VSGAnn2014

OK, counter-argument coming at you here. Get ready for some sarcasm -- I just don't have time to edit it out this morning. You're getting married in 3 months, so you can justify splurging lots of times between now and then. Showers, luncheons, nights out with the girls -- it's all an opportunity to eat / drink "just this one last time." Right? And then, of course, there's the week before the wedding. All those preparations. All those out-of-town guests. And then the big night! And then comes the honeymoon, probably at an all-inclusive resort. All of these are "once in a lifetime" experiences, right? Then comes the stress of post-honeymoon life -- young married life is great, but it has ups and downs and other first-time-evers, not all of which are going to be happily-ever-afters. Imma guess stress-eating might've played a role in your pre-op life. Right? You get my drift. Where's your line in the sand? If you don't draw it somewhere you can never stop crossing it.

Ask your surgeon.

OK ... here's the truth coming at you from an old broad who's seen some considerable s**t. Y'know how to tell if someone is an evil influence? It's when their unsolicited, invalidative advice offered "for your own good" crawls around your brain like a poisonous scorpion shitting on every cell of your mind and soul. From now on, you should make it blatantly clear to her that she is on your all-time s**t list. Don't pretend like you like her. Don't pretend like she has your best interests at heart (she doesn't). If she comes in and sits down at your luncheon table, get up and leave. She is dead to you. And if she does it again, tell her you're going to report her to H.R. if she tries it a third time. Oh, and don't assume anyone else is "talking about you." She is lying her ass off. That's just her imagining has any influence whatsoever over you. She might be self-aware enough to realize what she's doing. Or maybe she's just a meddling, clueless cretin. Either way, she is dangerous to your well being -- ONLY if you give any credence whatsoever to the idiot noises she issued while her mouth was moving. What she thinks and what she says is 100% irrelevant to your life. Now move on. P.S. BTW, you keep doing that Subway salad thing you did -- it's brilliant! Love it!

All these "requirements" vary dramatically, depending on the person's insurance requirements, surgeon's requirements, their starting weights, comorbidities -- and God knows what else. Some people just have to show proof (usually from a PCP) that they've been on previous diets (sometimes physician-supervised, sometimes not) and lost weight. Or didn't lose weight. And many people aren't required to go on any pre-WLS diets, eat specific ways, lose any weight, etc. These requirements are all over the map. What matters is what YOUR insurance and YOUR bariatric surgeon require. Protip: On this front, do NOT guess or assume, based on other patients' situations. Ask very specific questions of your insurance company and your surgeon's office to get accurate answers.

@@Kindle -- I'm so glad to hear you're feeling so much better. And the 135 number on the scales is great news, too. I also want to say how impressive to me your self-care has been these last few years. You're a strong role model for many. Your transparency helps so much. Thank you.

I agree with @@jess9395 about the enormous long-term value of being disciplined in your food choices until you've lost all your excess weight. Doing it that way gives your relationship with food a powerful reset. I bet almost 100% of us pre-op had some terrible eating habits. But bad habits can be changed by consistently practicing good habits. WLS makes this so much easier. I'm coming up on two years post-op, and eat so differently now and have very different emotions about eating than I used to. It's a shame to waste a sleeve.

Thank you for that new term. I have never heard it before. And there's not much I haven't heard of. For others who don't know what it means, it's "staircase wit" -- a French term used in English for the predicament of thinking of the perfect retort too late. Hubby and I are loving it! Thanks again.

OK, here are the facts as I understand them, about long-term WLS failure / success: * Half of the people who have WLS are "successful long-term" -- that's defined as maintaining at least half of their weight loss (for 5 years). * Half of the people who have WLS are "unsuccessful long-term" -- that's defined as gaining half of their weight lost or more, including regaining all the weight the lost. Your long-term success is determined by the quality of your surgical procedures and your ability to develop a healthy new lifestyle and follow that lifestyle consistently. Compare that to a 2% - 5% success rate for those who lose weight through diet and exercise. So no, WLS does not come with a lifetime guarantee. However, I personally know people who are definite successes as defined above. Those include people who have maintained 100% of their weight loss or 90% or 80%. Their lives are abundantly better. I have lost to 135 pounds. My lifetime goal is to stay below 150 pounds (which would keep me in the "normal weight" BMI neighborhood. Of course, I'd love to stay at 135 pounds.

Well, if you look a little more closely at that handout, you'll see it says to wait for "one year or until 75% of excess weight lost." Depending on your starting weight / BMI (?) and how much you lose pre-op, that could be six months or even sooner.

I have good friends who live in NOLA. And younger relatives went to school there. It is definitely Party Central. There's a parade every weekend. My friends and relatives who live there also walk their asses off (they all live a few blocks from Audubon Park). And they cook very, very healthy. Of course, they're foodies and eat out and cook with their friends and relatives who are chefs. Fortunately, they're all wine drinkers and probably don't have more than 1-2 glasses on days they drink. But if you hung in the bars and drank spirits -- oh mah gawd, that would be hard on your liver.

@@Christinamo7 ... I was just thinking that in the last 24 hours! The hugely brave thing we each did was to choose WLS. At 21 months post-op I have almost forgotten the terrors and weirdness I felt when I finally made that decision. One of the bravest things we can do is to approach a very difficult, hugely important problem from a brand new perspective, throwing away all historically acceptable, common-wisdom approaches that have not solved the problem. It's easy for us blame our prior failures on poor execution of the weight loss emperor's rules. Yet somehow we all found the courage to say that the emperor was naked. I'm still giving Einstein credit for this brilliant aphorism: "Insanity is doing the same thing over and over again expecting different results."

I am hugging ALL of you!

Well, there you have it. Some incompatibilities are developing in your relationship. So how do you guys want to handle this? IMHO, you've got more conversations to have. And my bet is that those conversations would be a lot more productive if you had them in relationship counseling.

Oh, Miriam! You're sliding down a very slippery slide. Do you know what kinds of leading questions my shrink would ask you? "How well do you think you're caring for yourself?" "Where do you think that continuing your current regimen will lead you to in 3, 6, 12 months from now?" "If you were caring well for yourself, what would that look like?" "Which of those changes would be difficult?" "Which of those changes would be easy?" "HOW DO YOU FEEL ABOUT THAT?" Sorry, I had to put that last one in there.

Jeez, I have no idea what's going on. Your eating less could be triggering his own food / eating insecurities or binge-eating (if he suffers from that). Or he could be sabotaging you because he doesn't want you to lose weight. Or he could be one of those guys who just does what he does and has no idea why he's doing what he's doing. Or he could be an asshole. Or you could be hormonal. Or you could even be imagining he's eating worse because you're under typical early-post-op WLS stress. Why don't you just ask him what he thinks is going on and see what he says?

Thanks, @@OutsideMatchInside . But I hasten to add that this theory of mine is just that -- a theory. It's sparked, however, by things I've read that were written by surgeons who do a lot of WLS and on outlier, negative results reported by some sleeved patients. (I've been reading WLS boards for almost three years now.) Long story short, if I were choosing a sleeve surgeon today, I would be asking much more detailed questions than I did two years ago. I'd make the questions open-ended and encourage the surgeon to talk as much as she/he wanted to. E.g.: * What can go wrong during the surgery with the surgical stapler that you and other surgeons use? * In what percentage of those WLS surgeries you have performed has the stapler(s) "screwed up"? * How do you think your skill with the surgical stapler compares to those of other bariatric surgeons? * When you're shaping the sleeve, what are you trying to achieve? And how do you do that? * What other tools do you use to shape the sleeve? * Would you draw a picture that shows how much of my stomach you're going to remove and how my sleeve will look after you have shaped it? * Months post-op, after the sleeve has healed, what does the ideal sleeve look like next to the hiatal valve and next to the duodenal valve? * Do you ever leave any of the fundus during surgery -- and if so, when and why would you decide to do so? FTR, I've never had any problems with my sleeve (so far). My post-op recovery was pretty easy. My mild acid reflux (which I had pre-op) is about the same as it was pre-op. I've never thrown up post-op. I've followed my surgeon's eating protocols closely. I'm maintaining well (so far). Knock on wood.

Actually, as a 70-year-old who was once 20-something I do think there are some unique issues that people your age go through related to bariatric surgery. You're in SUCH a different point of life than folks in their 40s and older. You're still trying to find your way in life in every way imaginable. Your obesity has such a big impact on all of your navigational challenges. Life and its burdens teach us a lot of lessons about what we're made of and how we can come through adversity, endure pain, and come out stronger than before. But most of you haven't dealt with some of these adversities: You probably haven't been married yet -- or divorced yet. Most of you haven't had children yet or cared for your own parents as they ail or age. You haven't yet changed your career trajectory more than once. Many of the lessons those experiences teach translate well in terms of the courage and self-confidence we need to succeed with WLS. On the plus side, obesity probably hasn't yet had a chance to impact your health, like it has for middle-aged folks and older. You have much more energy than we do. Your metabolic rate is higher than ours. Your body's ability to recover from WLS and to look like we all want to look like is far superior to older folks'. Your double chins will disappear. You won't have any wrinkles. For the most part, your skin will pop back and look like you were never overweight. Few of you will need plastic surgery. On the other hand, the 20s-style social life means you are probably spending much more time in bars and clubs than older folks. Alcohol and other drugs have caloric and other downsides for those following a WLS lifestyle. As some here have described, fewer people in their 20s are obese, compared to the proportion of obese people in their 40s and older. So that means your age-peers are not as sympathetic to the plights of the obese and are perhaps more ignorant and more scornful of WLS as a treatment for obesity. So, yeah, those are tougher attitudinal environments than older WLS patients have to weather. So I agree that you could be the one to focus on your generation and WLS. Do some serious research of your own. Interview surgeons. Interview patients. Report on their observations and experiences. You could start by blogging about your own experiences. Other 20-something WLS patients may also be blogging about theirs. You could write the book, go on tour, become a talk show host, build a media empire, become a bazillionaire! (You're welcome. )

You really can continue to lose weight. However, the important thing is that you recommit and take action NOW. Since you've posted here, it seems like this is a turning point for you. But nothing will change if YOU don't change your behaviors -- eating, drinking, moving, and other tools (you know what they are). Recommit. Change. Win!

OK, I'm gonna throw this out there ... Maybe the surgeons at your local clinic don't know how to do sleeves correctly? Seriously -- the more I read about the sleeve, the more persuaded I am that your surgeon's skill in shaping the sleeve and their skill in using the surgical stapler is critical to your long-term success. If they screw up the shape or the width of your sleeve at any point along the staple line, don't leave enough room near the hiatal valve at the top and near the pyloricc valve, and don't remove all the stomach fundus, you won't ever have the full benefits of your sleeve's potential restriction and/or ghrelin reduction. FYI, my surgeon (who's done thousands of WLS surgeries over the last 15+ years) is tremendously enthused about his sleeved patients' long-term successes. On a different point, I learned yesterday that he has quit doing ANY lapband surgeries.

Oh, Lord -- another person who thinks that losing nearly a pound a day equates to "weight is not going down." How in the world do people develop such unrealistic expectations about WLS results? My first four months post-op I averaged 10 pounds/month weight loss. And then the weight loss slowed. I still lost 100 pounds and am maintaining now at 135 pounds. This is not a bloody 50-yard dash. It's a marathon. And when you reach your goal it becomes a life-long lifestyle. Sorry for the mini-rant, but I really don't understand why someone who's averaging 24 pounds lost / month is disappointed in WLS. That's an amazing weight loss.

Thanks, Jamie. I have been thinking about you -- and your husband. You'll both pull through this and go on to much better times.

I really don't understand why y'all have to keep tasting while you're cooking. Is that really necessary to produce a good dish? Assuming that you're lifelong cooks / chefs and that you've been cooking some of the same dishes for so long, don't you know what the ingredients and amounts are? If not, couldn't you figure that out? I also don't understand how MFP could tell you with any accuracy what a "taste" of anything is. Surely, "tastes" range from licks to tablespoons. ??? Inquiring minds want to know.

I agree -- early on, my Fitbit was da bomb. As I lost weight I was able to walk and move so much more than I'd been able to do in years. Get one of those (or something similar). And don't do any exercise that will hurt your joints! The point is to get healthier and fitter. That doesn't happen overnight. But you will be amazed at how much fitter you can get if you do something physical every day -- and do a little more of it every week. It's magical!

All these rules about qualifying BMI vary by insurance policy, surgeon, and more. For those of you who want to lose weight pre-op, but are worried your qualification will get screwed up if you lose too much, consider this: You can buy weight belts that have slots for half-pound weights for a total of up to ten pounds. You can slip those half-pound weights in your pockets, bras, underwear, shoes, socks, etc. to compensate if you've lost "too much" weight pre-op. Theoretically speaking, of course. I would NEVER have done anything like that myself.

Throwing out another Protein shake idea -- I love GNC's Lean Shake 25 -- with 25 grams of protein and 170 calories. And it's lactose-free. If you get a GNC membership, you can get a discounted price on multiple cases of the shakes so they're less than $2 apiece. I love the Swiss chocolate flavored ones. Mmm - mmm! And yeah, fruit isn't what makes kids fat. (Apparently, a lotta docs get out of medical school without passing "Nutrition 101." Sheez.)