Debra_Awes

Great info! Thanks Irene!

WLS Do’s and Don’ts

DO remove the word ONLY from your vocabulary. Ex: I’ve ONLY lost 10 Lbs in 2 weeks… Now let’s look at this again without the word ONLY: I’ve lost 10 Lbs in 2 weeks!! See what I mean? Perception is reality folks!!

DON’T assume you’ll never eat all of your favorite foods again. This is just an excuse your brain has designed to allow you to indulge. You WILL eat all your favorites again someday, just much less but find it to me more enjoyable. Which leads directly into the next:

DON’T do the “last meal” syndrome. You will only sabotage your weight loss you might have pre-surgery or set you back further from your ultimate goal post-op. This surgery is very serious and is for the serious minded. Use this time wisely to get the feeling of how life might be like post op.

DO learn all of the rules pre-op that you will endure post-op. Such as, no drinking with meals, using smaller utensils and plates, engaging in some type of workout routine, limiting your sugar and sodium intake, joining as many WLS support groups as you can.

DO Celebrate every single pound lost! Imagine one pound of butter. Yeah… that’s gone from your body forever. It is noteworthy and worth every bit of a pat on the back as any others that may go along with it.

DON’T compare your successes and losses to others. Chances are very high that you will only come out on the short end and only find yourself disappointed. Everyone’s journeys are their own…

DO keep track of your losses in many different ways than just the scale! Examples:

DO keep one set of your largest clothes you’ve ever worn. Make it a point to try them on, especially when you’re having a down moment. You will find this will really pick up your spirits! This is a real rollercoaster of a ride, and anything that will keep you positive is what you should do!

DON'T keep any other fat clothes around. Get rid of them ASAP. You're never going to fit them again, right? So... off to donations they go.

DO take photos of yourself just before your surgery. Keep them close. Again, having a bad day? Look at them and compare them. As a matter of fact, take photos of yourself often. You will also find that the more you lose, the more you will want to take pictures. Nothing wrong with that!!! That goes with celebrating your losses.

DO take measurements of yourself often. Keeping track of all your inches lost will really keep you on the right track when your scale is being stubborn!!

DO reward yourself every time you hit a mini goal. Make some more worthy than others. I like to go shopping when I hit a goal, it is my favorite thing to do now.

DON’T let the scale define you. Great majority of us will endure many fluctuations and stalls in this journey. It is what it is… patience is the key here. Meditate and envision yourself months down the road at your goal. Smile, then move on!!

DO find out about measuring body fat! It’s more than just weight loss, FAT LOSS is the real goal here. Keep in mind that the BMI scale is greatly inaccurate and most Health Studies do prove this. According to the American Council on Exercise (ACE) our body fat % ranges should be average: 25-31% for Women and 18-24% for men. Any higher is considered obese. However it does go more in depth, according to ages and more. Everyone has different genetic make ups, frame sizes and fitness levels... even a different ethnicity can post differences.

DO have many goals in sight. Having only one, especially a simple weight goal you will find can be difficult. Have many MINI goals along your journey, and more than just ones that involve the scale. Such as, clothing size goals, body fat% goals, fitness or workout goals, dietary goals, etc…

DO challenge yourself always!! Whether it’s a global challenge with others, or personal challenges... It will keep you motivated and always willing to go further than you ever thought you could!

DO have a mentor! Find someone that you can trust and confide in, and that you know has “been there”. Preferably someone you know in person. You will find many folks in your life who have been there, for obesity is worldwide now and there are so many who have been able to defeat this demon. It’s not easy! It quite literally is the toughest feat I’ve ever had to endure. I can say this too, my job will never be done. This is for life!
DON'T believe the myth that your tool has an expiration date. Yes, it's true you will lose the most weight in the first year and it's also true that the further out you are and the closer you are to goal, the harder it is to lose. However, as long as you keep up with your healthy eating and fitness routines you will continue to lose weight and / or keep it off in the many years post op. It all boils down to calories in vs. calories out.
DON'T believe the myth that having WLS will keep the weight off forever. That is our individual responsibility.

And finally…

DON’T ever beat yourself up! We all make mistakes, and dare I say not one person on this Earth is perfect. I try hard to be, no doubt! I always admit that I’m a perfectionist – but I’m far from perfect. I just try to be… The only thing you can do is pick yourself up, give yourself a pep talk, perhaps contact your mentor for reassurance and move on!!! Again, this is for life. Every day you wake up is a second chance.

DO look for solutions to your problems. Otherwise they will just become excuses.


DON’T EVER GIVE UP! I don’t think any explanation is necessary here.

DON'T expect the scale to post a loss every single day. As a matter of fact, don't expect it to move that much even weekly! Just keep doing all the right things and the scale will move in the right direction when it needs to.

DO expect to see fluctuations on the scale, both down AND up. DON'T lose your head over it either. This isn't a miracle cure and the weight isn't going to magically disappear in a few weeks. You have to keep pushing with healthy eating, some type of workout and getting plenty of Fluid.

DON'T let the scale define your journey when there are so many pieces to that puzzle!!!



Good luck to all of you. This journey is a tough one, but if you are here, then you believed in yourself enough to give yourself the life you’ve always dreamed of. YOU WILL BE successful. Always keep that in mind.

Add-ons by other experienced sleevers:

DO keep a list of NSV (Non scale victories) to reflect on when times are getting hard. Can you walk up 2 extra flights of stairs before getting winded? Cross your legs?" and

"DO NOT be afraid to change things if they aren't working. Stalls happen even gains happen. If you are on a long stall look at your eating and decided if changes need to be made. Utilize your tool!" -- Southern Sleever

DO: Keep a food diary of what you eat and drink. This is a great learning tool as to which foods have what amounts of fat, Protein and carbs that add up to your daily intake goals. There are many ways to diary your food - from old fashioned pen and notebook to many options via smartphone apps. Keeping one is the important thing - however is right for you. I use mine now to look back for meal ideas when I hit a blank as to what to prepare for a day or a week.

DO: Realize this is not a diet to be followed for a while then set aside. This is a permanent lifestyle change. Yes, the amount of food you eat will increase as time passes, but your relationship with food will be forever altered. How you Celebrate your joys, successes and holidays will be different. How you mourn your sorrows will be different. Some people need outside help to get through the sometimes overwhelming mental changes this process brings. If you need help with this part of the deal- reach out and get it. -- SKCUNNINGHAM

DO roll with the punches!! -- fern

Hi everyone!
Posting my conversations in this blog now ... T-minus 2 days!!! So excited.

Interesting and certainly less invasive then most WLSs. An 8.3% improvement over the control group is significant. Let's hope it works in the long run.

I just heard about this last night and I, for one, am VERY interested!
While Medicare covers WLS and more recently Obesity Counseling, it specifically exclude by matter of law weight loss medications.
It will be interesting to see whether or not Maestro ends up getting covered.
If it does, I think I would prefer this route, at least initially, to lose weight. I have a BMI of over 60 so getting approved for surgery is extremely easy. However, the idea of permanent malabsorption. with the possibility for malnutrition, from a RNY gives me pause. Maestro promises faster weight loss than diet and exercise alone, without the complications of rerouting the GI tract.

Great news that there is another option to help people I this struggle. Because of its less invasive nature perhaps someday the threshold will get lowered to BMI of 30 and the comorbidity at 35 (and then 30) taken away. 8.5% difference is much better but once 35-45 BMI may need actual WLS to get more significant results. I am not sure if this would have been enough for me as I never needed to be hungry to eat. But perhaps it makes people like I was just after sleeve when I never thought about food at all not just the lack of hunger. (Unfortunate that was temporary for me!)
In any case glad there's another option and it will be out there for those struggling.

Here's news released today by the FDA:
FDA approves first-of-kind device to treat obesity

The U.S. food and Drug Administration today approved the Maestro Rechargeable System for certain obese adults, the first weight loss treatment device that targets the nerve pathway between the brain and the stomach that controls feelings of hunger and fullness.
The Maestro Rechargeable System, the first FDA-approved obesity device since 2007, is approved to treat patients aged 18 and older who have not been able to lose weight with a weight loss program, and who have a body mass index of 35 to 45 with at least one other obesity-related condition, such as type 2 diabetes.
BMI, which measures body fat based on an individual’s weight and height, is used to define the obesity categories. According to the Centers for Disease Control and Prevention, more than one-third of all U.S. adults are obese, and people with obesity are at increased risk of heart disease, stroke, type 2 diabetes and certain kinds of cancer.
“Obesity and its related medical conditions are major public health problems,” said William Maisel, M.D., M.P.H., deputy director for science and chief scientist in the FDA’s Center for Devices and Radiological Health. “Medical devices can help physicians and patients to develop comprehensive obesity treatment plans.”
The Maestro Rechargeable System consists of a rechargeable electrical pulse generator, wire leads and electrodes implanted surgically into the abdomen. It works by sending intermittent electrical pulses to the trunks in the abdominal vagus nerve, which is involved in regulating stomach emptying and signaling to the brain that the stomach feels empty or full. Although it is known that the electric stimulation blocks nerve activity between the brain and the stomach, the specific mechanisms for weight loss due to use of the device are unknown.
External controllers allow the patient to charge the device and allow health care professionals to adjust the device’s settings in order to provide optimal therapy with minimal side effects.
The safety and effectiveness of the Maestro Rechargeable System were evaluated in a clinical trial that included 233 patients with a BMI of 35 or greater. The weight loss and adverse events of 157 patients who received the active Maestro device (the experimental group) were compared to 76 patients in the control group who received a Maestro electrical pulse generator that was not activated. The study found that after 12 months, the experimental group lost 8.5 percent more of its excess weight than the control group. About half (52.5 percent) of the patients in the experimental group lost at least 20 percent of their excess weight, and 38.3 percent of patients in the experimental group lost at least 25 percent of their excess weight.
The clinical study did not meet its original endpoint, which was that the experimental group lose at least 10 percent more excess weight than the control group. However, an FDA Advisory Committee (the Gastroenterology and Urology Devices Panel) found the 18-month data supportive of sustained weight loss, and agreed that the benefits of the device outweighed the risks for use in patients who met the criteria in the device’s proposed indication.
In considering the benefits and risks of the device in its review of the Maestro Rechargeable System, the FDA considered the clinical study and the Panel’s recommendations. Additionally, the Agency looked at an FDA-sponsored survey relating to patient preferences of obesity devices that showed a group of patients would accept risks associated with this surgically implanted device for the amounts of weight loss expected to be provided by the device.
As part of the approval, the manufacturer must conduct a five year post approval study that will follow at least 100 patients and collect additional safety and effectiveness data including weight loss, adverse events, surgical revisions and explants and changes in obesity-related conditions.
Serious adverse events reported in the clinical study included nausea, pain at the neuroregulator site, vomiting, as well as surgical complications. Other adverse events included pain, heartburn, problems swallowing, belching, mild nausea and chest pain.
The Maestro Rechargeable System is manufactured by EnteroMedics of St. Paul, Minnesota.
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
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