WazzuCoug
Member
After surgery, there is absolutely no guarantee that you will reach your goal weight and be able to maintain it. There's no guarantee that you will get to a weight your surgeon or doctor thinks you should be. When you have the surgery, your biology will determine where that point ends. Once you reach that new level of body fat, no matter where it is, your body will start defending that point, regardless if it happens after 100 lbs lost or just 50 lbs lost. Just like trying to lose weight pre-surgery, if you try to will yourself past that point, your body will start to fight against it.
Your genetics, food choices and environment all play into how much weight you lose and your ability to maintain it, regardless of which surgery you get. For some people, their bodies may decide that 50 pounds of fat loss is it, others may lose 100. The point is, we can't "force" our bodies to have a lower defendable weight than what our biology sets for us after surgery. The fact that the surgery actually lowers that point is amazing and not entirely understood by science.
My question around setting a goal weight is this: what if we don't reach it because our biology determined our new weight was 20 or 30 pounds higher than our goal? Will we feel like we failed? Will we feel guilty because we didn't do what our doctor thought we should do, or what other people thought we should do? Will we fall into patterns where we start eating unhealthy foods again due to stress/emotions?
How can we let go of the fact that we really aren't in total control of where we end up after surgery? Can we accept and be happy with an maintain a weight that is 20-30 or even more pounds heavier than our goal weight, and we acknowledge that it is still way, WAY better than where we started before surgery? Or will we just backslide because, "it failed" when the reality is the surgery was successful?
It's a double edged sword. I think it is natural to want to have something to shoot for, to try and attain, but I think we have to go into it knowing that such goals are almost always aspirational, because at some point, our body will start defending a new weight (actually it defends your fat level) no matter what weight we wanted to achieve. Some people will reach their goals, many won't, and a few surpass them.
I have a passion for the science behind obesity, weight loss and optimizing this journey for success. I'm infatuated with ensuring the amazing way I feel now compared to my BS life (aka "Before Surgery", aka "Bull $&!^") stays the way I feel for the rest of my life.
A quick review on the biological reasons weight loss surgery works well for most people:
Success after surgery has very little to do with the small stomach/pouch. If that is all there was to it, we'd be starving and ravenous all of the time, and that is generally not what we experience. We still get hungry, of course, but getting hungry when you are eating 800 calories a day after surgery is WAY different than the hungry you feel if you tried to eat 800 calories a day in your BS life.
The hormone leptin is produced in our fat cells. The amount of leptin in our bloodstream correlates to the amount of fat we carry on our body. More fat = more leptin, less fat = less leptin. Leptin crosses the blood/brain barrier to your hypothalamus where receptors for leptin are constantly responding to the level of fat in your body. When leptin decreases, your brain reacts in two ways: 1. It slows your metabolism to reduce energy consumption, and 2. It makes you hungrier. Your brain does this because it is protecting your fat storage. Leptin is a fat management hormone so your brain can protect you from starving. It is the main reason most people fail over and over at dieting in the BS life.
When leptin increases, your body "technically" should decrease hunger signals and allow your metabolism to burn fat freely. However, when we are eating excessive calories through unhealthy food choices, the food you eat actually starts to interfere with the receptors for leptin in our brain. We become leptin resistant, meaning even though our leptin is increasing in line with increasing fat, our brain stops sending signals out that you are satiated. You still feel hungry even though your fat levels are above what is needed. We start eating more, we start searching for "physical fullness" (that stretched stomach feeling). The food we eat also influences the other satiation signals that we would normally get from our gut. It is there were hormones released in "real time" after you eat to tell us when we've had enough. These signals too do not pass to your brain like they should be. You eat more. As you eat more, the fat level your body defends goes higher, and higher. At that point, when we try to lose weight (pre surgery) as the leptin goes down in our blood stream, our brain does what it is supposed to do and fights against it. The more weight we lose, the harder your body fights against it, and eventually we gain it back. This happens not because we lack the willpower, but our biology is forcing us to make decisions that are truly now out of our full control.
Yes, some people can do it, and most of them are well known, they have YouTube with hundreds of thousands of followers, they have commercials, they make it look like all you need to do is what they did. Unfortunately, what they did worked for them, and it probably won't work for you. Their genetics/biology allowed them to be successful by the luck of their genetic lottery, and they made changes to their diet and environment that worked for them, but most likely, it won't work for the vast majority of people. They'll probably make some decent money off their success though.
The surgery has the wonderful side effect of actually affecting the signal reception for several hormones, specifically leptin, CCK and GLP-1. After surgery, when your body sees the decrease in leptin in your bloodstream, instead of triggering a fight, it now "sees" that you are supposed to carry a smaller amount of fat, so it allows the fat to burn without decreasing your metabolism and without making you more hungry than normal. At the same time, when you eat, as food passes into your intestine, CCK and GLP-1 are released as food is digested sending signals to your brain that you have gotten enough food and don't need to eat anymore. Your brain has become more receptive to these signals (they were suppressed prior to surgery similar to leptin resistance), and as a result, you lose fat and overall weight.
There is a limit to the weight loss however, and it isn't determined by us. After surgery, your brain has a new target for the amount of fat it is going to "defend" that has nothing to do with what BMI says your weight should be, or what your doctor says your weight should be, or what you think your weight should be. That new point that your body will defend it what your genetics and environment will allow. When you get to that point, if you try to lose more weight, your brain will again start to respond to the reduced leptin signals and slow your metabolism and make you hungrier. The more you try to lose, the more your body will fight back. You will start to crave higher calories foods, and if we succumb and start eating unhealthy foods again, the cycle of developing leptin resistance can start again and the weight will start to go back up.
It is imperative that we develop a new relationship with food that will keep us at our new defendable weight. If we don't reach our goals, we still need to keep doing the right things associated with food choices and exercise to keep from gaining it back. Your body has been reset, but it might not reset to the weight you want. That has the potential to be very frustrating, so the question is, how will you deal with it, if that is your situation?
Right now, I'm struggling with what I think I'd like to see as my end goal, and what I now where it feels like I'm ending up. I'm not saying my weight loss is done. I don't know that yet, but it's obviously slowed down a great deal, and my body fat is well within the normal range, so there really isn't a need for me to lose more. I'm five pounds from "onederland" but do I really need to get there? Part of me wants to, but if I try, will it send me into a cycle that repeats from the past? I don't know.
So, to circle back around (if you read this entire book of a post), are weight goals helpful, harmful or both? I think they can be both, but we need to try to focus on doing the right things and let ourselves be okay with wherever we end up, as it is almost certainly way better than where we started.
I've had a bodyfat goal to shoot for. I wanted to get to 18% or less and I'm at 20%. I'm happy with that although the weight on the scale is not quite what I thought I'd get to, and I have to be okay with that. That's where the "harmful" aspects of the goal comes...I can't get down on myself if I don't reach that weight. I'm not a failure if I don't get to 186 and instead come to rest at 205. It's a mental struggle and pretty hard to let go, at least for me.
What do you think? Helpful, harmful, both, neither? What strategy will you employ if you don't reach your goal, or if you reach your goal, but your body thinks you went too far and adds back 10 pounds, will you start harmful patterns again, or will you focus on food choices and exercise to maintain that new weight, even though its 10 lbs (or more) higher than what you wanted?
Your genetics, food choices and environment all play into how much weight you lose and your ability to maintain it, regardless of which surgery you get. For some people, their bodies may decide that 50 pounds of fat loss is it, others may lose 100. The point is, we can't "force" our bodies to have a lower defendable weight than what our biology sets for us after surgery. The fact that the surgery actually lowers that point is amazing and not entirely understood by science.
My question around setting a goal weight is this: what if we don't reach it because our biology determined our new weight was 20 or 30 pounds higher than our goal? Will we feel like we failed? Will we feel guilty because we didn't do what our doctor thought we should do, or what other people thought we should do? Will we fall into patterns where we start eating unhealthy foods again due to stress/emotions?
How can we let go of the fact that we really aren't in total control of where we end up after surgery? Can we accept and be happy with an maintain a weight that is 20-30 or even more pounds heavier than our goal weight, and we acknowledge that it is still way, WAY better than where we started before surgery? Or will we just backslide because, "it failed" when the reality is the surgery was successful?
It's a double edged sword. I think it is natural to want to have something to shoot for, to try and attain, but I think we have to go into it knowing that such goals are almost always aspirational, because at some point, our body will start defending a new weight (actually it defends your fat level) no matter what weight we wanted to achieve. Some people will reach their goals, many won't, and a few surpass them.
I have a passion for the science behind obesity, weight loss and optimizing this journey for success. I'm infatuated with ensuring the amazing way I feel now compared to my BS life (aka "Before Surgery", aka "Bull $&!^") stays the way I feel for the rest of my life.
A quick review on the biological reasons weight loss surgery works well for most people:
Success after surgery has very little to do with the small stomach/pouch. If that is all there was to it, we'd be starving and ravenous all of the time, and that is generally not what we experience. We still get hungry, of course, but getting hungry when you are eating 800 calories a day after surgery is WAY different than the hungry you feel if you tried to eat 800 calories a day in your BS life.
The hormone leptin is produced in our fat cells. The amount of leptin in our bloodstream correlates to the amount of fat we carry on our body. More fat = more leptin, less fat = less leptin. Leptin crosses the blood/brain barrier to your hypothalamus where receptors for leptin are constantly responding to the level of fat in your body. When leptin decreases, your brain reacts in two ways: 1. It slows your metabolism to reduce energy consumption, and 2. It makes you hungrier. Your brain does this because it is protecting your fat storage. Leptin is a fat management hormone so your brain can protect you from starving. It is the main reason most people fail over and over at dieting in the BS life.
When leptin increases, your body "technically" should decrease hunger signals and allow your metabolism to burn fat freely. However, when we are eating excessive calories through unhealthy food choices, the food you eat actually starts to interfere with the receptors for leptin in our brain. We become leptin resistant, meaning even though our leptin is increasing in line with increasing fat, our brain stops sending signals out that you are satiated. You still feel hungry even though your fat levels are above what is needed. We start eating more, we start searching for "physical fullness" (that stretched stomach feeling). The food we eat also influences the other satiation signals that we would normally get from our gut. It is there were hormones released in "real time" after you eat to tell us when we've had enough. These signals too do not pass to your brain like they should be. You eat more. As you eat more, the fat level your body defends goes higher, and higher. At that point, when we try to lose weight (pre surgery) as the leptin goes down in our blood stream, our brain does what it is supposed to do and fights against it. The more weight we lose, the harder your body fights against it, and eventually we gain it back. This happens not because we lack the willpower, but our biology is forcing us to make decisions that are truly now out of our full control.
Yes, some people can do it, and most of them are well known, they have YouTube with hundreds of thousands of followers, they have commercials, they make it look like all you need to do is what they did. Unfortunately, what they did worked for them, and it probably won't work for you. Their genetics/biology allowed them to be successful by the luck of their genetic lottery, and they made changes to their diet and environment that worked for them, but most likely, it won't work for the vast majority of people. They'll probably make some decent money off their success though.
The surgery has the wonderful side effect of actually affecting the signal reception for several hormones, specifically leptin, CCK and GLP-1. After surgery, when your body sees the decrease in leptin in your bloodstream, instead of triggering a fight, it now "sees" that you are supposed to carry a smaller amount of fat, so it allows the fat to burn without decreasing your metabolism and without making you more hungry than normal. At the same time, when you eat, as food passes into your intestine, CCK and GLP-1 are released as food is digested sending signals to your brain that you have gotten enough food and don't need to eat anymore. Your brain has become more receptive to these signals (they were suppressed prior to surgery similar to leptin resistance), and as a result, you lose fat and overall weight.
There is a limit to the weight loss however, and it isn't determined by us. After surgery, your brain has a new target for the amount of fat it is going to "defend" that has nothing to do with what BMI says your weight should be, or what your doctor says your weight should be, or what you think your weight should be. That new point that your body will defend it what your genetics and environment will allow. When you get to that point, if you try to lose more weight, your brain will again start to respond to the reduced leptin signals and slow your metabolism and make you hungrier. The more you try to lose, the more your body will fight back. You will start to crave higher calories foods, and if we succumb and start eating unhealthy foods again, the cycle of developing leptin resistance can start again and the weight will start to go back up.
It is imperative that we develop a new relationship with food that will keep us at our new defendable weight. If we don't reach our goals, we still need to keep doing the right things associated with food choices and exercise to keep from gaining it back. Your body has been reset, but it might not reset to the weight you want. That has the potential to be very frustrating, so the question is, how will you deal with it, if that is your situation?
Right now, I'm struggling with what I think I'd like to see as my end goal, and what I now where it feels like I'm ending up. I'm not saying my weight loss is done. I don't know that yet, but it's obviously slowed down a great deal, and my body fat is well within the normal range, so there really isn't a need for me to lose more. I'm five pounds from "onederland" but do I really need to get there? Part of me wants to, but if I try, will it send me into a cycle that repeats from the past? I don't know.
So, to circle back around (if you read this entire book of a post), are weight goals helpful, harmful or both? I think they can be both, but we need to try to focus on doing the right things and let ourselves be okay with wherever we end up, as it is almost certainly way better than where we started.
I've had a bodyfat goal to shoot for. I wanted to get to 18% or less and I'm at 20%. I'm happy with that although the weight on the scale is not quite what I thought I'd get to, and I have to be okay with that. That's where the "harmful" aspects of the goal comes...I can't get down on myself if I don't reach that weight. I'm not a failure if I don't get to 186 and instead come to rest at 205. It's a mental struggle and pretty hard to let go, at least for me.
What do you think? Helpful, harmful, both, neither? What strategy will you employ if you don't reach your goal, or if you reach your goal, but your body thinks you went too far and adds back 10 pounds, will you start harmful patterns again, or will you focus on food choices and exercise to maintain that new weight, even though its 10 lbs (or more) higher than what you wanted?
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