Barrr

I am a 50-year-old man who struggled with my weight most of my life, starting with being an overweight kid. No diet or exercise program produced tangible, good results. At my annual physical in March I weighed in at 405 pounds. I take no meds, and up to this point, my most serious health issue has been sleep apnea that I was trying to handle with CPAP (mostly unsuccessfully). Given my alarmingly high weight, my doctor recommended that I look into the bariatric surgery option. I eagerly started the process, looking at it as a once-in-a-lifetime chance for getting back to normal body weight and gaining a quality of life I have not enjoyed for a long time. The bariatric program I joined requires that patients lose 10% of their weight before even being scheduled for surgery. Insurance also requires at least 3 months of engagement with a managed weight loss program. I was determined that despite my past struggles with diets, I will do whatever it takes to make the cut. I met with the program's nutritionist and had a very nice discussion with her. Then I went home, and threw out the materials she gave me (calorie counting book, etc), and ignored all her directions and advice. I dove into reading and research and started implementing a diet largely based on Matthew Weiner's A Pound of Cure vegetable-focused program. I had immediate success, losing 20 lbs in the first month (guaranteed, a lot of that may have been water weight held onto by insulin). I kept reading and experimenting, incorporating advice from Sten Ekberg (Master Your Health), Eric Berg, Dave Asprey (Bulletproof Diet), Jason Fung (fasting strategies), and many others. At this point, I am three months into my pre-op personally directed diet. I have lost a total of 70 pounds have a current weight loss rate of 1 lb / day feeling great COMPLETE resolution of my sleep apnea issues 120/80 blood pressure (was somewhat high at the beginning of the program) went from a size 4XL to wearing 2XL (depending on cut of clothing) 48 inch waist to 42 inch waist not counting calories no hunger or craving issues I am just starting to discover the research (a recent Nobel Prize-winning one) regarding Autophagy and its related health benefits brought about by intermittent fasting, and many other possibilities. Next week I am scheduled to meet with the bariatric program's PA, do my weigh-in, and (pending insurance approval) schedule the surgery. I am torn and in doubt. The last few months have been some of the most exhilarating experiences in my life. Gaining control of my body and my overall health in the way I have done in such a short period of time is amazing. The bariatric surgery option, which just a short while ago seemed like a Holy Grail lifesaver to me, seems full of pitfalls and restrictions on the methods I can do to manage my body weight and health. I was looking forward to trying out possibilities with time-restricted eating, and using longer fasts (triggering autophagy) to eliminate loose, hanging skin that might come about otherwise with significant weight loss. On the other hand, I still weigh 335 pounds and am nowhere near my goal of a healthy 200. What if my weight loss stalls out well short of that goal? The sensible answer might be to simply wait, see what happens, and re-engage with the program if it seems necessary to keep pushing past a stall point. However, for reasons I do not want to detail, I might not have this option after this year. Under these circumstances, if this was your only chance to move ahead with a Gastric Sleeve operation, would you do it? Any other thoughts? Your help is greatly appreciated.

Congratulations on your amazing progress. Are you able to describe some of your challenges that you think you will be able to manage with the help of a therapist? What are some of the issues within your weight loss / bariatric experience that you think will require work and extra assistance. Also, you mentioned the foamies... what is your general daily eating experience, and are you happy with how your current diet seems to serve your overall health (besides weight loss)? Your perspective is greatly appreciated.

Thank you for your reply. Can you provide some details? What specifically are you finding as the most negative aspects of the sleeve? Rough recovery? Difficulty in losing weight? Overly restrictive diet? Something else? Your input is greatly appreciated.

Thank you so much for the many constructive and helpful responses. To clarify my worries, here it is distilling them to two points of greatest concern: Ability to incorporate good fats into a post-gastric-sleeve diet The foundation of my current diet (that I would be happy to keep for the rest of my life) consists of lots of vegetables, moderate amounts of high-quality protein, and the inclusion of a good amount of healthy fats (avocado, EVOO, butter, animal fats from pastured, organically raised animals). This is supposed to help the body adapt to regularly burning fat (whether from the diet or from our own fat stores), and to much more easily reach satiety and control hunger, in addition to the various documented nutritional benefits of these fats. I read over and over again about directives to keep post-bariatric diets very low fat for the rest of the life of the patient. Also various posts from patients about not being able to tolerate fats and struggling with digestive issues. How much of a problem is this universally (realizing and respecting that everyone's body, digestive system, and hormonal balance are different)? Ability to do fasting and support periodic zero-protein day(s) I have started to incorporate time-restricted eating (16/8) with great success and starting on my first 36-hour fast over the weekend. I have not only had great results on the scale, but starting to see amazing physiologic benefits outside of simply lowering my body weight. I definitely would want to have the ability to have a longer (3 day?) fast once in a while to trigger autophagy and reap some of the other benefits related to insulin and metabolic issues. I realize that for a period following surgery I would have to be adhering to the physician-prescribed diet aimed to maximize healing and avoid complications. But what is the situation six months or a year down the line? Can I incorporate fasting then, or am I eternally tethered to a 70g-minimum-per-day protein intake that I cannot violate without risking my health? Your help and insight are appreciated!

Interesting... is your doctor prohibiting you from coffee because of your Gastric Sleeve in general, or do you have other health conditions to warrant this? I am pre-op, but my research indicates that many bariatric surgeons are OK with their patients drinking coffee once they are in the solid food phase. Check out Matthew Weiner on YouTube among others regarding this topic.