I am at my 20 year mark since my first WLS. I maintained my weight loss for about 17 of those years and then became extrememly ill and had a revision. I am 2 years out since the revision (coincidentially in April, too) and I think we CAN control weight gain in spite of a tendency to bounce back, if that is even accurate. The science around WLS is far from complete or completely understood. Your doctor means well, but I wonder how deeply he has interviewed all his patients or made an attempt to account for what he observes. S In my opinion, having a doctor expect you to regain and telling you that you have no control may set up that result. HE may be the key to all that bounce back instead of any other factor. Setting up self-fulfilling prophesies in his patients. Do what makes you successful. I am also 5'9" tall and I gain and lose water weight fast. I even take diuretics for it which keep things on a relatively even keel. Over T'Day to New Year last year, I gained over 15 lbs. Lost that and more when I applied my program to the gain. Down now below where I started. I hate to say don't listen to your doctor on any topic but this may be the exception to the rule. Take heart, you don't have to bounce if you don't want to bounce. tee tee

Lei, Yep. That's a lot of potentially anxiety producing thought to chew on. I actually believe (but have little fact, just belief) that the "bounce back" Mmay have to do with the increased Villi Growth In the intestines that happens as a response To any removal or bypassing of small intestines. My father had colon/ileum cancer And had large portions of his intestines removed. The Doc in that instance said that as the body "gets it" That it is missing some of it's Absorption/receptor sites, It steps up the growth of them in the remaining tissue. Not a huge adjustment, But one that allows for many people to regain enough Absorption, to "make it" without The constant fear of extreme mal-absorption. I told his doc that I was most interested Because I too was "missing" Some of my intestine. He said it takes a few years, But indeed the body does respond by growing extra villi On the remaining intestinal surface areas. That made me very skeptical of relying In any way, on "mal-absorption" for future Weight maintenance at the same time It eased some of my fears stemming from The "extras" I had removed during my complications. My response to the news of my bodies response? "Gym Rat" here I come. I have upped my exercise and intend to do so till stopped. The little "head game" I play with myself is this- Even if it weren't about the weight, Increased Exercise will make me feel better And add years of "healthy Life" On to the end of this little span of time I've Got left. That's why I had WLS to start with- To keep those last 20 years out of a wheel chair. Exercise may push that to the last 25 Still active and living without pain. So far, Telling myself that is working for me. My response to the common- "It's surgery on our guts, not our brain!" Has been to work on my "brain" or rather "Mind-set" As much as I possibly can. I keep learning and finding ways To short circuit years of sloppy thought (as it relates to health.) Sort of the "Harold Hill School of Music" Applied to More healthy Living? Maybe. But so far, the "Think System" Seems to be helping me along my way. I maybe wrapping up so tight that one day I'll be on the Tower with a High Powered Rifle, Or I maybe "Letting Go" of anxieties and cares To the extent that I'll soon be useless to Any one for any reason- "I can't be bothered with that right now, I'm Living!" The second is more likely right now. I've always fluctuated between Extreme Lackadaisical introspection And "Stopping to smell the roses" observation, Or the Opposite of Frantic Flashes of Inspired Obsession - "Gotta Do This NOW!" I find that I spend longer times Letting things slide even as I add in more exercise. Nothing quite like a long walk And jog to Let Go of the superficial concerns. So, Bounce Back or Gain, By Design or as a response to WLS? I'll keep fooling myself By spending less time "In my Head," And More Time on the running trails in the park. Let my intestines adjust! See if I care.... I'll be walking away from their effects.... That's my story today! And I'm sticking to it. Until I'm not.... In the meantime I'm also staying clear of those darned "Crunchy Bagels!!" Best Wishes- Dx

Remember, Lei, when doctors and scientists talk about averages, that means whatever data falls in the middle. It means that some of their patients regained more than 10% and some regained less, and the mean or average weight gain works out to about 10%. You could be in the lower end group (of course you could also be in the higher end, but I prefer to be more optimistic!). Carlita

My internist says the key to weight loss/gain is calories in/calories out. As WLS patients we received a tool. What we do with it, is strictly up to us. I think we can prove all of the doctors wrong and start working hard not to have a "BOUNCE" and change the statistics. At almost 3 years out I see that I can eat almost ANYTHING. I choose not to most days, and some I endulge. I want to be the small percentage that does not bounce and prove my doctor wrong, and he wants me to prove him wrong. Let's get up each morning saying "I will make a diffence on those numbers and change things". Just my 2 cents worth. Missy

Lei, I think you should keep your "you're not gonna tell me to...." additude!! You're in control of your fate, not your doc or his experience with WLS patients and regain. Keep that 10 pound flucutation number in your head and stick to it. I'm fighting regain myself, and I don't like it one bit!! If I was to "accept" that I will regain, then you're right... buffet here I come. But I don't accept it, and I'm fighting it every second. Good luck! Michelle