If a sleeve becomes less effective, why?

[Jackie12]

Hi, all. I'm four and a half months out and doing well. I've made some healthy lifestyle changes and plan to maintain them. My surgeon keeps telling me how important it is to really stick with my new habits, especially for the first nine months for maximum weight loss. I've also read in various sources and comments that the sleeve isn't as effective as a weight loss tool after the first year. I'm curious as to why that is. I would have thought that the restriction was permanent, and with the right kinds of lifestyle changes that weight gain wouldn't be a concern. Can someone further out share your thoughts and experience?

[DesertGal]

That sounds strange to me. I would think having 80% of the stomach removed is permanent. I've heard the first year or so is when most weight loss occurs, and then the maintenance is the focus.

[Sandra3]

You will get the maximum restriction the first year. Then you can eat a little more.
For example, I was eating 1/2 cup until six months out. I'm 13 months out and now can eat more than one cup. I'm also more hungry than I was at 3 or 4 months. Hormone production does change in one year, in your stomach but also your body in general. And at some point when you lose a lot of weight your body is trying to send you messages to gain it back. It's also hormone related.
One publication I was reading a few months ago was basically saying that getting a sleeve would at the end of the weight loss help you to eat half of what you were eating before surgery. Protein first and not overeating is the way to go for me.

[Christie13]

I always find great answers on Obesity Coverage website. Here is the info on your question. http://www.obesitycoverage.com/weigh...tomach-stretch

[Ann2]

As someone who's 31 months post-op and has successfully and stably maintained my weight loss for the last 14 months (after losing 100 pounds) I honestly haven't seen any difference IN THE LAST 21 MONTHS in the restrictive or other powers of my sleeve to support my much improved eating choices and eating behaviors.

My theory (so far) is that those who think "the sleeve isn't as effective as a weight loss tool after the first year" are those who initially depended over-much on the sleeve's restriction to limit how much they ate and, after the thrill of rapid weight loss, fell back into their old, bad food choices and eating habits.

My experience has been that so very many things determine how much I can / could eat, including:

* Which foods I choose to eat

* When I choose to eat them

* How fast I eat

* Whether I choose to drink with meals

* Whether I graze between meals

* Whether I plan what I'm going to eat every day vs following a "see food, eat food" diet

* Utilize an "eating honesty and accountability" method that works (I continue to track my food on MFP, but there are other methods -- like eyeballing portions carefully, mindfulness, etc.)

* Weigh regularly (daily works well for me)

* Eat for health, not to assuage life's ongoing stresses (life's challenges won't stop until you are dead, so learn how to reduce or manage your stress. Protip: chocolate and chips won't help!)

[peasantme]

I was told that after the first year, some hormaones come back but to varying degrees for different people. So the first year you have restriction with most of the hormones not interfering, the second year, they come back to some degree, adding to your challenge. But the hope is that you have had already significant weight loss, and new healthier habits in place that will hold out over hormones....no pesonal experience yet as I am only 6 weeks out, thst what my surgeon said but reading blogs, it's so indiviual.

[Pam G]

Ann2, as always, spot on.

My theory (so far) is that those who think "the sleeve isn't as effective as a weight loss tool after the first year" are those who initially depended over-much on the sleeve's restriction to limit how much they ate and, after the thrill of rapid weight loss, fell back into their old, bad food choices and eating habits.

My experience has been that so very many things determine how much I can / could eat, including:

* Which foods I choose to eat

* When I choose to eat them

* How fast I eat

* Whether I choose to drink with meals

* Whether I graze between meals

* Whether I plan what I'm going to eat every day vs following a "see food, eat food" diet

* Utilize an "eating honesty and accountability" method that works (I continue to track my food on MFP, but there are other methods -- like eyeballing portions carefully, mindfulness, etc.)

* Weigh regularly (daily works well for me)

* Eat for health, not to assuage life's ongoing stresses (life's challenges won't stop until you are dead, so learn how to reduce or manage your stress. Protip: chocolate and chips won't help!)

[jamma]

Ann2, you are right. Change the habits, stick with the changes, you'll be fine.