July 29th, 2011
07:24 AM ET

Weight loss 'sleeve' a good option?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Friday, it's Dr. Melina Jampolis, a physician nutrition specialist.

Question asked by Lynn C. of Madison, Ohio

I have had a weight problem for 23 years. I have lost and regained over 400 pounds. My weight-loss doctor is offering the "sleeve." I have been told because of my gastroesophageal reflux disease that the Lap Band is not an option, nor is the more well-known gastric bypass because of a high family history of cancer.

I have all the problems common in morbidly obese people, some I had even when thin. High, difficult-to-control blood sugar, blood pressure and a mild heart issue controlled by meds. The sleeve has been done only a few years - can it be a good option for me?

Expert answer:

Hi Lynn. Although I'm a nutrition doctor and I focus on weight loss through lifestyle measures such as diet and exercise, I realize that sustained major weight loss is not always achievable and that surgical intervention, particularly when patients have obesity-related diseases like high blood pressure and diabetes, can be lifesaving and life changing.

Since I am not a bariatric (weight loss) surgeon, I turned to Dr. Kai Nishi, a highly respected bariatric surgeon at the Khalili Center for Bariatric Care in Beverly Hills.

He agreed that Lap Band may not be the best option if you have GERD as it could worsen symptoms.

However, if your GERD is due to a hiatal hernia, this could be repaired at the same time that your band is placed and your GERD could potentially be cured. Gastric bypass surgery is an anti-reflux surgery and in many cases can cure GERD.

Regarding your family history of cancer, the only type of cancer that would make gastric bypass surgery not an option is stomach cancer.

If you have a family history of other types of cancer including colon, lung, breast and prostate, this type of surgery, which has been around for longer than the newer sleeve procedure and thus physicians have more experience with the procedure and there is more research into the risks and benefits, would still be an option (the best option according to Nishi.)

The sleeve gastrectomy is a surgery in which 85% of your stomach is removed so you are left with just a tube for a stomach. Gastric bypass surgery also cuts the stomach, but it creates a new smaller pouch, about the size of an egg, which is attached to the second part of the small intestine.

This can lead to more nutrient absorption issues than the sleeve but it can also lead to better weight loss. With the sleeve procedure, results show 50-60% excess body weight loss at one year vs. 65-70% with gastric bypass and 45-50% with gastric band.

Excess body weight loss, or EBWL, refers to the percent excess weight a person begins with. If you are 100 pounds overweight and you lost 50 pounds that would be a 50% EBWL.

Weight-loss surgery in general leads to a 70-80% resolution of diabetes and 50% resolution of high blood pressure, with better results for both conditions with gastric bypass (because the sleeve is a newer procedure less data are available).

So if your weight-loss surgeon, who is fully aware of all of your medical history and issues, feels that the sleeve is the best option, and you truly do not believe that you are capable of maintaining weight loss permanently through lifestyle measures, (losing even 10% of your excess body weight can make a significant health difference), then I think the sleeve could be a good option for you.

If you do go forward with any type of weight-loss surgery, make sure that you have an adequate support system in place. It is still critical that you permanently adopt a healthy lifestyle including regular exercise and good food choices after the operation.

Follow Dr. Melina on Twitter.

soundoff (437 Responses)
  1. Goodstuff

    Eat fewer donuts.

    July 29, 2011 at 07:35 | Report abuse | Reply
    • dragonwife

      Unfortunately, that is not always the answer.

      The knee-jerk solution of far too many people, when faced with someone who's overweight, is to say "Quit stuffing your face and get off your rear end and exercise." Yes, for a large number of people, that's correct – they eat way too much, and of the wrong foods, and don't exercise. But there are those of us who for various reasons can not lose weight without drastic, and possibly surgical, measures. I am overweight and would absolutely love to lose a large amount. I eat healthy foods in reasonable portions, try to avoid junk food and fast food, exercise vigorously for an hour or more at least 4 days a week and often more, plus am taking a martial arts class. But I have maintained the same weight, within 5 pounds, for the last 4 years. In the past, I have gone on a medically supervised 1000-calorie diet, combined with at least an hour of daily cardio, and still could not lose weight. My overall health is very good (glucose, cholesterol, etc. all in the desirable ranges), my muscles are toned and I can walk 2 miles with no problems (can't run because of a knee injury – ironically, from running). My doctor has verified that I do in fact have the often-used-as-an-excuse slow metabolism. So what would be the solution for me? Eat less than 1000 calories and be constantly hungry? Exercise 2 hours a day instead of one? Please think about that before assuming we're all lazy slobs who sit around scarfing Ben & Jerry's and Doritos all day.

      July 29, 2011 at 08:34 | Report abuse |
    • kake79

      @dragonwife... If you are truly eating healthy and proper portions and the right amount of calories and getting the right amount of exercise and your blood pressure, cholesterol, and glucose are all good, guess what?, you're healthy! Just because you weigh more than the average healthy person, doesn't mean you need to lose weight. Just focus on your health and forget the idiots who think that because you're a bit bigger, that there's something you're doing wrong.

      July 29, 2011 at 10:07 | Report abuse |
    • HEY

      @dragonwife Thank you. I am the same way. I was an elite gymnast, weighing in at 145 and 5"5". When I quit, my weight went up to 180 and while fluctuating +/- 10 lbs, I haven't been able to get down to the 160s. I've made some major changes in my lifestyle, such as no sugary drinks, no fast food, no fried food, more whole fruits/vegetables, and an hour of cardio each day (jogging even with my runner's knee condition...same as you! but it's worth the great cardio for me). Despite my efforts, no weight loss. I don't let myself eat donuts, burger king, or pizza yet it's made no difference. Right now I'm doing p90x workouts but doubt they'll make a difference. My mother was obese and my sister struggled with her weight, and it really sucks knowing that my genetics are fighting against my metabolism. And i HATE when people say that a slow metabolism is an excuse. It's legitimate for some people.

      July 29, 2011 at 10:07 | Report abuse |
    • Liz

      Eat a low carb, higher protein and fat diet... then watch what happens! You will get healthier! Also read, "Health at Every Size" by Dr. Linda Bacon. She is a nutritionist who totally breaks down the myths surrounding diet and health. I read that book and it changed my life! I was a life-long dieter, have been since I was 6 years old. I've always had weight issues and I admit, I ate badly and didn't exercise. I also have PCOS (policystic ovarian syndrome, a hormonal disorder which affects up to 15% of women and can make weight loss very difficult, hense the low-carb diet). I read this book, started listening to my body queues, eating when I was hungry, stopping when I was satisfied, moving bc it felt good and 2 years later, I'm down 65 lbs. I still have more to lose, but I'm in the best shape than I've ever been and I feel great. And it was practically effortless! Sounds too good to be true, and it is difficult at first, but its the best thing you can do for yourself.

      July 29, 2011 at 14:38 | Report abuse |
    • Annie

      How shallow and ignorant you are... you obviously don't know what its like to deal with weight issues.

      July 29, 2011 at 14:41 | Report abuse |
    • Fifi

      Dragon wife, you need to learn to accept your body. If you are active and not overeating, you are the weight you are genetically meant to be. Forget trying to look like other women and concentrate on being healthy. Buy a scale that measures fat percentage, and work on keeping yourself in the healthy range. I'm larger than I'd like to be, but it's muscle and just 22 percent fat. Don't even look at your total weight. Just focus on the fat.

      July 29, 2011 at 14:42 | Report abuse |
    • Joe

      @dragonwife. I'm sorry, but the claim that you were "on a strict 1000 calorie a day diet with exercise and still couldn't lose weight" is ridiculous. It's physically impossible to not lose weight on a diet like that because it's damn near a starvation diet.

      July 29, 2011 at 18:49 | Report abuse |
    • Brandon

      While I'm not saying losing weight is easy, the formula for losing it is crazy simple: Burn more calories than you consume. And the reverse is true if you want to gain weight. While it's better to eat healthy food because of the nutritional content, you can get very big without ever touching a doughnut or other junk food.

      July 30, 2011 at 07:46 | Report abuse |
    • MPHKMP

      Weight Loss surgery is a blessing and it gers rid of a horribe curse

      July 30, 2011 at 13:42 | Report abuse |
    • Andres

      @dragonwife (or anyone else) Yeah I understand, it can be kind of tough... sorry if I'm a bit unclear, I'm kind of falling asleep after my 2 hour workout today (1 hour spinning class, 1 hour swimming, plus a bit of jogging to get from one to the other). You can always exercise more, you can always eat less. But there a couple of things that are worth noting. Loosing weight is tough with 1 hour of exercise a day. The body doesn't start burning fat bigtime until you warm up, which can be 30-45 if doing high intensity stuff. It may never come if you do low intensity stuff. So push yourself more, more intensity, more time. I'm right now a bit overweight, and when I kicked into a more constant training regime, i gained 3 pounds !! Three or four weeks later I'm down 6 or so, so it's worth it. Also, I'm increasing my volume little by little. The biggest loss will not come now, but in a couple of months, when I'm riding 30 mi in my bike, or doing 90 minute plus spinning classes. Of course it's a process, my body needs to get used to it, get my muscles in order, lower my HR, increase my VO2, etc. Can't run? Then swim. Don't know how to swim? Then bike. Walking is what you do to get from point a to b. Ohh... and I don't workout 2 hours every day, During the week I do 90 minutes max, and on saturday I'm a naughty boy and don't workout at all. On Sunday I go all out. Hey the muscles gotta recover. Also, I eat quite a bit. As healthy as possible, sometime only vegetarian, lean protein, little sugar. But if the body feels starved, it will lower the energy output to prevent starvation.

      July 31, 2011 at 11:58 | Report abuse |
    • vJones

      I had the sleeve in May 2009. Best decision I ever made. Went from 360's and just shy of my goal of 180. You don't have to go to Mexico. Just check out Dr. Pleatman in Michigan. Very affordable especially when your a self pay, like I was.

      August 1, 2011 at 13:13 | Report abuse |
    • Notorious BJC

      @dragonwife – There is a very real possibility that you are eating too little and your body is going into starvation mode. When you starve your body it will slow down your metabolism as it is trying to retain everything for the perceived famine. Try bumping your intake up to no less than 1200 calories.

      August 1, 2011 at 16:36 | Report abuse |
    • connie

      My Father just had the gastric bypass sleeve in Florida and he just died from the complications of the surgery. Dr. Perez performed the surgery and he nicked an artery in the surgery and had to go back in and do another surgery to repair the artery.
      My father was in ICU for 28 days and he passed away yesterday. We looked into a malpractice suit, but the doctors all team together and we cannot find an attorney to represent us.
      This surgery is NOT as easy as they make it out to be. DON'T DO IT! Hopefully this will save a life and then my dad's death will not be for nothing.

      December 31, 2013 at 12:44 | Report abuse |
  2. jessicaber

    How do you surgically implant a sleeve?

    July 29, 2011 at 09:23 | Report abuse | Reply
    • XtraMedium

      Read the article.

      "The sleeve gastrectomy is a surgery in which 85% of your stomach is removed so you are left with just a tube for a stomach. Gastric bypass surgery also cuts the stomach, but it creates a new smaller pouch, about the size of an egg, which is attached to the second part of the small intestine."

      July 29, 2011 at 10:55 | Report abuse |
    • Anna

      The Anti Obesity drug makers and diabetes drug makers take in 10 billion$$$$ every year with no cure!!

      Food Chemicals are the cause of the diabetes and obesity crisis

      The FDA and Drug makers know this and are laughing to the Billionaire$$$ bank

      The food chemicals break the gut(insulin) and this is the cause of the diabetes and obesity crisis

      A filmmaker has been reversing diabetes and Obesity WITHOUT MEDICATIONS in now 10 countries and the drug makers do not promote the story

      just google SPIRIT HAPPY DIET

      July 29, 2011 at 21:33 | Report abuse |
    • Sharon

      Anna- What a dolt. a FILM MAKER has been reversing obesity? ROFL. What special effects program does he use?

      July 31, 2011 at 12:52 | Report abuse |
  3. drsolo

    Year after year my weight crept up to 180 lbs. I finally realized I had to do something because I would get nauseated just trying to take a walk.
    1. I started by swearing off all "eat in" and "take out" restaurants. This food is a diet failure both in portion control and hidden carbs/calories.
    2. I downsized all our dishes to smaller sized plates and bowls.
    3. I prerecord anything I am watching on TV and zap thru the commercials so I dont have to see "food".
    4. We cleaned all the carbs out of the house and my DH hides any that he does bring into the house. Out of sight, out of mind."
    5. When just cutting back the carbs and portions didnt work well I went to plan B. I put everything I was going to eat THAT DAY on a single plate. This was mostly the same stuff I would eat each day. If I didnt lose any weight for a couple days I took something OFF that "daily plate of food" until I started losing weight. I was shocked at how little I need to eat to even maintain my weight much less lose. It is both the size of the portion and cutting out all carbs except berries and non starchy veggies and had to cut back on amount of proteins too.
    6. I have now lost close to 40 lbs in the last year. As I lost weight I had to take more stuff off that daily plate as well. It takes less food to maintain the lower weight.
    What am I eating now? At 11 or so I have 1 small zucchini dipped in a yogurt/blue cheese/poppy seed dressing "dip" my DH created. For dinner I have a medium salad with onions and small amount of shredded chicken, onions and that same yogurt dressing. OR, for dinner I have a chicken thigh and leg w/raw onions. OR, if I don't intend to lose I will have a small hamburger on one of those thin buns w/ onion and a couple pickle slices. For "snack" I have nuts in the shell, maybe 5-10 or, a small zucchini with no dip. I didnt get to this point all at once. As I passed up the sugar, the carbs I gradually didnt crave them anymore. I chew sugar free gum to keep my mouth busy. I do crack a few nuts if I feel I need to put something in my mouth. And because it was gradual and what I eat is high protein with fat, I don't feel hungry either.
    On election nights we do get pizza from our favorite place. I have 3 slices and gain a pound by the next day so it is avoided the rest of the time.
    I also practice the "one bite" rule. Somebody once said "the first bite lingers just as long in the mouth as the last bite". It is true. My DH gets something, I have one bite. It satisfies without ending up on my hips.
    OH, and I am now out walking with my DH almost every night, most times over a mile.

    July 29, 2011 at 11:39 | Report abuse | Reply
    • E

      raw onions, chicken and nuts is not a balanced diet and a mile is 15 minutes of moderate exercise, hardly an amount to brag about.

      July 29, 2011 at 19:44 | Report abuse |
    • Denim

      Good for you! You found a regimen that works for you.

      E, if you have nothing useful or positive to say to someone who has found a useful solution, feel free to get lost.

      July 31, 2011 at 17:04 | Report abuse |
    • KC

      UGH–all those onions–I'm amazed you haven't lost 180 lbs–your husband!

      August 1, 2011 at 00:05 | Report abuse |
  4. Mini Me

    I had the sleeve surgery in January 2010. I am down to a "normal" BMI of 20.5 and finally enjoying my life again. The sleeve restricts intake because it is so much smaller and "only holds so much". Of course, I only resorted to surgery after years of losing weight and failing to maintain. The yo-yo dieting was worse on my health than being obese. Yes, I can eat all day or drink my calories, but if I follow my plan, I can eat nutritious foods, the occaisional "bad" food, and maintain a healthy weight the rest of my life. It's definitely not easy, but at least it's not impossible like it was before.

    Before judging others with "eat less donuts" or "just keep your big mouth shut", try to put yourself in the shoes of someone who has struggled with this for their entire life. This is definitely not something to be considered lightly, but for many can save their lives along with the quality of that life.

    July 29, 2011 at 11:54 | Report abuse | Reply
    • MPHKMP

      Thank you Mini Me! I am i nthe process of getting pre surgical clearances done for my sleeve! I cant wait! I have tried to diet and maintain a healthy weight and its not just possible. I work out eat right and my body wont budge from 287 pounds its suck here. Its beter than the 320 I was and I have kept 40lbs off. I cant wait to have my sleeve and regain my life back I cant wait to stop waking up with chronic back pain its horrible. I cant wait!

      July 30, 2011 at 13:39 | Report abuse |
    • connie

      My Father just had the gastric bypass sleeve in Florida and he just died from the complications of the surgery. Dr. Perez performed the surgery and he nicked an artery in the surgery and had to go back in and do another surgery to repair the artery.
      My father was in ICU for 28 days and he passed away yesterday. We looked into a malpractice suit, but the doctors all team together and we cannot find an attorney to represent us.
      This surgery is NOT as easy as they make it out to be. DON'T DO IT! Hopefully this will save a life and then my dad's death will not be for nothing.

      December 31, 2013 at 12:45 | Report abuse |
  5. Elite Gymnast

    @ HEY, you were an "elite" gymnast at 145 pounds and 5'5"??? On what planet? No, seriously? That's doubtful... honestly. First of all 5'5" is tall for a gymnast... period. Secondly, 145 is HUGE for a gymnast and is above the ideal weight for someone of your height even if you were not a gymnast at all. I'm 5'5" and was an elite gymnast for over ten years. I NEVER weighed more than 120 pounds (usually I was around 115) while I was actively a gymnast and I was one of the biggest (and tallest) girls on both my gymnastics and acro-sport team. 145 is not the weight of an elite gymnast ANYWHERE.

    July 29, 2011 at 11:58 | Report abuse | Reply
    • kenny of salt

      Perhaps Hey is a man. 5'5" and 145 sounds about right for a male gymnast

      July 29, 2011 at 14:45 | Report abuse |
    • cmh

      I agree with Kenny of Salt. Why did you assume it was a woman? Being a gymnast you should know there is that whole 'men's gymnastics' going on in which case the height/weight seems quite reasonable.

      July 30, 2011 at 14:58 | Report abuse |
    • mkjp

      news flash, 144lbs is a healthy weight for someone who is 5'3". Healthy does not mean looks like a concentration camp victim.

      August 1, 2011 at 14:32 | Report abuse |
  6. jessicaber

    Thank you.

    July 29, 2011 at 12:19 | Report abuse | Reply
  7. thinker

    While I have never been obese, I am one of those people who have carried around an extra 20 lbs most of their life. I have finally started making a dent in that by establishing some specific, but still realistic, rules for myself.
    1) We eat our main meal at lunchtime. That means cooking ahead and portioning out our meals, which is very helpful in avoiding "seconds".
    2) No, I cannot eat as much as my husband! This was difficult for me and caused a lot of resentment, but I've finally come to terms with it.
    3) No alcohol during the week.
    4) Fat-free bean soup for breakfast.
    5) A smoothie for dinner (fruit and yogurt, with spinach).
    6) Plenty of fresh fruit.
    7) A couple of small treats (chocolate!) each day
    8) Regular and varied exercise: walk the dog, walk to work, weights and spin class at the gym, etc.
    While there may be some people for whom surgery is the only option, it seems as though some folks view it as a quick fix and don't take into consideration the long-term maintenance of their new digestive system. A serious effort via proper nutrition and exercise should always be the first approach.

    July 29, 2011 at 13:17 | Report abuse | Reply
    • Fifi

      Bean soup for breakfast? I hope you have some Beano with that.

      July 29, 2011 at 14:47 | Report abuse |
    • Hellscreamgold

      Bean soup? Talk about needless carbs.

      July 29, 2011 at 15:18 | Report abuse |
    • E

      beans are very healthy, low in calories and high in fiber.

      July 29, 2011 at 19:46 | Report abuse |
  8. jessicaber

    I do believe that chocolate is a health food. The Mayans ate it. I think that it was God's wife's food for us. I am a Latter Day Saint. I remember when I was working at Borders Book in Phoenix, Arizona in the summer of 1999 and The Akins Diet was popular a couple of woman came in the book store and one of them was saying "all I eat is potatoe chips and chocolate and I have lost 10 lbs" or something like that.

    July 29, 2011 at 13:25 | Report abuse | Reply
  9. todd

    I went from 170 to 150 (i'm a 5'6" maile). Switched from cupcakes and chocolate truffles as snacks to carrots, apples, and the occasional garlic bagel chip. If you exercise and eat 2000 calories a day, then no matter what your weight it, you are healthy. If you eat 7000 calories a day, then either you are Michael Phelps or you need to cut back. Even bariatric surgery won't work for long if you don't make lifestyle changes.

    July 29, 2011 at 13:52 | Report abuse | Reply
    • Crystal

      BMI is a joke...

      BMI Classification
      18.5 or less Underweight
      18.5 to 24.99 Normal Weight
      25 to 29.99 Overweight
      30 to 34.99 Obesity (Class 1)
      35 to 39.99 Obesity (Class 2)
      40 or greater Morbid Obesity
      Jack LaLanne 5'4" weight 172 lbs BMI 29.5 – Overweight
      Arnold Schwarzenegger 6'2" weight 260 lbs BMI 33.4 – Obesity Class 1
      Lou Ferrigno 6'5", weight 325 lbs BMI 38.5 – Obesity Class 2
      Stephanie Park 5'2" weight 145 lbs BMI 26.5 – Overweight
      Ronnie Coleman 5'11" weight 330 lbs BMI 46.2 – Morbid Obesity
      Yaxeni Oriquen 5'7" weight is 185 pounds. BMI 29 – Overweight

      Google these folks if you do not know what they are – or just Google pictures of them then tell me they are overweight and/or obese. "Health and weight" have little to do with each other...

      July 30, 2011 at 00:43 | Report abuse |
    • Hamdan

      do not do a colon cleanse and do not eat a high cliorae, high fat diet comprised of meat and cheese. That is stupid. Eating vegetables, fruits in moderation and lean meats (no red meats) all organic will help anyone lose weight. Just eat natural.To answer your question, they are the same. carbs contain clioraes. These are all purely sources of energy: proteins, carbs, fats and sugars.Sugars are the first used by the body, thus a sudden energy rush after eating sugary foods. Carbs are used second as energy during strenuous periods outside daily activity (e.g. exercise). Fats and proteins are different, however, in that fats are directly stored in your body for rainy day energy when you can't find food. Proteins are used to build and repair muscle tissue. All four of these contain clioraes, per gram, fat has 9 clioraes, protein has 4 clioraes and carbs have 4 clioraes. Thus a high protein diet is also high in clioraes and if you are not exercising your muscles and breaking them down. Your body does not need protein and stores it as fat. It is the same way with carbs. While insulin, stress and other factors do affect your body, it cannot work with resources that it does not have. If you give your body the right kinds of foods, everything will fall into place. Nature intended for our metabolisms to regulate themselves for survival purposes. Trust that your body can take care of itself. Processed junk foods ruined the natural process by introducing too much of everything, fad diets are just trying to profit off of fixing this. Remember, everything in moderation! from broccoli to cake don't eat too much and you'll be fine.Sorry for a long answer to a short question, but I had to dispel some myths thanks for your time.

      March 6, 2012 at 00:09 | Report abuse |
  10. confused

    What I don't understand, and probably never will, is how people can say that they eat healthy and watch portions yet suddenly when they CANNOT eat more than a certain amount, they lose weight. The surgery doesn't change what you can absorb, it just limits the amount of food you can eat at one sitting. If all you have to do is cut back how much you eat, then that should be possible with will power and not surgery. People who claim they need the surgery because eating less hasn't worked have clearly not tried eating that much less. Because that's the result of the surgery.

    July 29, 2011 at 14:11 | Report abuse | Reply
    • Fifi

      It isn't just reducing the amount you can take in, it's limiting how much nutrition your body can absorb...and calories. Go back and read it.

      July 29, 2011 at 14:50 | Report abuse |
    • Shivam

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      October 14, 2012 at 00:41 | Report abuse |
  11. Lisa Johnson

    I had the sleeve gastrectomy in May of 2009. I weighed 243 on day of surgery after losing approx 20 lbs prior. Today I weigh 161 and I have to tell you that I HAVE MY LIFE BACK. I'm still "fat" to some people, and frankly still feel that way myself half the time, but I am a size 10 and I do have some skin issues that will require some plastic surgery at some time, but I am also not done losing yet. I have been stable at this weight for about 4 months and all I have to do is be a little more strict with myself. The carbs have crept back into my life, and I know it. I cannot eat very much volume at one time, which is exactly the kind of restriction I wanted. I still usually eat a protein first, good carbs second diet. I don't deny myself a bite of anything, Sometimes it's hard to eat because you simply aren't hungry (compared to how you feel before surgery) yet know you have to have some protein. I've never had one side effect or complication and this was a DREAM surgery.

    Don't have ANY kind of surgery without lots of support both clinical and personal. At Weightwise Bariatric Clinic in Edmond, OK, you are required to take classes about nutrition, physiology and exercise, have a mental evaluation, as well as attend support group meetings (which are the bread and butter of life! pardon the pun because no bread is allowed anymore!). I chose the sleeve because of a number of factors, and the least side effects and complications, and I chose well. I also absolutely know that BECAUSE I had excellent counseling and a huge support group and attending the free weekly meetings, along with the nearly instant results, and continued results, I would encourage ANY body to do this surgery.

    I have a co-worker who for some reason, thought I paid $25,000 for it, and when she found it was $12,500 she started the process. She got lucky and also got a bargain price of $9999. She has lost over 100 lbs since January and is doing awesome. She has also not had any complications.

    Go to http://www.obesityhelp.com and view the forums regarding different experiences, comments and surgeries.

    July 29, 2011 at 14:16 | Report abuse | Reply
    • MPHKMP

      Hey Lisa
      Congrats! I am having my sleeve soon! I am about halfway through my pre surgical clearances! I am 287 and I need to lose the weight. The sleeve gives many their life back! Chronic back pain, PCOS arch pain, GERD, lets see what else being 26 and having to wear a 22 SICK OF IT! I cant wait to gain my life back~

      July 30, 2011 at 13:41 | Report abuse |
  12. Auticus

    I suffer from a slow metabolism. At my biggest I was 272 lbs. I've been around 235 most of my adult life. I am 6'2. This is how I finally beat my weight...

    I food logged for a couple weeks and saw some immediate issues. Even if you are watching what you eat, I can bet that most of you who still have issues have some more issues with your food. I know I did.

    Two – I started running and playing sports again. I dropped 10 lbs in a month down to 230 and hit a plateau. I was on a 1600 calorie a day diet and my body stopped losing weight. So I sought nutritional advice and training advice and started weight lifting again and raised my calories to 2000.

    I work out 6x a week total. 4x in the gym doing strength training (weight lifting) and 6x on the track running. I also play soccer.

    I watch the type of carbs I eat. I limit my intake to 40% protein, 40% carbs, 20% fat. Once a week I will have something that I really like. I call it my saturday IHop dinner because I love IHop.

    The end result is being in shape. It took hard work, exercise, really changing my diet through the help of a professional, and in the end it paid off. This is coming from a guy who used to blame his slow metabolism, because by itself a 2000 calorie diet a day was keeping me obese at 235 lbs. What you eat is just as important as how much. And I don't just mean skipping fast food. The grocery store is loaded with bad choices. Eliminate soda of any kind (diet or otherwise). Elminate sugary drinks.

    I challenge you to monitor how much sugar you take in each day. 40g or so is what you should aim for if you do no exercise. Most people consume 200g or more. One can of coke exceeds your daily reccomended amount of sugar. Bread is loaded with sugar. Educate yourself. Look at what you consume. Change your habits. You will lose the weight. I promise.

    July 29, 2011 at 14:28 | Report abuse | Reply
    • Fifi

      Good for you, but what you say isn't true. Calories are calories. The only difference, as far as weight loss goes, between eating your calories as "bad" food or "good" food is satiation. If you eat a high-carb, sugary sleeve of cookies, you will be hungry for more carbs very soon. If you eat a high-protein and good-fat bowl of (high calorie) nuts, you will be satiated for a long period. The basic mechanism for weight loss is calories in must be fewer than calories expended.

      July 29, 2011 at 14:59 | Report abuse |
    • Auticus

      The nutritional world disagrees with you as far as a calorie is a calorie.

      Empty soda calories are not the equivalent in nutrition to an apple, or an egg, for example.

      Calories in / calories out is great in theory but your body shuts down after a while. Go on a restrictive diet and watch after a couple weeks how your body adapts and you stop losing weight.

      I was on 1600 a day calories plus running off 500-600 calories a day. My resting metabolism was around 2100. That means my defecit sits at about 900-1000 calories a day, which puts me at a pound every 3.5 days. This worked for two weeks.

      Then it stopped.

      Then it reversed it self and I started gaining until I actually upped my caloric intake. Nothing else changed except adding 300 calories a day suddenly kick started the metabolism back up and I started dropping more weight despite the deficit being less.

      July 29, 2011 at 15:10 | Report abuse |
    • Fifi

      I was talking about calories (a unit of energy), not nutrition (vitamins, minerals, trace elements). Your body needs a certain amount of energy (calories) just to allow you to function. If you reduce your calorie intake too drastically, your body goes into starvation mode, and your metabolism changes. You will stop losing weight. The way to lose steadily (keeping in mind that there will always be a plateau because you lose a lot of water in the beginning) and permanently is to reduce your calorie intake by a small but effective amount. For an adult woman who is moderately active, a maintenance calorie intake is in the region of 2k per day. To diet intelligently, she should reduce that to 1800 per day. A certain weight loss company that sells meal-replacement drinks has a good Web site that helps you determine optimum calorie intake for your goals. Their system works, but all it is is a protein/vitamin drink and keeping a log of everything you eat. It's just calorie counting.

      July 29, 2011 at 16:03 | Report abuse |
    • Joe

      Actually, Auticus, you're wrong. Ask any real scientist. A calorie is a calorie is a calorie. A pound is 3,500 calories. It doesn't matter if that 3500 calories is ice cream or salad. This is as big a myth as the "don't eat after 6 pm" one. It doesn't matter if you eat at midnight or noon.

      July 29, 2011 at 18:54 | Report abuse |
  13. Auburn

    I had a sleeve gastrectomy about 7 months ago and have lost over 60 lbs. (still have about 32 to go to hit my final goal). I had the surgery done in Mexico (paid out of my own pocket, as my health insurance didn't cover it). I chose a sleeve gastrectomy over lap band or gastric bypass. I didn't want lap band because 1) it can be difficult to get the level of restriction right (you may need numerous "fills" to adjust, each of which costs $$$); 2) a significant percentage of lap bands have to be removed after a few years due to complications (slippage, or the band into the stomach and causes damage, or severe GERD develops and damages the esophagus); and 3) if the band comes out, weight regain is virtually guaranteed. I didn't want gastric bypass because 1) there are big problems with nutritional deficiencies and you have to take supplements the rest of your life, which can be very costly; and 2) most people with gastric bypass have severe problems with "dumping syndrome" (eating even minor amounts of sugary food can cause severe gastrointestinal distress) - so you have to be really careful about reading labels and watching what you eat. With the sleeve, you get permanent restriction but no foreign object in the body and no worries about malnutrition or dumping syndrome, so to me it was the procedure with the greatest balance of risk to reward. I am a small woman (5'1") in my mid 40's (so metabolism is slowing down) and basically in order to eat the right amount of calories each day for my height I would have to be on a life-long strict diet ... the sleeve helps me eat the right number of calories per day for my size, and yet not feel like I am starving myself or feeling deprived. I would do it again in a heartbeat. My only regret is that I didn't know about this procedure 10 years ago!

    Studies have repeatedly shown that 90% of obese people who lose weight cannot 1) loose all their excess weight and 2) keep it off for the long term. Weight loss surgery is by far the most successful method for obese people to lose a significant amount of weight and keep it off. And with the health risks associated with being obese, you can literally add years to your life if you can get (and keep) control over your weight.

    Check out verticalsleevetalk.com if you want to learn more about sleeve gastrectomy. There is a ton of information on that site and lots of people who have had the procedure and can tell you all about what their experience has been. Obesityhelp.com is also a good resource (as someone else mentioned) - they have forums for all the different types of weight loss surgeries so you can learn and make the best decision for yourself. Best of luck to you in your weight loss journey!

    July 29, 2011 at 15:28 | Report abuse | Reply
    • Sleeved 2008

      You mentioned that you won't need to worry about malnutrition but I'm sorry to say you are wrong. Please be careful in the coming years, the lack of absorption is just as high. Do not skip any of your vitamins for any reason, if you are not on an iron supplement get on one. I as well as several other have been sick for quite some time due to malnutrition. As for dumping, it's also not true for everyone when it comes to the sleeve. I know several other sleevers that have the issues with dumping which is also a problem that causes malnutrition. Be careful, take care of yourself, stay on top of your blood-work, and start looking for a PCP that has other Sleeve patients so they can help you properly as things begin to go wrong. Good Luck and Best Wishes.

      July 30, 2011 at 00:52 | Report abuse |
    • Just a chick

      Auburn, would you mind sharing the name of your surgeon in Mexico (or the name of the clinic). I have been researching VSG in Mexico as well.

      July 30, 2011 at 08:42 | Report abuse |
  14. someoneelse

    Being overweight can be blamed on genetics, being poor, and other factors. Being 400 pounds overweight, and hence obese, is 100% laziness. Absolutely.

    July 29, 2011 at 15:42 | Report abuse | Reply
    • Susan

      A gluten free diet is often high in caelrios. The gluten free alternatives like bread, cakes, cookies etc have more fat and sugar than the non-gluten free ones. This is because gluten keeps these items together (gluten=glue). When you take the gluten out, the food often falls apart and doesn't taste very good. So they add extra sugar, oils, fats and salts to keep it together and taste decent.So the best piece of advice is to remove all gluten free alternatives and eat a naturally gluten free diet as much as you can. So eat things like rice, eggs, fruit, nuts, vegetables, fish, meat etc etc.I've been on a gluten free diet for 5 years and I weigh less now than when I was diagnosed (I've lost about 15kgs=33lbs)Good luck =] .

      September 11, 2012 at 20:06 | Report abuse |
  15. jessicaber

    I would not want my stomach cut out of me. Sounds like a bad idea and going to Mexico to do it????

    July 29, 2011 at 15:47 | Report abuse | Reply
    • Fifi

      My body tried very hard to eject my stomach when I was in Mexico. No surgery needed.

      July 29, 2011 at 16:20 | Report abuse |
    • Auburn

      A lot of Americans have an unfortunate bias against having medical procedures done in Mexico, but if you do your research you can get outstanding treatment at a substantial savings compared to the US. In Mexico I stayed at a beautiful, modern, very safe, full service hospital, had a top-notch surgeon (who was far more experienced and qualified in the sleeve gastrectomy procedure than most US bariatric surgeons are), and had outstanding service (the surgical team were all fluent in English and most nurses had a good working knowledge of English). I had a large, private, very comfortable room, and a wonderful nurse outside my door who checked up on me all the time to make sure I was OK. I had at least 2 visits from the surgeon's team each day I was hospitalized (good luck getting that in a US hospital!) and I got to stay for 3 full days to recover (in the US most hospitals send you home the day after surgery, which is way too fast for major surgery). No complications at all and the doctors did multiple tests to ensure there were no leaks or other medical problems. I also got to stock up on some meds (acid reflux pills) there that were far less expensive than they cost in the US. I would do the surgery again in a heartbeat. I probably will need some plastic surgery once I am done losing weight and will go back to Mexico for that surgery too.

      Yes, there are some bad surgeons in Mexico - as in the US and elsewhere - so do your homework, but medical tourism in Mexico is huge business and for a good reason.

      July 29, 2011 at 17:04 | Report abuse |
  16. cheryl

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    July 29, 2011 at 16:29 | Report abuse | Reply
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  17. jessicaber

    Yeah, that has happened to me to in Mexico.

    July 29, 2011 at 16:52 | Report abuse | Reply
  18. aubrie

    I have a band and I lost 68% of my weight.... If I enjoyed exercise more, I know I would have lost more... Arthritis makes it uncomfortable... I'm happy with my results.... Always puzzled by the bad marks they give the band.....

    July 29, 2011 at 17:33 | Report abuse | Reply
    • XtraMedium

      Just wait until you have to have that band replace because it will wear out. They are not made to last forever.

      July 29, 2011 at 18:04 | Report abuse |
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  21. jessicaber

    I hear that honey can help you lose weight.

    July 29, 2011 at 19:57 | Report abuse | Reply
    • Jaqueline

      I'm sorry, there's really no such thing as a safe diet pill. They amoslt all contain stimulants that can damage the cardiovascular system, and then there's Alli, which can give you explosive diarrhea, so I don't think you want that pill either. Diet and exercise should work perfectly fine. I think you're probably either not giving it enough time (you should give it at least a month before you decide you're not seeing results), or you aren't dieting or exercising right.As for your diet, you should be eating high protein, high fat (saturated not trans, and no that's not unhealthy), low carb, low sugar. Keep your calorie intake around 1500 a day, carbs around 100-150 g a day, and as little added sugar as you can manage. Make sure to eat lots of fruits and veggies too.And you need to push yourself when you exercise. A nice easy pace won't do anything. You have to get sweaty, tired, and work hard. If you don't feel tired when you're done, if you're not out of breath, you're not doing it right. And you need to do both cardio and weight training, but on different days. Try and work out for at least an hour, 4-6 days a week.

      April 7, 2012 at 22:36 | Report abuse |
  22. glenda

    @Joe You're correct is saying that a 100 calorie diet is a starvation diet, but that your body "can't help but lose weight" is incorrect. You'll lose weight to a point (and not very much to make an ultra-low calorie diet worthwhile, but when your body goes into starvation mode, it begins to cling to every calorie that passes your lips. Ultra-low calorie diets can really screw up your metabolism, making it even harder to lose weight.

    July 29, 2011 at 20:30 | Report abuse | Reply
  23. glenda

    And by 100 calorie diet, I mean 1000 calorie diet...

    July 29, 2011 at 20:31 | Report abuse | Reply
  24. Ralph in Orange Park, FL

    My daughter works as a Medical Assistant in a surgical practice, some of which involves weight loss surgery. She says that a lot of the patients want the surgery, but do not want to make the lifestyle changes involved. Doctors can only do so much.

    July 29, 2011 at 20:47 | Report abuse | Reply
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  25. marissa

    I would strongly suggest that you look into metabolic typing and get a certified coach to work with you to find the right diet for you. You are probably a protein type who craves carbs ... but making the change to the right mix of foods will change your life.

    July 30, 2011 at 09:30 | Report abuse | Reply
  26. Gwyn phillips

    WEIGHT LOSS SURGERY IS A BLESSING FOR MANY FOLKS. Fat discrimination is the last acceptabe bias. The starving, health issues, yo- yo, self esteem isuues and most importantly the food issues/ addiction than is almost unavoidable after the years of wear and tear on the psyche is missunderstood by most.

    July 30, 2011 at 10:42 | Report abuse | Reply
  27. Maggie

    I had vertical sleeve surgery in 2009 through my HMO since there were issues with the lapband and I didn't want to have the very drastic gastric bypass. Unfortunately, the results were not good. I initially lost weight, but developed a terrible pain in my stomach when I ate and experienced up to an hour or more of gurgling and burping after eating followed by flatulence. The surgeon laughed and explained that I would have this problem for life. he said it was like pouring water into a Coke bottle – the air had to come out. He then refused to treat me starting three months following surgery. My personal physicial at my well known HMO starting with the initial "K" wouldn't refer me to another doctor. Finally after threatening legal action, she referred me to a GI doctor who did an endoscopy and a barium test. I just found out that as a result of the surgery I have a hiatal hernia (part of my stomach pokes up through my diaphram into my chest cavity) and developed GERD from the gas pushing stomach acid into my esophagus. I now have severe erosion and ulcers in my esophagus. Hopefully it won't turn out to be Barrett's disease which can become cancerous. The treatment for Barretts is to use part of your stomach to patch the esophagus. With this surgery I don't have any extra stomach since mine is supposedly the size of a small hot dog. I'm down to eating no more than 1/2 cup of food a few times a day and have lots of pain. Looking back, I should have tried hypnosis for eight loss plus moreweighloss counseling focusing on why I was eating too much and not exercising enough. I lost four times more weight with the counseling prior to the surgery than afterwards. I have also had severe tiredness and some vitamin deficiencies despite taking all of the vitamins and protein drinks recommended. When you have GERD, please realize that any type of weighloss surgery can make it worse. And if you are going to have surgery, remember when you read the long list of side effects, that you can be one of those who suffer from one or more of the side effects listed or from some that are not on the list.

    July 30, 2011 at 13:44 | Report abuse | Reply
  28. jessicaber

    Maggie, This is very close to my heart and I hope that this will help you. I feel like I barely have the energy and determination to type it out here to you, but here goes my effort. In 1999 "Mr. Right" asked me to marry him. I was in college in Arizona and my family is from Vermont. My parents were not okay with my engagement and suddenly started to disagree with everything that I did, even though I was doing everything right, was doing well in school, was happy, lived in a nice apartment, knew what I wanted for a career, etc. I was even baptised and confirmed in to The Latter Day Saint Church right towards the end of August of that same year. My fiance's family is the Mexican mafia so I am giving my parents the benefit if the doubt, but they will not even admit to me that I should. I do not get them at all. My parents are Catholic and my father's family is wealthy. His brother created Cape Cod Chips and other food brands, so that could be part of the problem (the religion issue). Although I do not understand that at all. So from 1999- 2011 my parents have continued to do terrible things to me. They had me hospitalized for supposed psychiatric issues for 3 years. They are responsible for SRS taking one of my baby boys from me for no reason, because my mom told a dr. at the time that I was seeing who was unfamilar with me that I had bipolar disorder. I have not seen my 1st born son in what will be 7 years this coming October. I am raising my second son by the same dad, but both the dad and I have been on an emotional downward spiral over it for years. The dad loves our second son too, so I know that he loves our first one he just never talks about it, because we have not been allowed to see him I think. I lost my fiance and many friends because of my parents lies. I lost my sanity many times in the early 2000's over it, which I think was easy to do, because there was a language barrier between my fiance and I. Him being able to speak some Spanish and my being from Vermont. So alot of the time, at least I can speak for myself I was reacting from my heart. It was a totally dillusional and terrible life style that we fell in to in that way. In the midst of all of this I met a woman at a step down facility that I was in back in the early summer of 2003 right before returning to one of my many apartments in the central Vermont area who put a movie in for me. It was an old black and white movie about a castle "Mandalay!" I think that she called it or something like that and she was sitting in the office off the living room and it was night time and she was on duty that night and there was something about her that brought me so much peace. For awhile I refected on it many times since then. She was eating her dinner, some little salad or bean salad maybe out of a tupper ware at the desk and the whole time she had this wheezy sort of breath. She explained to me that she had had some sort of gastric bypass surgery and that it had gone bad, but her happiness showed to me that maybe she had faith and hope that she would get better. I think that maybe it was staples that did not cover all of the holes or something. I hope that you will be able to heal too. And I hope that the world will smarten up and put an end to gastric bypass surgeries.

    July 30, 2011 at 14:17 | Report abuse | Reply
  29. jessicaber

    Lol. My son Ezra is 6 and has gymnastics camp in August. I think that he is pretty good. He is a good athelete. He is good at anything on wheels as far as I know. He is good a making friends and just overall very talented. He won my heart and his father's and my whole family's. His grandfather is atleast 7 feet tall, so I can see where he might fit in to the gymnast persona.

    July 30, 2011 at 15:15 | Report abuse | Reply
  30. Lunarose

    Hi, I had the sleeve done in Aug '10. I had been exercising regularly I walk 2 hours a day briskly with hills and have been for 30 years. When I was younger it kept my weight in check but as I aged the pounds packed on even though my intake wasn't really increasing. I am 5'2" and weighed 208 at my surgery my highest weight was around 215 and my lowest was around 195. I had high blood pressure and high cholesterol and a borderline EKG and my heart would just pound and feel like it was beating erratically when I hit the hills on warm days. So now 11 months out I am 140 off my blood pressure and cholesterol pills and my walks are so much easier no more palpitations. I was not a big fast food person I probably literally ate fast food 6 times a year but my problem is that unless I ate alot I never felt full I also rarely felt hungry so I'd go too long between meals and then eat a meal of 2000 calories and most times after 2000 calories I would not feel full. The sleeve was/is a life saver for me. But it isn't for everyone. It is not full proof no WLS is it is a tool. It makes you pay attentiion to what you eat.

    July 30, 2011 at 16:56 | Report abuse | Reply
    • Robby

      You burn calories at rest. The ighher your metabolism, the more calories you will burn while exercising, and the more you will burn at rest, the idea is to raise your metabolism.If you just QUIT eating, your body will go into starvation mode and think to itself HEY no food coming in… all systems SLOW down we need to conserve what we’ve got So you have to eat.If you have good muscle tone it is your goal not to lose it. You want to gain muscle and lose fat. Muscle also weighs more than fat, so instead of going so much by the ’scale’, you should be judging progress by how your clothes fit instead.So a person needs to eat… healthily. Every 4 hours, so you dont have that low blood sugar ‘crashing’ thing going on. No sugar, little fat, a lot of greens and veggies, drink much fluids (64 ounces a day plus an extra 8 ounces for every 20 pounds overweight), a ‘deck of cards’ sized portion worth of protein every day (only one day a week red meat) and complex carbohydrates (whole grains).IF you are taking in less food than the 2500 calories a person of normal weight would eat, then it is logical to assume you would be taking in less vitamins than you need, SO you need a daily vitamin supplement.The ideal exercise regimen would include 30 minutes of walking daily, three times a week aerobic training (get heart-rate up)and two or three times a week weight training. All this can be done at home (without a gym) but a gym with a personal fitness trainer is always nice. Oprah has one, why shouldn’t YOU?Also don’t forget about:-stress (dont need that… laughter best medicine, stay in good humor, be happy)-rest (need to sleep and get those REMs)-not smoking-little alcohol or caffieneI also say that you should do things to make yourself happy, like a nice hair trim (trip to salon for facial manicure pedicure etc.)buy a nice new shirt every time you lose five pounds and get your teeth bleached at the dentist office.Good luck on reaching your goal and congratulations on your progress thus far.

      March 5, 2012 at 23:28 | Report abuse |
  31. lizzy10

    Every weight loss journey is individual. Yes, some can eat less and lose weight-down 40 lbs myself. Some need help, my husband down 100lbs since the November 2010 with lap band. There isn't a "right" way to lose weight, it's just about what's finding the "right" way for yourself.

    July 30, 2011 at 17:58 | Report abuse | Reply
  32. chi girl

    I agree that it's a complicated formula to some extent. Genetically, the odds are against me – my family is large. I've run my whole life and have an RMR of around 1300. I'm 5 3 and 124 which is normal but for the effort i put in (1350 calories a day and running 4 miles 4 days a week) I think I should be leaner. I was told to eat MORE based on activitiy and calories and the minute I did my weight went up. But when I cut lower, my weight either stays the same or slowly creeps anyhow. So it's tough. I see women my age eat twice as much as I do, and excercise less – and they look great. My consolation – great BP, great heart rate, pretty healthy. But would be great to get to a happier place for all the effort and discipline!. Moral of the story – no quick answer that works for everyone.

    July 31, 2011 at 15:36 | Report abuse | Reply
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  33. Tim

    If you have gasto problems and you're overweight, good news: you probably have Celiac disease. Celiac is being linked more and more to obesity because it causes nutrient malabsorption, which triggers uncontrollable eating in some people to compensate. Once I learned about this and was tested, my excess weight started melting off because I stopped having the eating urges. Check out this lab that has a newer test that many doctors don't know about yet (it's better than the blood test): enterolab.com (I'm not affiliated with them). In fact, doctors seem to know very little about Celiac in general, to the shame of the American medical community. You need to do your own research on the latest studies (not the fad bloggers). Good luck!

    July 31, 2011 at 15:56 | Report abuse | Reply
  34. jessicaber

    If it is not one trend then it is another and seriously I know because my cousin & aunt are now selling gluten free chips and trying to make money off of it (hint: Late July). They will make money too, because they are the makers of Cape Cod Chips and Chatham Village Croutons. They are good people with a god palette, but when I hear people saying "Oh, I found freedom in my son having celiac disease and stuff like that is sends shivers down my spine. I am from Vermont. My family is from Mass.

    July 31, 2011 at 16:26 | Report abuse | Reply
    • Tim

      The difference between Celiac and other fads is that Celiac can actually be scientifically tested. Most other fads are just one idiot telling another idiot some subjective nonsense they heard about from someone selling some sort of quackery. Gluten intolerance can actually be measured and tested.

      July 31, 2011 at 16:52 | Report abuse |
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About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.