Long-Term Outcomes of Sleeve Gastrectomy: Weight Recurrence and Surgical Non-responders

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https://link.springer.com/article/10.1007/s11695-023-06730-z

I‘m not paying for the entire article but the stats don’t look good.

I’m glad for that 20%. I believe I know two who are doing well years later.

Closer to home, my sister regained every ounce plus another thirty or more pounds. And her daughter-in-law’s daughter is one of those non-responders; it appears as though she never lost a pound.

But if someone asked my advice, I’d keep repeating “How lucky are you? Because for four out of five, this doesn’t work.”
 
This is sad on several levels - first, because so many patients were sold on a major surgery with a low long term success rate, next, because they were directed away (perhaps be their surgeons, perhaps by on-line hype, who knows) from more effective options, next, because many of them won't be able to have a second bariatric surgery because their insurance won't cover it, next because they will be blamed, and worse blame themselves, for their "failure", and lastly because those who do manage to have another operation will mostly be shuttled back to gastric bypass, which is probably what most of them were trying to avoid to start with.
And those of us who were really, really well-informed saw this coming. Just sad all around.
 
About 10 years ago, a Baristric nurse confided to me that the surgeons love it. It’s quick and they quite often get to bill an insurance co. a second time for an RNY.
 
The bariatric surgeon I saw before we moved into our RV when our PCP decided he didn’t want to handle our labs called the sleeve, the sleeve ‘em am and leave ‘em surgery cause they needed no real follow up care unlike his core group, the RNYers. He sent us back to our PCP with a note for our PCP to do his job and monitor our labs.
 
I am actually thankful in switching jobs a few times since having had my VSG that I now have a new / different insurance that I didn't have when I had my VSG done initially. Sadly, I am one of those that regained all of my weight back. I was told VSG was the best surgery for me, etc etc....I was steered away from the RNY that I had initially settled on back then. In some ways I'm happy, in some ways not so much. I see my mom who had her RNY in 2007 lost weight, but also have that weight loss come back even for her. Now, I am pursuing revisional surgery to go from VSG to DS because I finally did some research on surgeries rather than jumping into the deep end blindfolded with weights shackled to my legs. There really needs to be better information out there for people who don't know....who truly believe that VSG is the end all best weight loss surgery. Its only restrictive....and it's really only effective for a period of time...a very small window. Eventually, people learn the ways around it....eventually people can start eating a little more, and more. Eventually, people have no punishment for not abiding by the VSG rules, because there really aren't any. When I settled on wanting RNY, I wanted it for the higher potential of dumping syndrome being the proverbial slap on the hand.....or slap to the face to wake me up and say, "HEY, numbskull....you can't eat chocolate anymore unless you enjoy feeling like you're gonna die!". I never got this with VSG. In fact, the only benefit I had with the VSG was portion size being small...and not allowing me to eat til my hearts content in one sitting. That doesn't mean I can't have a few bites now.....a few more bites 10 mins later, and so on until a giant plate of food is gone. So yeah, VSG is just not good long term, unless you can and do work extremely hard to maintain good eating habits, and work out.

I feel blessed and am looking forward to my DS surgery, and knowing that it will be the best tool to help me re-lose my weight and this time around, keep it off long term.
 

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