Hi,
I am currently researching my options for bariatric surgery and was hoping someone could give me some advice.
I’m super afraid of failing at my surgery. Let me back up a bit. I have been overweight almost my whole life. Middle school was awful, let me tell you. I am now 28, I’ve tried every diet strategy under the sun and nothing has worked. I’m also a 1st grade teacher, so as you can imagine, I am running around quite a bit. I almost always hit my 10,000 steps by the end of the day! But, still, I can’t seem to get down to the weight I want. I’ve gotten pretty close before, but then I ballooned back up. It’s so hard to keep the weight off!!
So, it’s looking more and more like bariatric surgery is my last remaining option. But, I’ve been reading a bunch of failure stories from people getting surgery, both the sleeve and the bypass, and it’s gotten in my head a little bit. I was hoping someone might have some advice for me about how to avoid bypass and sleeve failure. Any strategies would be much appreciated!
Much thanks,
Jenny
Patient Responses to the Question Above
Surgeon Response to "Looking For Some Gastric Bypass And Sleeve Failure Stories"
by: John Rabkin, M.D., Pacific Laparoscopy
Dear Jenny,
Bariatric surgery has a very high likelihood statistically of working for you and, therefore, you shouldn't fear "failure" going forward with your decision to proceed with the weight loss surgery (WLS.) After a lifetime of failed medical weight loss efforts trying to address your morbid obesity, you most likely will find the success that you'll experience with the WLS refreshing!
The degree of success enjoyed by WLS patients does vary patient to patient as well as by procedure type. Following the recommended dietary and exercise guidelines provided by your WLS team will generally ensure that you achieve the success that you're seeking: durable (lifelong) weight loss and reversal/prevention of obesity related medical illnesses without the development of medical complications due to the WLS itself. These guidelines will vary according to the WLS procedure that you choose to undergo.
In general however, the 'restriction' of caloric intake is the main mechanism affecting the weight loss with all four of the standard accepted WLS procedures: the Adjustable Gastric Band (AGB), the Verticle Sleeve Gastrectomy (VSG), the Roux-en-Y Gastric Bypass (RNY), and the Duodenal Switch (DS.) Therefore, minimization of caloric consumption is the key to the weight loss and its durability. After WLS you want to eat only enough food ('protein first') to satisfy your hunger and achieve satiety without 'overeating' which will induce discomfort.
The complete and total avoidance of liquid calories of any kind (including even liquid protein shakes) once recovered from the surgery and able to tolerate solid food will enhance your weight loss: liquid calories, particularly liquid carbohydrate calories, can defeat the WLS. Avoiding between meal snacking/grazing and limiting the duration of your meals is also beneficial. Minimizing the ingestion of 'calorie dense' foodstuffs, particularly concentrated carbohydrates and fats which are of limited nutritional value, is very important for achieving the overall maximal weight loss.
It almost goes without saying that we all need to routinely exercise: this not only enhances the weight loss achieved with WLS but is also very important for maintaining the durability of that weight loss over time. Undergoing post WLS reconstructive surgery to remove the excess skin that comes along with the weight loss has been demonstrated to enhance the durability of the weight loss. Finally, it's been clearly shown that patients who regularly participate in bariatric support groups maintain more of their weight loss long term than non-participants.
One WLS procedure, the DS, also employs the mechanism of 'calorie malabsorption' alongside the caloric 'restriction' of the other three WLS procedures. This enhances the weight loss over and above the WLS procedures that rely only on 'restriction' to accomplish the weight loss. More importantly, this 'calorie malabsorption' greatly increases the durability of the weight loss: as the 'restriction' lessens over time as the reduced capacity of the gastric pouch gradually increases as the pouch stretches, the 'calorie malabsorption' steps in to limit any potential weight regain as patients gradually consume more food/calories to fill the larger pouch in order to feel satiated than their metabolism uses.
Due to the 'calorie malabsorption,' DS WLS patients can consume many more calories and enjoy a much more relaxed dietary regimen without the associated risk of weight regain. The DS statistically has the best weight loss and, by far, the best durability/sustained weight loss of any of the four standard WLS procedures.
Overall, your likelihood of benefiting from WLS is very high: go forward with the confidence that you'll succeed!
John M. Rabkin, M.D.
Pacific Laparoscopy
(click here for Dr. Rabkin's full bio & contact info)
DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.
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