The weight loss yo-yo

Diets, health-kicks, shakes and pills… Often the weight is lost but just as quickly put back on.

How do you break the cycle once and for all?

Comprehensive long term weight loss teams are the only proven solution.

Classification BMI
Underweight <19
Ideal BMI 19-25
Overweight 25-30
Obese (Class I) >30
Severely Obese (Class II) >35
Morbidly Obese (Class III) >40
Super Obese (Class III) >50

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Weight loss surgery on it’s own

Weight loss surgery is proven to provide meaningful results. The usual result is loss of between 60 – 80% of excess weight over 12 to 18 months. We are excited to celebrate these life-changing effects!

The problem comes in what happens afterwards!

After the early results comes a plateau stage and eventually slow but steady regain. If nothing but surgery is performed, most people are close to their starting weight at around 5 years following surgery. This is disappointing and makes it difficult to justify the cost and risk for adverse events.

At Perth Obesity Surgery, we are interested in the the long game. We want you to be healthy and happy in ten, twenty and even thirty years and so are invested in keeping you on track for sustainable results.

The key to avoiding weight regain is keeping involved with multiple experts within our team working with you individually to target the issues that contribute for you. Outside perspectives work through your situation to identify areas for improvement.

It’s like an annual service to keep on track… and if you find you need a period of more frequent contact, we have the “Back on Track” program!

MECHANISMS OF WEIGHT REGAIN

As with most ideas around obesity and weight loss, there is more to weight regain than meets the eye. “Stretching” the sleeve and eating more is but one part of it. We often intuitively think about the mechanics when it comes to weight loss and gain but need to appreciate the more subtle neuro-hormonal, psychological and societal factors.

Causes of Obesity.

After weight loss surgery, many things change. Most patients have less hunger signals and feel satisfied quicker (and for longer). Food preferences change as does the timing for when you desire certain foods. This is in stark contrast to what happens in a restrictive diet situation.

When you are on a low calorie diet, you feel more hungry and desire calorie rich foods. Often people develop a pre-occupation with food… an obsession. This doesn’t happen in the weight loss phase of bariatric surgery. The tool helps you consume less calories without facing the overwhelming desires and obsessions. These signals and emotional responses are the key to success. In experimental models, “failed” operation subjects are actually able to consume the same amount of calories as before the operation even though the sleeve/ pouch has not increased in size. It’s all about the signals from gut to brain and how the brain responds.

Predictors of success.

One observational study in 2010 showed behavioral factors associated with effective weight maintenance:

  • Control over food urges,
  • Control over eating habits,
  • Engagement in self-monitoring (weighing regularly and keeping records),

In contrast, behaviors/ factors associated with weight regain included:

  • lack of control over food urges,
  • Concerns over alcohol and other drugs,
  • Lower depression scores,
  • Poor post-operative wellbeing, and
  • Lower number of follow up visits.

The people who stay in the game, keep the results. This means coming to the post-operative appointments and accepting referrals to dietitians, psychologists and exercise physiologists when fine tuning adjustments need to be made.

Mechanisms of Weight Loss…

Several options are available for losing weight:

  • Diet and calorie restriction,
  • Meal replacement shakes and soups (VLCD),
  • Appetite suppressants and malabsorptive medications, and
  • Bariatric surgery.

VLCD’s can be effective in starting weight loss, but most (80 – 90%) of people cant keep it off for the long term. This is mostly because our body has programmed compensatory processed trying to stop us losing weight. It’s kind of like a thermostat for fat stores leading to higher levels of hunger and less feelings of satisfaction. Often people become obsessed with high energy and sweet foods.

Bariatric surgery is the only approach proven to allow sustainable meaningful weight loss and resolution of obesity related diseases.

  • Improves obesity-related diseases and reduces risk of death (both from heart disease and all causes),
  • Gastric bypass works by reducing hunger, increasing satisfaction, changing food preferences and the amount of energy used in absorbing diet,
  • Gastric banding works through the reduction in hunger, possibly through stimulation of the vagal nerve, and
  • Sleeve gastrectomy shares some mechanisms from banding and some from bypass.

No procedure is a quick fix nor miracule cure. Weight is still difficult to lose and effort is needed in remaining active and controlling portion size. One must remain disciplined and sensible in food choices with the operation seen as a tool only (Not THE SOLUTION). A period of time is granted for more satisfaction and less hunger allowing people to regain control of their weight and health.

Meaningful and sustainable weight loss needs change in behaviours and habits. This is not easy and no-one can do it alone! Our weight management package includes sessions with a group of experts all bringing their own knowledge and experience together for your benefit, at all stages:

  • Initial assessment,
  • Post operative care,
  • Long term follow up including,
  • Back on track in the case of weight regain.

Weight regain is unfortunately quite common at around 3 to 5 years following surgery. Because of this we keep you linked in with our experts. More surgery is not the answer but we do have answers!

Ready To Find a Healthier You?

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