So many thoughts after first appointment! Help!

Hi Thatbaygirl I totally understand your obsession. Our PHI kicks in August this year, and I have spent alot of time researching this topic. I have researched into both gastric sleeving, and gastric bypass, as my husband is having the operation in August and I am also planning to follow 6 months later. I also have struggled with my weight all my life. I now believe that weight loss programs are like casino's, they rely on repeat customers. They get rich of our failures. I initially was looking for an option to treat my husband's diabetes, but now see weight loss surgery as an option for both of us.

Our surgeon also said that the trend in the States, is that people are having the vertical sleeve gastrectomy (VSG), putting on weight and then opting for a Roux-en Y gastric bypass (RNYGB).  My husband is having an omega loop bypass aka mini gastric bypass( MGBP), which is a combination of a sleeve with bypass surgery. This operation has the combined benefits of a sleeve shaped stomach, with the malabsorption of the bypass which helps keep the weight off. It has less complications than a RNYGB, and similar benefits.  It is a relatively new procedure being performed since 2001. 

Both the VSG and MGBP procedures assist in reducing the hormone Ghrelin which causes appetite. This is because the portion that is either cut away or sectioned off is no longer able to produce that hormone, therefore only the stomach remaining can release this hormone, and the amount is greatly reduced. So in theory appetite is also reduced. This is a great help with the reduced stomach size in initial weight loss, as well and ongoing management of weight stability in the later phases.

One study I have read compare VSG to MGBP patients 5 years after their procedures. Prior to surgery the average BMI was 55. Five years post operatively they found that VSG patients had an average BMI of 35 compared to MGBP patients with an average BMI of 28. The number of people in this study I think was around 700-800. But I haven't been able to find much information on long term results as it is so new. I have also read that the MGBP is superior to VSG for those that experience gastric reflux (which I do). 

However, I am not qualified to give medical advise, and I am sharing information I have found.  I have found people on this forum very generous with their information, and I trolled the surgeon's section, reading reviews to get an idea of other people's experiences. Our surgeon is very blunt and matter-of-fact. I liked him as he was confident, knowledgeable, and very clear with what he said to us. He was up to date with the latest research, and has a real interest in this field. He had been recommended to me by someone I know. I initially thought the VSG was the best option, but after talking to him, and doing my own research I now feel comfortable with the MGBP option for us.

I do believe that some people will continue to overeat and their sleeve will learn to accommodate the greater portions of food. I have seen youtube vlogs where people have put on weight post RnYBP in the States.  My mother had her stomach stapled in the 90's, and she is now a size 18/20, and has no difficulty consuming large servings of food.

I also understand that the main benefit of the surgery is that we will all loose weight initially with reduced appetite and a smaller stomach. However, we have to work on ourselves to keep it off, and learn new ways of coping with food.  The hope is with the weight loss that people will be motivated to exercise more, and change their eating habits so that the weight does not go back on. But of course there will always be those who despite having surgery will put their weight back on. If we eat more than our bodies need, the weight has to go back on. We have to work with our minds as well. That's why we need a team to educate us when we undergo this procedure, dietitians, surgeons, psychologists.

Still I haven't had the op yet, so it's all theory for me. 

Take care

I think the one in 5 could be for a few reasons - though, I've not heard that stat before, and, given it's relatively a "new" procedure, I'm not sure that stats from the first sleeves 10 years ago will ring true for stats from sleeves done now anyway.

Possible reasons to go to a bypass - reflux could be one.  Always a chance a sleeve could induce intractable reflux needing a surgical solution.  Weight gain - stats seem to show that some will go on to regain significant amounts of weight, and bypass could be an option.   I guess maybe adhesions could feasibly cause scarring that creates strictures in the long term that might need a bypass.  That one's a guess.

As for the lecture - it's hard to know his tone without being there - but yeah - it's a very important point for him to get across to prospective sleevers, so probably good reason to be serious.  This is not a miracle cure, and it will not work long term without an absolute commitment from you to change your eating habits.  The sleeve is a tool, but you still need to swing it right.  

You have a while to wait - I did too.  I used the time to start seeing a psychologist and making changes in my diet and fitness prior to the op, and I truly believe it has helped me immensely.   It was hard work - but when I was hungry or aching, I managed to continue on because I knew "help was coming" (the sleeve) where in the past, I would have given up, knowing I could never continue dieting forever by myself....because....hunger.

Hi guys, 

I'm new here. I had my first appointment with the surgeon (Dr Costs Karihaloo - Newcastle area) on Tuesday (14/6). 

Some background; I'm 28, have struggled with my weight my whole life. Definite emotional eater and have had bouts of depression and anxiety in the past. Currently have a BMI of 42. 

I left feeling fairly happy, but have been mulling on a few things. 

Firstly was his almost negative approach to me. 
I'm not sure if he was giving me 'tough love' in order to gauge my commitment and preparedness, or if he thought I wasn't a good candidate. He was very serious and kind of lectured me on eating habits and what not. I of course understand all of this, and that its just a tool and that a lot of work needs to go into re-learning old habits. 
Has anyone else had this experience with him or your own surgeon? 

Secondly was something he said: 1 in 5 sleeve patients will need a bypass in around 10 years. 
Does anyone know why that is??? 
At this point in our discussion I was a bit flustered and intimidated from his manner that I didn't ask. 

Any help would be appreciated. I've still got till April next year until my PHI kicks in but I'm kind of obsessed with this atm 😖😖