Barry W

Male size here, basically waistline - I don't know my initial waistline, but I started at 46 pants with elastic waist which expanded to as much as 50, and am now wearing a 42. Hope to eventually get down to a 38 or a 36. Need to take what my body will give me though...

I use Splenda and since I don't like my coffee real sweet, use only half a bag per mug. Am not worried about that.

I have had some snack foods starting at about 6 weeks out. But, I make sure to: - buy them rarely - buy whole grain/high Fiber - buy a small package I also normally look at the # portions and calories per portion and multiply to reckon the total calories in the package. If your "fun food" package has 1500 calories, it's hard to work that into any diet without creating problems.

I am probably causing more confusion than I am clearing up. I did find a nice diagram online from the prestigious journal Nature Endocrinology and Metabolism It shows the relationship between ghrelin, leptin, and neuropeptide Y. You can see that ghrelin is secreted primarily by the stomach and leptin primarily by fat cells. They both act through the hypothalmus to affect neuropeptide Y activity - and ghrelin up-regulates neuropeptide Y while leptin down-regulates it. There is more to the whole story than this picture, but this is a great summary of these players. http://www.nature.com/nrendo/journal/v2/n2/fig_tab/ncpendmet0080_F3.html

You're right, it's not just leptin, insulin plays a role, and so do ghrelin and neuropeptide Y - there are a whole suite of hormones that affect hunger, satiety, metabolism and energy homeostasis. The way that I think about it is that eating and maintaining weight are so important, that you have all kinds of systems that evolved so that you don't have to *think* to eat, you *feel* you must eat and have a powerful drive to do so. Any organism that doesn't have this will go extinct very quickly! The trouble is that these mechanisms that ensure survival in the short term, don't necessarily function ideally in every individual, especially in the long term, and they can work against best health. A lot is known, but there are still a lot of questions to answer, and the system is complex, depending on genetics, and having crosstalk between different components, and then you have hormonal resistance that can develop (as in insulin and leptin), so unfortunately there is no simple rule like "If you do X, then Y will happen". The role of leptin in hunger was first discovered in the early 1990s, and a lot of pharma and biotech researchers were very excited, thinking that all they'd need to do is to teach microbes how to make leptin with their newfound bioengineering methods, and they'd all get rich giving fat people leptin injections to make them nice and svelte. Unfortunately, it wasn't that simple. They learned that fat people were usually leptin resistiant, and there were other mechanisms at work too.

You can also try the PatchMD Multivitamin patch, or just try to eat a continually varying spectrum of fruits and vegetables every day.

Yes, I noticed confusion as well as straight up malfunction. The latter was most obvious. I was trying to speak, and the wrong word came out of my mouth to express a concept, and I couldn't stop that from happening in the same discussion - same wrong word kept coming out. My colleagues were even laughing. It was really odd. That had never happened in my life before, but it was happening now. Fortunately, that has passed, but I'd say it took at least 8 weeks after surgery for me to feel cognitively strong, and I am now 10 weeks out, and I am still not sure if I am 100% as sharp as I was going in.

I have not even looked at this book, so I say nothing against it, but I have a similar general instinct about using caution with books on weight loss for the lay public - I think there is a lot of bad information out there. Bad info can actually be worse than no info.

Well, I think an equal number of people may complain about lack of energy :-) If that is a problem, I'd ask: - are you sure you're getting enough Vitamins in your diet? - are you just eating too little? - are you getting regular exercise? - are you over-exercising? ..those are some likely suspects anyway....

I don't know what equipment you have, but a basic regimen I am using at the gym now that I have recently started going back is: - curls (bicep) - either lat pulldowns (bicep/trapezius/lats) or rows (bicep/trapezius) - bench press (shoulders and pecs) - fly (shoulders and pecs) - military press (shoulders and triceps) or tricep extension (triceps) - leg extensions (quads) - leg curls (hamstrings) - leg adbduction (hips/butt) - leg adduction (hips/inner thigh) - toe raises (calves) at 3 positions of foot alignment - abdominal curl/crunch in machine (abs) - abdominal extension in machine (lower back) From the mat: - leg raises (abs) - crunches (abs) - side leg raises (butt and thigh) - supine trunk twisting w/bent legs (lower back flexibility) - standing trunk twisting (lower back flexibility) - toe (or as far as you can go ) touching (lower back and hamstring flexibility) - overhead stretch (upper back and shoulder flexibility) Not saying that you need to do these things, there are lots of options, but this covers the body fairly well and gives some muscle work as well as flexibility work. I am older - 56, and I spent 15 years as a young man reading about and doing weightlifting, and another thing I'd suggest is that while muscleheads and trainers, especially young ones say "no-pain/no-gain!" and also advise one to choose a heavier weight allowing you to do no more than 8 reps to build maximum strength.... if you are older, maybe dealing with some injuries, aren't that flexible, or just haven't been exercising, I would say absolutely do not do that. Choosing a weight that allows you to do 15-20 reps before exhaustion will still allow you to build strength and build muscles, but (1) you'll have more endurance, which is helpful in practical situations, and (2) your likelihood of herniating or tearing a muscle, or tearing or even snapping a tendon, will be a lot lower too. The pain of lactic acid burn is one thing, but the pain of an injury is something else.

I am about 10 weeks out, and I eat about 1200 calories per day. I need to repeat the food diary for a few days to check to get a more precise answer. My weight loss stalled for about 4 weeks, and I recently added a few hundred calories, and that seemed to actually restart weight loss. I have no plans to go under 1000 calories again.

Some of my favorite breakfast foods: Quaker Organic Instant Oatmeal with Wyman's of Maine frozen Wild Blueberies Post Shredded Wheat & Bran Cereal with Simply Smart Fat-Free milk Arnold Extra Grainy toast with Peanut Butter & Co chunky peanut butter Jimmy Dean Delights Applewood chicken Sausage, Egg Whites and cheese Muffin Sandwiches (250cals!) Chobani lemon, lime or black cherry Greek yogurt A banana or an apple

Walking is really one of the best exercises because it brings big benefits, with low risk of acute or chronic injury, it can be done anywhere without needing to waste time traveling to the site, and you don't need much equipment, just quality, comfortable shoes. Also very good are cycling and swimming. Both smooth motions with low injury potential, and can be done in endurance, sprint or mixed modes. If you're going to use specialized exercises in the gym, I'd only say to be sure you hit all the major muscle groups a little bit - do just one set of each of a variety of exercises, making sure you hit both biceps and triceps, shoulders and chest, quadriceps and hamstrings, calves, and then trunk/core. I was advised to avoid any exercises stressing the abs for at least 6 weeks though.

I don't count carbs. But I avoid sweets entirely, and I avoid these starches: white rice, potatoes, corn, white bread, ordinary Pasta, crackers and chips. I do eat legumes like black & kidney Beans, edamame and chickpeas a few times per week, 1 piece of fruit per day, and 1 portion a day of whole grain bread or low sugar whole grain cold Cereal or low sugar hot oatmeal.

Here are a few resources I found helpful: "The Physiology of Body Weight Regulation: Are We Too Efficient for Our Own Good?" http://spectrum.diabetesjournals.org/content/20/3/166.full "Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight" http://ajcn.nutrition.org/content/88/4/906.long "After 'The Biggest Loser', their bodies fought to regain weight" http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=0 The physiological mechanisms of regulation of body weight - how they work and how they are altered, is still a very active area of research. Sadly most people, even most doctors, aren't well versed on this subject.

At some level it is still true that (calories in) - (calories out) is proportional to your weight loss. What happens though, is that (calories out) doesn't stay constant. This quantity, or more precisely, resting metabolic rate, tends to go down as your weight goes down. The body has a physiological tendency to try to remain at an equilibrium point, and this includes not only body temperature, but also body weight. The equilibrium weight value is often referred to as the "set point", which comes from engineering - control theory. I have been reading the scientific literature on this the past couple of weeks, as my metabolism has clearly slowed down. Apparently it was first reported decades ago, but whether this even happened was at first muddled by conflicting studies. Unfortunately, there doesn't appear to be a great deal of clarity around what to do about it. A number of studies suggest that slow, steady weight loss is better in this regard than large, rapid weight loss. The other point that I think is pretty well established is that for people who have really lowered their resting metabolic rate, this can persist for a long time - years, and perhaps indefinitely. Hormone levels associated with hunger are also altered. In particular leptin, which makes you feel satisfied, decreases with weight loss. A recent well publicized study of the participants on The Biggest Loser, who experience both large and rapid weight loss, found that their resting metabolic rate and their leptin levels were both significantly lower, 6 years later, than would be expected, which explained why nearly all of them had regained their weight. Of course, that is not the same as bariatric surgery, but it's not completely independent either. It's an extreme form of what we can run into. Learning about these things is why I have decided not to push harder, using ever lower calories or ever higher exercise, to try to maintain my rate of weight loss. I don't want to wreck my metabolism. I am eating roughly 1200 calories a day, and if things stall, then they stall. 1200 calories is already quite low for a 6 foot man. I may even bump it up a bit to 1400, but I won't go down further.

I didn't like the Premiere Protein shakes - got a small case with 3 of each flavor, meh! I prefer SlimFast High Protein/Advanced Formula, Pure Protein, or Muscle Milk. These may be the ones you're describing as "chalky", but I guess tastes vary!

This morning I weighed 238lb. My high weight was 295lb. I was down to 267lb on the day of surgery, and so have lost about equal amounts before and after so far. I started dieting a little before New Year's day, and am about 10 weeks post-op now. Weight loss has really slowed these past 4 weeks. I have been reading about metabolic adaptations to weight loss though, and am not inclined to try to push harder by eating next to nothing or exercising crazy amounts - I will just be content as long as I stay the same or decrease, without worrying about the speed.

I've been wearing the multivitamin since surgery. Haven't had any major issues with fatigue like many report. I have also been using Protein shakes with Vitamins and minerals in them, and eating a variety of fruits and veggies though, so hard to know if I should give all credit to the patch.

This may sound too obvious, but don't think about it! If I think about pizza, pork sausage, a thick burger, etc, I will be craving them every time, but I mentally "change the channel" any time those thoughts come into my head.

I addition to Vitamins, I think mild hypogylcemia (low blood sugar) could be a factor here. I am not saying to eat snickers bars, but make sure you are eating enough, and some healthy carbs, those with soluble Fiber - i,e, fruits, legumes, and low sugar oatmeal, will give a dose of carbs, but absorbed gradually, spread out over time instead of a sudden sharp spike.

You are a star, congratulations! :-)

I think everyone's experience varies. Could I have gone back to work after one week? Yes. Would that have been easy? No.

I took two weeks off to recover from surgery, and the first week back at work, I didn't jump into long days at work, I worked two 1/2 days and then three 3/4 days, kind of "off-the-books" but agreed with my boss. I still wouldn't say it was "a breeze, you're fine in two days", as one guy here apparently experienced, but as it was handled, I made it through without any drama. I can't speak to short-term insulin fluctuations but I am sure that you know that the weight loss associated with bariatric surgery has a high likelihood of improving Type 2 diabetes over the first year, so big picture, this is the thing to do.

Avoid carbs like the plague - no sugars and no starches, and you will be less hungry. Make sure the shakes have 1/3 the RDA of Vitamins and minerals, or take a good Multivitamin.