Chessboard

Alcohol habit and band surgery - please help

53 posts in this topic

4 hours ago, Chessboard said:

Thank you!! :rolleyes:

Hi Chessboard, recently on vacation and just saw this thread. Given my moniker you can imagine (correctly) that I think wine is not a complete no-go. But I don't think wine or no wine is the core question ("to be, or not to be,..."). In alcohol there is a tangle of morality, addiction, self-blaming, and pleasure. So, let me be fully candid here. 

Your BMI is 38 and your chances of getting to a normal BMI (150 lbs or lower) is statistically about 1% with dieting. Stopping 3 glasses of wine a day (250-300 calories per day) you might lose 25-30 pounds, get down to a BMI of 35, if your body didn't ask for a caloric replacement. (But it will). The best clinical trials data suggests that persons eating a Mediterranean diet and with lots of support and concurrent exercise can lose about 6 kilos, 13+ pounds, at 2 years. You need to lose 85 lbs. to get to a BMI of 25. If you lose 13 pounds with a good diet you are 72 lbs short. 

Losing a lot of weight is NOT in most people's control, your body has a set point and will do anything to make sure your weight remains there. As has been documented in the scientific and popular press your body will turn your metabolic rate as low as possible to maintain your high weight. You could be God's gift to self-discipline and your chances of success are still about 1%. (You really don't want to hear this opinion, do you?? The statistics are pretty dismal). A lot of the people posting on the Forum are pretty disciplined. It just turns out that diets fail almost all of the time because we are hard-wired genetically and physiologically to maintain our weight in case of famine. 

All of the scientific data I have seen on people who successfully lose and maintain losses of 80, 100, or more pounds without surgery is not only are they rigid about their diets, they also exercise an average of 90 minutes a day. On this Forum I'm known for being a bit of an exercise advocate... and in part it is because of that data. Exercise is NOT critical to weight loss but it likely critical to maintaining very substantial weight loss if it is done without surgery, in part because of its effects on metabolic rate. You can't exercise for 90 minutes without if affecting your metabolism rather profoundly. 30 minutes... well okay, it adds a few hundred calories to your needs. 90 minutes is a lot more. This data is very hard, very consistent.

Outside of the realm of scientific studies - Read the articles by Jay D'Souza in the Huffington Post about people who lose and maintain weight loss. All now exercise a lot; perhaps there is someone who doesn't but I've read a lot of those stories and that is one of the consistent elements. Just like the more scientific studies of successful individuals first referred to at the start of the prior paragraph. 

There is little harm in trying to diet your way to a lower BMI. You might be one of the 1%. And, in your 30s without diabetes or hypertension yet, there is a touch less pressure on you than if you already had metabolic complications of obesity. My suggestion is that if you were to choose a diet approach, have it be part of a larger plan ... if it does work, GREAT! and if it does not work, you then move on to Option B, surgery. It could allow you to save up a bit more, and to develop habits that will help you, like exercise or rigorous calorie counting. 

Type of surgery:

Like many of the others I was initially considering a band. Ended up with a sleeve; my surgeon would not have done a band anyhow, they are essentially not done any more in this area (Boston) because of the higher complication rate  along with lower success differences.... but then here, the costs of surgery are so high that few people self-pay. Not sure how much you would pay in the UK but lots of people, like @NerdyLady and @Jen581791 who post here often, had surgery in Mexico, and others have had in Eastern Europe. Perhaps given the cost differential a sleeve or bypass might be within your range. 

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11 minutes ago, Chessboard said:

Hi! The practice manager guy spoke to me first and was very pro band. Then i saw the consultant who pretty much advised me to go for the sleeve due to my busy lifestyle. I'm feeling very relieved and much more positive. The advice you all gave was right and it's helped me consolidate my plan. Thank you everyone and I look forward to continuing my journey with you :wub:

Oh Ho! I just sent you a long post as you posted this. Ack. BB

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19 minutes ago, Chessboard said:

Hi! The practice manager guy spoke to me first and was very pro band. Then i saw the consultant who pretty much advised me to go for the sleeve due to my busy lifestyle. I'm feeling very relieved and much more positive. The advice you all gave was right and it's helped me consolidate my plan. Thank you everyone and I look forward to continuing my journey with you :wub:

I'm glad you received solid advice that you trust. Let us know how we can help you during your journey. 

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40 minutes ago, Chessboard said:

I think I'll be in the sleeve club by the end of October. I just need to work out my annual leave to have two weeks off 

That's great to hear - glad you have decided to go with the sleeve. I hope you have a nice easy path :) 

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Glad you had a great consult and feel good about your decision!

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On 8/22/2017 at 2:52 PM, BurgundyBoy said:

Hi Chessboard, recently on vacation and just saw this thread. Given my moniker you can imagine (correctly) that I think wine is not a complete no-go. But I don't think wine or no wine is the core question ("to be, or not to be,..."). In alcohol there is a tangle of morality, addiction, self-blaming, and pleasure. So, let me be fully candid here. 

Your BMI is 38 and your chances of getting to a normal BMI (150 lbs or lower) is statistically about 1% with dieting. Stopping 3 glasses of wine a day (250-300 calories per day) you might lose 25-30 pounds, get down to a BMI of 35, if your body didn't ask for a caloric replacement. (But it will). The best clinical trials data suggests that persons eating a Mediterranean diet and with lots of support and concurrent exercise can lose about 6 kilos, 13+ pounds, at 2 years. You need to lose 85 lbs. to get to a BMI of 25. If you lose 13 pounds with a good diet you are 72 lbs short. 

Losing a lot of weight is NOT in most people's control, your body has a set point and will do anything to make sure your weight remains there. As has been documented in the scientific and popular press your body will turn your metabolic rate as low as possible to maintain your high weight. You could be God's gift to self-discipline and your chances of success are still about 1%. (You really don't want to hear this opinion, do you?? The statistics are pretty dismal). A lot of the people posting on the Forum are pretty disciplined. It just turns out that diets fail almost all of the time because we are hard-wired genetically and physiologically to maintain our weight in case of famine. 

All of the scientific data I have seen on people who successfully lose and maintain losses of 80, 100, or more pounds without surgery is not only are they rigid about their diets, they also exercise an average of 90 minutes a day. On this Forum I'm known for being a bit of an exercise advocate... and in part it is because of that data. Exercise is NOT critical to weight loss but it likely critical to maintaining very substantial weight loss if it is done without surgery, in part because of its effects on metabolic rate. You can't exercise for 90 minutes without if affecting your metabolism rather profoundly. 30 minutes... well okay, it adds a few hundred calories to your needs. 90 minutes is a lot more. This data is very hard, very consistent.

Outside of the realm of scientific studies - Read the articles by Jay D'Souza in the Huffington Post about people who lose and maintain weight loss. All now exercise a lot; perhaps there is someone who doesn't but I've read a lot of those stories and that is one of the consistent elements. Just like the more scientific studies of successful individuals first referred to at the start of the prior paragraph. 

There is little harm in trying to diet your way to a lower BMI. You might be one of the 1%. And, in your 30s without diabetes or hypertension yet, there is a touch less pressure on you than if you already had metabolic complications of obesity. My suggestion is that if you were to choose a diet approach, have it be part of a larger plan ... if it does work, GREAT! and if it does not work, you then move on to Option B, surgery. It could allow you to save up a bit more, and to develop habits that will help you, like exercise or rigorous calorie counting. 

Type of surgery:

Like many of the others I was initially considering a band. Ended up with a sleeve; my surgeon would not have done a band anyhow, they are essentially not done any more in this area (Boston) because of the higher complication rate  along with lower success differences.... but then here, the costs of surgery are so high that few people self-pay. Not sure how much you would pay in the UK but lots of people, like @NerdyLady and @Jen581791 who post here often, had surgery in Mexico, and others have had in Eastern Europe. Perhaps given the cost differential a sleeve or bypass might be within your range. 

BB - so much great info in here. Thank you for posting and sharing. It was the 1% stat that convinced me WLS was the way to go. 

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5 minutes ago, Stephtay said:

BB - so much great info in here. Thank you for posting and sharing. It was the 1% stat that convinced me WLS was the way to go. 

Me too. I tried to lose weight with exercise and dieting multiple times, and when that failed, looked systematically into the success rates. It was so shockingly low (the 1%) I was speechless. I had to succeed with weight loss or retire early, a musculoskeletal cripple. Nothing like such a choice to focus the mind! Speaking of which, thank you so very much for your calm demeanor, clear voice, and considered comments. Your postings have given me Hope when the Weight Loss Ghouls were lurking and the Winds of Doubt were howling. 

@Chessboard I would tag and follow the wise @Stephtay ...

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21 hours ago, BurgundyBoy said:

Me too. I tried to lose weight with exercise and dieting multiple times, and when that failed, looked systematically into the success rates. It was so shockingly low (the 1%) I was speechless. I had to succeed with weight loss or retire early, a musculoskeletal cripple. Nothing like such a choice to focus the mind! Speaking of which, thank you so very much for your calm demeanor, clear voice, and considered comments. Your postings have given me Hope when the Weight Loss Ghouls were lurking and the Winds of Doubt were howling. 

@Chessboard I would tag and follow the wise @Stephtay ...

Thank you! I'm flattered and honored! I'm happy to share my experiences. As prepared as I thought I was for what life would be like post-op - I was more wrong than right. You are doing fantastic by the way! 

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Hi Chessboard,

Just sharing my experience as my situation sounds similar to yours. I am a professional woman with a stressful job involving a lot of travel and was in the habit of unwinding every day with 2-3 glasses of wine (plus cheese or chocolate). Since VSG six months ago, my intake of alcohol has greatly decreased - after 2 months I started having an occasional glass of wine or spirits with low calorie mixer for special events etc. Interestingly, I would say I was less in control of my alcohol consumption before the surgery - I don't think I was addicted but it had become a strong habit. For example, if I had a glass of wine I would always finish it: now it is quite common to just drink half a glass and leave the rest. Part of the problem was being tired from being overweight and inactive and using alcohol as self-medication for stress reduction. I feel better about myself and healthier now and so don't need that crutch.

I found a paper showing that, among people going into WLS who drink more than they would like, around half have no change after surgery and for the other half the problem goes away. I seem to fall in the second category. On the other hand, many studies show around 5-10% of people who never had a problem with drinking, develop it after WLS. Extract below:

Wee et al. conducted annual interviews in 541 bariatric surgery patients. Around 20% had high risk drinking behavior at baseline. Although 7% of patients reported new high-risk alcohol use 1 year after bariatric surgery, more than half who reported high-risk alcohol use before surgery discontinued high-risk drinking.

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Wow thank you so much for this reply it has really helped my anxiety about this subject. I have pretty much settled on a decision to have the sleeve procedure - I'm working out the practicalities of it in terms of taking time off work- the surgeon recommended I take two weeks off - what do you think? My role is not manual - I think once I can drive I can go back to work. 

I've also been thinking about who to tell. Anyone have any thoughts about this? 

Thank you everyone for the supportive and kind replies x 

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32 minutes ago, Chessboard said:

Wow thank you so much for this reply it has really helped my anxiety about this subject. I have pretty much settled on a decision to have the sleeve procedure - I'm working out the practicalities of it in terms of taking time off work- the surgeon recommended I take two weeks off - what do you think? My role is not manual - I think once I can drive I can go back to work. 

I've also been thinking about who to tell. Anyone have any thoughts about this? 

Thank you everyone for the supportive and kind replies x 

Two weeks off will be good. After 4 or 5 days of healing, my only problem was fatigue. I was back to work in 2 weeks and back to working out in 2 and a half weeks.

As far as telling people, I told only a handful, and I'm SO glad. Having more people ask me how I'm feeling, how much I've lost, if I can eat this or that would drive me CRAZY. So glad I kept it quiet.

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I only told my husband who was supportive. I am a private person (introvert) and didn't feel comfortable telling many people. Also, if you tell one person (apart from close family and people you trust completely) you tell everyone! With a sleeve, you lose more slowly so it is not startlingly obvious that something major has happened. I tell people I lost weight through diet and exercise, which is the truth, though not the whole truth.

I think people who are comfortable with sharing that they had WLS do a great public service and help others. It is also a way to get "real life" support. But I know for me, the added stress of going public would just have added to all the stresses of the operation and got in the way of a recovery, so I decided, on balance, not to tell. If I told friends and family, they would be worrying about me which would stress both them and me; if I told co-workers and acquaintances, they would be curious and maybe judgmental which would stress me. 

Because I did not tell people (apart from my husband), I was limited in time off work. I was in Washington for work and I flew to San Diego and then by road to Mexico on a Thursday. I had the operation on a Friday, flew back to Washington the next Tuesday, and was back at work Wednesday. So 4 days leave (Thursday, Friday, Monday & Tuesday) and 2 days where I really could not function in any way normally (Saturday & Sunday). Ideally I would have taken a week off. My work is meetings and computers and if it was a more physical job or one requiring a lot of interaction with people, I think i would not have been able to return to work so quickly.

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10 hours ago, Chessboard said:

Wow thank you so much for this reply it has really helped my anxiety about this subject. I have pretty much settled on a decision to have the sleeve procedure - I'm working out the practicalities of it in terms of taking time off work- the surgeon recommended I take two weeks off - what do you think? My role is not manual - I think once I can drive I can go back to work. 

I've also been thinking about who to tell. Anyone have any thoughts about this? 

Thank you everyone for the supportive and kind replies x 

I could have gone back to work at 10 days but took a month. I had pretty severe back and joint issues and ended up working out for 1-2 hours a day (swimming, cycling, walking) - a form of physical therapy really - right after surgery, and could do critical job related tasks from the house. (My orthopedist certified me as having a physical handicap just before my WLS). I often have to do a lot of air travel, and work in places that are not on anyone's list of places to visit, and my travel before surgery had been torture. So I tried to cement the hour a day as aphysical therapy routine, and got a lot of other structures in place. But again from a physical point of view -- for most people 2 weeks is fine. I still had the odd abdominal wall twinge then but nothing major. 

re: who to tell - this is really up to you. There are a zillion posts on the subject here; my guess is if you read a couple of threads you would get the vast majority of the rationales people have for being discrete or being open. A lot of people posting here are fearful of have negative, or judgmental, social repercussions; others don't. I have chosen only to tell a few people at work and to tell others that I am not discussing personal medical information. Now that I look so very different, nearly 80 lbs down, it's hard to me to think all honest queries about my health is inappropriate. I do tell people I am doing much better and that my back pain is 99% gone. I am also a senior person in my workplace and it is unlikely there would be any negatives that could affect me. Having said that -

About 4 months ago there were a series of postings by someone who had had surgery, and knew a 30 year old young man who died suddenly from obesity related conditions. She wished very hard she could have intervened with him earlier, and wondered if she had been more open about her own WLS she could have helped him. This goes to the imperative some people feel to bear witness to their success, so that others might be more open to WLS. As I go forward and my success at losing weight is more secure, and I am more confident that I can maintain my loss, I think this may be where I end up - being totally open about having had it and with any luck being a sounding board for others considering it. Unlike many others I did not have a totally miserable childhood because of obesity, and have had a lot of professional success despite my weight. So my scars are more superficial. 

But you just have to gauge your own situation. 

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The thing is that I work in a really small team. They will notice my change in eating habits. I am thinking of telling them. I also think I will need their support- although I think I'll come up against jealously if I lose weight. I'm not on social media so I won't be going mega public. The perception is that surgery is the easy answer when it is clearly the opposite 

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On 8/16/2017 at 11:38 AM, Chessboard said:

What about the stomach getting bigger after sleeve surgery - does the surgery effectively only last until that happens?:blink:

Actually I think this is what people feel or think ... but the scientific data is that the stomach does NOT change very much. I think "the truth" is that the volume doesn't change but it can distend a bit more with time. If you search "pouch size" or stomach size after VSG, the scientific literature says they don't change very much. I can dig these up...

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1 hour ago, Chessboard said:

The thing is that I work in a really small team. They will notice my change in eating habits. I am thinking of telling them. I also think I will need their support- although I think I'll come up against jealously if I lose weight. I'm not on social media so I won't be going mega public. The perception is that surgery is the easy answer when it is clearly the opposite 

Well, if you do tell them, suffer a lot and make them suffer with you. Then they won't be fast to tell you how easy it is. Just keep making the point that it is effective, unlike dieting, and that you risked your life to have the dman surgery. If you are a close team say one problem is that people feel jealousy because the surgery is almost always successful. Be overt.  And be sure to swear them to silence and remind them of the civil and criminal penalties of discussing other people's medical conditions at work.  Hee Hee Hee. 

Ok, more seriously - your success will silence the blah blah blah over time. If they have to know, they have to know, and better you tell them along with your expectations of professional behavior. I would state that the surgery is effective, the post-op course is no joke, and if anyone thinks it is the easy way out, they have no idea. ... and a duel is in order. I have found that the people I told were thorough professionals. 

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Mmm thanks all. I will need to give more thought to this. The alternative is that i essentially lie about why I'm having time off and how i came to lose weight. I admire the people who create you tube blogs on the subject  (I most definitely won't be creating one of those) and i note they all comment about the support they have received through doing so. Maybe I shouldn't feel ashamed and be proud of my brave and life changing decision :huh:

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Relax.  Don't overthink this. Just do it. Tell people whatever you tell them. And let everyone watch you become skinny and healthy.  We are here to support you and to be impressed by your weight loss. :)

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Ok I'll try. Just getting prices them going to book it mid October :rolleyes:

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Only my husband, mom and daughter know I've had WLS. I just didn't want the baggage of telling people and being up for scrutiny. Also, people do think that this surgery is the easy way out, and given how slowly my weight is coming off despite following all the rules, I'm glad I haven't given people the option of thinking I took the "easy way out"! I'm walking 10k steps a day, go to a weight training and pilates class thrice a week and am keeping my carbs below 50---nothing "easy way out" about that! :D

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On 8/27/2017 at 6:15 PM, Chessboard said:

Mmm thanks all. I will need to give more thought to this. The alternative is that i essentially lie about why I'm having time off and how i came to lose weight. I admire the people who create you tube blogs on the subject  (I most definitely won't be creating one of those) and i note they all comment about the support they have received through doing so. Maybe I shouldn't feel ashamed and be proud of my brave and life changing decision :huh:

Pre-op I read here "you cannot un-tell someone". I took this to heart and told very few people. My boss knows but he is my best friend and has been for 10 years. I knew he would keep it in the vault. At work I told people I was having a hernia repaired. Once I started losing people would ask me how I was losing weight, I answered honestly:  eating high protein, low carb and working out like I was training for the Olympics. All was true - except for the Olympics part. I work for a very appearance conscious company. I work at the home office and of the 500+ people who work here, maybe 10 are obese? I know people here suspect I had WLS, including people on my team, but they can think whatever they want. 

My health and my body isn't anyone's business but mine. 

 

All that said, I applaud those who are open about their WLS. It helps to demystify it. I'm just not in that camp. 

 

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1 hour ago, Raddy said:

I'm glad I haven't given people the option of thinking I took the "easy way out"!

People who think this.....are truly uninformed or ignorant of the rigorous road we travel before/during/after WLS.  That makes me crazy lol.

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Yes I think I'll keep it quiet. I agree it seems like a cop out to the outsider. Does anyone know what the blood tests prior to surgery are for? 

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Ok reading your presentation I want to congratulate you to have the courage to face your demon and take in consideration a big change. I will suggest like a echo that the band is really NO NO option!! not good results and really prone to infections. Gastro sleeve look your best choice. But let me tell you. You need to work on your bad behavior (drinking), when you are commit to it you have to stop to drink and smoke in case you do. Really bad  bariatric  DOC  will not approve you if you still do it. best of luck and let us know how it goes!!! :D

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