Why gastric bypass if calorie deficit works?

I think the bottom line is that there's a limit to willpower - which is why the person is in that position in the first place. You might do ok for 6 months and lose 50 pounds then when there's a slow down in weight loss, lose your momentum and quit trying and go back to old habits and gain 60. Gastric Bypass and other weight loss surgeries force a lifestyle change for an extended period of time - at least a year - and when it gets tough, they can't just fall back on old habits (well, some can - you've seen those that gain the weight back, or even don't lose weight at all - I'm not sure how that even happens). You do have a good point, but weight loss requires the lifestyle change that some just don't have the mental ability to enforce on themselves

My understanding of it is that the surgery is a life saving effort to get the weight off fast because the person wouldn't likely live long enough to lose it more slowly (via calorie deficit). I don't know if this is entirely true, but it makes the most sense because given that situation, if calorie deficit were an option, I would much rather not have a hugely invasive surgery. Then again, I'm often surprised by what people choose if they think it will take weight off quickly.

From a friend of mine who had it: it forces behavior change. She admitted she didn't have the will to go it alone, so she had the surgery, and when she fell off the wagon and overrate or ate too much sugar her body responded viciously. She said it re taught her how to view food. She stuck with it and by the time I met her I took her for plump and fit. She was nearing 450lbs 20yrs earlier.

Other than that I dunno. A dr suggested the surgery to me once and I got angry at him so I don't think it's for me!

There's a limit to how much one can help themselves. A friend had it and lost over 100lbs in a year. It wasn't a life saving thing insofar she had to have it or die, but she had issue with hunger, and couldn't control it due to physical symptoms. Sometimes its really hard to maintain a deficit when you're hungry all the time. I've considered it only because of comorbid issues of hypothyroidism, it would be easier to lose on 500 cals because my metabolism is so damn slow.

I've known two people who went through the surgery.

One went through months of evaluation leading up to clearance to go through it. He was significantly obese (Class III), and was a hospital admin, so he had a full suite of resources available to him for diet management before and after. He's had a very good outcome and is maintaining in a normal to moderately overweight range.

A former coworker of mine also did it. She spent years going from fad diet to fad diet with very little result. She made no secret that she doctor shopped to find one willing to do the surgery on the schedule she wanted. After she had the surgery, she did lose weight, but her compliance was very poor. The last time I saw her she had suffered several complications that resulted from how she ate after the surgery, and had put a big portion of the weight back.

For certain people, the surgery is a valid if drastic tool to make a change and enforce it. Just like any medical intervention, it works best when the doctors are actively managing the patient's case and there are resources available to support the aftercare. When it's used as a quick fix it's very dangerous.

daniwilford wrote: »

I do not think they do the surgery unless getting the excess weight off quickly is medically necessary. The person has to have tried several diets and failed. Many can get 50 lbs off but can not sustain eating at a deficit long enough to reach a healthier weight. I have a friend that had surgery 18 months ago, her loss has slowed way down. My total weight loss is quickly approaching hers. I started four months ago. She has had tons of issues. It is misleading to say it is easier or even quicker than the traditional approach for most people. Given our two experiences, I would take mine over hers any day.

It's easier than you think to have the surgery recommended. I was told that I qualified for it if I wanted to look into it. I didn't have any additional risk factors aside from my weight, and it was long before I reached my heaviest weight of 250 (bmi 44). It just made zero sense to me. I wasn't ill or dying or anything. Everything I've read about it and learned from friends and family members who had it done convinced that it was the worst thing I could do for myself. Just the drawings of how they mangle your insides were terrifying.

It's definitely not easier than counting calories (counting calories doesn't make you puke up blood in the restaurant parking lot or need transfusions because of malabsorption or wind up with a hernia from coughing), and if you don't learn to control your intake, the surgery won't have lasting results. It's just another means to the same outcome, except with lots of punishment for being naughty. It really ticks me off when people call it "the easy way out," and I haven't even had the procedure.

Several years ago, I lost about 75 pounds over the course of 12 months (475-400.2...never broke that stupid 400 pound mark). It was the first time I had any success at losing weight, and I was ecstatic. Then I hit a small bump in the road, I lost my ability to keep up with that work, and the weight piled back on. I managed to stop the gain about 10-15 pounds below my original high weight, but it was still pretty devastating. Over the next few years, I worked and worked at the weight loss, but I never had the success I did that one time. I eventually "settled" at a weight that fluctuated between 440-450.

I moved to a new state, redoubled my efforts and shaved off another 20 pounds or so, but again couldn't seem to break through lower than 425. That's when I started the process toward bariatric surgery. My insurance required a 6-month supervised weight loss program prior to approving surgery. During that 6 months, we met with dieticians, physical therapists, psychologist, and medical (PA or NP), and they not only assessed each patient and provided advice, but also emphasized a lot of what surgery can and can't do. During that 6 month period, I lost about 25 pounds by putting into practice as much of their advice as possible.

Then I had my surgery. I went for the Sleeve Gastrectomy rather than the R-n-Y bypass, based on surgical risks, my health history, etc. It's been 3 months since I had the surgery, and I've lost 50+ pounds over that time. (I have also drastically cut the amounts of diabetes and BP meds that I take...improved health is as big an outcome for me as the weight loss itself.)

The surgery really doesn't make you lose weight. (A friend who went through the same procedure with the same doctor lost a bit, but then immediately re-gained. One of the big differences is that he paid out-of-pocket (different insurance that didn't cover any bariatric surgery), so he didn't have to go through that 6-month process of learning.) It is a tool that helps you implement the other methods of losing weight.

First, I can't physically eat as much food as I could before (this is especially true as my surgeon informed me that my stomach was about 50% bigger than the average, a wonderful genetic precondition that was screwing me over). This has very obvious benefits for weight loss. Second, and I think much more important for me, it has almost entirely destroyed my ability to feel hunger. I just am not hungry anymore (to the point that I have to remind myself to eat at regular intervals), which was one of my big downfalls with earlier attempts. Third, these surgeries can help ameliorate some diseases (like diabetes) that impact the ability to lose weight (though this seems to work better/faster for bypass than the sleeve).

For me the decision boiled down to the fact that I've failed at losing weight so many times before that it was almost pointless to try to continue with the traditional methods alone. Bariatric surgery offered me a new tool to add to these efforts and it's working wonderfully.

It's definitely not for those who need to lose a few pounds to get to some arbitrarily defined ideal weight. But it's also not just for the "My 600 Pound Life" set either.

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I'm not slamming people who have the surgery. I'm sure they did what was right for them. I never ask people why, if they were able to lose weight before the surgery, why didn't they just keep going on their own? The only reason I don't ask online is because it might come off like, "You're lazy and should've lost it on your own," which is not what I think. I just don't get it. If you can lose without it, why go through all that, KWIM?

But that's just curiosity on my part and really none of my business.

Everyone does their best.

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?