Introversion

It's called body dysmorphia... Yes, I still often see a fat person staring back at me in the mirror although I'm 100+ lbs lighter and have been weighing 118 lbs since entering the maintenance phase nearly a year ago. Evidence that contradicts my perceived 'fatness: *the size 2 and 4 clothes I easily fit; *comments such as "I can tell you stay in the gym" or "You're in such great shape" or "You're so tiny!" Don't get me wrong...I regularly see the progress I've made over the past two years. However, I still do see the big girl in the mirror on occasion. Thanks for bringing up this timely topic.

Firstly, your article was informative and empathetic at the same time. Thank you! Nonetheless, many bariatric surgeons, dietitians and nutritionists never mention the concept of slider foods to bariatric surgery patients before or after their procedures. Many of these people find out the hard way...after a large regain of the weight they'd lost. The protein-first way of eating is instilled into bariatric patients. However, many of them do not adhere because a number of high protein foods cause early satiety and discomfort (which is the point...so we won't overeat). So, some folks turn to sliders such as crackers, mashed potatoes, pretzels, biscuits, chips and popcorn without realizing that these foods do not challenge the surgically-altered stomach pouch or sleeve in the same manner that protein-rich foods do. In addition, no one ever warned them about sliders. A person with a pouch or sleeve can eat a dozen of donuts in one sitting and feel no fullness or satiety whatsoever, while a dozen of ground turkey patties would be impossible to eat. In summary, I think more bariatric surgery program staff members should instill into their patients the importance of moderating the intake of slider foods. Again, thanks for the article.

Months 1 through 3 = about 800 kcals/day Months 4 through 6 = about 1000 to 1200 kcals/day Months 7 through 9 = about 1200 to 1500 kcals/day By 12 months out = about 1700 kcals/day By 18 months out = 1800 to 2200 kcals/day I purposely increased my caloric intake in a stepwise pattern per the suggestion of a veteran who once posted on this site frequently. While this tactic may have led to slower weight loss, I am thrilled about being able to maintain a body weight of 118 to 120 pounds on 2000+ calories daily. I suspect the incremental increases in my caloric intake helped preserve my metabolism.

When is the last time you lost an average of 12+ pounds per month through the old-fashioned way of diet and exercise? 37 pounds is a little more than 12 pounds monthly. You're actually losing faster than me. I lost 33.5 pounds at 3 months post-sleeve. What matters is the fact that I'm 2+ years out and maintaining a 100+ pound weight loss, whereas many people in my shoes who lost faster have started to regain. It's not the speed or rate of weight loss that matters. What really matters is your ability to keep it off. I should also mention that I eat 2000+ calories per day in maintenance, while those who kept their intake too low for too long seem to struggle with regain. Good luck to you.

I'm 2+ years out (26 months since surgery), so take my words and utilize them as you wish. My weight loss phase was painfully slow. It took me 18 months to lose 100 pounds. Nonetheless, I maintain my weight loss without tracking, dieting, counting, measuring, or restricting. I weigh 118 pounds and maintain on 2000+ calories daily, although I don't really track it. I'm also hypothyroid and insulin-resistant, but daily exercise has kept my metabolic rate boosted. Here's the real deal...most of us weren't able to adhere to diets for the long haul prior to surgery, so why live like that after bariatric surgery? Dieting, counting calories, measuring food, tracking, and restricting intake are all aspects of the dieters' mentality that I refuse to partake in. I am not on a diet. I eat freely, but stick mainly to lean protein because it is difficult to overeat protein regardless of your lack of restriction. We can eat 25 slices of toast (2500 calories) and never feel any restriction, or eat 2 chicken breasts (275 calories) and feel stuffed. It's all about wise choices at this point in the game. My restriction has also lessened with the passage of time. I can eat 2 fast food double cheeseburgers in one sitting even though I choose not to. I can eat 2 extra large slices of pizza in one sitting even though I choose not to. The type of food we place in our mouths matters far more than the size of our sleeves or pouches. Sliders, a.k.a. slurry foods (crackers, pretzels, popcorn, chips, bread, cookies) are the root of most peoples' regain problems. These foods turn into a liquid slurry in our digestive systems and you'll never feel full, so you can eat unlimited quantities of them. If you eat sliders, tread carefully and don't fall off the cliff. You'll notice nobody ever says, "I am regaining after eating 100 grams of protein each day. I eat chicken thighs, steak, ground turkey, and hard-boiled eggs, but the weight gain won't stop." Protein has a high thermic effect; our bodies burn considerable calories digesting animal-based proteins. Many of those who regain started incorporating slider foods into their diets. Unfortunately, sliders promote rapid weight gain since they 'slide' past the stomach into the intestines where the calories are stored as fat. Good luck to you. Let me know if you have any specific questions.

I took 2 weeks off work, but could have taken just 1 week off due to an uneventful recovery. Back then I worked a partially physical, partially sedentary job as an RN supervisor at a specialty hospital, so I was able to spend a considerable part of my shift behind a desk. I drove myself home from the hospital (45 miles on the interstate). I was off all pain meds by the 4th postoperative day and grocery shopping on the 5th postoperative day.

I've been hypothyroid for 12 years. I was also pre-diabetic. I was sleeved a little over 2 years ago, lost 100+ pounds, and have easily maintained my weight loss with decent food choices and exercise. My metabolic rate also seems higher today than it was before surgery. I can maintain my weight on 2000+ calories daily now. Prior to surgery, I could gain weight rapidly and fiercely. Here's the catch: I was a dreadfully slow loser. I lost an average of 6 pounds monthly with my sleeve, possibly due to my hypothyroidism and insulin resistance. However, I'm pleased with my results.

I generally stay off the scale. I only weigh in once or twice a month and focus on the aspects that really matter, such as my improving health and the more flattering fit of my clothes. If you weigh yourself on 10 different scales, you'll get 10 different weights. This is why it's important to not fixate on the number on the scale. It's unimportant in the long run. Your scale probably is calibrated differently than the one at your doctor's office. Also, our weight can fluctuate wildly from hour to hour. We tend to be lightest upon awakening. You'll gain water weight by gulping a pint or two of water. You'll gain more temporary weight after each meal. Meanwhile, if you defecate a large poopy turd or urinate a lot, you'll lose temporary weight. You'll also lose water weight after perspiration due to a hot day or intense workout. The moral of the story? Stay off the scale unless necessary.

I am more than 2 years out. I maintain my body weight of 118 to 120 pounds on an intake of 2000+ calories per day. I run at least 5 days a week, either on the treadmill or outdoors. I also lift heavy free weights 3 times a week. My hard-earned muscle mass enables me more freedom with food choices. To give my knees a break from running, I'll exercise on a stationary bike, elliptical machine or stair mill at the gym. My food choices are rather liberal. As long as I hit my daily target of 120 grams of protein per day, I don't give a rat's ass how many carbs or fat grams I eat. Since I'm physically active, my body tolerates the carbs and fat quite well.

Bariatric surgery is associated with a number of risks...nonetheless, remaining obese is the bigger threat to your daughter's health and social life. The sleeve gastrectomy results in less than one percent of major complications. It's a 30 to 45 minute surgery. Since your daughter is young, she's less likely to experience major complications. Physically, obesity predisposes your daughter to diabetes, heart problems, high cholesterol, high blood pressure, arthritis, sleep apnea, certain cancers, infertility, and other illnesses. Socially, being obese predisposes your daughter to lazy judgments from society, reduced options in the dating marketplace (the majority of young men prefer normal-weight women), and missed career opportunities (many hiring managers prefer to hire normal weight applicants). The sleeve was also the first surgical procedure I'd ever undergone in my life. Due to having weight loss surgery in my 30s, I will have avoided the need for other surgeries as and procedures I age (e.g. knee replacements, open heart surgery, diabetic amputations, dialysis).

The surgery prevents massive weight gain only if we eat lean, dense protein and veggies that challenge the sleeve. Otherwise, it's possible to gain 100+ pounds with a sleeve. I know someone who regained 150+ pounds in a little over a year by going off the rails. Her starting weight was 395 pounds. She lost 140 pounds in her first year with the sleeve before sliding back into old habits by grazing on sliders (read: chips, crackers, popcorn, cookies, ice cream) during the second year. Her unsupportive husband also griped about the healthier meals she cooked, so she reverted back to preparing unhealthy food. To keep a long story short, this lady now weighs 400 pounds and wants to get "back on track." Regaining 150 pounds with a sleeve must be a horribly dispiriting experience. Massive weight gain with a sleeve can happen if a person grazes on sliders all day. Someone can eat 25 cookies (2500 calories) in one sitting and feel no fullness or satiety whatsoever, whereas it is impossible for the sleeve to accept 25 chicken thighs.

Personally, if I lost my job today due to layoff or termination, I have enough money saved to live on for the next 5 years without working. This doesn't even include the funds in my 401k and IRA. Due to being raised in a paycheck-to-paycheck household by parents who often mismanaged household finances, I learned firsthand what not to do with money at an early age. I'm a good saver. I also have no children, so I have no cash outlays for pricey kid necessities such as daycare, toys, clothes, school supplies, diapers, lunches, etc. My lifestyle is also low-key with a starter home, two used cars (read: no car payment), occasional fine dining, and a couple of yearly vacations. Meanwhile, I've considered an arm lift (brachioplasty) in Monterrey, Mexico. I may or may not get it. I'll make up my mind in a year or two. The rest of my body is fairly toned.

Personally (and my answer is purely anecdotal), I start with a weight that is heavy enough to challenge me. If I can complete at least 3 sets of 6 to 8 repetitions, I'll start with that weight. Once I've built enough strength to easily complete at least 4 sets of 12+ repetitions with that same weight, it's time for me to move onto a heavier weight that will once again challenge me.

No, it is not too late for you. After all, you'll be sleeved for life, foverer and ever. It's not as if your banana-shaped sleeve disappears into thin air after one year. Here's the caveat...you are the only one who can conjure up the intrinsic motivation to get back on track and stay there. Here's another reality: whatever method you utilize to get back on track will need to be the method you use to stay on track. An obesity physician once spoke wise words: "If you didn't like what you did in order to lose the weight, you won't like what you need to do to maintain the weight loss." In other words, the habits you adopt while losing weight are some of the same ones you'll need to adhere to if you want to maintain the weight loss for life.

NOTE: I only use free weights, a.k.a. dumbbells, barbells, and weight plates. I also run 5 times per week for my cardio exercise. Workout A (Monday) Barbell Step Up Incline Push-Ups (Chest) Dumbbell Lying Row (Back) Tricep Extension Hammer Curl Upright Barbell Row (Lateral Delt) Plank Single Leg Forward-Angled Calf Raise Workout B (Wednesday) Lunge Dumbbell Pullover (Chest) Overhead Press (Anterior Delt) Bar Lying Row (Back) Barbell Reverse Overhand Curl Dumbbell Full Can Lateral Raise Plank Single Leg Forward-Angled Calf Raise Workout C (Friday) Squat Bench Press (Chest) Barbell Row (Back) Fly (Chest) Curl Front Shoulder Raise Plank Single Leg Forward-Angled Calf Raise

Your daughter could most certainly lose weight without surgery. In fact, with the help of a nutritionist and personal trainer, she could probably lose 100+ pounds. Here's the caveat...obesity is a time-dependent disease process. It is never curable, ever. While obesity can be put into remission by dieting and/or exercising down to a normal body weight, your daughter has been overweight so long that her biochemistry will ensure she regains the weight fast and furiously if she loses it without the metabolic reset that bariatric surgery provides. Here's my weight history. I am 36 years old. My weight has yo-yo'ed up and down since my mid-teens. At 15 years of age I lost 30+ pounds on a summertime low-calorie diet, going from 155 to 125. I regained all the weight plus more in three years. At 20 years old I weighed 176 lbs and was 5'1 tall. I lost 60 lbs on an 800-calorie diet plus exercise and got down to 116 lbs. I regained it all plus more. By the time I was 24 I weighed 205 lbs. At 26 years old I weighed 216 lbs. I lost 55 lbs with diet and exercise, but regained most of it. At 29 years old I weighed 203 lbs. I lost 25 lbs with diet and exercise, but regained most of it. At 32 years old I weighed 180 lbs. My friend asked me to be a bridesmaid in her wedding, so I lost 52 lbs with diet and exercise, weighing 128 for this event. I regained fiercely and was 200+ lbs a year later. At 34 years old I weighed 225, my highest weight ever. I had the sleeve gastrectomy 2 months after my 34th birthday. While bariatric surgery doesn't ensure anything, this is the first time in my adult life that I've been weight-stable. What was the point of my lengthy post? It's to emphasize that when people say, "You can lose weight without bariatric surgery," I totally concur. As you've read, I've lost 200+ lbs over the past 2 decades. Losing weight was not my problem...keeping it off was problematic. Bariatric surgery has bestowed upon me the last glimmer of hope for keeping the weight off. I know my struggle will be for a lifetime.

Breakfast: three cups of coffee with half & half and sweetener Lunch: turkey/cheddar sandwich, 1/2 grapefruit, cottage cheese Pre-workout meal: flatbread pizza with turkey pepperoni and jalapeno Dinner: turkey/cheddar sandwich on 45-calorie multi-grain bread Bedtime snack: two Morningstar spicy black bean patties, slice of white American processed cheese, an Enlightened sea salt caramel ice cream bar, handful of peanuts, turkey sausage stick, string mozzarella cheese

It depends on when your surgeon officially clears you to start exercising. The people at my surgeon's office cleared me for all types of exercising (aerobics and weight training) at 6 weeks post-op. I didn't resume exercise until 3 months post-op. I started with a walk/jog routine. Two years later I run 5 days per week, either outdoors or on a treadmill. I also lift free weights as heavy as possible 3 times a week. I went from 40+% body fat to just under 18%, which is in the lean range for a female.

Personally, I'd undergo a sleeve gastrectomy if I weighed 185 pounds and ultimately had less than 80 lbs to lose. Nonetheless, the decision is yours to make. As the previous poster mentioned, most people do not lose too much weight. In fact, the majority of weight loss surgery patients never reach their goal weights. Also, the 'lightweights' (read: those who weigh less than 200 pounds) often lose their weight in a slower and more controlled manner than much heavier people.

NOTE: There was a 6-hour power outage during the early part of the day (7:00am to 12:45pm) because of severe thunderstorms, so I could not cook or brew my morning coffee due to no electricity. Breakfast: leftover chicken enchilada casserole, 1 navel orange Lunch: McDonald's large coffee w/cream & Equal, protein shake Post-workout: protein shake, leftover chicken enchilada casserole Mid-afternoon snack: 1/2 pint Enlightened red velvet ice cream Dinner: leftover chicken enchilada casserole, 1/2 grapefruit Bedtime snack: peanuts, 1/2 pint Enlightened red velvet ice cream

Each bariatric aftercare program is different. The dietitian at the bariatric practice that I go to preferred that we avoid coffee for the first postoperative month due to its high acidity. However, as the stomach heals, many bariatric programs allow patients to resume drinking coffee. Personally, coffee cuts my appetite and enables me to perform more optimally during workouts, so I'll continue to drink it. Plus, I like it!

Personally, I resumed coffee at two months post-op. I only drink caffeinated coffee. I'm addicted to the caffeine. Decaf would do nothing for me.

Breakfast: 3 cups of blueberry muffin-flavored coffee with half & half and sweetener Pre-workout snack: cottage cheese, yellow squash casserole, and half a grapefruit Lunch: ham & cheese sandwich and yellow squash casserole Mid-afternoon snack: Quest protein bar (chocolate chip cookie dough) Dinner: ham & cheese sandwich and yellow squash casserole Bedtime snack: strawberry banana protein shake

In addition to the DEXA scans that have been mentioned by previous respondents, I also wanted to mention hydrostatic body fat testing. I paid $49 for the hydrostatic body fat test. It's considered the gold standard for body fat testing as far as accuracy is concerned. I donned a swimsuit and sat in a tub of warm water for a few minutes as the technician conducted her analysis. The results indicated my body fat level is just under 18% and that I have more pounds of muscle mass than the average female in my age range. They also conducted a RMR/TDE test. My TDEE (total daily energy expenditure) was estimated to be approximately 2090 calories a day. This means I can eat up to 2100 calories daily without weight regain. I am over the moon about these results.

I'm vertically challenged at 5'1 so my original goal weight was 110 pounds, which would have placed me at a very normal BMI of 20 and into single-digit clothing sizes. At three months post-op I adjusted my goal upward to 130. The weight was coming off at a painfully slow rate of about 5 to 6 pounds monthly, so I thought I'd never make it to my original goal. I reached my revised goal of 130 pounds at 14 months out. My surgery day weight was 218, so I decided to lose a nicely even 100 pounds by getting to a body weight of 118. 118 pounds was my new goal. It took another 4 months to lose the additional 12 pounds to get to 118. I've been maintaining this body weight without a great deal of effort while eating in the ballpark of 2000 calories daily. This is the first time in my adult life I've been weight-stable. I wear a size 4 and enjoy life as a normal-weight person.