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How Does Surgery Make Long Term Weight Loss Easier?

Neecey

Member
As I'm sure most of you have also done, I’ve dieted my entire life. My biggest successes have been in WW. At one point I lost 120# on WW. And yet here I am. Again. Which is why I’m considering gastric sleeve at age 68.

I’ve read and read and see that most people who have had surgery are thrilled. Yet I also see that many continue to struggle with food addictions and gaining back some of the weight lost, even after surgery.

So my question is: Does gastric sleeve really make it easier to stick to a healthy eating plan? If I need to stick to a special diet after surgery, why not do that diet and lose the weight naturally? (Obviously, I’ve tried the latter over and over again.).

In other words, what was it about the surgery that helped you lose and stick to a healthier eating plan to keep the weight off? Does the surgery really make it easier to eat healthy long term? Does it diminish the cravings? I often eat for many reasons other than hunger!
 
My personal beliefs is yes and no, not confusing at all right? LOL Continued success at weight loss and maintaining that loss is psychological. While the surgery helps the loss, my brain is going, “Heck yeah this is awesome! We can do this!” But the devil on my shoulder is saying,”There’s cake in the fridge, let’s have that for lunch.” Addiction is not cured by the surgery, and neither are cravings, and you didn’t indicate that, but it’s something I have to remind myself of. If I want the long term success that I not only want, but need for my health, then I have to stomp the cravings, food wants, or whatever you may call them, by focusing on the things I can have, not the things I cannot. Plus there is nothing wrong with a small indulgence from time to time, and there are a lot of products available that are sugar free or high protein (Halo top ice cream, yum!), that can allow me that treat without feeling like I let myself down.
 
I think it does make it easier because of the restriction but that doesn't mean that it is not possible to fail at this. You could just decide to eat all the unhealthy foods out there and not stick to your plan of protein first and graze all day. It will take work, this isn't an easy way out by any means. BUT... this is a very helpful tool that when we follow our guidelines can do amazing things! One thing that is important is that you also have to work on the mental as well. Besides working on the outside, you need to work on the inside. It really does make a difference. There are lots of great YouTube videos out there and/or books that are helpful. I find the more I stay connected the more it keeps me on track.
 
My cravings and actual over all like for food has decreased. Which, can be bad as well. Because I dont care for the taste of most foods I find myself wating to keep eating something until I find something that tastes good. I used to be a major sweets person and no longer have a craving for them. Majority of it is psychological. There is a reason you have to meet with a psychiatrist before hand, take full advantage of it and do the therapy needed to break patterns. Even though I dont have a sweet tooth I will eat it of it is there. Because I have kids there are treats in the house, they stay in a bowl on top of the fridge...out of sight out of mind.
 
Long term success depends almost exclusively on making good food choices and not so much the restriction of the surgery. The surgery gives you a window of time, generally 12-24 months where you can reboot your relationship with food and build new eating habits to maintain long term weight loss. You can certainly gain the weight back after any weight loss surgery if you make poor food choices. There are several reasons why it is so difficult to lose weight "naturally" especially after a person enters the "obese" or "morbidly obese" range. I'll sound like a broken record for those on here to who know me well, but I'll share some of the science behind it.

First, our bodies are designed to protect weight and not lose it. For as long as humans have been on earth, there has only been a plentiful food supply for a very, very small fraction of that existence. Our genetics try to protect us from starvation on several levels, but there is one hormone that seems to have the greatest impact that causes obese people from keeping weight off after they lose it.

The hormone leptin is produced in our fat cells. When we are obese, we obviously have a lot more fat in our bodies and therefore much more leptin. When we lose fat, the leptin in our blood stream decreases. Our brain recognizes the decreased leptin and interprets it as a warning signal of reduced energy storage (aka, it thinks you may be starving). It triggers two primary reactions. Your brain slows your metabolism and increases your hunger. This effect is actually increased the more fat we lose, so while we will have some effect if we lose 20lbs of fat, then second 20lbs of fat will actually elicit a stronger response to the leptin. This continues to occur as you lose fat. You body wants to slow your metabolism and it wants you to eat high calorie foods. It is very hard to resist, and it is why so most people regain their weight on "yo-yo" diets. Your body is driving you to get back to the weight it was prior to the attempted weight loss. Now, there are some lucky unicorns out there who are able to do it, but it's rare. If it was easy, there would be far fewer obese people, and the weight loss industry would be very small instead of what it is today. Most people fail, and repeat, and fail, and repeat. Most people who do reach their goal weight "naturally" have to eat less and exercise more to keep it off than a person of the same weight who was never obese. As soon as they slack off from that, the weight usually piles back on. Again, there are always a few who are able to do it, but it's not the norm.

That's not all there is to it, but it is a huge part of why it is so difficult. The amazing thing about the surgery is that it actually helps you bypass that leptin response. It doesn't try to "protect" your heavy weight and your brain doesn't respond to the leptin changes signals as it would have without the surgery. Scientists don't know for sure why this side effect occurs. It's one of several side effects related to hunger and the microbiome that they are studying. The restriction is only a small part of the reason people lose weight. It's pretty fascinating stuff. The University of Michigan has a great obesity research department that is exploring the side effects of surgery that have this profound effect on our biology.

So, what does that mean for us? It means that most of us can lose a lot of weight over the course of a year or so and our bodies aren't going to fight against us too much. However, that doesn't make it easy. The surgery doesn't help our coping mechanisms for stress and other emotions or food addictions or other psychological issues that might drive a person to make poor food choices. We still have to learn to battle those demons like everyone else, but generally the ability to lose weight fairly quickly after surgery allows us to concentrate a bit more on ourselves and maybe learn to deal with those things better. Some of us seek professional help, some of us self-help, and some of us just cruise along and never look back. We all have slightly different stories and experiences that lead to our obesity. Likewise, our experience transforming back to non-obese will vary from person to person.

If you've dieted and failed more than once, the cold hard truth is that you are unlikely to be successful trying to diet again. It's not because you lack willpower, but because your biology and brain will battle against you, and it is a very difficult war to win. It's possible for a few, but the surgery is such a great tool or "weapon" in the fight. It's not to be undertaken lightly, but it is by far the best chance for success both short term and long term IF you commit to making good food choices moving forward with your new body, otherwise, if you just think you'll be fine eating the same stuff but in smaller amounts, it will probably just lead back down the same road to obesity in the future. That being said, your chances for long term success are much greater with the surgery than without.

As far as cravings go, everyone has a little different experience with that as well. Some people's tastes change significantly. I'm on almost a 100% plant based diet and I never thought I'd do that, but it's what I crave now. I still eat some meat, dairy, or eggs every now and then, but I don't crave it. I don't crave fast food like I used to. I still have a bit of a sweet tooth, so I have to keep that out of the house, but I'm also more sensitive to sweet, so I generally it generally takes less sweetness to satisfy me.

Some people still feel like they get as hungry as they used to before, and some feel like they aren't hungry enough. Sometimes your brain can play some tricks on you, but overall I think most people experience far less hunger for the first year, and as I mentioned earlier, that is the window of time when you can really focus on building great new habits with food.

I still really enjoy my meals and I do a lot of cooking and still enjoy that. It hasn't diminished anything for me as far as culinary delights go, I just have to get used to different serving sizes.

So, it comes down to what sort of quality of life do you want and are you willing to change your food habits a bit of long term success? You can still enjoy eating, but it will need to be a little bit different. The surgery will give you an amazing tool to succeed, you just need to use it to it's full potential and reap it's benefits when they are the strongest.

Best of luck no matter which direction you go!
 
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My VA Dr. said the road to weight loss surgery is a commitment, like having kids it is for life, just because they grow up doesn’t mean they are not your child anymore. Weight loss surgery is not an easy path to follow. It requires changing patterns of thinking, it requires changing from couch potato to active body activities such as walking or bicycle riding or swimming. It is important to monitor yourself, logging your foods and recording what is happening on days that you have an error in eating. He said one other thing is to never feel like once you lost the weight that the weight loss team support is gone, they are always there for you, even if you slip back. When you notice something is off you have to reach out. Annual visits are a big key to keep the weight off and be accountable for yourself.
 
WazzuCoug, this may be the best explanation for my lifelong go-yo dieting I’ve ever read. Thank-you for taking the time to write such a comprehensive response. So many of us who are morbidly (I HATE that word!) have spent a lifetime of shame and guilt for losing and then gaining it all back again. I never thought I would ever consider this surgery, but when I learned about the sleeve and considered it as a “tool” rather than a “fix” it all makes sense. To have a year to retrain myself would be an amazing gift.
 
My cravings and actual over all like for food has decreased. Which, can be bad as well. Because I dont care for the taste of most foods I find myself wating to keep eating something until I find something that tastes good. I used to be a major sweets person and no longer have a craving for them. Majority of it is psychological. There is a reason you have to meet with a psychiatrist before hand, take full advantage of it and do the therapy needed to break patterns. Even though I dont have a sweet tooth I will eat it of it is there. Because I have kids there are treats in the house, they stay in a bowl on top of the fridge...out of sight out of mind.
Tokash, I wouldn’t mind losing my cravings for sweets at all! But I can understand the desire to find something that tastes good, especially since after surgery you can eat so little. You want to enjoy what little you can ingest. I will take your advice on the psychologist. I especially need to learn how to handle social eating, as I’m married to a foodie who loves to eat out.
 
Long term success depends almost exclusively on making good food choices and not so much the restriction of the surgery. The surgery gives you a window of time, generally 12-24 months where you can reboot your relationship with food and build new eating habits to maintain long term weight loss. You can certainly gain the weight back after any weight loss surgery if you make poor food choices. There are several reasons why it is so difficult to lose weight "naturally" especially after a person enters the "obese" or "morbidly obese" range. I'll sound like a broken record for those on here to who know me well, but I'll share some of the science behind it.

First, our bodies are designed to protect weight and not lose it. For as long as humans have been on earth, there has only been a plentiful food supply for a very, very small fraction of that existence. Our genetics try to protect us from starvation on several levels, but there is one hormone that seems to have the greatest impact that causes obese people from keeping weight off after they lose it.

The hormone leptin is stored in our fat. When we are obese, we obviously have a lot more fat in our bodies and therefore much more leptin. When we lose fat, leptin is released into our blood stream and goes to our brain. It triggers two primary reactions. Your brain slows your metabolism and increases your hunger. This effect is actually increased the more fat we lose, so while we will have some effect if we lose 20lbs of fat, then second 20lbs of fat will actually elicit a stronger response to the leptin. This continues to occur as you lose fat. You body wants to slow your metabolism and it wants you to eat high calorie foods. It is very hard to resist, and it is why so most people regain their weight on "yo-yo" diets. Your body is driving you to get back to the weight it was prior to the attempted weight loss. Now, there are some lucky unicorns out there who are able to do it, but it's rare. If it was easy, there would be far fewer obese people, and the weight loss industry would be very small instead of what it is today. Most people fail, and repeat, and fail, and repeat. Most people who do reach their goal weight "naturally" have to eat less and exercise more to keep it off than a person of the same weight who was never obese. As soon as they slack off from that, the weight usually piles back on. Again, there are always a few who are able to do it, but it's not the norm.

That's not all there is to it, but it is a huge part of why it is so difficult. The amazing thing about the surgery is that it actually helps you bypass that leptin response. It doesn't try to "protect" your heavy weight and your brain doesn't receive the mass leptin signals that it would have received without the surgery. Scientists don't know for sure why this side effect occurs. It's one of several side effects related to hunger and the microbiome that they are studying. The restriction is only a small part of the reason people lose weight. It's pretty fascinating stuff. The University of Michigan has a great obesity research department that is exploring the side effects of surgery that have this profound effect on our biology.

So, what does that mean for us? It means that most of us can lose a lot of weight over the course of a year or so and our bodies aren't going to fight against us too much. However, that doesn't make it easy. The surgery doesn't help our coping mechanisms for stress and other emotions or food addictions or other psychological issues that might drive a person to make poor food choices. We still have to learn to battle those demons like everyone else, but generally the ability to lose weight fairly quickly after surgery allows us to concentrate a bit more on ourselves and maybe learn to deal with those things better. Some of us seek professional help, some of us self-help, and some of us just cruise along and never look back. We all have slightly different stories and experiences that lead to our obesity. Likewise, our experience transforming back to non-obese will vary from person to person.

If you've dieted and failed more than once, the cold hard truth is that you are unlikely to be successful trying to diet again. It's not because you lack willpower, but because your biology and brain will battle against you, and it is a very difficult war to win. It's possible for a few, but the surgery is such a great tool or "weapon" in the fight. It's not to be undertaken lightly, but it is by far the best chance for success both short term and long term IF you commit to making good food choices moving forward with your new body, otherwise, if you just think you'll be fine eating the same stuff but in smaller amounts, it will probably just lead back down the same road to obesity in the future. That being said, your chances for long term success are much greater with the surgery than without.

As far as cravings go, everyone has a little different experience with that as well. Some people's tastes change significantly. I'm on almost a 100% plant based diet and I never thought I'd do that, but it's what I crave now. I still eat some meat, dairy, or eggs every now and then, but I don't crave it. I don't crave fast food like I used to. I still have a bit of a sweet tooth, so I have to keep that out of the house, but I'm also more sensitive to sweet, so I generally it generally takes less sweetness to satisfy me.

Some people still feel like they get as hungry as they used to before, and some feel like they aren't hungry enough. Sometimes your brain can play some tricks on you, but overall I think most people experience far less hunger for the first year, and as I mentioned earlier, that is the window of time when you can really focus on building great new habits with food.

I still really enjoy my meals and I do a lot of cooking and still enjoy that. It hasn't diminished anything for me as far as culinary delights go, I just have to get used to different serving sizes.

So, it comes down to what sort of quality of life do you want and are you willing to change your food habits a bit of long term success? You can still enjoy eating, but it will need to be a little bit different. The surgery will give you an amazing tool to succeed, you just need to use it to it's full potential and reap it's benefits when they are the strongest.

Best of luck no matter which direction you go!
THIS AS AN AMAZING ANSWER! WOW! THANK YOU!
 
As I'm sure most of you have also done, I’ve dieted my entire life. My biggest successes have been in WW. At one point I lost 120# on WW. And yet here I am. Again. Which is why I’m considering gastric sleeve at age 68.

I’ve read and read and see that most people who have had surgery are thrilled. Yet I also see that many continue to struggle with food addictions and gaining back some of the weight lost, even after surgery.

So my question is: Does gastric sleeve really make it easier to stick to a healthy eating plan? If I need to stick to a special diet after surgery, why not do that diet and lose the weight naturally? (Obviously, I’ve tried the latter over and over again.).

In other words, what was it about the surgery that helped you lose and stick to a healthier eating plan to keep the weight off? Does the surgery really make it easier to eat healthy long term? Does it diminish the cravings? I often eat for many reasons other than hunger!
I had the gastric bypass and yes it has made it so much easier to stick to healthy eating as I can't eat over 4 oz of food at a time or it comes back up so I know I have to stop before I go over the 4 oz. I am around sweet stuff and while I still would like to have it I start thinking of the vomiting it back up and I am like it's not worth me getting sick. Now I do know the closer I get to being a year out from my surgery I will be able to eat more and eat more of a variety of foods which I am kind of nervous about but I remind myself of what I felt like and what I wasn't able to do prior to the surgery vs now and I give my self a stern talk and say....you know why you wanted this surgery and what you had to go threw to qualify for the surgery is it worth blowing it? Good Luck.
 
WazzuCoug, this may be the best explanation for my lifelong go-yo dieting I’ve ever read. Thank-you for taking the time to write such a comprehensive response. So many of us who are morbidly (I HATE that word!) have spent a lifetime of shame and guilt for losing and then gaining it all back again. I never thought I would ever consider this surgery, but when I learned about the sleeve and considered it as a “tool” rather than a “fix” it all makes sense. To have a year to retrain myself would be an amazing gift.

I'm right there with you. I went so far as changing doctors rather than face him again after weight regain...I actually did that more than once, with more than one doctor. I was just so embarrassed that I couldn't keep the weight off after having some initial success several times, sometimes fairly dramatic success.

I spent a lot of time researching why the surgery works and what effects it really has on our biology beyond just the stomach restriction. If the only thing we got out of it was the restriction, our long term weight loss wouldn't be much better than most yo-yo dieters because our bodies will still be driving us to gain that weight back.

We still have to commit to making a lot of changes and good choices, but the surgery can really, really help. I'm proud that I took the step to do this, and I'm going to do my best in ensuring that it doesn't go to waste.

R
 
the best chance for success both short term and long term IF you commit to making good food choices moving forward with your new body, otherwise, if you just think you'll be fine eating the same stuff but in smaller amounts, it will probably just lead back down the same road to obesity in the future.
I always like your science-y explanations, Ryan but this sentence right here is the REAL DEAL. And where I think most of us end up struggling. It's pretty easy to get comfy in your new body and fall back into old habits. But your new body needs all those new habits you developed to thrive. Not only was this a great response but something I personally needed a reminder of.
 
I always like your science-y explanations, Ryan but this sentence right here is the REAL DEAL. And where I think most of us end up struggling. It's pretty easy to get comfy in your new body and fall back into old habits. But your new body needs all those new habits you developed to thrive. Not only was this a great response but something I personally needed a reminder of.
It is a major point for success, I think. It does not take much to get off track. The 10 days I had without power lead to poor eating habits, mainly because we didn't want to cook and dirty dishes, pots and such because water was limited for cleaning. Soooo, there was a lot of snack foods, processed foods and eating out. I felt the difference both in how I felt and new cravings after starting to eat outside of my normal routine. I'm back to my normal routine, but it was an eye opener as to how simple it can be to let things get off track. It made me think about different foods that I could keep on hand to turn to in a situation like that. Of course, if it would have been a long-term disaster scenario, I would be eating to survive and I probably wouldn't care about the food choices too much at that point, but even for 10 days I didn't set myself up well to have good food options in that situation. We learned a lot of lessons during those 10 days, so we are making a few updates to our emergency plan. If we are faced with a situation like that again, I plan to make much different choices and have different options available.
 
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