Question:
Has anyone else noticed 25% of last 20 questions are about regain?
I am seeing more and more questions on a daily basis about regain or inability to lose to goal. Aside from the fact that we're human and we screw up sometimes.......why do you think this is? Do you think we weren't educated enough preoperatively? Do you think we don't provide enough support post operatively? Do you think we had unrealistic expectations going into the surgery? Did we think it was a magic pill? Or, are we just lazy? What do you think the solution is? This is very interesting to me. — ronascott (posted on January 7, 2005)
January 6, 2005
I think part of it is due to the fact that so many of us aren't properly
educated pre-op. Very few of us are informed that, in time, most of us
will be able to eat once again as we did preoperatively. We will be able
to eat foods that we can't eat immediately following surgery in time and
they won't bother us like they did when surgery was first done and for
awhile afterwards. We are told that this surgery is a tool, and it is, to
help us learn to develop new habits; but most people go into having this
done expecting the surgery itself to be a cure for morbid obesity, when it
is not.
— SnowWhiteDove459
January 6, 2005
Some may be not educated properly going into the surgery or had unrealistic
expectations. I think the truth is that losing weight and adopting the
post-surgical lifestyle is HARD. Think about people who struggle with
giving up smoking or drinking alcohol or drugs. It's breaking old habits
and comforts and taking on new ones that require large time commitments for
some of us (exercising several hours per week is tough to fit in). Also,
take into consideration the calendar. Halloween, Thanksgiving, December
holidays, and New Years -- all back to back food fest-style holidays. Then
after the new year, many of us (including myself) resolve to de-carb and
get back on track. That's my 2 cents. Have a great day!
— Yolanda J.
January 6, 2005
weight gain is from straying. Not 'reaching' goal is from being uneducated
- WLS does NOT guarntee 100% weight loss.. can you loose 100% yes but it
requires work.
— star .
January 6, 2005
Rona...This is such an excellent question. I agree, I don't think we're
told as a preop that in time we'll be able to eat as we did before. I am
now 16 months post op and although I have never eaten sugar, I find I am
battling the same issues. I've lost 174 pounds and feel wonderful and I am
so extremely grateful with this amazing tool that helped me to have this
success. But now the "honeymoon" is over. The days of jumping
excitedly on the scales and watching the pounds rapidly fall away are
behind me. That was a wonderful incentive. There would be times where I
would think no I don't want to eat that because tomorrow I won't lose a
pound. That helped keep me on track. Now I have to exercise like crazy
which I rarely did in the early days. I just returned from a 2 week
vacation and after weighing myself this morning I found I gained 6 pounds,
actually I thought it would be more, I feel so bloated and my clothes are
tight. I know what the problem was, I ate like a normal person. I never ate
a great deal, or ate sugar, but I ate carbs. I would eat a few of my
husband's french fries, twice I ate a wonderful exotic sandwhich with a
bun, breaded seafood. And let me tell anyone who isn't aware of this, if
you have been faithfully on a low carb regime and suddenly eat carbs you
will gain. It was my fault, I wasn't disciplined and I knew it would
happen. I kept telling myself when I get home I'll get it right back off.
And today I am. Total carb control. So to answer your question I think we
need to be told, settle your food issues along the way. If we want to keep
the amazing bodies we now have we have to realize this is a lifelong
challenge. Whether you eat because of emotional eating or because you love
food. Those issues will ALWAYS be there. We must realize that and learn to
deal with it....Nancy
— nancysho
January 7, 2005
I think the reason many of us regain, is because as you stated we thought
it was a magic diet pill that fixed everything. We jumped on, thought our
weight was the real issue and then realized that we have mental hangups
about food that have nothing to do with being overweight. If you ran to
food when you were obese, there is a big chance that it will be the same
post op. Maybe not at first, because jumping on the WLS bandwagon,
everyone seems to lose and be good at first, just like every diet we have
ever been on, but then the old self who deals with everything by stuffing
down food comes back. Now this may not be the reason everyone gains, but I
do know that the majority of people that I talk to that have had WLS, this
is the reason. I really think that part of the process of getting approved
for WLS should be counseling before and after. If you have used food as a
friend for years, it's hard to say goodbye to your old buddy without some
help. JMO
— Carey N.
January 7, 2005
I think many of us are educated pre-op, but there's always this thing I
call "i want instant grits" that I see so much of in the American
populace. A lot of people, just like on any diet, think they can control
their eating for a while and then go back to a fuller eating program after
they've lost the weight. One lesson I've learned with this is I can never,
ever eat like a normal person again. I find if I exceed 1200-1500 calories
in a day, I will experience a weight gain. I exercise, take my vitamins,
get protein first, but I know what my limits are. I've 2-3 lbs. from the
holidays to get off now, so I'll have to work hard for a few weeks.
I wish in the pre-post educatin plans most surgeons have, they would
emphasize, the you can never, ever go back to normal eating if you wish to
remain successful. My heart goes out to people who have learned that the
hard way.
— Cathy S.
January 7, 2005
I don't think it's a case of not being educated enough preoperatively or
not getting enough support post operatively. I do think many of us have
unrealistic expectations going into the surgery. In the back of our minds
we hoped it was a magic pill. I do not think it is a case of being lazy.
I do think we all need to realize is that the reason we have all gotten
weight loss surgery is our amazing ability to gain weight coinciding with
the increasing inability, s we age, to lose weight and the ease with which
we can rebound to pre-diet weight and then some.
Weight loss surgery is a fairly new phenomenon. We do not have long-term
generational studies of people who have had the surgery. It's the new kid
on the block where the diet industry is concerned. An industry that is, at
present, torn between whether the best way to efficient and permanent
weight loss is a low-carbohydrate or low-fat regimen!
In view of the fact that many of us are predisposed to obesity, we have had
very unrealistic expectations about how we are going to look and what size
we are going to end up. I have also noticed many post-ops reverting to
self-defeating patterns such as being too obsessed with what they see on
the scale. Many obese people don't know that our bones alone are denser by
the practical necessity of hauling all our fat. We might have a denser
musculature structure, too.
We are so wrapped up in the scale and weight loss, we are not concentrating
on nutrition. We are not examining what we are doing in our diets that may
be setting off hunger triggers or what we may be imbibing or ingesting that
may be inhibiting weight loss or even encouraging weight gain. Like the
national curse that is High Fructose Corn Syrup, an additive that is put in
practically everything we eat.
In view of our predispositions, I think we need to concentrate less on
weight loss programs and more on fat loss through lean muscle-mass building
programs. I'd welcome more information from people who are going to gyms,
what kind of exercise they are doing to successfully combat problem spots.
What kind of nutrients they are taking, if any to burn fat, build muscle,
and promote energy.
Probably, the least self-defeating thing to do would be to concentrate on
our measurements, see what clothes sizes we are using. How we fit and look
in our clothing might be the best measurement of how we are doing than a
scale that fluctuates with water weight from one day to another.
I was driving myself crazy from day to day with my scale. This year, I've
resolved to put it up and concentrate on nutrition and getting on the right
exercise program.
— Michelle S.
January 7, 2005
I've often wondered too if any studies have been done to compare regain in
persons who have been obese all their lives, vs people who didn't become
obese until they were adults. We all know WLS is not the magic cure-all,
and the surgery is done on your stomach, not your head. So are people who
grew up non-obese more likely to maintain the habits that are crucial to
avoid regain? I've been obese since childhood and am regaining because
I've fallen back into my life-long habit of eating to deal with stress.
Would it be different if I had not developed this habit until adulthood? I
hope this makes sense.
— Jules B.
January 7, 2005
Hi Rona,
I've been wondering about this also. Are there any statistics from MCE on
what percentage of people fail to get to goal? I'm also interested in
finding out if there are many who get to goal past the two year post op
period. I know in my case, to be honest, I lost 106 pounds (in a yr and
half) then let carbs, grazing and lack of exercise back in my routine and
saw a 14 pound regain very quickly. I seem to stay much hungrier now and
seldom feel satisfied and full. I think that MCE has an excellent preop
program but I think a more extensive post op program would be helpful to
keep us all motivated. Maybe a few more visits to the Drs and close
nutritional monitoring with the nutritionist would be beneficial. If we
think we're going to be getting on the scales a little more often, it might
help keep us on track and also any problems could be addressed. Although, I
realize that they can't "babysit" us and that we are responsible
for using our tool to it's fullest. I attend monthly support group
meetings at Helen Keller hospital and that does help some. I can't imagine
not having this website nor any local support group!! I know Dr Facundas
in Huntsville has his patients see a nutrtitionist post op on a regular
basis. I wonder, also, how much does our digestive systems adapt to WLS?
Would this account for some regain since we'd need far less calories at our
lower weight? I'm back on track now and losing again, but I know those
last thirty or so pounds are really going to take a lot of effort and
continued committment. I guess motivation and committment are key and
maybe more post op monitoring would be helpful. PLEASE, DON'T ANYONE FLAME
ME!!! Rona asked... and I'm just giving my opinion.
— Donna H.
January 7, 2005
Great responses folks! Personally, I think inadequate post op
"attention" is a BIG factor in regain. I absolutely believe that
regular follow up with your surgeon, regular support group attendance and
regular post op visits with a nutritionist are key to remaining successful.
Here's the catch with that though...........PEOPLE WON'T COME BACK. It's
the darndest thing. People have surgery, lose weight, stop their follow up
visits with the doctors, stop coming to support group, never see the
nutritionist and then the only time we see them is when they've experienced
regain and they're frantically looking for a solution. I know many
programs require follow up - ours does - but how can you MAKE people come?
It's not like you can repossess their surgery. It's frustrating. I do
think many people go into it with the attitude that it will be a miracle
cure and that it will be easy. I wish I'd had greater emphasis on changing
our way of eating during the honeymoon period. I also wish I'd known that
it would be a struggle, or not really a struggle but a concerted effort
every day for the rest of my life.
Keep your great comments coming and thank you so much!
— ronascott
January 7, 2005
Thank You Rona, this is interesting to me also. There are a lot of people
who believe that by having this surgery they will forever have no weight
problems ever again. There are a lot of bariatric programs and surgeons
out there that in my opinion do not do enough to educate their patients
before surgery on nutrition and post-op lifestyle. I know so many people
who after having this surgery they still are stocking their kitchens with
junk food and go back to eating the wrong kinds of food. It still will
take an effort to lose weight and keep up the excercise post-op after those
first couple of years after surgery when the lbs are dropping fast. Before
having this surgery do the research, learn about nutrition and excercise,
learn about how your GI tract works, learn about the vitamins you will
forever need to take post-op. And don't stop the support groups. The
support groups help keep you on track. Having this surgery is not the
easy way out. This surgery helps *HELPS* give you a second chance. I've
been coming to this site for almost two years now and I have listened to a
lot of people who have not been educated enough before undergoing this
surgery.
— Kara J.
January 7, 2005
Just wanted to add my two cents. I feel like the poster child for WLS
Failure. After a WL of about 90, I've have slowly but surely gained 45
back. The ONLY thing I can't eat/drink is Milk. Sugar, grease, fries,
meat not a problem. Get this, I can drink a milk shake w/ no side effects,
but not milk.
So, here I sit in the exact same situation I was before my WLS w/ the
inability to properly diet and exercise. As I keep telling my husband, my
mother and myself, I had surgery on my stomach, not my head.
The main thing that keeps me going is I know it's possible to loose weight
w/o WLS so I'm going to just keep at it. I'm doing better and better w/ my
exercise but I just can't (or won't) give up the sweets.
I wanted to add, that I never thought that WLS was a magic pill and I knew
that it would take work after that "window of opportunity", I
just hoped that the head-start from the surgery would have made it easier
to continue on the journey than it actually did. And just as one other
poster commented, I constantly hungry. I don't eat much when I eat, but it
no time I'm hungry again.
I'm just going to keep on keeping on and good luck to all of us on our
continuing journey!
— D W.
January 7, 2005
Hi y'all. While I definitely agree that some options require more rules
and dieting to be abided (for life) or else suffer regain, there is a WLS
option that allows for more "normalcy" as well. The BPD/DS is a
WLS that doesn't come back to bite you nearly as bad as other surgeries.
You can eat anything (I mean that nothing makes you sick or hurts you) and
as long as you don't binge and go berzerk, it's much much harder to regain.
Personally, I eat like a pig quite often. My BPD/DS was nearly three years
ago and I've regained about 10lbs since my lowest weight, but I am pretty
stable now - even with my occassional gluttony. I am praying that it stays
this way! But who knows... maybe in a few years I too will have issues.
All I know is that I do not exercise and I eat pretty normal, and there is
no other effort that has gone into this for me. I probably could've lost
more had I done these things... but after 30 years of doing things one way,
it's a hard habit to break. *arg* While I think that learning to eat
healthier is DEFINITELY a good thing, you also don't want to choose an
option that will really penalize you for being "human."
There are quite a few people I know who've had a revision from other WLS
options to the BPD/DS - so if you find yourself in a situation where you
are out-eating your surgery or being penalized for being "human"
(let's face it, we all like to eat our cake, too) - it might be worth it to
check into it. http://www.duodenalswitch.com has a LOT of info!
Good luck!
— Amber S.
January 7, 2005
Rona, as more and more WLS patients get further and further out, especially
beyond the 2 year mark, this issue of regain will get more and more air
time. I think we have a few factors working here. First, the most weight
loss is during the first year to year and a half. After that it is either
very sloooow, or has stopped so if you have hundreds to lose, you often see
post-ops struggling with 50 or more pounds left to get to their goal. And
for those who had 100 or so to lose, often times they do lose in the first
year or so down to those small sizes. I truly believe that the weight goals
chosen are very unrealistic in most cases. As formerly obese people, we
need to get a grip and realize that being a size 4-6-8 is just NOT the norm
for us, even after WLS. People forget that in the long run it is still a
calories game and if you take in more than you burn up, you WILL gain.
Soo, think this thru. To be or stay a size 6, you have to eat far fewer
calories than it would take to be and stay a size 12. I truly believe that
if post-ops would adjust their goal expectations, we would find fewer
complaints about regain, and post-ops would find it easier to maintain. So
I think that some who originally achieved lower sizes and then see a
regain, well, perhaps the original size/weight achieved was just
unrealistic to begin with. Then there are other factors involved, many of
which were already mentioned-some of us do not like to exercise and most of
us love to eat, not a good combo. Many of us looked to food for comfort
pre-op and never resolved those issues so when stressed or upset, reach for
that cookie. So, what is the solution? I think better education from those
of us who have been there to the pre-ops. They have to be told and made to
understand the truth that they need to commit to a program of watching
their calories and exercising and choosing a realistic goal weight or they
will not maintain a weight loss. Too many of them are dazzled by the before
and after pics.. Its that simple, now whether they "get it" is
another story.....
— Cindy R.
January 7, 2005
I beleive that as much as we don't want to hear it it is still a matter of
will power. I, for one have the knowledge to keep the weight off, it is a
matter of whether I consistently use the knowledge. Maybe the education
could be a little heavier on the regain question, but how many of us would
really think it pertains to us? Pre-surgery I also knew how to loose
weight, but didn't use that info properly. At some point you almost have
to test the waters and learn for yourself what will happen if you over-do
it. Hopefully you have the will power to stop and reverse the action
before it gets out of hand. At least once you have surgery it is easier to
drop back down. This is just my experience and opinion. I am 2 1/2 years
out -120 lbs and below goal.
— Penny D.
January 7, 2005
Great question! I think too the topic has come up alot more recently
because its after the holidays---just because we've had WLS doesnt mean we
have control over our eating. They operated on our stomachs and intestines
not on my brain and I had 48 years of eating way too much--even was a fat
baby! I too as a preop knew how to diet and how to exercize and just could
never apply it all correctly. As a postop I will not drink alchol, or
carbonated beverages or eat refined sugar...and I think if I had I would
have probably gained about 20% of my weight back. I work out every day at
a college wellness center at least 35 minutes of cardio along with weight
training before I go to work in the morning...without this habit I'm sure
the pounds would have creeped back on. I still overeat ---no to the point
of getting sick and I eat too many carbs and I eat when my emotions get the
best of me. As a post op I spent almost two years in counseling and should
probably go back. I guess what I am saying is I think that no matter how I
try NOT TO ACCEPT IT sometimes...I am just like the alcohlic or drug addict
...food will always be a problem. I am blessed that I was able to have WLS
and get most of the weight off but now I have to keep it off the way normal
people do---diet and exercise. I turn to prayer many times and it really
helps. Life is great and I thank God everyday for my blessings especially
my health.
— debmi
January 7, 2005
Personally, I think it is because, a: In the past we have all lost weight
only to gain it back again plus more. It is imbedded in our brains that if
we lose weight it comes back, which leads me to reason b: Since we have
lost and gained it back this surgery seems like a huge chance to take if we
are just going to gain it back.
I was very well informed and did tons of research. I have read it all and
still, somewhere in the back of my mind, I worry that I will fail my
surgery and, if I do make it anywhere near my goal, it will come back. I
know all of the rules and follow them, but still I have the thoughts. It
sort of is like you can take the girl out of the fat body, but you can't
take the fat body out of the girl... well sort of, but you know what I
mean!
Have a great day!
Amber
— septembergirl73
January 7, 2005
Before I look at other replies, here are my thoughts. . .
I think some folks have unrealistic expectations and think this is a magic
pill. Even after doing a lot of research folks want to lose every lb of
excess weight. But the reality is they say we will lose 70% of our excess
weight. That is far less than goal for many of us (me included) Technically
with 150lbs lost I am a success story, but I sure do still want to lose 50
more lbs. We live in an age of instant gratification and with the surgery
we want instant results. This is also a stressful time and we often eat for
stress. A bad thing for us obese folks. Well now I will read the other
responses. Thanks, Cathy
— catleth
January 7, 2005
I am 3 years post op and have had a very sucessful weight loss down from
300 to 140 at one point. You have to remember that people will get to a
very low point below their goal at one point and then will gain about 10%
of their total weight back. But you have to keep the weight gain under
control. Some people freak out when they gain a few pounds, again control
is the key here. Yes it was great being at 140 lbs and now I am 150 lbs at
6'1 but I also have to keep under control since I can eat almost anything I
want too.
— Lisa B.
January 7, 2005
I agree with much said below, Cindy - You are the voice of reason.
Initially I asked my doc for a goal - number of pounds I should lose and I
hated his answer, he said " let's wait and see where your body's
comfortable weight will be" He told me I would have a series of
plateaus and eventually stop losing then I would experience a rebound gain
of aprximately 10% of what I lost. I didn't like that answer at the time,
but Now I believe it has saved me a whole bunch of heartache. If I went
into this planning to weigh 110 I would be crying right now as I am at 130.
I have not had a regain (yet) but I do eat well and exercise like a demon.
I am focusing on my most important gaols, Lower cholesterol, normal blood
pressure and no BP meds, aches and pains gone, achilles tendon healed.
reduced risk of dying soon of a heart attack. being thinner and eating
healthier even reduces my risk for breast cancer and colon cancer (really
important as my mom died of it young) So, My advice is to concentrate on
your health rather than the scale and the rest will follow.
— **willow**
January 7, 2005
I don't think the regain issue is from not being educated enough preop. I
was told that to be a sucess with this surgery 70% of my overweight body
mass will come off...the rest is up to me. I was even told this is not a
magic pill and that I run the risk of gaining back about 50% of the 70%!
Now the regain of 50% bothered me. Dr said a lot of people can revert back
to old behaviors once they find away around the surgery restrictions with
grazing. I feel I was properly educated and it is my responsiblity to take
charge of the situation. The surgery cannot be the magic pill to
skinniness! I think we are so unhappy with our body pre op that we don't
listen to everything that is said to us. I also feel that the further out
you go with this surgery the better you can eat and the bad choices come
sneaking in. It is ultimately up to us on how we are going to maintain and
where we want to maintain. And to me that is the hardest part of this
journey. I asked something similar at a support meeting and No One could
answer that for me. I hope that I can keep positive with this experience
stay on track and keep focus on the weight. I am a scale whore and I plan
to stay that way. Its a very good indicator that I have to slow down on
foods or get to the gym more often. I am only 6 mos out from surgery but
fear the time when I am 2 years out because I know that is when the battle
will start for me. Great question and lots of good responses.
— dcox94
January 7, 2005
Great question. Wonderful responses!!! Thank you one and all! :):) I have
been wondering the same EXACT thing too! There have been so many posts
about this subject on ALL my message boards. All 15 of them!!! I had open
RNY proximal on June 23, 2003. T/T on June 21, 2004. I have been
maintaining a -125 pound weight loss for quite sometime now. I exceeded my
doctor's goal weight for me. We had agreed on -100 as a great goal for me.
I weigh myself each and every day.( Scale whore as one person commented!!!)
LOL!! Some people don't like that! They wait until their clothes start to
get tight. That might be okay for them, but not for me. I feel like IF I
weigh EVERY day, I can keep a "grip" on my issues. I did not get
my RNY at a bariatric center. Just a "regular" internist. No, I
did not have alot of pre counseling, but I had researched the RNY subject
for well over a year, before proceeding with the operation. I had 7
strictures for the first 3-4 months. I was scared they would never stop!
But they did. I had a hernia operation on November 12, 2003. That was by
far the worst operation and recovery. T/T was sooooooo piece of cake for
me! I was up and at 'em in 2-3 weeks. I also had 2 thumb joints replaced in
2004 as well. I am the queen of strictures and 5 operations in less than a
year!!! LOL!!! I love myself, my new body, and my new skinny/thin self.
:):) I was NOT obese as a child or teen. It was in the mid 1990's that I
became a hundred pounds overweight.As many others do, I lost 100 pounds
through diet and put it right back on by returning to my "old"
ways. I had been a yo-yo dieter all my adult life. Even after researching
the GBS for over one year, I sort of felt this was the proverbial
"magic pill". DUH!! I found out @ 9 months out, my appetite
returned with a vengence! No, I could now only eat very small quantities of
food, but then realized the "honeymoon" was over! It now would
take very hard work to keep losing the weight. That said, I've done very
well at maintaning the loss. I just began a new weekly goal plan with a
preop best friend. She will be having her surgery at a bariatric clinic in
June 2005. We each set up a weekly goal sheet. Of course our goals are
different, but we BOTH have pledged to maintain our set goals. I do believe
this will help. I also subscribe to nearly all sites with daily message
boards about obesity/protein/vites/etc.! Sure spend alot of time on line,
but, belonging to about 15 obesity sites helps me so very much. We also
attend monthly support group meetings as a buddy system along with our
weekly goal sheets. I have not exercised at Curves for awhile, but do walk
regularly. My new goal is to walk laps even more than I do now. I'd like to
lose -10 pounds more, only because of the rebound issue @ 2-3 years out. If
I don't lose anymore, that is okay too. I love myself, and that is what
works for me. I am scared to death to gain ANY weight back. Therefore, the
daily weigh in thing 4 me!!! Best of luck to one and all. I love ALL my
message boards and you, too!!! :):):) Best of luck to all of us to eat
healthy, exercise, eat lower carb amounts, and NO sugar like Vitalady!!!
What a lady!! She is a wonderful success story for so many of us. God Bless
One and All. We can and will do this. "If it is to be, it is up to
me"!!! "Nothing tastes as good, as thin feels"! 2 of my
mantras!!!! Good luck! Take care, Kathy O'Neil Riffle
— Kathy R.
January 8, 2005
Haven't been to the Q & A section in a while, but it's questions (and
responses) like these that keep it interesting. I think the notion of a
regain is very psychologically damaging, because WLS is, like, the ultimate
solution, it seems to me. I mean, how much more drastic could our weight
loss efforts get, short of removing our stomachs entirely? I find myself
getting antsy about it, esp. as my hard-fought exercise habit easily went
out the window in Dec. (back somewhat on track now, thank God) and I too
can nibble on anything and everything. However, I do feel I have much more
CONTROL now; the compulsion to eat an entire bag of cookies is
"outweighed" (forgive the pun) by the compulsion to remain in my
size 6/8s...so somehow I make myself stop. Copious amounts of food just
don't do it for me anymore, so I guess that's good, but I know that working
out is 1/2 of the puzzle, and if I don't pull it together, this house of
cards may tumble. It's a tough issue, that's for sure...
— rebeccamayhew
January 8, 2005
You know, I always seem to arrive from another planet, so here goes. I
think we were educated improperly pre-op and post. Some people withdraw
from support, live or online, when they see the goal coming. The honestly
believe they are normal and it WAS the magic pill. Most people hope they
will, but don't expect to lose 100%. But they spend all their energy
researching the doc, the pain, the hospital and none on long term effects.
So, they can inadvertently sign up for a surgery that will not take them
the distance and/or they think this is still about diet and exercise.
People often stuidiously avoid things that won't make them fat and indulge
regularly in the things that will. Some are coached in bad habits from day
1, never knowing that their obedience will cost them later. I'd NEVER
label us as a lazy population! No way! Show me any slim person who's
gained "a few" who has dieted/exercised as much as we have!
However, there is the arrogant period, and that precedes the regain. But
that is only my opinion, FWIW
— vitalady
January 8, 2005
Here is my view on the situation. When I went to the seminars pre surgery
all I heard about wast he individuals who lost to goal or below. How they
were wearing size 2/4. I never once heard anything about those who lost 50%
or 75%. The emphisis was put on those who lost 100%. My expectations when I
had surgery was that I would lose close to goal or more. I now realize that
I will in all likely hood not make down to a size 4, but more likely a
10/12. My pcp has been great about explaining metabolism to me, something
that was not done during any of the seminars I attended. At first I was
very dissappointed that I would not get to be what I was when I was 18, but
now I have a more realistic view. Being a size 10/12 beats the heck out of
a size 26. I still have a ways to go, but i think I will make it. Also, I
have talked to so many who have wls and have found that more people are
like me than like those described in the seminars. The majority, from what
I am seeing, do not make it to a size 2. Sometimes we are set up for
dissappointment by others. This may be not be intended, but the result is
that we have to high an expectation of what will come from wls. Saying that
it is to motivate us is wrong. I would have prefered the surgeons be honest
about the weight lose averages at the seminars. I would not have felt the
dissappointment when i realized that i would not be able to reach such a
goal. I have went back and reviewed the literature and only once does it
mention the prospect of not losing all the excess weight. Also, I never
read or heard anything about rebound gaining from any surgeon or in the
literature. I am not putting the blame for not reaching a size 4 on the
surgeon, just that they also need to present a realistic picture to the
patient from the start.
The reality of wls is, you have to give it 100% otherwise it will not work
for you. Commitment is imperative to success. I am pleased thus far with my
progress, 82 gone in 6.5 months. I would have liked more, but realize that
I am following the rules and that my body will only do what it can. There
are a lot of variables, metabolism, age, gender, and type of surgery
performed. This surgery is for life and we have to understand that and use
it accordingly. Just my thoughts and opinions.
— bubbleboo K.
January 9, 2005
One of the things I've learned in the past 22 months since I had WLS, is
that there are probably no two Drs. who have the exact same approach to
helping us with our battle with this disease of obesity. Even within the
same practice you
will see differences in the preop and post op programs. This is true from
the pre-op education to the post op nutrition. You will especially notice
this at support group meetings where everyone seems to be on different food
plans. What one Dr. may allow is taboo for the next and there are many
different timetables for introducing types of foods post op. For example,
when I had surgery in Birmingham, I went home on soft foods. My friend had
her surgery in Huntsville and had two weeks of liquids after surgery. I
remember being surprised at my Dr.'s educational seminar when he stated the
statistics for actual weight loss and maintainence. He said that most
people could expect to lose down until they were about 20 lbs above a
normal weight for their body and remain in the overweight region of the
graphs. A regain of about 5-10 percent was usual I really went into the
seminar thinking that a 100 percent excess weight loss would be promised if
I followed it strictly...but that's not what I heard!! I've researched WLS
for over three years now. Most of the numbers I've seen were a 65-70
percent excess weight loss within a year to year and a half.
I asked Dr. Terry Simpson about it in a chat a few nights ago. Unless I
misunderstood him, he answered that 81 percent of his patients reached a
BMI of 20-25 within two years. So...two Drs and two different set of
numbers. Most of the people I've talked to have had great improvements in
their health after WLS and that should be the main focus for having it in
the first place. Even if we only lose 50 percent of our excess weight,
that has to be beneficial to our health and therefore makes the surgery
successful. I'm in the process of stressing this to myself now since I've
lost about 70 percent of my excess weight and have had great improvements
in my health (off all meds for the first time in 20 years). Sorry, this
post is so long, but maybe I needed to answer the question for myself-as
well as give my opinion to others. Good luck to all of us in breaking the
bonds of obesity.
— Donna H.
January 9, 2005
Thank you again for all of your wonderful answers. Now I'll give my
answers and you tell me what you think. First, I agree and echo your
sentiments that we go into it without proper or accurate education. Then,
I think we have the surgery and the weight loss is so easy. Let me clarify
before I get flamed right off the board. :) The surgery is not easy by
any means, complications are not easy by any means, sometimes adjusting to
a new way of eating is not easy but the weight loss is basically easy in
the honeymoon period simply because we're incapable of overeating. After a
few months we get brave and discover that we can tolerate sugar so we treat
ourselves a little. But, since we're still in that honeymoon period we
still lose. We look good, we feel good, life is so exciting! We stop
going to support group meetings and doctor's follow ups. All of the sudden
our appetite returns with an amazing vengence and we seem to be hungry all
the time and even though we're eating small amounts we seem to be eating
all the time and next thing you know we're gaining weight. We horrified
and frustrated and embarrassed and then we CAN'T go to doctors follow up or
support group meetings because people will see us as a failure. I can't
begin to tell you how many people have described this scenario to me in
some way or another. The common thread that I see running through every
answer is that people finally have to come to an understanding that, while
the initial loss may be easy, the maintenance will be an everyday effort.
I wonder if the maintenance would be easier if we put more emphasis into
developing better eating and exercise habits DURING the honeymoon period.
I feel sure it would. I think we may also still have that "all or
nothing" mentality that alot of us had prior to WLS. I know I used to
start a diet on Monday and the first time I fell off the wagon it was over
- get back on the wagon? forget it! It's all or nothing. So when we see
a regain we just tell ourselves that we really are the failures we thought
we were and we give up. Obesity is a cruel demon. But, guess what - we're
not failures. We're pioneers! 20 years from now when this journey has
been honed to an exact science we'll be saying "Boy, I wish it had
been this easy when I did it!". Let's don't give up on ourselves. We
just have to accept that we're never going to be truly normal where food
is concerned and then find our path to good health. We can do it! Keep
the comments coming. Best Wishes everyone!
— ronascott
January 9, 2005
This is the most useful posting I've ever seen on this board. I'm 21
months post-op and this discussion really hit on the many issues I've
experienced. Thanks for asking the question.
— Daisy C.
January 10, 2005
Thank you so much for posting this question. I'm sure it this discussion
has been very educational from a pre-op standpoint. I wish I had read more
posts like this one as a pre-op. As a post-op who is coming up on my
one-year anniversary, it really hit home. Although I surpassed goal by
about 15 pounds (no flaming, it wasn't intentional, the more I ate, the
more I lost), the issues are really starting to come back. Right now I'm
maintaining, I haven't lost anything in about a month, and I fluctuate with
the same 3-4 pounds. However, the ravenous hunger is back, as is the
obsession about "what's for dinner." Now there's the new
obsession with the old obsessions coming back. I'm terrified of regain.
Mind you, not the 10% bounce-back, but what if it continues on upward past
that?
Thank you again for a timely discussion...as it has helped me formulate my
New Year's resolutions. One is to start attending my support group
again...Rona, when will the MCE site be updated for 2005 meeting dates?
— Le P.
January 10, 2005
I am 3 years out this month and I don't come back to the boards often, but
I was browsing and found this question. I started at 390, and at my lowest
was about 205...and I am now anywhere between 220-230 on a regular basis.
I was told that most patients WILL gain a few pounds back and stabilize at
that weight. I do notice if I eat poorly that I will gain a few pounds. I
think that, well for me at least, eating is a constant struggle. I think we
get used to being able to eat whatever and the surgery taking over
internally and we still lose or maintain...but once that grace period is
over it is just like every other normal person....blood, sweat, and
starvation to get the weight off. Lately I have been struggling with
ordering too much food, eating too fast, and the like. Psychologically I
feel like I need to eat a bunch- like what if I can't eat again for awhile,
or what if someone else eats my food? I don't know why I feel this way, but
I do. My husband has had the surgery, too, and I even feel this food
hoarding around him. If I don't eat it, then he will. I think lots of
people think that surgery is the cure, but it truely is a tool. I think to
answer your questions, we do get a bit lazy. My hubby says that if you're
ready to lose the weight, you will will do it. I guess we're not determined
enough to lose the last bit?? Good luck to you.
— Paula Prichard
January 11, 2005
What a great question, and fantastic answers too. This is why we come
here, isn't it? I can't really add anything more to what has already been
said - these responses are so honest and valid. So I will share my
personal strategy, and some of my personal experience. I had surgery on
9/11/03, so am about 16 months out. I never set a goal weight for myself,
nor did my doctor. I had fantastic pre-op education from them, and
excellent follow-up. I lost the weight I wanted to lose, but I'm not a
skinny-minny by any means. I'm blissfully happy in my size 12 body, at
5'8" and 165 pounds. I never expected to get much lower than this,
nor do I want to. My lowest adult weight (back in high school) was about
160. I'll be honest here, too. I have not been on a low-carb regimen at
all since surgery. I eat much the same way I did pre-surgery, only much
less. I don't dump, so sugar has not presented that issue, and I do enjoy
eating it. I love a wide variety of foods, including all healthy foods, so
I feel I'm eating a very balanced diet, which I also did as an MO person.
But I also enjoy sweets and desserts, just not ALL THE TIME. My chief tool
thus far has been weighing myself every day. I decided that 165 is my top
number, and I won't allow myself to go over that. I have gone over a
couple of times, and at that point, I usually increase my protein intake,
lower carbs slightly, and increase water. Thus far, I have not been a
regular exerciser, so in many respects I feel that part of the equation can
be called upon at a later time, should I need extra help maintaining. I
was actually much better at regular exercise when I was fat, because I saw
it as something necessary to lose the weight. After WLS, it was not
necessary for me, and in my mind, I still view it that way. However, I
will call upon it if needed. I do not participate in any local support
groups - AMOS is my support group, and my small group of personal
friends/family who are post-ops (my son, 2 co-workers, 2 friends who I
email a lot). I believe it is important to stay informed and to be
realistic about issues that can come up for post-ops, weight regain being
just one of them. I am religious about taking my vitamins and making sure
that each meal includes some protein. I am grateful for this surgery,
because it helped me to lose an amount of weight I could never lose on my
own, pre-surgery. I know it is up to me now to maintain the weight loss,
but I feel I've got a "fighting chance" at it, something I never
felt before WLS. I also had dealt with my emotional eating issues well
before I ever had surgery, so that isn't really a problem for me at this
point. Emotional/stress eating is a real problem for many people (not just
MO) and is something that needs to be dealt with, no matter the methods we
choose to work on it. Thank you for the thought-provoking question, Rona.
— Carlita
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