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Your hunger pain is very possibly not hunger at all, but acid pain. Did you doctor prescribe a proton pump inhibitor (PPI) such as omeprazole (Prilosec, Losec, etc.)? You may need this in the beginning and on-going for a while (I still take one x2 daily at 10 months post-op).

Your friend could be concerned that the surgery may have complications and that she may lose you, or that you could become debilitated as a result of the surgery. With more knowledge, she could/would have a better understanding of your surgical choice and be less afraid and more supportive. She may however be concerned about being "left behind". If you lose weight, an ongoing common bond between you will be broken and she may feel she is going to lose your friendship with your new slimmer lifestyle. She may also not want to be "the fat one" in the relationship after you've lost the weight, as it will feel less "equal". There are so many reasons she may be feeling this way.........and these are just my two random guesses, without knowing either one of you or your relationship dynamics. If she's asked you to give her space, it's probably best to do that. Focus on your own health and commitment to improving your future. If she's ready to come back to the friendship, she will, on her own timeline. You'll have plenty to keep you busy pre-op, post-op and in maintenance, believe me! I'm only 2/3 of the way to my goal, but I'm very busy now with things I had let go in the past 20 years (all kinds of sports activities, more socializing, shopping, etc.). I hardly have time to breath! And it's very satisfying, believe me, to know I'm getting the life I always wanted back again. Don't count the friendship as lost just yet though......she may just need some time to readjust her thinking, get over any fears she has about your health and to see that you still love and care about her just as much when you're skinny as when you weren't.....

First things first. Congratulations on you fantastic loss and getting to goal! You did it! Now let's get your head straight.......... You mentioned that you are off-track. You're here telling us, which means you're looking for help. And you're going to get it! Support, some tough love, you'll get it all from your wonderful VST support crew! But you know that you are the only one who can do this and keep the weight off! You reached your goal in 6 months (fantastic), but that wasn't enough time for you to retrain yourself from a lifetime of bad habits! That's how you got to the surgery point in the first place. You need to continue with logging and counting for at least another year until it becomes second nature to you to watch what you eat and know what you're putting in your mouth. Then, after you've been stable at goal weight (+/- 5 lbs) you can get a bit less vigilant. You mention that you are losing inches still. That is normal, as you body is remodelling itself with the new weight. That is NOT a quick process! As I mentioned above, you need to be stable at goal weight and see how things "shake out" over time! Are you exercising? That could be some of the inches lost (muscle tone building, fat moving around, etc.). Even if you've been off-track eating, at least exercise gives you a bit of an offset. Not to mention exercise has many added benefits beyond a number on the scale...... Now let's talk about the scale. We all know it's our mortal enemy. When you started this whole process, it was with a goal in mind to lose X lbs. But what you really wanted was to lose body fat. A regular scale does not discriminate between fat and muscle and bone and Water. So you could lose 100 lbs and have lost mostly muscle! If you can, try to get a body fat reading (some scales do this and are not that expensive). You can get it done at a gym by a trainer (using fat calipers), or even possibly at your primary care physician. Body fat % is a much better indicator of how well you really are doing in your loss AND in your maintenance. Don't let the number on the scale rule your life, your mood or your motivation! Do you physically feel better? I'll bet you do! And that was the whole point of getting the VSG. Your health is exponentially better now. So use your physical body feelings to guide you. Are you tired? You might need more exercise to build stamina and muscle base. Are your energy levels fluctuating during the day? Look at your food intake and find out what causes the changes. Are you sleeping well? If not, try drinking less caffeine, changing your nighttime routine and hours of sleep. Rest is a key component of our health and gives us the energy to tackle the new day (including the desire to exercise and eat right!). You are driving this bus dear. You've completed a huge challenge in getting to goal. Now tackles the new challenge of living a full healthy happy life by using your new skills to keep yourself in this "happy place".

Wow! I see from your profile that you lost 142 lbs in 26 weeks! That is CRAZY! That is 5.5 lbs per week! How the heck did you manage that? I'm happy with my steady loss (I won't call it slow because it's not!). But I can't imagine how you were able to keep such a dramatic loss going for so long. Do you have any tips or pointers for the rest of us that you'd be willing to share?

Your number (based on your starting weight, current weight and goal weight) is 41% of excess weight lost! Well done!

I've lost 69.5% of my excess weight. Starting weight = 319 lbs Current weight = 191 lbs (42 weeks post-op) Goal weight = 135 lbs Surgery date May 14, 2012 And still losing well! I'm hoping to reach goal weight by my birthday (Oct. 20). I'm in training to Celebrate my 44th birthday this year with a 1/2 marathon walk!

If you're not able to watch TV surgery, I would not encourage you to watch the Youtube videos of VSG procedures either. It may just add to your anxiety! There is a great deal of information available, either from your surgeon or online that is "theoretical" or shown with diagrams. Seeing an actual procedure is not required for your education and is really only available for those who have an interest and the ability to watch a surgical procedure without stress. Research the procedure steps and diagrams, it will give you the information you are looking for. Here are a few places to start: http://tinyurl.com/3qzm9au http://tinyurl.com/7lbskv4 http://tinyurl.com/cp9zutc

A concern regarding your past post-op infection history is NOT a little question. Infections can KILL you. Please be diligent and make sure you are completely informed and at ease with your surgeon's direction and decisions before you commit to this (or any) surgery. There is a very low complication rate with VSG, but there are still complications and some are debilitating and even fatal. Infection is one of them. If you have a prior history of post-op infection (and you do......), do everything in your power to prevent that from happening this time! Fill your brain with information, fill your medical team's ears with your concerns. Get your questions answered. Then you can move forward.

The "sleeve" is actually just your stomach (no object added other than the staples used to close the open end). Some surgeons (most) also "oversew" the staples, meaning they staple the opening closed, then sew the entire opening together as well. This helps prevent leaks (which can be life-threatening!). The "sewing" can be used with natural materials ie. the classic "catgut" (no guarantee your immune system won't be activated by this), or synthetic materials (such as polygycolide (P.G.A.) or polydioxanone (PDS)). Catgut is made from twisted strands of collagen fibre taken from bovine (cow) intestines. It is a monofilament absorbed by the body usually within a 90 day timeperiod. Polyglycolide and Polydioxanone are sythetically produced. The first is a braided multifilament made from polygycolic acid coated with amino acids. It is absorbed by the body within 60-90 days. The latter is a monofilament synthetic prepared from polyester and is absorbed by the body complete within 200 days. It sounds like you either have an very active immune system that is hypersensitive, or you've had some less than completely sterile surgical experiences and/or post-op care. You must be sure to provide your surgeon with a complete medical history and give special attention to the post-surgical infections you have struggled with. He/she may wish to consult with your former surgeons to determine the root cause of your infections and then decide what his/her best surgical approach will be. In addition, any other medical conditions you have, especially allergies, adverse reactions to medications, etc. need to be fully explored and discussed with your surgeon prior to surgery. Good luck! Do your research (just as you are here....and more!) and tell your medical team EVERYTHING.

Nothing wrong with your question dear. Nor with the answer moregoodtimes gave...........moving right along...... Grehlin is a peptide hormone, as you mentioned. So it circulates throughout the body (just like insulin - also a hormone). So Grehlin itself cannot be removed. There is however an area of the stomach in the Greater Curvature (the fundus) where the P/D1 cells produce Grehlin. As this part of the stomach is removed in the vertical sleeve gastrectomy (VSG) procedure, there is a significant reduction in Grehlin production in the body (though it is still also produced in the epsilon cells of the pancreas). The less Grehlin in your system, the less hunger you feel. The pharmacological mechanism is complex and I won't go into detail. However, it is important to note that Grehlin works in partnership with another hormone (Leptin) that induces satiation (a feeling of fullness and hunger satisfaction). Before you eat, increased Grehlin levels make you hungry and after you eat, increased Leptin levels let you know you're full (in addition to stomach stretch receptors). In this equation, if you reduce the amount of Grehlin, but leave the amount of Leptin constant, your body will feel full faster (biochemically), in addition to the mechanical signal of fullness from the smaller stomach. There is however no longer a stretch receptor area in the stomach (also removed in VSG procedure), and it takes time for the brain to register signals from stomach to tell it to stop eating. That is why VSG patients (especially in the beginning of solid food phase) can easily overeat. 1-2 additional bites past capacity happen frequently unless the patient is weighing their portions. The brain can't keep up with the mouth! It is also important to note that Grehlin has other much more important and useful functions for the body! The ability to learn and adapt to change are influenced by Grehlin availability. It also has a role in glucose metabolism and cell transcription/migration. Some other studies point to Grehlin's role in protecting against stress-induced depression and sleep duration and quality. So you don't want Grehlin removed completely! Of course no amount of physical change to this complex interwoven system can fight the evils of head-hunger! That is a learned response that we must each battle through in the beginning and good routines, will-power and in many cases supportive psychotherapy are key to ongoing success!

WOW WOW WOW WOW! You did it! You are a superstar! Look at how gorgeous you look! You have lost the weight equivalent to a healthy 6'1" man! Think about that.......it's mind boggling! Keep up the great work Kate. You ROCK!

Keep it up! Just order the most basic items on the menu where you have a good idea of the protein and carb counts. Make sure you get take-out container right away so you're not tempted to overeat. You are VERY successful......remember that. 92 lbs in 6 months is AWESOME! That's an average of 1/2 pound a day!

Great to hear from a "veteran"! And it's good to know that the good habits we are developing during our "honeymoon phase" of the first 6 months to 1 year serve us well in the long run! I weight my food at home too. As my calorie intake has increased, I find that my "eyes are too big" for my stomach more and more often. But if I weigh out my portions, I'm satisfied and not tempted to overeat. As to eating out, I do my best to research the menu online beforehand if I know were we are going and it's available. That way I know what I'm ordering without touching the menu and not tempted by the marketing and "drool-inducing" pictures, etc.! Plus I always ask for a take-out container at the same time I'm ordering. They bring it with the meal and I immediately pack 70-80% of the meal. Left-overs (x 2) are great and economical, and I still get to clean my plate! No "is everything alright?" questions when I've only just "touched" my meal........

As others have said, let me begin by congratulating you on your 100 lb loss! Fantastic! Now, as to your "lazy" heart. 130 bpm prior to surgery was a MAJOR sign that you were taxing your heart to the maximum. As mentioned, generally speaking, a healthy adult has a heart rate (HR) of 60-100 bpm. A rate of 130 bpm is considered tachycardia (fast hear rate) and can be caused by a number of health issues. If you were never diagnosed with a cardiac arrhythmia (irregular heartbeat), and your rate is now down to 80 bpm, it was most likely caused by your heart trying to compensate for all the extra work it was doing to feed blood (and therefore oxygen) to all of your blood vessels. As mariamitani mentioned, think of it as a motor trying to pump Water out to a thirsty crowd of people that just can't get enough to drink. Too much demand for one tiny little motor! The poor thing was going as fast as it could and even then it wasn't keeping up! Good think you've lost the weight as you may have been headed to serious cardiac disease if you heart continued to work that hard! There is also a chance that your blood vessels were somewhat blocked with lipids (fat) and cholesterol build-up and that was decreasing the diameter of the blood vessels. Think how much harder it is to blow through a thin straw than a nice wide-open thick one? That's what your heart was working against........so it had to probably pump harder and faster to overcome the resistance (and maybe a symptom of hypertension (high blood pressure) was also present?). Now you've most likely dropped your lipid count (even inside your blood vessels) and your cholesterol level. Nice open arteries (and veins) are lowering the work for you heart. Fantastic! But if you're tired, you may be feeling that way due to low Iron levels (and possibly low carbohydrate levels and dehydration as well). Iron is required to bind oxygen to your red blood cells (RBC). When your RBC reach the muscles, the oxygen is detached and used to convert glycogen to energy and make the muscles work properly. Low iron means low oxygen and greater fatigue, less aerobic capacity, strength and stamina. So get your iron levels checked! Green leafy vegetables are a great source of iron, but the best source is red meat (just watch the fat levels!). Talk to your doctor or nutritionist (NUT) for more info and proper medical advice on this...... And of course, exercise is great not only for your heart, but your whole body, your lungs, your emotional health, energy levels, etc. Just make sure you're in good enough shape physically to start (slowly) and build your way up to more vigorous regular exercise. Congratulations!

Some great suggestions here for you to follow. Since you are only about 6 weeks post-op you need to be careful that you are following your surgeon's post-op food plan and not introducing solid foods or difficult to digest food too quickly. You stomach has been through a MAJOR TRAUMA and you need to give it time to heal properly. It can take up to 6 months for the swelling to completely subside and the healing to complete! My second focus is to suggest you adjust your state of mind..........you've lost 35 lbs! In 6 weeks! When was the last time you lost 6 lbs/week? Not losing much? Wow! I am 10 months post-op and my average loss right now (over those 10 months) is 2.85 lbs/week. You are losing LOTS! Believe me! And if you happen to be stuck (or stalled) right now, that is completely normal. Type "Week 3 stall" into the search box in the top right corner of this website. You'll see alot of people stop losing weight temporarily around this time period. It's great that you're looking for advice on protein intake (perhaps you should start logging your food on a website/app such as MyFitnessPall?). Just remember that your weight loss is a journey that is non-linear and you will have stalls, periods of fast loss (that sometimes don't make sense!) and some slow periods (but still losing). Your body is trying to figure out what's going on. It's making adjustments and adapting to it's changing physiology and energy stores. Give your body time, and your mental health with thank you! Good luck!

I often eat cottage cheese as it's quick, and a great source of Protein with low calories and fat. To make it more palatable, I sometimes add some blueberries, cut up strawberries or raspberries to it (just a few). You could try making some chicken salad or tuna salad the night before and smear some on a lettuce wrap. Or hard-boiled eggs (still egg, but feels different than scrambled, somehow...........and it's portable too!). I also eat Turkey sausage sticks (Old Wisconsin brand), for 4 g protein/stick and about 45 calories (meets my baseline requirement of 10 g/protein per 100 calories). Cheese (babybel light is a favoure) with a few grapes also gets me going in the morning. Just a few ideas for you to consider that are quick, easy and generally mostly protein with a few carbs.

Congratulations! Well done! I'm 75 lbs less than my wedding weight 2 1/2 years ago (266 in Sept. 2010). And I gained weight after the wedding...all the way up to 319 lbs (in May 2012)! I'm shooting to hit my goal weight of 135 lbs (184 lbs lost) by our 3rd wedding anniversary this fall........

Wow! You have done amazingly well. I am SO GLAD you followed your instincts and had the surgery done, despite the lukewarm reception from your doctors! Your life now must be completely different......and as you mention, the small risk of surgery is nothing compared to the nearly certain risk of disability and death from morbid obesity. Enjoy your new lease on life BenisaMartim4, you worked hard to earn it!

Thanks for this link, BTW. Very informative and prompting me to see if perhaps I can cut-back and eventually cut-out my PPI usage.

Sounds like you should introduce some more "balance" into your diet, just as PdxMan and Butterthebean have suggested. I avoided fruit for the first 8 months as I was concerned about the carbs. But since I've had small doses of fruit on nearly a daily basis, I find my energy levels are much better, my sugar cravings are much more in control and skin and immune system seem much better also! Vegetables were always in my diet (as a solid 2nd choice behind protein). I track my protein/fat/carbs on MFP and Fitbit and things are roughly 35%/35%/30%. I am usually within these guidelines, even when I'm indulging my "cravings". Try the rounded meal approach for a while and reevaluate how your body feels and is performing!

deli meat (low sodium), cheese (I love Babybell light!) chicken salad tuna egg salad hard boiled eggs laughing cow cream cheese triangles (all flavours!) Broiled fish (tilapia, salmon, cod, etc.) shrimp Roast chicken (or BBQ once summer arrives again...) steamed vegetables (avoid cauliflower and broccoli until you're further along, or make sure it's really well cooked) high-Protein low carb bars (I like supreme protein and oh yeah brand bars) mixed greens salad with lots of veggies and some pre-cooked chicken strips and a low-fat high taste dressing greek yogurt (low sugar) omelets (usually 1 egg for me) with sauteed veggies, some deli meat and grated cheese) meat loaf (you can make small individual loafs and take them for lunch) sugar-free Jello or pudding sugar-free popsicles or freezies cottage cheese (try cutting up a strawberry into it, or add blueberries, raspberries, etc.) And on and on and on..........take a look on the recipes section of the site here.........or use the search box (top right-hand corner). You'll find lots of ideas I'm sure! The most important thing is to make a plan, at least for the day and make sure you have the proper ingredients available at hand. Otherwise you'll be tempted to go "off script", pick up junk that's quick and easy and get off track!

If you have any in your house, GET IT OUT! If you're going to the mall or ice cream parlour.......STOP THAT! You are doing well in your post-op diet and losing weight. Why derail that and get back into the old habits that brought you to the point of needing surgery in the first place! VSG is a tool only. It helps you lose the weight and keep it off by portion control. If you eat around it (and ice cream, even no sugar added is a PRIME EXAMPLE of eating around your sleeve), you may as well have not had the surgery in the first place! Sorry for the tough love, but you sounded like you needed it. Be stronger. You can do this. Keep working on building your new healthy habits! Once you've reached your goal and keep up your fantastic healthy new lifestyle for at least 6 months after that goal is met, you can consider the occassional small treat. You will have developed the good habits and discipline to withstand the slippery slope. Right now, you are NOT prepared for "cheating". The consequences are too serious. Get back on the program.