Does the sleeve only help for the first six months or so? (long and lots of questions)

[pengworm]

Hello everyone. I'm a new member here who has gone back and forth about weight loss surgery for years. I am 35 years old and only five foot one and weight about 260ish right now. Last October and November I had gotten up to 300lbs and was so terrified I lost forty pounds on my own and have kept it off. Although it helped I am obviously still VERY big. Diabetes runs in my family and I was just told I have prediabetes. I'm terrified of having surgery and terrified of not having it. I've always struggled with weight but have been morbidly obese since I was a about 20. I've lost forty pounds on my own a couple of times but usually gain it back and then some. Like I said I've managed to keep this last forty lbs I lost off for a year but it has been hard. I always find the pounds creeping back up again and have to really get myself in check to not gain it back. I have so much more I need to lose and I just don't know if I can do it on my own even though I want to.

For years now I've been interested in the sleeve. Gastric Bypass scares the crap out of me and I want nothing to do with the lap band. The thing that I'm wondering about the sleeve though is if after the first six months to a year or so if it still continues to be a tool? What I mean is after that initial weight loss do most people go back to having hunger and the ability to eat the way they day preop? It's wonderful reading about so many say 10 months out who are doing well but I know how it is. When you are doing well in your weight loss journey you truly feel like you will never gain it back again, but then it happens. I get that I have to be able to eat right forever to lose and maintain. The thing is does the sleeve continue to help with that long term?

I'm at this point where I feel so much guilt. I'm terrified of having surgery and dying or having complications. I have three kids and even though I miss out on a lot because of my weight at least I'm here. I feel selfish for not being able to handle my weight on my own without going through such a huge surgery. I fear that if I cannot do it now that how will I do it after the surgery? Then again I have managed to keep forty pounds off for a year which is something I've never done. I'm also at the point where I'm just scared and don't know what else to do.
Sometimes I feel like I'm fooling myself thinking that there is no need for the risk of surgery when I can and should be able to do it myself. I'm just so confused. I'd love to hear any advice any of you guys have. Thanks for listening.

[Ann2]

You would be interested in the information found on this page of the American Society for Metabolic and Bariatric Surgery. In fact that whole site is a good one for those trying to determine whether WLS is a good choice for them.

https://asmbs.org/patients/bariatric...misconceptions

[terrora]

The majority of the weight is lost in the first six months but there are a lot of veterans here who continue to lose weight long after and have restriction forever. (See "1 year post sleeve accountability group)
There is nothing magical about the sleeve. You can decide whether or not you want to apply the principals and NOT lose from pretty early on. For instance I have head hunger and could graze all day if I want and not lose. I could eat high calorie foods and not lose.
I have had hunger from day one. I heard that sometimes it takes a while for the ghrelin to get out of your system and that there are other sources of ghrelin in the body. But most of us who struggle with weight didn't eat ONLY when we were hungry. And still when I am full I wanted to eat,,again head hunger.
What this does Is gives you a step up to be able to make some changes while having the benefit of restriction. The more you decide to change your patterns the easier it will be to keep it off forever. It is like starting from day one with a new stomach,,and learning how to listen to it like we all should have done from an early age. You learn when you are hungry and when to eat,,and listen to yourself when it is time to stop. If you practice listening to your sleeve it will be easier to not stretch it out.

If you don't push yourself and feel stuffed every time you eat you will not stretch out the sleeve. So chance of regain are less.

Nearly everyone is scared of surgery but if you don't get your weight off you WILL have diabetes. If you don't know much about it,,it is a long, slow disabling disease that leads to early death.
You are at 260lbs? So can you really do it on your own? And this is not the easy way out,,because you will have to do it on your own. The surgery is just the first part. How you use your new sleeve is in your control.
I had the sleeve at 199lbs, 5'6" tall. I was starting to have high BP and was also told I was prediabetic. Yes I could have got the weight off,,or SOME on my own, but not keep it off.
Keep researching, you will know when the time is right.

[Luann]

I am about a year out, and still have good restriction. I am not terribly strict about my diet and could be better - have never totally cut out bread from my diet. I can eat a little rice. I didn't have over a hundred pounds to lose, but I did have a good result from my sleeve. Getting in enough water is a challenge, I struggle with that.
Still, it was one of the best decisions I ever made. My cholesterol was very high, my chronic back pain was only getting worse with the extra weight, and then that made it harder to do anything. It was a vicious circle. I have found out even after losing so much weight & belly fat that I am pre-diabetic. Now. I had never had my A1C checked until after I was close to goal weight - likely it was worse before. I certainly feel better about myself now.

It isn't a magic wand but it has helped me lose more weight than I ever could have without it. Before my surgery I was struggling just not to gain, dieting to stay at the same weight & still failing.

[sraebaer]

I'm at a year, and have maintained my current weight (normal BMI) for 4 months now, without really trying. I can't eat too much, it's just impossible.
I know if I started working it I could lose my last 10 pounds, but I feel so good where I am, I'm not sure if I'll do that or not. I do weigh myself every morning, and I always stay within 2 pounds, up or down. I never lost that hunger hormone, that's for sure. I walk everyday. Love my sleeve!

[wpgbrett]

Hi There,

I was sleeved about 4 years ago and DID NOT follow all the post -op instructions. I can't tell everyone how important it is to work with your sleeve. It is not a magical cure. If you don't follow a plan you will gain weight. I am am emotional eater and I don't eat when I am hungry.. (well, I do) but I also eat for no reason...lol. I did not respect my sleeve and work with it . Now I am in a unfortunate situation. I have gained back most of my weight and I am getting re-sleeved in a few months. I am embarrassed to even type that.. But I have no one to blame but me.
Follow a plan, keep in touch with other people in the same situation, respect your sleeve and use the sleeve as a tool.

[chrissy58]

hi,
I am only 6 weeks out and have lost 36 pounds. I hardly ever feel hunger and before the surgery I felt like I could eat all the time! and I cant eat a lot of food. yesterday I had one meatball for lunch and it filled me up. I am losing about 3 to 6 lbs. per week. I cant imagine ever putting weight back on but I know people have. it is all in the choices you make. I always eat my protein first. that way nothing else fills me up. I need the protein. its that simple. I eat about every 3 hours. I cant say if this is going to be like this forever but it is the only thing that has ever worked for me!~ good luck!

[wpgbrett]

Chrissy,

You are doing it RIGHT! Keep up the good work! I know lots of people who are 2-3 years out and are still having great results...BUT.. they follow all the rules. I am reading a book about emotion eating and hopefully this time around I will be a better person for it.

[bikrchk]

I'm 13 months out and have been in my goal range for 4 months. I lost the bulk of my weight in the first 6 months, but I still have good restriction today. The only way to have this work is to change your relationship with food. That looks different for everyone, but I guess what I'm saying is if you always do what you've always done, your're gonna get what you always got! Things that I personally changed are:
1. I do not over eat. It's just too painful now. On the occasion that I slip, I have a very unpleasant reminder and do not repeat again anytime soon.
2. I exercise now, 5 days per week, religiously.
3. I eat what I like in small quantities - I'm only going to get a little bit, so I make it count. This includes bread and the occasional treat. I still choose protein first and get about 75g per day with the help of 2 supplements per day. How do I manage to eat what I like and lose\maintain? See #2.
4. I weigh once per week. No more, no less. We all want to see the numbers go down, but scale focus is not good. Checking in with your progress so you can make adjustments in your behavior is important. If I put on 5 pounds, I modify my diet until it comes off, typically a week or 2.

[Rainbow]

I am 4 years out and can tell you for me this was the best choice. I maintain my weightloss easily. I only fluctuate about 5 lbs. My tummy is tiny and I have become very comfortable with the reality that I have to eat very small portions. But that is the way supermodels and tiny skinny women have done it everyday for years! With my tiny tummy it makes it easy for me to do this and not feel hungry. I blogged my journey and you might enjoy reading some of the stuff I wrote to help newbies! Good luck, love Rainbow

[cowgirljane]

You have gotten some great answers.

I am 5'5" started at 308 (lifetime recorded high of 332). I will be 3 years post op in December and am maintaining in the 140s. It isn't always easy, I do have to work it. Flip side, I could not have done this, could not maintain without the sleeve as a tool. Of course follow all the rules as best you can, but my nutritionalist gave me what I consider my #1 success factor - EAT SMALL. Do not eat the point of "full"; eat to the point of no longer hunger. That is a retrain your brain exercise.... It is a key thing for long term success because over time, you lose that feeling of restriction if you keep stuffing yourself.

I get chastised from time to time for remarking that it isn't so important "how much can you eat" but rather "how much do you eat"

I know pre op I was so afraid of long term failure - frankly, I still am and I remain diligent! I failed miserably with the lapband and that was such a disappointing and depressing experience. (I did better on weight watchers than with the band). What I will say is that it was harder work for me to try to stay under 300# pre sleeve than it is for me now to stay under 150#. They both take work, but this particular "work" is alot more rewarding. Looking and feeling good in single digit clothing sizes, good health and good looks motivates me so much more than ANY weight loss / maintenance I experienced in the 300# ballpark.

Good luck whatever you decide. I know for me, I tried EVERYTHING under the sun and just could not do it without the assistance of the sleeve. If I do have a big regain, i will resleeve, revise to another surgery - I will try just about anything. My quality of life is about a million times better at a healthy weight and I simply will not give that up. I just can't go back to where i was.

[cowgirljane]

I appreciate this post, as someone who "failed" on my go around with the band. The single biggest mistake I made was letting my shame and horror send me into hiding instead of seeking support, guidance and help. You really point out the value of respecting the tool and seeking support from fellow patients and help from the medical professionals as needed.

Obesity is a DISEASE process. We may look slim, since our primary symptom (excess weight) is under control, but we still have the disease of obesity just sitting there waiting for a chance to put that weight back on. It is partly physical, partly mental/emotional - but in a way it doesn't matter WHY it is simply a fact that once you have been morbidly obese, your body will want to regain (ok, there are exceptions, but I think this is about 95% true).

Hi There,

I was sleeved about 4 years ago and DID NOT follow all the post -op instructions. I can't tell everyone how important it is to work with your sleeve. It is not a magical cure. If you don't follow a plan you will gain weight. I am am emotional eater and I don't eat when I am hungry.. (well, I do) but I also eat for no reason...lol. I did not respect my sleeve and work with it . Now I am in a unfortunate situation. I have gained back most of my weight and I am getting re-sleeved in a few months. I am embarrassed to even type that.. But I have no one to blame but me.
Follow a plan, keep in touch with other people in the same situation, respect your sleeve and use the sleeve as a tool.

[pengworm]

Thanks so much everyone. Cowgirljane your response really hit home for me. I read over and over again that you have to do what you should and not overeat after you have the surgery which is obvious. However if I were able to do that I wouldn't be 260 pounds in the first place. So I guess I worry that the sleeve won't be enough to keep me from doing what has gotten me here in the first place. I of course wouldn't go into this planning to screw up and gain the weight back but then who does?

I just have a lot of fear and so many questions. Thank you all again for your responses, they were great.

[cowgirljane]

Well, there is a reason that many people don't get to goal or have a partial (or heaven forbid a complete) regain.

I don't have an answer because I was a pretty advanced case of obesity. Look at my before picture... At one time, I probably weighed even 30# heavier than that...i was miserable and very obese.

I think that you need to use the first 3-6 months post op very wisely. Your appetite will be decreased and at times nearly gone. That is the window of opportunity to change your brain. The sleeve helps because it does a couple of things:
1. Initially greatly reduced capacity to eat
2. Initially, greatly reduced desire to eat - I could not maintain a healthy diet back when i was hungry quite literally 24/7. My hunger-meter was just plain broken and the surgery gave me a chance to reset and learn new habits while that was in check.
3. Rapid weight loss gives you motivation (like I said, it was not all that motivating for me when I went from say 330 down to 275 - still morbidly obese!!!) that you can build on
4. You put your life on the line - literally - to have this surgery. Hopefully that speaks to a level of committment to the long term that you feel deep inside
5. Long term support - medical, support groups, online forums. I view this is a fight for my life and I will pull every resource to help me.
6. Get away from the things that caused you issues in the past. For me, it was all or nothing thinking. Gain 10#, give up, might as well be 100#. Now, if I see a little regain, i relose it immediately!!!! Others it might be different issues - but think about it.
7. Use this time to truly examine your lifestyle - do you need to become more active? Do you need to take care of yourself, make yourself a priority? Find more joy in life from real activities and people (not food and tv)? Find spiritual or community meaning? What is missing or blocking you from living the life you want?

Thanks so much everyone. Cowgirljane your response really hit home for me. I read over and over again that you have to do what you should and not overeat after you have the surgery which is obvious. However if I were able to do that I wouldn't be 260 pounds in the first place. So I guess I worry that the sleeve won't be enough to keep me from doing what has gotten me here in the first place. I of course wouldn't go into this planning to screw up and gain the weight back but then who does?

I just have a lot of fear and so many questions. Thank you all again for your responses, they were great.

[pengworm]

You are so correct about the motivation. I have worked and continue to work so hard to lose and keep off the 40lbs I've lost and I'm still extremely obese. To work so hard and still not be able to fit into any clothes, it just sucked. Yes it did make me feel better but it is so hard to imagine being able to lose anymore when this has been so hard.

I'm with you on the all or nothing thinking too, it's exactly what got me to where I am. With this forty pound loss I have had to be so vigilant and whenever I let myself go to far and see a couple of lbs (or five) sneak up again I go back and lose them. Again though it is so hard just to do this and still be so huge.

It is very cool for me to see someone like you that has done so well. Sometimes I see people's before pics on here and wish I looked that good! I'm glad to know someone with a lot to lose was able to do it. I agree with what you said about feeling hungry all the time. I think those of us who have been like this for years just cannot imagine that we could be another way.

For some reason each time I was pregnant my appetite went away. I wasn't sick to my stomach or anything, that crazy out of control hunger just went away. I could and did eat just the amount my body needed and I was able to stop. Each pregnancy I would love fifty or sixty pounds and feel sooooo much better. Then every single time as soon as I had the baby my body went back to its old ways. It was insane, like a switch had been flipped. So for me I know a lot of it is in the head but my experiences while pregnant proved to me that there is something going on inside my body that is hormonal or god knows what but something. So my hope is that the surgery would bring me back to the way I always felt while pregnant. Just eating to live and not feeling like I'm obsessed with food.