Introversion

No, I take the regular Centrum that are swallowed whole. Keep in mind I'm more than 2 years out. I took Centrum chewables in the first few months post-op, but haven't taken them in over a year.

Today's plan... Breakfast: three cups of coffee with half & half and sweetener Lunch/pre-workout meal: turkey/cheddar sandwich, navel orange, cottage cheese Late afternoon meal: leftover faux chicken bruschetta casserole Dinner: leftover faux chicken bruschetta casserole Bedtime snack: peanuts, string cheese, turkey sausage stick, pickle

I've never taken the expensive bariatric vitamins and supplements. I am 2+ years out after having had the sleeve. My nutritional lab work is perfect. I take over-the counter Centrum multivitamins. I also take store-brand calcium citrate, vitamin D, and iron. A 90-day supply of Centrum costs about $10 since you only need to take 1 tablet daily.

I had approximately 100 pounds to lose and only one comorbid health problem (elevated cholesterol). I was also prediabetic and hypothyroid. I chose the sleeve. I gradually lost the 100 pounds of excess weight and have been able to maintain the loss with a relatively normal intake of 2000+ calories a day. All bariatric surgeries are great. I personally didn't want the bypass due to a phenomenon called intestinal adaptation: years after the Roux-En-Y, the intestinal villi enlarge and become more adept at absorbing calories. This primes the body for rapid regain, though people can and do regain with any bariatric surgery. I also like the fact that the sleeve leaves the pyloric valve intact.

If you aren't carb-sensitive, you may experience some bloating from water retention and increased glycogenation when you reintroduce carbs, even if it's whole wheat pasta and brown rice. If you are carb-sensitive, your weight loss might stall long and hard.

You can lose weight without surgery. So could I. In fact, prior to surgery, I'd lost more than 200+ pounds since my teens. I'd lose 50 then regain 60. I'd lose 60 then regain 100. Rinse and repeat. Most obese and formerly fat people can lose weight just fine without weight loss surgery. But here's the lick...can you keep it off without surgery? In all likelihood, nope. I'd bet top dollar that you probably wouldn't be able to maintain whatever weight you lose without bariatric surgery. Without surgery, there's a 95% chance you'll regain it all plus more. So, yes, you can do it in your own. However, there's a catch. Always remember that obesity is not curable, ever. Your body will fight to regain and resist any weight loss efforts you initiate on your own.

V8 has added sugar and is sodium-laden. There are reasons it isn't on the majority of 'approved' acceptable liquids lists. 12 ounces of V8 has 15 grams of carbs and 12 grams of sugar. You'd be better off sticking some carrots, tomatoes and celery inside a juicer.

You may gain weight. However, it probably won't be fat that you gain. Rather, you'll likely gain water weight by reintroducing carbs without engaging in moderate intensity exercise on a routine basis. Starchy carbs (e.g. corn, potatoes, rice, breads, yams, etc.) may cause bloating in susceptible people due to several mechanisms. High-carb food causes the body to store three times as much water compared to protein. This increased water storage is in the form of muscle glycogen stores. To summarize, you may see a bump upward on the scale from water weight gain if you resume eating carbs. However, this can be minimized by working out. For instance, I eat as many carbs as I want, but I keep my activity levels high because I dislike restricting macros from my food intake.

You used the word "restrict" and I suspect that's the issue. Since you should no longer be on a diet, severe restriction of food needs to be done away with. The more you restrict, the more you crave. Restriction is a relic of the dieters' mentality. My dietitian did not have me restricting calories ever. I reached my goal weight and have maintained my 100+ pound weight loss. Here's the method to the madness: those who eat enough protein will naturally keep their calories low and metabolic rate high without tracking or counting. Protein has a very high thermic effect and the body must devote considerable time and energy digesting it. This revs up the metabolism. I increased my calories incrementally. By 4 months out I was eating 1000 kcals. At 6 months I was up to 1200 kcals. By 9 months I ate 1500 kcals, and at 12 months out I was up to 1700-1800 kcals a day. I am now 2+ years out and maintain my 118-pound body on 2000 kcals daily, though I don't closely count. The incremental increases in food intake preserved my metabolic rate and I am reaping the rewards today. I eat about 120 grams of protein a day. I don't count carbs or fat grams. So my advice would be...1) stay off the scale for a few months; 2) consume 80+ grams of protein per day, preferably meats and eggs, and 3) gradually increase your food intake. Good luck to you! By the way, I'd lost 41 pounds at 4 months out. Not everyone is a rapid responder to bariatric surgery. What really matters is the long run, a.k.a. your ability to maintain the weight loss without regaining.

And, by the way...dietary fats and protein do not elevate serum cholesterol levels. The culprit for high cholesterol in most people is increased carbohydrate intake. Our blood cholesterol is produced in the liver. It doesn't come from the animal proteins we eat. http://drhyman.com/blog/2016/01/14/7-ways-to-optimize-cholesterol/

Listen to your doctor. Animal-based proteins will cause you to start losing due to the thermic effect of digestion. Your body must expend considerable energy and calories to digest protein, and this process keeps your metabolic rate revved up. You need water in order to enhance your body's ability to metabolize the fat you hope to burn off. Drinking enough water can boost the metabolic rate by up to 30 percent: https://www.ncbi.nlm.nih.gov/pubmed/14671205 You mention snacking. I suspect you snack on carb sliders such as crackers, popcorn, etc. If you do (and I'm not saying definitively that you do), I think you know why you may be stalled. There's a saying: "Insanity is repeating the same mistakes and expecting different results." Good luck to you. I think, deep down, you know what to do. You don't need our validation to start doing it.

Liquids/fluids don't prompt the feeling of restriction. You won't feel restriction until you start eating dense protein sources such as chicken, beef and fish. Veggies and fruits also cause restriction. You will also not feel restriction with "slider" foods such as crackers, pretzels, chips, cookies, ice cream, donuts and popcorn. These foods turn into a liquid slurry once you chew them. They slide past through your stomach without producing restriction, so they're called "sliders."

It really depends on your insurance company. The insurance company I had at the time I was sleeved was more lenient than most. I qualified for the sleeve at exactly 200 pounds. Approximately two weeks before my surgery date I was up to 225 pounds. Yep, I gained 25 pounds in six months due to inability to control my eating plus food funerals (eating my favorite foods one last time before saying "goodbye"). The surgery still happened, and 2+ years later, I have no regrets about the process. I feel a sense of control with my eating that has eluded me for my entire adult life.

I had lost 41 pounds by the time I was 4 months post-op. Not everyone is a rapid responder to weight loss surgery. Realistic expectations and keeping your eye on the prize are of immense importance during this lifelong journey.

Yep. My weight has yo-yo'ed up and down since my mid-teens. At age 15 I lost 30+ pounds during a summer-long low-calorie diet, going from 155 to 125. I regained all the weight plus more in a couple of years. At age 20 I weighed 176 pounds and stood 5'1 short. I lost 60 pounds on a very low-calorie diet plus exercise and weighed in at 116 pounds. I regained it all plus more, and by age 24 weighed 205 pounds. At age 26 I weighed 216 pounds. I lost 55 pounds through diet and exercise, but regained most of it. At age 29 I weighed 203 pounds. I lost 25 pounds through diet and exercise, but regained most of it. On my 32nd birthday I weighed 180 pounds. I was asked to be a bridesmaid for an upcoming wedding, so I lost 52 pounds through diet and exercise, weighing in at 128 pounds on the wedding day. I regained it all (plus more) within a year. By my 34th birthday I weighed 225, my heaviest weight ever. I had weight loss surgery two months after my 34th birthday. Bariatric surgery is no guarantee of anything, but this is the first time in my life that I've been weight-stable and not so fixated on food. So when people say, "You can lose the weight without surgery," I agree. In fact, I've lost 200+ pounds over the past couple of decades. Losing weight was not my issue...keeping it off was problematic. Bariatric surgery has offered the last glimmer of hope for keeping the weight off. However, my struggle will be lifelong.

Some people get a runny nose or nasal drip when fullness sets in. Others feel gentle pressure in the lower portion of the abdominal area. And still, others don't know they're full until their stomachs hurt. Here's a tip for the rest of your sleeved life: try to avoid eating or drinking to fullness. Stop when you're satisfied, but do not keep going until you're full and stuffed. The brain takes about 20 minutes to give the rest of the body feedback that it's had enough food; hence, this is why dietitians suggest we take 15 to 20 minutes to slowly eat/drink. Prior to weight loss surgery, some of us enjoyed the feeling of fullness after a large meal. Nonetheless, eating/drinking to fullness is not the best habit for those of us who have had surgery.

The hair loss is something you can't really prevent. It occurs due to a process called telogen effluvium. Bariatric surgery shocks our systems, resulting in temporary trauma to the hair follicles. Basically, the hair follicles go dormant for a while and the hair sheds. The hair shedding due to telogen effluvium usually starts at 3 to 4 months post-op and stops before the 1-year mark. Some swear that biotin supplementation and Progaine shampoo works. However, the only proven treatment is time and healing.

To break it down: Lap-bands and sleeve gastrectomies lead to less nutritional deficiencies since these surgeries have no malabsorptive component. No malabsorption means a lower chance of vitamin and mineral deficiencies. Gastric bypass and the duodenal switch involve an increased chance of nutritional deficiencies due to the malabsorption of certain vitamins and minerals. Of course, the gastric balloon would result in a very low likelihood of deficiencies, but I personally do not consider that procedure to be a definitive weight loss surgery.

Today I plan to eat stuffed bell peppers...they just came out of the oven. The house is smelling so delicious right now. The stuffing consists of ground beef, ground turkey, Italian seasoning, brown rice, and tomato sauce under melted mozzarella.

In October 2014, as I was completing the pre-qualification process for the sleeve, my total cholesterol was 254. So my official comorbid diagnosis was dyslipidemia, a.k.a. high cholesterol. In April 2015, a few days before being sleeved, a recheck of my total cholesterol indicated it was 197. It had further dropped to 160 approximately two months post-surgery. In October 2015, my six month post-op labs indicated my total cholesterol had spiked into the 300s. Apparently some people experience a phenomenon called transient hypercholesterolemia whereby the free fatty acids that we burn off during weight loss end up in our bloodstreams. People do not always realize that cholesterol is also tied up in our stored fat and muscle tissue. When we burn off our fat stores during weight loss, stored fat gets mobilized into the bloodstream. My primary care provider wanted to place me on prescription cholesterol-lowering drugs. I refused because my body tolerates them horribly. I started taking high doses of niacin and red yeast rice, and my cholesterol is now in the high 100s.

You don't eat leftovers? Really? I live off leftovers...as I type this, a two-pound squash ranch meatloaf is baking in my oven. Since I also live alone and there's no way I'd eat two pounds of ground beef and turkey by the end of the day, this meatloaf will comprise the majority of my meals for the next couple of days. I suppose I'm weird, but I prefer the taste of day-old food rather than something that's piping hot and fresh off the stove or just came out of the oven.

How long ago was your surgical procedure? I'm 2+ years out. My favorite go-to recipes are blackened tilapia, flatbread pizza, salmon croquets, mackerel cakes, sardine fritters, Italian meatloaf, beef nacho casserole, chicken enchiladas, and cheesy tuna casserole. When I don't want to cook I eat roast beef & cheddar sandwiches, chef salad, Lean Cuisine dinners, canned soups, cottage cheese, and veggie burger patties. I consume about 2000+ calories per day and 120 grams of protein. I don't count fat grams or carbs. I don't track, weigh or measure since those behaviors remind me of the dieters' mentality. Many of us sucked at diet adherence before surgery, so why live like that? Tracking isn't for me. I exercise 6 days a week. My favorite exercise is running, but I also lift weights.

In less than 10 percent of cases the sleeve fails due to anatomical issues, poor surgical technique, or other issues that are no fault of the patient. Also, a tiny percentage of unfortunate souls have no favorable markers of chromosome 15, rendering them nonresponders to bariatric surgery. Nonetheless, 90 percent of sleeve failures are due to the person failing the sleeve (e.g. behavioral issues). http://thebodyimagecenter.com/wp-content/uploads/2016/03/why-we-hear-so-many-stories-of-failure-after-bariatric-surgery.pdf

I had the sleeve gastrectomy with a starting BMI of 42. My health issues that interfered with losing weight and keeping it off included hypothyroidism and insulin resistance. I reached my goal weight and have been maintaining it without a great deal of effort. My BMI is now 22 instead of 42. I've lost 100+ pounds with the help of my tool (the sleeve). And now I have a fighting chance to keep this weight off. That's what's important...

Over time it's normal for a sleeve to relax and stretch somewhat. While it won't ever stretch back to the presurgical stomach capacity of about 40 to 48 ounces, it's normal for sleevers who are 1+ years out to be able to consume 8 to 12 ounces at each sitting. At two months out I was eating 3 to 4 ounces per meal. Now, at 2+ years out, I can eat 8 to 9 ounces. So my normal caloric intake of about 2000 kcals/day comes from increased volume per meal. Also, keep in mind that each surgeon creates the sleeve differently. Some use different bougie sizes to shape the sleeve. Others make the sleeve tight and some shape it loosely. Therefore, my sleeve may be larger or smaller than someone's sleeve that was created by a different surgeon.