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You do not know the difference between acid and hunger. A stomach grumbles because the acid bubbles up in the empty space. When you have an excess of acid in a tiny sleeve, the SAME thing happens. It triggers the "I'm hungry and must eat" response that we learn early in life. So the first thing is ALWAYS to either check that your PPI is working (we see a lot of folks on Prevacid need to change to something else) or to start on one if you aren't on it. From there, fiddle with your diet. If you're on purees, you shouldn't be feeling hunger. It's common to suffer head hunger and acid problems in liquids, but not once you're on actual food. ~Cheri

Being healthy in the long run means being able to treat food like a person that never had a weight problem or an emotional relationship with food. The most important thing you can do for yourself is approach your long term goals that way. Sounds like you're on the right track, and it's the little accomplishments that mean a lot. Every now and again I'll feel like I've completely overdone it, but the reality is that I haven't...it's just such an odd occurrence these days for me to indulge and snack that it seems over the top, even when it's firmly within my daily limits. You're doing great - keep up the good work, ~Cheri

As it pertains to the sleeve, there really isn't one. I'm seeing some posts here that say things like, "I really need to make the first six months count because my surgeon told me loss slows after that," or "My surgeon told me I won't lose after a year and will be in maintenance at that point." This causes a panic and pressures patients to lose the weight as quickly as possible. It also causes a lot of people to feel frustrated or like they've made a poor decision with the sleeve if they aren't dropping five pounds a week! With every WLS the patient is going to lose the most weight in the first few months post op. It's purely logical. We go from eating far too many calories a day to eating almost nothing. We go weeks on a liquid diet. Even once we're on solid food, our capacity is so limited that it's laughable. In addition, almost everyone is diligent about diet and exercise at first. OF COURSE we see rapid results when we're in this stage! Many people see a slower loss from months six onward. OF COURSE they do. It doesn't mean the sleeve has stopped working and we need to panic because we're not at goal yet. It means that we're closer to goal and our bodies are losing at a slower pace. It's also our bodies compensating and adjusting because we lost so much in the earlier phase of life post op. Does loss slow from one year onward? OF COURSE it does! At one year out most people are close to or more than one hundred pounds lighter. We have less weight to lose, and yes, once we're at that point it does come off more slowly. If you're a lightweight and had less than 100 pounds to lose, expect this slowing sooner. Again, the closer you are to goal, the harder to get those final pounds off. That does not mean the sleeve works any differently. In fact, it's the same from day one. The sleeve is restrictive and that's what it does: it restricts the quantity of food you can eat in a sitting. It does NOT cause malabsorption which is going to speed up your weight loss. I've seen the study that was posted about dumping with the sleeve, but even that is not going to majorly affect your loss pattern. Your sleeve does not stretch like a bypass pouch, either. Your capacity will vary, but in my case, at about nine months post op I was double what I could fit at first with solids, and at around two years that doubled again. Sounds scary...until you realize that I'm talking about fitting in roughly 6-12 ounces of food at a time, depending on what I'm eating. That's FAR less than a pre-op stomach. So this idea of a "honeymoon" is misleading. In some respects, yes, there is an easier period of loss. But this is not due to the sleeve working more effectively. Our bodies do not look at a calendar and say, "Oh, wow, we're closing in on one year post op and so let's just transition to maintenance and stop losing now." It simply doesn't work that way. Your sleeve will work as long as you work your sleeve. When you give up and slide into maintenance or worse, into bad habits, is when you'll see the loss stop. Outside of your body's own limits on loss, there is nothing stopping anyone from achieving goal at any point post op. I just wanted to post this because we really do see a lot of questions about this and a lot of panicked posts because people aren't losing as rapidly as they want. We put on the weight over the course of many years - we cannot expect it to fall off in less than one year. Some people will fly to goal in a short period of time, but they are the lucky minority. The rest of us need to work at it and it's a longer process than a few short months. Good luck! ~Cheri

I'm not here to lecture, but just because it can take, doesn't mean it should. You're early out and while I fully encourage a moderate approach to diet in the latter part of the loss phase and in maintenance, be careful not to build up bad habits right now that are hard to shake later. You're so early out that you can eat just about anything and see a drop on the scale, but in a few months it won't be so simple. Lecture aside, you're lucky you could handle that type of food...or perhaps unlucky. Because being able to tolerate the junky stuff means the biggest burden of choosing healthier options lies on your willpower alone. If you're within your daily calorie limits for the day and making mostly good choices you should be fine. Fibrous veggies and any types of greens or lettuce are notorious for causing issues for a long while post op. Some people never experience this but many do. I still cannot eat iceberg, it causes discomfort and digestive problems every time. I can eat any other greens and any other vegetable I'd like, though. It just took about nine months to get there. And why do I feel like I'm stalking BTB around the forums today? Seriously, every time I go to post somewhere, he was there first. ~Cheri

I was about to chime in and say the same thing, but BTB beat me to it. Yep, those shots are a waste of your time and your money. Investing the time and energy into finding a Protein shake you like and want to drink is worth it because the protein will help you in the long haul. It's HARD to get enough protein in on diet alone, and it's worse if you're hitting the gym to get fit at the same time and need even more. There are hundreds of options out there - don't quit just because you've tried one or two things made one or two ways and didn't like them. Good luck, ~Cheri

I had a few pieces from Hips and Curves a while back. I will say that in my experience quality varied drastically from piece to piece, but overall it was just nice to have pretty lingerie in my size. In plus, I really loved the selection at Secrets in Lace. Now that I'm at goal my favorite items came from What Katie Did. The prices reflect it, but they sell very high quality shapewear/lingerie in retro styles that feel great and look ridiculously flattering. I also like the shapewear from Rago. I splurged on a custom corset and skirt for a ball (from a different place) in 2011 and that was worth every penny. I now buy fewer pieces of lingerie but they're very nice quality pieces that I'll enjoy for years to come. Of course, when you love to shop pinupgirlclothing.com you have a greater appreciation for the classically styled undergarments. ~Cheri

Yep, I'd agree that you're an ideal sleeve candidate based on stats alone. The RNY will certainly work for you, too, but it might be more surgery than you need, and yes, there's the lifelong issue of Vitamin malabsorption to consider. I'm 5'1" (and a little extra) and was 242 on surgery day. That's a BMI of 45.7 and pretty similar to your starting BMI. Whatever you decide, good luck! ~Cheri

Lady, I am WITH you on this. I had a big loss exactly TWO months out of the seventeen it took me to get to goal. I never experienced the "honeymoon" either. But I did lose more in the first six months and it slowed down again after one year. And I completely agree with aligning expectations with reality. We all read it and we've all heard it and it's a completely tired line but the sleeve is NOT A MAGIC WAND. It's a tool, and one we have to utilize properly for long term maintenance. I'd also add that I think the idea of a honeymoon period is bad for some people because they'll pretty much lose weight no matter how awful their food choices immediately post op. They then think that they can eat whatever they like, just in smaller portions, and get to goal (and stay there for-ev-er) but they inevitably wind up horribly disappointed when their stomachs heal and they find that they can still graze an entire bag of Oreos in a day and they aren't going to lose weight doing it! In any case, I think the more people stumble across this PRIOR to surgery the better. ~Cheri

I am not here to browbeat you, BUT of the PPIs I see used here on VST, Prevacid is the one that seems to help people the least. I was on Prevacid for a while and it worked okay at controlling heartburn but did not stop the acid from making me feel that emptiness and hunger you're mentioning. The abundance of acid in your sleeve is what lets you feel that emptiness and that triggers "hunger" and our desire to eat. I really, really would try a new PPI for a short time and see if that helps. It sounds like you're eating a good diet and not depriving yourself. I really hope that the easiest thing to try is the solution for you, because having a sleeve and still feeling like you're on a diet is not the way anyone wants to live. Best of luck to you, and in the meantime, an extra Protein shake or some protein sludge or even some SF Jello might help a bit. ~Cheri

My vote is for coffee and jelly bellies. And I can't eat a two egg scramble with two sausage links and I'm 2.5 years out AND pregnant! Each sleeve is not created equally, though my OB would be thrilled if mine had the capacity of Fiddleman's. I remember a study when I was a kid about OJ being bad for us (as in, orange juice, not Simpson) but now it's touted as full of anti-oxidants and as a healthful food in moderation. A study can be performed to show everything is bad for us and a few weeks, months or years down the line we'll see a contradictory study. So hey, do what makes you happy and what you're comfortable with. The argument about cholesterol only affects you if you have a problem with cholesterol and comparing egg yolks to smoking is a ridiculous attempt to stir people up about nothing. I know people that can eat ANYTHING and have no cholesterol problems, while I also know folks that eat a pretty balanced diet and are fit that are on medications to control theirs. It's more up to genetics than anything, if you're not the person eating fast fried foods all day every day. I eat the heck out of eggs AND yolks, because yolks are a great source of many Vitamins and nutrients lacking in my diet. ~Cheri

You can lose as much as you'd like with the sleeve, as the previous posters have told you. I've seen some over 200 pound losses here, and we have a few active folks right now that wanted to lose around 200 pounds. You will lose as much as you want to lose that your body will allow. Sometimes our bodies set a goal weight a bit higher (or even lower) than our personal goal, so know that going in, but I certainly feel that 200 pounds is achievable if you put in the work it will take to get there. The important things to remember are that weight will always come off faster immediately after surgery, so a slowdown is normal and should not discourage you from trying for your ultimate goal. Additionally, because you want to lose more than 70-120 pounds, your journey will be longer. There's nothing wrong with that! Just expect that, and know that every pound lost, no matter at what pace, is a pound lost forever. Life at goal is the ultimate goal here - and dedicating one to two years of your life towards that is a small price to pay. Congrats on making this decision, and on your new sleeve. Please update the boards as you progress, so that there is more information out there for people in a similar situation. Everything you contribute about your own experience can help others see if this is the right surgery for them. Good luck! ~Cheri

Are you on a PPI and if you are, is it working for you? The signs of acid overproduction aren't limited to the burning in your throat or tightness in your chest or abdomen. One of the biggest indicators is that feeling of hunger - like a growling stomach prior to surgery. It's easy even for vets to miss this - I'm 2.5 years out and when I got pregnant was sure that the pregnancy was making me ravenous around the clock. I was SO hungry, even within a short time of a meal. Well, duh...you'd think time and experience would have made it clear sooner, but the issue was acid production. It didn't even occur to me because the heartburn was so infrequent, and again, I chalked that up to pregnancy. As soon as I was on a PPI again, I was back to forgetting to eat my Snacks between meals. So, first step is ALWAYS to check your PPI. If you're not on one, try one for a week or two and see if it helps. If you are on one, you might need a different one. I had two that worked for short periods of time but eventually stopped. It was only once I was on Prilosec (omeprazole) that I felt real relief that lasted a full 24 hours. Everyone is different, and what you're on might not be working for you. Beyond that, yes, Protein will help. Drinking Water will help. Being 100% certain it's not head hunger or hormonal hunger is important. But there are people that don't lose the hunger for the long haul. They are few and far between but they do exist. It's normal to feel "hungry" on a liquid diet. But once you're on solids it's far more common to feel no hunger and many of us actually start to hate eating because it becomes a chore. Good luck, I hope you find a solution. ~Cheri

A SF Jello won't hurt you. Are you on a PPI? My bigger concern is that you feel "hungry" so quickly after eating a solid meal. Don't get me wrong, there are people here that never lose the hunger. But it's far more common for people to have NO appetite at all. I do not say this to concern you or so you'll start to think something is wrong. But be sure that you're on a PPI like Nexium or Prilosec, because the noisy, gurgling acid does feel like a hungry stomach. Also be sure that you're actually hungry..not just eating at night because it's what you used to do, or because you'd like a snack when you're watching television or something. Curbing head hunger from the very beginning will only help you in the end. But if you're hungry, the biggest thing is to eat! I'd recommend tracking your calories daily. That way if you're hungry or want a snack later in the day you know if you have calories to afford - and if you want a small meal or a small snack. Many days I'd hit the evening and feel like I should eat something, only to realize I was several hundred calories short of my daily goal. That's a meal, not a snack! Oh, and Protein shakes or sludge are always great before bed Snacks because they stave off the hunger, fill the sweet tooth and give you an extra protein boost for the day. I eat about every three to four hours (when I remember to eat!) and to me it's normal to feel a need to eat again a few hours after a meal. While that salmon might have seemed like a substantial meal, especially so newly onto real food, I doubt it was enough to tide you over for twelve hours! Good luck, and congrats on your new sleeve, ~Cheri

Yeah, OTR! I was glad this thing might finally be dead, but hey, now that it's not... The big issue I have with this thread is that it's a panic button for uniformed people that don't bother to read the posts (you know, the handful of sensible ones in here, wedged in between the name calling and arguing) and it has so many words that will come up in frequent searches. It doesn't matter if I unsubscribe because I could care less about the nastiness in this thread and I'm not annoyed that it exists, just at way the thread evolved. What matters to me is that as a vet, every time this thread gets resuscitated (like I'm guilty of doing right now), we can expect to get slammed with questions about stretchy sleeves, rapid regains, etc. when there was no real need for people to get into a tizzy. Very few people have the patience to read through more than 21 pages of posts to find the relevant pieces of information. ~Cheri

This is exactly the right approach. Until you're mentally ready and have shed the emotional eating or habitual eating, incorporating foods that require moderation won't work. Because you aren't ready for moderation yet! But going back to basics and eating Protein first will help you immensely. You'll need to break the carb cycle - for a lot of us, too many poor quality carb choices wake the carb monster. If you've ever seen anything I've posted you know I don't advocate low carbing post op, but I do recognize the very real reactions that processed foods cause in our bodies. Sugar, in particular really hits a trigger with some folks. Do not expect perfection from yourself. None of us are perfect. But do make the little steps you need each day to transition those bad habits into better ones. If you want your morning coffee, indulge - but drink a Tall, not a Grande, or make it a skinny one. I think tracking your calories again if you've stopped will also help you see the big picture. Thank you for posting. People all too often assume the sleeve will do the work for us. And to some extent, that's true. But those ingrained habits and "head" issues that contributed to our obesity do not go away just because our stomach is smaller, and it's important to face them and overcome them if you want long term success. Best of luck and know that you are not alone with this struggle. If you focus on these habits now, you have the chance to reach goal well adjusted and with a healthy, moderate approach to food. That's what you want to live easily at goal for the rest of your life. ~Cheri

Great job. I will chime in as a negative nancy and warn you not to expect the same results every week. Usually a huge drop is followed by a slowdown, so don't feel defeated if that does happen or if you happen to hit a stall earlier because you've lost so much so quickly. Just try to look at the big picture and enjoy this huge drop so soon after surgery. Good luck and congrats on your new sleeve, ~Cheri

It's easy to fall into old habits, even once you're a vet. It's a learning process. No worries, I'm sure you're fine. It's just a matter of needing to go slow and steady. For me, at least, measuring was critical for a very long time. Even now it's all to easy to think I've eaten very little or a lot in a day but it isn't until I track everything that I see I was on target. We forget how many bites we've taken, our memory of what we've eaten is easy blurred if we're distracted. Next time, set aside a nice little portion for yourself and see how it settles before attempting anything more! And if it's any consolation, I was making huge batches of hummus for an event a few weeks ago and did the same darn thing. I didn't feel sick but I ate to the point of being full and uncomfortable because I was snacking on chickpeas as I was making salads and hummus. A handful here, a handful there and it adds up! My problem lies more in getting distracted by what I'm doing and forgetting to eat regular meals and Snacks. We all have our bad habits to overcome, and some of these challenges are with us for the long haul. ~Cheri

You're still on a liquid diet. If you're really concerned, call your surgeon's office, but honestly, I do not really think it makes a difference. Pre op diets are very challenging and it's not as if you're asking for validation to stop at a doughnut shop instead of drinking your shake. Do what you need to do to get through this time, in my opinion. ~Cheri

Sorry, just saw this! I use the King Arthur Flour recipes - I've made both the organic whole wheat and the golden pitas and my family loves both. I'll say that I do think the whole wheat ones make better pita chips...just a texture thing, I think. I make my own because you cannot buy them here and I bake 100% of my bread because we don't care for the local breads. I just make a double batch of the pitas and make half of them into chips. We use the other half for sandwiches. These freeze really well if you're not a regular baker and you decide to freeze the cooled pitas. Just thaw them in the fridge overnight and make chips from there. This also works if you won't be eating a lot of them. Here are links to the two recipes I've used. I don't modify either of them - they work just as written with my oven. To make chips I just heat the oven to 350 degrees and brush the pita with olive oil and sprinkle with sea salt (or if I'm making fruit salsa instead of hummus, maybe I'll sprinkle with some sugar and cinnamon) and then I'll cut each pita into eight wedges. Arrange them on a lined baking sheet and bake for about fifteen minutes. Check to make sure they're crispy - they could need more or less time, depending on your oven and the thickness of your pitas. Best of luck! http://www.kingarthu...it-salsa-recipe (I've never tried the salsa) http://www.kingarthu...ta-bread-recipe ~Cheri

Thanks for sharing. I'm pregnant and realized the other day how much trouble I was having moving around. Sure, some of it is that pregnancy awkwardness but a big part is that I'm up twenty one pounds. That's not a lot of weight if you think of it in terms of one hundred or more pounds to lose. I mean, I remember being frustrated in the beginning when I'd "only" lost forty pounds. But it impacts my ability to move and it wears me out. To think I used to carry 105 extra pounds on this body at one time, and didn't really even realize the impact. Great post. People get too hung up on scale goals and forget quality of life and long term maintenance goals because they're distracted by the numbers. ~Cheri

Ladies - I'm seeing that a huge percentage of our pregnant ladies are ones that were using the IUD as their primary form of birth control. But what I haven't seen is someone taking the time to say, "Hey, this is a possible issue and be aware of it BEFORE surgery." The IUD can shift and/or fall out with a drastic change in weight. I wish more surgeons were discussing this possibility with their patients, because I'm getting the feeling that they aren't always doing so and that many women are unaware that this can happen. Please be sure to address your choice of the IUD with your doctor so that you can decide if it's the right choice for you while you're in the initial loss phase. I've seen a large number of surprise pregnancies lately and almost every one of them was an IUD user. We all love babies, but it's nice to be more in control of the process and not be surprised with a pregnancy while eating a drastically reduced diet and learning your sleeve. And the early months are emotional enough without complicating matters. So, just my official suggestion that even if your surgeon or PCP does not bring this up (and particularly if you're self-pay and won't be seeing a regular team of doctors) that you bring it up yourself if you're currently using this type of birth control and not trying to get pregnant. ~Cheri

I'm so thankful you had routine care that caught this immediately. Positive thoughts and prayers for you. I had preterm labor with my twins but after the steroid shots and with the extra monitoring I was able to carry full term, and never did dilate any more until delivery. Here's hoping you have the same positive outcome. Take it easy, lady! Rest whenever you can, though I'm sure your doc already told you that. ~Cheri

I was absolutely messing with you. I'm just jealous that you can eat a cheeseburger and I can't. They can't make a proper cheeseburger in Central Asia, and I can't really make one myself, limited by the quality of the local beef. And why am I not surprised that Fyre chimed in with "babies?" ~Cheri

Hey! Stay on topic!!! The OP asked a question and you're distracting us all with your talk of delicious, cheesy cheeseburgers... Dang. I wish I could eat a cheeseburger where I live. OP - I don't feel any guilt about anything I eat. I eat what I want, in moderation and by golly, I enjoy it. If I'm only going to eat a few bites at a time of something, they had better be wonderful or I'll get testy. Sometime around 12-15 months out I shed the idea that eating something I enjoy had to be a treat or something to feel guilty about. So, my not-so-guilty pleasure? Being healthy in both body and mind, and enjoying food like a woman that didn't spend half her life obese. ~Cheri

Congrats! Mine is in remission, too, and I couldn't be happier. It was the big medical motivator for me to have the surgery and I am so pleased that it worked for me. It's just one more way the sleeve will improve your life. ~Cheri