It is just a tool

KarlaYP

In the Pre Op phase they tell us, many times, that our surgery is only a tool for weight loss. Then they teach us what we need to eat during the post op period at each stage of healing. Which is great! But, what I don’t think they stress to us enough is the fact that we will have to still diet forever to maintain the weight loss.

What I wish they would stress to people the most is if you return to eating the same foods as you always have that you will regain the weight! I don’t recall ever hearing anything like that during my pre op teaching, but I would think that would be the most important thing we would need to hear! That if you don’t change what you eat you won’t keep the weight off!

Sure, the first year and a half is wonderful! It’s so easy to lose the weight!! Effortless in a way which makes it depressing when it stops and begins to go the other way all because we didn’t learn new eating habits during the honeymoon phase. Then we want to think our surgery has failed, but it wasn’t the surgery that failed.

I watched my mother, and sister, regain all of their weight because they never changed their choice of foods! So, when I went into my surgery I knew I would have to change things or I would be in the same boat. I didn’t want to be in their boat!

So I learned what works for me and have been able to maintain my weight loss (within 10 pounds of my original goal) for almost three years now. I am primarily ketogenic in my way of eating. I won’t claim to be perfect with it, but I’ve been at it for so long now it’s my way of life. I won’t ever eat any other way because if I do I will regain.

I hope this can help anyone who is on the journey of with pre or post op weight loss surgery! The surgery doesn’t take away the need to ever diet again!! Hugs everybody!

HLaR79

The program I went to does stress that you have to change things for , but that you will find a new normal not be on a forever diet. They continue to follow up with you as you go along, we have access to nurses, dietician, kinesiology and psychologist when needed, of course I’m only 6 months out so I don’t know.

my surgeon told me that one of the worst things people could do is stop logging. He suggested logging for one random week every two months at minimum after your first year (or more).

KarlaYP

So glad to hear that! Maybe some doctors are getting it! Mine does have the dietitians and the yearly follow ups with lab work but they don’t ask me what I eat or if I keep a diary. I guess I’m not necessarily a “challenge “ for them since I’ve made my own success at maintaining. It would have been nice for them to have stressed it more in the pre op phase.

I have a niece who had the sleeve done about a year and a half ago. She’s already beginning to regain her weight, but won’t talk to me about it for nothing and I don’t bring it up. It has to be her.

I can remember coming to the realization that I was going to have to change what I ate for life and that the surgery wasn’t going to fix me forever. I realized I’d gone into it with blinders on thinking it would be the fix for me. I’m so glad I had a chance to figure it out before I regained it all!

time2change1111

I totally agree that it is very important to changes your habits. This was drilled into my team from day 1.

I’m 18 months out from surgery and still believe getting my sleeve was the best decision of my life.

NicoleL874

Eh. They told us, but they didn't teach us.

@KarlaYP like your program we got detailed, step by step instructions for the first 8 weeks after surgery. My plan is lacking seriously in the nutrition department. Once I got to regular foods, I begged and pleaded for numbers for fat and carbs. They continuously told me to focus on protein and I'd be fine. Well, no. I wasn't. My loss stopped and slowed to the point my surgeon used the term, "statistical failure". I got my own butt in gear and researched myself. I found a company to figure out my macros. I paid them for what I felt I was paying my nutritionist for, and rectified my situation. I ended up losing 165lbs. My surgeon's goal for me was losing 112lbs.

Their lack of assistance, and me finding out what worked for me made me feel I didn't need them. I did. I thought "I got this." I didn't. I've gained about 30lbs back, but have lost 16 of those.

This is the point in my journey that I'm doing a lot of nutritional research on my own. I'm researching a variety of plans, to get a variety of perspectives. Right now, I'm doing a modified keto plan for bariatric patients. I'm trying to find something to get me to goal, that I can sustain long-term.

I do believe the issue is the minimum requirements held by insurance companies to call a program a "Center for Excellence". I see so many people on Facebook tout that their program is a "Center for Excellence". It is unimpressive. It just means they meet minimum requirements. My program lost that title because they switched locations within the hospital campuses. It took less than 2 months to get it back.

I believe there is a lot lacking in the overall program as a country. The surgery itself is a tool. One tool. It doesn't cure obesity. Obesity is just another bit of mental health. I truly believe in that first year after surgery there should be a therapy part. Whether one on one, or in group settings, I don't see how anyone would do anything but benefit. Maybe have early "graduation" for the people that truly had some type of medical issue that caused the weight.

Either way, my first 18 months were easy peasy, lemon squeezie. My second 18 months were a waste of time, I proved I had learned nothing. Now, I'm in a period of really focusing on my nutrition for me.

loveshoe

I'm one of only a handful of people that attend the monthly bariatric meetings held by the office that did my surgery. People tend to show up for the minimum number of meeting requirements prior to surgery then never again. Are the meetings perfect, no but I try to find one thing that can help me maintain my weight loss.

I believe that losing the weight and keeping it off is like a super large jigsaw puzzle that you have a vague thought of what it's supposed to look like but not the clear picture on the box. Once you have the puzzle together then you have a good idea of what your personal puzzle looks like. All puzzles are not the same, what works for one person may not work for another.

The only thing that works for everyone is to not give up if the weight loss is slow or if you regain some weight. You have to keep trying to figure out that jigsaw puzzle every day. I'm almost 4 years out and my puzzle still isn't quite clear to me and it isn't complete.

HLaR79

It’s amazing how different each surgeons office/program is, what they teach and offer, thank goodness there are groups of people out there like this one, even with all my programs help, I relied a lot on my peers here!! It was so helpful

KarlaYP

@NicoleL874 that’s mine exactly! Nothing beyond the permission to eat solid food and focus on getting protein and that was it! I was originally a sleeve in 2010, and had to convert to bypass because of reflux, that was horrible, in 2015. After losing 110 pounds, but never getting to goal with the sleeve, I saw the bypass as the opportunity to get to goal. I also realized that if I didn’t change what I ate post bypass that the weight would be put back on. I found MFP and the ketogenic diet during the post op period of the bypass. As soon as I was allowed solid foods I went to keto and except for a few times out since then I have maintained that way of eating. Anytime I see any weight coming on I drop the carbs back down and get them back off.

It’s the only time in my life if been able to arrest weight gain and reverse it near effortlessly it seems. Because I’m not able to do any more exercise than walking and that’s still limited because of four bulging discs in my neck. It doesn’t like the repetitive pounding of the steps. So, I’m just not able. Keto helps me with that.

My surgeon just says, “You look good!” Considers me a success. Takes my money and sends me out the door. If he didn’t order my lab work I wouldn’t even go anymore because I don’t feel like he does anything for me. He had me on the wrong doses of PPI and Zantac and it took my new GI doctor to get me straight on that. He told me I had to take both of them, twice a day, due to the malabsorption. So, I did and I was still getting ulcers (one was even perforated!). The new GI doctor explained that they cancel each other out when you take them together and for me to take one in the more I get and the other at night. My stomach has been feeling better since a few weeks after changing it! So, no, I could do without him if I didn’t need him to order my lab work!

No two surgeons are the same, and it’s a shame! Because mine is a “Center of Excellence” too. Also, I went to the support group meetings for about a year post op and it’s all for pre op and newly post op folks. Once you get past a certain point there’s no new information there for you. I was disappointed because I was hoping for support. I’m still looking for it.

Thanks for the responses! I was hoping to see that I wasnt alone in my thinking!

NicoleL874

Let me make one thing clear. I ABSOLUTELY, UNEQUIVOCALLY LOVE my surgeon. He is a great man. He has a soul-deep passion for helping people become healthy. He has little control over his staff, beyond his RNs and other surgeons. I've always had an issue with the nutritionists and have told him so. He shakes his head, makes notes, and truly looks sad.

I have stopped seeing him at his WLS office. There's no reason. My PCP knows what additional labs they want done. They are all a part of the same hospital, so she does the labs with my annual.

My surgeon and his wife (my therapist, lol) run a weight-loss center of their own, privately. If I need help, I pay out of pocket to see him there. Sick and sad, but true. I'd rather go pay him directly and know that I have all his attention. Or, see one of his girls, or go pick up vitamins or whatnot.

I'm still an active part of our support group. Now that the RNs have retired and work at our surgeon's office, the nutritionists have taken over and I don't think they are all that thrilled with me. I don't care. We have two meetings a month, one Monday night and one Saturday morning. The hospital is an hour from me and due to my schedule, I cannot make the Monday nights. I try to make the Saturdays every month. The meetings are one hour. When the nutritionists leave, we all move to the hospital cafeteria and stay for HOURS. I have a Facebook group, separate from the hospital's, and we try to get together at least monthly on our own.

I feel staying active with other patients is vital to our success. I had a "I got this" mindset for a short time, and started to fail. While my friends and boyfriend can sympathize with my struggles, only other patients can get it. Only other patients get why nearly every aspect of life ties back to surgery.

KarlaYP

I feel my surgeon has his patients best interests at heart too! I actually have no doubt about that, because it’s his life. He’s from my home town and he wants to help people here. I just think he’s so busy that he doesn’t think about what he’s doing sometimes when it comes to telling a patient “You have to take them twice a day because of the malabsorption “. He’s not truly focused on what those two medicines do to each other. He only ever prescribed PPIs, not usually Zantac too. So he’s never had to consider that they were blocking each other from working!

But, in the three minutes he spends with me in follow up at this point, how could he? By the time he walk out of that exam room I’m no longer on his mind.

Don’t get me started on the dietitians who don’t even recommend logging your food after a couple of years! Or the non nurses he chooses to staff his office with!

littlefoot612

The programme here stresses that we must change our choices and lifestyle in order to have the best chance of success with our new tool. We have multiple appointments with a nurse, dietician and social worker to help us make these changes. Inability to make the necessary changes can mean a delay in getting approval for surgery. There's a programme here called Craving Change that's reccomended for us to take.

2 years 4 months post op, down 140lbs, maintaining 25 lbs below surgeon's estimated goal since December 2017.