Questions about Bariatric Surgery and Calorie Restriction
CarboUnload
Posts: 30 Member
This fall when I hit the highest weight that I have ever been, I knew that I needed to make a change and NOW. Anyway, I made the necessary appointments and started the process of consultation with a Bariatric surgeon, as well as starting up MFP.
Long story short: I've been reading about the surgery and basically, it's just a way to lose a lot of weight quickly by severely restricting calories...we're talking like 300/day. What if I just restricted my calories like that without actually having the surgery?
I'm afraid of a few things: not having enough energy to exercise and general mood from hunger, but it has to be better than having a non-reversible surgery, right?
I would love to hear opinions about those that have had the surgery and those that haven't. My first "lifestyle class," with the surgeon's office is next week, as is my consultation with the doctor. I've not made any final decisions yet.
In the process, though, I've lost 17 pounds since starting MFP. Which is awesome!
Long story short: I've been reading about the surgery and basically, it's just a way to lose a lot of weight quickly by severely restricting calories...we're talking like 300/day. What if I just restricted my calories like that without actually having the surgery?
I'm afraid of a few things: not having enough energy to exercise and general mood from hunger, but it has to be better than having a non-reversible surgery, right?
I would love to hear opinions about those that have had the surgery and those that haven't. My first "lifestyle class," with the surgeon's office is next week, as is my consultation with the doctor. I've not made any final decisions yet.
In the process, though, I've lost 17 pounds since starting MFP. Which is awesome!
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Replies
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A VLCD (very low calorie diet) like that requires medical supervision. Some people do lose weight that way, but it's important that a doctor be monitoring you to ensure you don't suffer from the side effects VLCDs can cause.0
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Doing that without doctor's supervision is extremely dangerous and against MFP's guidelines. The doctors provide you with supplements needed to make up for what you can't eat (my sister-in-law had it done two years ago). But without, you'll basically wreck your body.0
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I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?0 -
Why the rush? Making changes NOW to be healthier and eating less while still eating enough to get appropriate nutrition, won't that result in weight loss? Maybe slower, but long term more sustainable, without compromising your health by starvation and possibly developing an eating disorder.0
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CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.0 -
tcunbeliever wrote: »Why the rush? Making changes NOW to be healthier and eating less while still eating enough to get appropriate nutrition, won't that result in weight loss? Maybe slower, but long term more sustainable, without compromising your health by starvation and possibly developing an eating disorder.
No rush. Just looking for information and experience of other people that have or haven't done it. Also, the reason to consult a surgeon is because if I even did decide to have the surgery, insurance requires at least six months worth of lifestyle classes and food-logging. It's more preparation than anything. My thought was that I can gain something from a lifestyle class...even if it doesn't lead to surgery.
Truthfully, I would prefer not to do it, but I want to make a decision based upon gaining as much knowledge as possible.0 -
If you can lose without surgery, do it. That's the goal. I had RNY in January when I had absolutely no other choice. It was literally "surgery or die" and I was dying quickly. I wish I'd found my current diet plan a couple of years before surgery, because I might have avoided surgery completely.
With that said, here are some answers to your questions...
Calorie restriction...
VSG (Vertical Gastric Sleeve) - yes, it's purely portion and calorie restriction. Because most of your stomach is removed, you physically cannot eat much.
RNY (Roux-N-Y Gastric Bypass) - it's portion and calorie restriction as well as forced malabsorption. Part of your intestine is bypassed, as well as your stomach reduced in size.
Which surgery you get is based on a lot of factors including age, amount of weight to lose, co-morbidities, lifestyle, necessary speed of weight loss, and insurance/cost.
Energy...
You'll have some energy problems at the beginning, but they will pass. You'll start a special diet before surgery and you'll continue it afterwards. Most of your energy issues will be pre-surgery when you start the diet. Post-surgery, your energy issues are mostly from healing.
Hunger...
Most patients have little to no hunger post-surgery, some for weeks or months. Once the hunger comes back, it's hoped that by then, you know how to handle it. There is a load to learn before you have surgery. You'll need to learn your triggers (food, situations, emotions, hormones) and you'll need to learn how to deal with those triggers without resorting to food. It's a mental game that takes a while to get the hang of. Hopefully, you'll get access to a psychiatrist that specializes in bariatric psychiatry. They can teach you some coping techniques to really help your success.
Severe Calorie Restriction...
You cannot do this without medical supervision. It's incredibly dangerous and it's not promoted here on MFP. If it's doctor-ordered, then ok. You'll have a medical team to monitor you and a buttload of lab work regularly to ensure you're doing it as safely as possible. But it isn't safe and there can be some life-long complications. We can talk about starvation diets or you can read my comment in this thread... http://community.myfitnesspal.com/en/discussion/comment/33631848/#Comment_33631848
Personally, I wish I hadn't needed surgery. It's royal pain in the azz. Seriously, it's really hard work. Any thought that surgery is the easy way is just pure ignorance of the process. 11mo later, I still have incision site pain and lots of trouble eating certain foods. These are common complications with the surgery and sometimes, they are life-long. I'm glad I did it, because dying would have sucked. However, I wish I'd been exposed to different diet options (like keto and IF) during the 5 years before surgery. I wish I'd known about trigger foods and tools for dealing with cravings. Learning about these a few years ago might have kept me out of surgery.
There's a pretty large learning curve before surgery. It's a huge mental game and you're going to need to learn and then use the tools available to you. Learn what foods and situations trigger reliance on food as a solution. And then fix it. Because those problems will still exist after surgery. Surgery won't fix a broken you. All the bad habits that got you here still exist and if you aren't forever diligent, they'll come back and so will the weight. If you can learn better habits and lose without surgery, that's the route to take.
This is a great group for LAP/VSG/RNY http://community.myfitnesspal.com/en/group/637-gastric-bypass-vsg-lapband Read through the threads, because a lot of your questions are probably already answered there.
Good luck.0 -
janejellyroll wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.
I've been reading studies about those that do not have surgery and those that do, but the results are kind of underwhelming in both instances, so getting information from those that have actually done it, versus mice that have done it (just saying) is helpful.0 -
CarboUnload wrote: »janejellyroll wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.
I've been reading studies about those that do not have surgery and those that do, but the results are kind of underwhelming in both instances, so getting information from those that have actually done it, versus mice that have done it (just saying) is helpful.
Absolutely. Good luck!0 -
I had RNY is July of 2014, and I most definitely do not eat 300 calories a day; more like 1000. And that's because I'm still losing (6 lbs to go to goal!). I haven't had any complications and haven't come across any types of foods that I'm not able to eat. Because of the restriction and malabsorption, I need to be vigilant about what I eat and I track my macros every day to make sure I'm getting adequate protein and minimal carbs. I also supplement with multiple vitamins daily and have my blood work done every three months to check my levels. It's a trade off and I'd rather do this than live the life I wasn't living at 300+ lbs.
I know the issue of bariatric surgery can be polarizing, but for me it was right. You need to educate yourself and make the decision that's right for you.0 -
You probably could do an extreme calorie restriction diet on your own without surgery & you would lose weight.
I decided against RNY because I didn't want the malabsorbtion. I was worried about the risk of malnutrition. I do not like very many foods. I went with the VSG. For me, the surgery allows me to be satisfied with the amount of calories that I am allowed to eat in a day. One of my challenges has always been hunger & the surgery makes it easier for me to maintain because I can control my hunger. Maintenance has always been so much harder for me than losing the weight. I can't say how many times I've lost weight only to gain it all back again. I had my surgery in 2012. I had a horrible year last year & went way off track with my eating. Because of my smaller stomach, I simply wasn't able to pack in the food like I would have prior to the surgery. I did regain some weight, but nowhere near what I would have & not an overwhelming amount. I have already lost half of it back again. That is what the surgery has done for me. I know that I will never be perfect, but it is a tool that I will always have.
Even if you ignore the severe consequences of doing a VLCD without medical supervision, it's not realistic because you eventually cave in & over eat. It just feeds into an unhealthy cycle of restriction & binging that will not result in lifelong weight loss.
That being said, you do not eat 300 calories for very long at all after the surgery. I probably ate that right after the surgery when I was still recovering & only on liquids. At that point the main focus is trying to get in your required protein. You definitely increase your calories pretty quickly out of that dangerous level. When I'm losing, I generally eat around 1000 calories a day. I see a doctor every month & get my blood work done every 3 months. I maintain at 1430 (because I'm short). I did end up needing a mound of vitamins every day anyway even without the malabsorbtion. I would do it again. It was the right decision for me.
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CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
In all honesty: satiety. With a smaller stomach, you physically cannot eat more. However, not having the surgery does save you the risk of having major surgery.0 -
I had a Gastric Sleeve Surgery 3 years ago and am still on MFP daily, love this site.
When you first get a surgery you can only consume 300-500 cals a day of liquid due to the SURGERY effects and HEALING process, this will not be so in a month or 2 when your incisions and internal organ has healed. The only reason for that low of a calories is so you wont rip your incisions and really because of the surgery itself you wont have much appetite...especially since your on liquids and soft foods only for the first several weeks. Eventually it will be easier to eat more...and eventually lots more...you use this time to get used to a lower calorie LIFESTYLE...ween yourself off of the addictive cravings especially for things like Binge Eating and Sodas etc...I would suggest not eating any "splurge" items even if within your calories for at least 3-6 months after surgery to retrain your taste buds.
BUT the real answer is YES you could do it on your own if you have the willpower....which I know myself enough to know I did not have the willpower and needed a surgery to just reset my horrible habits of a lifetime...especially binging. My BFF who is scared of surgery and so opted to start using MFP recently and walking daily....Since my heaviest of 240 I have kept off 64 lbs lost due to surgery but am still working daily on losing my last 25lbs even w/ the surgery. (I did break my ankle in 2 places last year and that set back my weight loss by almost a year , having to retrain myself to count and exercise from when I was waited on hand in foot while healing that ankle). My BFF is now down 40lbs and almost caught up to me just by exercise and MFP of 1200 daily. It is a very personal choice....we both believe we have made the choice that is best for each of us....I will note that if I go off my 1200 cal a day for a month and am evil...I feel like it is easier for me to get back on path than her....because even when I overindulge I am still only able to eat a smaller portion than her...she can slip right back into eating huge portions due to her not being sleeved. My splurges are more about being over calories than over portioned, if that makes sense.
Not sure if this helps...just my personal experience.0 -
CarboUnload wrote: »This fall when I hit the highest weight that I have ever been, I knew that I needed to make a change and NOW. Anyway, I made the necessary appointments and started the process of consultation with a Bariatric surgeon, as well as starting up MFP.
Long story short: I've been reading about the surgery and basically, it's just a way to lose a lot of weight quickly by severely restricting calories...we're talking like 300/day. What if I just restricted my calories like that without actually having the surgery?
I'm afraid of a few things: not having enough energy to exercise and general mood from hunger, but it has to be better than having a non-reversible surgery, right?
I would love to hear opinions about those that have had the surgery and those that haven't. My first "lifestyle class," with the surgeon's office is next week, as is my consultation with the doctor. I've not made any final decisions yet.
In the process, though, I've lost 17 pounds since starting MFP. Which is awesome!
Welcome!
17 pounds is great! Congratulations!
I have put in bold the most important thing in your posting. I can't advise you one way or the other regarding surgery because I've never had, but I urge you to continue eating at a calorie deficit while you research the procedure. Just see what happens. If you choose to lose weight without surgery, I have 100% confidence that you are motivated enough to follow through. Your attitude sounds great.
Also, exercise is not necessary to weight loss, but it has its benefits health wise. If you choose to exercise, just do what you can and set some small goals.
Keep us posted, please.
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In addition to my posting above, I do know having weight loss surgery is no guarantee for losing the weight or keeping it off. My sister in law had the surgery, lost about 100 pounds, and then gained about half of it back. Two or three of her sisters had it, one lost weight at first then put it back on, and I don't know about the other sister. It is not a quick fix, as my SIL and sisters thought.0
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janejellyroll wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.
I don't get the impression she's doing a VLCD now. I think she's referencing the calorie range in regards to the surgery.
@CarboUnload, can you please clarify?0 -
janejellyroll wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.
I don't get the impression she's doing a VLCD now. I think she's referencing the calorie range in regards to the surgery.
@CarboUnload, can you please clarify?
I don't think she is either. I was stating that because she asked why she couldn't use a VLCD to achieve the same results as surgery.0 -
I did say later on that there were severe consequences & that it is not the way to long term weight loss. I don't recommend it, but we all know that it's true.0 -
janejellyroll wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
If you are able to create a deficit without surgery and maintain your weight loss afterwards, I don't think there IS a benefit to surgery.
Keep in mind that a VLCD will probably create some of the same side effects you're concerned about from the surgery (low energy, hunger). A more moderate calorie deficit will allow you to maintain your energy level and avoid excessive hunger.
I don't get the impression she's doing a VLCD now. I think she's referencing the calorie range in regards to the surgery.
@CarboUnload, can you please clarify?
No. Currently just using the suggested calories on MFP, exercising and considering all options with no final decisions yet. I am excited about the progress that I've made with this tool, so if I can keep losing, ramp up movement and lose more...then that would be awesome.0 -
dayzeyblue wrote: »I had a Gastric Sleeve Surgery 3 years ago and am still on MFP daily, love this site.
When you first get a surgery you can only consume 300-500 cals a day of liquid due to the SURGERY effects and HEALING process, this will not be so in a month or 2 when your incisions and internal organ has healed. The only reason for that low of a calories is so you wont rip your incisions and really because of the surgery itself you wont have much appetite...especially since your on liquids and soft foods only for the first several weeks. Eventually it will be easier to eat more...and eventually lots more...you use this time to get used to a lower calorie LIFESTYLE...ween yourself off of the addictive cravings especially for things like Binge Eating and Sodas etc...I would suggest not eating any "splurge" items even if within your calories for at least 3-6 months after surgery to retrain your taste buds.
BUT the real answer is YES you could do it on your own if you have the willpower....which I know myself enough to know I did not have the willpower and needed a surgery to just reset my horrible habits of a lifetime...especially binging. My BFF who is scared of surgery and so opted to start using MFP recently and walking daily....Since my heaviest of 240 I have kept off 64 lbs lost due to surgery but am still working daily on losing my last 25lbs even w/ the surgery. (I did break my ankle in 2 places last year and that set back my weight loss by almost a year , having to retrain myself to count and exercise from when I was waited on hand in foot while healing that ankle). My BFF is now down 40lbs and almost caught up to me just by exercise and MFP of 1200 daily. It is a very personal choice....we both believe we have made the choice that is best for each of us....I will note that if I go off my 1200 cal a day for a month and am evil...I feel like it is easier for me to get back on path than her....because even when I overindulge I am still only able to eat a smaller portion than her...she can slip right back into eating huge portions due to her not being sleeved. My splurges are more about being over calories than over portioned, if that makes sense.
Not sure if this helps...just my personal experience.
This is extremely helpful, Thank You.
I am looking for answers/advice from people that are using this tool and have had these experiences prior.
I appreciate any and all feedback while I research.
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CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
The difference? Willpower.
With surgery the capacity of your stomach is reduced. Without surgery you need the willpower and determination to stop eating before your stomach is full.0 -
AngryViking1970 wrote: »I had RNY is July of 2014, and I most definitely do not eat 300 calories a day; more like 1000. And that's because I'm still losing (6 lbs to go to goal!). I haven't had any complications and haven't come across any types of foods that I'm not able to eat. Because of the restriction and malabsorption, I need to be vigilant about what I eat and I track my macros every day to make sure I'm getting adequate protein and minimal carbs. I also supplement with multiple vitamins daily and have my blood work done every three months to check my levels. It's a trade off and I'd rather do this than live the life I wasn't living at 300+ lbs.
I know the issue of bariatric surgery can be polarizing, but for me it was right. You need to educate yourself and make the decision that's right for you.
What I don't understand is what happens once the patient reaches his/her goal weight. The patient still has the band or sleeve or bypass, so wouldn't intake continue to be forcibly restricted below maintenance, so they would continue to lose? After all, 1000 calories a day is below maintenance for the vast majority of adults at a healthy weight. Do the patients have the surgery reversed after hitting goal weight? Or do they switch to more frequent meals with more calorie-dense foods so they can maintain a health weight?0 -
lynn_glenmont wrote: »What I don't understand is what happens once the patient reaches his/her goal weight. The patient still has the band or sleeve or bypass, so wouldn't intake continue to be forcibly restricted below maintenance, so they would continue to lose? After all, 1000 calories a day is below maintenance for the vast majority of adults at a healthy weight. Do the patients have the surgery reversed after hitting goal weight? Or do they switch to more frequent meals with more calorie-dense foods so they can maintain a health weight?
The band can be removed, but the RNY or VSG surgery can't be reversed. It's permanent. More calorie-dense foods are added to increase calories to maintenance. My dietitian began having me do this (calorie cycling) one day every couple of weeks around 9mo out from surgery to learn what foods I could add in what quantities and how would they affect me. After surgery, all foods affect me differently than they did before. It also helps in slowing weight loss when someone is closer to their goal weight, as well as bring those of us that were VVLC back up to a livable calorie allotment while maintaining weight loss.0 -
lynn_glenmont wrote: »What I don't understand is what happens once the patient reaches his/her goal weight. The patient still has the band or sleeve or bypass, so wouldn't intake continue to be forcibly restricted below maintenance, so they would continue to lose? After all, 1000 calories a day is below maintenance for the vast majority of adults at a healthy weight. Do the patients have the surgery reversed after hitting goal weight? Or do they switch to more frequent meals with more calorie-dense foods so they can maintain a health weight?
The band can be removed, but the RNY or VSG surgery can't be reversed. It's permanent. More calorie-dense foods are added to increase calories to maintenance. My dietitian began having me do this (calorie cycling) one day every couple of weeks around 9mo out from surgery to learn what foods I could add in what quantities and how would they affect me. After surgery, all foods affect me differently than they did before. It also helps in slowing weight loss when someone is closer to their goal weight, as well as bring those of us that were VVLC back up to a livable calorie allotment while maintaining weight loss.
Thanks for explaining.0 -
VLCD, by surgery or not, isn't the only option. Keep going to the classes and meetings, but as long as you can keep losing by simply limiting your own intake, there's not much point in getting surgery.0
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lynn_glenmont wrote: »AngryViking1970 wrote: »I had RNY is July of 2014, and I most definitely do not eat 300 calories a day; more like 1000. And that's because I'm still losing (6 lbs to go to goal!). I haven't had any complications and haven't come across any types of foods that I'm not able to eat. Because of the restriction and malabsorption, I need to be vigilant about what I eat and I track my macros every day to make sure I'm getting adequate protein and minimal carbs. I also supplement with multiple vitamins daily and have my blood work done every three months to check my levels. It's a trade off and I'd rather do this than live the life I wasn't living at 300+ lbs.
I know the issue of bariatric surgery can be polarizing, but for me it was right. You need to educate yourself and make the decision that's right for you.
What I don't understand is what happens once the patient reaches his/her goal weight. The patient still has the band or sleeve or bypass, so wouldn't intake continue to be forcibly restricted below maintenance, so they would continue to lose? After all, 1000 calories a day is below maintenance for the vast majority of adults at a healthy weight. Do the patients have the surgery reversed after hitting goal weight? Or do they switch to more frequent meals with more calorie-dense foods so they can maintain a health weight?
I'm not there yet, but I would think more frequent and/or calorie dense meals would be added so a maintenance intake is reached. Reversals are not typical, and only done if the patient has major complications.0 -
annacsophia wrote: »beemerphile1 wrote: »CarboUnload wrote: »I understand the risks and wouldn't do it without supervision.
The question is, what is the difference between having the surgery to restrict calories...and just restricting calories?
What is the benefit of the surgery if you're able to restrict and supplement without it?
The difference? Willpower.
With surgery the capacity of your stomach is reduced. Without surgery you need the willpower and determination to stop eating before your stomach is full.
You need that after as well. There are plenty of people that eat around their surgery. Weight loss surgery does not mean one is weak or does not have willpower, it is used as a tool.
Yes, you could eat around your surgery, or drink around it if what I hear is correct. But that would require a conscious effort to do so. The feeling of being overfull is often unpleasant enough to discourage people from eating more. If you are overweight now and tend to stop when you're overfull, there isn't any reason to believe you would change that behavior after surgery.
At the moment, bariatric surgery is the most effective and sustainable method of weight loss we have. It's not for everyone and it doesn't work for all the people who undergo it, but it's the best thing we have at this time. That's not a popular statement around here but it's what the current science of the day tells us.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/0 -
My doctor was gently pushing me to get bariatric surgery. Thankfully, i did not have any medical conditions that made it a life or death situation. I have heard so many horror stories that I was afraid and decided to lose weight without surgery. Of course the process is nowhere as fast as surgery but i am pleased with how I am progressing. I have a ways to go, but my life has been transformed. I can move without hurting. I get up and exercise every day and I eat and I am not starving.
A friend of mine, who is nowhere as large as I was, or am, is going to have the gastric sleeve done, but she has serious medical issues. I wish her the best. I feel as long as you are truly educated, whatever choice you make is yours to make. Good luck.1 -
I have heard of two differences between surgery+calorie restriction vs. calorie restriction alone:
-surgery reduces ghrelin level, ghrelin secretion stimulates appetite so the immediate drop in ghrelin could make it easier to comply with the restricted calorie diet
-surgery can have an positive impact on type 2 diabetes very quickly, i.e. before significant weight loss0
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