JuneyP, I can share with you my experience and answer your questions as they pertain to me. Just remember weight loss surgery isn't one size fits all and other people do different things that are highly successful.

1. I'm aware that VSG is not "magic" but logistically, it's difficult to figure out how or why this works when other options don't. Is it the size of the stomach? The reduced hunger hormone (ghrelin)? All of the above? I didn't necessairly have surgery to lose weight but to keep the weight off once I lost it. I was a professional yo-yo dieter and had lost weight many times but never kept the weight off. Something about the surgery to me represented my last chance to get it right

2. For those of you who had a lower bmi to start, and have kept the weight off, do you think the surgery gave you a boost that just dieting alone or a program like WW, Jenny Craig, Atkins, etc. didn't give you? Prior to surgery I did every diet under the sun. I took what I learned from all of those diets and use those skills to keep the weight off in addition to regular exercise. I also use food scales for portion control and get on my bathroom scales daily.

3. What keeps you motivated? Fear, plain and simply fear of regaining weight. I understand that fear isn't healthy but it works for me.

4. How difficult was it / is it to radically change what you eat? Do you ever eat the things you shouldn't? I followed the nutritionist guidelines for calories/carbs/fats and protein until I got to goal weight. I was a slow loser, 16 months to lose 103 pounds. I also looked for new favorites that I would continue to eat after I got to goal weight. I do still sometimes eat things I ate pre surgery but I counter the negative consequences with exercise.

5. Why and how are you able to do things differently (diet, exercise, motivation etc) after VSG that you couldn't before? I believe it's because I actually got to my goal weight. I got within 30 pounds back in 03 and started to regain and just decided I was supposed to be fat. I was unhappy but I gave up in the past. This time I've decided I will go to my grave fighting to stay fit. I have to think about what I'll eat daily and what type of exercise I'll do but those activieies are a hell of a lot easier than struggling to walk up stairs, fit in chairs, buy clothes, etc.

You are right to ask questions. I actually took a notebook to the doctors office with my questions because I wanted to fully understand the process. Do I wish that I had elected to have surgery earlier, no because I did not have the skill set to keep the weight off. I needed to fail at weight loss to prepare me for surgery.

Hopefully my answers will make sense, I'm typing on a phone which can be difficult.

Life is good!

After surgery go to the web site Baristric Choice and get the Shape Wise Chews. They help with hunger also it help slim you down, build lean muscle..They also lots of good things to eat and keep you on track

My two cents worth, having tried multiple diets over the years, is that this procedure basically resets your system, by reducing hormones secreted by the stomach indicating hunger, and it creates a physical barrier to eating too much at one setting. I find I can eat most of what I used to but in much much smaller quantities. Having to focus on protein (or choose to look like Yul Brynner) does displace junk foods, and I find sweets make me feel ill and carbonated beverages taste like seltzer water, so that reduces intake of both. I just don't have the cravings I once had, and I find even when I feel like I've totally jumped the shark, my calorie consumption does not go over 1800. More typical is 1300 - 1500, and many times me going higher is an effort to hit my protein target at the end of the day.

1. I'm aware that VSG is not "magic" but logistically, it's difficult to figure out how or why this works when other options don't. Is it the size of the stomach? The reduced hunger hormone (ghrelin)? All of the above? All the above, and also that the hormone that tells you you are full kicks in more quickly. A 1/2 C of food (chewed that is) is about a meal. But I'm never hungry and I recognize my "full" cue quickly now.

2. For those of you who had a lower bmi to start, and have kept the weight off, do you think the surgery gave you a boost that just dieting alone or a program like WW, Jenny Craig, Atkins, etc. didn't give you? My BMI before surgery was down to 39. But I've tried lots of things and due to metabolic syndrome, cancer treatments, med interactions, it just went back up. I'm a year out 10/4, and weigh 123. Feel great

3. What keeps you motivated? I feel good. I have energy. I take way less medicine. I fit in fun clothes, and my health is over the top better.

4. How difficult was it / is it to radically change what you eat? Do you ever eat the things you shouldn't? Not too hard - no appetite. And yes, once in a while. But only a bite (a tsp bite)

5. Why and how are you able to do things differently (diet, exercise, motivation etc) after VSG that you couldn't before? Well its kind of a full time job right after surgery to work your way through re=eating plan. And as self pay, I can't afford to throw away $13000+

1 mostly the size of the stomach if you continue to do smart food choices....eating junk (sliding food like cookies, candies, pasta etc) can make you regain all of it.
2 I had a really high BMI, but since a diet will induce hormones that will make you more hungry, in the long run a smaller stomach will help keeping the weight down...hunger will come back even after a sleeve, but eating lean meat and green beans and having help for the quantities is just amazing..
3 life post sleeve is "back to normal". It is amazing to be active again, have more energy and be able to do so much in a day. My motivation is my health mostly, I don't want to be back at the morbidly obese state with much more health issues

4 not hungry at the beginning but it does come back! I was eating a balance diet but had many veggies I couldn't eat before the sleeve since I had IBS so I was eating to much carbs and those in excess make me balloon... The sleeve almost cured my IBS at 90% and I can eat plenty of salad and fibrous veggies that were forbidden before. It does help a lot!

5 when you are +100 pounds lighter, everything is easier. I had my surgery in Asia because I was living there at the time, my insurance did cover it but it was around 7000$. In Mexico people pay around 5000.
Eating post-sleeve is not that complicated, you can make things simple, be organized and pre pack your lunches and snacks and be successful. In Asia I couldn't find all vitamins or supplements I needed, I had to order it online....sometimes even finding organic eggs or organic chicken was a mission, so tuna was a favorite often...almonds a great snack easy to carry...there is always solutions!

I did many diets, my longest non stop "successful" was over a year but I would lose 60 pounds, be hungry all the time then regain most without even eating crazy things...right now I did regain only with medication because with walking often and eating a balance diet it is easy to maintain post-sleeve...

Good luck!