NickelChip

What a transformation!!! You look great and you must feel so much better.

Okay, so the weight loss looks great, but can I just say that your hair wins the day! I absolutely love the new style! And are those lavender highlights? It looks fabulous!

That sounds about average to me. I've met with a few different nutritionists on and off for several years as I was in the non-surgical side of my hospital's program for about 6 years before my doctor recommended starting to pursue surgery this past summer. This time around for the surgery prep meeting, I discussed my eating habits, asked a few questions, and we went over the stages of eating after surgery plus supplements, etc. But honestly, if they get the sense you understand how to eat healthily and there aren't any specific issues to go over, that's about it. Mine was about 45 minutes.

I was hoping for November but it looks like my date won't be until December 27. Wishing all the November peeps good luck!

I imagine price might have something to do with the reason your doctor is starting with this one. I've never taken it, but I looked up the price and it's very affordable, like under $10 at some pharmacies. If this works for you, affording it long term will be a breeze. The newer GLP-1 drugs might sound so much better in terms of effectiveness, but at over $1k a month, I'd be praying for something else to work!

It's funny because I have a friend who is naturally very thin, bordering on underweight, and she is always cold. We were out walking on a horribly hot and humid day this summer where everyone else on the street was in tank tops and shorts and looking ready to die, and she had on a light denim jacket. I almost wouldn't have believed she could feel cold, but her hands were like ice to the touch. I have to say I wouldn't mind this side effect because I hate the heat. If it makes summers more bearable, I'll take it. (Of course, I say that now, before the onset of what they're all saying is going to be an epic New England winter.)

Good luck tomorrow. So happy for you and I love your good attitude!

What about adding a higher calorie shake like the Ensure Complete Nutrition, which has 350 calories in a 10 oz serving? It's generally considered too high in calories for using if you're trying to lose weight, but if you had three of those per day, you'd be getting 1050 calories and 90g protein right there before even having soft foods. You should be able to manage that amount capacity-wise with no problem. They have 8g fat and 15g added sugar, which might cause some risk of dumping, but I would think it would be worth a try. It seems like you'll need to hit about 1400 calories per day minimum to stop losing weight, whereas in the early days the guidelines you get from the doctor that are intended for weight loss may put you well under 1000.

So, post-op he is definitely not advocating for a pound of veggies per day, at least no time soon. That goal is for a person who has not had surgery or is years out and has regained a pretty standard appetite. What he does suggest for bariatric patients is that for that honeymoon period of the first year or so, you focus on protein first. But as time goes on and your hunger returns and you have more capacity to add foods, you should increase the veggies you eat while keeping your protein and starch servings small by comparison. He likes to say veggies should be the star of your meal. In other words, instead of going from 3 oz of chicken to 6 oz so you can feel more full, you would eat your usual 3 oz of chicken and fill up the rest of the way on healthy veggies (but only to your personal capacity, whatever that is). Same with snacks. If you get hungry and need a snack, make it a healthy one with veggies instead of a junk food snack. From what I gather, the strategy is one that really helps to combat that weight gain in later years when it becomes a little too easy to eat a lot more like you used to (the way that got us all into trouble to begin with!)

1. Less aching in my feet and joints 2. Being able to walk faster and longer 3. No more blood pressure meds (hopefully!) 4. Healthy lab work and no more prediabetes 5. Shopping in a store and not having to think "they probably don't have it in my size" or "that won't look good on me."

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My advice is not to think in terms of "being on a diet" but in terms of "what does healthy eating look like." I know at least for myself, I've spent so many years counting calories or doing fad diets, and I'm burnt out on the tracking and the counting, and feeling deprived and waiting for it to be "over." What I've started doing instead is focusing on what healthy eating really looks like and trying to choose mostly the good things and eliminating the bad things. For example, I've started having a smoothie every morning with 2 oz spinach, plain Greek yogurt, unsweetened almond milk, frozen fruit, chia, flax, and hemp seeds, and protein powder. I know that everything in it is great for fueling my body and I feel good about drinking it. At lunch, I have a massive salad. Like, I bought a serving bowl and I fill it to the top with spring mix, spinach, shredded carrots, cucumbers, tomatoes, cabbage, beets, and mushrooms. I put about 3oz chick peas and black beans on it, and 2-3 oz lean deli meat, plus a Tbsp each of pumpkin seeds, sunflower seeds, and sliced almonds. I top it with a freshly squeezed lemon and Tuscan seasoning blend instead of dressing. I'll be honest, the thing is so filling I barely have room for dinner. I do eat dinner, but it's light and mostly protein and veg. Since I've started doing that and gotten all the snacks out of the house (no more buying pretzels, crackers, and other easy carbs or sweets) and only allowing myself fruit or nuts for a snack, I haven't really felt hungry at all, and I haven't been craving junk like I used to. I've also cut back on caffeine and stopped drinking diet sodas. I started making these changes in July and I'm down almost 15lbs without having to write down everything I do, because it's mostly the same every day. For me, this is something I can keep up long term as long as I am mindful of what I allow myself to bring into the house. Give yourself time, you can do it!

Did they test you for Graves' disease? I assume they ran thyroid tests, but I have a number of people in my life who have had Graves' and the inability to keep weight on despite eating constantly is a top symptom.

The story behind the 2000 calorie per day number is kind of interesting. It's to make it easy for food labels. The USDA wanted to be able to give nutrient information for comparison between foods, so they surveyed lots of Americans in the 1990s to see how many calories they ate per day and got a range of 1600-3000. But putting a range of nutrition values on a food label is messy and confusing. They decided on 2000 because it makes the math easy. But 2000 is actually too high for most adults not to gain weight, which might be why almost 70% of Americans are overweight or obese!

If you are at 1000 calories now, 1500 would be an additional 50% of calories. If you look at it like that, it's a lot more than what you're eating now! It's like going to work and getting a 50% raise! You just have to make sure you choose wisely how to spend those extra calories. I'm on the other end of things, waiting for surgery and working on improving my nutrition in the meantime. Honestly, one of the biggest things that has helped me in the past few months has been following the advice in Dr. Weiner's A Pound of Cure book. I had gotten into some really bad habits, like white toast for breakfast and a sandwich with lots of cheese and mayo for lunch, and I was constantly hungry and snacking on pretzels and other simple carbs, or candy (my biggest weakness). I hardly ever got much protein or veg and fruit. In July, after my doctor recommended surgery, I bought the Pound of Cure book and made the decision to incorporate a pound of veggies every day into my diet, and to follow the other guidelines as I was able. I stopped buying the junk food and reduced my dairy and wheat intake significantly, plus eliminated all artificial sweeteners and most added sugars. Now I have a smoothie in the morning that has just under 400 calories and 40g of protein in it, and gives me 2-3oz of spinach. At lunch, I make a salad that is around 450 calories with 30g of protein and literally weighs more than a pound of veg, beans, and seeds. I usually add a couple ounces of smoked salmon or turkey breast, but I've been skipping the dressing in favor of lemon juice and a spice blend. I usually have around a 400 calorie dinner that is mostly protein plus 4oz or more of veg, and I'll have some fruit or nuts if I need a snack. This stuff is so much more filling than my pieces of toast with butter or my sandwich ever was that I find I'm really not that hungry much of the time. In fact, I feel like I'm eating way more, and I'm not craving snacks the way I did, yet I'm rarely above 1500 calories on a regular day. So if you choose wisely, you will be amazed at the volume of food you can consume for under 1500 calories. I know I've been really surprised by it, and I've managed to lose around 15 pounds in 2 months without really feeling deprived. I know for me the biggest risk would be to fall back into the old habits, so I'm trying to keep things as simple as I can to make it less likely. But not feeling hungry all the time really makes a difference.

I saw this Swedish study linked to the one you posted: https://pubmed.ncbi.nlm.nih.gov/35595650/ They found that continuous use of NSAIDs in bypass patients for 30+ days was a significant risk for ulcers, but temporary use was not. Additionally, they found no association between NSAID exposure and peptic ulcers in sleeve patients. So it seems you might be right about the extreme use of caution (to avoid being sued). Not to say anyone should disregard medical advice, but it does help to put the risk into perspective.

I've recently started squeezing one fresh lemon for my salad and adding a dash of pink salt and several shakes of a Tuscan herb blend. I'm not missing the dressing, and I appreciate I can use enough lemon juice to actually coat all my veggies. The herb blend really delivers on flavor. Since I'm pre-op, my salads are pretty massive, and 31g of dressing for a bowl the size of a serving bowl is laughable.

It's wicked expensive, but Ka'Chava protein shakes are sweetened with coconut flower nectar, which does add a bit of sugar but within the guidelines I was given (I was told no more than 10g sugar per serving, and calories no higher than 10x the grams of protein, so ). I haven't tried it yet but did order a bag. I've also ordered a sample pack of Truvani protein powder flavors to try. Those are sweetened with monk fruit, and also on the pricey side, but made without artificial ingredients which appeals to me. I've been trying so hard for the past several months to clean up my nutrition and get rid of artificial stuff, so it pains me to think I will be spending months drinking shakes filled with artificial junk.

That's awesome! 26 years ago I think I was still just under 200 lbs. A couple years later, I crossed that mark and came close once but have never seen the other side of it since. When I see that 199 finally come up on the scale, I think I will cry. You must feel like a whole new person.

Ugh. It sounds like you would basically have to turn eating into your full-time job to reach the daily goals if you can only go a bite or two at a time.

Is there anything specific that you think is stopping you from reaching the goals? Would a clear protein drink help you kill two birds with one stone?

So I haven't had surgery yet, but I do have some relationship advice for you based on my own life experience. My ex and I used to have that same nightly ritual of putting the kids to bed and then filling up bowls of ice cream, candy, or whatever other junk food was on hand and watching TV together before bed. It got to a point where that was the only thing we really did together, and when I would want to make healthier changes (it was always me who would suggest it) he would go along but then always act like I was the" mom" who would or wouldn't give him permission to "cheat" with dessert on any given night. It was such a stressful thing when I already was trying so hard to stop myself from giving in. But the TV and snack routine would always win out in the end. Not saying this was the reason the marriage failed, but I sure wish looking back that we had found other, healthier activities we both enjoyed than just watching TV and eating. Even on weekends it would be like "What do you want to do?" and the answer was always, "I don't know, but we could go out for dinner, I guess." I think if you can come up with ideas now that allow you to spend time together in more fulfilling ways (I mean, when you watch TV, you're really not interacting as much as you think), you'll end up a lot happier as well as more successful in kicking the old habits for good. Go for walks together, explore new places on weekends, or try learning ballroom dance from YouTube videos in your living room at night.

Wow! You look fantastic, and as distressing as I know the hair loss must be, you can't tell at all from the photo. What an amazing transformation. Congratulations!