Barry W

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.

Great news :-) Glad to hear that you are feeling improvements in your comfort and well being. Based on my own experience, I think there will still be bumps in the road here and there, but that overall you will be feeling better and better in the coming weeks....

Don't set up a pattern where you are vomiting after eating chicken. This will create an association in your brain such that the taste and even smell, can make you nauseous. Skinless chicken breast is one of the healthiest Protein sources going, so you don't want to have to quit it "cold turkey".

Regarding exercise, it doesn't need to be a long, grueling workout. Just go for daily walks, and start small and gradually lengthen them.
Regarding the alcohol, I'd suggest seeking out a support group or counselor.

Yes, cold cuts are processed meats, especially stuff like bacon, sausage, bologna, hot dogs, salami... these are considered unhealthy for all people, not just post op bariatric surgery patients. I think that a few cold cuts, like turkey breast, are much less manipulated and have fewer nitrites and salts....
On whole grain bread, you can alternatively use tuna salad, reduced fat cheese, or Peanut Butter as healthier alternatives.

Regarding exercise, it doesn't need to be a long, grueling workout. Just go for daily walks, and start small and gradually lengthen them.
Regarding the alcohol, I'd suggest seeking out a support group or counselor.

My advice?
Stay off the scale.
Follow your program.
Track your food.
Focus on getting in at least 64 oz of Fluid a day and reaching your Protein target.
Avoid added sugars (especially high fructose corn syrup), starches and fried foods.
Exercise when cleared.
Practice eating mindfully, eating slowly, taking small bites, and chewing thoroughly.
Did I mention staying off the scale?

There are a lot of anti-carb evangelists out there. As to carbs being of zero biological value (and only being a negative), I would direct people to look at research articles looking at epidemiological findings of diet components of whole grains. For example, this one entitled "Consumption of whole grains and Cereal Fiber and total and cause-specific mortality: prospective analysis of 367,442 individuals".
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371798/
...which states "Consumption of whole grains were inversely associated with risk of all-cause mortality"... you will find similar findings from MD/PhD Walter Willett of Harvard, who manages the large multi-decade Nurses Health Study.
All carbs are not alike. Those foods containing substantial nutrients and Fiber with them can be beneficial. Not saying you should eat HUGE amounts of multigrain bread, fruit or legumes - all healthy carb-containing foods, but studies show that in moderate amounts, they are beneficial. People can do whatever they like, but my opinion on carbs is that one should not throw the baby out with the bathwater.

I had the same problem, think that's normal. You're just going to have to sleep the best you can on your back for a little while. As I recall, first I could only lie on my back comfortably, then on my side, and finally on my stomach. I don't recall exactly, but I think it was 4-6 weeks before I was really comfortable lying on my stomach again.

I am a chemist and I think there is an awful lot of bad information out there that can be confusing for both lay people and health care workers alike. If you don't have confidence in your nutritionist I wouldn't hesitate to find someone else to advise you. Also, once you get past the special restrictions of the first 2-3 months, you should basically be following the same nutritional advice as everyone else - lots of fresh fruits and vegetables, emphasizing fish, skinless turkey and chicken for Protein, plenty of legumes, and moderate amounts of healthy (fiber-rich) whole grain carbs, along with Portion Control to keep your weight moving down.

I am a chemist and I think there is an awful lot of bad information out there that can be confusing for both lay people and health care workers alike. If you don't have confidence in your nutritionist I wouldn't hesitate to find someone else to advise you. Also, once you get past the special restrictions of the first 2-3 months, you should basically be following the same nutritional advice as everyone else - lots of fresh fruits and vegetables, emphasizing fish, skinless turkey and chicken for Protein, plenty of legumes, and moderate amounts of healthy (fiber-rich) whole grain carbs, along with Portion Control to keep your weight moving down.

I am a chemist and I think there is an awful lot of bad information out there that can be confusing for both lay people and health care workers alike. If you don't have confidence in your nutritionist I wouldn't hesitate to find someone else to advise you. Also, once you get past the special restrictions of the first 2-3 months, you should basically be following the same nutritional advice as everyone else - lots of fresh fruits and vegetables, emphasizing fish, skinless turkey and chicken for Protein, plenty of legumes, and moderate amounts of healthy (fiber-rich) whole grain carbs, along with Portion Control to keep your weight moving down.

I am a chemist and I think there is an awful lot of bad information out there that can be confusing for both lay people and health care workers alike. If you don't have confidence in your nutritionist I wouldn't hesitate to find someone else to advise you. Also, once you get past the special restrictions of the first 2-3 months, you should basically be following the same nutritional advice as everyone else - lots of fresh fruits and vegetables, emphasizing fish, skinless turkey and chicken for Protein, plenty of legumes, and moderate amounts of healthy (fiber-rich) whole grain carbs, along with Portion Control to keep your weight moving down.

The first couple of weeks are were pretty rough for me, but then things got better day by day. Your body has to make many adjustments and so does your mind. Stay positive and do your part and good things will happen over time...

Progress has been very slow these past few months, but I am down to 228lb, and I see that I have just ducked under the bar for the obese category - very psyched!
Spent the past week at the beach in NC with family, and for once in recent years, didn't feel ashamed of my body. Also got in a lot of good exercise walking and bodysurfing, feel a little more spring in my step after all that activity

The first couple of weeks are were pretty rough for me, but then things got better day by day. Your body has to make many adjustments and so does your mind. Stay positive and do your part and good things will happen over time...

Progress has been very slow these past few months, but I am down to 228lb, and I see that I have just ducked under the bar for the obese category - very psyched!
Spent the past week at the beach in NC with family, and for once in recent years, didn't feel ashamed of my body. Also got in a lot of good exercise walking and bodysurfing, feel a little more spring in my step after all that activity

Progress has been very slow these past few months, but I am down to 228lb, and I see that I have just ducked under the bar for the obese category - very psyched!
Spent the past week at the beach in NC with family, and for once in recent years, didn't feel ashamed of my body. Also got in a lot of good exercise walking and bodysurfing, feel a little more spring in my step after all that activity

Progress has been very slow these past few months, but I am down to 228lb, and I see that I have just ducked under the bar for the obese category - very psyched!
Spent the past week at the beach in NC with family, and for once in recent years, didn't feel ashamed of my body. Also got in a lot of good exercise walking and bodysurfing, feel a little more spring in my step after all that activity

Progress has been very slow these past few months, but I am down to 228lb, and I see that I have just ducked under the bar for the obese category - very psyched!
Spent the past week at the beach in NC with family, and for once in recent years, didn't feel ashamed of my body. Also got in a lot of good exercise walking and bodysurfing, feel a little more spring in my step after all that activity

I am almost 6 months post-op, and have had iced tea from a cup when out probably a dozen times and drank it from a straw, no problems for me. Mebbe I have good straw technique?

In terms of eating, some things I do that I think are helpful are:
I try to minimize carbs that don't have good Fiber - stick mainly with whole grain breads and cereals, fruits, and legumes in the carb category - sugars and simple starches can make you hungrier, in addition to being less healthy I do try to eat with good variety, not just chicken breast and broccoli 24x7, I mix it up, try new things, like making my own smoothies, or trying the par-boiled farro and bulgur grains that Trader Joe's sells, a recipe for seared lemon-pepper fish filet... I do allow myself some fun foods, but they are rarely "the full monty", for example I might have a frozen yogurt bar, some whole grain crackers with guacamole, a small veggie pizza with whole grain crust Mentally speaking, if I find myself thinking of a big slab of blueberry pie with vanilla ice cream, or a large pizza with pepperoni and sausage and extra cheese... I "change the channel" mentally, quick!

Awesome job, Tony!

I eat a lot of salads, mostly the prepared leafy salads from Trader Joe's, as a low-calorie, healthy lunch. I enjoy them. Most of them have some skinless chicken breast or soybeans in them for Protein, but I also really like their curried cauliflower and kale salad.
I also eat a fair number of the prepared legume salads - black bean, chickpea, and edamame, from Cedar's for lunch - good low cal Protein and oodles of soluble Fiber.