question about surgery and VLCD

hortensehildegarde

Can someone explain to me the point of weight loss surgery and how it fits with concerns regarding VLCD and/or rapid weight loss?

Isn't the point of the surgeries to allow people to eat a VLCD?

If you could just eat the VLCD, would you have the same results even though you didn't have the surgery?

Why do doctors allow people to do these surgeries if VLCD are so dangerous and will "break" your metabolism? Isn't it just setting the person up to make it even harder for them to keep the weight off?

I guess I am wondering if eating below 1200/losing more than 2 lb per week/etc is so bad why is there a procedure designed to allow people to do just that?

Perhaps I am just not understanding the purpose of the surgeries? Not considering it or anything I just had a friend who went through it and I guess I am just trying to learn more without asking her stupid questions.

MoreBean13

VLCDs are used by doctors in extreme cases where the person's weight is causing immediate, usually life threatening complications. They have to get the weight off fast, or they're at risk of dying, or organ failure, or stroke, or heart attack- whatever it is. In these cases getting the weight off is more important than the metabolism consequences of the VLCD.

The people put on the protocol are followed very closely by their doctors including exams and bloodwork, etc, and nutrition within the VLCD is strictly controlled- often in the form of pre-made shakes that are formulated to give the exact nutrition that person needs to sustain life and lose the weight as fast as possible.

hortensehildegarde

ahhh that makes sense. I knew my friend said it was going to fix a lot of health problems but I guess I didn't realize exactly how sick she was (she wasn't even 300 lbs so while very overweight, it's not like it was so abnormally high).

So is the surgery then just to enable the person to stick to the diet? It seemed like such an extreme measure but she is doing great and is already a lot healthier so that's been good to see.

thank you for explaining!

MoreBean13

ahhh that makes sense. I knew my friend said it was going to fix a lot of health problems but I guess I didn't realize exactly how sick she was (she wasn't even 300 lbs so while very overweight, it's not like it was so abnormally high).

So is the surgery then just to enable the person to stick to the diet? It seemed like such an extreme measure but she is doing great and is already a lot healthier so that's been good to see.

thank you for explaining!

I honestly don't know enough about the surgeries to comment. Hopefully someone else who understands that piece will come to answer that part of your question.

gigglesinthesun

there was a guy in the UK who ate nothing for a year, was supervised by a medical team, received vitamins and yeast a few times and at the end lost all his weight and only gained 15lbs back when he stopped (he was quite obese). Is it recommendable? Of course not, but for him it worked and so the newspaper wrote about him. The thing is the newspapers don't write about the fat people who eat very little and die of a heart attack, because it was too much for them and they were not under medical supervision.

EvgeniZyntx

ahhh that makes sense. I knew my friend said it was going to fix a lot of health problems but I guess I didn't realize exactly how sick she was (she wasn't even 300 lbs so while very overweight, it's not like it was so abnormally high).

So is the surgery then just to enable the person to stick to the diet? It seemed like such an extreme measure but she is doing great and is already a lot healthier so that's been good to see.

thank you for explaining!

Surgeries either reduce the amount one can physically eat in one sitting or reduce absorption during digestion or both. It creates a situation were either one is forced to eat less at a time or the food eaten delivers less nutrients. There are a lot of different types of surgeries. Some surgeries are both food restrictive and create malabsorption like gastric bypass surgery.

The surgery does not *just* allow someone to stick to low cals. Without a change in behavior it is totally possible to gain weight even after surgery.

Success, side-effects and focus are really very different depending on the type of surgery elected.

SezxyStef

I've recently seen the effects of weight loss surgery....

It's not pretty.

There is a woman I know who is sickly looking, guant, pale and all around just not healthy looking.

She can't eat very much at one sitting....and is losing weight very very quickly.

You couldn't pay me to do it if that is what happens.

I am sure she is being supervised by her doctor and she has been obese her entire life as is most of her family but to be frank...she could have lost the weight on her own...her sister did...

elyelyse

It's also worth mentioning that very often, those patients, even under medical supervision, experience major side effects as a result of the VLCD. Vitamin deficiencies, problems digesting certain types of foods, thinning hair and brittle nails, fatigue, loss of muscle, loose skin, etc. A doctor may feel those issues are worth it, if the danger of being so overweight for that patient has reached a critical level...but for the general public, it's not a healthy idea.

ball_FXDWG

ahhh that makes sense. I knew my friend said it was going to fix a lot of health problems but I guess I didn't realize exactly how sick she was (she wasn't even 300 lbs so while very overweight, it's not like it was so abnormally high).

So is the surgery then just to enable the person to stick to the diet? It seemed like such an extreme measure but she is doing great and is already a lot healthier so that's been good to see.

thank you for explaining!

I don't understand fully why/how so many people seem to be getting different variations of surgeries who are not even extremely overweight. Times have really changed. Now it seems about as difficult a procedure to have done as getting your teeth whitened. I would 100% not recommend it unless it was a last resort.

3laine75

VLCD are not as dangerous for people who have that much fat (and lean mass) to fall back on.

Make sure your friend has done her research though - the excess skin people are left with, not to mention some of the complications people have had would seriously put off most people.

yarwell

there was a guy in the UK who ate nothing for a year, was supervised by a medical team, received vitamins and yeast a few times and at the end lost all his weight and only gained 15lbs back when he stopped (he was quite obese). Is it recommendable? Of course not, but for him it worked and so the newspaper wrote about him.

That was actually a paper published in a peer reviewed journal, not a "newspaper".

At the time (1960s) fasting was the method of choice for severely obese patients, VLCDs have superseded that as they are lower risk due to having enough protein to minimise muscle loss.

castlerobber

The surgery does not *just* allow someone to stick to low cals. Without a change in behavior it is totally possible to gain weight even after surgery.

An acquaintance from my church had bypass surgery 30 years ago. It worked--for a while--but she out-ate the bypass and regained all the weight. About 11 or 12 years ago, when her youngest child was 5, she decided to have surgery again. Several surgeons flatly turned her down, calling it too dangerous. She finally found one 150 miles away who had done other revision surgeries, albeit with less than optimal results.

My acquaintance had severe complications and nearly died. She spent a month in the hospital before she was well enough to come home. She had another related surgery or two once she got home, dealing with leakage of stomach contents into the abdominal cavity. It took six months or more for her to recover.

She lost the weight, and it's stayed off. I see her in the fellowship hall on Wednesday nights, eating her usual small salad and bowl of soup. She looks 10 years older than she is, haggard, gaunt, worn out.

I've never asked her if it was worth it.

gigglesinthesun

there was a guy in the UK who ate nothing for a year, was supervised by a medical team, received vitamins and yeast a few times and at the end lost all his weight and only gained 15lbs back when he stopped (he was quite obese). Is it recommendable? Of course not, but for him it worked and so the newspaper wrote about him.

That was actually a paper published in a peer reviewed journal, not a "newspaper".

At the time (1960s) fasting was the method of choice for severely obese patients, VLCDs have superseded that as they are lower risk due to having enough protein to minimise muscle loss.

In my defence it was in the newspaper here recently, so I just assumed it was something that happened recently and that the newspaper reported it in it lifestyle section for that reason. Clearly I don't look through peer reviewed journals in my spare time

My point was that if someone at home would decide that they were going to lose weight by not eating for a year, it is very likely that they would die before they get thin, but it wouldn't get reported. I also didn't want to sound as if I supported such aggressive strategies. Ultimately for people who are very obese, their obesity presents a higher risk to their health then vlcds, but it is for their medical professionals to decide what is an acceptable risk and what not.

hortensehildegarde

thanks for all the replies and info. She did say a few things about deciding between the different options and now I understand more about why she choose what she did. And also that I should be VERY supportive of her sticking closely to Dr's orders for the limited food she can eat right now! This stuff is some serious business!

kikkipoo

I had gastric bypass surgery 10 years ago, so if I may defend it and answer some questions from the perspective of experience. Like a poster above said, this surgery was designed to both restrict the amount I could eat and reduce the amount my body absorbs from what I do actually eat. I have seen time and time again where people do actually gain a ton of weight back, or in reverse get so sickly and malnourished. What I will say about either one of those types of people is that they ARE NOT following their dr reccomndations about protein, macros, supplements, water, exercise, etc. We are given the tools and the education to do this correctly before and after surgery, but we are also talking about people who have dealt with years and years of severe food issues that are far deeper than hunger. It's a mind game. You're either mentally strong enough to stick with it and do what is instructed, or you're not. A lot of people are not, and they are the examples that are always being thrown in my face.

To answer the original question, yes, you are on a vlcd with weight loss surgery. Not just in the beginning, but forever. Immediately after surgery, you are lucky to eat 300 calories a day and all through liquid and soft foods. The incision has to heal. People who try to force down a steak or a eat a candy bar face the risk of causing damage to their new "pouch" and even get a leak as described above.
From about 3-6 months you are eating closer to 600-800 calories a day and can begin to tolerate a lot more things. 6 months and beyond we are still instructed to stay at 800-1000 calories a day, I'm assuming in part because of a poor metabolism. I'm able to eat much more than that now at 10 years post op, but much above 1200 and I will gain.

Lastly, yeah the excess skin is not fun. Period. I did have skin removal surgery and breast augmentation, because let's face it. Your body will never recover after a 150+ weight loss, no matter how you do it.

Iknowsaur

Weight loss surgery is a tool that allows people to feel fuller with less food, and produces severe discomfort from eating beyond fullness. It is very much possible to have weight loss surgery and, after an initial period, gain the weight back. The stomach can stretch out again from either the sleeve or the bypass. People who have the surgery eat around 1,200 calories. The point is that those calories, because it is a low calorie diet, need to be packed with protein and nutrition, especially because a side effect of the surgeries are that vitamins are not absorbed as well (more so with the bypass.) It is a huge, life-long commitment, especially because you need to take vitamins every day and frequently get b-12 shots, plus yearly doctor visits.

Source - am having a sleeve done in May, and have been talking with my surgeon/team quite a bit :P