Introversion

Do you like your current lifestyle that probably resulted in morbid obesity? If you remain obese and initiate no lifestyle changes, you'll likely dig yourself an early grave. How many obese elderly people walk among us in society? Very few... Malnutrition isn't really an issue with the sleeve since there's no malabsorptive component to this weight loss procedure. Just take your supplements and you'll be fine. Good luck to you.

It gets substantially easier after surgery...at least it was that way for me. Prior to the sleeve, my hunger was insatiable. Nothing provided satiety or fullness. Upon awakening from surgery, I was no longer hungry. It was as if a switch had flipped. I'm 2.5 years out and my hunger levels are still low compared to those pre-op days.

Obesity is a time-dependent problem...this essentially means the longer a person's been obese, the less likely he/she'll maintain a weight loss after diet and exercise. Assume we have two 40-year-old women. Both are 5'5" and weigh 300 pounds with identical body fat percentages. The difference is one woman's been obese since childhood while the other one was thin all her life until massive weight gain during pregnancy in her mid 30s. The woman who's been obese since childhood is unlikely to maintain a major weight loss without surgery. Her body's had 30+ years to hormonally adopt obesity as its default state. If/when she enters a weight-reduced state with diet/exercise, her body fights to return to 300 pounds (and usually succeeds). Meanwhile, the woman who has been obese for a few years has a better chance of losing and keeping weight off. Her body hasn't had time to adapt to the potent hormonal influences of obesity. Diane Carbonell is a woman who was thin/average-sized until she became obese (300+ pounds) in adulthood after several pregnancies. She lost weight the old-fashioned way via diet/exercise and has kept it off since the late 1990s. I suspect her body never really had a chance to become acclimated to obesity since she wasn't fat for a terribly long time: http://www.dianecarbonell.com/

I'd select option 'D': all of the above... Friends, family, and environmental factors influence food choices. It's no secret that obesity is more prevalent in lower-income social circles and thinness is more prevalent in wealthier upper echelons of society. Some of these disparities are due to food costs, while other variances can be attributed to social norms. If we've got health-conscious friends and family members, there's more social pressure to eat right and make reasonable choices. If our social circle is filled with overeaters, we'll stand out like a sore thumb if we skip the weekly Sunday brunch at the all-you-can-eat buffet. Our minds and emotions influence food choices. Most 'comfort foods' are starchy and highly palatable such as macaroni & cheese, loaded baked potatoes, and white bread grilled cheese sandwiches. These foods bestow comfort upon emotional eaters who eat to soothe anxieties and stress. Our stomachs and intestines influence food choices. The greater curvature of the stomach produces the hunger hormone ghrelin, and so does the small intestine to a lesser extent. The gut also produces other hormones that affect hunger and satiety such as peptide YY and GLP1.

You probably need surgery because, although anyone can lose weight without a surgical procedure, it's doubtful you'll ever keep it off for the long term. I'm just being honest here. Those of us who were once obese have permanently altered biochemistries. In other words, once a person has become badly overweight, his/her body will fight like hell to defend the higher set point if/when weight loss through old-fashioned diet and exercise occurs. Weight loss surgery is the only durable method that reduces an obese person's weight set point. Once we undergo a bariatric procedure, the body now fights to lose enough weight to get to a lower set point due to favorable neurohormonal alterations. Click on the link below to read the thoughts of obesity specialist Dr. Arya Sharma. http://www.drsharma.ca/arguments-for-calling-obesity-a-disease-4-limited-response-to-lifestyle-treatments By the way, I've lost 200+ pounds over the past 2+ decades before having weight loss surgery (lose 30, regain 50, lose 60, regain 90, rinse and repeat) and I'm only in my mid 30s. I could lose weight just fine prior to surgery, but couldn't keep it off. I was sleeved 2.5 years ago and this is the most weight-stable I've been in my entire life since puberty.

The choice is purely yours to make. Ask yourself the following questions: Do you want to run the risk of dying early due to obesity-related illnesses because you wanted to avoid some loose skin? Do you want to enhance your qualify of life and be a normal-weight person, even if it means you'll have some loose skin? If you back out of weight loss surgery because you're afraid you'll develop loose skin, you're possibly having surgery for the wrong reasons. Bariatric surgery is about reclaiming and/or enriching one's health, not about eye-candy aesthetics. Sometimes loose skin is the trade-off for the chance to live to the fullest. Only you can decide if you wish to fight the battle or run away from it because you fear your skin may sag. Also, be honest: do you truly like your obese body the way it looks today? If not, why are you so worried about the potential of some skin sag?

The bariatric practice that I use, Ultimate Bariatrics, is in Fort Worth. I've had no problems with the follow-up care over the past 2+ years. http://ultimatebariatrics.com/

Dr. Frenzel's surgical practice is located in Arlington. His staff knows how to get insurance companies to pay for skin removal in many instances.

I didn't need a brace, and neither did any weight loss surgery patients with whom I'm acquainted in real life. I'd save the $35 if I were you. Nonetheless, your mileage may vary. good luck to you.

You said you completed a 'light' workout. That may be the key to your weight gain... Glycogenation is the dominant reason for weight gain when working out while consuming so few calories. Exercise boosts our muscles' energy storage capacity. Since active people need more fuel, a body that has just exercised adapts by increasing its capacity for glycogen storage. This process leads to temporary water weight gain. Also, very low-calorie diets (read: the pre-op liquid diet) can result in water retention. Therefore, you may be losing fat, but the progress you've made is masked by water weight gain. Maybe you lost a pound or two of fat the first few days but gained a few pounds of glycogen and/or water in that time. In summary, stay off the scale. Let your body sort out the changes it's experiencing. Measure your progress by the looseness of your clothing, not by an arbitrary scale number. Good luck to you.

I lost 15 pounds my first month. By the 3rd month and thereafter, my rate of loss slowed down to 3 to 7 pounds per month. I was a slower loser who took 17+ months to lose 100 pounds.

Weight loss with a sleeve differs depending on the manner in which the sleeved person works their tool. If you devote extra effort, you'll likely be rewarded by reaching your goal weight. Some peoples' sleeved honeymoon periods last only 6 months whereas others slowly lose weight for up to 24 months post-op. Personally, I entered maintenance at 18 months out. Then again, I was a slower loser who took 17+ months to lose 100 pounds. I eat one cup of food per meal. Usually it's about 5 to 6 ounces of meat and about 3 ounces of steamed or roasted veggies. Physical activity is what helped get me to my goal weight. I started a walk/jog routine at 3 months out. Nowadays I run 20+ miles per week and do weightlifting 3 times a week. The weightlifting has kept my metabolic rate high, even in the face of hypothyroidism. I have more muscle mass than the average 30-something female, so I maintain my 118-pound frame on 2000+ calories daily when most people my size would regain with that amount of food intake.

I had a hiatal hernia repair at the same time I was sleeved. According to my bariatric surgeon, the operation time was 30 minutes for the sleeve and 90 seconds to repair the hiatal hernia. So overall, surgery time was less than 35 minutes.

I exercise 5 to 6 days per week. I do weightlifting 3 times weekly. I also run on most days of the week, either outdoors or on the gym's treadmill. In addition, I use the gym's stationary bike, elliptical machine, and stair mill.

I recovered alone. I'm single and my extended family lives out of state. A friend offered to help, but I gently declined. My recovery was swift and uncomplicated. I no longer needed pain medication after the 4th day post-op and felt fine enough to go grocery shopping on the 5th day.

Although I'm happy with my sleeve, the gastric bypass is the gold standard procedure for those with obstinate metabolic issues such as diabetes, PCOS, and genetic obesity. Gastric bypass usually results in a speedier rate of weight loss during the first year post-op and 70 percent excess weight loss due to restriction, malabsorption, and gut hormonal changes. Also, it is supposedly reversible. The main drawback of gastric bypass is that it leaves some people metabolically challenged years after the surgery, priming them for rapid weight regain due to a phenomenon called intestinal adaptation. The intestines adapt to being bypassed by enlarging the villi and efficiently absorbing more calories, thereby setting the individual up for easy weight regain. Another bypass con is the potential for nutritional deficiencies due to the malabsorptive component. The sleeve's benefits include a quick surgery time (30 to 45 minutes), an intact pyloric valve, 60 to 70 percent excess weight loss, favorable gut hormonal changes, and reduced chance for nutritive deficiencies. The sleeve's drawbacks include slower weight loss than the bypass, less resolution of metabolic comorbidities in some cases, the fact that it is an utterly irreversible procedure, and the potential to regain weight if one slides back into bad habits.

Baked chicken drumsticks Sandwiches with your choice of meat Hard boiled eggs Protein bars Pork chops Ground turkey patties Tuna patties

Nope...quinoa is a higher glycemic carb that doesn't have enough protein to make eating it worth it to me. One cup has 30+ grams of carbs and only 8 grams of protein. With a glycemic index of 53, quinoa has been known to cause frequent stalls and plateaus in sleeved people during the active weight loss phase. However, your mileage may vary. http://www.wheatbellyblog.com/2011/09/can-i-eat-quinoa-carb-counting-basics/

It was no big deal... The psychologist basically asked me about my upbringing, focusing on any childhood trauma or adverse experiences that may have occurred during my youth. She asked about my typical eating habits and probed as to whether I would change them. She wanted to know about my living situation and whether or not I had family and/or social support to sustain the lifestyle changes prompted by surgery. She asked about my motivations for seeking weight loss surgery, wondering why I didn't just "stop eating when I wasn't hungry." As a thin person who had probably never been obese, she likely didn't understand that my physical hunger was insatiable and I felt hungry all the time. She asked about my relationship history, wondering why I wasn't actively dating at that time. I told her my personal experience of dating being more of a challenge as an overweight woman compared to when I was thin. She understood and actually agreed with me. She asked about my goals, educational level and career. Since I once worked in psych, I know how the psych eval is compiled. She likely listed my strengths (college education, career, realistic insight, having sought professional help in the past) against my pitfalls (childhood trauma, living alone, history of emotional eating) to formulate her recommendation. Honesty is important. The psychologist would rather hear you admit to overeating than sit across from someone who insists, "I eat 1000 calories a day and can't lose weight!"

I concur...most personal trainers are educated at the high school/GED level and earned national certification to call themselves personal trainers. Just like anyone can become a real estate agent, virtually anyone can become a personal trainer. A personal trainer is the last individual you'd want to ask for nutritional advice because you run the risk of receiving anecdotes or outright 'bro-science.' Some personal trainers advocate low-carb/moderate fat/high protein diets. Others espouse a paleo way of eating. Other trainers will just tell you to eat cleanly 80 percent of the time.

Your so-called 'friends' are focusing too much on weight loss by suggesting a gym membership when the real issue for most obese people is keeping the weight off. We've all lost weight without surgery. However, we couldn't keep it off without surgery. Obesity is not curable, ever. While it can be put into remission by achieving a normal weight, our bodies will always fight to regain. Hence, 95 percent of people who lose weight with diet and exercise regain it all plus more. Before I ever had surgery, I'd lost 200+ pounds over the years through yo-yo dieting (lose 30 pounds, regain 50, lose 60, regain 90, and so on). I've had a gym membership for 16+ years. Based on my history, I could lose weight without a problem. However, keeping it off is an uphill battle and surgery was my last hope for maintaining any type of weight loss long term. I find it strange that your mother and friends discourage a life-saving surgery, yet these same people express no concerns about your obesity, high blood pressure, and elevated cholesterol. Your obesity will lead to an early demise faster than any type of weight loss surgery out there. Good luck to you.

If your insurance company doesn't have bariatric coverage, they won't cover bariatric surgery under any circumstances. This is known as a bariatric surgery exclusion. Since your insurance has no bariatric coverage, and you don't have the money or financing to pay cash, your best bet is to find another job with insurance that will pay for weight loss surgery. Again, good luck to you.

Yep...I see the original poster is 5'8" and weighs 400+ pounds. If she's insured by a policy with no bariatic surgery exclusion clause, she should qualify for weight loss surgery without any illnesses or comorbid conditions since she's instantly considered super morbidly obese at that weight.

Are you willing to go to Mexico? A bariatric surgery practice called Long Term VSG charges $2,999 for the sleeve. You can finance it into small monthly payments. http://longtermvsg.com/gastric-sleeve-surgery-in-tijuana-mexico The vast majority of their patients are from the US.

What did you do to lose those first 65 pounds during your first year of sleeved life? The equation is deceptively simple: Start doing the things you did to lose the weight in 2014, and stop doing the things that resulted in your recent 15-pound weight regain. Contrary to popular notions, exercise is not necessary for weight loss. 90+ percent of weight loss happens in the kitchen with the dietary choices we make. Since you were sleeved 3 years ago, you should be able to eat anything. Most of the foods that will kickstart your weight loss once again can be found at most dollar stores, such as tuna, mackerel, soups, sardines, light mayo, seasonings, eggs, and so forth. Even with limited funds, dollar store groceries are affordable. Notice that all the aforementioned foods are high in protein. Protein speeds up your metabolic rate and promotes weight loss due to the thermic effect of food: our bodies burn off a considerable amount of calories to digest and process foods that contain protein. You can go back to liquids, but remember that the way you choose to lose the weight must also be the way you choose to maintain the weight. Liquids simply aren't sustainable in the long run for weight maintenance. Good luck to you. You've got this.