Possible to maintain life-long weight loss after morbid obesity?

FatGirlOnaDate · July 2020

Anyone have any insight about maintaining long-term healthy weight naturally if you were once in the 300+lbs range?

My doctor recommended WLS to me a few years ago and said it was very unlikely someone of my weight could lose/maintain a significant weight loss. I asked him to give me a year. I lost 100+lbs that year, but then regained every bit over the next few years.

He’s now pushing hard for WLS. But in talking to him, he admitted that as much as 50-70% of all WLS participants regain much of their weight within the first 10 years. But he still recommends it as it “prolongs life and delays health complications even if it isn’t a permanent solution.”

Anyone have doctors with similar opinions or have personally gotten down to a healthy weight from 300+lbs and maintained for a long period of time?

KrissDotCom · July 2020

I imagine that if maintaining your loss is hard, there is more needed to be done during your weight loss, such as psychological counseling, to address underlying issues and perhaps learn some new coping skills and behavioral changes.

richardgavel · July 2020

I would surmise that 50-70% of people that do weight loss WITHOUT surgery gain much of their weight back after 10 years too. It's not easy to do. The trick is to figure out habits in the eating and exercise areas that you feel you can maintain for those 10 years. Dieting hard doesn't build stable maintainable habits and my opinion is that those habits are more important than the loss itself.

Hanibanani2020 · July 2020

If you gained all that back then there’s a chance there is an unhealthy relationship with food that also needs to be addressed separately so that you can be successful in long term weightloss. Most people who have this yo-yo weightloss/gain are often dealing with unresolved issues and overeating is a symptom of this. Therapy should definitely be a part of any weightloss journey where the struggle is ongoing. Your doctor’s main concern is your physical health but dealing with your mental health can largely impact your physical health so it’s never a bad thing.

shaumom · July 2020

Okay...this is gonna ramble, but I'll answer this by the end, LOL.

A ketogenic diet is one that seems to be increasingly recommended by doctors to help people who overweight and are prediabetic/slightly insulin resistance.

In the USA, about 1 in 3 people are estimated to be prediabetic, and higher weight is one of the common things that may cause this. It's usually not diagnosed, as there aren't necessarily symptoms that stand out or anything.

The reason I mention this is because insulin resistance will actually alter how your body puts on weight, and the more carbs/sugars that are eaten, the more the body seems to put into fat instead of it being utilized by the cells like it should be (I'm just starting to research this myself). Because of this, a diet with the recommended level of carbs/sugars may potentially lead to weight gain, while a low carb or ketogenic diet may help.

So...I have known a few folks who were prediabetic, and overweight, and medically HAD to keep that weight down, you know? And while it's only been a few years, some who went low carb/keto seem to still be doing all right.

Myself, I might be insulin resistant. When I eat 'normal' levels of carbs, I gain weight. Same calories but eating very low carb, I can keep weight lower. Same exercise, or sometimes even less exercise when I go low carb, too.

I have never seen anything reliable that suggests the keto diet is great for losing weight for everyone. But for folks who were overweight, and did become insulin resistant, it might be worth exploring to see if that or low carb might be able to help you maintain your weight when the weight is lost, maybe.

Wishing you good luck. I know it's so hard, and SO frustrating when the weight starts coming back, but we're rooting for you!

EDIT: this article talks about it for losing weight with Type 2 diabetes, but again, some docs are recommending it BEFORE Type 2 diabetes kicks in, from what I read.
https://www.healthline.com/health/type-2-diabetes-ketogenic-diet https://healthline.com/health/type-2-diabetes-ketogenic-diet

spiriteagle99 · July 2020

It is possible to keep the weight off after major weight loss, but it requires making permanent changes to your way of eating and living. Going back to old habits will result in weight gain, so you have to stick to your new habits as much as possible. From what I've read about the Weight Loss Registry, where people who have lost more than 50 pounds and kept it off do surveys about their habits, most who lose weight continue to be vigilant about what they eat, they weigh themselves often, and they exercise regularly.

Buttermello · July 2020

I lost just under 100lbs 5 years ago and have maintained it, within a 15lbs range, fairly easily.

For me, it was CRITICAL to change how I see food, and to make tracking and exercise a part of my life forever. There is no 'going back to normal and no longer weighing/logging food's because when that happens, my weight creeps back up and I need to lose 10-15lbs again.

I make sure to get on the scale at least 2xs a week and use a weight tracking app to see a trend. It's a lot easier to correct a gain if you notice it within 10ish lbs, than once you hit 50lbs.

I also made exercise a MANDATORY part of my life. Every single day I hit my step goal (15k) and try to do additional exercise at least 4xs a week.

Courtscan2 · July 2020

Certainly it's possible, but once you've lost the weight you can't just go back to eating "normally", as your version of normal, your collective habits and attitudes towards food, will be what made you overweight in the first place. You can relax a little bit once you've lost the weight, but you will likely still need to monitor and track and weigh and measure everything you eat for quite a long time after you have reached your goal weight so that you know what your new "normal" eating looks like, and you have established long term habits that you will be able to maintain. The idea of watching what they eat forever is, I think, often just too overwhelming for people, so they fall back in to old habits as it's easy and comfortable. Forming new habits actually takes a really long time, and consistency is so, so important. It's hard. Possible, yes. Easy, no.

The_Wallflower · July 2020

I was 355lbs. Lost 220lbs. I’ve maintained for 6 years. I had lost 130lbs on my own and then had the sleeve for maintenance. Ended up losing nearly 100 more.

It’s mental this far out. I weigh once a week. I give myself a 10lb curve. If I gain 10 it’s back to basics for me until I lose it again.

Geneveremfp · July 2020

Lots to agree with on here. I think that is worth having a bit of support with mental health to improve your chances of success. I generally believe that everyone could do with a bit of therapy and support sometimes as you never really get taught how to deal with emotions and negative feelings we just bumble along hoping we're getting it right.

I also really noticed the words "naturally" in your post and I'm curious. When you lost the weight did you keep logging and keep an eye on your weight? Did you have a number that if you saw on the scale you'd get on the scales every day to see if it was genuine and then you went into loss mode again? From what I've seen people who have been successful in maintaining have a solid plan. It might be worth planning for maintenance now. Think about what went wrong the first time and really examine your habits and think about where you made choices that led to regain that you can change. Did you stop logging? Did you stop doing exercise? Did you give yourself too many treat days? It'll probably feel horrible but don't judge yourself for those actions. They're done now and as you know lots of people do them. No shame in it just try to formulate a rescue plan based on it.
I know when I regained it happened when I became pregnant so I didn't have the scale check in and so I went to myself well that's fine I don't really need to log and then I avoided the scale and took too long to get back on it because I knew I'd gained and didn't want to handle it. It was when I felt a bit better that I got back on it. I now plan on weighing myself once a week when I'm in maintenance and if I see a set number up weigh three days in a row. If it stays there to go in deficit. I also have an I have stopped logging plan to make myself just log and not worry about hitting any goals. Just log all my food to get myself honest and then I can work on things.

callsitlikeiseeit · July 2020

I weighed 300+. Lost 130 6 years ago. Gained back 30 over last 2 years. Now working on losing that as well as the rest of the weight I needed to. So yes, it can be done but yes, it does take some discipline and permanent lifestyle changes.

bmeadows380 · July 2020

So he admits that 50-70% of people who have WLS gain most of it back, but still thinks you should have it done even if its only temporary?!!! WLS, especially if you have the full bypass, is major surgery and permanently altering to your body! My brother and sister in law both had the full bypass and there will be issues they have will have to deal with for the rest of their lives because of it. My cousin had the sleeve and yes, she's regained a chunk of the weight too.

WLS is life saving for many people, but its a major and permanent change to your body and it should be well thought out and all pros and cons strongly studied out before someone chooses to have it done. There are many people who have no regrets in having done and will tell you it was the best decision they made in their life, but there are also many people who wish they had never considered it and will tell you it was the worst decision they made. I highly encourage everyone to read stories from both sides and carefully consider their own situation before opting to have it done. Explore it with an unbiased view, learn as many facts as you can, talk to people who are 5+ years out from the surgery to get an idea of what it takes to maintain the weight loss - make an informed decision based upon as many facts as you can find and not on the glowing testimonials provided by the clinics to encourage you to pay to have the surgery done.

From my experience watching several people I know who have had it done struggle, my opinion is that WLS patients regain the weight the same way that non-WLS people do - they go back to old eating habits. In WLS, the first year your stomach is healing and you lose the weight because you literally cannot eat or want to eat since hormone levels are also affected. But if you don't learn new habits and a new way of eating that you can sustain long term while your stomach is healing, when your body has healed, you can easily return to the old eating habits because that stomach pouch can be stretched, leading to weight gain.

Personally, I'd rather that WLS be a dead last option and only in a case where I was facing imminent major health issues, especially after watching what my family members went through who had it done. They all have so far kept a portion of the weight off, true, but they never hit goal, don't have the support in place they were promised, and are now finding that to lose what they have regained they either have to go onto a diet or are being pushed to have another WLS surgery.

If you can lose it without WLS, I encourage you to form sustainable habits now. And no matter how you lose the weight, maintenance will require vigilance to keep it off. I'm not to maintenance myself yet, but I've been at this game for 3 years now and am finding that vigilance is the name of the game for me. I cannot judge a portion size and have learned that my biggest enemy is "head" hunger meaning I will never ever be able to just eat "intuitively" by following my body's cues, because my body's cues are messed up, which is what led me to overeating and becoming morbidly obese in the first place. So since I can't trust my body's signalling, I will need to continue to use a food scale and logging to ensure I keep my intake where it needs to be, and I'm okay with that.

Possible to maintain life-long weight loss after morbid obesity?

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