SpartanMaker

I understand, but the problem is that for most obese people, the number these simplistic calculators spit out is way too low. None of them take into consideration that obese people have things like enlarged hearts, denser bones, more blood volume, extra skin, etc. in addition to the fat. While some of those things will eventually change over time, it's not nearly as quick as the fat loss, especially for bariatric surgery patients. I've seen way too many people shoot for weights that are unrealistic and frankly would be unhealthy for them. That's why I said pick a higher number and reassess there.

To put it simply, Ideal Bodyweight is a crock. These are all based on one of 3 things: BMI, population studies like the NHANES survey, or body fat %. None of these can tell you what YOUR ideal bodyweight should be, only what an average range of weights might be. Why? Let's look at these individually: BMI: Frankly the fact that this psuedo-science is so widely used is downright scary. This is all based on a formula created almost 200 years ago by a mathematician (not a physician), trying to determine what an "average" man would look like. It does not take into consideration muscle mass, frame size, or any thing other than height and weight. As an example of just how messed up this is, consider that some professional bodybuilders fit into the morbidly obese category even though they may only have 5-8% body fat. Population Studies: Studies that look at large populations have the same flaws in that they only look at averages. They are good for understanding population groups, but are not instructive to know what YOU should weigh. Body fat: In general, these formulas are going to be better than the above (as an example, see Gallagher et al., "Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index." American Journal of Clinical Nutrition, 72 (3): 694.), because they are at least based on your stats (% Body Fat), but they have 2 fatal flaws: First, they rely on BIA (Bioelectrical impedance analysis), but BIA is not that accurate overall. Second, Lean mass is also is lost as someone loses weight, but if the estimate is based on body fat alone, it will be wrong. My point is the best way to know what your ideal weight should be is based on how you feel and look once you get there. If you need a goal to shoot for, aim high when looking at ideal weight charts. If you're not happy once you get to that weight, you can always adjust downward.

You might like "This American Life". If you asked, I'm not sure I could explain what it's about, but based on your likes, I'm guessing you might enjoy it.

Same here. Sleeves can often make this condition worse.

I think it came back from insurance in a couple of weeks, but due to the backlog at the clinic, it took them about a few weeks to submit it. The biggest delay was just getting on the surgical schedule. I think they are still running at a reduced schedule due to COVID, so the delay to even get on the schedule can be a month or two. Also, based on previous experience in this area, most facilities only schedule out a couple of months at a time, so like clockwork, I got my date exactly 2 months prior. I trust the surgeon, she is very experienced, but I think the hospital and staff are just swamped with a huge backlog.

Hopefully it doesn't take you as long as me! I had all the pre-work done by May and it took 4 more months to get insurance approval and get on the surgery schedule. Now some of that I suspect is because I'm going to a large teaching hospital and their schedule is still massively delayed due to COVID.

Ah, got ya. Not sure about how your procedure differs from other sleevers, but they may be better able to advise on how they are on sugar. I wanted to suggest you try the monk fruit sweetener (with erythritol), and see how you tolerate that. I find it's a little better for me in terms of taste and side effects compared to many other sugar substitutes.

I sincerely mean no disrespect, but I'm honestly a little confused? You said you did the surgery to change your relationship with food, but here you are a few days post-op and already asking if you can deviate from your prescribed plan? This seems incongruent to me. If you're really serious about changing your relationship with food, why deviate so early?

I took the first thing they offered, but was given the opportunity to reschedule if that didn't work. I took it because there's never a "good time for it", and I wanted to have it done as soon as I could.

May depend on the insurance. Some may want to see the person you spoke with have a US credential like RD, or RDN.

It's entirely likely they will tell you to go to the ER. This may or may not be related to your surgery, but is definitely serious enough to warrant a trip to the ER to get checked out.

Would also love to know how the preop diet is going for you? Struggling? Any tips for the rest of us? How's the hernia and GERD doing now?

So let's set aside the actual weight loss part for a moment... I'm curious what improvements folks have seen in their overall health as a result of the weight loss. For example, Normal A1C without meds, normal blood pressure without meds, improved cardiovascular health, no more need for a CPAP, etc. Care to share?

I think you may be being to hard on yourself. I say this because you know it's water weight, but you still find that discouraging. This is why lots of people encourage those on this journey to use additional tools like BIA scales & body measurements in addition to just tracking pounds. Weight alone is not an accurate representation of health, or even of how much fat you're carrying.

I'm right there with you. Nonalcoholic fatty liver disease (NAFLD) and the more severe form: nonalcoholic steatohepatitis (NASH), are both pretty common for obese people. Note that about 25% of people with NASH develop cirrhosis. Thankfully weight loss surgery is pretty successful in reversing NASH, as well as a host of other issues like GERD, sleep apnea, diabetes & heart disease. At the end of the day, only you can decide if surgery is the right thing for you. If you do go the surgical route, you'll find lots of supportive people here.

Tough one. I've not had to deal with this in a long time (my kids are grown), but here's some things I thought of: Make stuff your kid likes, but you don't, chew gum and keep your water close by and reach for that instead. You could also start now and reward yourself (non food, of course), whenever you make it through the day without doing this. I think ultimately it's just a mental game. You have to convince yourself that your goals are more important than this habit and consciously tell yourself not to nibble as you cook. Try to be more aware of when you are doing it and why. Knowledge may help you overcome the urge.

My surgery's not till the 20th, but I'm not really planning anything special? A "last meal" makes it sound like I'm dying or something, but I think of this as more of a re-birth. Is that weird?

Please, please talk to your doctor. Some issues with vitamins is normal, but the rest of what you're describing is not.

I actually bought several different vitamins, from several different companies, and in a few different forms (capsules, chewables, soft chews). I've heard some people have issues with one or the other post-surgery. I'd rather have them now so I have choices if I end up needing them. I figure eventually, I'll be able to use them, even if I can't stomach some of them early on. I doubt I'll waste entirely them unless they are just really terrible. One thing I have not done is compare standard off-the-shelf vitamins to these supposed bariatric ones. I really want to know if there's a difference?

So I just wanted to point something out here. GERD and an ulcer are not the same thing. Having experienced both, I can say neither is fun. Certainly someone could have both conditions, but most likely, what you are experiencing is one or the other. Ulcers are basically a place where the lining has been damaged. These are most common in the stomach, but can occur in the esophagus or small intestine as well. ALL bariatric surgery patients are at some increased risk of these occurring, but they can happen to anyone, including non gastric surgery patients. GERD is a chronic condition due to recurring episodes where excess acid enters the esophagus from the stomach. Almost everyone has occasional acid reflux, but GERD is when this happens repeatedly. In most cases of GERD, the valve at the bottom of the esophagus is damaged or not working correctly for some reason. (Note that long term exposure of the esophagus to excess acid from GERD can cause an ulcer in the esophagus, but I digress.) Bypass patients almost never have problems with GERD, because the small pouch has very few acid producing cells. Sleeve patients on the other hand are more likely to experience GERD than the general population. This is thought to be due to the sleeve putting extra pressure on the esophageal valve. Both groups (sleeve and bypass), are subject to ulcers and are at more risk of them than the rest of the population. How to know the difference? WHERE it hurts is the biggest tell. if you are having a burning sensation in your chest or throat, that's likely GERD. Ulcers typically hurt in your belly. If you are having this issue, talk to your healthcare provider ASAP. Both conditions can have serious complications and you should not tough it out or hope it will go away.

There seems to be some confusion in this thread and it's not clear from the original poster, what's meant by "Steroids". There are 4 things I suppose you might mean, so we should probably clear that up: Testosterone Replacement Therapy: Since the OP is female, I doubt you are on this, as it's typically prescribed for older males with low testosterone. Anabolic Steroids: I also doubt the OP means this as these are highly controlled drugs and only prescribed in very limited circumstances. That said, a lot of bodybuilders abuse these. (Ever hear of "Roid Rage"?) Corticosteroids: These are commonly used medications typically prescribed for inflammation. The most common oral example would be prednisone. It would be rare (but not unheard of), to be on this long term as the side effects can be worse than the inflammation it purports to treat. NON-Steroidal Anti-Inflammatories: As the name implies, these are NOT steroids, or even related to steroids. They got this name because they were originally developed as an alternative to corticosteroids. Common examples include the over the counter medications ibuprofen (Advil) and Naproxen (Aleve), as well as the prescription drugs meloxicam (Mobic) and Celecoxib (Celebrex). Typically this is a class of medications that doctors like you to be off of for bariatric surgery because they can cause stomach ulcers. I'm assuming the OP meant one of the latter two, but don't know for sure?

So, we’re jumping forward to May 2021. Picture this: I’m about to talk to my cardiologist at my 1 year surgery follow-up and am getting nervous. Mentally I’m going through all the things I’m going to say to convince him I’m fine, and that he should definitely approve me for WLS. Turns out, I was worried about nothing. He went through the standard checkup stuff and at just about the point that I was ready to go into my well rehearsed sales pitch, he actually asked me if I was still considering bariatric surgery. Imagine my surprise at that one! When I said yes, he didn’t hesitate to say he was fine with it and didn’t see the heart surgery as an issue at all. He just became my new favorite doctor. I walked out of his office ecstatic and ready to call the bariatric center to get the weight loss surgery scheduled right then. I mean if they would have taken me in tomorrow, I was READY. It was late in the day though, so I decided to wait. Turns out waiting was a bad choice. I woke up the next day with horrible back pain. I’d had back issues for many years, but it had been mostly stable for a while. Now I was experiencing a bout of sciatica that was so bad, I had little to no muscle control in my legs. Great, more health issues to deal width and once again bariatric surgery would have to wait. Let me jump forward a bit here. It took a few months, some new meds, some injections, and some aquatic therapy, but the back was feeling tolerable, at least. I was finally ready to call the bariatric surgeon’s office. Remember me saying I should have called sooner? It turns out they had a 2 month backlog for “new” patients. You see, because I had been out of the program for almost 18 months at that point, I basically had to start over. Fast forward to September 2021 and I finally get to meet with a PA and start the “intake” process. I then did the standard psych evaluation and 6 months of dietitian visits required by my insurance company. The surgeon also decided that I needed to do an abdominal CT scan with contrast. Not sure if this was typical, or something “special” just for me. Unfortunately, once again something wasn’t right. This meant the surgeon wanted a closer look, which meant more testing. Pro tip, if you ever get told you need to do a fluoroscopic swallowing exam, see if you can get out of it. Seriously. This was probably one of the top 5 worst exams I've done. I went in thinking it would be no big deal and was much more worried about the endoscopy they also were planning. Turns out, I had it completely backward. I slept through the endoscopy, but the swallow study just was miserable. After a few tense days of waiting for results, my surgeon’s office said they found a couple of issues, including a hiatal hernia, but I was okay to proceed to surgery! Now it became a waiting game for insurance approval and surgical scheduling. (Apparently they are still way behind and not able to accommodate a full surgical schedule due to a COVID-19 induced backlog.) After an eternity waiting, I finally, finally got scheduled for September 20th. I just thought I was anxious before. Now the waiting really begins!

LOL, my vote is for "nervited". Excivous sounds more like what happens when your surgeon gets in a hurry! Anyway, whatever it's called, I'm sure we're all feeling it!

Sounds like your program is more like mine. Best of luck and let us know your you're doing!

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