Bariatric Surgery

[azure]

He is right in that the statistics back up that the rate of type 2 diabetes goes down. You're right about type 1 of course but I'm sure he knows the difference and assumed we all did too and it was not necessary to point that out. But come to think of it he might be wrong about that, maybe there are folks who have no clue what the difference is.

I think it is important to be clear and precise in using terms like that, because as you say, there really are people who don't know that these are really different diseases. And to be curative, even in the less precise sense of "permanently controlled", it's not enough that the rate goes down, that's not surprising. But if it were simply that it happens because one finds it easier to keep to a healthier diet, then as you say, it would be the diet rather than the surgery that effected the "cure", and it seems that many people manage to continue to eat excessive amounts of unhealthy food even after the surgery.

But I do accept @weilke's word as a specialist that the diversion of the food path in some forms of the surgery suppresses the release of hormones involved in diabetes, so it is more than just behavioral change that works this "cure", and maybe turns it into a true cure.

 

[weilke]

Interesting, I didn't know that. Thanks!

BTW, the term "Type III diabetes" isn't very well known, in fact your posts are the first time I've ever encountered it

Lol. I did not intend to create a new type of diabetes. This was me typing on a small screen without my readers.
Everything I said was in reference to type II (insulin resistance based) diabetes.

 

[azure]

Lol. I did not intend to create a new type of diabetes. This was me typing on a small screen without my readers.
Everything I said was in reference to type II (insulin resistance based) diabetes.

Heh. In that case, sorry. I would have assumed exactly that, except that my search turned up something that might have sort of made sense (except that my next question was going to be why it wouldn't have the same effect on someone with plain old Type II... )

 

[Rushie]

The effect of certain bariatric surgery techniques on diabetes goes beyond the reduction in food intake. They divert the food around the portion of the gut that triggers the release of some of the hormones involved in the disease. The effects of Roux-en-Y gastric bypass or a duodenal switch bariatric surgery on type II diabetes is immediate. In some of the series 80-90% of diabetics experience resolution of the disease.
At the same time, these are the most invasive surgical options and they leave the patient with the need for long term vitamin supplementation and nutritional support. For someone threatenend with some of the complications of type II , this can be a worthwhile trade-off. For someone 'just' struggling with weight, it may not be the right option.

I knew it had a little effect, had no idea it was that high. I might have to backtrack what I said. I'd like to look at some good studies though, differentiating between the effects of the surgery vs simply not eating - because you just had the surgery. Heck, I'm getting ready to "resolve" my pre-diabetic condition immediately this Thursday with the colonoscopy prep.

Anyone who thinks about doing this needs to be evaluated by a center where you find folks who can look at the individual situation and recommend a plan. This is all a bit more complicated than what can be explained in an internets post

^^^ THIS. The increased mortality from accident and suicide really needs a hard look. The prevailing theory AFAIK is that the surgery and subsequent weight loss uncovers pre-existing psychological disorders. I would hope the evaluation always includes thorough psych testing.

 

[Checkout_my_Six]

It's the loss of weight that fixes the diabetic issues....how you lose and keep it off is your choice. Technically the surgery does nothing but help one physically make the behavior mods by not eating the calories.....

If all y'all experts can find another way not to consume the calories....more power to ya. In my +50 years I wasn't able to....and I use to be a runner back in the day.

 

[ttexrbomb]

I did the gastric band in 2003. It worked for me.

Weight on 5/2003 - 353
Weight on 11/2003 - 233

Weight has fluctuated from 209 (5/2017) to 273 (7/2007).

Current weight is 221.

Use it as a tool, not as a crutch and it will work.



Sent from my iPhone using Tapatalk

 

[weilke]

It's the loss of weight that fixes the diabetic issues....how you lose and keep it off is your choice. Technically the surgery does nothing but help one physically make the behavior mods by not eating the calories.....

That is somewhat true for purely 'restrictive' types of bariatric surgery. These days that is mostly the 'lap band' where an adjustable band is installed around the entrance into the stomach.

In a sleeve gastrectomy, in addition to reducing the size of the stomach (iow a restrictive procedure), most of the stomach cells that secrete the hormone ghrelin are removed. This is one of the hormones that mediates the hunger sensation and it also seems to play into the glucose metabolism and the ability of fat cells to make more fat.

All this seems to be a bit more complicated than everyone thought for the longest time.

 

[BrianNC]

Low carb/keto took off my weight. 370+ on the left, 240 on the right. I agree with @Ryanb. If you have to change the lifestyle to get the surgery, and after the surgery, why not just eat like they make you eat after the surgery without getting the surgery and taking all that risk? And it's all about what you eat. Exercise is just to keep you physically fit in some manner. I've proven experientially that weight loss is 100% diet.

I put on about 30lbs over that right pic because I got off of it, but in the process of taking it off again. even with that 30 lbs I put back on, I'm still down 100 lbs. which is much better than 370. But again, if you're gonna have to change how and what you eat after the surgery, why not just do it without the surgery and take the 100% safe method?

 

[RyanB]

Low carb/keto took off my weight. 370+ on the left, 240 on the right. I agree with @Ryanb. If you have to change the lifestyle to get the surgery, and after the surgery, why not just eat like they make you eat after the surgery without getting the surgery and taking all that risk? And it's all about what you eat. Exercise is just to keep you physically fit in some manner. I've proven experientially that weight loss is 100% diet.

I put on about 30lbs over that right pic because I got off of it, but in the process of taking it off again. even with that 30 lbs I put back on, I'm still down 100 lbs. which is much better than 370. But again, if you're gonna have to change how and what you eat after the surgery, why not just do it without the surgery and take the 100% safe method?

Excellent work!

 

[Lachlan]

What causes the issue for me is that after such a busy day of being super active I probably overeat. Eating the right things but too much of it.

It’s not a lack of self discipline it is a matter of not being able to not eat as much because I am miserably hungry otherwise.

So I could do less activity and then eat less, but I still put on weight because I’m doing less stuff. It’s a balancing act that I lose on either way.

Fad diets are a joke. To recommend Keto as an alternative is almost laughable.

Start an honest journal detailing your daily food intake. Don't skip a single entry. (Example: Coffee? Zero calories. Cream/sugar, adds lots of calories. Include EVERY calorie you put in your mouth for 30 days.) If you are upwards of 300lbs and you're exercising regularly then you must be a Denver Bronco. If not, then go back to that journal and note that it will indicate that you're taking in a large excess of calories vs. what you're burning. If you're eating under ~1600 calories per day, every day, and exercising as much as you say, then you WILL lose weight. It will NOT feel good for a long time. Months. You will need to abandon your current life and never, ever return to your current ways. You must develop willpower to enact change. Start by eating an apple 15 minutes before your main meal, and a good glass of water. Your feelings of being unsatisfied, or still being hungry, must be overcome. That comes from your head. Who's in charge in your body? Your gut or your brain? You can do this.

 

[weilke]

Start an honest journal detailing your daily food intake. Don't skip a single entry. (Example: Coffee? Zero calories. Cream/sugar, adds lots of calories. Include EVERY calorie you put in your mouth for 30 days.)

Find a dietician who offers image based dietary assessments. You take a picture of anything that goes into your mouth and email them to your dietician. Takes away some of the subjectivity (iow the tendency to lie to yourself).
Most people tend to eat much more than they think they are. And yes, unless you have the power of nuclear fisssion, you are going to lose weight on a 1600cal diet combined with regular exercise. He'll, your basic metabolic rate at 300lbs should eat up most of 1600.

This past week I have worked 72 hrs. Still managed to get 2 runs, 2 bike rides and a swim in. Knees are shot, tomorrow is my day off.

 

[Rushie]

This is all good advice. I have to fast for the rotisserie chicken deal this week (colonoscopy/endoscopy) so hoping to lose a couple pounds which will motivate me to kick start the good eating habits again.

 

[SkyHog]

All great advice. Once I get the barometric surgery for which I have consulted actual professionals about, I will consider this advice for the future maintenance of my weight.

 

[Checkout_my_Six]

This is all good advice. I have to fast for the rotisserie chicken deal this week (colonoscopy/endoscopy) so hoping to lose a couple pounds which will motivate me to kick start the good eating habits again.

I gots news for you....that lil bowel movement will not produce weight loss.

 

[Rushie]

I gots news for you....that lil bowel movement will not produce weight loss.

Well poo.

 

[Checkout_my_Six]

Well poo.

Yup....no worries. It will fill back up in no time.

 

[mryan75]

I'm considering bariatric surgery. In the very beginning stages of research.

I searched the forum and found quite a few threads with posts from those that have had the surgery. Most were from the 2014-2015 time frame.

I'm interested in hearing how you are doing now. Have you kept the weight off? How hard was it psychologically? Would you have made the decision to get surgery if you knew what you know now? How did it affect your flying? Were you grounded for some amount of time post surgery, etc.? How might it affect my BasicMed medical?

Thanks for any information you can provide.

Chris

My mother was considering it until she heard firsthand accounts from people who have had it. My girlfriend has had several clients who did it (she's in the fitness industry) and they are to a (wo)man completely miserable. You have to make huge diet changes after the surgery - you have no choice - so why not just do it without doing the surgery? I can't imagine not being able to eat something as simple as a sandwich for the rest of my life.

I've lost 30 pounds in the last year. My advice: take the long view. Start drinking more water. Cut out sugar and bread. Meat, foul, fish and veggies. It will be hard, but it's like 1/10,000th as hard as what you'd have to deal with post-surgery. Why anyone would do that to themselves is beyond me.

 

[Checkout_my_Six]

with the sleeve....after 6-8 months eating is almost normal (drinking is separate from eating)....cept the volume is the size of your palm. And after 3 years I can't eat a whole sandwich or whole cheeseburger. It's all good. I eat and am satisfied.

 

[mryan75]

Nope, I’m not.

I will also bust the myth that people who drink more water will end up losing weight. NOT TRUE!

Fat is not water soluble, so water will not flush out fat. Fat absorbs fat—that’s why the keto diet is so effective.

Contrary to what people believe, that ‘your body is 90% water’ or whatever the saying is. Your body is actually zero percent water!

There is zero pure water in your body (other than that glass you just drunk), but rather it’s liquids—not water. The liquids for example are electrolytes, blood, urine and lymph. So people who think that drinking more water will help in weight loss are wrong and they can also dehydrate themselves because they are flushing out all of their electrolytes by drinking so much water (that is given that the water they are drinking is not electrolyte water). As for me, I may only drink 2 or 3 glasses of water per day. No need to drink this “1/2 your body weight in ounces” stuff.

The only way to lose weight is to be in a caloric deficit. Period.

I've never heard anyone argue that water would flush out fat. Though I don't doubt it. What drinking water does is keep you hydrated. Often the feeling of hunger is actually thirst. And you absolutely should drink half your body weight in ounces. It's very difficult to do, but trying is a good thing. Almost everyone is perpetually dehydrated.

 

[mryan75]

I’m planning on doing the Gastric Bypass next year. I can’t lose weight and even with exercise and proper eating, I’m gaining weight, not losing it.

I am a very active adult - I ride bikes, run, walk, hike, etc., but I still put on weight every year - over 310 pounds now and probably over 400 by the end of the decade on this path.

Nothing lazy about me. I just underwent back surgery due to a burst disc and 2 slipped discs. Mostly caused by being so active while being overweight.

What do you consider "proper eating"?

 

[JOhnH]

Oh, and drinking water is not a weight loss method. However, consistently replacing soft drinks, sweetened coffee drinks, fruit juice and beer with intake of water instead will significantly affect your calorie and particularly carb intake. It's not the water. Its the reduction of easily absorbed carbs that has an effect on your health.

That and this:
The body often interprets dehydration as hunger, thus if you don't drink enough water, you will probably wind up eating for the wrong reason. I occasionally "feel" hungry but find if I have a glass or two of water and then wait a few minutes, I lose the craving to raid the fridge. At least of a little while.

As that guy that want's us to check out his backside said, there are a lot of experts on this board that think they fully understand the solution to a problem that they don't understand. If losing weight were as easy as eating less and exercising more, we wouldn't have the obesity problem we have. I read some weight loss advice the other day that said, "just substitute a few carrots for those potato chips. That will satisfy your craving for the crunch. I'm sure that was written by some anorexic wench.

 

[JOhnH]

Keto is: you eat a half stick of butter and you aren't hungry, it will keep you satisfied for hours. You eat a half stick of butter with just a half teaspoon of sugar in it, you will have hunger pangs very soon, not only that, you aren't likely to stop at half a stick, you'll eat a whole stick. You really need to eliminate ALL sweets and carbs from every single bite you eat for it to work.

At some point in the distant past, I read about a diet (probably Atkins) where it said you could eat a whole stick of butter if you wanted to. The problem was that most people thought that meant they could put a stick of butter on that loaf of bread they were eating.

 

[JOhnH]

My issue is with the definition of the word "cure". It's not like taking an antibiotic and curing an infection.

I just had my annual physical and I asked the Doctor why his report stated Type II DM. I pointed out that my latest A1C was 5.3 and has been since I lost 50#s (although I have gained back 20 of those). He said that once you have the disease, you always have the disease. It may be controlled by medications, or as in my case, by weight loss, but I still have the disease.

 

[tspear]

What causes the issue for me is that after such a busy day of being super active I probably overeat. Eating the right things but too much of it.

It’s not a lack of self discipline it is a matter of not being able to not eat as much because I am miserably hungry otherwise.

So I could do less activity and then eat less, but I still put on weight because I’m doing less stuff. It’s a balancing act that I lose on either way.

Fad diets are a joke. To recommend Keto as an alternative is almost laughable.

Have you looked into a few techniques to reduce hunger and portion control? For example, cold water is not easily absorbed as warm water. So if you drink 8-12oz of very cold water twenty minutes BEFORE eating a meal, you body will actually start the signal process from your stomach to your brain that your are full. It will also "make" you feel full very quickly.
Other items I have found, that unfortunately the experts are correct.
1. Plate size matters, standard plate in the US is 12in, use a 10in salad plate and you will have a smaller portion. I even tested this stupid theory by making a plate of pasta on 10in, then put the pasta on a 12in plate. The plate looked a little empty, but it was the correct portion. Put in the fridge, came back later for dinner, and added more to the plate without thinking.
2. Reading, TV, and other non social activities are distracting, you eat faster and consume more.
3. Eating in the kitchen is bad, move to a dinning room and leave the serving dishes in the kitchen. The very act of walking back to the kitchen reduces the number of servings.
4. Change when you eat carbs. We crave carbs, so I start my day with carbs, maybe a few at lunch. Dinner is low fat, and high in protein meats/fish with some veggies and fruit. Fat, protein and fiber are some of the items which take longer to digest so I focus on fiber and protein for dinner. Leaves me full, and does not add to the waist line. Note: Using a food diary, I have tried to beat this, use measured quantities of everything, ate at home... eating the exact same meals just changed the order for two weeks each. When I ended the day on carbs, I gained two pounds. When I started the day with carbs and ended with protein and fiber, I lost three pounds. That is a five pound swing.

There are other items, but my suggestion, start a food diary, be very specific and honest, then talk to a nutritionist. Find techniques you can live with forever.

Oh, FYI. Since 2004, over six years I lost 40 lbs, and kept it off for almost a decade. I started losing weight again two years ago, I am back on track for roughly 10 lbs a year.

Tim

 

[Checkout_my_Six]

lean and green is my mode....and what the dietician teaches.

binge eating is the problem.....

 

[tspear]

Find a dietician who offers image based dietary assessments. You take a picture of anything that goes into your mouth and email them to your dietician. Takes away some of the subjectivity (iow the tendency to lie to yourself).
Most people tend to eat much more than they think they are. And yes, unless you have the power of nuclear fisssion, you are going to lose weight on a 1600cal diet combined with regular exercise. He'll, your basic metabolic rate at 300lbs should eat up most of 1600.

1600? I have done calorie counting. I maintain weight at 2500. Doc and nutritionist think I am screwed up. But they verified the numbers, evening using the picture method. lol. Somehow I still managed to gain a lot of weight in my 30s!

This is all good advice. I have to fast for the rotisserie chicken deal this week (colonoscopy/endoscopy) so hoping to lose a couple pounds which will motivate me to kick start the good eating habits again.

Ugh, I can wait... based on genetic history, GI doc wants me to start the colonoscopy this year on my birthday. Primary care agreed... And they said never go more than three years for the rest of my life.

All great advice. Once I get the barometric surgery for which I have consulted actual professionals about, I will consider this advice for the future maintenance of my weight.

Much harder after surgery. Start the simple habits first.

Tim

 

[Checkout_my_Six]

not really that hard after the surgery....my experience. There really isn't much choice after the surgery. You are limited with liquids for a while ...weeks later food is re-introduced at a slow rate. So that will form the new eating patterns. The doc will try and get some weight loss before the surgery to get the liver to shrink....but, that isn't really for eating habits...

Plus, years of eating habits are not erased quickly....even when the body will self limit volume.

 

[RyanB]

I've never heard anyone argue that water would flush out fat. Though I don't doubt it. What drinking water does is keep you hydrated. Often the feeling of hunger is actually thirst. And you absolutely should drink half your body weight in ounces. It's very difficult to do, but trying is a good thing. Almost everyone is perpetually dehydrated.

I wish it were true. As I mentioned before, water itself is NOT hydrating, it’s the electrolyte content within that hydrates. This is why you see on most commercially produced water labels that it’s infused with electrolytes. If you drink too much water, it will dehydrate you even further, solely due to the fact that it’s flushing out your electrolytes.

And yes, there are many groups who believe that water helps to eliminate fat from the body. Another myth that is sadly not true.

 

[mryan75]

All great advice. Once I get the barometric surgery for which I have consulted actual professionals about, I will consider this advice for the future maintenance of my weight.

Just remember, regarding those professionals: to a man with a hammer, everything looks like a nail. None of them are going to tell you the surgery is a bad idea. I've never met someone who had the surgery who would recommend it. If you can't change your diet now, what makes you think you will be able to after the surgery?

Best of luck with your decision.

 

[Checkout_my_Six]

I've never met someone who had the surgery who would recommend it.

well....there are a few of us here who are recommending it. I'd do it again in a heart beat and highly recommend the sleeve.

 

[mryan75]

I wish it were true. As I mentioned before, water itself is NOT hydrating, it’s the electrolyte content within that hydrates. This is why you see on most commercially produced water labels that it’s infused with electrolytes. If you drink too much water, it will dehydrate you even further, solely due to the fact that it’s flushing out your electrolytes.

And yes, there are many groups who believe that water helps to eliminate fat from the body. Another myth that is sadly not true.

So if you took in electrolytes and NO water (or any other liquids), you would stay hydrated?

And yes, drinking too much water can reduce your electrolyte levels to dangerously-low levels, but that doesn't mean you're dehydrated. You surely can drink too much after, but it's pretty hard to do unless you're clubbing on ecstasy.

 

[mryan75]

well....there are a few of us here who are recommending it. I'd do it again in a heart beat and highly recommend the sleeve.

But you also had a different type of surgery than being discussed here if I understand you correctly.

That's the thing I don't get: the surgery isn't a magic pill. You still have to change your eating habits. So why not just do that?

 

[JOhnH]

. I've never met someone who had the surgery who would recommend it.

I think your sample size is too small. I know several people that swear, several years later, that bariatric surgery saved their lives.

 

[mryan75]

I think your sample size is too small. I know several people that swear, several years later, that bariatric surgery saved their lives.

I will admit you are correct, and certainly it's a different story if you're morbidly obese and facing serious, life-threatening health issues. But as an elective surgery I think it's crazy.

 

[RyanB]

So if you took in electrolytes and NO water (or any other liquids), you would stay hydrated?

To some degree yes. There’s a big difference between drinking water and actually absorbing the water that we drink (which is hydration). The common belief is that we should be drinking tons of water throughout the day, but what happens is you’re not absorbing much of it at all because you don’t have the minerals, electrolytes, and salts to keep it in your system, so you urinate the vast majority of it right back out. In essence you’re simply flushing your system and not allowing the body to actually absorb the minerals that the body needs. For people who fall within a normal BMI, two to three cups of water per day is plenty.

Think of it like this. When somebody vomits excessively and dehydrates themselves, they don’t go and reach straight for a bottle of water alone, they usually go for a sports drink that has a high electrolyte content like Gatorade. When you go to the hospital for dehydration, they stick you with an IV pouch which contains a high electrolyte content in fluid (usually water).

 

[Checkout_my_Six]

But you also had a different type of surgery than being discussed here if I understand you correctly.

That's the thing I don't get: the surgery isn't a magic pill. You still have to change your eating habits. So why not just do that?

Where you're wrong is that surgery is a magic behavior mod. Bad habits can alter that...but, not always.

and I have two family members with the Ruin-Y....they are doing fine. There are other issues with that procedure, but it will do the job too.

BTW...the OP doesn't say what procedure he's getting....

 

[RyanB]

Where you're wrong is that surgery is a magic behavior mod. Bad habits can alter that...but, not always.

I’m sure you’re joking. I guess for the people who lack self control, that’s true.

 

[mryan75]

To some degree yes.

I'm sorry, but the answer to my question is a resounding "no". Electrolytes are salts. They regulate certain functions in the body. I guess in some ways you could say that they hydrate in the sense that they regulate the flow of water in and out of cells, but they are not in any way a form of hydration. You could have all the electrolytes in the world and not be hydrated.

With the amount of sodium that most people get in their diets, it is virtually impossible to drink so much water so as to reduce your electrolytes to dangerously low levels. In fact, hypernatremia, a condition in which there is too much sodium (one of the four primary electrolytes in the body) in relation to the amount of water, can be life-threatening, and is caused by drinking too little water.

You can drink too much water, yes, but that is usually found in users of club drugs. Drinking too little water is a much bigger and more common problem. I don't know where this new thing about "you don't need to drink water" is coming from, but it sure has become a thing lately.

 

[mryan75]

Where you're wrong is that surgery is a magic behavior mod. Bad habits can alter that...but, not always.

Unless I'm misunderstanding you, I have said exactly the same thing.

*edit: I just reread what you wrote, and my response is... huh? Surgery is surgery. If you can't modify your behavior before surgery, why would you think you can modify it after surgery?

 

[gdwindowpane]

Next step for me is an appointment with a weight loss medical center. I assume they will assess my situation and provide medical advice to move forward. I have tried a keto diet in the past (Atkins) and lost 40+ pounds of which I gained back 40++.

I may give it another try. We’ll see what the Dr. at the weight loss center has to say. My only concern would be his motivation to advise bariatric surgery (his specialty).

If he recomends and I decide to persue surgery I am leaning towards the sleeve procedure as it seems to have the greatest amount of success stories.

The fact is that I need to do something.

Thanks for all the comments. It has definitly provided food for thought (pun intended lol).