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14 Years.

I didn't make a 12 or 13 year update?  Really?  It might be the distracted distraction: 
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It occured to me that I don't have photos to share, partly because I have been sitting at the same. exact. weight. (within five or so pounds) for two-and-a-half years (*see distraction) and there's really nothing to update in that aspect.  
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I started "this journey" more than 15 years ago.
 
My highest weight was 320 pounds.  I have reached a low weight of 145 lbs, once.  I gained over 210 lbs. while pregnant in 2006 and 2015. 
 
I have spent the majority of the last 14 years at or about 170 lbs.  
 
All of this is in the history here on the blog.
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Self – last week
 
I would say that 170 is my eat-what-you-want and "don't do jack shit for cardio aside from chasing a hyperactive toddler/house cleaning and seizure" weight.
 
What do I eat?
 
Old-lady food.  I still loathe cooking.  I would not cook a thing, ever, if there weren't kids here.  I don't cook much anyway, since I was told "not to ever use a knife unattended" or "a stove," so, I just … do, but I don't.  If money were no object, I'd be all over home delivery.
 
Coffee with almond milk, tea, whole grain toast, probiotic cottage cheese, frozen meals, chicken salad.
 
I mix it up with a take out meal about once a week, usually a cold sandwich like roast beef and all the veggies or a BLT.  
 
I regret most meals eaten away from home, so I am careful about food choices if we go out.  I trust no one not to kill me.  I dump on the most random things, or have awful reactions later, so I stick with what Should Work.  
 
I'd say I take in 1500 or so calories most days. Today?  
  • Dave's Killer Bread + Light Butter
  • Two bites protein cookie, the rest donated to the kid
  • Frozen chicken a la king, tossed some of the chicken away
  • And it's nearing 5pm.  Typical.  I'll eat dinner at bedtime.
 
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Bob and I at his police graduation, 2017, his 14 years is next month
 
I have that excess 20- 25 lbs hanging around.  I know how to lose it. I don't do it. At least I have not in the last few years. With my last (POST WLS!) baby who is now eleven, I would get walking for miles, but I don't anticipate that happening anytime soon with my special-fall-on-the-ground-head-crack seizures that developed in the last few years (*see the timing correlation?) Well, at least I did it back then and did not realize I was falling down.
 
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Christmas Day, 2017 – Myself and all the "kids"
 
I have two cardio machines in the house. I'm not using them and my excuse is the youngest child that climbs on them with me. (YOU HAVE TO KNOW HIM.  HE IS THAT CHILD.)  Getting up before he does or climbing out of bed after he sleeps to exercise is … not tempting. I'm just not that into it, yet.  Clearly exercise is not a priority. 
 
I think that remaining upright — is?
*On that topic which some of you don't like to read, but it's a huge part of my life/day — I'm taking lots of medications, which need a little tinkering (again, usually once a year I'm in the hospital for a tune up) since I am obviously having lots of seizure activity.   I currently take ONFI, Topamax, Banzel, and as needed Lorazepam.  They are treating my various types of seizures.  I just tapered off of a huge amount of Keppra. I suspect these will change in the near future, because me.
 
People ask me if I blame my gastric bypass for this "condition" or it's increasing changes/etc.  No.  I was born with the brain malformation that causes seizures, and at this point in my life I believe I had seizure activity longer than anyone knew (maybe since I was very small, in the form of smaller seizures that no one noticed, I understand the symptoms now) — but the gastric bypass caused a trigger by changing my gut.  The science shows that the gut can affect the brain — and I feel that in some way the WLS lowered my seizure threshold by altering my gut, and making my malformation — "turn on" and show it's full power.  I feel that there's a cure in my lifetime, if it's fecal transplants, brain stimulators or who knows what else – because there are many of us out there with post WLS seizures
 
What do you want to know about "long term" post weight loss surgery life?  
 
Any questions, I am a too-open book.  Ask here or Facebook.  Just don't sell me anything unless you plan on sending it to me free.
 
 

From NYT – Why WLS Works When Diets Don’t

Don't shoot the messenger, I'm sharing this for my blog's historical reference because it's AMAZING INFORMATION — and even if you "don't agree," because it's not your experience, it's science!

Via New York Times - https://nyti.ms/2kBVirc

Bariatric surgery is probably the most effective intervention we have in health care,” says Laurie K. Twells, a clinical epidemiologist at Memorial University of Newfoundland. She bases this bold claim on her experience with seriously obese patients and a detailed analysis of the best studies yet done showing weight-loss surgery’s ability to reverse the often devastating effects of being extremely overweight on health and quality of life.

“I haven’t come across a patient yet who wouldn’t recommend it,” Dr. Twells said in an interview. “Most say they wish they’d done it 10 years sooner.” She explained that the overwhelming majority of patients who undergo bariatric surgery have spent many years trying — and failing — to lose weight and keep it off. And the reason is not a lack of willpower.

“These patients have lost hundreds of pounds over and over again,” Dr. Twells said. “The weight that it takes them one year to lose is typically back in two months,” often because a body with longstanding obesity defends itself against weight loss by drastically reducing its metabolic rate, an effect not seen after bariatric surgery, which permanently changes the contours of the digestive tract.

In reviewing studies that followed patients for five to 25 years after weight-loss surgery, Dr. Twells and colleagues found major long-lasting benefits to the patients’ health and quality of life. Matched with comparable patients who did not have surgery, those who did fared much better physically, emotionally and socially. They rated themselves as healthier and were less likely to report problems with mobility, pain, daily activities, social interactions and feelings of depression and anxiety, among other factors that can compromise well-being.

Equally important are the undeniable medical benefits of surgically induced weight loss. They include normalizing blood sugar, blood pressure and blood lipid levels and curing sleep apnea. Although bariatric surgery cannot cure Type 2 diabetes, it nearly always puts the disease into remission and slows or prevents the life-threatening damage it can cause to the heart and blood vessels.

 

Even in the small percentage of patients who ultimately lose little weight after surgery, significant metabolic benefits persist, according to findings at the Cleveland Clinic. In a study of 31 obese diabetic patients who had not lost a lot of excess weight five to nine years after surgery, a “modest” weight loss of just 5 to 10 percent resulted in a reduction of cardiovascular risk factors and blood sugar abnormalities, Dr. Stacy Brethauer and colleagues reported.

For the two most popular surgical techniques — the gastric bypass and the gastric sleeve — “the metabolic benefits are independent of weight loss,” Dr. Brethauer said in an interview. Both methods permanently reduce the size of the stomach. However, the gastric band procedure, which is reversible, lacks these benefits unless patients achieve and maintain significant weight loss, he said.

Furthermore, as a study last year of 2,500 surgical patients at the Veterans Affairs Medical Center in Durham, N.C., found, those who underwent bariatric surgery had lower overall death rates up to 14 years later than comparable patients who did not have weight-loss surgery.

Experts in the field regard the reluctance of some medical insurers, including Medicaid programs in many states, to cover the cost of bariatric surgery as a penny-wise, pound-foolish position. Failing to reverse extreme obesity can end up costing far more per patient than the typical $30,000 price tag of bariatric surgery — sometimes even millions of dollars more.

 

Counter to popular impressions that most people treated surgically regain most or all the weight they lose initially, the latest long-term research has shown otherwise. In a decade-long follow-up of 1,787 veterans who underwent gastric bypass, a mere 3.4 percent returned to within 5 percent of their initial weight 10 years later. This finding is especially meaningful because the researchers at the V.A. center in Durham were able to keep track of 82 percent of gastric bypass patients, a task too challenging for most clinics.

The study, by Matthew L. Maciejewski and colleagues published in August in JAMA Surgery, found that 10 years later, more than 70 percent of surgical patients lost more than 20 percent of their starting weight, and about 40 percent had lost more than 30 percent. Gastric bypass, an operation called Roux-en-Y, resulted in a somewhat greater weight loss at 10 years than the newer gastric sleeve surgery and significantly more than the adjustable gastric band (Lap-Band) surgery, which “has fallen out of favor in the last two or three years,” Dr. Maciejewski said.

 

Bariatric surgery, regardless of the method used, is also much safer nowadays than it was even a decade ago, said Dr. Jon C. Gould, a surgeon at the Medical College of Wisconsin in Milwaukee who wrote a commentary on the V.A. study. However, he noted, the surgery is “vastly underutilized,” to the detriment of patients’ health and the nation’s health care costs.

“Less than 1 percent who would qualify for bariatric surgery are actually getting it,” Dr. Gould said. “Although the vast majority have health coverage, insurance companies and many Medicaid programs put it out of reach for most people by demanding that they already have several obesity-related health conditions and are taking a slew of medications to control them.”

 

For example, he said, to be covered for bariatric surgery, Wisconsin Medicaid requires that a person with dangerously high blood pressure has to be taking three or more medications for it and still not have a normal pressure.

He cited a further deterrent to bariatric surgery: “a perception that it’s dangerous and doesn’t work,” beliefs countered by the research findings cited above. Most of the surgeries are now done laparoscopically through tiny incisions.

 

Given the well-documented safety and effectiveness of bariatric surgery, it is now increasingly being performed in people whose obesity is less severe — those with a body mass index (B.M.I.) of 35 or perhaps even less — but who have a metabolic disorder like Type 2 diabetes related to their weight.

In recent years, the profession has promoted what Dr. Gould calls “centers of excellence,” where 100 or more bariatric operations are usually done in a year. Practitioners at these centers “learn from experience, share their knowledge and push for quality improvements,” he said.

Dr. Gould suggested that people interested in bariatric surgery seek out programs that have been jointly accredited by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery, which have combined forces to promote quality control.

While experts agree that money would be better spent on prevention than treatment, Dr. Twells pointed out that “we have yet to find a way to prevent obesity, and people whose health is compromised by their weight deserve to be treated by the most effective method we have.”

 
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Year Eleven, Plot Twist.

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Oddly enough last year was my best in terms of weight loss and weight maintenance after my roux en y gastric bypass now eleven years ago.

I just searched the blog for my yearly *cringe* “surgiversary” updates and it appears it really was.

 “Best.”  I maintained a nearly-normal bodyweight for half of the year, guys.  If I look back on my averages over the last ten years, the weight is smack-dab in the middle of average.  I am just that.  

Super-average.  

I started out the year at my near lowest, while using the gym and eating decently.  My goal had been to continue that – and ignore weight if I could add muscle tone.  

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One of the most common questions I get inboxed to me is:  What Do You Eat Everyday – What Do You Do?!  Here is the thing:  PEOPLE VARY DRASTICALLY.  I realized that my intake vs. output is a delicate balance.

Here’s my intake for the most part of the last 90 days:

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This looks mostly like this, with days of “Want pizza for dinner?  Who wants mozzarella sticks?”  Once a week.  I eat very little meat, though I am still cooking it a couple times a week for the family.

Breakfast – 

  • Coffee – unsweetened almond milk – cocoa powder
  • Frozen tofu based meal, other

Lunch –

  • Leftovers from dinner or
  • Soup or salad or
  • Bread + cheese

Snack – 

  • Chickpeas, whole grain crackers, cheese, veggie burrito

Dinner – 

  • Protein, veggie, carb – whatever is made for the family or…
  • Frozen vegan meal

Snack –

  • More dinner, usually, I honestly don’t eat at dinner time… I eat before bed.  I might have a few bites at dinner time, especially if I am cooking, and then I don’t want anything.  

This isn’t much different than my eating of the year before – and I maintain my weight at this level of calories.  I would assume I eat about 1500 – 1700 most days with days lower, and days higher (rare).  

I actually lose weight at this intake if I am moving enough.  

Disclaimer, BMI SUCKS and I have NEVER been in the normal category for more than two minutes because I am SHORT AND I AM SHRINKING so if I want to EAT, I HAVE TO MOVE MY ASS.

I was.  I’m not.   No excuses.  

My intentions were good, but life always seems to have different plans.  

I developed some super fun back pain that coincided with less time at the gym (…yes I think movement HELPS pain, but getting past pain to MOVE is now the problem!) and was diagnosed with some degenerative disc disease.  My time working out was cut drastically with my spouse’s work schedule changing – kid’s school schedules and just having no means to go.  Adding the lack of gym time to pain = Beth not moving her ass because it hurts = Beth not moving.  I started slugging out at home from August (…when the schedule changed) to this winter.  I hate to whine because Everybody Huuuurttttts.   I’m also super realistic and I know I’m getting older, and it is unlikely that my back will Get Better at this age.  It isn’t going to benefit me to complain about it now because it’s going to get worse with time.  

Grinding along through back pain is difficult though, when it makes every part of your day a little more complicated – you’d think just sitting would be restful – easy.   Sitting here is the most painful part of my day aside from attempting to sleep laying down, I live in a series of twitchy z-z-z-zaps.  If I could pace all day long, I’d be fine.  

And I just may start doing that.

Why?  *changing tenses, writing badly but writing*

There was a single motivation — I got on the scale after knowing that I was not fitting in my size medium running pants.   THEY SQUISHED ME LIKE A SAUSAGE.  I knew I had gained weight, I could see it – but – I kept squishing into them.  So what if my legs are more puffy?  Whatever.  

And then my boobs.  MY BOOBS.  I didn’t HAVE ANY, and a few weeks ago I’m all – O – O – and WHY DO THEY HURT I’d better start my cycle RIGHT NOW or I am going to cry and I just might cry right now or throw up.

Oh.  

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I’ll save you the dramatic implosion that occurred after three of those, but I’ve been to the MD twice, and I see a maternal-fetal medicine doctor tomorrow.    I was not planning this, obviously, nor was I telling anyone, but a certain spouse outed me – and a lot of people took it as a joke.  

I don’t find it funny.

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I’ve got this.  I have never had a pregnancy WHILE on anti-epileptic medications, so that is of course of concern as I CANNOT be unmedicated and live safely.  If you recall, my seizure activity became evident during my first post-RNY pregnancy and it was undiagnosed for a very long time.   Also, apparently, I AM OLD.  I am “Of Advanced Maternal Age.”  

ADVANCED.  AGE.   3-5.  This was the year, that I told my husband, I think we are old enough to have kids now.  Forget that my oldest is the same age as I was when I got pregnant with her.  

She said, “Well, at least it isn’t me.”  Yes, thanks for that.

Grandma MM doesn’t really have a ring to it.  And I think my mother would explode. 

 


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Forget #WLS – just exercise 4-6 hours a day says Dr. Huizenga

  • Exercising for four hours a day and following a strict diet can yield the same results as weight loss surgery, a leading doctor has claimed.
  • Dr Robert Huizenga, of UCLA, says his extreme diet and exercise plan should replace bariatric surgery as a treatment for obesity.
  • He says bariatric surgery is expensive and carries risks of death, muscle loss, bone thinning and mental health issues.
  • His 'Biggest Loser' weight loss plan, which was made famous by the hit TV show of the same name, helps people lose the same amount of weight and is cheaper than surgery, he claims

Dr. H says that "we" watch TV for four hours day, surely we have time to exercise that long, but FRANKLY, I DON'T WANT TO.  

I am LAZY.  

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Do you honestly think I would have even considered it at my former size at ALL?  NO freaking way.  I am in a normal body weight range right now and there is zero point zero chance of getting me to exercise aerobically four hours daily — at 320 lbs — I would have sooner had weight loss surgery — and I DID.   Eleven years ago.  LOL.  It worked.

<3, MM.

Baby

Bariatric surgery may improve pregnancy outcomes – mostly

Many women opt for bariatric surgery in order to increase chances of maintaining a healthy pregnancy.  A recent study suggests that weight loss surgery can help a woman do just that, but there are risks.

Personally, my full term post bariatric surgery pregnancy was different than my pre-WLS pregnancies.  I was at a more normal bodyweight at the time of my daughter's gestation, and I did not seem to suffer the ill effects of obesity on pregnancy like I had with my prior children.  I had no high blood pressure, no high blood sugar, nor did I land on bedrest – which I had with previous babies.    My post RNY pregnancy offered me anemia and rampant hypoglycemia.  I was not well. 

She was born healthy, but small, in comparison to my earlier babies.  I noted a lack of body fat at birth.  This is several weeks old.

Baby

My post bariatric surgery baby – my smallest birthweight baby.

 

New York Times

While the study found some risks for women who had surgery, including more babies born too small and a greater likelihood of stillbirths, experts said that overall the results were better.

The findings have implications for an increasing number of women and children, especially in the United States, where nearly a third of women who become pregnant are obese. Obese women have more problems in pregnancy, including gestational diabetes, pre-eclampsia, and stillbirth. Their babies are more likely to be premature, overweight or underweight at birth, have certain birth defects, and develop childhood obesity.

The study, published Wednesday in The New England Journal of Medicine, sought to find out if surgery could safely mitigate some of those effects. Swedish researchers, led by Kari Johansson, a nutritionist at the Karolinska Institute, evaluated records of 2,832 obese women who gave birth between 2006 and 2011, comparing women who had bariatric surgery before becoming pregnant with women who did not.

They found that women who had had surgery were about 30 percent as likely to develop gestational diabetes, which can lead to pre-eclampsia, low blood sugar, birth defects and miscarriage. They were about 40 percent as likely to have overly large babies, whose challenges can include lung and blood problems.

The outcomes were worse in some categories. Women who had surgery were twice as likely to have babies who were small for their gestational age, suggesting the need for better nutrition for pregnant women with surgically-reduced stomachs. And more of their babies were stillborn or died within a month after birth, although the number of such deaths in each group was very small and might have been due to chance, experts and the authors said. There was no significant difference in rates of premature births or babies with birth defects.

The study via NEJM –

BACKGROUND

Maternal obesity is associated with increased risks of gestational diabetes, large-for-gestational-age infants, preterm birth, congenital malformations, and stillbirth. The risks of these outcomes among women who have undergone bariatric surgery are unclear.

METHODS

We identified 627,693 singleton pregnancies in the Swedish Medical Birth Register from 2006 through 2011, of which 670 occurred in women who had previously undergone bariatric surgery and for whom presurgery weight was documented. For each pregnancy after bariatric surgery, up to five control pregnancies were matched for the mother’s presurgery body-mass index (BMI; we used early-pregnancy BMI in the controls), age, parity, smoking history, educational level, and delivery year. We assessed the risks of gestational diabetes, large-for-gestational-age and small-for-gestational-age infants, preterm birth, stillbirth, neonatal death, and major congenital malformations.

RESULTS

Pregnancies after bariatric surgery, as compared with matched control pregnancies, were associated with lower risks of gestational diabetes (1.9% vs. 6.8%; odds ratio, 0.25; 95% confidence interval [CI], 0.13 to 0.47; P<0.001) and large-for-gestational-age infants (8.6% vs. 22.4%; odds ratio, 0.33; 95% CI, 0.24 to 0.44; P<0.001). In contrast, they were associated with a higher risk of small-for-gestational-age infants (15.6% vs. 7.6%; odds ratio, 2.20; 95% CI, 1.64 to 2.95; P<0.001) and shorter gestation (273.0 vs. 277.5 days; mean difference −4.5 days; 95% CI, −2.9 to −6.0; P<0.001), although the risk of preterm birth was not significantly different (10.0% vs. 7.5%; odds ratio, 1.28; 95% CI, 0.92 to 1.78; P=0.15). The risk of stillbirth or neonatal death was 1.7% versus 0.7% (odds ratio, 2.39; 95% CI, 0.98 to 5.85; P=0.06). There was no significant between-group difference in the frequency of congenital malformations.

CONCLUSIONS

Bariatric surgery was associated with reduced risks of gestational diabetes and excessive fetal growth, shorter gestation, an increased risk of small-for-gestational-age infants, and possibly increased mortality. (Funded by the Swedish Research Council and others.)

PS.  Post RNY baby is eight years and four months old now.  She's fine.

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Exercise improves insulin sensitivity after gastric bypass

Clinical trial demonstrates additive effect of exercise following gastric bypass.   

So. do. it.  I know, I know, easier said than done. 

Over 75 million adults in the US are obese. These individuals are predisposed to health complications, including diabetes, heart disease, and cancer. Gastric bypass surgery results in dramatic weight loss and can improve diabetes symptoms in obese patients. A new study in the Journal of Clinical Investigation reveals that exercise following bypass surgery provides additional benefit for obese patients. Bret Goodpaster and colleagues at the University of Pittsburgh conducted a study on individuals that had recently undergone gastric bypass surgery. One group followed a moderate exercise protocol for 6 months, while the control group underwent a health education program. Individuals in both groups exhibited dramatic weight loss and reduced fat mass. However, individuals in the exercise group had improved insulin sensitivity and cardiovascular fitness. The results of this study support the inclusion of an exercise program following gastric bypass surgery.

Read the article released earlier this week in JCI: http://buff.ly/1wlKroB

New

#itfits

It, fits?  OH COME ON.  

The NEW AND IMPROVED LAPBAND!  

You can do better!

New

Apollo Endosurgery, Inc., the leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures, today announced the launch of the “It Fits” campaign, aimed at rejuvenating the LAP-BAND® System and educating a broad range of patients about the benefits of the minimally-invasive weight loss procedure.

“It Fits” supports the company’s decision to place greater emphasis on the unique advantage of the LAP-BAND® System – the only FDA approved device for weight reduction for people with at least one weight-related health problem, and having a BMI of 30 or greater.

Read more: http://www.digitaljournal.com/pr/1989812#ixzz34taKYjn9

The new ad spot – from Apollo – tugs right there at your heart, don't it?  I might be tearing up over all of the completely stereotypical situations right here in this here commercial!  OMG I CAN FIT IN THE AEROPLANE SEATBELT WITHOUT AN EXTENDER COULD YOU PLEASE PUT ME IN A COMMERCIAL ALTHOUGH I WAS NEVER SUPER MORBIDLY OBESE I AM JUST AN ACTOR!

Until this and my tears dry up!

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Because of course we will ignore the patient histories of thousands — to have a procedure to lose how much weight?  

Just as a frame of reference, that makes me qualify in a few BMI points.  Confession:  when I reached my high weight about the same time the new BMI-qualifications for the Allergan-owned lap-band came around, I decided THAT WAS IT.  I could not possibly do it again, my butt was not revising band-over-bypass for that much weight, not after watching this weight loss community for 12 years.  Nope.

Jawdrop

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Ethicon Bariatric Surgery Comparison Tool Online – What can you lose?

I am easily distracted online by quizzes, gadgets, tools, and "Who Will You Be When You Grow Up?"  (Which said TEACHER, BTW, ME, The Kid Who Failed Half Her High School Classes…) quizzes, which is when I saw this - Online Tool Designed to Help Patients Evaluate Potential Bariatric Surgery Outcomes – thingamajig – I did it myself even though I am already ten years and two months post gastric bypass.

How cool is this?

Are you considering weight loss surgery?  Check this out.

LA Times –

A new tool nveiled at the annual meeting of the American Society for Metabolic and Bariatric Surgery may help patients with a body mass index over 30 — the threshold at which obesity is diagnosed — to navigate those complexities. Based on the accumulated experiences of 75,000 bariatric surgery patients, the Bariatric Surgery Comparison Tool details the expected outcomes of gastric banding surgery, gastric bypass surgery and sleeve gastrectomy, the three most common bariatric procedures.

I did it myself, based on my start weight – height – though I have lost an inch of height.  (Shut up.)

Start weight – 320, start height 5 ft 4.  I am close to 5 ft 3 now.

Are you considering weight loss surgery?  Check this out.

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And now –

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And the tool gave me these results based on the potentials of experiences of 75,000 patients (… surveyed out of the most common WLS) 

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The stats for the gastric bypass are damn close to what my surgeon "quoted" me for my landing place after my procedure.  

I bottomed out lower than this, my very lowest was 147 lbs, but wouldn't you know I bounced exactly to 175 lbs and maintained around there for a good portion of the years after my RNY?  The gastric bypass got me there, everything after that was a lot more work.  (See the blog.  I was pregnant immediately after.  And, so on.  This was 2005, guys.)  

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The 24 month data is EXACTLY right!  I am ten years post op and 149 – 158 lbs!

I guess what I am saying is — that the data for this "tool" —  (and you know I loathe that word) is there, it is right on the money.

Some goobledegook from Ethicon - 

  • The tool (officially named the Ethicon Bariatric Surgery Comparison Tool) pools data from more than 75,000 U.S. people who have had bariatric surgery, and based on personally provided, anonymous information, shows what people of similar demographics have experienced after undergoing bariatric surgery. The tool shows data for gastric bypass, sleeve, and adjustable gastric band surgeries.

o   Ethicon understands that no two patients are identical.  For example, when considering bariatric surgery, obesity related conditions like diabetes, hypertension and cholesterol need to be taken into consideration – this tool helps do just that.

o   Based on patients who have had similar conditions to theirs, prospective patients using the tool are able to see what surgical outcome looked like for patients just like them and can use this as a discussion point with their doctor about  which treatment option might be most appropriate for them (i.e., gastric bypass, gastric sleeve or gastric band).

 Now is a promising time for people in need of support for obesity and illnesses associated with it (such as type 2 diabetes).  There are safe, effective ways for physicians to help patients better manage their conditions.  There’s a growing body of clinical evidence that shows that bariatric surgery not only helps with weight loss, but that it also can help with issues like type 2 diabetes.

Some things you should know about bariatric surgery and the tool

Bariatric surgery is used in severely obese adult patients for significant long-term weight loss. It may not be right for individuals with certain digestive tract conditions. All surgery presents risks. Weight, age, and medical history determine your specific risks. Individuals should ask their doctor if bariatric surgery is right for them.

The tool is provided for educational purposes only and is not intended to be a medical evaluation, examination, consultation, diagnosis or treatment. The tool provides potential results by procedure type including pounds lost and medication reduction over time based on personal information provided by the user of the tool. Patients should consult a physician or other health care provider to determine whether or not bariatric surgery is right for them and for guidance on expected outcomes benefits and risks.

The weight loss, medication, and diagnosis information provided by the tool is derived from statistical analysis of historical claims and clinical databases as well as research published in peer-reviewed journals. While predictive modeling techniques were used, the results cannot predict the specific outcomes for any individual. The information presented does not represent any statement, promise or guarantee by Ethicon Inc. concerning a patient’s eligibility, experience, or potential outcomes. Individual patient results may vary.

 I had gastric bypass in 4/2004 in Boston, MA with Dr. Michael Tarnoff

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The Effectiveness and Risks of Bariatric Surgery – March 2014

Study - 

The Effectiveness and Risks of Bariatric Surgery

Importance  The prevalence of obesity and outcomes of bariatric surgery are well established. However, analyses of the surgery impact have not been updated and comprehensively investigated since 2003.

Objective  To examine the effectiveness and risks of bariatric surgery using up-to-date, comprehensive data and appropriate meta-analytic techniques.

Results  A total of 164 studies were included (37 randomized clinical trials and 127 observational studies). Analyses included 161 756 patients with a mean age of 44.56 years and body mass index of 45.62. We conducted random-effects and fixed-effect meta-analyses and meta-regression.

In randomized clinical trials, the mortality rate within 30 days was 0.08% (95% CI, 0.01%-0.24%); the mortality rate after 30 days was 0.31% (95% CI, 0.01%-0.75%). Body mass index loss at 5 years postsurgery was 12 to 17. T

he complication rate was 17% (95% CI, 11%-23%), and the reoperation rate was 7% (95% CI, 3%-12%).

Gastric bypass was more effective in weight loss but associated with more complications.

Adjustable gastric banding had lower mortality and complication rates; yet, the reoperation rate was higher and weight loss was less substantial than gastric bypass.

Sleeve gastrectomy appeared to be more effective in weight loss than adjustable gastric banding and comparable with gastric bypass.

Conclusions and Relevance  Bariatric surgery provides substantial and sustained effects on weight loss and ameliorates obesity-attributable comorbidities in the majority of bariatric patients, although risks of complication, reoperation, and death exist. Death rates were lower than those reported in previous meta-analyses.

The Effectiveness and Risks of Bariatric Surgery