Hi! I apologize if this is a dumb question, but a bit of searching Google for the answer didn't yield much.
If someone is 450lbs but has never overeaten- and simply has a body that processes food in a really extreme way- how does gastric sleeve surgery help them lose weight? I have a loved one who's been about that size his entire adult life, often eating less than most people. It seems that, generally speaking, gastric sleeve surgery helps people lose weight primarily by reducing their desire and ability to overeat- but if he's that size on 2000 calories a day (or less) anyway, how can the surgery help him?
He has risk factors for various complications- most notably, he won't be able to exercise after the surgery because he has an undiagnosed illness (that's probably/partly unrelated to his weight) that prevents him from doing so, so I'm worried about the possibility of blood clots. Between his inability to exercise, his relatively high BMI (~59), his age (45), and the fact that he's got some kind of undiagnosed illness that affects his heart rate, it seems like the surgery is fraught with serious risk for him, and I don't really understand why it's worthwhile since eating too much isn't his issue. Can someone explain? Are the effects on metabolism greater than the stuff I've been reading suggests? I know that initially after surgery people have really low caloric intake for a while, and I see why that would help (because even for him eating 800 calories a day causes weight loss), but over time doesn't caloric intake go up? He has said that he can eat 1200 calories a day and still be 400lbs.
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