Ms skinniness

Gosh, I really love being the smaller one in the group now......I am actually the stronger one because I have the coping skills to take care of me when all is said and done. I know what it's like to be on both sides of the coin now. It is a miracle in our self esteem as well. It will take a lot of work and will be psychologically painful at times, but the end result is so worth it! I highly recommend working with a therapist throughout this process to gain new insights and coping skills to change the old thought processes that have driven you till now. You will be a great success and will be very proud of yourself too.....

I chose this surgery because all other diets failed me and I was so tired and depressed about my weight. I intuitively knew that I needed this surgery for my health. Yes, the sleeve is just a tool and it does help with reminding me that I need to eat healthy and cut out the sugars as much as possible. It has helped me learn more about the addictive things that are put into our food that makes us want more. I can eat a ton of candy if I choose to and I always feel like I let myself down and it shows by an increase in weight. So I jump back on the wagon and cut out all sugars and the weight decreases. I am a food addict and the sleeve reminds me the toxic relationship I have with sugar......I eat mostly paleo and cut out the majority of processed foods. I don't eat anything with corn in it except on rare occasions and I love eating small portions now. OP: If you are questioning this, then perhaps your not ready for the surgery yet. It is ok to wait because this is a permanent procedure that in non reversable.... I love my new journey with my skinniness and feel so much more healthier too. It is still work and I'm learning to deal with the struggles of healthy eating....... This is the life I have chosen.........

Look at you girl! Sitting on top of the world in your skinny body! You look absolutely beautiful! You are a success.........Yep, you are just right with your skinniness! Love it you skinny Goddess!

Liver and bacon sounds like torture to me..... Fast day was a little difficult but I did it and I came in at 200 above 500 but will take it. weighed myself today and am down a couple of pounds... Some must be Water weight. Today I plan to eat low calorie and Protein loaded. Need to get at least 4 lbs back off. Shouldn't be too hard. Maybe it's time for some fun and getting out and walking.

OD your surviving your brother's visit.....Yayyyyyyyyyyyyy! Tomorrow is a new day ad you will get those pesky pounds off in no time.

It is a wise decision to cancel the trip to Hawaii. It's better to be proactive with treating this cancer and getting it in remission. You can always do Hawaii at a future date... Hoping for the best for your hubby!

OMG I hate squats! Good job!

Thank you so much for sharing this......I've only experienced dumping syndrome 1 time and it was horrible....

Coops I love your pic! What a handsome young man with you..... FYE you did great last night...... Kathy it's great to hear you survived the weekend! LV I hope your having a great time in Big Sur! Georgia I'm missing you but knowing your doing really well. As for me, i have fell completely off the wagon......Sugar galore and grazing all day long. Today I will be doing an all Protein day and keeping calories under 500 (I hope). I don't seem to be able to discipline myself lately and have gained a few lbs from my sugar intake...... Threw away some candy yesterday and focused mostly on nuts and they are totally high calorie..... This is so sad to have this struggle and seeing myself spiral down hill right now. Today I will be going to the mall and walking and avoiding the See's Candy store.....Shoot, who needs it anyways..... I need some good old fashion discipline and a quick swift in the butt..... Happy fasting to all fasters.

You are a veteran too me. You had surgery in 2008 and that more than qualifies you as a veteran too me. Go ahead and join us, newbies still post there and they are very new. So please join us! You are a veteran.

Some of us veteran's are doing the fastdiet. Also know as 5:2 diet. This is where you eat normally for 5 days and 2 days you eat 500 calories. We have done very well losing some of the stubborn lbs that we regained....Check it out in the Veteran's forum....

I loved this part of the surgery.....the cold was a pain but so much nicer than the heat. Now I'm pretty much back to normal and not cold like before. So it does go back to the status quo......I love my windows being open and the fresh air coming in and a lot of blankets to keep me warm.....

I hope you will join us in the Veteran's section of VST......I'd love to hear more from a fellow veteran.....

Post-Surgery Weight Regain: Mental Health Regular readers will appreciated the importance of mental health factors both as a promoter of weight gain as well as an important barrier to weight management. It is therefore no surprise that in our systematic review of weight regain after bariatric surgery, published in Obesity Surgery, we found substantial evidence for the role of mental health factors both in failure to lose adequate amounts of weight or to regain any weight lost. Out of the sixteen studies included in the review, all studies that examined this factor, implicated uncontrolled mental health issues as an important cause of weight regain. These included, binge eating disorder, depression and addictive behaviours (alcohol and drug use). In fact, there was a linear relationship between the number of reported psychiatric diagnoses and the magnitude of weight regain. Overall, patients with two or more psychiatric conditions were approximately six times more likely to either lose no further weight or regain weight than patients without psychiatric problems. At least one study reported that 80 % of patients identified pre-operatively with an eating disorder, and who did not receive any treatment pre-operatively, had recurrent feelings of binge eating at 6 months post-operation. In addition to binge eating, some researchers describe a new sub-clinical disorder described as “grazing” (consuming multiple small meals with feelings of loss of control with eating), the incidence of which appeared to increase after surgery and was associated with an increased tendency for weight regain. Interestingly, one study found that completion rates of behavioural modification therapy increased to 91% when performed post-operatively, compared to 14 % when done pre-operatively. Nevertheless, it probably makes more sense, when possible, to address mental health issues prior to undergoing surgery. In summary, our review finds ample evidence that a wide range of mental health problems can lead to maladaptive eating, which if unregocgnised and untreated will prove a persistent impediment to surgical weight loss. This is why extensive mental health assessments and interventions both prior to as well as following surgery should be a routine part of bariatric care. If you have experienced specific mental health issues to be an important factor in weight gain after surgery, I’d like to hear about it. @DrSharma Edmonton, AB Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349

M2g it really needs to stop raining right now.....You have had enough already...Keep dry..... LV I hope you are having a great time in Big Sur......Can't wait to hear how your trip went..... Kids will do fine. They have a great mom who loves them...... Swizzly I hope you have a wonderful time traveling. I use to be how you described yourself but have learned to just go with the flow. It was hard but what the heck, I hate stress.. Georgia it is so funny that you brought up binge eating because I just read an article by Dr Sharma on it today. Here is the link, interesting eating: http://www.drsharma.ca/post-surgery-weight-regain-mental-health.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+AryaSharma+%28Arya+M.+Sharma%2C+MD%29&utm_content=Yahoo!+Mail

This would stress me out too......When you get in the vehicle and drive away, let your worries go and have a wonderful trip......Your wonderful children will be just fine.

M2G I am so sorry you had to endure all this stuff. I'm very thankful yours was minimal. Thanks for showing us the pics.....

How Common is food Addiction? Although there is little doubt that food addiction exists, the question of how common this may be remains a matter of debate. Now a study by Pardis Pedram and colleagues from Memorial University, Newfoundland, examine this issue in a paper just published in PLoS One. I am a food addict. I found this to be confirming.... The study looks at 652 adult volunteers (415 women, 237 men) recruited from the general population. ‘Food addiction’ was assessed using the Yale Food Addiction scale (YFAS), a questionnaire consists of 27 items that assess eating patterns over the past 12 months. The YFAS translates the Diagnostic and Statistical Manual IV TR(DSM-IV TR) substance dependence criteria in relation to eating behavior (including tolerance and withdrawal symptoms, vulnerability in social activities, difficulties cutting down or controlling use, etc.). The criteria for ‘food addiction’ are met when three or more symptoms are present within the past 12 months together with clinically significant impairment or distress. Based on these criteria, ‘food addiction’ was present in 5.4% of participants (6.7% in females and 3.0% in males) and increased with obesity status. Interestingly enough, the clinical symptom counts of ‘food addiction’ were positively correlated with all body composition measurements across the entire sample (p<0.001) – not just in those with higher BMI. Nevertheless, “food addicts” substantially heavier (11.7 kg), had 4.6 units higher BMI, and had 8.2% more body fat than “non-addicts”. Furthermore, food addicts consumed more calories from fat and Protein than controls. Thus, this study shows that as many as 1 in 20 (or 5%) of the general population may have a diagnosis of “food addiction”. Those who do are substantially heavier than individuals who do not meet these criteria. Furthermore, individual symptoms of “food addiction” are associated with higher body weight across the entire range of BMI suggesting that even mild to moderate signs of “addiction” (below the threshold of a formal diagnosis) may contribute to weight gain in the general population. As with all addictions, simply warning about the “evils” or making consumption more difficult (taxing, banning, punishing) is of limited help in addressing the problem. In addition, given that total “food-abstinence” is not an option, the best you can hope for is “harm-reduction” – a rather conservative goal for any addiction. Clearly, not recognizing the potential role of food addiction as a contributor to the obesity epidemic means missing the boat on providing appropriate care to individuals with this condition. As with other addictions, “Simply say no” approaches are naive at best in addressing the problem. @DrSharma Edmonton, Alberta

This is so interesting too....... Post-Surgery Weight Regain: Hormonal and Metabolic Factors Posted: 13 Sep 2013 06:00 AM PDT In yesterday’s post, I discussed the importance of dietary factors in weight regain after bariatric surgery. In this post, I will discuss the role of hormonal and metabolic factors identified in our systematic review of post-surgical weight regain published in Obesity Surgery. It is now widely assumed that the efficacy of bariatric surgery is not solely dependent on causing a “restriction” or simply “malabsorbtion” of calories. Rather, there is now growing consensus that the key reason why bariatric surgery works is through its impact on gut hormones and neurological signals from the gut that significantly reduce hunger and/or satiety. Thus, it is not surprising that in our review we found several studies that noted a significant relationship between post-surgical levels of the “hunger hormone” ghrelin and post-surgical weight regain. Patients who experienced less weight loss or greater weight regain after sleeve gastrectomy and/or roux-en-y bypass surgery demonstrated higher fasting and post-prandial ghrelin levels. Elevated ghrelin levels were also found to correlate with a return of hunger in patients with regain. Other evidence points to the role of hypoglycaemia in promoting weight regain in some patients. Reactive hypoglycaemia after bariatric surgery may result from the rapid transit of ingested carbohydrates into the small intestine thereby generating an early and significant insulin surge which results in a reactive hypoglycaemia shortly after a meal. This would in turn prompt snacking and increased caloric ingestion resulting in weight regain. While there is currently no medical treatment to deal with ghrelin elevations, the latter problem can potentially be managed by dietary measures, including the avoidance of high-glycemic index foods. Given that there are many gut hormones that may be altered by bariatric surgery and their individual roles are still poorly understood, it is clear that we will need further studies to better understand how these factors may explain why some patients failure to lose weight after surgery or show a greater tendency for weight regain. @DrSharma Chicago, IL Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349

When you finally have your thyroid out, you will lose more weight because it will be difficult to swallow.....another tool to help with not eating. LOL Laura I am very happy for you that it's benign..... M2G I want you to be safe and send all that rain to Southern California, we do really need it. you have have to experience this....but good job on your fasting day..... I didn't fast yesterday but my scale basically stayed the same......Today my DH and myself are going up to Big Bear to see how the work on our cabin is coming along and tomorrow we are going to the USC football game. Hopefully they play better this time. I would rather not go because of the heat and my junk food monster comes out. So I plan on going to the University have some of their delicious chicken and stuff myself so I have no room for anything else......I will get a lot of exercise too....It is going to be in the 90's so I'm really dreading going...... Oh well, I need to make it fun, after all, it's a day in my life..... LOL Have a great day everyone......

I found this is to be very interesting. Hope you guys enjoy it..... One of the key reasons why bariatric surgery is so much more effective for treating severe obesity than non-surgical approaches, is because of its profound effect on food intake. Thus, bariatric surgery significantly affects hunger and satiety and may even have important effects on “wanting” and “liking” of high-caloric foods. However, this effect on ingestive behaviour is neither “guaranteed” not are these effects consistent between individuals. As I tell my patients, “The surgeons operate on your gut, not your brain”. Thus, it can only be expected that a certain proportion of patients will struggle to control their food intake despite surgery, thereby either losing less weight than expected or putting the weight back on. In an article, published in Obesity Surgery, we systematically reviewed the published evidence on the role of dietary factors in this issue. As may be expected, patients reporting “loss of control” of eating behaviour post-surgery lost less weight or had a higher risk of gaining back any weight they may have initially lost. Thus, individuals with self-reported “high-adherence” scores tended to lose and sustain greater weight loss than those who did not. Given that bariatric surgery may limit the amount of food that can be eaten at a single meal, some patients resorted to grazing behaviours (defined as consumption of smaller amounts of foods over extended periods of time) leading to subsequent weight regain. In addition, it was reported that poor diet quality, characterized by an excessive intake of calories, Snacks and sweets, as well as oils and fatty foods, was statistically higher in patients experiencing weight regain. Interestingly, even short-term dietary “indiscretion” (or falling off) can result in very rapid weight regain. This is not surprising as, in this regard there is little difference between someone who has lost weight through surgery or simply through diet and exercise. Irrespective of how the weight is lost, the body appears to retain its ability to rapidly regain lost weight if allowed to do so. Thus, as we discuss in our article, “The existing literature strongly suggests that nutritional and lifestyle compliance is crucial to weight management post- bariatric surgery.” “Comprehensive weight management programs must therefore provide improved patient education and promote adherence to post-bariatric surgery diets in order to ensure success. These programs must take action to support patients towards a long-term goal of healthy and appropriate dietary choices with active monitoring (journaling) and reinforcement (review of food records) strategies provided by a multidisciplinary health care team.” As I have discussed previously, although bariatric surgery increases the chances of success, it is no magic bullet or easy way out – all patients have to work hard at learning to use their surgery as a tool to help them better control their food intake and will likely do better, the more they understand and comply with the post-surgical nutrition recommendations. On the other hand, there may be very good reasons why certain individuals, despite best efforts, struggle to meet these recommendations. I will discuss how neurohormanal and metabolic factors can make dietary compliance difficult in my next post. @DrSharma Edmonton, Alberta Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349 . http://feeds.feedburner.com/%7Eff/AryaSharma?i=wMfPqkosbes:izEZ_Ig4Atc:D7DqB2pKExk http://feeds.feedburner.com/%7Eff/AryaSharma?i=wMfPqkosbes:izEZ_Ig4Atc:F7zBnMyn0Lo http://feeds.feedburner.com/%7Eff/AryaSharma?d=YwkR-u9nhCs http://feeds.feedburner.com/%7Eff/AryaSharma?d=7Q72WNTAKBA http://feeds.feedburner.com/%7Eff/AryaSharma?i=wMfPqkosbes:izEZ_Ig4Atc:V_sGLiPBpWU http://feeds.feedburner.com/%7Eff/AryaSharma?d=qj6IDK7rITs http://feeds.feedburner.com/%7Eff/AryaSharma?d=l6gmwiTKsz0 http://feeds.feedburner.com/%7Eff/AryaSharma?i=wMfPqkosbes:izEZ_Ig4Atc:gIN9vFwOqvQ http://feeds.feedburner.com/%7Eff/AryaSharma?d=TzevzKxY174 http://feeds.feedburner.com/%7Eff/AryaSharma?d=yIl2AUoC8zA http://feeds.feedbur...tm_medium=email Why Do Some People Regain Weight After Bariatric Surgery? Posted: 11 Sep 2013 06:00 AM PDT http://www.drsharma.ca/wp-content/uploads/sharma-obesity-bariatric-surgery21.jpgAlthough bariatric surgery is by far the most effective treatment for severe obesity, it is not a magic bullet and there are a significant number of patients, who either fail to lose a significant amount of weight or ultimately regain most of their weight. In a paper published in Obesity Surgery, we conducted an in-depth review on the issue of post-surgical weight regain. Following an initial screen of 2,204 titles and review of 1,437 abstracts, we found only 16 studies with meaningful information on this issue. These studies included seven case series, five surveys and four non-randomized controlled trials, with a total of 4,864 patients for analysis. There were a number of methodological issues with these studies as they varied widely in terms of duration and quality of follow-up, definitions of surgical failure or weight recidivism, as well as the actual surgical procedures, all of which had important implications for the interpretation of the data. Thus, for example, inconsistent definitions of exactly what constitutes “excessive” weight regain or “insufficient” weight loss makes it virtually impossible to determine even exactly how often this treatment can be considered to have “failed”. (Remember, it is always the treatment that fails the patient and never the patient who fails the treatment!). Nevertheless, it is clear that post-surgical weight regain is highly multi-factorial (like obesity itself), involving both patient and surgery related factors. Overall, we identified five principle aetiologies representing nutritional indiscretion, mental health issues, endocrine/metabolic alterations, physical inactivity and anatomic surgical failure, each of which I will discuss in upcoming posts. There is no doubt that the issue of post-surgical weight regain requires a systematic approach to patient assessment focusing on contributory dietary, psychologic, medical and surgical factors. @DrSharma Edmonton, Alberta http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349

The band is a failure, not you! Just go in and do it! They really can't say no........this is for your health......

This is so true! I forget about remission and constantly have to remind myself....

Wow, look at all the choices you get to make......not fun......nutrition could be a big issue this early out....best wishes on your decision......

This is something that I don't worry about too much. My body does regulate itself and if I eat healthy, meaning proteins and veggies then I do really well. If I eat too much sugary foods than I will gain weight. NTVTxn has done very well with her plan. We all will and must find our niche.....