Hello from the Delaware Watergap

[Denis Korb]

Hello everyone, I was on the OH forums and got a message from someone who suggested I check out this forum as well. I was getting frustrated with the OH website as it seems to have issues with its nutrition tracker, and wont allow me to create more then 3 foods without snuffing up. Anyway I am 566 pounds as of the last visit to my doctors at the beginning of February. My home scale said 548 a few days ago but it seems my home scale and the doctors scale don't always coincide. I have been doing great sticking to my high protein diet. The biggest difficulty I have found is eating enough calories if you can believe it. My resting metabolism burns 5100 calories and they want me to eat 2300 calories a day, which I have found very difficult to do unless I eat an 18oz Rib eye Steak every night, and I still fall slightly short of their requirements if I stick to the partial liquid diet they have asked me to utilize. I still have 2 months before they discuss my surgery date, so I'm hoping to have lost a significant amount of weight between now and then. I have eliminated all simple carbs from my diet, and no starchy foods like potatoes or rice. I no longer drink coffee or anything that has caffeine in it, and I have started drinking smart water to avoid sodium in my water. I live and die by protein shakes for snacks with my breakfast consisting of 2% cottage cheese, mixed unsweetened fruit, lunch normally being Tuna with onion 1 Tbs. of Helmans mayo (my one thing I wont sacrifice) on 6 leaves of Romaine Lettuce, and Dinner being either 18oz Rib eye, Taco Salad on Chopped Romaine (no tortilla, or chips), Buffalo Chicken Salad, Baked Chicken, pretty much any meat that I can eat. My Goal is to be 250 pounds by Christmas...where I want to take my wife to NYC to see the tree lighting. Anyway I haven't decided between the RNY or the Gastric Sleeve...I know that on the OH forums there are a lot of people swearing by the DS, but I cant imagine removing that much intestine being good for anyone. I was looking at the gastric sleeve because it would seem to me to have the least invasive effect over time.

 

[DianaCox]

I'm sorry to tell you, but there is no way in hell you're going to lose that much weight with the sleeve, and the long term stats for the RNY (especially for SSSMO like you) are abysmal. You need a DS - period. Who are you planning to use as a surgeon?

And you are not even close to understanding enough about the various surgeries to make a fully informed decision in any case. "I cant imagine removing that much intestine being good for anyone." Clearly, you don't understand what a DS is - there is no intestine removed, it is just rearranged.

While you are doing the required pre-op weight loss, STUDY, RESEARCH, LEARN about all of them. Learn to read scientific articles. Learn about statistics. Learn about the difference between short term studies and long term outcomes.

PS - another thing you need to wrap your head around - even though you are male, and males usually lose faster, there's almost no way in hell you're going to be 250 lbs by Xmas. You can expect to lose about 50% of your excess weight by six months after surgery (assuming you get a DS - all bets are off for a lesser surgery), with a gradual slide to a lower weight over the next 18 months or so.

 

[Denis Korb]

You may be right, I might not make 250 by Xmas, but that's my Goal. Math doesn't lie...currently I burn 5100 calories a day resting, if I'm eating 2300 calories a day 5100-2300=2800 calories a day lost assuming I don't exercise or preform daily tasks. That equates to 2800 calories * 7 days a week = 19600 calories lost a week divided by 3500 = 5.6 pounds a week lost. this of course will change over time as I lose weight, however in order for me to hit my goal of 250 I will need to lose 316 pounds by December divided by the 40 weeks I have left in this year = means I will need to lose an average of 7.9 pounds a week by the end of December to reach my goal. will it be easy...no, my hope is that I will lose enough in the good months after surgery to average out the weight loss to around 8 pounds for the 40 weeks. its all willpower and sticking to the diet. Keep in mind again I have eliminated all simple carbs...no bread, pasta, sugar, potatoes, rice, milk, coffee, soda, tea...all things that were vices for me before...20 days creates a habit, I have been on this new diet now for almost the entire month of February, I am happy with my current diet, High in protein and fats very little carbs. I will happily post my progress or lack thereof here as I progress...but I know myself I will be 250 pounds by Christmas or very close.

 

[DianaCox]

Not intending to discourage you - just trying to give you a more realistic point of view. And specifically, goals and numbers aside (they are pointless, by the way - in particular because the more you lose, the more your body is going to fight you on further weight loss), the main thing is that you need to do your research before you chose (1) the surgery you need and (2) - in that order - your surgeon. There are no DS surgeons in DE, and the bariatric surgeons who are in DE will tell you that the DS is "too dangerous" - because (a) they can't do and therefore they can't sell you one and (b) - most charitably - they don't know better (though they certainly should and shame on them if they don't).

We always look with bemusement on the naive and earnest commitment of the newbies to their new "healthy lifestyles" and naive belief that they can control their weight simply by committing to healthier eating, even combined with a lesser surgery. You have been living on this ascetic diet for a month now, and believe you have already created "new habits." Maybe you have - odds are, you haven't. What is important is creating a lifestyle that is DOABLE, SUSTAINABLE, and that WORKS, and for that, the odds are you are going to need the big guns of a DS to accomplish your lifelong goal of good health. Trust me, living long term on the diet you describe, even with a sleeve, is unlikely to be a long-term strategy for attaining and maintaining weight loss and resolution of comorbidities - Gandhi himself would be unlikely to be able to maintain that ascetic regimen long-term, and throw in the biological urges you are going to have to regain, and the metabolic derangements you must have to have gotten that big in the first place, and you are setting yourself up for not only failure, but self-blame. You will not be at fault if/when this plan fails - the only blame you should take responsibility for is choosing the wrong surgery if that happens.

THINK TWICE, CUT ONCE.

 

[Larra]

Denis hi and welcome! You have come to the right place.

I strongly agree with Diana's recommendation that you learn all you can about all your options. However, I also agree with her that the DS is far and away your best, probably only, chance for losing the weight you want to lose and keeping it off permanently. The DS has the best statistics of any bariatric operation for percentage excess weight loss, for MAINTAINING that weight loss, and for resolution of almost all comorbidities. Gastric bypass and sleeve both have less weight loss to begin with and higher failure rates. We are seeing new people all the time with RNY and sleeve looking into revisions to the DS. They tried their best. They were complaint. They exercised. And the weight loss simply stopped in its tracks and the regain began. And these people started out with much less weight to lose than you.
You also need to learn more about metabolism, and how the human body resists weight loss. We are programmed to hang on to extra weight to get us through the lean times that might be in the future. Of course, nowadays in our society food is readily available and there are no lean times, but that doesn't change our physiology. Do you really believe that just because you are using willpower and establishing new habits that this will last long term? In reality, your body will fight you every step of the way. Your metabolism will slow down. No one needs to consume 5000+ calories/day to start with, and after a month or two your metabolism is going to slow down and burn less calories even if you exercise more. At the same time, your body will ramp up production of hunger inducing hormones like ghrelin (there are others as well, but this is the best known). Instead of getting easier as you go because of your new habits, dieting and weight loss become harder and harder with time. It's not your fault! You are fighting your metabolism and physiology and your only weapon is your conscious mind. Obesity is very complex, not a matter of calories in/calories out.
So let's get real. RNY and sleeve will NOT get you the weight loss you clearly want and need. No amount of math and rational thought will change this. The DS does NOT include removal of anything except part of your stomach - and probably removal of less stomach than if you have a sleeve as a stand alone. You are in the right place, keep researching and reading. But you have a lot yet to learn.
since you are already on OH, I would also recommend you read the revision forum. I'll be honest with you, I can't bear to read it, it's too depressing. See how people struggle with regain. Remember that it's the long term results that matter, not how happy people are in the first few months after their surgery when they are losing and so certain that they've made a great choice. We see those same people a couple years later when they are no longer happy. You can learn from their experience.

 

[newanatomy]

Hello and welcome. I hope you will stay here and read all about the different surgeries. I had the DS 14 months ago and am still losing weight albeit slowly. I had about 150 pounds to lose. Some people lose faster than others in the beginning but we all slow down in the end. This is a great place for support and for research. Dig in!

 

[Bagaof4]

Yes ^^^^^^to everything above. Please read as much as you can before making a decision. While I was not SSMO but was in fact a lightweight at 245 lbs, I never considered any other surgery than the DS. At 61 at the time of my surgery, I knew this would be my best shot at losing and maintaining my loss. I would not want to face a revision later. I have lost and maintained a 125 pound loss at 2.5 years out and have not regretted my decision for a second. The trade off is being religious about my supplements, protein and labs. It is a minimal price to pay for my health and being able to eat a varied diet much like a 'normie.'
Some people would say the DS is too extreme for someone like me. I vehemently disagree.
For someone like you, I believe it's the ONLY choice.

 

[Denis Korb]

Not intending to discourage you - just trying to give you a more realistic point of view. And specifically, goals and numbers aside (they are pointless, by the way - in particular because the more you lose, the more your body is going to fight you on further weight loss), the main thing is that you need to do your research before you chose (1) the surgery you need and (2) - in that order - your surgeon. There are no DS surgeons in DE, and the bariatric surgeons who are in DE will tell you that the DS is "too dangerous" - because (a) they can't do and therefore they can't sell you one and (b) - most charitably - they don't know better (though they certainly should and shame on them if they don't).

We always look with bemusement on the naive and earnest commitment of the newbies to their new "healthy lifestyles" and naive belief that they can control their weight simply by committing to healthier eating, even combined with a lesser surgery. You have been living on this ascetic diet for a month now, and believe you have already created "new habits." Maybe you have - odds are, you haven't. What is important is creating a lifestyle that is DOABLE, SUSTAINABLE, and that WORKS, and for that, the odds are you are going to need the big guns of a DS to accomplish your lifelong goal of good health. Trust me, living long term on the diet you describe, even with a sleeve, is unlikely to be a long-term strategy for attaining and maintaining weight loss and resolution of comorbidities - Gandhi himself would be unlikely to be able to maintain that ascetic regimen long-term, and throw in the biological urges you are going to have to regain, and the metabolic derangements you must have to have gotten that big in the first place, and you are setting yourself up for not only failure, but self-blame. You will not be at fault if/when this plan fails - the only blame you should take responsibility for is choosing the wrong surgery if that happens.

THINK TWICE, CUT ONCE.

All I can say is Wow...for not wanting to discourage, you do a great job of doing so, but let me enlighten you a bit. My original intention was to skip surgery all together 2 years ago. I started on a diet called the advanced health systems diet from Robard while being watched by a bariatric doctor when I weighed 596 pounds. I could only purchase these product from her as she was the only doctor in my area that could prescribe the diet...I would eat 3 bars, and 2 meals from the Robard menu and then eat an 18oz rib eye and a salad. I did this for around 2 months and lost from 596 to 554 pounds...I would have continued this diet with her if she hadn't gotten married and ran off to Hawaii. I consulted my family and we decided that this diet wasn't that different from the Atkins diet so we began buying the Atkins meals and bars from Wal-Mart. If I had the money I would have gone to Live in Fitness in Hilton Head South Carolina, as they have had significant success with patients dedicated to losing the weight through exercise, as it stood I began using the pool at my local YMCA for 45 minuets every other morning. I was seeing significant body changes, but then I injured my right knee exiting the pool. I went to the doctors and they told me to stay off the knee until it got a bit better then go back to doing what I had been doing. Sadly not long after this my car broke down, and my wife and I noted that we gained some weight even while using strictly frozen Atkins meals from Wal-Mart. Upon closer inspection of the Atkins website we found that you should only eat 2 Atkins products a day as there are hidden sugars in their products. At this point I was quiet discouraged, and had to deal with the lack vehicle that could get me around from summer 2013 until July 2014 where I had developed a back issue (possibly Sciatic) and ended up in bed for the next 4 months. I hit a rock bottom point where my back was spasaming so badly that I finally called a hospital and was put in touch with a social worker who has helped me a lot...he has been an angel on my shoulder. I watched how my health affected my wife, and I vowed that this was the last time I would make excuses. I have made up my mind, I will lose this weight by any and all means, and I will never allow myself to sit in my house again.

I don't look at surgery as being my only option to lose weight I look at it as a tool...regardless of what surgery I get I understand that there is a limited time during which I will lose weight 1-2 years. I am former military so I know that I am capable of doing whatever I set my mind to do, and I use logic and math in determining what is a sensible way to proceed. "goals and numbers aside (they are pointless, by the way" I am stunned that you would say anything like this especially to a new member of this board. having a Goal that you wish to attain should be encouraged in every way, though possibly tempered with some reality...you apparent attempt at a reality check is the equivalent of bashing someone over the head with a club. I understand that for you my diet may seem unsustainable, but for me this diet was typical as it wasn't that different from the diet I ate in boot camp for 6 months during training. The reason I gained weight in the first place wasn't due to binge eating as I suspect your implying, it was due to a lack of sleep, working 16 hours a day, not eating breakfast or lunch and then eating excessive dinners (2-3 helpings of spaghetti and meat sauce)...Pizza, Lasagna, Mac and cheese, corn, Mashed potatoes, foods that I no longer am eating for obvious reasons. Yes, if wanted to eat excessively and not change my habits I'm guessing going with a DS seems sensible, but I have been through the process of changing my eating habits for nearly 2 years now. I know how to exercise, I just haven't applied it in years. I have looked into weight loss surgery 3 times in the past....I haven't met my surgeon yet as I am going through the process through Geisinger Health systems in PA...Oh yes, also the Delaware Water Gap is in PA/NJ off of I-80.

 

[Denis Korb]

Denis hi and welcome! You have come to the right place.

I strongly agree with Diana's recommendation that you learn all you can about all your options. However, I also agree with her that the DS is far and away your best, probably only, chance for losing the weight you want to lose and keeping it off permanently. The DS has the best statistics of any bariatric operation for percentage excess weight loss, for MAINTAINING that weight loss, and for resolution of almost all comorbidities. Gastric bypass and sleeve both have less weight loss to begin with and higher failure rates. We are seeing new people all the time with RNY and sleeve looking into revisions to the DS. They tried their best. They were complaint. They exercised. And the weight loss simply stopped in its tracks and the regain began. And these people started out with much less weight to lose than you.
You also need to learn more about metabolism, and how the human body resists weight loss. We are programmed to hang on to extra weight to get us through the lean times that might be in the future. Of course, nowadays in our society food is readily available and there are no lean times, but that doesn't change our physiology. Do you really believe that just because you are using willpower and establishing new habits that this will last long term? In reality, your body will fight you every step of the way. Your metabolism will slow down. No one needs to consume 5000+ calories/day to start with, and after a month or two your metabolism is going to slow down and burn less calories even if you exercise more. At the same time, your body will ramp up production of hunger inducing hormones like ghrelin (there are others as well, but this is the best known). Instead of getting easier as you go because of your new habits, dieting and weight loss become harder and harder with time. It's not your fault! You are fighting your metabolism and physiology and your only weapon is your conscious mind. Obesity is very complex, not a matter of calories in/calories out.
So let's get real. RNY and sleeve will NOT get you the weight loss you clearly want and need. No amount of math and rational thought will change this. The DS does NOT include removal of anything except part of your stomach - and probably removal of less stomach than if you have a sleeve as a stand alone. You are in the right place, keep researching and reading. But you have a lot yet to learn.
since you are already on OH, I would also recommend you read the revision forum. I'll be honest with you, I can't bear to read it, it's too depressing. See how people struggle with regain. Remember that it's the long term results that matter, not how happy people are in the first few months after their surgery when they are losing and so certain that they've made a great choice. We see those same people a couple years later when they are no longer happy. You can learn from their experience.

I appreciate your post Larra I will read the Revision Forum...that might have been a better way to get the DS point across without an immediate criticism of my goals. There is a difference in having a goal and attaining a goal stating that you are amused by someone's commitment is a sad and offensive way to join what I understood to be an encouraging community.

 

[southernlady]

Welcome, @Denis Korb

I was great at LOSING weight but my issue was being able to keep it off. Sounds like you as well....and while I applaud your effort in what you have done so far, it's become apparent to you that you need more help or you wouldn't be considering surgery.

Since you are near Philly and NJ, check into Dr. Greenbaum in NJ...he does the DS and let him explain it to you. Or Dr. Bonanni at Abington.

Read everything here...there is a wealth of information.

I'm gonna tag a few of the active male members, @robs477 (who couldn't lose weight regardless of what he tried, even on 800 calories a day) and @chevtow

One thing I do suggest is remember that everyone here may not be as warm & fuzzy as we might like. This is the internet.

 

[DianaCox]

I am trying to discourage you from making a MISTAKE. Your belief that you can overcome being SSSMO with diet and exercise, or even with a less effective surgery, is magical and irrational thinking. The recidivism rate with diet and exercise alone for people who are "just" morbidly obese (BMI between 40-49) is over 95%. The failure rate for VSG and RNY is not much better after 5-10 years, and in particular, the rate of remission of comorbidities of morbid obesity are even worse.

Geisinger does not have a DS surgeon - so you are going to be looking for a Ford dealer to sell you a Mercedes - ain't gonna happen.

I'm not trying to discourage or belittle the heroic efforts you are trying to make - I'm just trying to save you the time, money, irreparable physical damage and emotional devastation that will result when you almost inevitably fail, no matter how hard you try to make this work with diet and exercise, with or without an an ineffective surgery.

"Bemused" is not the same thing as "amused." It is very admirable that you are trying to make this commitment to change, and we see it over and over and over again - people come with naive enthusiasm and high hopes for being able to cure their disease of obesity by "making lifestyle changes" - it is part of the learning curve and utterly predictable in pretty much every way. What I am trying to SHOCK you into realizing (and yes, deliberately trying to annoy you into doing your research to try to disprove me, which should lead you to the conclusion that I know whereof I speak) that your plan is a nice theory, but utterly doomed to fail.

Rather than investing time, effort, money, starvation, misery, and risking long-term damage caused by the inevitable failure to select a treatment plan that has a snowball's chance of actually WORKING, I want you to realize as quickly as possible that the DS is almost certainly the ONLY treatment that will fix what's broken with you - which is your metabolism, far more than your "bad habits." When your metabolism is fixed by the DS, the "habits" (which are most likely predominantly inappropriate biological urges caused by your broken metabolism that are about as hard to ignore as an itch) are much easier to fix.

But, sadly, like many people who can only learn the hard way, if you don't want to hear this, you won't.

You are free to ignore me if you wish - but you probably shouldn't.

(Going on 12 years post-DS, PhD in medical biochemistry and molecular biology, long-term advocate for DS, and Bad Cop)

 

[newanatomy]

Please don't get your knickers in a twist over perceived insults on here. No one is trying to insult you. They are trying to help you. Diana and Larra are true experts, not simply veteran DS patients. They give generously of their time and knowledge to help people learn to advocate for themselves and to educate us. Take a deep breath and re-read what is presented above in this thread. Read it as if it were written in a medical journal and not directly to you. Keep the "personal" at bay.

I know I personally have lost hundreds of pounds over the years of fighting my obesity. Getting the pounds off is a small part of the problem. Keeping them off is the bugger. That is why I chose the DS. I need help to maintain healthy habits.

 

[Denis Korb]

Oh, make no mistake Diana, I am fully capable of thinking, and I'm willing to do research, I just find your method to be quite wanting. I have serious issues with Doctors who believe they know what's best simply because of their education. You seriously need to rethink how you deal with the average individual, Had I not dealt with Doctors in NYC as a Network engineer and weren't aware of your sort of mentality, I may have had a few choice words for you and went back to the OH forums. Luckily I have an Uncle who is a Psychologist and another who is a Nuclear Physicist, so I have heard the I know it all and you don't so you should listen to me argument before.

 

[Denis Korb]

Please don't get your knickers in a twist over perceived insults on here. No one is trying to insult you. They are trying to help you. Diana and Larra are true experts, not simply veteran DS patients. They give generously of their time and knowledge to help people learn to advocate for themselves and to educate us. Take a deep breath and re-read what is presented above in this thread. Read it as if it were written in a medical journal and not directly to you. Keep the "personal" at bay.

I know I personally have lost hundreds of pounds over the years of fighting my obesity. Getting the pounds off is a small part of the problem. Keeping them off is the bugger. That is why I chose the DS. I need help to maintain healthy habits.

Newanatomy, she clearly intended to "shock" as she admitted in her post. I get it, I understood it, I would preferred to have heard it a different way, I joined this community at an invitation with the interest of being encouraged not discouraged. I don't have the ability to go to New Jersey to seek out specific doctors as has been suggested...I am essentially house Locked, I have ambulances take me back and forth to Geisinger, and I have been on a path of working toward getting the surgery. I am working with a social worker, physical therapist, and psychologist who informed me to find communities that would help to encourage me on this journey. And while I get that Dr. Cox has the best of intentions, she is biased having had the DS. And while I'm sure there are many who have failed in their long term efforts after having the VSG, and RNY, there are many more that have not. and to assume immediately that I couldn't possibly stick to my diet simply because she may not have is kind of insulting. If we are here to encourage one another, then lets do that...lets not assume the worst....lets hope for the best. Should that fail, we support those who have made the decision they felt was best for them at the time.

 

[DianaCox]

Well, good for you - I'm happy to know that you are clever enough to be "on to me." Because, you know, I haven't run into anyone like you in 12+ years on the obesity message boards. And because my "tag line" on my avatar isn't "Bad Cop" for any particular reason. And because after 12+ years, maybe someone like you is just the person who can convince me to change what I have concluded is a very effective teaching posture on the internet. Right.

And I'm so glad to know that you will not be biting off your nose to spite your face by leaving in a huff (or a minute and a huff) to get your "information" from OH.

This message board has a very lame "ignore" function, but perhaps it will be effective for someone like you.

PS: My message is and has been, DO YOUR OWN DAMNED RESEARCH - I'm just pointing you in the right direction. You should come to your own conclusions based on scientific evidence - but you were so clearly WRONG in your first post, you obviously needed a kick in the ass to let you know just how much you don't know - before you make a very foolish mistake.

PPS: I don't win a toaster or free cruise for "recruiting" new DSers. I just hate seeing people make terrible uninformed mistakes, which will affect them for the rest of their (probably shortened) lives. You are free to make all the INFORMED mistakes you wish, with no further intervention from me. And I won't even bother to say "I told you so."