Gastric sleeve (obesityb "cure") surgery - experiences? Knowledge? Thoughts??

In My Humble Opinion
1

One of my best friends has finally been accepted for gastric sleeve surgery, which basically reduces an obese person’s stomach capacity to accept about one half a cup of food at a time. It is a significant life style change and hopefully (her focus) will ameliorate some of the many health challenges she is currently facing due to diabetes and other obesity-related issues. She is almost 60 years old and frankly tells anyone relevant that her issues with food basically center around addiction - she is addicted to eating. Since she will be limited to tiny servings, and eating a big burger/fries/pop/plus dessert will be forever verboten after surgery, she is understandably both excited, and stressed about whether she can “handle it.” It is a really, really huge behavioural change - I think she is absolutely capable of being compliant, but she is scared she won’t be.

Anyhow, the hospital she is going through strongly encourages the patient to have a “support team” to go with on doctor and nutritionist visits, support group meetings and so on. So I have been going with her to appointments (along with her husband, who is awesome) and am committed to being as supportive as I can; but I do want to do it right.

She and I have done a bunch of reading and research, she has passed the cardio and psych clearance necessary and is just waiting for her GP’s report to go through, the insurance is going to pay for it, and hopefully she will be scheduled within the next month. She will be going here.

I want her to succeed, and I want to be the best support possible. Any insights, tips, personal experience stories - very welcome!

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There was a dope thread recently about lap band and gastric bypass procedures and I was surprised by the number of post surgical complications and that people somehow managed after several years to regain excess weight even with the measures in place.

3

Isn’t that just confirmation bias in a sense?

People with bad experiences usually share their stories more often than success stories (that’s what I usually see on the net, but YMMV).

4

Both of my ex-inlaws had bypass, didn’t have any complications that I know of and each lost probably 200 pounds. This was probably 7 or 8 years ago and neither of them have put the weight back on.

5

Success (as measured by keeping weight off 5 years after weight-loss surgery) is 50-50 among those who I know have had the surgery.

However, the sample size is 10…

6

My wife had a gastric bypass, it was VERY successful, she lost a lot of weight and kept it off for five or six years since. The procedure is not easy … as mentioned, many women do gain the weight back. For the first few months/years after you have the surgery, you get very sick if you eat more than a tiny bit of food at a time. My wife had been dieting hard for years prior to the surgery, she kept at if afterward and it DID help her lose weight and keep it off. She has gained some weight back but not much. Many of the women who were in the training classes she attended prior to the surgery gained the weight back, which is really sad considering the great effort, pain and discomfort.

However, my wife has been much healthier and happier since losing all that weight, I think it was a wonderful thing for her, but I wouldn’t care to predict the same outcome for anyone else. If you can possibly lose the weight through diet and exercise, that’s a much better way to go.

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Complications are certainly possible and a lot depends on the person being very compliant with the diet for life - it’s quite restrictive and there are lots of things she will never be able to eat again. But for those who are truly compliant the success rate is pretty good, it seems. Plus, now most of these procedures are done laparoscopically and the gastric sleeve is the most minimally-invasive surgery of them all. According to her surgeon, she’ll be made to get up about four hours after the surgery, and most likely back home the next day.

I truly believe she’s willing and able to follow through, though. She’s been trying to get insurance to cover this procedure for almost a decade and she is absolutely elated and can’t wait to get it done, now that she finally got approval. The hospital she’s going through has ongoing support - groups, an online forum, seminars, classes, counseling etc, for life. Plus her husband is incredibly supportive.

Of course diet and exercise are best, but she’s been overweight her whole life. At age eight she was put on a liquid diet. I’ve known her for 13 years and much of that time she’s been dieting, one way or another. She did Atkins for a long while and attended Curves faithfully and lost about 80 lbs, but by now she’s got so many health complications due to her diabetes, she’s gained the weight back. And she is super-morbidly obese: 5’1" and 370 lbs. She and her husband have been doing a South Beach type diet faithfully since May - he’s down 40 lbs, she’s lost ten. She’s just discouraged and exhausted and wants her health to improve, even just a little bit. The bottom line is that she is going to continue to become sicker and more mobility-challenged and will die early if she doesn’t lose the weight. This procedure is giving her a chance.

Evil Captor, good on your wife! We’re aware of the fact it’s going to take a lot of self-discipline. Only a half-cup of food at a time, yikes.

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Best of luck. It can be so hard when people go through the surgeries and all the changes, and still gain the weight back. It sounds like you and your friend’s husband make up a very loving support system, which a lot of people don’t have, so that is a huge bonus.

“Food creep” seems to be how people gain weight back. They eat a little more once. Then again. Then again. And then a little more still. And soon they’re eating 12" subs, soda, chips, and a cookie for lunch, and complaining of “cramps” (true story with a former colleague who had gone through old-style open gastric bypass).

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Yep, and my friend is also very worried about this and her ability to maintain discipline. That worry is almost universal in obese bariatric patients. She understands that a lot of her eating is emotional and that she is, essentially, addicted to food. But since I’ve known her she’s been able to kick the soda pop habit and also has all but quit eating desserts - as I understand, those are major “triggers.”

She does not have a gall bladder anymore, so she’s aware of the very unpleasant gastric dumping syndrome, which happens easily with bariatric patients who over-eat. We are joking that this surgery will sort of be like Antabuse for alcohol addiction - if she does over-eat, the symptoms can be extremely unpleasant, as well as life-threatening.

And of course, I am going to be kicking her butt big-time and becoming an insufferable nag if she starts drifting back to bad eating habits. Because I will be watching…:cool:

10

My best friend for most of my life was sleeved (that’s what they call it) earlier this year, so I know quite a bit about it. Second hand, but I’ve had a front row seat for 40 years.

I went with her to all the seminars and pre-surgical appointments and took care of her post-surgery, and have held her hand through this whole thing and for starters:

Buy her some 4 oz ramekins. The size of the ramekin will be the size of her new stomach. She can’t ever exceed that, three times a day. She now eats by volume. No eyeballing anything. No liquids 1/2 hr before or 1/2 hr after eating because it will create what they call washout. That means it will wash the food out of her stomach and she will be hungry sooner.

They will send your friend home from the hospital with a graduated liquid diet that she will have to follow for a while. You may have to prod her to get the liquids down at first, but that is just until the swelling goes down. Don’t take no for an answer. She can’t get dehydrated. If you have to make her sit there with one sugar free popsicle after another melting in her mouth for 12 hours a day for the first week, do it.

Your friend will still be able to eat crappy food if she wants, so the trick is to get her hooked on clean eating. I bought a really good book for my friend by a surgeon named Dr. Duc Vuong. It’s kind of an everything practical you need to know book by someone who knows what he is doing for $9.99 on Amazon Kindle. It’s a big help on the how to get someone to eat healthy and not be afraid of vegetables front.

I quite literally cleaned out my friends kitchen of everything except for seasonings during her first night in the hospital because I knew there was no way in hell that she was going to come back and not have a little of this and a little of that. Hot fudge sauce in the cabinet every time she opens it? Get real.

Get rid of everything that isn’t going to make the cut for her new lifestyle, because that is what this is. Everything changes when she wakes up from the surgery. No going back.

You may have to be her little grocery store Hitler and food police until she gets the hang of things, but she will appreciate it later. If she has never been taught or developed good eating habits, she is like a toddler in that regard and someone literally has to parent her until she can do it on her own. The difference now is that since she will have had the surgery, she will now be motivated to learn.

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Thanks Lurker! Very helpful. Yes, she already has the Scary Diet Plan for both pre- and post-op. Pretty strict liquid diet for a few weeks, then very gradual introduction of things like two ounces of ground turkey, apple sauce, Greek yogurt and so on.

That right there is the scary part…she actually eats pretty clean these days but I know the sugar addiction and big meal addiction is going to be tough for her. As in the “food as a reward/comfort/stress reliever” mindset; she will have to break that pattern. We have found an online sleever community and some post-sleeve recipe blogs that should help.

You did give me a good idea: clean out the kitchen of all junk. I WILL do that! Her husband is really supportive but I am not sure he understands how truly restrictive her diet is going to be, going forward. We’ve already talked about how she’s going to have to quit watching TV food porn and shift her focus to non-food stuff. I have no problem being a “grocery store Hitler.”

The surgeon and nutritionist both stressed that this operation is a tool, not a cure. I will do what I can to be a total bitch about keeping her compliant. :smiley:

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I’m going in for a gastric sleeve in about two weeks, yesterday I started the prep diet (two weeks of very low calorie shakes/soups etc.) mainly to shrink the liver so that it easier to lift and work under.

The pre-op tests also revealed a small hiatal hernia which the doc will fix at the same time. That explains a lot as I’ve been treated for bad reflux for several years. Long term reflux also increases the risk of cancer so I’m getting a two-for! :slight_smile:

I’ve been overweight or obese pretty much my entire life - I’ve had a few periods where I lost a lot of weight but it eventually creeps back on. After a lot of research I decided on the surgery. I’ve seen figures that only about 5% or obese people who lose weight by just dieting and excercise keep if off long-term.

The ‘tool, not a cure’ has been hammered into my head as well. It is still possible to eat past the sleeve but not as easy as banding (I’ve read some horror accounts of people blending a Big Mac or KFC into the consistancy of babyfood and pouring that on down.) :eek:

I suspect I’m a lot like your friend from the description of eating habbits - mostly not bad but far too much and the occasional binge of junk. There are a few good online support groups, one of which I’m a member of under a different name - PM me if you want to talk more.

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Battle Pope, I sincerely wish you well with the procedure, it is a gutsy move! I am PM’ing you.

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I have a long-time friend who had roux en y bypass in mid-June. A little younger than your friend (45,) but facing more-and-more serious health problems due to a lifetime of obesity. I have no idea what her highest weight was - that’s not information she shares publicly, and it’s not really my business - but I’d estimate that she’s 5’10", and her pre-diet weight probably started with the digit 5. (When I first met her, we were in seventh grade. L probably weighed at least 275 then, and 300+ by the time we graduated high school.) L began dieting three months before her surgery, and is currently down by about 115 pounds. It’s a truly wonderful thing to see her confidence and radiance grow as her size shrinks.

As noted above - hydration is vital, but difficult, immediately post-op. L wound up back in the hospital due to kidney problems about two weeks after surgery. That can be a life-threatening complication for anyone, much less a patient with high blood pressure and other co-morbidities. Your friend can try to research her favorite sugar-free popsicle flavors now, to stock up, but don’t be surprised if her tastes change after the surgery. L’s did, and my stepbrother’s did, too, when he had RNY bypass about ten years ago.

If you’re playing kitchen clean-up before she returns home from the surgery, double- and triple-check the condiments. Everything is sugary. There are some good recipes for things like homemade sugar-free catsup and BBQ sauce on-line, or commercial products are available at some larger grocery stores or on Amazon.

Be prepared: The damnedest people will (intentionally or not) hurt the process more than they help. I’ve been absolutely infuriated with L’s sister, who has never had a major weight problem, and who says things like “Well, I hope your two bites of scrambled eggs were good. I’m enjoying my Moon Pie and coffee for breakfast!” (Bitch.) Or L’s husband and (obese) 16-year-old son, who insist that certain foods must be in the pantry. I’m sorry, but if you’re old enough to go get it for yourself, then you’re old enough to realize that L really doesn’t need a dozen doughnuts in the larder, or pizza brought in every Friday night.

Like your friend, L is probably addicted to food. Before going in the hospital for surgery, she started learning to crochet - a habit that kept her hands busy and out of the cookie jar. That has been tremendously helpful for her. Any number of hobbies could substitute for crocheting, if your friend thinks she might benefit from that sort of thing. L also joined a gym, but due to knee problems, she doesn’t benefit as much as she’d like. With support from another friend, who is a water aerobics instructor, L actually ordered a swimsuit the other day. There’s a local water attraction here, with a year-round indoor pool and early-morning hours available for individual exercise. L plans to start going there, with the instructor, as soon as her bathing suit comes in the mail. (L said that this is the first swimsuit she’s ever bought for herself. The last one she owned, she was 9 years old. :frowning: )

And one thing that really, seriously amazes me, especially from a woman who has spent decades dieting in one form or another: L’s knowledge about nutrition, portion sizes, etc. She has none. One of the chief ways I’ve tried to help her is by finding recipes for her, or suggesting substitutions to improve the content of a favorite meal or recipe. Last week, L sent me a recipe for a pizza with five kinds of cheese, plus a cream cheese crust, extolling the virtues of all of the veggies it included, and how much she thought her son would enjoy it as a healthy alternative to a Meat Lover’s from Domino’s… I want L to keep asking, else how will she learn, but I was just flabbergasted that she didn’t realize the fat/calorie content of most cheeses… Be prepared, just in case your friend has the same blind spot!

Finally, as for long-term success: That, as you know, will be up to your friend, no matter how much you want to help. My step-brother, as I mentioned, had bypass surgery about a decade ago. He lost about 250 pounds. He has regained about 100 pounds since, but (a) the weight gain has leveled off, and (b) 280 pounds is a damned-sight healthier than 430 pounds was. He can function at work, and enjoy his leisure time, and his blood pressure is better, he no longer takes daily meds for diabetes, etc. It’s not a quick or easy solution, but I’m so glad that both he and my friend have had this option…

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I’d keep her away from the online communities. They are poison disguised as help. Hang around one for a while and start counting the excuses for why people can’t eat vegetables or a salad or why someone just has to live on only protein shakes and cheese sticks instead of learning to dealing with real food. Then there are the crybabies.

Food porn will be ok, but she is going to have to get it from searching for recipes made with ingredients she can eat so she doesn’t get bored.

My friend has made strides I’d never thought I’d see in this lifetime. The past few years I had been preparing myself for the eventuality of her heart giving out and her dropping dead any day. I had given up any hope of her getting this under any sort of control at our age.

Buy her Dr. Vuong’s book to give her a jump start on her post-surgical food choices. I could not believe how that book resonated with her, and apparently with many other people with food addictions. She is following about 90% of his food advice and loving it, which is mind-boggling to see.

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Lacunae, thank you so much for some very real stuff - like the hydration issue (I have read that can be hard post-op, and the pt may have some serious vomiting with just a sip of liquid) and also how people may sabotage the procedure. I hadn’t thought of that - my friend’s husband is awesome and she has some strong friends in her corner, but also has some toxic people in her life. So that will bear watching! It didn’t occur to me until just now that some of the people in her life might resent her doing this.

She is extremely well-versed in nutrition; and knows that the discipline/emotional/addicted part will be the main challenge. I actually think that food addiction is an under-recognized contributor to obesity - luckily the hospital she is going through provides counseling for life WRT the addiction aspect.

Good for your step-brother! Perhaps not perfect, but it sounds like he had great success, health-wise. That’s what my friend’s goal is: She doesn’t care about thin or sexy or anything. Just better health and reduced need for meds.

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I set up the MyFitnessPal App on my friends iphone for her. I use it for every bite before it goes into my mouth and I taught her to use it also so she could see the effect it will have on her BEFORE the food goes down the hatch.

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Really, IRT to the online communities? That bad? We found one that seemed very active and supportive.

I’m definitely going to purchase that book.

I know what you mean about preparing yourself…if R or her husband doesn’t respond to calls or texts within a day, I start getting fussy and worried.

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MyFitnessPal is an amazing app! I highly recommend it, myself.

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Agreed – it’s also good for anyone trying to follow a healthy diet. I don’t keep things like hot fudge or caramel sauce in my house…because I’d eat it!

Good idea on buying some 4 oz ramekins. It visually underscores why everything eaten post-surgically has to be healthy and nutritious. You don’t get much room to screw up.