summerset

I'm currently reading Karen Koenig's latest book "Helping Patients Outsmart Overeating". It's a book for both patients and health care providers. While no magic wand I think it's a little gem. It's definitely an interesting read on this subject. I think people make these changes to different extends. The more you change towards healthy behaviors, the better the outcome will be, both physically and psychologically. However, people are people with different personality traits and ailments and histories etc. - and a lot of people may simply not be in the position to make all the necessary changes to reach and maintain a normal weight or reach and maintain a normal weight without much hassle. I have ADHD. I will most likely never be this organized, constantly calorie tracking accountant like person who follows plans to the last minuscule detail. So I have to operate within certain limitations and adapt to it. Don't get me wrong - I'm quite good at making plans and organizing stuff, but I absolutely suck at following through, so I'm glad I get to delegate certain things at work. (That said I'm proud of myself being able to function at work at high level without side-effect having medication but I have to be careful with energy levels so I simply won't prepare elaborate meals everyday.)

I dislike shopping as well (do I really have to do this after I come home from work?) and I don't like cooking (do I really have to do this after I come home from work?) and cleaning up after (do I really have to do this after I come home from work?). I also dislike preparing food for the next day (do I really have to do this after I come home from work or before work in the next morning?). My compromise is that I keep it as simple as possible. I buy ready made soups that only have a few ingredients listed, even though they're relatively expensive. In general I think of warm food as more satisfying than cold food (e. g. warm oats are more satisfying IMO than cold oats) so I usually don't eat a sandwich/bread on its own but with soup. Soup and sandwich is a go-to for me when time is scarce. I also use frozen vegetables a lot. Saves both shopping, preparing, cleaning up and cooking time. Rice I cook in batches with a microwave rice cooker and freeze it in batches. After I started my new education my working times have changed (including 24 h shifts which are draining as hell) I'm struggling a bit as well, though it's more with regular exercise. I never got into the real groove again after my shoulder injury so far. Ok, I usually bike to work and I have been lucky with the roads not being icy so far but that's about it. Interestingly enough I haven't gained an ounce so far, even though I didn't feel I ate less food (though I must have anyway?). That's kind of a liberating observation. Convenience food (like sandwiches from the cafeteria) or eating lunch at the cafeteria even though they have a salad bar makes for less than ideal choices too often. I don't notice it in terms of weight gain (even lost a bit since starting my education), but I feel tired and drained a lot which I think is only partly because of different working hours. So even though I don't might like it, I will see to preparing oatmeal in the evening to grab in the morning instead of simply buying a sandwich at the cafeteria. There's no way though that I'll be nibbling on a piece of cucumber at 2:30 AM when I want something sweet. Protein bar for me then.

If that's really the case I wonder why you don't go back to a diet that really satisfy you. I always went back to "eating not ideal foods" because this clean eating didn't satisfy me. Add on top of this that I don't like to cook and I knew I had to come up with creative solutions. IMO these are perfectly fine foods to eat. (Well, maybe not that kind of bread that has a gazillion chemicals as ingredients.)

Me neither, but just as every other medical therapy on this planet doesn't work in 100% of the cases with 100% success it's not realistic to expect 100% of WLS patients being 100% successful. I think most surgeons have a way more distant and neutral view of this treatment method than most patients. The patient's view seems to be loaded with emotions (no surprise here) and that is reflected on this board as well. It's never the treatment method that fails, it's always the patient who isn't strong enough, disciplined enough, motivated enough if goal weight isn't 100% or 100% maintained for the rest of life. This is very interesting because we used to be the same with diets. Then came the "diets don't work" movement along, backed up scientifically. And then as a last resort there is WLS - it's kind of depressing to accept that this last resort treatment isn't 100% fool proof either. It's easier to blame the fellow patients because it's quite frightening to think about the fact that you yourself might be one of the patients where it doesn't work 100%. And this sword of doom looms above your head for a very long time, if not forever. You always worry and if it's only in that little chamber in the back of your brain: "Will I be able to get down to a normal BMI?", "Will I be able to maintain my weight loss?", "Will I regain everything I lost or most of it?", "I simply can't accept even a slight gain or I'm a failure", "Will I be able to function on this high level of discipline and vigilance for the rest of my life?", "What about my 15 h per week exercise program when I suffer a serious injury and have to pause for several months?", "Am I really doomed to always follow a rigid diet for the rest of my life?" I dunno - maybe after having had surgery almost 17 years ago now and having had one revision and adhesiolysis I tend to see things differently than I had 10 or 15 years ago. I went through quite a few things during these years, including some regain when I stopped smoking, being obsessed with clean eating, exercise addiction before several sports related ailments stopped me in my tracks and being just burnt out from all the above. This is why I'm convinced that we should strive for a sustainable middle ground when it comes to eating and exercise and I can't see that much on the various WLS boards so I'm still searching for a place to settle down. Maybe it's because there aren't much people around whose surgery lies back so many years. Here you are a "veteran" after you're - what? - 18 months out IIRC. I personally think this is not a very long time out. Also being 2 or 3 years out is not much. I'm not sure how I can bring my point across without sounding like a total ass. Think about long term relationships maybe. All the couples who're together for 5,10,15,20,25 years or longer will know what I'm talking about when I say "that's not a very long time".

In the end that's no surprise. Before WLS we couldn't adopt these new and oh-so-healthy habits - why should the whole bunch of WLS patients be able to do that after surgery? What tremendously helped me changing behaviors (though I have enough "bad" ones I guess, lol) was reading books about normal eating and it was also the fact that it's easier to maintain the weight when you're close to your goal. When I look into the mirror, being fully clothed I can say to myself "Well, that's not bad - don't mess it up!" - I think I should really look into plastics even though I dread the whole procedure (I fear I will have to shell out the money because I don't have any inflammation or what not in the skin folds) but it seems to be a fact that patients who had plastics do better at maintaining a low weight. Might be because of "Well, that's not bad - don't mess it up!" but also be because empty fat cells are removed that don't scream to be filled or most likely both.

But... but... the CARBS!!!!! Regarding the artificial sweetener: I think a lot of protein powders are actually already too heavy on sweeteners, depending on the brand (unless you buy powders without flavor that is). ... Anyway, I used to mix Syntrax Peanut Butter Cookie and Chocolate with milk and then pour it into my coffee. I haven't had that in a while now - will give it a try again because I have so much of it left and it's still good.

I can't believe that some people seem to hate about every protein shake (or protein bar) on the planet. Ok, this stuff gets olds like any other food you eat often enough but I'm sure there is a protein shake or protein bar out there for every taste. If you don't like the pure stuff, there are several ways to jazz up a protein shake though not everything will agree with everybody of course. Same with protein bars. There are good tasting ones out there (at least IMO).

Never. May I ask why you want to eat raw vegan instead of a mixed vegan diet?

This. Both losing and maintaining is finally possible without that much hassle. I'd say the "normal" amount of vigilance a lot of other people who were never fat have to use is necessary to not gain at the moment. Because fat people need to be punished and need to suffer - at least this is what a lot of people seem to be thinking. Others might be thinking "I need a lot of discipline to battle my weight, too - why should you have it any easier?" which boils down to naked envy.

If you're having reflux issues with the band why does the surgeon want to make a sleeve and not a bypass?

"No excuses" - that was the mantra that got me to burning out. "Relax" - that is the mantra that helped me the most. --- Seriously, this whole holiday eating thing gets overblown on about every dieting website on the web every year. The relatively few holiday meals weren't what got us fat. It was the food choices and the amount of food during the rest of the years that were the problem. If you can stomach it, enjoy the food instead of making up some excuses why you need to deprive yourself of this or that particular food.

I wonder what she will tell you if her gallbladder really has to be taken out some day. That it grew back? SCNR

That's why I would never advice someone making up stories about "lifestyle changes" and "eating healthy and exercising". No need to broadcast it but I don't think there is a reason to lie about the surgery or hide it.

I hope people do the same if they decide to e. g. continue driving a car. Many people die in car accidents as well, even if they're good and responsible drivers and they have families that need to be taken care of, too. Same for smoking. I hope every smoker has a big life insurance policy.

This. It's a way to put other people down to feel better and superior yourself. It's the same "advice" people used to bawl about when they got it crammed down their throat by random people before they had surgery. I'll never get it into my head that this is really the top "advice" that is given to fellow WLS patients who're struggling. It strikes me odd that when it comes to WLS the most judgmental group is the WLS patients themselves. --- ETA: When I tell people that I have MGB done because of reflux and that I'm in the unfortunate group of 20% who got way better but aren't able to wean off the PPI I usually get an "Aw, this really sucks!" I guess the reactions would be different if this was about lack of weight loss or weight regain.

Overgeneralizing and judgmental. Some people need a second chance. Nobody gives a flying f**k if a patient needs a second fundoplicatio because of heartburn or a second PTA because that stenosis needs a second dilatation but God forbid that someone needs a second WLS procedure.

Sounds a bit like the mini mental test. Did you have to fold a piece of paper and drop it to the floor by any chance?

I absolutely agree with this. We don't know what "slightly under" means in this case, but if it's a BMI of 39 instead of 40 we're talking about only a few lbs right now (not even 10).

Had my fair share of these as well. My shoulder is still bothering me. Also obsession with "healthy eating" was quite bad for a whole while. I can feel the pendulum swinging in that direction again. I don't really have any red flags right now but something is different. My thoughts wander into this direction more often than usually.

Ultimately not many WLS patients will achieve a "new, thin, sexy body". Yeah, maybe with plastics and when young enough the body will look decent enough. Anyway I personally like being able to enjoy both food and a body that looks normal when not naked.

I personally don't believe that it's possible to become heavy enough to qualify for WLS without an ED. It's not uncommon that eating disorders change gear. Anorexics become bulimics. Anorexics become orthorexic and fitness obsessed (see websites on "recovered" anorexics who seem now simply obsessed with fitness and healthy eating instead of losing weight). People with COE or BED become bulimic. EDs very often don't go away, even with therapy there are very high relapse rates.

IIRC 3-4 months.

Makes me wonder what kind of stuff is usually sold as "bread" in the US.

This is kind of random now and maybe also off topic but this irks me since a whole while: general advice is given. What happened to "diagnosis before treatment"? When it comes to problems with gaining/stalls/etc. that have likely to do with food intake (or maybe supplement intake as well) I think the first advice should be that evaluation is necessary, i. e. "food tracking" and if there is a problem identified: "why is that problem there?". Everything else comes later.

Oh, as far as skipping breakfast goes: I did that, too - because when I ate breakfast, my weight would climb up even higher. Now I usually don't eat breakfast - or maybe I should rather say that I don't eat immediately after waking up? I usually get up a 6:30 and have a cup of coffee. I usually eat something between 9:00 and 10:00 when I'm actually getting hungry. I'm not a morning person.