summerset

Nah, the feeling of really low blood sugar is some trembling hands, being sweaty and being able to kill for some instant sugar. It's gone within a few minutes. It's majorly annoying when it wakes you up.

Salad bowl with Moroccan cornbread.

Hmmmmmmmmmm, are you sure it's head hunger and not more subtle hunger signals than you're used to? Also what exactly do you mean by "eating a lot"? When you take a look at your intake from an outside-WLS point of view: would it still be seen as a lot? Views on portions sizes are quite often pretty warped in the WLS universe, same with the amount of calories people refer to as "a lot", that's why I'm asking. Your BMI is about 26-27 if I calculated that correctly (sorry, metric girl here). It's harder to tolerate a caloric deficit the lower your weight is. I became pretty much intolerant to a calorie deficit myself and I definitely would be f*cking starving on what some people on here refer to as "a lot of food". I'm maintaining at a BMI of 23 but I agree: sometimes it feels indeed a bit scary.

Meh, I usually only get the shakes when I eat too much sugar and alcohol is involved. My liver having to break down glycogen for stabilizing blood sugar while having to activate alcohol dehydrogenase at the same time doesn't seem to like that. And now guess what combo I had today, lol. I don't seem to learn that lesson, too, but I'm prepared to experience the late dumping and don't do that kind of thing in the evenings but at noon or early afternoon so I get any adverse reactions during the (early) evening and can react accordingly.

Anything with dairy in it I used to like and doesn't have a non-dairy substitute I like. The non-dairy substitutes of cheese e. g. are just awful tasting to me with the exception of cream cheese spreads. Sometimes I crave my grandmother's "Frikadellen" - though even if they would be available now I most likely wouldn't eat them because meat. I wish there was a decent vegan substitute for tuna to eat once in a while. (Unfortunately chickpeas don't do it for me.)

That's indeed very good news.

Boring stuff today. Mixed fruit, red and yellow bell pepper. Will get something at the cafeteria today.

That's the fake salmon I talked about. Whipped up a honey mustard sauce and made a sandwich kind of thing.

Portion sizes must be big enough to meet nutritional needs during the feeding window. Early out that's most likely going to be a problem.

Garden Gourmet Falafel with self-made tzatziki.

Comfort food after 24 h shift.

Welcome! 😁

Not really. I'm cold when I'm getting tired in the evening and sometimes in winter during the fasting window.

This is true and I wish treatment teams would be more flexible when it comes to the care of their patients because a guideline is different from a fixed rule you have to follow. Albeit they're often treated as such, especially by patients and inexperienced clinicians ("but the guideline says..." - I'm not able to count how many times I've heard this). However, in the end an evidence-based guideline is only as good and reliable as the people who're involved creating them, the processes that are used to get to an agreement and as good and reliable as the studies they are deciding they're going to use (again: cui bono? much too often for my taste). Making myself this clear after being very into EBM for quite a long time was quite sobering. I tend to take guidelines, systematic reviews etc. with a grain of salt long since. Given the fact that many clinics have their own in-house guidelines for something. Usually these in-house guidelines are in reality SOPs but for many this doesn't make a difference and it's kind of annoying a lot of the time. Yes, hijacking threads is annoying. My apologies as well.

If there are many, there isn't obviously a best one because if there would be a best one, there wouldn't be many. Guidelines differ, evidence-based or not, depending on what studies are included or not. If one wants to cherrypick studies in one direction it's always possible. There are also too many unpublished studies rotting away in desks because the results were not the desired ones (that might be more of a problem when it comes to drug therapy though). Crappy study designs. Sky-high drop-out rates and having to rely on self-reporting (that seems to be a big problem in the weight loss field). Thats why I lost quite a bit of trust and belief in EBM over the years. There's also always the question of "Cui bono?" hovering and the principle of "publish or vanish". Bonus icing on the cake: whenever I read a study about nutrition, behavior, psychological or environmental factors that might have impact on losing and maintaining weight (or not for that matter) one term at the end of the discussion almost always seems to catch my eyes: "needs further evaluation". What's a clinician supposed to do with that? Wait and see or change treatment protocol? What I said. And that's where this whole guideline and rules thing seems to go out the window. In the end it boils down to trial and error for the patient and I wish treatment teams would admit to this and therefore being more flexible in their approaches instead of practicing a one-fits-them-all approach. The clinicians I know usually want to have trustworthy diagnostic tools and effective treatments they can offer their patients. Nothing more frustrating than not coming to a proper diagnosis and being able to offer effective treatment. Most likely they do and that's why there is so much eminence-based treatment out there, hence the difference between recommended diet protocols after WLS.

While I agree with this in general I also hold the opinion that there don't seem to be really that much evidence-based treatment guidelines around. Most of the stuff seem to be more eminence-based instead. If there would be really evidence-based guidelines out there about what treatment protocol provides the best outcome possible then why do e. g. days of planned hospital stay, peri-operative eating guidelines and longterm diet protocols vary that much, not only from country to country but also from treatment center to treatment center? The only reason I can think of is that there is no evidence-based best protocol out there yet (and honestly, I doubt there will ever be).

Oh, don't be fooled! 🤣 It doesn't taste anything like Lebkuchen/Spekulatius at all. It's too heavy on the aniseed for that - some people reviewing it compare it more to "Pfeffernüsse" and I agree. I personally think it's absolutely undrinkable on it's own but it adds a really nice flavor to a chocolate protein shake when used sparingly. I'm thinking of trying the Pumpkin Spice one next time. I already had this idea a while ago. Unfortunately only the same limited selection of products one can get in Germany. Oh, well...

True. There will always be a-holes and batshit crazy zealots around. I absolutely hate what the above mentioned idiots have done to both the fat acceptance and HAES movement.

Meh, I'm really craving Gulasch these days. Have to find a recipe for it that's vegan.

I had some fake chicken that had to go but was more in the mood for bean pasta with something-tomato. So there it is: tomato sauce, fennel, red bell pepper, the chicken and cashewsan on bean fettuccine.

Honestly I'm on the fence with this one. I've seen unhealthy eating and/or exercise behavior promoted often enough on WLS boards or weight loss boards in general. Support groups, be it one IRL or an online one can be very helpful. However, they can also be highly toxic environments. People seeking support should be aware of their own inner reactions and act accordingly. I for sure do. Ever seen how the reactions to these posts are? Way too often plain smug, arrogant and downright insensitive. Who would want to talk about struggling and regain in such an environment? Not me.

I'm also still frustrated with my body and I can't think of a person I know (be it a woman or a man) who isn't to some degree. It runs rampant in our society. One has to learn to live with imperfections and limitations.

Hm, I had my first surgery in 2001. I don't know though if my weight would be different if I didn't have these intolerances and complications. If you maintained for 10 years - do you have any idea what caused the weight gain? Like having a new job and being less active or entering retirement or something like this?