sebastiana

Hi there - You're asking some good questions. First of all, you can live on approximately 800 calories a day. This is called a very low calorie diet (VLCD), and there is some evidence that you live longer by doing so; this has something to do with free radicals and antioxidants, I think. But that's here nor there. If you eat they way They are telling you to, you're basically replicating a high-protein, low carbohydrate diet, low calorie (but not VLCD) diet, not unlike Atkins. Once you start to get close to your goal, it does seem harder to lose weight. I'm not sure if this is related to set-point theory (which I'm not even sure is legitimate); but I'm pretty sure it's due to the fact that the less mass you have, the fewer calories you need. In other words, you indeed will have to change something about your life because you've now identified the number of calories it takes your body to work in a day. When "calories in equal calories out" there is no change in weight, as you've discovered. Your options are to eat fewer calories or expend more calories. Duh, right? Some people talk about lean muscle mass increasing your overall basal metabolic rate, but interestingly, replacing 2 lbs of fat with 2 lbs of muscle increases your caloric need by a whopping 10 calories a day. Exercise hardly seems worth it except for the fact that it has a variety of non-weight-related benefits for cardiac health, mental health, etc---so you should probably exercise. Also there is some evidence that women stick with weight-loss programs longer if exercise in involved. According to Meckling "the inclusion of an exercise program seems to be an important element of the success of the subjects, their compliance, and their reluctance to drop-out whether they saw improvements or not. Thus, a high-protein diet combined with a moderate-intensity combination aerobic and resistance training protocol seems the ideal program for short-term weight loss in this subject population. Long-term follow-up studies should confirm whether these benefits are maintained once counseling ceases." None of this addresses your specific question about the rate of weight loss as goal weight approaches. Unless you were severely morbidly obese, I don't think excess skin removal is an option. It does indeed come down to the fact that calories in must be fewer than calories out. Write back if you are interested in more scientific studies or other information. I'm decent at finding things in PubMed. Good luck. Hang in there.

Indeed, typically you do not lose as much weight with banding as with gastric by-pass, but I'm hoping you will help me figure out how to lose it all. Suggestions? Advice?

What percent of your excess weight have you lost? How have you accomplished it?