BetsyB

I aim for 800-900 calories, 80-100 g protein/day (now that I have good restriction, it's usually around 80), <50 net grams of carb/day (from veggie and legume--and occasional fruit--sources only), and --and this is really the most important part, IMO--exercise every single day, often twice. I really think that exercise is the most crucial aspect, if you want to know the truth. Re: fat intake. Yes, some Protein sources provide a wallop of fat. But when your caloric intake is so low, and you focus primarily on lean sources, there's plenty of leeway, fat-wise. I don't choose lowfat cheeses; I simply don't eat enough of any single food to be concerned about fat. I keep an eye on it (I journal on fitday.com), but never exceed the AHA's guidelines for fat intake. Getting adequate fat is important for satiety, and paring down too far can cause other problems. I have lost consistently well. I suspect that you would not think the rate particularly fast, but 2.5 pounds/week over 8 months--well, look at my signature.

It depends on how you approach things. If you wait to reach restriction before modifying your eating, you won't lose until you hit your sweet spot. OTOH, you can eat as though you have restriction from Day One, and lose steadily throughout your journey. That's the approach I've taken. I've consistently lost about 2.5 pounds/week from the beginning. ETA: I have to agree that exercise is a critical, critical part of the equation for me, as well.

I'm not sure I'd be comfortable with a doctor who uses the same band, always, for everyone. My surgeon was reasonably certain he would use an 11 cc Realize band on me, but told me he couldn't be positive until he was inside me, and could assess my stomach. For what it's worth, though, he never uses the 4 cc bands any more--for anyone. I would want to know more about the doctor's rationale for band selection.

It's normal to feel little or no restriction until you've had a series of adjustments (fills). However, just because you can eat anything doesn't mean you should. Use this time, as you work toward restriction, to learn and practice the good habits you'll need when you do have restriction--you'll be glad that you did when you see the results. What sort of eating regimen does your doctor recommend?

I've reviewed doctors on Angie's List--and I know they learned of the feedback, because their approach changed dramatically. It's not a bad place to leave a review. I hope you know I wasn't asking about hunger and satiety condescendingly--just trying to get an idea of what is going on with you. It sounds like a tremendously frustrating situation, and I think there are tons of us who'd love to see you happier and losing the weight you want to lose. I agree that for some people, carbs are important for satiety. I'm unfortunately not one who can lose weight well while incorporating them to any significant degree. (I fought this like hell, and look where I ended up!) I have been unusually fortunate with my band, though. I am one of the lucky ones for whom satiety occurs with a small volume of food, and lasts for a handful of hours. Not everyone is like me--not everyone starts out from the same place or with the same needs. (I just needed to get my caloric intake way down; I have freakishly slow metabolism.) I'm sorry you're having such a difficult time. I do think in your shoes I'd try tiny incremental fills to see if they do help with the hunger. In the hands of a skilled doctor, you might fare so much better than you initially did. I'd also try different combos of food--switching the protein/fat/carb ratio (or making sure all carbs are complex, or whatever...just mixing something up). You never know what might trip the switch and get the weight loss ball moving again. Still, it is a very discouraging situation, and I understand your feelings---I would be so disappointed in your shoes.

You've got a great attitude. The ability to love and accept yourself no matter what will take you very, very far.

I think it's probably a good idea to talk with your doctor about this. Though the pain of gall bladder disease generally is located in the center of the abdomen or off to the right a bit, it's not terribly uncommon for it to occur the way you describe. After 10 months of loss, gall bladder disease is often the culprit for abdominal pain. But it's important to let your doctor know what's going on so that s/he can do a full assessment. Chances are, it's nothing that is of enormous concern. But it's always better safe than sorry.

Not scolding, just offering the observation that the foods you're choosing are not among those that really would increase satiety. I totally understand the salad--the whole time I was "off" vegetables, the one thing I craved more than anything was salad. I don't think either food will harm you. They chew down to nothing. But on the other hand, they don't really offer any sort of staying power. If you're genuinely hungry, you'd be better off choosing a bit more of the soft Protein you're allowed. Or adding a Protein shake once or twice a day.

I usually have a couple of weeks post-fill when I am very susceptible to swelling if I push solids too fast. And because I'm impatient, I often do push solids. My doctor's rule of thumb is that we MUST be able to tolerate liquids. If not, an unfill is necessary within ..well, hours. But if we can tolerate liquids, then advance to soft foods, we can "take it easy" for a while to see how things shake out. Early on, I had no difficulty. As I teetered on the brink of restriction, I had to be really careful. As I got closer and closer, the time required to adjust after a fill got longer. Now, I have a solid three weeks or so when I have to play it by ear. I find that eating the wrong thing too early really exacerbates swelling, so I don't get a good feel for how the band really is until about 3 weeks out. In your shoes, I'd give it a bit more time. Stick with the soft foods for another week or so. If you think swelling may be the culprit, you might find (like I do) that liquid Benadryl helps. Gradually add regular solids back in, cautiously. If you still have difficulty, yes--I'd consider a tiny unfill. But easing off and taking it slowly has always allowed me to work with the restriction I have---and it has always ultimately resulted in deciding the fill was okay.

Elfie has a good point about how to locate good doctors. (I also would recommend leaving feedback about the one you have.)

It'll be okay. It's family, and they can adapt to your needs. They will be just fine if their visits don't focus on food. Proficiency is a process. And I think you'll find that you can really get a good sense of mastery from tackling things like family visits. If you aren't feeling well, that's a different story; by all means, in that case, let THEM take care of YOU! But if you feel generally well, stick with your plan. Your son and sister can join you for walk or, if you prefer to get into your own routine, occupy themselves for an hour a day. (My family is usually still sleeping when I walk in the morning; when I walk in the evening, they're doing their thing.) Enjoy your family--I hope you have lovely visits and discover how well your new way of living fits into "real life."

We must read and post to a different message board. I see very little nastiness. I see a lot of successful people who are willing to share what has worked for them. I'm sorry you're so unhappy here. There are other really supportive boards. One is below my signature.

I don't feel "full." I feel not hungry, or satisfied. When you have restriction, even one bite too many can push you from not-hungry to real discomfort--so you really learn to listen to your body's cues. I find that I get "full" (new version of full) with a very small volume of food, and stay not-hungry for 3-4 hours. Some days I'm hungrier than others---and some foods have more staying power than others. You just learn to listen to your body

My port had really nagging pain--at 8 months out, I still get twinges. Do call your doctor for peace of mind. But I wouldn't be hugely alarmed.

Cleo's Mom, do you make a distinction between hunger and lack of satiety? I ask, because they are very, very different things for me. My physical hunger is removed by the band. I mean, I do get hungry, but when I am satisfied physically, I consider myself to be no longer hungry--even if my MIND would like to eat more. I also find that my mind doesn't clamor for more very often now--the physical satisfaction really extinguished that for me. Your surgeon sounds like a monster--seriously, if you have not reported him to your state licensing board, I would. It is inexcusable that you were given so much misinformation and were lied to. You have no fill in your band currently. That was the right thing to do when you were stuck and subsequently swollen. But it doesn't sound like it's the right thing now. I understand apprehension about refilling--but do you think that cautiously doing so might not be a good idea? (WIth a different doctor, of course!) It might be that with the correct fill level, and really cautious eating, you'd fare better. What do you eat, routinely? I know you said you journal, and that's great---but how does your typical day break down, in terms of calories/protein/carb/etc? It's not fair, but for some of us, the breakdown is really critical.

It's really common for the first (and sometimes second, or even third) fills to have little discernible effect on satiety. I know it's frustrating, but try to think of yourself as being one step closer to where you want to be. Use the time you are approaching restriction to build good habits that will serve you well when you do have restriction. Choose foods carefully, eat them in appropriate amounts, chew carefully. It's a process--and you're on your way

I could--and I did. Many times. For me, the real obstacle was metabolism shot by crazy diets my mother had me on starting in early elementary school (when I was not overweight). My body gains weight if I take in more than 1100-1200 calories/day. So, to lose (or maintain when I'm at goal), I need 800-900 calories. And many, many times, I ate 800-900 calories to lose weight, and was successful. Only, that's not sustainable, long-term. Very real hunger was a real impediment. For me, the band is a great solution, because it takes that hunger out of the equation.

Yep, I agree with Elcee. I was taken off, but am back on again, albeit at half the dose I used previously. I have a family history of hypertension--even among normal-weight family members. So I keep a close eye on the numbers now.

Yep, you're ready! It really is about doing it for yourself.

It's not an ignorant question, Amber. It is a good one. The band, at first, doesn't really provide much help. It takes a period of time to reach a good level of restriction. That said, once you do achieve that, the band makes it SO much easier to do the things you've had difficulty doing your whole life. Yes, it does "force" some things. But the fact of the matter is that you won't need forcing. Let me give you an example, using me. For many years before the band, I followed Weight Watchers. I was always told I needed to eat more to lose. Guess what? I gained. I tracked my intake and exercise on fitday.com, and discovered that I really don't lose weight unless I eat 800-900 calories a day, and exercise every day, too. I couldn't find support for that kind of regimen from anyone--everyone told me I couldn't meet my nutritional needs, would go into starvation mode, etc. They didn't really look at the evidence I had (showing that I lost in that range and, if careful, really DID meet my nutritional needs). They just flat-out told me to eat more. And I gained. Fast forward to when I grew a spine: I woke up one day and said, "Gastric band!" And made an reservation at my surgeon's seminar. A couple of weeks later I was in his office, with my food journal, and he identified that I was the perfect candidate for the band. It would make it possible to eat the way my body needs to eat in order to lose, and would--and here's the really critical part--remove the always-present gnawing hunger. So I was banded. For the first few months, I just stuck to his recommended eating regimen. Was I hungry? Yes. But I told myself, "This is the last time I will be hungry in the name of weight loss," and powered through. Each fill made me a bit more comfortable, and kept me satisfied a bit longer. Now I have restriction. With hunger removed from the equation (and by that, I don't mean I don't get hungry for meals; I do...I just mean that the ever-present "dieter's hunger" is gone), obsession with food is gone. I am able to make the choices my body needs. I fill up quickly and stay satisfied for long enough that, when the next "feeding time" comes, I am eager to put something into my body that will give it what it needs. Does this mean I never have treats? No, not really. But I don't have them often, and I NEVER EVER EVER EVER feel deprived. The band is a great tool. It does part of the job--it keeps that hunger at bay. The rest of the job is up to us. We can make food choices that bypass the band---but when satisfied by foods that meet our needs, the compulsion to do so really, really diminishes. ETA: Carmen, I'm 48--eek, almost 49--and changes related to aging haven't kept me from being one of the best losers in my doctor's practice. I have the metabolism of a lobotomized tree slug, but have simply decided to use this tool to the best of my ability. And I have been amazed at how well it's worked for me.

It's a process. You have a lifetime of bad habits to correct, and that won't happen overnight. If you make a point of focusing on the habits you wish to adopt, and extend yourself some grace and patience, it will begin to fall into place as you approach restriction. Every day of "practice" takes you closer to well-established, healthy new habits. Will you slip up? Sure. Especially during the early weeks/months, when you don't really have the restriction you need. But it really gets so much easier with time (and adjustment).

I've had a steady loss of around 2.5 pounds/week since banding--restriction or no. I've had a couple of very brief stalls, but in general, I can count on a couple of pounds a week. I have always eaten according to my doctor's regimen, and I exercise routinely. Now I have good restriction, so being compliant food-wise is pretty easy. (Do I want sweets? Eh, most of the time, no. When I do, I can easily persuade myself to skip 'em.) I'd recommend that you journal your eating and exercise at fitday.com so that you can be sure you're meeting--and not exceeding--your body's needs. It may be that you need to pare out those sweets. Or bump up Protein. Or any of a million other things you can do to tweak things to get things moving the way you want them to move. For me, what works is aiming for 80-100 g/protein (usually closer to 80 these days, with restriction), <50 g net carb (from veggie, legume, and fruit sources), 20-30% of calories from heart-healthy fat, and 800-900 calories/day. Your "formula" might be very different; this is how my doctor's recommended regimen shakes out, though, and those of us who are compliant fare far better, in terms of loss, than those who do not.

Ask to see the doctor instead of the PA next time. When you go in, have a log of (a) what you eat, and when, and ( how long you are satisfied after eating. Looking at a band fluoroscopically does give information about its tightness. However, your band has plenty of "room" for more fill, and chances are, you'd tolerate a conservative fill nicely. If you are making wise food choices, and are getting hungry too soon after eating, then YOUR experience needs to be taken into account when making decisions about fill. It's not just whether you're losing weight, or the band looks adjusted. It's how it feels, too.

Thank you! I think I misunderstood. I was thinking you were already on the PREOP preop diet; you're referring to the sort of supervised pre-op period. My doctor had a specific requirement for loss during mine, but it was much longer than your 3-4 weeks. I bet you don't have anything to worry about. Do your best, and when you get to the liquid stage, pay attention to those rules the best you can. (If you get a choice of Proteins, I strongly recommend the Inspire and PURE Protein powders from bariatriceating.com. If you order now, they'll come in plenty of time for your preop liquids.)