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Researchers generally determine Protein quality by using the protein efficiency ratio (PER) or the protein digestibility corrected amino acid score (PDCAAS). They determine the PER by evaluating the weight gain in growing rats fed a particular protein compared with a standard protein, egg whites being the gold standard. The higher the PER value, the greater the protein quality. The PDCAAS was introduced as a more accurate way to evaluate protein quality for humans, because it uses human, not rat, amino acid requirements to calculate the amino acid score. It compares the amino acid profile of a protein with the essential amino acid requirements for humans according to The food and Agriculture Organization. When a protein meets this requirement, it gets a score of 1.0. PDCAAS has now been adopted as the official method by the World Health Organisation, the US Food and Drug Administration and the US Department of Agriculture. Although the PDCAAS method is the internationally recognised standard for comparing Proteins for human consumption, it does not allow for differentiation among proteins with a PDCAAS of 1.0, so proteins can have different PERs while still having a PDCAAS of 1.0. This is significant, because researchers are now exploring how variances in specific essential and/or conditionally essential amino acids, as well as the availability of various peptides and micronutrients, affect human physiology. Claims of consumer-relevant superiority or inferiority, when performance of physique modificaitons are concerned, have yet to be supported by population-specific evidence in humans. Protein PCDAAS PER Gelatin/collagen 0.08. -- Beef/poultry/fish 0.80-0.92. 2.0-2.3 Soy 1.00. 1.8-2.3 Ovalbumin (egg) 1.00. 2.8 Milk protein 1.00. 2.8 Casein 1.00 2.9 whey 1.00. 3.0-3.2 Bovine colostrum. 1.00. 3.0-3.2 Table 1 Table 1 (above) lists the PER and/or PDCAAS for the major types of protein used in nutritional supplements. The following discusses the relative strengths and weaknesses of these basic types of proteins that are often used as starting materials for nutritional supplements. Of course, adding deficient amino acids and other nutrients to these proteins may increase the PDCAAS, nutrient value and/or functionality of the protein. <><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><><> As you can see above collagen/gelatin is nearly useless to the human body. This is what is in almost all protein shots. Always check the ingredients. Many makers of protien shots are giving them names that have Whey in their title but are still using collagen/gelatin as their primary protein source. Also keep in mind that ingredients on labels are listed in the order of amount used. So if collagen or Gelatin is listed first then it is the primary protein source for that product.

Thank you all so much for your responses I agree I need to actively try and get my highs from a new productive habit. I'll have a good think about it. It's so weird how similar the over eating and over spend cycling is.... the delicious anticipation and planning or the pure joy of a suprise temptation... the shutting out of the thoughts that tell you you will regret this.. the raised heart rate and excitement of the purchase or eating... the warm glow that follows and the brief high.... then the guilt sets in.....after a few cycles of that you face major weight gain or debt issues which add to the stress and of course you need to feel good again.... I guess I should be grateful I hate cigarettes and alcohol!

There's no way, physiologically or otherwise, that you can gain 6 pounds of true fat after one or two so-called "cheat days." 6 pounds of fat gain would have required you to consume and store 21,000 excess calories as body fat. It cannot happen in a couple of days. What is happening is water gain due to consumption of too many starches. Eating too many carbohydrates without enough physical activity will cause bloat. Foods with a high carbohydrate level cause the body to store three times as much water compared to protein. This storage is in the form of glycogen, which requires a considerable amount of water. The end result of eating too many carbs without enough activity is water weight gain, at least in susceptible people. In carb-sensitive people, carbohydrate loading (a.k.a. "cheating") causes fluid retention that results in a lot of temporary water weight gain. Recall that the liver utilizes water as it creates and stores glycogen from all the carbs one eats. Thus, water weight gain will show up on the scale as a heavier weight. I do not have cheat foods or cheat days. If I want a slice of pizza or a cheeseburger or taco, I eat it. Since I have no forbidden foods, I have minimal desire to go off the rails. "Cheat days" are a part of the dieter mentality. I sucked at diets; therefore, I am not on a diet. As long as that burger can be worked into my daily calorie budget, it is not a cheat food for me.

I haven't heard of anti-depressants causing gas but I know some can cause weight gain. Regardless, you need to stay stable on your meds! I take Wellbutrin and Lamictal. In the hospital they split Lamictal 100 mg into 4 tiny 25 mg pills for me to swallow. Two in the morning, 2 at night. They went down fine. For some reason they never ordered my Wellbutrin in the hospital so I missed two days but just swallowed the pill the night I came home. Psych doc was supposed to call in a dosage not extended release but never made the call (common for my psych) so I'm still taking the same dose extended release. Having no problem swallowing the pills. Be sure to take care of yourself. Ginger

I am new to this site. I just received my first order and I was under the impression that everything was going to be "carb friendly", which in fact, most everything has excessive carbs that I could have purchased at any local store. Any recommendations on products that are offered on here that are no high in carbs? I had the gastric sleeve in December of 2017. I have gained 25 pounds back. I don't really get hungry, but my metabolism drops, which in turn, causes me to eat impulsively, which of course, created the weight gain. Trying to figure out a "diet" that will help me meet all my needs and goals. Any advice?

Well after my psych eval in march is when my doc will submit to my insurance. And yes waiting is the hard part, but I'm going to stay positive because I have been doing what I'm supposed to. I decided to switch to the DS firstly because my doc brought it up, and I didn't know insurance would cover it till I talked to him so I didn't do my research to begin with, and then decided to do my research and there's a lot to the DS that I feel would be a bit better for me. Such as keeping the valve unlike in the RNY also because with RNY you only lose about 60% of excess body weight and with the DS you actually lose about 85% excess body weight, and with the RNY people usually gain some weight back, and with the DS weight gain is almost never seen. So that's definitely a plus for me. because if I'm going to get surgery and do everything right I don't want to stable out with some weight gain from my lowest weight which usually happens with RNY paitients (not all but some) so I've done a lot of research and I feel the DS is for me. There are some things though that are negative such as body odor is stronger but fixes itself within the first 6 months and having to take in MORE protein and vitamins but that's ok for me. He said the DS isn't for everyone but I do believe its for me. And I've done A LOT of research on it.

Most insurance companies and Bariatric centers of excellence require a 3,6 or 12 month program. They want to make sure you are truly ready for all the changes required to be successful. This time requires that you go to monthly appts with a nutritionist that monitors and coaches your progress, a physcologist to ensure you really are ready, a fitness specialist who helps you build a plan to get moving, a Bariatric surgeon who examines you and works with you to determine the best WLS surgery given your health issues. Some programs even require you to go to classes and support group meetings. It is because this is not easy, and they want to ensure if you have the surgery you will put the time in. I will tell you, it is so worth it and today I am thankful for the 9 months my program took because it really did help me get ready in my head and take the right actions ahead of time. If you smoke, you will have to quit. If you drink caffeine or soda, you will have to quit, you will also learn mindful eating habits and the rules of WLS. There are a few that will ensure you are successful. In terms of the checklist it is mostly checking off if you qualify under the program. Some checklists require you have met with your PCP, they look for information if you have sleep apnea, if you have not been tested they will likely request that you have a sleep study which by the way helps get insurance to approve you. You will likely need to have a BMI over 40 or have a BMI over 35 with comorbitities like sleep apnea, diabetes, high blood pressure, reflux to get approved through insurance. All this stuff is on the checklist. Also on mine I had to write a diary of my weight gain and loss and all the diets I ever tried. I also had to write a paragraph on why I thought WLS was the solution for me..... I know it sounds like a lot but again it is worth it.

I have been required by my insurance to participate in a 3 month supervised weight loss plan prior to submitting a request for weight loss surgery. I weighed in on November 07, 2013 and I have to do my final weigh in on December 19, 2013 prior to my doctor submitting a claim to my insurance, blue cross blue shield federal plan. My question is this, I believe I have gained about 4 pounds since my last weigh in and the whole time I have been on the diet I have lost. I am guessing I did not do as good as I thought throught the holidays. Has anyone ever gained weight in the supervised diet with blue cross blue shield federal and got denied or approved. Any feedback would be greatly appreciated.

One last comment. I think that using 0 calorie beverages as a substitute for Water is workable to an extent but should be done in moderation. However, I have read quite a few articles regarding consumption of a high level of artificial sweeteners having a negative effect on health. Some people get headaches and start to feel achy or lethargic. If you are drinking a lot of 0 calorie "sweetened" beverages during the day but have not been feeling 100%, you might want to switch to primarily water for a couple of days to see if it helps. There have also been articles stating that artificial sweeteners are sometimes linked with weight gains in that it causes the body to crave more sugar. Anecdotally, most people I know that are significantly overweight are also diet pop-aholics (and that included me before banding and the pop restriction). I have actually started drinking things like mint tea completely unsweetened with a spot of creamer. It is hot, tasty, 0 calorie and there are no chemicals involved.

Hi Marisol, Everyone is different, but I can honestly say that gastric bypass was never an option for me. Because: 1) It's a more dangerous surgery (more complications/risks possible) 2) It's permanent (unlike lapband) 3) Causes "dumping" and horrendous smells (by gas and/or "dumping") 4) Like any weight loss, if you don't maintain your lifestyle changes you WILL gain the weight back (but at least with lapband it's again not permanent, so your risks associated with weight gain are lower at least) 5) If you don't follow the proper diet (ESPECIALLY YOUR DAILY VITAMINS), you are really setting yourself up for serious problems (I have a personal story about a family member to back this one up - but I won't post it here to avoid upsetting anyone. If you want to know it, just let me know and I'll send you an email with the details) Anyhow - those are just the primary reasons I felt lapband was a choice and gastric bypass was not. Hope that helps.....

I am going through that very thing right now. Insurance denied me because I had shown a weight gain during my weight management, but at my last weight management appt i had shown a weight loss of 20lbs. Insurance claims they did not receive my paperwork from May which is the month that shows the weight loss. My doctor is going to do a peer to peer phone call with my insurance to have the decision reversed. My doctor also told me that they were not giving the requirement that I could not gain weight. So, I am hoping to receive good news soon. IF your insurance denies your request then you should have the option to appeal their decision. I would talk with your surgeon to find out how to go about something like that. For now, stay positive! You never know, you could be approved! ????

Yep same thing here and I was devastated. It is coming back off. As long as you are following the rules - Protein, Water, etc. - you couldn't have done anything to actually cause a real weight gain. Your body is just adjusting. It will come back off.

Hi everyone, I had a slight weight gain (6lbs) between my very first visit with the clinic and surgeon ( I had my period and I was weighed at different times of the day) and I was told you can possibly be denied for that. I did call the clinic and they told me it was ok, you are allowed some fluctuation. I’m the same now. I am waiting for insurance approval at this point. Anyone have any experience with this? Thanks in advance!

I'm required to complete 90 days of the program which includes 2 nitrition appointments, psych eval, no weight gain among other requirements. What do you mean by "approved instution"? Do you mean the hospital must be approved?

My doc wanted to check my thyroid, turns out it is lazy. Might explain the 44lbs weight gain in the last 18months, or at least how more easely they came than before. So I am starting on some thyroid meds. But what I am worried about is does it affect the surgery or more so the weightloss after surgery? It would suck so bad if it will cause me to lose less after taking this step and all the sacrifice.

Just got approved for VSG last week and am scheduled for next Monday--4/25. Have gained weight since process started in 12/10 and was chastised by surgeon. Will start liquids tomorrow. Has anybody else had weight gain and then gone thru surgery? I'm less than 300 lbs and am nervous now.

So I've spent 10k on this procedure, gone through some discomfort & told far to many lies to people about how I'm losing weight then I get on the scales this morning & I've gained 1kg......WTF????

I had mine on 1/18/16, lost 20lbs in the first 10 days, then gained back 6 and have stalled. I'm encouraged that at least I'm not the only one who has stalled, but the weight gain is what has me worried. Guess we'll have to have patience and wait it out, which is always fun...

Hi everyone I'm sorry if these questions have been asked before it's been a while since I've been on this site. I had my sleeve surgery done 5 years ago so I have been through a lot of ups and downs and I would say I'm on the more experienced side of being a sleever..... I am at a stage now where I have put on quite a bit of weight, probably over 20 kgs since I hit my goal weight. I lost overall 55 kgs on the sleeve and I was so happy. There has been a few complications such as a hiatus hernia operation, appendicitis and I've recently had surgery on my ankle which has made me put on even more weight. I am trying to get back to my goal weight and I am finding it difficult to shift any weight. I have POS which makes it hard too. I've tried shake diets, low carb diets and I lose maybe a few kgs, then put it back on if I even have one day of eating something such as bread. I'll admit I'm not in the best place the moment, most days I'm sad and down about this and all I want to do is get back to what I was. I wanted to know if anyone has gone through what i am currently going through and have you been successful in losing weight again? I really need advice and some tips and the best people would be the ones who are going through this journey with me. Thank you.

I had my husband tie my shoes, but we walked the neighborhood because Dr. said no to the treadmill. Perfectly normal to have weight gain after surgery. They pump you full of fluids. Every thing else seems normal. I ended up taking some Miralax in order to get the bowels moving.

This is tough because, for me, I've lost a lot of weight several times on my own only to gain it all back! With my pattern, I'd still have the surgery. If you have been obese for a long time, statistics say I believe only 10% of people will lose weight and keep it off. Crazy right? Not saying you won't be successful, but something to think about. With every weight gain came depression and absolute loss of control. Right now, I'm smaller than I've ever been as an adult! I had my surgery 5 1/2 months ago. I'm happier than I've ever been and have no fear of gaining the weight back! Good luck with whatever you choose and you are doing an amazing job!

I know why I over eat... I LOVE food, I love cooking food, I love eating food and I love sharing food. I too watch The Biggest Looser and love the show, but I'm sorry, when they do that "root problem" thing, I just laugh. It has nothing to do with my weight issues. I have people in my life that have suffered unbelievable pain and sorrow and nope they're not fat, nor alcoholics or drug adicts, and I have friends that have the greatest life in the world and they're fat, so, to me I believe it's about will power and the ability to change your eating habits and no longer indulge in wonderful tasting fattening foods. I frankly LOVE food, I love butter, whipping cream, cream cheese, and that will never change. I need to be held accountable for my own weight gain and poor eating habits, it has nothing to do with my life issues. There is a member on here that was on "The Biggest Looser" and the world watched her loose all her weight, but soon as her life and reality started again, she began gaining, so was recently sleeved. I haven't read anythig from her lately, so I hope this has helped her.

Sensy, your doctor will have his own thoughts about how much to fill, but it has nothing to do with whether you're a piggy or not. Every doctor has a personalized approach, and even docs who are pretty aggressive with a fill probably won't be that way on the first fill. And you don't want him to be. Whatever fill you get will be more than you have, and will therefore take some getting used to. You may be hungrier than you thought you'd be at this point, but if you pay attention I'm sure you'll find that you are already eating less than you were pre-band. And that's the whole and only point. Many people do gain a little weight back in the period before a fill, but it's weight that you lost on the liquid diet, not actual weight gain. It's a sort of bounce-back effect and inevitable once you are off liquids and eating solids again. Don't worry about it! Just practice eating slowly and mindfully, so when you have restriction you'll be ahead of the game. So many people are ready to jump right in with mega-restriction right out of the gate. Those are the same people who come back later saying "I can't eat at all! All that goes down is ice cream!" Learning to live with restriction and eat healthfully takes time and we have to allow ourselves that time. As a very wise woman said, this process does not have to be drastic to be effective. Sorry for the lecture--it's not directed at you. But there is no specific amount of fill that's right for everyone, so there's no answer to your question.

I decided to go back on BC pills and not have another mirena. I think that was a factor in my weight gain after my pregnancy.

Hi I am only 3 weeks out and getting concerned. The scale dropped like lightening the first 8 days. Since then it's barely moved and in the last 3 days I've gained. Is that normal? I am following everything to the letter so I'm not sure where and if I'm actually falling short. Please help