Need views

[wanttolose]

So, since my surgery was postponed due to ulcer and treatment, I took the opportunity and time to quit smoking, really clean up my shopping for food and eating and joined a gym, got a personal programme, have been working out every day and have lost weight. If I submitted now to my insurance for surgery approval, I probably would not get it. The gym has had an amazing impact on my diabetes control, basically giving me mostly normal figures and the same for blood pressure. So yes, the question does pop into my mind when I sit in the sauna....do I go forward like this with a changed way of living (eating and exercising) or do I maintain my surgery plans? I know it is a very personal decision and reaching out to all of you here who have had surgery will give me a favourable view on surgery... But I still need to ask. And yes, I can and will continue the gym and my new low carb way of eating.

[Happy966]

Here is my honest opinion. I am very, very glad I had surgery. But I am glad I tried hard on my own for many years before. Yes, part of me thinks "If I'd done this years ago, I wouldn't have spent my 40s as an obese woman" but realistically I couldn't have had *this* surgery 15 years ago and I learned a lot about myself and food in my struggles that is really helping me now. I came to surgery extremely convinced that I would die an obese woman without surgical intervention.

If I were were having your success at this point, I probably wouldn't go ahead with surgery. But I'm not saying this is the right decision. I'm just saying, I know myself and if I'd quit smoking, changed my eating and started exercising, *and* felt I could make that change permanent, I wouldn't have surgery. I have seen people make these changes on their own - usually at a lower starting weight like yours - and be successful for many, many years.

The problem for me, and for many of us, is that *we* could not make those changes permanently. At some point, I would fall off the wagon and spiral into a period of addictive eating, weight gain, incomprehensible demoralization, all that. I felt like I couldn't face it anymore, not without trying something that had a shot of working.

[calendargirl]

I see you're going to have a VSG? Friends that I know who've had the VSG say they feel completely normal. Afterwards they said they can't tell, really, except feeling satisfied sooner keeps them from eating more.

I personally was able to maintain a healthy weight for maybe 1 year after a controlled eating and exercising evironment. But after that it was really hard to maintain the discipline. My body gets more and more efficient with calories every time I go on a restricted diet. Now I can't lose unless I maintain intake of 500-800 calories a day and do aerobic exercise of 60 minutes a day. So for me, even the VSG might not work. If I want a prayer of making it to a normal BMI, it's gotta be the DS.

Just some thoughts... Good luck with your decision. You've chosen a great surgeon!

[wanttolose]

Thank you both! Yes, I know my surgeon is apparently amazing and I am very thankful for that. I am convinced now that I could make the changes permanent but who really knows?? Maybe I too will fall off the wagon, which is something even people with surgery can do. That scares me a lot...about on par with the acid reflux fear. Gotta keep thinking and reading everyone's experiences.

[califsleevin]

I went thru much the same thing that you are going thru in that I lost around half or a bit more of the weight that I needed to lose (before regaining some. but less than half of it) by way of adopting the healthier lifestyle while my wife went thru her DS journey. Since I was able to maintain a stable weight for several years after that, had adopted the healthy tools to maintain my weight but was not able to make more progress without resorting to extreme fad diets which have such a low probability of long term success, I opted for the VSG to complete the job.

I think that it gets down to your confidence on being able to reach your goals, or at least get down to a satisfactory healthy weight and maintain it, without the added help. You will probably hit some prolonged plateaus along the way, and may, like me, hit a total wall where you are unable to go further.

At this point, having gotten to goal and transitioning to maintenance mode, I find that I am eating largely as I did before surgery, but less. Before I could not get myself below 26-2800 calories on any sustainable basis but now am working between 16-1800 calories trying to find a stability point while adding back the nutrition I was missing during weight loss. It's quite a shift in mindset to be looking for ways of adding calories to my diet (healthy calories - adding junk calories is not a problem!)

You mention your new low carb way of eating, and the VSG is very amenable to that approach, but it doesn't insist upon it like some WLS do. My earlier success was with the basic balanced good nutrition along with exercise approach, and I maintained that basic philosophy to the extent possible with our limited post-op intake and protein requirements. So, since the sleeve maintains our original anatomy to a very high degree, what one finds to be workable pre-op should work just as well long term post-op, so there is flexibility in that area.

[califsleevin]

Feb 5, 2012 11:14:13 GMT -5 wanttolose said:

Thank you both! Yes, I know my surgeon is apparently amazing and I am very thankful for that. I am convinced now that I could make the changes permanent but who really knows?? Maybe I too will fall off the wagon, which is something even people with surgery can do. That scares me a lot...about on par with the acid reflux fear. Gotta keep thinking and reading everyone's experiences.

I don't think that I ever really fell off the wagon on my lifestyle adaptation, which occurred over eight years time or so, but more ran into a wall of how far it could take me. It was a long term exercise in experimenting to find places where I could cut some calories while maintaining nutrition. You are right in that the surgery doesn't prevent one from falling off the wagon dietarily - one can torpedo any WLS by drinking calories or going for high calorie slider foods (even with the DS, though it's harder to do!)

On the reflux point, that is another of those variable things - some have little problem with it and are off the PPI meds within a very few weeks while it lingers with others - I am still working on weaning off of the PPIs, but it's well controlled with the meds. There is the perception within the industry (which changes as more longer term research becomes available) that the larger sleeves have less reflux problem, while possibly being more prone to regain issues. That is certainly something to discuss with your surgeon, and since he is a well experienced DS and sleeve guy, he should have some good valid opinions on that point. It may be that with your early adoption of successful lifestyle habits and relatively moderate weight loss goals that a little larger than average or normal sleeve would be appropriate for you - at least there is a talking point there.

[nandmsmom]

That's a hard decision. It took me 4 years to get to the point that I was ready to make this decision. While doing the pre op, I lost the weight pretty easily and had a few moments when I thought that I would just do it myself. Then reality struck, which for me meant that I just can't keep it off myself. It's too easy to fall back into the huge servings of crap. I'm well aware that it's still possible to regain with the VSG, but it does make it easier to keep things under control.

As for the reflux; I've been on Prilosec for 10 years or so. Every now and then I even need to add something to it because of break through reflux. While they were doing my surgery, they were able to fix a hiatal hernia. I still have reflux post op (I'm almost 4 weeks out), but the prilosec is still doing it's job. It's not a big deal for me to take it long term. It's second nature at this point.

[reinventingangela]

I thin the only person that can truly answer this question is you because deep down, we are the only ones who really know the extent of our past weight loss efforts, our triggers, our patterns, etc.

I look at your situation and I see that you are currently under 200lbs, I see that you have co-morbidities but your diabetes (if type 2) and joint pain could go away completely as you continue to lose and get things straightened out in your body. You dont seem to have a problem following a diet and exercise program as a general rule and you quit smoking which means you will have fewer health issues to deal with in the long run even if slightly overweight.

So really, the key here is whether you are for one of the first times in your life REALLY doing whats right or whether you have done this a hundred times before only to fall off the wagon each time. I think, if you are for the first time getting really honest with yourself and saying hey, I never really put this much effort into my health before and now that Im seeing the results I think I can do this, then I think you should just keep doing what youre doing and try to avoid surgery altogether.

If you are once again on this health kick that never seems to last, then you will know at what point you need to turn to surgery to help rectify a deeper problem and create a more permanent environment in your body for change.

Either way, I say dont stop what youre doing. Surgery will be there if you dont make it, but Id rather believe that you will! Youve come so far already and Im proud of you!