Berry78

But here's the real question.. what's with the sharp drop off in the women's line above 35bmi?

Thanks for pointing that out.. you're right, the line I was looking at was 18.5 for women. Oops. Guess I just was looking at the 20.4. I did the same mistake for the men. 'Parently I need more 'lernin how two reed graffs. Doh!

I've had no issues getting my protein in since week 2 postop without protein shakes. During the healing phase it was all about milk, protein kefir (40g in 16oz), yogurt, cottage cheese and homemade broth. After I was on solids: beans, tuna, eggs, and nuts. Every meal features protein containing food. I didn't consume food that didn't have protein until I could eat 3-4oz solid meat at a sitting. Now I can have a couple meals with low protein count (still eating 6 times a day). That's how i get in fruit and veggies.

How severe is your diabetes, and do you have a history of GERD? I really think you should put DS out of your mind. The DS requires huge amounts of protein and vitamins that could potentially cause problems with your compromised kidneys. The idea is you won't absorb all of it, but the management would be a nightmare. At your weight, even maintaining 50% excess weight loss will get you into a much healthier range. If you have a history of GERD, go with bypass. If you don't, then if your diabetes is mild (controlled on 1 oral med), or very severe (you've had it a long time or need lots of insulin).. go with the sleeve. If your diabetes is moderate, go with bypass.

Very nice. And I agree with almost all of it... but the healthiest BMIs are actually more like 22-26.5 for men and 20.5 to 25 for women.

213

For life, it's all about the calories. Most protein shakes are quite low in calories, that's why you've lost weight again drinking them. (The lack of carbs makes you drop water weight too). Fresh, real, whole food has fewer calories than food that has been premixed for you. You need to use a kitchen scale and measure everything. When I shop, I look for food that has 1 ingredient. I do buy canned beans and cottage cheese that have added salt. Weight loss food groups: Nonstarchy vegetables (unlimited) Starchy vegetables (limit to 7oz a day) Fruits (limit to one fresh whole fruit a day) Legumes (like black beans, 7 oz a day) Nuts/seeds (limit to 1 oz a day. Very important not to guess!) Dairy (limit to 1 or 2 servings a day. Avoid added sugars) Meat (fish is superior, limit to 3-4oz at a sitting) Avoid grains (especially white flour) and added sweeteners. We all have to become lay-nutritionists for ourselves. 99% of what you see for sale in the grocery store isn't really good for you. A whole isle devoted to potato chips, and another devoted to soda? Tells you something

I hope everyone is counting his/her carbs. The preop diet is supposed to be low fat and low carb and low calorie. If you aren't sure, ask your program peeps.

My plan had me drinking water and broth days 1-7. Milk and protein shakes days 8-14. Days 15-21 were more like yogurt and pudding. Creamy and smooth, and just thick enough to need a spoon instead of a straw. Chicken and broccoli? I couldn't have imagined it.

I had a good experience with Dr. Illan.

This very issue (weight vs. volume) confused the heck out of me preop, and the source of the confusion was the general idea that your stomach can hold 1/4 cup or 1/2 cup, etc. Now that I'm postop, I realize that the stomach doesn't work that way. Liquids go pretty much right through. I can eat 8oz of soup, but only 3 oz dense steak. So ultimately volume doesn't mean a thing. Weigh your food, and start out with 2oz of anything that is thick enough you need a spoon for. Eat slowly and stop at the first sign of fullness. You might only get down 1oz at first. Once you are easily eating 4oz of cottage cheese or yogurt, it's time to pay attention to protein and calorie goals, and make a plan for how to meet those goals. I'm 6 months out, and still stop at 4oz cottage cheese because ........ drumroll please.... 4oz is a serving! For the first time in my life, the recommended serving sizes of foods actually mean something....

My first was split pea soup. 3 spoonfuls and I was full...

Yeah.. weakness lasts surprisingly long. Your body is still processing the IV fluids too, so all that peeing is good. Sounds like you are doing just fine...

Nope. Sorry. Should slow down and stop by 12 months postop. I'm in the same boat...

As long as you are getting over 40oz and are peeing 3-4 times a day or more, then you are doing fine and just keep trying. I found it easier to meet my goals by drinking out of pint jars. Sip sip sip, but 4 if those jars is 64 oz. Of course if you start getting dizzy or otherwise feel bad, feel free to contact your team.

Soo many possibilities. Your electrolytes could be off too. Best thing is to see the doc so they can track down the cause.

Well, because you stayed at 260 for years, it's safe to assume that was a new set point. So I think, technically, the start should be 287. But, even so, you did the work of dropping below 325, so it definitely counts. Put whichever number up you want. It's your journey! My preop weight happened to be my highest #.. but if it hadn't been, not sure which way I would have gone..

Ok, so this is what I've gleaned so far.. Muscle cells have a "back door" for glucose to enter without needing insulin. Fat cells and the liver need insulin. Exercise seems to be the way to decrease insulin resistance (IR). Higher dairy consumption is linked to increased IR. (The study didn't count cheese.. it looked at liquid milk and yogurt). Omega 3 fish oils had some protective effects for prevention of IR, but once the resistance is established, it can't reverse it. Calorie restriction alone had a small effect on IR. Exercise alone had no effect on IR. Exercise combined with caloric restriction had a big effect. The US consumption of red meat has decreased since the 1960's, but chicken consumption has gone up dramatically. Our combined meat, chicken, and fish consumption has increased from 110 pounds a year (per capita) to 150 pounds a year. Our added sweeteners have increased dramatically. In 1820 we consumed about 8 pounds a year of added sweeteners. In 1920 we consumed about 75 pounds of added sweeteners, and consumption leveled off until about 1980 when it began climbing again, up to a high in 2000 of about 110 pounds per person, per year. It's gone down slightly, but still around a hundred pounds a year or so. These are rough estimates, but the idea that we're eating 1/3 of a pound of sugar (or HFCS) per day is sickening. Our added fats have increased from a little over 30 pounds per person to over 50 pounds per person between 1970 and 2010. The biggest jump was right before the year 2000 when there was a dramatic increase in added cooking/salad oils (specifically soybean oil). Saturated fat consumption from beef tallow/lard, and butter have remained consistent and low. As much as these authors want to point to red meat and butter as causing all these problems, these are not the foods that have increased! We've increased our fructose (in high fructose corn syrup), our chicken, and our soybean oil. What does it all mean? Well, I haven't finished yet.. but the simple answer is to decrease your calories and increase your exercise. Here is an interesting chart showing fatty acid composition of various fats/oils. http://web.pdx.edu/~wamserc/C336S12/fat.pdf

You'll be fine. First thing when you stress things is pain. Since you didn't feel anything, you're ok. Zucchini, when well chewed, is going to be pretty soft. Just do better next time, but don't stress over this one.

Fluffy! Congrats on getting halfway to goal!!!!

I pm'd you.

Thanks for the link. " Fatty muscles, in the context of too many calories, leads to a fatty liver, which leads to an even fattier liver." He describes the build up of fats in the muscles, liver, and pancreas as the cause of diabetes, but it's the number of calories that causes the fat accumulation, rather than fats themselves... at least this is how I read it.. Again, caloric density is at fault, rather than fat its self. Now he does mention saturated fats being a problem, so I'll continue doing research until I feel confident in the answer... Not everyone that develops diabetes is obese, and not everyone that is obese develops diabetes.. so there has to be a piece that I'm not understanding yet...

I have seen sooooooo many movies, and yet, y'all keep pulling out titles that I haven't seen! Still looking for someone that has seen "Frequencies" https://www.rottentomatoes.com/m/frequencies/

Ahh.. but now I think we're back to caloric density. Is it FAT that is the problem, or is it the concentrated number of calories the fat contains, which makes us store excess fat.. etc. etc. ?? I think I'll have to take a nice long gander at all the scientific research into what causes diabetes in the first place. In the meantime, I'm going with the moderate approach. Whole, real food. Small amounts of animal proteins. Keep my calories low so I can continue losing weight. Take vitamins. The long-lived cultures WERE calorie-restricted, but not compared to the bariatric population. They were eating like 1800-1900 calories a day. Americans eat around 2500. We should keep in mind those populations may have been significantly shorter in stature than us as individuals as well. The WHO recommends fat in the diet to not drop below 15%. 15% of 2000 calories is 33g of fat. (An egg has 5g, an ounce of whole milk mozzarella has 6g, a Tablespoon of olive oil has 14g, an ounce of nuts has about 15g). Lets make sure we don't drop below 33g of fat, because fat is used by the body for lots of functions (like making hormones), not just energy. And even though we are on a low-energy diet, we still need to make hormones. 33g is the minimum amount, you can safely double it (but I can't recommend consuming more than 66g of fat a day). Boy, I'm glad this came up, because I hadn't done this research before! I think my fat grams typically run in the mid 50's, but I'll be more sure to pay attention in the future. (I don't plan on decreasing it, unless it's above 65g).

Fluff.. man, you drew the short straw when it comes to being a baker! Eek! Fingers crossed for you too, that surgery can help your diabetes!