Do you see crowds of thin, slim, meager people? Only a negligibly small percent of them has ever experienced a weight loss surgery – most of them have never heard the word "bariatric" at all. Isn't it a valid proof that you can get slim without surgery? Is it possible that all those slim models were created from a different sort of clay? If they are not aliens from other planets – then the answer is no. Genetics perhaps? Well, in the past most people used to be slim and meager – while having quite various genetic ancestry. Maybe you were cursed? Sounds reasonable for those believing in daemons, jinxing and magic spells. The real difference between "obese you" and "those slim guys", as it seems, is not paranormal: it is that their "natural mechanism" works fine and yours goes wrong. If we imagine this mechanism as rotating wheels, we can compare eating 3-4-5 (or even 6!) times a day with putting sticks between the spokes.
Intermittent Fasting (simply speaking, 1-2 meals a day without snacks) just repairs this mechanism. It removes unnecessary impediments, "takes the sticks out of the spokes". There are lots of case studies where really obese people, who had been trying various diets without success, finally regained normal weight (BMI 23-25) over less than 1 year and turned type 2 diabetes into the remission stage (normal sugar level, no medicines to take). The effect was stronger than that of a most efficient bariatric surgery – but without surgery as such (and all the related risks and torments of the post-surgery period).
Now, let's discuss some key differences between two the approaches.
Uses brute force to partially fix the consequences of incorrect working of the natural mechanism (by the rule "the best of martial arts is a good loaded gun"): you are FORCED to decrease your daily calories intake in so radical way, that it's enough to compensate the harm, caused by your insulin which is high through the whole day since you eat 6 times, producing one insulin spike after another.
Completely fixes the mechanism, and nothing is interfering anymore with the nature's plan – that's the whole magic. You are not FORCED to decrease your daily calories intake (otherwise something bad will happen) - you can eat as much as you wish in your eating window. But you decrease that calories intake BY FREE WILL since you are in ketosis and, hence, not hungry (find more details here).
Food quantity. The maintenance stage (keeping your weight low after becoming slim)
When you exceed the limit of eating just once – and there is risk that your stomach will expand and you will grow fat again, or when you eat something wrong – there is "dumping syndrome" (you can even faint); your meal becomes a quasi-religious dogmatic cult where any backsliding is punishable. By the way, the stomach may expand in the future anyway, and some people do have to make a "revision surgery" – sleeve surgery requires additional contraction of your stomach, and gastric bypass requires contraction of the stomach entrance by reducing its diameter. There is really something to be afraid of.
People who underwent bariatric surgery are doomed to mental anguish when "the grapes are sour": they want so badly to eat as many tasty things as possible, as they are used to eating them – but there is no physical possibility, or it may end up badly. If worse come to worse, you can drop your diet, or at least to "sin" from time to time (it is easy to feel psychologically that you did not cut your ways to retreat); however, in case of bariatric surgery you are completely changed inside and cannot attach back the part of your stomach that you lost. Sometimes it results in such traumas that people have to see a psychologist!
After you get slim or even meager due to IF, you keep your weight at this new low level easily and without extra efforts – the regime of having your meals remains unchanged if you used to eat twice a day, or becomes 16:8 if you used to eat once a day. In addition, you can eat something that would make you pick up your weight fast in case of dieting; moreover, it will make no sense to limit quantity: you will not want much – it's hard to push yourself and stuff your mouth with something that you do not really want. Knowing that intermittent fasting in the process of losing your weight is an easy thing (when I hear a comment "Unless you cannot endure it any longer and snap", I reply "How can I no longer endure something that is easier to do than not to do?"), the phase of weight containment (when the process is over and a lot of previous food restrictions are lifted) must be way easier.
If during your Intermittent Fasting (or upon completion) you decide to eat a lot of something (for example, at your friends' party, in a restaurant, or you simply want to nibble all of a sudden) – it should not be a problem, nor there is a limit on the food you can eat that time (you will stop eating when you feel full – no further restrictions are necessary). In other words, Intermittent Fasting does not involve forcing yourself all the way to the end of your life.
You cannot drink at least half an hour (some sources mention even 45-60 minutes) before and after meal (to say nothing about drinking while you eat) as it can extend the walls of your stomach (a common fear for life of those who underwent surgery). Moreover, those who had gastric bypass do not verbally have place for the water, as their brand-new egg-sized stomach will be filled after eating – the water will drain back together with the meal (users of bariatric forums call it "giving a hug to White John" – a decent replacement of "vomiting into the toilet"). Can you imagine eating something salty or spicy without a possibility to drink after? It is historically known as a type of torture. You can surely watch out that your meal after surgery does not contain anything spicy or too salty, but it is hard to keep an eye always on everything.
As in the process of losing weight with IF, and upon reaching the ideal weight you can drink before, during and after eating (it's a matter of disputes whether it is necessary or not; well, at least, it is certainly allowed with no extra limits in addition to the natural limits everybody has).
Taking care of your meal
Those who underwent bariatric surgery are bound for life to watch their meal: to cook only the allowed food, to carry a bag with food containers, to look CONSTANTLY for proper time and place just to have their meal. Having no choice, them become submissive slaves of their eating schedule, devoting a lot of time, effort and thought to that.
IF not only does not impose new duties on you – it makes you even more careless than ever before. Having just one meal per day – yoo-hoo, I am as free as a bird!!! When I finish eating, I don't care about it for almost 24 hours – and so every day! I enter the kitchen almost exclusively in order to make tea or coffee, or to take some mineral water from the fridge (or to cook my only meal for the day, if on that particular day I eat at home). I don't care anymore about cooking my breakfast and spending time on its eating – I just set my alarm clock 45 minutes later than before. During the lunch break at work, when everybody goes to have meal, I sit in a comfortable armchair in the resting area and watch films on my phone (I eat at 5:30 PM when I come back from work). If I am busy in my usual meal time, I eat it later (sometimes around 8 PM) - not a big deal at all (a few times, I didn't eat that day at all, and the sky did not fall to the ground). If I see that I WILL be busy in my usual meal time, I can eat earlier - sometimes in 2 or 3 PM (I know that I will not be hungry until the end of the day).
I've read an article with a joke saying that eating many times a day was invented by misogynists (women haters) in order to chain women to the kitchen. But I think that they were misanthrope (all people haters) because they wanted to chain males too.
From The Joy of Fasting:
When you realize that you are no longer a slave of a constant need to have food within easy reach, it's incredibly liberating. This is exactly what happens when hunger takes its claws off of you. You cut the leash; you now decide when you eat and how much. Longish trip with nothing but airport food around; unforeseen change in work schedule; hike turned out to be longer than planned – none of that taxes you too much anymore, as you simply use it as an opportunity to introduce a fasting time in your day.
Appearance of people who have lost weight
Surgeries (especially such their types that restrict absorption of food – gastric bypass, biliopancreatic diversion, SADI etc., and sometimes even sleeve) may entail shortage of vitamins and minerals – even though you take pills. As a result, patients look really worn out by life troubles; changing the dosage does not help – the situations only aggravates over time. Indeed, they lose weight, but they look gloomy and many years older. Alas, I can find a few examples of this among the people I know. I came across a Facebook profile of my old friend who I had not seen for a few years and thought it was his full namesake. An old man with wrinkly face and saggy cheeks was looking gloomily on me from the picture. And the one I knew used to be young and cheerful – still obese and with a double chin, but full of life! Unfortunately, it was not a namesake, but he himself, a few years after a gastric bypass. The appearance of these people is only half the trouble: the constant shortage of vitamins and minerals cannot but affect their health and longevity... Of course, this happens not to all – I have no statistics, and this topic is a strict taboo on bariatric forums (after all, these forums are advertising their owners, bariatric surgeons), nor will you see such post-surgery patients on their video commercials. I may even admit that the above problem is rather an exception from the general rule. However, everybody who contemplate a possibility of bariatric surgery should know that such development of events is possible in principle.
You gradually start looking healthier, more attractive. It's not only your face but your skin as well that improve – as though you drank the Elixir of Life.
Extra bonuses of Intermittent Fasting
- No heartburn (as a side effect of sleeve gastroplastics).
- No need to take vitamin and mineral pills for life.
Fasting is basically the same as having Bariatric Surgery, but without the need to go under the knife. You are subjecting yourself to the same limitations... not eating much or anything. And you are doing this without the need to have surgery, something which can go bad and end up with the death of the patient even if it is a simple surgery. The anesthesia itself can be dangerous. Now, if surgery is necessary, like when I had my heart bypass surgery last year, then the risk of the surgery is worth it, because without the surgery you will die. But, if there are other methods available that will have an equal or better effect without the need for any surgery at all, why not choose the safer option?
Think about this... if you have gastric bypass, and then there is some reason that you NEED to eat a larger amount, you cannot do it, because you will get sick. If you have been fasting and that same need arises, you can just eat.
Let's listen to a famous doctor
Now, please read a fragment from the article Bariatrics is Surgically Enforced Fasting by Dr Jason Fung. The first part of the article seemed too scientific for me (follow the link if you want to read it), so I copy here the second part - the more popular:
We know that bariatric surgery is quite effective at reversing T2D and also, over time, reducing weight. We also know that bariatric is simply surgically enforced fasting. So here's the crucial question. If all the benefits come from fasting, why not do the fasting and skip the surgery entirely? In essence, fasting is ‘bariatric surgery, without the surgery'.
So, why don't we do it? No good reason. It's just a little crazy. If I, as a doctor, recommend cutting out a person's healthy stomach and rewiring their intestines from the normal configuration to some bizarre man-made creation, people think I'm great. If I recommend fasting, which accomplishes everything that bariatric surgery does without any complications or costs, then I'm some kind of crazy Internet guy with a tin foil hat on his head.
We believe that we cannot fast by ourselves, without help. That we are too weak-willed. That it is too hard. That we will all likely fail without help. What is disturbing is that this assessment is made before anybody has even tried to fast.
People say this to me all the time. "I can't fast for 1 day". So I ask them, "How do you know? Have you tried it?" To which they answer, "No, I just know that I can't". WTF?? How do you know that you cannot fast if you have never tried it. In fact, it is clear that almost everybody can fast. There are literally millions of people around the world who fast for religious purposes on a regular basis. It is part of virtually every major religion in the world. Like anything else, doing it more often makes it easier. But to simply give up without even trying? That's just wrong.
Likewise, consider the colonoscopy procedure – now routinely done millions of times a year. In order to prepare for this procedure, it is often standard to fast for 24 hours so that there will be less stool in the intestines to get a better view. Is it fun? Not really, but that's not my point. People can fast if they put their minds to it. It doesn't take particular skill – almost everybody can do it. This is because fasting is not something 'to do' – it's something ‘to NOT do'. It is the absence of, not the addition of. This makes it almost the exact opposite of every piece of advice ever given. Take vitamins. Take drugs. Take surgery. That's probably why fasting is so successful.
So here's the bottom line. Bariatric surgery has many proven benefits. Multiple studies show a short term benefit, although long term, it is more questionable. Weight loss and T2D are successfully reversed in the short term. But it's not necessary. Imagine this. Bariatrics without surgical post operative complications. Without cost. Without the need for expensive hospitals or surgical equipment. Without the need for specially trained surgeons. You can simply do 'medical' bariatrics – or bariatrics without the surgery – fasting.
A quote from another article of Dr Fung, Controlling Hunger:
Many of our IDM Program clients have undergone bariatric surgery. Their appetites were so far out of control that they felt they needed invasive, expensive surgery to regulate their unruly bodies. And despite all the promises of bariatric surgery to allow patients to lose weight and improve health, it fails almost invariably. The stories are eerily similar. Initially, they lose some weight, but after several months the weight creeps back on. But worse, they feel that their appetite is just as out of control as it has ever been. "How can this be?" they ask despairingly. "I've had my stomach physically stapled to make it smaller!"
They misunderstood the problem with hunger. It's not about the size of your stomach. Hunger does not occur because your stomach is too big. And if that is not the problem, then surgically cutting it smaller is not going to help. Likewise, hunger is not about your willpower or self-control. You cannot will yourself not to be hungry. You cannot ‘decide' to be less hungry. You are hungry or you are not. Your appetite is hormonally driven. That is what we need to fix. Not surgically rewiring our intestines. Not counting calories. If you don't regulate your appetite on a hormonal level, you'll never regain control no matter how small your stomach is.
I mentioned in the American bariatric forum that it's possible to lose weight without surgery - with the help of intermittent fasting. The result did not take long:
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