VSG: regrets anyone?

The only reason I didn't try surgery... was because I was too chicken.
And I'm glad I was a chicken approximately 7 years and 125lb ago

We often truly believe we have tried everything to lose weight. Diet, exercise, keto, fasting. We lose we regain, right? I definitely sincerely believed that I was not an emotional overeater. (Turns out that when I am frustrated, angry or tired, I overeat and I sure as heck don't reach out for carrot sticks when I do so... is that emotional?). That I didn't eat excessively. (Turns out that I ate at all you can eat restaurants several times a week. Sometimes twice on the same day). That I didn't believe in myths (except that I would add oodles of olive oil to my salad because olive oil is healthy while commercial dressings are not! And let's not tackle the part where I drank full sugar pop from 2L bottles because artificially sweetened pop was unhealthy )

I have an outsider / lay person's perspective to this. NOT SCIENCE BASED because I don't think anyone has done any serious studies along the lines of what I'm thinking. And because most studies are conducted from a pro-intervention perspective given the low overall success rates of non intervention dieting (but are surgical intervention results SUFFICIENTLY better to justify the risks and personal/health costs? are the initial samples that are being considered similar? and the interventions equivalent subject only to the addition/subtraction of the surgery? Not so sure) Still, let's call the following UFO theories!

We lose weight fast or for a long time period or a combination of the two. Our hormones (especially leptin and ghrelin) get out of whack. We are very susceptible to regain at the time period of early maintenance. (I am aware that VSG studies show ghrelin fall with surgery and that this may contribute to early maintenance success)

--non surgery dieter: you're on your own. unprepared for rebound hunger. little or no plan and no access to counselling on how to cope. perhaps little or less clear understanding as to how and why you've succeeded in losing weight so far and how you can adjust to your changing circumstances. No fall back positions or newly cultivated habits to fight against regain and less vigilant while you're floating on the laurels of your success so far.

--surgical dieter: dealing with the complications and discomforts of the surgery. having to deal with the aftermath and medical protocols and follow ups to the surgery. In dealing with all this committed to following protocols or having to work around physical limitations that have been imposed upon you and paying the price of discomfort when you don't.

In both cases time passes and the maintenance of a lower weight (if successful) slowly allows you to find a new balance at that lower weight. hormonal upheaval diminishes and you stabilize at a new level of activity and intake either proceeding to stabilize or (for many people given the easy availability of food) slowly regain but in a potentially more easy to control fashion when mindful.

Which of the two situations has more impediments to regain? The dieter who is floating on cloud 9 because of their earlier success or the person in pain who is working around limitations?

So, ultimately, the surgical dieter has a higher probability of getting through the one or two years that it will take for hormones to stabilize and for a new normal reinforced by habits to develop.

OR, you could try to develop these habits and prepare yourself ahead of time without having to rely on pain and physical limitations.

REMEMBER all the above is JUST A THEORY. NO PROOF. WHATSOEVER.

The following is NOT a theory:

If you (ANY YOU), a currently obese person, start pushing towards eating like your future normal weight self who is equally active (or inactive) as you are currently and pushing towards incrementally changing your movement and activity level (assuming they are not already high) .... you WILL lose energy reserves (fat).

Because by virtue of being larger you currently have higher energy needs than your future normal weight self will. For MOST people doing so will result in the loss of 0.25% to 1% of body weight a week over a period of months depending on your current weight and activity levels. This is usually tolerated pretty well and produces meaningful results especially when starting from morbidly obese levels.

When you get to the four to six month mark you may start having to re-evaluate and see whether you should be varying your intake to slow down or speed up your weight loss and/or to deal with your (presumably increased by then) activity levels.

From what I've heard, most surgical programs require an extreme reduction in calories "intake" diet phase that you have to successfully complete before they will operate on you.

I would take that time period and run with it... only instead of having the surgery after a few months, I would continue to tweak that diet to a more sustainable and more "my normal future self will be able to eat this way" method, by discontinuing the extreme deficits that these diets seem to promote (and which makes them difficult/impossible to sustain) and replacing them with sustainable deficit levels that you can continue with for the duration of a good two or three years you will probably need to spend losing weight and/or tweeking your weight assuming a start from BMI 35+ levels.

Either way, between loss, early maintenance, and maintenance, it will be a good 5+ years that you will be dealing with your weight and health. One path has extra pain... for me that's a bug, not a feature and, as mentioned, I'm a bit of a chicken!

To return to the OP, since I went into a tangent enjoying the air-conditioned office... I don't regret NOT doing the surgery when I had the option to do so for free seven years ago!

(the comment by @jdbly3373 below also, in my opinion, supports what I'm saying--that surgery may or may not always actually be the last resort people often perceive/believe it to be: root cause analysis would suggest that counselling re: issues that may have led to weight gain and which may encourage its continuation could be of greater/equal benefit to surgery. I am personally convinced that this is true in many cases of obesity)

I regret it, I think it was a waste of 30k. I don't have any restriction on the amount I can eat. I get hypoglycemic on a regular basis. Im not diabetic, Its from the surgery.
I've lost 105 pounds, tracking macros and learning how to eat.

Feel free to message me and Im happy to chat more about what I went through.

In 2012 my sister had a VSG - at the time her BMI was 44, mine was 41. Her surgery led me to re-evaluate my own health, and I started to eat more healthily and exercise more. My sister had access to her full bariatric team, which included her surgeon, a psychiatrist, a psychologist, a CBT therapist, a dietician, and a physical therapist. She was given (and still has) free gym membership. I was on my own. Within 18 months we had each reached a BMI of 25.

Floating on the laurels of my success as described above by @PAV8888 I failed to plan for how I would maintain my lower weight. I assumed the 18 months of successful weight loss had prepared me mentally, emotionally and physically for continued success as a maintainer. I was wrong. The weight crept back on, until I found myself in March 2021 back almost to my starting point (BMI 39.8).

My sister continued to have access to her full healthcare team once she reached maintenance. She was provided with amazing support. Despite this, she's had 9 years of health issues, mainly due to her inability to control her emotional eating. Her stomach is smaller than before her surgery, but she eats through her physical pain. She will be in agony, but still compelled to eat. She can (and does) still eat hundreds of excess calories from low-volume-calorie-dense foods such as gelato, chocolate, sweets and fried foods. In the meantime, the side-effects of her surgery (gallstones, acid reflux, nausea, poor nutrient absorption) make her feel drained and unable to exercise. Her BMI is now 47 (3 points higher than when she had the surgery).

The surgery wasn't a magic bullet. None of the issues that caused her emotional eating were resolved despite hours of counselling. She's obese, despite having to take dietary supplements because she's not getting enough nutrition. She is utterly miserable, feels hopeless about her prospects of losing weight, and is now almost housebound due to her poor health.

I accept that bariatric surgery is a life-saver for some super-morbidly obese people, but IMHO it should be an absolute last resort, once all other non-surgical avenues have been exhausted.

Since March, we've been supporting each other to live healthier lifestyles. My sister is trying her best but she's profoundly burdened by pain, emotional baggage and poor health. Her route to success is beset with obstacles. The challenges I face feel insignificant in comparison.

I only know two people who have had it done. Because they didn't resolve their emotional issues they put everything straight back on and more. Now they are even more down on themselves than they were prior to surgery. My personal opinion is that it is an awful lot of trauma to go through and I would rather just use MFP and be patient.