Anonymous wrote:

Anonymous wrote:This practice https://twitter.com/DoctorTro/status/1748334587204272375 along with https://www.virtahealth.com/ are getting very good results. They do a lot of virtual monitoring of CGM and other data and do offer support and education around food addiction issues. Cheaper than the drugs, I'd probably start there.

These are nutrition-based programs?

Or do they offer medication and/or surgery as well?

Anonymous wrote:

Anonymous wrote:My SIL had WL surgery (not sure which one) to lose around 80 pounds. She threw up after every meal and regained all the weight within 1-2 years. She never changed her eating habits (high carb, high fat, lots of sweets) or took up an exercise regimen.

I'm the pp who lost 83 lbs, and no judgment at all, just a little baffled. I have no clue how it's humanly possible to gain back the weight. Maybe some, but all seems physically impossible due to the structural restrictions of the reduced stomach. When I hear stories like your SIL's, I have so many questions.

Anonymous wrote:

Anonymous wrote:My husband and I both had the gastric sleeve after both loosing and gaining back 60 pounds several times. It's one of the best decisions we've ever made. No complaints in any way. We both look great and are healthier. Surgery was easy, recovery was easy after a few days. Neither of us ever gets very hungry but we do eat delicious healthy meals, just smaller portions. And slowing down means we really enjoy our food now. Some of the hearsay stories are clearly about older types of surgical procedures. The sleeve is very different from gastric bypass. Any good bariatric surgeon will go through all of the options with you, including medications. I've had several surgeries and the sleeve was by far the least painful and problematic. My c-section and having upper and lower bleph on eyes were substantially more painful and left permanent complications. The sleeve was a dream for both of us. My mother also had it done at 70 and also loves it. She's a major complainer and even she says this was easy.

Your mother had weight loss surgery at 70? That is unusual

Anonymous wrote:Forgot to add, visit realself's forums. It's what you are looking for. Thousands of reviews about every type of surgery. I think gastric sleeve was ranked as the number surgery for patient happiness afterwards.

Anonymous wrote:This practice https://twitter.com/DoctorTro/status/1748334587204272375 along with https://www.virtahealth.com/ are getting very good results. They do a lot of virtual monitoring of CGM and other data and do offer support and education around food addiction issues. Cheaper than the drugs, I'd probably start there.

Anonymous wrote:

Anonymous wrote:Please encourage him to spend some time - weeks/months, not hours - reading in the bariatric forums and support pages on Facebook, Reddit, etc.

I was considering bariatric but was depressed at the time so my therapist wouldn’t initially clear me psychiatrically.

I used the time while my depression was resolving to do a deep dive into the research on rates of weight regain and rates of transfer addictions in bariatric patients. I was shocked, and remain disturbed by how little attention is paid to this in the surgeon’s presentation to patients - I met with the surgeon twice, the dietitian several times and did all the extensive pre-op screening testing to be approved for the surgery and the entire time risks and complications were downplayed and zero attention was given to regain and addiction until I raised it with the dietician who acknowledged it’s a reality.

The weight control program I went to is excellent, the surgeon is excellent and has a super low rate of complications etc. I don’t doubt that they are among the best bariatric centers going as I live in an area with some of the best healthcare in the world.

That said, there is little offered in terms of resources on food addiction as a behavior disorder. Patients are encouraged to get counseling if they feel they need it. From what I read about on the support pages and forums, this is a huge problem and the pun is intended.

Patients are posting about hacking their diets before they even get surgery and wanting to get back to their food favorites within days - those who experience the worst physical side effects (vomiting, nausea, chills, etc.) when they try to eat the old way are typically the ones who start up an alcohol or other addiction - and it’s easy to do because the altered gut metabolizes alcohol differently so bariatric patients have a totally different relationship with alcohol.

I would strenuously encourage the weight loss drugs first - they are largely reversible. Once you alter your gut through bariatric surgery yes it can stretch and you can gain all the weight back, but you will still have the same long term risk of obstruction and malnutrition if you aren’t religious about supplementing because you can never absorb nutrients from food again the same way.

As for me - not at all virtuous, still struggling with food urges and working all the time on the behavioral aspects of my disordered relationship to food which in my case is related to childhood trauma. But I have lost 35 of the 160 pounds I gained over the decades and am steadily losing weight- slowly, healthfully - by eating a much healthier diet with lots of plants, much less saturated fat, little to no processed foods and very, very minimal sugar. No alcohol, fizzy/sweetened drinks or fruit juices.

Honestly to lose 100 lbs I would recommend trying just about anything else before major gut resection. Therapy for what’s at the root of the eating, and significant dietary changes plus exercise for the mental health benefits and to boost metabolism and maintain muscle as he loses.

This is really good advice

Anonymous wrote:My husband and I both had the gastric sleeve after both loosing and gaining back 60 pounds several times. It's one of the best decisions we've ever made. No complaints in any way. We both look great and are healthier. Surgery was easy, recovery was easy after a few days. Neither of us ever gets very hungry but we do eat delicious healthy meals, just smaller portions. And slowing down means we really enjoy our food now. Some of the hearsay stories are clearly about older types of surgical procedures. The sleeve is very different from gastric bypass. Any good bariatric surgeon will go through all of the options with you, including medications. I've had several surgeries and the sleeve was by far the least painful and problematic. My c-section and having upper and lower bleph on eyes were substantially more painful and left permanent complications. The sleeve was a dream for both of us. My mother also had it done at 70 and also loves it. She's a major complainer and even she says this was easy.