I am sure some of you are thinking that surgery is a pretty radical solution for something I have proved that I can do in the past. I guess it is easy to think that I just needed to stick with it - in fact I told myself that many times.
Once surgery was recommended to me - and when it comes from a specialist, you really have to think about it seriously, I did some research. One of the proved facts with weight loss through dieting is that after 2 - 5 years, 95 percent of people will regain the weight they have lost, and more. Surely this can't all be lack of self control - and why would it be? For goodness sake, anyone who loses weight knows how much better you feel, why would you give up on it?
Can you think of another medical treatment - because with severe obesity that I have, it is a medical problem - that if research showed that there would be a recurrence of the disease, with further complications after 2 years in 95% of the cases - that ANYBODY would accept that treatment. It doesn't matter how strong the motivation is, or compliance with the treatment.
Then research found two very interesting little hormones that are associated with weight control. There has been a little media coverage on this, but generally not much real understanding.
There is the hormone leptin, which is released in the stomach and from fat tissue which tells the body that you have had enough to eat, and don't eat any more. This is a marvelous hormone that stops overeating. it would seem that if you had more fat tissue, then more of this hormone would be released, and then you would use up the fat stores. What a beauty.
Then there is ghrelin. Like most hormones in our body, it is designed to create a balance. It would be too bad if your body kept using its fat stores for energy, in fact, it would lead to death. So Ghrelin is released by the stomach and hypothalamus (in the brain). Ghrelin sends a message to the body that it is time to eat, eat now, danger danger, you need to replenish your energy stores.
These two hormones are meant to work in balance, but as usual one is stronger than the other - guess which one - ghrelin. If for some reason there is a conflict, and ghrelin is being produced when leptin is there also, ghrelin dominates, and demands more food.
Oh - what could cause these imbalances I wonder?
Factor Number 1: Sleep
"When you don't get enough sleep, it drives leptin levels down, which means you don't feel as satisfied after you eat. Lack of sleep also causes ghrelin levels to rise, which means your appetite is stimulated, so you want more food," (quote from some PhD of sleep disorders).
Anyone who normally sleeps well ever had a sleepless night, how were you the next day when it came to food - wanted to graze all day hmm? Well for me, my normal sleeping pattern since I was first pregnant (guess when my weight ballooned up) was to sleep for less than 2 hours at a time, and wake up 3-6 times a night. In reality, I would be lucky to get more than 2-4 hours of serious sleep a night. This is why Dr Carey wanted me to have sleeping tablets, and they helped - sometimes I would sleep for 4 hours at a time. But, like all of these sorts of medications, they become less and less effective, and of course addictive, besides being expensive... so I stopped having them.
Another quote: "The result: Those who slept less than eight hours a night not only had lower levels of leptin and higher levels of ghrelin, but they also had a higher level of body fat. What's more, that level of body fat seemed to correlate with their sleep patterns. Specifically, those who slept the fewest hours per night weighed the most."
See this study Factor Number 2: Losing weight
Huh you say - wouldn't losing weight make it better for you -- nuh!!!!
"In the new study, published May 23, 2002 in The New England Journal of Medicine, a team of Seattle scientists, headed by Dr. David E. Cummings of the University of Washington, measured daily fluctuations of ghrelin in 13 obese subjects before and after a six-month weight-reduction program. The subjects, who weighed an average of 220 pounds before the study began, lost an average of 38 pounds in three months with a combination of diet and exercise, and kept it off for three more months.
The researchers found that ghrelin rose sharply before meals and fell shortly after meals, confirming earlier studies showing that it triggers the desire to eat. After the subjects lost an average of 17 percent of their body weight, ghrelin output rose roughly 25 percent. In fact, their lowest ghrelin levels after the diet-induced weight loss were nearly as high as the pre-meal peaks at the start of the study.
"It’s well known that your body works against you when you try to lose weight," Dr. Cummings told Time magazine. "What’s new, is the possibility that a rise in ghrelin is the way it’s done."
see this report (Read this whole report - but with a grain of salt because this guy is trying to sell something. However, it has some interesting hints for those of you who don't have a lot to lose, and how not to (maybe) upset the hormonal balance).
Boy do I know the effects of a massive increase in ghrelin after dieting. Remember, I said that 6 months (or so) after beginning to lose weight, I just could not with any techniques, prayer, and self will continue to eat sufficiently less calories to stay on a diet. You can imagine that the ghrelin was raging in my body at that time. Now the hunger appetite is extremely powerful - it is in response to life and death for the person. I worked this out 15-20 years ago, but didn't know or understand what it was.
If you read the last linked article, you will see a clue as to why I considered surgery. As a matter of interest, you mainly hear about "gastric bypass" surgery - which is one of three methods of surgery that can be used, and is most popular in the USA. I will go into the differences between this and my surgery at another time. But I have a lapband which is adjustable. It is reversible (and if I every do that, I will put all the weight on again, very fast. I do not want to consider that!).
Anyhow - here is a quote from research into the effects of gastric bypass surgery on the production of ghrelin "Conclusions The increase in the plasma ghrelin level with diet-induced weight loss is consistent with the hypothesis that ghrelin has a role in the long-term regulation of body weight. Gastric bypass is associated with markedly suppressed ghrelin levels, possibly contributing to the weight-reducing effect of the procedure."
read the research OK - this was pretty persuasive for me. But what were the results of lapband surgery.
In essence, the success rate of people losing weight after lapband surgery (remember, it is less than 5% after dieting) was much higher. Research shows that most people will lose 50-60% of excess weight within 1-2 years of surgery, and the maintenance rates are higher. I will go into all of that later on, and give you the relevant research links.
Anyhow, that was enough for me. The risks - yeah I was a risk to have an operation, I could cheat the system and chose not to lose weight. The pros - most people lose weight, and keep it off. The risks of not having it, and trying dieting again - losing the weight, and putting more back on, not being able to walk with my knees, heart attacks, diabetes, earlier death by up to 20 years etc. etc. Advantages of not doing it - costs less (well - really in the long term.... hmmmm), not having my stomach cut open for keyhole surgery.
I decided to go ahead. I have to admit the night of the surgery I wondered if it was worth it, but by midday the next day, I was NOT sorry.
The best thing so far - being able to eat a little bit, and actually feeling that I could NOT eat any more. I have almost NEVER felt this in my life (that I can remember). Then, not only to forget about eating for a while (which I MAY have experienced once every 2-3 months for a half a day or so), but to actually feel I DON'T want to eat. That is why I did the surgery.
Enough reading for you - those who get to the end of this deserve a prize. The prize is, you get to have me in your life for 20 more years than was likely 2 weeks ago!!!!
Love you
Janet