Considering Surgery Q & A

A blog reader, Cara, sent me a thought-provoking email today. She is considering weight loss surgery and had some questions for me. I recently took a friend, Andrea, under my wing who is also considering surgery and have answered a lot of her (and her parents) questions lately. I love to help and share my experiences. I'm not perfect and could have done/still want to do better. But I believe if you share only the positive experiences you are doing a disservice to prospective surgery patients. I am sharing her email here (with permission) and my answers to it in hopes that it may help others!


Hello Christie!

I've followed your blog for years and don't think I've ever left a comment -
but I've very much enjoyed following your journey and am just so impressed
with your weight loss.  Congratulations and great work!!!  You are a big
inspiration!

I'm starting to consider some sort of weight loss surgery (after a lifetime
of weight issues myself).  My husband might do it with me too - so we have a
lot in common with you and Ian.  You haven't mentioned his weight loss much
lately.  Would you mind my asking if he's also had a positive experience?
Do you mind me asking you a few other questions about your experience?

Here are some of my thoughts/questions for you....

1)      Do you recommend doing the surgery with your spouse?  Did it make it
easier?  Do you think it would have been a lot harder if you hadn't done it
together?

I think if you have this option it is absolutely a wonderful thing to do, and as close together as possible. Ian had his 2 weeks after me so I had time to recover, but that way we went through a lot of the eating phases together and we ate small portions together. It helps greatly for both of you to be focused on small portions, high protein eating, and making your food choices a priority, such as packing a lunch box when you are going to be out for the day. It also makes it nice to split meals at restaurants and still bring home leftovers. I think for me personally it would have been harder doing it without him, because it was nice to have him on board.
On the other side of the spectrum, though, is that we tend to do everything together both good and bad. Ian has never been as dedicated to the weight loss as I have (which I will cover further in answer to your other question), and when he lacks motivation in exercise or decides to splurge on treat, or sits down snacking on the couch, it makes me feel like I can do it too. That has definitely affected me. If he were a little more dedicated, it would help me stick to my plan better. But, I am still very glad we did this together and it was SUPER helpful to me especially in the beginning. It still is now in the fact that he understands what I have gone through, am going through, and my goals. An outsider/non-op doesn't understand those things as well.

2)      Do either of you ever regret the surgery?

No. Not EVER! I know some people have complications, so I won't pretend that's not a possibility... but neither of us ever had any. Some people deal with remorse and sort of mourn the loss of being able to pig out. We never felt like that and we loved being able to enjoy smaller amounts of food. I have thoughts of things I wish I had done differently if only I had known - such as, if I had it 6 months later, I think I would have had more success because my surgeon now makes the sleeve tighter so this patients eat less for longer and they don't have hunger anymore, which Ian and I both have always had. But, how do you ever know that kind of stuff. I have never once regretted surgery and neither has Ian. Best decision we have ever made.

3)      What's been your biggest complication (health issues) as a result of
the surgery?

None. Again some people have complications but we never have. The surgery has had nothing but positive impacts on our health.

4)      It seems like a lot of people who get the sleeve surgery lose 100lbs
in the first 6 months and then stall out there.  Honestly - I'd be THRILLED
to lose 100lbs and maintain that loss (even though I'd still technically
have a lot more weight I could lose).  But I'm confused why it seems so hard
for people to get beyond the 100lb loss.  You seem to eat so little and do a
great amount of exercising.  Does it frustrate you that you haven't lost
more?  Do you think there's an issue with the surgery that makes it hard to
lose more?
It definitely frustrates me that I haven't lost more and I have my days that it drives me nuts. However there are a lot of contributing factors. One, I have always had hunger which has made it a bit harder for me. Two, I did so well in the beginning I think I tricked myself into thinking I could slack off more, which I did, and now I have a harder time getting back on track. Three, if I had started strength training from the beginning, I think that would have made a big difference.
I do think I can still lose more, and I'm sure going to keep trying. I thought I would reach goal with no problem, especially considering how quickly I lost at first. So at times I get really bummed out about it. But overall, I am so much better off. I am thinner AND healthier than I have EVER been. I weighed 230-270 throughout high school, even. I was probably this weight in 6th grade. Not to mention, I have been able to KEEP the 100 lbs off for a year and a half now. I did have a bit of a gain, but I got rid of it quickly. Just the ability to maintain is something the surgery is still helping me with every day. Without the restriction, I'm sure I would gain.
Then there's a good way to refocus - and that is - if someone had told me before surgery I would lose 100 lbs and that's all - I still would have done it. So I need to remember that.
As for if there is an "issue" with the surgery, I don't think so. It seems to me most people having sleeve don't have more than 100 lbs to lose. When Ian and I had it, we were encouraged to go with bypass because it's a lot more successful if you have MORE than 100 lbs to lose. Sometimes I wonder if we should have listened... but I am also glad I did it this way. I can always revise and add the bypass if I choose to, but I feel so much more NORMAL without having done the bypass. No digestive issues, or special restrictions, or problems absorbing nutrients and vitamins.

5)      One of my fears is that I'll have to constantly be thinking about
food after the surgery. Do you feel that way?  Do you feel like you spend
more time now having to plan, prepare, think about food (making sure you get
the right amounts of protein, etc) or does it just become second nature?
One of the reasons I want the surgery is to be less of a 'slave' to what I
eat if that makes any sense.  I know I'll have to put a lot of work in and
that it is by no means the 'easy' way out - but I guess I just don't want to
spend the rest of my life being consumed about what I do/don't eat.

To be honest, sometimes I feel like I am thinking about it a lot. But sometimes I don't! It will go through phases. In the beginning you do have to think about it a lot because you are on a special diet. On my plan there was a liquids phase, a soft/pureed phase, a soft solids phase and then into solid foods... and very specific things we were supposed to eat. Once on solid foods it was easier... but we still did a lot of planning of taking a lunch box with us all the time, because we eat every 2-3 hours and if we didn't have food with us it would be a) harder to make a good food choice and b) would make us have to inconvenience other people to give us a chance to eat. Bringing a lunch box is easy to do, but you do have to think about it and take time to do it. A lot of things do become second nature so after a while it became easy to choose high protein, low carb foods and to plan ahead. However, it also was easy to get off track, which I did for a good year to year and a half and is part of why I haven't had more success. So now, I'm going through a big phase of learning to cook more/plan dinners as well as plan other meals for the day for me, hubby and my dad since I'm trying to help all of us lead more healthful lives. Meal planning is a pain in the butt, and can be overwhelming when you start. However think about it this way - whether or NOT you have surgery, meal planning is pretty essential in eating a healthy, well balanced diet and losing weight or maintaining weight loss. If you aren't planning, you're grabbing, and that usually leads to poor decisions and weight gain. I think it's a reality you have to accept that if you have a problem with weight, you need to do meal planning. It's a lifetime commitment. That's with or without surgery.

6)      And again - can you share any of Ian's experience and if he has any
regrets?

Ian's experience has been very different than mine. Before surgery, he talked a big talk and he completely understood that he would have to work hard to be successful. In the beginning, he was successful, but his loss was slower than mine and he never really fully got his head in the game. When I look back, I think he let the surgery do the work and he never fully committed. He was so excited to be losing weight, but it was so easy to do so that he didn't see the need to exercise more (he hates exercise). He did change his eating habits quite a lot in the first 6 months, but we BOTH let a lot of bad habits back into our lives (especially more carbs, snacks, sweets) and because he didn't exercise as much as I did, it led to more weight gain for him. He originally lost 88 lbs but has gained about 45 back. He still talks with me frequently about wanting to do better. He has just made himself a workout schedule and he is trying to snack less. I've taken on trying to pack him more meals (even just to eat at home) so he has healthy, convenient things to grab instead of grabbing empty carb snacks. He has struggles like we all do and I still have hope that he can overcome them. He is always saying things like "you are trying so hard and I need to be trying harder" and "I can't keep gaining weight while you keep getting smaller"... so he is fully aware of what he needs to do. SURGERY WILL NOT FIX YOUR HEAD. It will also not magically give you dedication and motivation. You need to work on all of those things, even in the phase when things seem easy, so that as weight loss slows down, you have the right habits in place for continued success.

One more question if you don't mind...

There are times I think, "Well - I could just limit my calories and eat like
I'd have to after the surgery and I bet I'd lose the same amount of weight
without having to actually HAVE the surgery."  Do you have think about that?
(I kind of already know the answer and that's that if that was truly all it
took, I'd have lost weight and kept it off years ago!)  But it's an
interesting concept.  Do you think you could have ever reached/maintained
this type of loss without the surgery???

You hit it on the head. Of course it is possible to limit your calories and lose 100 lbs. People manage to do it all the time. However it requires LIFE LONG dedication to be successful at keeping it off. Of course, it does through surgery as well, but for me personally, I don't believe I would have gotten this far without surgery - and not for lack of trying either! Low calorie diets are extremely hard to stick to long term AND they are bad for you (lots of research on that). If done in a high protein, low carb way it does help because the high protein helps your body continue to lose fat and stay strong and healthy despite the low calories which is why this diet is stressed post-op. You are consuming SO FEW calories when you are in the early stages post op. But it is not long term.
I feel that if someone is considering weight loss surgery and has never given a serious, lengthy effort to weight loss without surgery, then they should do so before having surgery. Many women gain their weight after having children and then are looking for a 'quick fix'. However when it is a lifelong battle like it has been (and always will be) for me, and sounds like it is for you, then that's a different story. Like you said, if you could have, you would have by now, right? And that's how it was for me.

I know this is a lot to ask and I COMPLETELY understand if it's too personal
or you don't have time to share.  Your journey/success has been an
inspiration and I figured it was at least worth a shot to ask these
questions...

THANK YOU so much for being so open on your blog!!  I can't even remember
how I found it - but I love every new post you do!

:-)