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Bariatric Surgery/Weight loss stopped

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Question
I had a sleeve gastrectomy 2/22/2012.  During the 7 months of evaluation prior to surgery I lost 97lbs.  I hit a few plateaus during that time but they didn't last long.  During the 3 weeks of liquid diet after surgery I lost 15lbs.  When I was allowed back in the pool at 3 weeks post-op, I thought my weight loss would excellerate.  But it stopped.  I hit a plateau that lasted about 6 weeks.  Then I lost about 10lbs in the next 2 weeks.  After that the plateaus got longer and the time inbetween got shorter and by 6 months out weightloss stopped even though I was following all the rules carefully.  Shortly before Thanksgiving my therapy pool (my main source of excercise broke down.)  I went into a blue funk and gave up.  I told myself it would be just for the holidays but it was the end of January before I got back to the diet.  The pool was working by then, but still no weight loss.  My weight loss since surgery is 80 lbs.  It's now more than a year since surgery and I can't seem to get really motivated like I had been because no matter what I do no weight comes off.  My surgeon says I might just have to accept this is as good as it gets.  But I'm at 285 lbs and am 5'6" And that is just not acceptable to me.  I want to lose 130 more pounds.  Any advice?

Answer
Hi Susan:

I understand how frustrated you must be.  From what I gather from your post, from your heaviest pre-surgery until now, you've lost 177 pounds? (97 pre-surgery, 80 pounds post).  Congratulations.   I'm going to be honest and say that in my 6 or so years researching the sleeve, you've had one of the highest sleeve-only weight losts I've heard of.  I've not heard of anybody losing 300+ pounds with a sleeve alone (which seems to be your goal).  The only surgery that I've ever heard to have weight loss anywhere near that is the duodenal switch.   It's quite possibly that your surgeon is correct and that you have reached the limitations of your surgery (especially if your BMI was really 60).  In the early 2000s, they used to do a two-part dudodenal switch on people with BMIs of 55-60+.  They'd do the VSG first, and then add in the intestinal part 6 months to a year later, once the operative risk was lower.  It sounds like that might be a plan for you.  These days, some surgeons just do it all at once--others still favor a two part approach.  .  The DS is the surgery that has shown to be most successful with people who have BMIs over 50--and having already had the VSG, you're halfway there anyway.  If you're in South Caroline, then the closest vetted DS surgeon that I know of is Dr. Smith in Georgia (Marietta, I believe).  You can check out dsfacts.com and the DS board on Obesity Help for more info.  

However, it doesn't mean that you need to give up.  A lot of RNYers, Bandsters, and VSGers find doing something like the 5-day pouch test to help spur things along (even though you don't have a pouch!).  It's free.  http://5daypouchtest.com You could try adding a program such as Weight Watchers or something similar to see if that spurred more weight loss.  You could also try working more closely with the dietician in your surgeon's office to see what she suggests.  Go back to the basics of protein first, followed by non-starchy veggies, fruits, and then carbs/starchy veggies to see if that helps.   Track your protein.  Limit your diet soda.  Etc.  In theory, there is no reason why you cannot lose more, it's just rare that it happens.  You can show them and me that they're wrong.  Realistically, however, it may also take substantial plastics to remove excess skin before you approach the 150-range, once you are closer to goal.  

I wish I had more to offer.

Good luck.  You still have achieved remarkable weight loss.  If you can maintain a 177 pound weight loss going forward, that would definitely be a success in anybody's book...although I know it's frustrating to have lost so much, and to want to finally be a "normal" weight.  I hope you prove me wrong!

Karla

Bariatric Surgery

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Karla K.

Expertise

I'm very familiar with the four main types of bariatric surgery: Lap-Band/Adjustable Gastric Band, Vertical Sleeve Gastrectomy, Roux-en-Y, and Duodenal Switch. I'm familiar with the Mini-Gastric Bypass and Revisions as well. I'm also beginning my seventh year post-op as a successful bariatric patient--so I can answer questions regarding pre-op, post-op honeymoon, and maintenance phases. I'm less familiar with the nuances of plastic surgery following bariatric surgery--but I do know a bit.

Experience

Have been an avid researcher of the science of obesity and bariatric surgery for over ten years now. My professional career used to involve medical device research.

Education/Credentials
Master's in Business Administration.

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