VSGAnn2014

Hi, Laffey. Ann

Are NUTs well educated about bariatric surgery? It's a worthy question to ask and to consider. Every once in a while I wander over to http://www.todaysdietitian.com/current_issue.shtml , "The Magazine for Nutrition Professionals" just to see what they're saying to each other about bariatric surgery. http://www.todaysdietitian.com/ And what they're saying pretty much sucks. The articles about bariatric surgery (when there are any, which is rare) are extremely superficial, cite old research, and pretty much read like Reader's Digest Lite. The advice the magazine recommends that nutritionists offer to post-op bariatric patients include jewels like these: Vitamin and mineral supplementation may be necessary; it's important to take personal responsibility for one's health; and (my favorite) reduce intake of high-calorie Desserts. Seriously?! Seriously?! Is it any wonder that bariatric patients -- or for that matter, anyone seeking useful, specific dietary and nutritional recommendations for weight loss and weight maintenance post-op -- could have any respect for these lightweights? BTW, I didn't choose the word "lightweights" as a joke. It turns out that one of the raging professional debates within the nutritionist world is whether or not a registered dietitian should offer her services as a consultant to patients if she herself is overweight. I f**king kid you not. You can read all about it here: http://www.todaysdietitian.com/newarchives/050114p32.shtml What some of these "professionals" think about overweight people in their own profession will blow your mind.

@@Sajijoma ... I just read a study last week that contradicts the bit bolded above. Check it out: This study was done by the same researchers who did last week's Obesity-published research that compared the metabolic rate changes between 13 of The Biggest Loser contestants vs. 13 RnY WLS patients. The WLS patients' metabolic rates dipped about half as low as TBL folks. And best of all, a year after surgery their metabolic rates came back to where they were pre-op. http://www.ncbi.nlm....es/PMC4236233/ http://www.ncbi.nlm....es/PMC4236233/ Admittedly, this is a single study. But it is at least directional, if not conclusive. And it's encouraging for me. FYI, I've lost 100 pounds and maintaining at 135 pounds while averaging 1700 - 1800 calories/day. Of course, I don't know if this will continue. I plan to keep weighing and tracking my food daily to find out.

@@AnnMcD ... If you are determined to feel like a failure, you are welcome to go there. But you're not. Seriously.

There's a strange attitude we see around BP and in other WLS circles among some who've had WLS that the only reason a WLS patient does NOT publicize their having had WLS is due to their "shame" about having had WLS. Aside from what you'd think would be a general acceptance by WLS patients of all other WLS patients' needs to handle their WLS journey the way that works best for them, this hassling we get from others -- whether they're other WLS patients, fatties, skinnies, concerned family and friends, assholes, trolls, whatever -- is something that many of us want to avoid completely. I'm one of those on the down low about WLS. There are people in my life who were / are ignorant of and critical of WLS. And I simply didn't want to hear about it. Any of it. So I just didn't tell 'em. That approach has worked fabulously for me. I have zero guilt or shame about my WLS. And I have zero guilt or shame about not telling others about my WLS. This journey has been incredibly successful for me. It has been so pleasant traveling this path without enduring catcalls from the peanut gallery or third-degree depositions by random acquaintances. Each of us should choose the path that works best for us. Keeping my WLS choice private has worked incredibly well for me.

I feel your pain. I really do. But think of it this way -- as wonderful as WLS is, and it is! -- in order to be successful long-term you are going to have to develop the muscles called "Delayed Gratification." Think of this period as exercising the s**t out of your Delayed Gratification. Pump that behavior! Pump that behavior!

These fluctuations are par for the course -- especially if you're doing everything by the book so early on. Really, do not worry about it. You should see my daily / weekly weight loss graph -- it looks like a drunken snail staggered down a very bumpy hill. Yet, in the end, I've lost 100 pounds and am maintaining easily at 135 pounds. There's a happy ending to these stories.

A little thread necrophilia -- it's 4 years old.

Damn, that really was good! Thanks, @@OKCPirate . Truly worth the watch time.

@@Babbs ... I know I would -- I just haven't had time to watch it today. Will try to watch it soon. I have it bookmarked. Thanks, @@OKCPirate . A.

Yup. Take it. Stomach acid doesn't stop being produced because you're drinking liquids.

Yeah, those old pictures that are shocking! Shocking! SHOCKING! I've run across a huge cache of pix from the past 15 years recently. And I honestly can't believe I was that huge. It's not even an "I hate those pictures!" reaction. I just simply can't fathom how big I was and how I managed to survive physically being so much larger than I am. Boy, we sure did put on blinders (in many ways) to survive those days.

@@nikki99 ... best to you. Thank you.

There actually are some good reasons not to be eating 800 calories at 9 months post-op (at least per my surgeon's practice). If you lose weight by instituting a very large caloric imbalance for months and months, your body will develop a lower metabolic rate and set point (compared to what your metabolism was like pre-op). As a result, you will wind up slimmer faster, but will have to eat much less to maintain than if you'd not lowered your calories so drastically to do so. If you haven't yet read the threads here about The Biggest Loser contestants' metabolic changes study published last week in Obesity magazine and reported last week in The New York Times, you might want to read about what the TBL contestants experienced. Also, see this post: http://www.bariatricpal.com/topic/367314-landmark-study-on-maintenance-%E2%80%93-what-do-you-think/?hl=%2Blandmark#entry4150753 Acknowledging that we all are told various things by our NUTs and surgical practice advisors, my surgical practice advised me that 800 cals/day was fine through Month 4 (after all, we can hardly eat more than that while our sleeves are still healing, eh?). But thereafter I was advised to eat 1,000 cals/day during Months 5-6 and 1,200 cals/day thereafter while losing weight. The reason given was, as stated above, to avoid coercing my body to maintain at a lower rate than I would have to during the maintenance phases. FYI, I've lost 100 pounds, am maintaining at 135 pounds, and am doing so (so far) at 1,700 - 1,800 cals/day. Caveat: There is a terrific range in which WLS patients of the same weight can eat to maintain their weights. I don't have a clue as to what all the independent variables are that affect this outcome. But you just have to find out what works best for you and accept it and do it. IMHO.

Nikki ... I don't understand what you're saying. Would you try again?

@@Man With No Answers ... your wife sounds like a keeper! LOL!

@@DrCollins -- yes! This is what I mean when I say "it is what it is." I honestly don't know how people can figure out what their maintenance menus should be unless they've done this kind of information collection and analysis to find out. My maintenance budget is much higher than yours. But again, it is what it is. And we move on from there.

Like many people here, I've also been divorced. I'll say one thing about relationship counseling -- no matter what you guys decide to do about the marriage, there's another relationship that will benefit just as much from counseling as rebuilding your marriage. And that's learning how to be sanely and undestructively divorced. (That sounds like something Gwyneth Paltrow said, although I don't think she did. ) A healthy divorce is just as deserving of the investment of therapy as a revived marriage. Plus, you've got a child you will both have to co-parent, whether you're married or divorced. And that co-parenting relationship is even more deserving of your therapy investment. Very best to your family -- whatever you all decide to do moving forward. P.S. Rant away.

@@Bluesky1 ... I just use the Caltrate brand -- 600 mg calcium + D3 (800 IU). But the best part is that it's a chewable chocolate truffle candy (15 cals). Here's a picture of the package: https://jet.com/product/detail/9c51e9300fbf47a8ac7c10238c51e714?jcmp=pla:ggl:gen_health_beauty_a3:health_care_fitness_nutrition_vitamins_supplements_a3_other:na:na:na:na:na:2&code=PLA15&ds_c=gen_health_beauty_a3&ds_cid&ds_ag=health_care_fitness_nutrition_vitamins_supplements_a3_other&product_id=9c51e9300fbf47a8ac7c10238c51e714&product_partition_id=165063968940&gclid=CjwKEAjw6sC5BRCogcaY_dKZ2nESJABsZihxr_Iz_0--SEmfqMVtuzOku566KHOl8aIZhTO_6cK3JRoCjh7w_wcB&gclsrc=aw.ds

How do I stay focused, you asked .... (BTW, I'm nearly 21 months post-op, have lost 100 pounds and am maintaining at 135 pounds.) Here are some things I do to keep my eye on the prize: 1. I weigh every morning and record my weight on MFP. 2. I plan and track all my daily menus using www.myfitnesspal.com . And when my eating diverges from my plan, I change my MFP data to reflect those changes. This really does help me focus. 3. I review my MFP stats via the Reports function, from time to time, to see how far I've come and to become aware of patterns and changes in patterns. 4. I see a therapist once a month about eating / self-care issues. This helps me continue to become and stay a lot healthier than I was several years ago. 5. I am active on a couple of online WLS forums and constantly learn from others who are traveling this path from their posts and the information they "bring to the table" here. Posting online also serves as a form of positive self-talk for me. 6. When I was losing weight I threw away ALL my big clothes as soon as they were too big for me to wear. Had never done that before. It was my way of burning my ships to remove the option of retreating. 7. I'm now friends (mostly online) with people who are also WLS patients, and these relationships feel very supportive to me. They're all quite positive people, by the way, and most of them are funny as can be. 8. Finally, my husband has been a great source of support for my WLS and recovery from obesity. He's just about the best booster I could hope for. He doesn't coach, he just acknowledges my healthier lifestyle and WLS accomplishments. EDIT: Whoops -- I just realized you were asking how to stay focused during the time of waiting for surgery to happen. So here are some things I did during that time: 1. Changed a lot of behaviors -- see #s 1, 2, 3, 4, 5, 7, 8 above. 2. Changed a lot of other behaviors -- dialed way down on the coffee, sodas and carbonated drinks, stopped drinking entirely 2.5 months pre-op, started to walk / move more than I had been before making the WLS decision, started eating a lot slower and chewing my food much better, put myself on a 1,400 calorie/day diet for 2 months because I was so crazed waiting for the WLS train to start rolling. 3. I also journaled a lot and made long lists of how my daily life would change and what I would do differently in terms of self-care post-op. I just visualized and visualized and visualized! Even though my motivations were mostly all health-related, I made lists of new clothes I would buy for myself and be able to wear when I reached my weight goal.

@@KindaFamiliar ... thank YOU for your contributions to science. Seriously. However, I am seriously disturbed at the news from @@meatpie 's Down Under pharmacist that face-tightening ingredients have been removed from arse cream. Which just goes illustrates that what once was true may no longer be true anymore. And that's some good science, too.

@@FabFatFish ... thank you for the ASMBS link. It's chock full of information I'd missed finding on ASMBS's site before. Seriously, folks -- whether you're pre-op or even long-term post-op, if you haven't read all this information you really should. Much of the information there describes the issues everyone grapples with during weight loss and weight maintenance. Thanks again.

GREAT post! GREAT GREAT post!

Alex, thanks for raising this topic. The study has been much discussed -- there are already two long threads on this article: http://www.bariatricpal.com/topic/366761-study-of-season-8-biggest-loser-contestants-re-weight-regain-causes/?hl=%20biggest%20%20loser http://www.bariatricpal.com/topic/366768-ny-times-article-on-weight-loss-metabolism-and-hunger-hormones/?hl=%2Bbiggest+%2Bloser But even more revelatory to me was learning about (thanks to @@Sylvia13 ) another study (done by the same researchers who did last week's Obesity-published research) that compared the metabolic rate changes between 13 of The Biggest Loser contestants vs. 13 RnY WLS patients. The WLS patients' metabolic rates dipped about half as low as TBL folks. And best of all, a year after surgery their metabolic rates came back to where they were pre-op. Here's the link to this second study: http://www.ncbi.nlm....es/PMC4236233/

IMHO, unless you have some odd post-op complications, you should be good to cruise 3 months post-op. Just make good choices, which you can do at that point, since you'll be on real food. Protein. Protein first. Veggies and a little fruit (by that point). Lots of Water.