Re: Calculating your excess weight loss

[Guest guest]

Chris

I have a couple of questions the first is about the " 18 month

window " . What I don't understand about it is this, why does weight loss stop

after this 18 months have passed, what happens to our bodies at about 18

months? Because our stomach stretches over time what keeps us in say 5 years

or so later from gaining more weight back?

My eating habits fluctuate drasticly. For instance in this past

month I have lost a conciderable amount of weight, simply because I have

been so hyper I am totally unable to eat. In these times of being so active

which causes me to take on so much more than I can handle, I get stressed

out, it feels like my insides are swollen and I can barely get small amounts

of food in. The stress also cause loss of appetite for me because of being

on the go 18 hours a day. I am afraid if I slow down I will once again feel

that burning desire to eat eat eat.

I also recalled that after my VBG I experienced this same feeling of

extreme hyperactivity once I reached this same weight. It didn't slow down

either until I started to regain the weight when the VBG failed. LOL, when I

say extreme, I am NOT kidding, I went to bed at 10 and was up at 3 am

cleaning house and mopping floors like a mad woman. (I am wondering if I am

trying to reproduce the sterility of the operating room at home)LOL .I

noticed I even move at a very rapid pace. Have any others had this same

experience, does it subside?

Renae

>From: chull1@...

>Reply-To: duodenalswitch

>To: duodenalswitch

>Subject: Calculating your excess weight loss

>Date: Tue, 02 Oct 2001 17:23:38 -0000

>

>Hi Everyone,

>

>I have seen so much misalignment of expectations that I though a

>simple write up on how to cacluate your excess weight and what to

>expect in terms weight loss.

>

>Calculating your excess weight loss

>

>

>Excess Weight Loss =

>

>Starting BMI – Current BMI ] / [ Starting BMI –22.5]

>

>

>Expected excess weight Loss:

>

> BMI 40-50 BMI 50-60 BMI 60-80

>3 months 35% 30% 25%

>6 months 50% 42% 35%

>9 months 65% 55% 45%

>12 months 75% 65% 55%

>18 months 75% 75% 75%

>

>

>Example:

>

>Starting BMI 45.0 55 70

>3 months 37.1 45.3 58.1

>6 months 33.8 41.4 53.4

>9 months 30.4 37.1 48.6

>12 months 28.1 33.9 43.9

>18 months 28.1 30.6 34.4

>

>Assume Height = 5' 4''

>

>Starting Weight 262 320 407

>3 months 216 263 338

>6 months 196 241 311

>9 months 177 216 283

>12 months 164 197 255

>18 months 164 178 200

>

>

>

>These numbers are only averages, and your weight loss may vary.

>

>

>Hull

>

>

>

>----------------------------------------------------------------------

>

[Guest guest]

> What I don't understand about it is this, why does weight loss

stop

> after this 18 months have passed, what happens to our bodies at

about 18

> months? Because our stomach stretches over time what keeps us in

say 5 years

> or so later from gaining more weight back?

A number of factors influence the time frame. First, when you loose

weight your body naturally burns fewer calories. Lean body mass

burns more calories than fat body mass. If you do weight training

you will increase your lean body mass and therefore your metabolic

rate will stay high (i.e. # of calories your burn) and you will keep

loosing weight. If you stay sedentary, you will loose more lean body

mass and your metabolic rate will drop as you loose weight. When

your body burns the same number of calories as you absorb, you reach

equalibrium and your weight loss stops.

Two other factors influence the weight stabilization, but I believe

they are secondary. First, the stomach does stretch for the first

year or so and then stabilizes. Second, the instestines tend to

adapt to the new situation and expand logitundinally. This effect is

minor though.

Now the big difference between the VBG and the DS is that the VBG is

a purely restrictive procedure. Therefore, calories absorbed is

equal to calories consumed. There is no malabsorption. The result

is that after your weight stabilizes, any increase in eating will

result in an immediate gain of fat. Unfortunately, fat does not

change your metabolic rate by much, so you will continue to gain

weight for a long time (several years) without increasing your

consumption rate. Further, the VBG tends to allow consumption of

high density caloric beverages and discourage consumption of meat and

other protien rich sources (in essene you eat junk food). Finally,

the VBG is prone to mechanical failure in about 1/3 of the cases.

The staples fail and the procedure is defeated.

With the DS there is a constant malabsorption factor in your favor

(as long as you don't eat sugars in large volumes). The ability to

consume a reasonable amount of food allows you to focus on protien

rich foods that tend to satisfy you more quickly and keep you from

snacking. Also, research indicates that as you increase the volume

of food you eat, your absorb a smaller percentage of the calories

that you eat. This self-regulating mechanism further explains the

stable weight loss accomplished by the malabsorptive procedures.

So as long as you stay away from the cola and chips and eat mostly

protien rich food you will not regain weight (even if you overeat

tremendously).

Hull

[Guest guest]

Dear

Thank you for all your insightful and informative posts! I have

only recently gotten into your folders and find them very

enlightening. I am wondering if, in your research, you have ever

found someone who has gotten an insurance provider to totally cover

WLS surgery even though the provider had a stated limit to such

surgery much lower than the actual cost? Also, do you or does anyone

else have a list of providers that do totally cover WLS surgery? I

want to use such a list in my appeal letter to my own insurance

provider. Please let me know and thanks again.

Sue Everett

In duodenalswitch@y..., chull1@s... wrote:

>

>

> > What I don't understand about it is this, why does weight loss

> stop

> > after this 18 months have passed, what happens to our bodies at

> about 18

> > months? Because our stomach stretches over time what keeps us in

> say 5 years

> > or so later from gaining more weight back?

>

> A number of factors influence the time frame. First, when you

loose

> weight your body naturally burns fewer calories. Lean body mass

> burns more calories than fat body mass. If you do weight training

> you will increase your lean body mass and therefore your metabolic

> rate will stay high (i.e. # of calories your burn) and you will

keep

> loosing weight. If you stay sedentary, you will loose more lean

body

> mass and your metabolic rate will drop as you loose weight. When

> your body burns the same number of calories as you absorb, you

reach

> equalibrium and your weight loss stops.

>

> Two other factors influence the weight stabilization, but I believe

> they are secondary. First, the stomach does stretch for the first

> year or so and then stabilizes. Second, the instestines tend to

> adapt to the new situation and expand logitundinally. This effect

is

> minor though.

>

> Now the big difference between the VBG and the DS is that the VBG

is

> a purely restrictive procedure. Therefore, calories absorbed is

> equal to calories consumed. There is no malabsorption. The result

> is that after your weight stabilizes, any increase in eating will

> result in an immediate gain of fat. Unfortunately, fat does not

> change your metabolic rate by much, so you will continue to gain

> weight for a long time (several years) without increasing your

> consumption rate. Further, the VBG tends to allow consumption of

> high density caloric beverages and discourage consumption of meat

and

> other protien rich sources (in essene you eat junk food). Finally,

> the VBG is prone to mechanical failure in about 1/3 of the cases.

> The staples fail and the procedure is defeated.

>

> With the DS there is a constant malabsorption factor in your favor

> (as long as you don't eat sugars in large volumes). The ability to

> consume a reasonable amount of food allows you to focus on protien

> rich foods that tend to satisfy you more quickly and keep you from

> snacking. Also, research indicates that as you increase the volume

> of food you eat, your absorb a smaller percentage of the calories

> that you eat. This self-regulating mechanism further explains the

> stable weight loss accomplished by the malabsorptive procedures.

>

> So as long as you stay away from the cola and chips and eat mostly

> protien rich food you will not regain weight (even if you overeat

> tremendously).

>

> Hull

[Guest guest]

Sue,

If you have a PPO and you go to a contracted suregon then they agree

to accept the contracted amount and you are usually only responsable

for 10-20% of the cost up to an out of pocket maximum. If you go out

of network then you are responsible for typically 30-40% of the cost

up to a much larger maximum, plus the costs above the contracted

amount. Many surgeons and some hospitals that are not contracted

will still accept the contracted amount, but you must negotiate it

before your surgery.

In my case Aetna only approved two out of the five request

procedrues, so I will be out of pocket $4800 unless my surgeon's

appeal succeeds.

Many providers cover WLS, but a number of them are restricting their

coverage to RNY surgeons that are " in network " . Perhaps the best

program is United Healthcare PPO. HMO's are always difficult, and

lately Blue Cross PPO has changed their policy to deny the DS but

will still approve RNY's.

Please join us on the list:

DS-Insurance_Authorization_Problems

Hull

> >

> > > What I don't understand about it is this, why does weight loss

> > stop

> > > after this 18 months have passed, what happens to our bodies at

> > about 18

> > > months? Because our stomach stretches over time what keeps us

in

> > say 5 years

> > > or so later from gaining more weight back?

> >

> > A number of factors influence the time frame. First, when you

> loose

> > weight your body naturally burns fewer calories. Lean body mass

> > burns more calories than fat body mass. If you do weight

training

> > you will increase your lean body mass and therefore your

metabolic

> > rate will stay high (i.e. # of calories your burn) and you will

> keep

> > loosing weight. If you stay sedentary, you will loose more lean

> body

> > mass and your metabolic rate will drop as you loose weight. When

> > your body burns the same number of calories as you absorb, you

> reach

> > equalibrium and your weight loss stops.

> >

> > Two other factors influence the weight stabilization, but I

believe

> > they are secondary. First, the stomach does stretch for the

first

> > year or so and then stabilizes. Second, the instestines tend to

> > adapt to the new situation and expand logitundinally. This effect

> is

> > minor though.

> >

> > Now the big difference between the VBG and the DS is that the VBG

> is

> > a purely restrictive procedure. Therefore, calories absorbed is

> > equal to calories consumed. There is no malabsorption. The

result

> > is that after your weight stabilizes, any increase in eating will

> > result in an immediate gain of fat. Unfortunately, fat does not

> > change your metabolic rate by much, so you will continue to gain

> > weight for a long time (several years) without increasing your

> > consumption rate. Further, the VBG tends to allow consumption of

> > high density caloric beverages and discourage consumption of meat

> and

> > other protien rich sources (in essene you eat junk food).

Finally,

> > the VBG is prone to mechanical failure in about 1/3 of the

cases.

> > The staples fail and the procedure is defeated.

> >

> > With the DS there is a constant malabsorption factor in your

favor

> > (as long as you don't eat sugars in large volumes). The ability

to

> > consume a reasonable amount of food allows you to focus on

protien

> > rich foods that tend to satisfy you more quickly and keep you

from

> > snacking. Also, research indicates that as you increase the

volume

> > of food you eat, your absorb a smaller percentage of the calories

> > that you eat. This self-regulating mechanism further explains

the

> > stable weight loss accomplished by the malabsorptive procedures.

> >

> > So as long as you stay away from the cola and chips and eat

mostly

> > protien rich food you will not regain weight (even if you overeat

> > tremendously).

> >

> > Hull