DLCoggin

Jane I think you make two critically important points... Viewing obesity as a disease dramatically improves the self-esteem of those struggling with the affliction. It would be difficult to overstate the importance of this changing perspective. Defeating the disease requires individual ownership of the lifestyle changes that must be made in order to be successful. It is a lifetime commitment. Many, if not most, are intimidated by that prospect. Countless attempts and countless failures make it difficult to get your head around the idea that surgery changes e v e r y t h I n g. Much of the unparalleled success of bariatric surgery is the result of making those lifestyle changes very achievable. It is very challenging for folks who suffer from obesity to understand that past failures have no bearing on future successes following bariatric surgery. It's a new day.

I saw that study and it is indeed a very interesting one. I did not anticipate the results they got. The question becomes how should the results be interpreted. The study indicated that increasing self-esteem and body satisfaction resulted in less favorable food choices among obese subjects - good news/bad news. So the logical conclusion is that some who might have pursued weight loss options when obesity was a "choice", might abandon that goal when obesity is a "disease". What is the likelihood that most folks who suffer from obesity (currently defined as a BMI >30) will ever achieve long term success with diet and exercise or any other currently available means other than bariatric surgery? Many studies have shown that 95% of folks who lose weight with diet and exercise will regain that weight, and in some cases additional weight, within two years. A study financed by Medicare concluded "It's not a question of if weight loss via diet and exercise will be regained, but rather when it will be regained." Does the possibility that classifying obesity as a disease may encourage those suffering from obesity to make poorer dietary choices outweigh the potential benefits such as increased research funding, greater involvement of the medical community in addressing the obesity epidemic and expanded insurance coverage making surgery (and other possible options in the future) available to more candidates? Is obesity a choice or a disease? Either option will have costs, and benefits.

Right on, right on!!

"The 2014 Advanced Framework for a New Diagnosis of Obesity as a Chronic Disease" was very recently presented at the American Association of Clinical Endocrinologists (AACE) 23rd Annual Scientific and Clinical Congress in Las Vegas. In a summary article published by Medscape Medical News on March 17th, the author states "The framework is the latest step in an ongoing process to develop new approaches to obesity, based on the American Medical Association's June 2013 designation of it as a chronic disease, which originated with a proposal from the AACE. The need for a new obesity definition was among the major ideas to emerge from a consensus conference on the subject, held in March 2014, which involved participants from healthcare, research, science, government, industry, insurers and advocacy, according to AACE President, Dr. Jeffrey Mechanick." This is a powerful example of what @@Alex Brecher stated in his article - "An important benefit of classifying obesity as a disease is the increased awareness." The AACE in conjunction with proposals from the American College of Cardiology, the American Heart Association and The Obesity Society is suggesting three classifications for obesity: Obesity Stage 0 (BMI 30 or greater with no obesity-related comorbidities), Obesity Stage 1 (BMI 25 or greater with one or more mild to moderate obesity-related comorbidities, and Obesity Stage 2 (BMI 25 or greater and one or more severe obesity-related comorbidities). The recognition of obesity as a disease by the medical community does not mean that the stigma surrounding obesity is going to disappear. It does mean that many obstacles have been removed, and many doors opened, for researchers and physicians to formulate and pursue treatment options for the global epidemic of obesity. That is good news for the millions who suffer from this debilitating and life-threatening disease. Full Article

The statistical incidence of stretching a pouch is, I believe, considerably less than most folks think. Does it happen - yes. Is it common - no. Even less likely within a few short weeks following surgery. And all but impossible as long as you're following your plan. Your pouch contains stretch sensors (nerves) that are temporarily ineffective following surgery. As a result, your brain is not receiving "full" signals that will resume once those nerves are healed. That healing usually takes two to eight weeks. In the meantime, there is a rule that I have followed since my surgery to this day. I never eat less than two hours or more than four hours apart. Less than two hours is "head hunger". Fluids of just about any kind are an amazingly effective bridge between meals. My personal choice is decaf coffee but there are any number of options. More than four hours and you run the risk of getting overly hungry which increases the risk of overeating. You guys are doing absolutely great! Just a little case of post-op jitters. Perfectly normal and it will pass once you get a little more experience with your new tool. Great job and you ain't seen nothing yet!!

There isn't a single one of us that doesn't understand your concern. But it is based on fear and fear is the enemy. Fear prevents you from taking action. Fear is what stops you and makes you weak. It is your will that turns your thoughts and desires into reality. This surgery is not a "diet". Using past failures with dieting as some kind of foundation for predicting the future outcome of bariatric surgery is like saying you took an aspirin to heal a broken leg. After 25 aspirin didn't work, you're afraid your new cast will fail as well. A completely invalid comparison based on fear. Illogical and self-defeating. The reality is that you have no previous experience that has any relationship to the journey you are on now. None. Zero. Trust your body and most importantly, trust the process. Follow your plan as closely to the letter as you possibly can. Stay positive. Stay patient. Maintain a food log. Exercise to your ability. Do those things and the weight will take care of itself. There is no doubt. The laws of science and the universe cannot be denied. Persistence, along with absolute belief, can never be defeated. Relax and allow your new tool to do its job. Your goal is physical change but your challenge is mental discipline. You're gonna love the new you!

I've been using MFP for two and a half years and love it but there are any number of apps that do essentially the same thing. I think it's important to remember that MFP was not written for bariatric surgery patients. For that matter, I'm not aware of any app that was written specifically for bariatric surgery patients. The MFP program (and all others that I am aware of) was written with a "one size fits all" formula that calculates your daily calorie goal based on your gender, age, height and weight goals. But there is no one size fits all, especially in the area of bariatric surgery. So the key for any app is ability to customize your goals to meet your individual needs. It goes without saying that your daily calorie goal is the one that your surgery team gives you at your specific point in your journey. One of the strengths of MFP (I can't comment on other apps) is that you can customize it to virtually anything you want. While some changes can be made on the app itself, many more options can be customized from the MFP website. A 600 calorie/day goal - easy to do. Set a higher percentage of your daily calories to come from Protein - also easy to do. It is that ability to tailor your goals to your situation that is perhaps the most important deciding factor in whatever app you are considering. Regardless of the app that you chose, maintaining a food log is, next to the surgery itself, the most powerful tool you can have in your weight loss (and maintenance!) arsenal.

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Your question is very broad and it's almost impossible to offer any meaningful suggestions without more insight. Have you discussed your weight gain with your surgeon and if so what was the recommendation? What type of revision are you considering? Do you maintain a food log? Did you ever maintain a food log during your journey? Do you exercise regularly and if so, how much? How much weight did you lose following your surgery and did you reach your goal? What are your thoughts on what changed from the five year mark to the point that you started gaining? What steps did you take when you initially started to gain weight? What was the result? There are lots of knowledgeable folks here who are anxious to help in any way we can. Help us help you.

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You are certainly welcome! Have a great weekend!

Good morning Nancy. I'm more than happy to answer any questions. If I were making the surgery decision today, I would make exactly the same decision to go with the bypass. I would do it again without a moments hesitation. That said, the sleeve is a safe and effective option that many have had great success with. In my case, I had a history of acid reflux which was completely eliminated with the bypass. Type 2 diabetes, sleep apnea, hypertension, high cholesterol, knee and back pain and 130 lbs - all gone. Vitamin and mineral profile is spot on across the board. I'm walking five miles, at least three times a week. And doing strength training (Total Gym), at least three times a week. I can go into any store, anywhere, anytime and buy clothes from a mind boggling selection. I'm healthy, I'm happy and I'm lovin' the new me! Follow your plan as closely to the letter as you possibly can. Regardless of what your weight is doing, your response is a l w a y s the same - follow your plan. Stay positive. Stay patient. Exercise to your ability. Trust the process. Trust your body. Your goal is physical change but your challenge is mental discipline. Almost as important - maintain a food log. I've been logging in MFP for over two and a half years and I would be lost without it. Logging allows you to manage your weight like no other tool that I am aware of. My weight went from 285 to 155 in just under 14 months. In the year and a half since, my weight has never been below 151 or above 156. This morning it was 154. That's the power of logging. I tried, I really gave it some thought. But in all honesty - I don't know of anything I would have done differently. Other than having the surgery twenty years earlier! You guys have a great weekend! You're gonna love the new you!

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No trouble at all Jolene. It's in the cloud!

Yes ma'am, it are me!

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