Gastric bypass surgery ... it's not successful?

[morningcoffee]

Someone mentioned on the "Mama June" thread that gastric bypass surgery isn't successful in the long term.

 

Is that true for all weight loss surgery? I had the impression that people who had previously struggled to lose and/or maintain a weight loss did really well after having surgery.  Maybe there's different success rates for different types of weight loss surgery?  :confused1:

 

 

[ktgrok]

Depends on how you define success. Many who have surgery are still overweight, but significantly less so. They generally no longer have diabetes, high blood pressure,e tc. They are no longer morbidly obese. But often they don't end up at a size four, or at least not long term. That does happen, and how big you were when you started, and what surgery you have has an impact, as well as your dedication to diet and exercise. 

 

Also, often people regain about 20 pounds for every 100 they lose, but that still is an 80 pound long term loss, better than pretty much anything else can deliver. 

 

Now, can you "eat around" your surgery? Absolutely. "Slider" foods don't fill you up no matter how small your stomach is, so you can eat say, milkshakes and potato chips all day long even if you have surgery. So you are supposed to eat dense foods, like meat/eggs/etc first when you eat, to fill up and stay full. That does require a mental commitment, but it works. 

 

And yes, there are various outcomes with various surgeries. The Duodenal Switch has the highest weight loss, but the most complications. Gastric Sleeve patients lose a bit less than Gastric Bypass, but less long term complications. etc. Also, how big a person is when they have the surgery has a big impact. 

 

another HUGE factor is where you have your surgery. A good surgery center will provide (and require) psychological evaluations and counseling and nutritional classes BEFORE approving your for surgery. I had to meet with a therapist, make sure I didn't have any eating disorders, that I had a good support system, etc. Then take several classes with a nutritionist, etc. Plus more AFTER surgery. I think in the "old days" that stuff was less likely to happen, and that effected outcomes negatively.

 

Personally, everyone in my online support group of people that had surgery the month I did is a "success". They are not all stick thing (some are). They all are incredibly more healthy, and have lost a huge percentage of body weight. Some have gained back a bit, but within the expected amount. 

 

My own stats...I went from morbidly obese with a BMI of 41 to overweight, with a BMI of 29, and then got pregnant. I'd like to get to a normal BMI, but even at overweight I was so so so so so much healthier than I was when morbidly obese. 

Edited February 27, 2017 by ktgrok

[EndOfOrdinary]

There are various procedures.

 

Most people do extremely well in the first 5 years, then weight starts to return. If you read what the studies call successful, it is often a combined loss of 50% of your body fat. You initially lose 200 lbs, but over ten years gain 100 back. That is an extreme example, but essentially of the five people I know who have had the surgery all have gained over 40% of their weight back. This is a small sample, but if you look at the long range data it appears to be very normal. Most data are only talking in the first 3-4 years, many in the first 1-2, where you see large numbers.

 

As a life threatening obesity procedure, it is wonderful. It depends on your personal viewpoint of "successful." It also depends on how dramatic of a long term medical plan you want. It appears continued therapy and nutritionist check ups for the 10 years has been the most successful.

 

There are quite a few studies. You just need to look specifically at what is considered "successful" and measure it up to your expectations.

[Luckymama]

My sister's surgery was 11 or 12 years ago. During the year after the surgery she lost 50.% of her weight, about 150 pounds. Since that time she has regained only 20-25 pounds---and most was at year 3-5 when our parents died.

[Annie G]

I only know one person IRL who had weight loss surgery.  It was about 15 years ago and she ended up losing more than 150 pounds. She's kept the majority of it off, even after having another child. She's probably 10 pounds heavier than she was 12 years ago when she was done losing weight and after she had the surgery to remove some of the saggy skin.  

 

She still works out- I see her at the gym nearly every day.  I don't know her eating habits, but she looks pretty healthy. 

 

She went to South America to have her surgery - both the bypass and the skin removal. It was cheaper, including a couple of weeks of aftercare while she was recovering.  

 

[Ali in OR]

We have a woman in our church who had surgery maybe 10 years ago now. She was once in ads for the medical group that did the surgery wearing her cycling clothes on her bike. She was never stick thin, but she lost a lot. Her mother also attends our church and is maybe 400 pounds, has to use a motorized scooter, and has significant medical issues. The daughter has gained enough weight back that people who don't know her would think her significantly overweight, but I think with her gene pool she's still way better off and healthier than she would have been without surgery. My guess is that it took a lot of work with diet and exercise to get to where she was at the time of the ad and that was just hard to maintain long term.

[goldberry]

The only person I know did not exercise or eat properly.  As mentioned, she ate ice cream and other things that were easy to get down.  She did not have a good result, but she very much expected the surgery to "do it all" and did not take any responsibility herself.

[Guest]

The only person I know who had this surgery did it to treat diabetes. And it worked. He will probably always be chubby but he is s lot healthier and is 100% off diabetes meds.

[Audrey]

I only know 3 people who have had bariatric surgery -- my brother, a very close friend, and an occasional acquaintance who lives in my area.  My brother's surgery was 2 years ago.  He has lost about 1/3 of his previous weight, but more importantly, he no longer takes meds for diabetes and his high blood pressure, which was once at a level considered "uncontrollable" is now very much under control with a very modest amount of medication.  For him, it has saved him years of life.

 

My very close friend had her surgery about a year and a half ago.  She went through the process that included a great deal of counseling and required one to lose weight on a liquid diet before they would do the surgery.  She followed every protocol faithfully and then had the surgery.  She lost more weight prior to surgery than after surgery.  She is very strict in sticking to the eating guidelines given her, but she's very disappointed in the results.  She has said that she would rather have done the liquid diet for the rest of her life and gotten those results (which she considered better).  She did not have any complications from surgery, but there are definitely aspects of her life that are affected by being unable to eat normally and by the vitamin deficiencies which she has to take supplements to avoid.  Despite supplements, she has lost quite a lot of her hair, which is a devastating thing for her.  My heart hurts for her.  Her self-esteem is far lower than it was prior to surgery. 

 

The acquaintance had her surgery at least 8 and maybe more years ago.  She lost a dramatic amount of weight very quickly when she first did it, but has since gained back most of that.  I do not know if she has any other issues or complications.

 

All in all, from what I've seen and the statistics calling bariatric surgery successful when excess weight is reduced by 50 percent and the weight loss is sustained for five years, I'm very sure that it is not something that I would do myself.  I have always struggled with weight, but I lost over 100 pounds once and kept it all off up until the last year when I had some unrelated health complications arise.  I'm working on taking off the weight I regained, and it's coming along rather slowly, but surely.  

 

If you read up on bariatric surgery testimonials you will find that people are very enthusiastic if they have had the surgery within the past 1-3 years, but if you look at patients who have had the surgery 5 or more years ago, they report quite a bit differently.  Whether it is the best choice for someone is up to them, but if you are considering it for yourself, I would do a lot of research and talk to people who have had their surgeries at least 5 or more years ago to see what the long term results and issues can be. 

[6packofun]

Dh and I know a couple who were morbidly obese and both had the surgery.  They both lost a significant amount of weight and were still overweight for many years.  Over the past few years, the weight has crept back and I'd put them both in the morbidly obese category again although not as bad.  I know 2 others who had the surgery and both eventually gained back more than I'm sure they wanted to.  One had serious health complications of all sorts due to the surgery but none of the others has.

[umsami]

Most successful long term is the duodenal switch.  Least successful would probably be Lap-Band.

 

Weight loss success is usually looked at keeping off 10% of excess weight for over a year.  That's the gold standard for drugs and such.  Most WLS will let people keep off roughly 50% for 5 years.  So, say you are 150 pounds overweight.... let's say you weigh 300....that's a 75 pound loss.  Pretty awesome.  Yet, you are still 225.  Still likely obese.  Are you healthier? Absolutely.  Are you likely skinny? No.

 

I've had two weight loss surgeries....Lap-Band and Sleeve Gastrectomy.  I'm 8-1/2 years out with the Sleeve, and I'm a tough loser.  I ended up losing 75 pounds...and matching my lowest adult weight, but I didn't stay there long.  Gained about 20 pounds...stayed there for a few years...  gained another 10.  Now, today, I'm only down 20 pounds from my surgery.  Gained about 15-20 pounds over the past year due to stress.   I still cannot eat a full sandwich, more than two pieces of pizza, etc.  That's just how messed up my metabolism is....starting dieting at 11/12...given 700 calories from some doctor.... etc.   I'm missing 85% of my stomach, and yet I'm still very overweight.  Most likely, I do need malabsorption via an intestinal bypass (duodenal switch or its variation the SADI)....not sure I will go there.

 

Do I regret it? Nope.  Would i recommend a Lap-Band or Roux-en-Y today....16 years after my first procedure and knowing so many revisions...nope. (I'd recommend a Sleeve, because it's an easy revision if needed, less malaborption/vitamin issues (but not zero...I had D/PTH and B12 issues)....and if somebody had diabetes or a BMI over 44/45 or most of adult life as morbidly obese, then a duodenal swtich.)

Edited February 27, 2017 by umsami

[morningcoffee]

If you read up on bariatric surgery testimonials you will find that people are very enthusiastic if they have had the surgery within the past 1-3 years, but if you look at patients who have had the surgery 5 or more years ago, they report quite a bit differently.  Whether it is the best choice for someone is up to them, but if you are considering it for yourself, I would do a lot of research and talk to people who have had their surgeries at least 5 or more years ago to see what the long term results and issues can be. 

Interesting ... thanks!

[Schadenfreude]

I've known 6 people who have had gastric bypass. All of them gained back all of their weight by 10 years out and one of them is dying slowly from vitamin deficiency. As you get older your body naturally no longer absorbs vitamins efficiently, added with the malabsorption rate of the surgery has left her with little hope. Once she hit 55 she became ill. She takes 30 vitamin pills 3x a day and vitamin b shots daily. She had her surgery 30 years ago.

[cjzimmer1]

Yes losing 50% of your excess weight and keeping it off five years or more is the yard stick that weight loss surgeries are measured by.  By this definition, Lap Band has a success rate of 30-40%, RNY (most commonly referred to as gastric bypass) has a success rate of 60% and the Duodenal Switch has a rate of 80%.  The trade of is the complexity of the surgery as well as risk of problems goes up hand ind hand with the success rate of the surgery.  

 

 I've talked to many people who are considering weight loss surgery and when I say what surgery are you thinking of?  I don't know, whatever they do at such and such place. Do you know what they are planning to do?  Some vague answer, or maybe make my stomach smaller.  Do you know what to expect afterward?  I'll eat less and lose weight.  I'm just astounded how many people are willing to have a surgeon rearrange their inside and really have almost no understanding of what is being done to them and what they need to do afterwards.  I'm not surprised that many of those people aren't successful long term.

Edited February 28, 2017 by cjzimmer1

[kiwik]

With regard to the lack of research and knowledge of the surgery (not quoting) -  I am constantly amazed that in the age of the internet people can still be so ignorant of vital information and so trusting about leaving decisions to others.

 

I have started to consider that everyone pretends to be ignorant to make me feel more knowledgeable. It seems a bit of a stretch though unless it is some major conspiracy - maybe just some people.

[Lanny]

My belief is that the patient needs to make huge lifestyle changes after the surgery or it probably is going to be unsuccessful.  There is a Hypnotist in NYC who does a "Virtual" Gastric Bypass Surgery. I've seen an "Extra" on TV about that, many times. When they taped it, he charged $1500.  I think that was for 4 sessions, but am not sure of the cost.   I've known at least one person (a woman in Cali, Colombia) who had the surgery but am not in contact with her now (we were customers of their small business) so I don't know whether she was successful with it or not.  

[Carrie12345]

I know 2 people who have kept (most of) the weight off long-term. And 2 who didn't.

[ktgrok]

10 yr results - In a linked editorial, Jon C. Gould, MD, from the Medical College of Wisconsin, Milwaukee, highlights this study's "remarkable" finding that only about 3% of RYGB patients gained their weight back to within 5% of their baseline weight over 10 years.

 

http://www.medscape.com/viewarticle/868216

Edited February 27, 2017 by ktgrok

[Sneezyone]

I am 12 years post RNY and don't exercise much anymore. I lost 115 lbs. in the first year, got down a big 6/small 8, and have gained back a total of 30 lbs., mostly due to inactivity and the onset of perimenopause. Nothing in my body works like it used to (thank you mother nature...NOT!). I'm sure there are people who eat their way out of success and I know at least one woman who is dying due to malnutrition/malabsorbtion (she is mentally ill and refuses to eat and take vitamins) but I don't believe for a second that she is the norm.

Edited February 27, 2017 by Sneezyone

[TechWife]

I know two people who had successful experiences. One is more than five years in and the other is about three years in, IIRC. The friend who is five years in recently had surgery to remove excess skin. Her plastic surgeon requires people to have maintained weight loss for three or more years, no matter how they lost their weight.

[DawnM]

I have actually considered it.  My BMI is not quite there, but because I have a co-morbidity issue, they said they would approve it.

 

BUT, DH begged me not to.  He is worried about the long term affects, death rates, complications, etc.....

 

I am strongly considering doing a medically supervised weight loss program though, and he doesn't like that a whole lot either, but the regular ways to lose aren't working for me.  I have tried it ALL.  And I am miserable.

 

But back to the surgeries.  I know a few people who have had it and my dad has talked about several he either knows of or performed himself (back when surgery wasn't quite so specialized and surgeons just did whatever was needed.)

 

The three I can think of who I know personally who have had it......two lapbands and one gastric.  

 

One Lapband was 8 years ago.  The woman lost 100+ pounds and has kept 90% or more of it off for the entire time.

Another woman cheats as much as possible, lost some weight initially but is now heavier than she was without it.

Another friend had gastric bypass 3 years ago and has kept it off.  But she is also in love and I think new love is a great motivator!  She just announced her engagement.   She is over 50.  I am very happy for her to have finally found love.  

[DawnM]

For those of you who have lost a lot of weight.......what do you do about the loose skin?  Are you getting (or have you gotten) surgery to remove the loose skin?

 

 

[ktgrok]

I have actually considered it.  My BMI is not quite there, but because I have a co-morbidity issue, they said they would approve it.

 

BUT, DH begged me not to.  He is worried about the long term affects, death rates, complications, etc.....

 

 

 

Normally it's either a BMI of 40 OR BMI of 35 with comorbidities. Lap bands are no longer advised due to lots of complications (scar tissues, slipping band, adhesions, esophageal widening, etc). 

 

As for death rates/safety it is now considered on par with say, gallbladder removal, if that puts it in perspective. Complications do and can happen, but they do depend on which surgery (sleeve gastrectomy has the fewest long term). I chose sleeve because less weight loss was ok with me if it meant less chance of nutritional complications, hypoglycemia, internal hernia, etc. 

 

Also, complication rates vary vastly from one surgeon to another. You want a Center of Excellence, and he surgeon should be able to give you their complication rates, etc. 

Edited February 28, 2017 by ktgrok

[ktgrok]

For those of you who have lost a lot of weight.......what do you do about the loose skin?  Are you getting (or have you gotten) surgery to remove the loose skin?

 

I don't have THAT much loose skin, which is sheer luck. I do have a bit of an apron..but I've had it since my c-section and it isn't really any worse. I figure God made Spanx for a reason, lol...if I'm wearing something like a sheer dress I use Spanx. Arms aren't terrible..not bad enough to have surgery for. Maybe someday I'd do skin removal, but it's a pretty painful procedure. My sister did a tummy tuck and it was a LONG recovery. 

[lavender's green]

My uncle had it done and gained back a lot of the weight. I haven't seen him recently so I don't know exactly how much. I remember he was required to meet with therapists and nutritionists, which seemed to really hurt his pride or something, because he told them all to eff off. :lol:  Anyway, even though he gained a lot of it back, he had some really valuable years. He was able to fulfill a lot of dreams - he took foreign language classes, traveled, met and married someone on his travels, and become a father (at an age where most of his friend's kids were adults). None of that, even the classes, was possible before the surgery because of his poor health. Now at the very least he has a family, a lot of great memories, and all the benefits of knowing another language.

[DawnM]

Normally it's either a BMI of 40 OR BMI of 35 with comorbidities. Lap bands are no longer advised due to lots of complications (scar tissues, slipping band, adhesions, esophageal widening, etc). 

 

As for death rates/safety it is now considered on par with say, gallbladder removal, if that puts it in perspective. Complications do and can happen, but they do depend on which surgery (sleeve gastrectomy has the fewest long term). I chose sleeve because less weight loss was ok with me if it meant less chance of nutritional complications, hypoglycemia, internal hernia, etc. 

 

Also, complication rates vary vastly from one surgeon to another. You want a Center of Excellence, and he surgeon should be able to give you their complication rates, etc. 

 

None of that will matter to my husband.  Really.  If it is elective surgery, you don't need it.  No sense in putting yourself at risk unnecessarily.

 

so, I will go a different route.

 

Yes, my BMI is somewhere between 35 and 40.

[ktgrok]

None of that will matter to my husband.  Really.  If it is elective surgery, you don't need it.  No sense in putting yourself at risk unnecessarily.

 

so, I will go a different route.

 

Yes, my BMI is somewhere between 35 and 40.

 

Gotcha...I can understand that. i think what swayed my husband was the fact that surgery was shown to decrease mortality overall, by reducing the comormidities. So risk of surgery vs risk of staying obese. But if there is another option to kick the obesity that works for you, by all means, take it!

[DawnM]

Gotcha...I can understand that. i think what swayed my husband was the fact that surgery was shown to decrease mortality overall, by reducing the comormidities. So risk of surgery vs risk of staying obese. But if there is another option to kick the obesity that works for you, by all means, take it!

 

 

I am currently looking into a physician's supervised program.  I am meeting with them tomorrow.

Dh honestly believes that if you just exercise more, you will be thin.  He has never been one ounce overweight in his entire life.  He thinks the diet thing is just a very small part of it.  

 

We no longer discuss weight loss.  We just fight.  He tells me to do whatever, just don't ask him for opinions.  Although surgery he would have to be on board with.  So, I will go check out this weight loss program tomorrow and will most likely join.  Insurance will cover some of it.

[kiana]

Dh honestly believes that if you just exercise more, you will be thin.  He has never been one ounce overweight in his entire life.  He thinks the diet thing is just a very small part of it.  

 

Grrr.

 

I was spending 15 hours a week hardcore training martial arts and never lost any weight because I just ate more to compensate (not realizing it at the time, but I did). It is very damn hard to outrun your fork when you're someone who's inclined towards gaining weight. 

 

I'm sorry that he's not inclined towards actually learning about the facts. 

[Carol in Cal.]

I didn't realize that insurance would pay for physician supervised weight loss!  I've never even looked into whether mine does.  Live and learn.

[DawnM]

I didn't realize that insurance would pay for physician supervised weight loss!  I've never even looked into whether mine does.  Live and learn.

 

 

I didn't know either, until my cousin lost 65 pounds and I talked to her about it.

 

She said it used to not pay anything, but it was approved about 6 months ago (AFTER she started and paid for her first 3 months.)  She now pays a $20 co-pay per weekly visit instead of the $75.

 

I had them run the numbers for me based on my insurance, and it is a co-pay for visits, up to a certain number of visits, and the bloodwork and EKG are less than half price in the beginning, so it should be at least a drastically reduced number for a while.  Then it will go up.

 

Dawn

[DawnM]

Grrr.

 

I was spending 15 hours a week hardcore training martial arts and never lost any weight because I just ate more to compensate (not realizing it at the time, but I did). It is very damn hard to outrun your fork when you're someone who's inclined towards gaining weight. 

 

I'm sorry that he's not inclined towards actually learning about the facts. 

 

 

He seems to think these ARE the "facts."  I am just seeking out people online (trainers, doctors, etc...) who agree with ME.  So I told him to go find some who would agree with HIM and he didn't do it.

 

It is just better we don't discuss it.

[ktgrok]

I am currently looking into a physician's supervised program.  I am meeting with them tomorrow.

Dh honestly believes that if you just exercise more, you will be thin.  He has never been one ounce overweight in his entire life.  He thinks the diet thing is just a very small part of it.  

 

We no longer discuss weight loss.  We just fight.  He tells me to do whatever, just don't ask him for opinions.  Although surgery he would have to be on board with.  So, I will go check out this weight loss program tomorrow and will most likely join.  Insurance will cover some of it.

 

Good luck!!!!!

[Sneezyone]

For those of you who have lost a lot of weight.......what do you do about the loose skin? Are you getting (or have you gotten) surgery to remove the loose skin?

My BMI was 41 but I had no comorbidities. I also had practically zero loose skin b/c I was under 30 when I had it done and had been very active/athletic as a teen. Lots of muscle to work with. I've never had any other surgery.

[Sneezyone]

He seems to think these ARE the "facts." I am just seeking out people online (trainers, doctors, etc...) who agree with ME. So I told him to go find some who would agree with HIM and he didn't do it.

 

It is just better we don't discuss it.

Studies are actually pointing out now that, for unknown reasons, people who lose massive amounts of weight through exercise alone actually damage their metabolism/slow it down which causes them to have to eat waaaay less or gain back waaaaay more. They studied biggest loser contestants, I think. Ktgrok, you posted that article, no?

[Sneezyone]

Here are those links...

 

After ‘The Biggest Loser,’ Their Bodies Fought to Regain Weight

A contrary-ish/more nuanced view from the Atlantic: What the New York Times' Biggest Loser Story Left Out About Weight ...

 

 

[Ottakee]

Just a very weird suggestion here but have you looked at a fecal transplant as an option?

 

Sounds gross but compared to surgery it isnt. You get a donor stool from a thin, healthy, screened individual and then it is transplanted during a colonoscopy.

 

It is fairly experimental right now but has almost no risk factors. It changes your gut health.