Help me understand-Lap band/gastric bypass

mayamagallanes

So people who get lap bad/gastric bypass cut down the amount of food they intake drastically. So why does the body not go into the dreaded "starvation mode"?

ShannonMpls

What makes you think there aren't significant metabolic changes that come about from WLS?

mayamagallanes

Oh im not sure. I was just wondering if someone could explain it.

pluckabee

The way starvation mode is used on this forum isn't correct.

What people mean when they say 'starvation mode' is often people will stall or plateau while eating quite low calorie, and find that when they increase their intake, they start losing again. This is likely due to the calorie deficit being offset by a lack of energy that comes with low calorie diets.

People who get weight loss surgery are eating much much lower calorie counts than the average dieter (supported by a doctor to make sure they are getting sufficient nutrients) and circumvent the energy offset by an even more agressive calorie deficit.

MsPudding

Lap band and gastric bypasses are massively different procedures. The lap band is simply restricting the size of the stomach pouch whereas the bypass restricts stomach pouch size and replumbs a chunk of the intestine leading to malabsorption of food.

There's not really such a thing as starvation mode if by 'starvation mode', what you mean is that the body stops losing weight altogether. What happens if you restrict calories too much is that your metabolic rate temporarily slows (by up to 30%) to compensate - it becomes more energy efficient in order to survive on the fuel available. You will lose weight because it's physically impossible to eat a large deficit and NOT lose weight (if it weren't, we wouldn't have seen photos of skeletal concentration camp victims).

So with those bariatric procedures the metabolic rate will slow down because intake slows down due to the smaller stomach pouch. However as those procedures are normally done on morbidly obese people who have a lot to lose, they're still going to lose a lot even with a slower metabolic rate. Of course it doesn't stay slow forever - you don't 'destroy' your metabolism for good.

pbrahan

My husband is a surgeon and is pretty much opposed to any sort of gastric surgery for weight loss, for two main reasons: one, there are really no long-term studies showing the success rate or complication rates of these surgeries 20+ years down the road. You can't be sure what the long-term efficacy or risks are, so for that reason, he doesn't support it. Also, without addressing the behavior associated with the overeating, you're not going to be able to maintain the weight loss. All surgery does is make the body less capable of ingesting large amounts of food. You can accomplish this with behavior modification. I say this knowing that's a lot easier said than done, and Lord knows I've looked for every other mechanism other than diet and exercise for my own weight loss, but that's just his educated/scientific opinion on the matter. I have friends and a relative who've been very successful with WLS, and I also have a good friend who had the LapBand with horrible complications. People who have WLS STILL have to diet and exercise to maintain the weight loss, and people commonly gain part or all of their weight back if they don't change their behaviors related to food.