Weight Gain after Vertical Sleeve

Question
I had my lap band removed and replace it with a Vertical Sleeve in November 2010.  In the first couple of weeks I lost 12 pounds but have gained again.  I believe that I'm eating how I should but the weight won't budge.  I had lap band surgery in 2007 and weighed 260 and lost down to 155, then went back up to 202 when I had the band removed and sleeve performed.  After surgery I went from 202 to 190 but am back up to 199.  Is there anything I can do to help jumpstart the weightloss or do I need to accept that I may not lose any weight?

Answer
Hi Helen:

You must be so frustrated.  Have you spoke to your surgeon?  Have you logged what you are eating?

Some people find with the Sleeve that although they're not eating much per meal, they're eating too quickly after finishing a meal.  So I would definitely not only log what you're eating, but when.  I'd also look at whether or not there are certain meals that keep you satieted longer than others.

Others find that they're eating too many carbs or not enough protein.  Many people find that increasing their protein to 100 grams/day seems to be the key in weight loss.  Divide that into 5-6 meals and commit to eating 20 grams of protein per meal first before any other foods.  Then follow with fruits and non-starchy vegetables, followed by a limited portion (1/2 cup/1 slice of bread) of carbs. (Healthy fats can be a part)  Also ensure that in between meals you are drinking plenty of water and no-calorie fluids.  If you are going to include treats in your meals, then limit it to once per day--preferably after a healthy meal or at least 20 grams of protein.  If you prefer to eat "real" foods, then just please try to get your protein in first.

Have you thought about joining Weight Watchers or a similar program? With your smaller stomach, you're likely to find sticking to it much easier.  You don't need to reduce your points any more than a normal person--just give it a try.

I also would advocate exercise.  In looking at long-term success for bariatric patients, exercise seems to be one of the keys.  So, before you throw in the towel, give a regular exercise program a try if you haven't already.  If your currently exercising, then look at either increasing the intensity or duration of your current workouts.  

My final suggestion would be to talk to your surgeon about getting some early stage bloodwork. It might be that you have a vitamin deficiency or thyroid issue that could be hindering things.  How? Some people find themselves craving a lot of food and eating more than necessary in an attempt to self-medicate a previously unknown deficiency.  If bloodwork doesn't appeal at this stage, at least make sure that you're taking 500 mcg B12 sublingual per day, 5000 IU Vit D, 1000 mg calcium citrate, and a standard multivitamin.  

I faced something similar as a Band to VSGer.  Honestly, as a former Bandster current VSG, I'm of the opinion that the Sleeve is probably not the best choice for somebody who was not successful with a Lap-Band. It is mainly a restrictive operation, but unlike the Band whose pouch gets tighter over time, the Sleeve stretches.  Personally, I love the improved quality of life--no PBing, more normal eating, etc.  But I probably would have achieved better success with a restrictive/malabsorptive operation rather than just another restrictive operation again (although one could argue that the VSG is restrictive plus hormonal).  

What did work for me is realizing that in the Sleeve I have a great tool--I just needed to apply some discipline to my eating.  I lost only 50 pounds in about six months with my sleeve--and then all weight loss stopped.  Fast forward a year and miraculously it started again--another 25 pounds.  Why? No real idea.

Don't give up yet. Remember, your stomach is 85-90% smaller than it was.  This has to be good for something!  I often think that people who have trouble losing weight after bariatric surgery give further credence to why they actually needed surgery in the first place.  If one has trouble losing weight when one's stomach is 90% smaller than a "normal" person's--how on earth were they supposed to lose it with a "normal" stomach?

Be positive.  This is hopefully only a small hurdle.  If it's at all helpful, I've been researching the Sleeve since 2004.  I've never seen a patient lose less than 30 pounds with it.  Not once.  Even people with less than 50 pounds are truly rare.

Karla

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