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Pretty common sense stuff, but I thought this was a good distillation of a lot of common themes from threads across Bariatric Pal. http://www.everydayhealth.com/news/ways-avoid-weight-gain-after-bariatric-surgery/

Thing is... we all have food issues or we wouldn't have gotten fat. So while it is true that some target groups will try harder and put forth more effort, I don't think anyone goes into this thinking that they aren't going to put some effort into it. Most people I have seen fail any WLS type goes into this determined to change their eating habits and food choices just to discover that maybe they can't do it afterall. The band or sleeve or any other WLS type doesn't do a thing to fix your head. It seems so easy on some levels, get surgery and darn well just change head stuff. It doesn't work that way. You really don't discover just how many food issues you have until AFTER surgery and then you also discover the severity of these food issues. Before my surgery I kinda didn't believe it was going to work. I knew I was going to try very hard to do it but I really didn't think I could change my food choices and habits. I shocked myself when I did it. Today I prefer healthy foods and getting back to basics. I won't eat a burger from Mickey D's, you couldn't pay me to do it. I never thought I could give up fast food but I did. I'm lucky, a lot of people try their best and have the best of intentions and they discover they just can't do it. So you can't really take just those that are able to change food habits and use that as a target group for average bandsters because they aren't average, they are above average. The average bandster will lose about 55% of their excess weight (considering loss and the well known regain for all procedures) by 5 years time. That includes people like me that really seriously changed diets, added exercise, etc. AND it includes those that just can't hack it. Then there are issues of another nature. One problem with banding is that each time you have a complication the fill is removed and you are put on liquids for a time and then solids but with no fill. Esophageal dilation, pouch dilation, slip, etc., it's an unfill. That puts a dead stop to weight loss and actually turns into weight gain for most. Then the problem is resolved and you are back to getting fills again and finding a sweet spot. This is one reason banded folks have slower weight loss on average. Then you have mechanical failure. Leaks in the tubing, port, or band itself. You lose restriction and quite frankly if we could do this without restriction we wouldn't have had surgery to begin with. Without restriction weight gain happens again until surgical repair. I guess my point is that you can't just take successful bandsters and use that target group as the average WLS person. They aren't average, not in the least. We all make all sorts of plans and promises to ourselves that we will do this or that but the true test is when it's time to do it. Then we discover it wasn't as easy as we thought. My guess is 100%. Nobody is perfect with food issues all the time. Some do a better job than others. LOL! You are in for a big surprise. Banded and sleeved people make cheap dates too. ;o) It's also a matter of less food in your body to slow down absorption of alcohol.

I have lost 25 pounds since surgery November 19th. That includes the weight gain from the IV. I have not been 216 pounds or in size 16 pants in ten years! I am not complaining but it does cross my mind that the loss should be faster. I examine myself all the time to see what I can do better or differently. I work out 4-5 days a week for a hour or two . I am trying new things at the gym all the time. I do not feel well if I eat below 800-900 calories, so I stick with that most days.

awwwww....you guys are so great!!! i'm all teary right now, not b/c of what Daddy said but b/c of what you all said. It is so nice to know that "strangers" can be so kind and loving!!! please know that i am very very very happy about my 18 pounds of weight loss!!! I LOVE IT!!!! i was just crushed to know that it wasnt even noticable..... maybe it was just a good 'reality check'??? anyway...i love the thought of not reporting my weight loss b/c i certainly did NOT report my weight gain!!! great idea!!! :tt2: THANK YOU!!!

Thank you Gmanbat! I'll pick some up tonight...it certainly sounds like its worth a chance. My head has been so upset over the weight gain that I didn't stop to evaluate my supplements. Great advice to everyone...

Bornagainbabe, Nikki & everyone else out there whose having problems with weight gain- I want to express my sincere "thanks & gratitude" for sharing your stories. So often we hear about the success stories & no one is brave enough to talk about their struggles. I knew that this wouldn't be an easy journey. I appreciate you stepping forward & take comfort in knowing there are people to share my strengths & weaknesses with. Although I am only 4 mos out, I have had my fair share of ups & downs. This concerns me that the road ahead is going to be a bumpy one, one i have traveled many times. Many do not know this but I'm ready to share, in hopes this may help someone else. I am a bulimic, once getting down to 102 lbs. I went to therapy for years.. Ive got a grip on my disease, at the moment. I later found out it caused a condition known as gastroperesis (stomach paralysis). I eventually gained weight over the years but it's so easy to let food have a powerful hold on me & my weight climbed up to 180. Due to comorbidities & the gastroperesis I had VSG. I am currently off most meds, know what I need to do, but still struggle daily with a never ending battle within myself. You can overcome your inner demons by taking one step at a time. I wish each & every one of you the best of luck in your journey & take comfort in knowing we are here for each other.

I am curious the process people went through for Sleeve to Bypass? I've been seeing a gastroenterologist for pain, nausea, vomiting. I have had 2 EGD's, both show chronic inflammation and gastritis, due to reflux. My surgeon is sounding very reluctant to do this surgery. I did get down to 115 lbs and have put on 50 lbs since my lowest. He is blaming the reflux on the weight gain, but I was at my lowest, when the first EGD showed inflammation due to reflux. He just ordered a barium swallow, and all came back normal. I am seeing the nutritionist, she said she spoke with the surgeon, and we would be going over the new pre-op diet, since it is different than the sleeve and has changed since I had the sleeve in 2019. I am afraid he will refuse to do the surgery and I will be left with this pain, nausea and vomiting; I have been battling for almost 3 years, with no relief. My gastroenterologist is at his wits end and doesn't want to continue seeing me go through this. I wake up choking on acid, had tests run by my pulmonologist and cardiologist. My asthma had gone away but returned. The surgeon also blames that on the weight gain. Pre-sleeve, I had walked 27,000 steps in a year. This year, I am at 1.7 million steps and ride a stationary bike 10-15 miles a day. This is huge for me, I have something called Pulmonary Arterial Hypertension. Pre-sleeve, I was knocking on deaths door. I only found this "terminal" illness, from my pre-op tests for the sleeve. Since the weight loss, I went from 6 months to live, to medication that has me at "normal/high" levels vs "high". My specialist is afraid the weight gain is spiraling and illness progressing. What changed for me, the medication I take for PAH, you have to consume 250-300 calories per dose with 30-50% fat content. Otherwise, you get violently ill. I take 3 doses a day. When I was diagnosed and first 2 years, I was on a CADD pump and that medication didn't have dietary requirements. Sorry for the long story........I just can't take the reflux (even though the barium swallow does not show but EGD definitely does and has, in 3 different tests) and the weight gain is scaring me to death. What was your process with your surgeons, going from sleeve to bypass? Is this a long process? Did you have a difficult time with insurance approval? Any suggestions on getting this done? Your experience and help, is greatly appreciated!

I am in the same boat. I had been taking Belviq and phentermine which stopped working after 6 months. In that time I had lost 38 pounds. When I went for my very first appointment about six months ago, I weighed 207. Today I weigh 225. I feel my weight gain is the result of having to stop the Belviq/phentermine combo so I am now ravenously hungry all the time. Surgery can’t come soon enough. Scheduled for 1/2/18. Good luck to you!

Vera, you know me better than I know myself! Self-hater? NOT. I'm too in love with myself for all that! Though if I continue to eat & gain, I will certainly join Penni in her depression. I'm all about love, babies! And Vines, I just kissed my fur babies goodbye on the way to the post office to mail my daughter her Easter basket and birthday gift. Peace, love & flower power. I've completely let go of my past so I don't blame my childhood for being fat. Yes, there's the big connection to my childhood since that's when this addiction/hoarding/binging started, but now it's just plain addiction. I'm addicted to the bad eating habits, and my brain simply screams at me to eat. That's what I did all my life, so the screaming doesn't just stop because I want it to. I'm up 10 pounds, POOF, just like that. And my stomach pain is getting better, but the acid in my esoph gives me a full time lump in my throat with cough. As far as OA meetings, I've been a 12-Stepper most of my life. Southern California has the BEST OA meetings in the world. They say when things get bad to go to 30 meetings in 30 days, but there aren't even 30 meetings in Vegas to go to. Vegas is a different planet than the rest of the world. We have thousands of AA meetings and just as many NA and GA (Narcotics & Gamblers Anonymous.) But the OA meetings here are lousy; I've tried going throughout the years, and there's no sponsorship here. Nobody "works the OA program" here. Small group meet and focus on sharing, but NOBODY shares about their food struggles, it's just a big bitch session. I've shared that I need help with my food and and weight gain, and I've asked for phone numbers, but they look at me like, "Who's the fat girl interrupting our chat session?" Weird... definitely weird in Vegas.

I also have no food addictions or medical reasons to have gotten to 243 at 5'3". My weight gain was caused by making poor choices at nearly every opportunity. French fries or steamed veggies, vinaigrette or ranch, etc., etc.. I simply made the tastier choice because my mindset was, "this one meal isn't going to make a difference" This was compounded by going from a physical job to a sedentary job in my mid twenties. Then my weight gain accelerated when I began traveling and entertaining for business.

If you don't eat, your body will think it's starving and it will hold on to every little calorie, every bit of fat, everything to protect you. That will be what causes you to gain weight, or at the very least, not lose. You have to learn to walk that fine line between eating enough to stay healthy but not too much to cause weight gain. It's a learning curve, and takes a while to figure out. But you'll get there. Just make sure you get your protein in first, then carbs (from veggies and fruits), HEALTHY fats, and enough calories. The first 2 weeks, I never had more than 600 calories per day. Weeks 3 and 4 it went up to between 800 - 900 per day. Weeks 5 and 6 I was around 1000 per day. Once I was completely cleared for all exercise, I went up to 1100 - 1200 per day on non work out days and between 1300 - 1400 per day on work out days, depending on what work out I was doing that day. You absolutely HAVE to give your body the fuel it needs to survive and thrive. The point of the surgery isn't to starve yourself into being skinny. It's a tool to teach us to make better, healthier choices and stick with them.

I wish I knew . . . . . . some Protein shakes can taste horrible. I should have gotten a sample before I bought a very expensive barrel sized canister of Protein shake that has been gathering dust in my kitchen closet for six months now. . . . ready to drink Isopure clear shakes were tolerable to drink and helpful for protein intake directly after surgery since they fit in as a clear protein. . . . I did not realize logging all calories and protein on fitday.com would be so helpful during the early days. . . . I thought the journey really started when I was banded, but the help did not really come until after my second fill. I did not have realistic expectations of the unfilled portion in the early days where you are soooo hungry but can not eat anything much. I also did not realize that so many people had weightloss stalls (or some even gain)at this point. . . . I did not realize that weight loss comes in fits and starts. It was only easy and steady directly after surgery during the liquid phases. In general for me it looked more like this 202, 202, 201, 198, 202, 199, 202, 200, 199, 199, 198, 200, 198. I now have a rule that I don't change a ticker value unless I maintain a maximum weight for at least three days. . . . I didn't realize that plateaus can be easily broken if you know what to do, so I suffered a little more in the beginning than necessary. . . . I didn't realize that my TOM means an automatic weight gain(3-5 pounds in the beginning and 1-3 pounds now) that comes and goes in about a week. . . . I did not know that losing weight rapidly floods your body with hormones so that your TOM can be drastically worse than normal (not to mention that you can be verrrryyyy moody as well). However, six months out and I think I have stabilized somewhat. Perhaps the general tone sounds like complaints, but it is not. All of the good far, far, far outweighs the bad. If I listed all the good, I could go on for pages and pages. I love my band and I can not tell you how much better I look and feel at this stage of the game. Congratulations on selecting a most interesting journey and change in lifestyle.

I may be old school (63), but when did a spouse telling his/her wife that "eating Starbursts will make fat" become Domestic Violence? I've been married 36 years and along the way to becoming 80 lbs overweight, my wife told me "to stop eating so much" many times along the way. It was hurtful to hear, but absolutely true and probably helped motivate me to finally take action. Do you think anyone struggling with obesity should be eating Starbursts? Do you think any average weight person enjoys seeing their spouse gain weight (while continuing to overeat)? Do you think spouses should speak honestly about their feelings with one another, particularly in matters of health? I'm not saying preacher boy is in the right, but I've read nothing here that convinces me he's ready to be charged with a crime! I'm still waiting to learn if the OP has told him how SHE FEELS about her weight and his lack of support. Hi, Thank for sharing your experience. I did respond to your original response. Not sure if you saw that. You are right about Starbursts. Unlike many people, I had to GAIN 7 pounds to have this surgery. I enjoyed, and have enjoyed every second of that. For most of my life I have been dieting, taking diet pills, excercizing, and depriving myself...only to fall of the wagon and gain weight. It has been wonderful to eat what and when I want, for these last few months. I have been up and down 30-70 pounds over and over and over. My husband only met me 3 years ago, so he does not know the 70 lb heavier me that I am now. But, I had just lost 55 lbs right before I met him. In answer to your questions, yes I do believe you should be able to be honest with your wife about her health. But, to keep at it until she's sobbing is not the way to do it. I KNOW I have a food addiction, and a weight problem. That is why I am having this surgery. For my health, for my self-esteem, of my chronic pain, and for my husband. I don't think he has committed a crime. I just think being more supportive would probably get him a lot further, and we would have a much better relationship than the approach he is taking now. I have asked, screamed, and begged him to stop. He thinks he is helping me, and so he always manages to bring it up. He also does not want me to have the surgery. If this was an issue of health, he would realize that the surgery is for my health. Anyways, he is not a horroble man. He is just making his wife feel horrible about her weight. Something that I don't need any help with, I already feel bad about it. I can't wait to Feb. 23d, to have the sleeve surgery and start to lose weight. Thanks again for sharing. Thank you for sharing the additional info. My wife was "blessed" with a Mediterranean metabolism that allowed her to eat as she pleased and not gain weight until she was about 60. I am the home chef and I know we were both eating the same food in the same quantities and I grew to 275 while she stayed at 145. She would give me advice based in total baloney and sometimes it would get ugly. And, she wasn't that supportive about my wls decision at first. She suggested hiring a nutritionalist and a personal trainer for a year. When I lost 30 lbs pre opt, both her and my mother told me to call it off! Now I'm 4+ months out and down 86 pounds (overall). Now she tells me to stop losing! Just put your head down and stick to your program. The best way to get the upper hand is to do the surgery, lose the weight, buy smaller clothes and get your confidence back! You can do this... Thank you for all of your support and sharing your experience with me. It really is invaluable. Few people stay married as long as you have, and it appears you've survived the weight issue causing problems in your marriage As far as my marriage and weight issue. I've also really tried to look at this from my husbands perspective. He is frustrated. He wa/n't expecting this kind of weight gain in a year, and he is not a Complusive Eater or yoyo dieter. He simply doesn't get it. I love my husband. In many ways he shows his love for me. Good provider, faithful, responsible, and he does love God. He just thinks that He can fix this issue for me (with his diet and exercise program) and "Tough Love" and be can't. He truly does not get that this is 20 years of this weight battle, and I'm DONE. No more doing the same thing I have always done, that has always failed without surgery. I have been busy with life, and getting ready for surgery. Thank you again for your enouragement. I'll see you on the otherside on Tuesday, a Sleeved Woman! ????

Honestly, I think we all compare with each other's results on this journey and I think it can be a bit emotionally damaging especially when we see those large numbers other people are putting out there (congrats to them btw). The problem I have is that I'm not losing 1 or 2lbs per week at all (I wish it were that steady). I'm on this weird stair step trend where I drop a couple pounds, gain a couple, lose some again and then stall for a few weeks. It makes me feel like I'm not doing my personal best and that's the psychological part I've hated about this journey. The diets I'd been on since 2012 had been more of a steady loss so I ended up getting used to that type of weight loss cycle. But this one is taking quite a bit of getting used to for me. Maybe I have some Fluid retention which causes the crazy fluctuations...IDK All in all I'm very happy I got the surgery and wouldn't change a thing. I know that in the long run VSG will help me stay the course and give me the opportunity to bounce back from any future weight gain I may have. I absolutely know for a fact I wouldn't be able to do it on my own if I hadn't gone this route so I'm extremely thankful I could afford to pay for this. Good luck to everyone who's working hard to stay the course and I'm happy to be on this journey with you all!

You have to like what you're doing at least somewhat. I mean, I have stopped kidding myself that I will EVER go to the gym and lift weights. Its just not going to happen. But I do love running. What I love about running: - you can set goals. Distances, times, fun runs, small goals (5K) big goals (half marathons). You can measure your improvement, you can do it in different places. And it was just a goal of mine. I never ever get over the kick of being able to say "I am a runner". To me, it was the ultimate of what losing weight is all about. And on that note - its about focussing and enjoying the outcome, perhaps even more so than the process. I plan to do a hard interval run on my treadmill tonight. I dont really "want to" per se, but I know I will and once I get going I will feel awesome about what I am doing and when I am finished I will feel GREAT. And I have accepted that its what I have to do to have the body I want. I look around the workplace, there's a few of us women between 40 and 55 and nobody is really obese but everyone has softened into middle age, and has big tummies and large breasts and thighs that want covering. They all sit at lunch in the staffroom with healthy lunches, salads, fruit and yogurt, rice cakes and avocado. Nobody eats crap. nobody brings chocolate for Snacks, nobody drinks soft drinks. I am the only one who is not fat and looks fit. I have a lapband and I'd say I eat more during the day than half of these people. The difference is my running. I wont ever stop! I've been through early menopause at the age of 43 thanks to chemoradiation and I have none of that typical round the middle weight gain and accelerated body aging. Bone density tests have shown excellent results (they were worried about me what with being only 43 and so thin) - that's thanks to running. I got through it with minimal pain - thanks to running. Anybody that doesnt exercise will live a substandard life as they age, its that simple. It keeps you young. Thin is only a small part it.

Here read this about SLIDERS.. Slider Foods Spell Weight Regain For Weight Loss Surgery Patients Soft processed carbohydrates, slider foods, are the bane of good intentions and ignorance often causing dumping syndrome, weight loss plateaus, and eventually weight gain for gastric bypass, gastric band (lap-band), and gastric sleeve bariatric patients. To the weight loss surgery patient slider foods are the bane of good intentions and ignorance often causing dumping syndrome, weight loss plateaus, and eventually weight gain. Slider foods, to weight loss surgery patients, are soft simple processed carbohydrates of little or no nutritional value that slide right through the surgical stomach pouch without providing nutrition or satiation. The most innocent of slider foods are saltine crackers, often eaten with warm tea or other beverages, to soothe the stomach in illness or while recovering from surgery. Understanding Slider Foods The most commonly consumed slider foods include pretzels, crackers (saltines, graham, Ritz, etc.) filled cracker Snacks such as Ritz Bits, popcorn, cheese snacks (Cheetos) or cheese crackers, tortilla chips with salsa, potato chips, sugar-free Cookies, cakes, and candy. You will notice these slider foods are often salty and cause dry mouth so they must be ingested with liquid to be palatable. This is how they become slider foods. They are also, most often, void of nutritional value. For weight loss surgery patients the process of digestion is different than those who have not undergone gastric surgery. When slider foods are consumed they go into the stomach pouch and exit directly into the jejunum where the simple carbohydrate slurry is quickly absorbed and stored by the body. There is little thermic effect in the digestion of simple carbohydrates like there is in the digestion of Protein so little metabolic energy is expended. In most cases patients in the phase of weight loss who eat slider foods will experience a weight loss plateau and possibly the setback of weight gain. And sadly, they will begin to believe their surgical stomach pouch is not functioning properly because they never feel fullness or restriction like they experience when eating protein. The very nature of the surgical gastric pouch is to cause feelings of tightness or restriction when one has eaten enough food. However, when soft simple carbohydrates are eaten this tightness or restriction does not result and one can continue to eat, unmeasured, copious amounts of non-nutritional food without ever feeling uncomfortable. Many patients turn to slider foods for this very reason. They do not like the discomfort that results when the pouch is full from eating a measured portion of lean animal or dairy protein without liquids. Yet it is this very restriction that is the desired result of the surgery. The discomfort is intended to signal the cessation of eating. Remembering the "Protein First" rule is crucial to weight management with bariatric surgery. Gastric bypass, gastric banding (lap-band) and gastric sleeve patients are instructed to follow a high protein diet to facilitate healing and promote weight loss. Bariatric centers advise what is commonly known among weight loss surgery patients as the "Four Rules" the most important of which is "Protein First." That means of all nutrients (protein, carbohydrates, fat and alcohol) the patient is required to eat protein first. Protein is not always the most comfortable food choice for weight loss surgery patients who feel restriction after eating a very small amount of food. However, for the surgical tool to work correctly a diet rich in protein and low in simple carbohydrate slider foods must be observed. The high protein diet must be followed even after healthy body weight has been achieved in order to maintain a healthy weight and avoid weight regain.

Welcome jen!!!!! In my opinion, (I am 2.5 years out) and was heavy my whole life...... the sleeve is the best thing that ever happened to me. Could I have lost more weight? yes. The sleeve seems to work varrying degrees for people. Some people lose all their excess weight, some 30lbs. It depends on what you put in, and what you want. Post-op life is so much better (weight gain is not like before when dieting) but there is a risk of going back. I see the scale go up a few pounds then I blow an imaginary horn in my head. I can eat entire small box of cheezits in a few hours. I also can only eat 3 oz of steak and a few bites of veggies. It all depends of choices. What I am getting at is the sleeve is amazing but it is not guarantee to be thin for the rest of your life... (although I wish it was)

Look what I found on another thread! From Physicology Today Article from the author of Passing for Thin Size and Sensibility Losing half her body weight was no picnic. But living thin—and expanding her sense of self—nearly made Frances Kuffle’s world blow up I had been summoned to The Show, the Holy Grail for authors and the fulfillment of all my mother’s dreams. In a harried day of phone calls from Chicago, at the tail end of a snowstorm, the producers of Oprah decided, with 90 minutes to catch the last shuttle out of LaGuardia, that they might want me. You’d think, on the eve of what could catapult my book to national attention, that I would be too nervous to eat. I am never too nervous to eat. As I grazed the basket of goodies in my expensive suite, I had two questions. First: Would Harpo Productions’ bean counters go over my hotel tab and ask, “Isn’t that the woman who lost all that weight? What are these charges for chocolate-covered almonds and honey peanuts doing here?” Second: Why am I eating all this stuff? I might be on TV tomorrow! What with Oprah replaying 24/7, everyone in America could count the bread crumbs on my velvet dress. So much for the can-do kid, who, after 42 years of obesity and missed opportunities, had lost 188 pounds and written a book about it. Passing for Thin: Losing Half My Weight And Finding My Self is an account of how I used my radical change in weight to turn a small, private worlds of eating and surviving into one as big as my former size 32 dresses. I climbed mountains! I swaddled myself in cashmere and had lovers; I went to Italy. I floated out of the gym after lifting weights, I sat in restaurant booths, wore bracelets, and crossed my legs and took the middle seat in airplanes. Then I used my weight loss to do the next impossible thing: I became and author. Being thin opened the doors to experience and intimacy. National exposure, however, was an intrusion I hadn’t considered. I am not a pundit or a role model. You’re going to be pilloried, Frances, I thought with the vehemence of a Sicilian curse. And yet, there I was gobbling Oprah’s $12 Cookies. I put on my pajamas and pulled back the comforter on the king-size bed. It was littered with wrappers. My cheeks were burning with shame and calories. Tomorrow, I promised myself solemnly. And when tomorrow came, I smiled and joked, and I was gracious when I wasn’t, after all, needed for the show. I ached not from disappointment but with the hangover of sugar in my muscles, the sour gas in my gut and the heartbreak of being a liar. After a failed romance and a change of jobs, I drifted into relapse in March 2003, a year before Oprah, I had time on my hands—and time, in my case, is the enemy. I filled it by studying where and how I went wrong, at the office, in the bedroom. Intellectually, I knew that the boyfriend was emotionally frozen and that my former employer was abusive and infantilizing, but I couldn’t shake my ingrained conviction that I was responsible for everything that went wrong. I stopped going to the gym: I started eating peanuts or rice cakes between meals. A little of this, a little of that, and one morning I announced to a friend that I saw no reason why I couldn’t eat blackberry pie and ice cream, get the craving out of my system and return to my abstinence by noon. I wasn’t talking about a slice of pie a la mode. I was talking about a whole pie and a pint of ice cream. A whole pie? That summer I was reminded at every turn that I needed to be thin to promote my book. “You don’t want those cookies, honey”, my mom said as I carried off a stack I’d grabbed from the cooling rack. “Remember: You’re going to be in Oprah’s Magazine.” She was wrong. I did want those cookies, and I didn’t need reminding about Oprah. I sighed and took two more. When I asked myself what I needed, I was met with an unconsoling barrage of hungers. I needed to know I was not disposable. I needed a resting place. I needed to know I had enough stuff to carry off the rest of my life—enough talent, discipline, and intelligence—and enough sufficiency to protect myself from more heartbreak. I needed enough hope to find the friends and man I mourned the lack of. From August 1999 to August 2003, I’d gambled that losing weight would get me closer to all that, and I was told what to eat in those years. Now, after three years of maintaining my weight loss, I needed to be told what to feel when everyone but me has an opinion of who I am. I knew I—not just my body but my very self—was in trouble when I brushed aside a fleeting thought about how fat I looked with the answer “Never mind. You’ll like yourself when you get thin.” How does one live with self acceptance as a future and an always-conditional state of mind? More pragmatically, in lieu of my size 8 clothes, my career depended on self assurance. When asked, I admitted that I’d gained weight, adding that I never presented myself as the poster girl of thin. I said this with poise, which is not the same thing as confidence. Poise is teachable; confidence is one of the elements missing from the periodic table, three parts self respect to two parts experience. To get to confidence, I was going to have to listen to my self-accusations and sit with the rejections. Maybe shame had something to teach me. My next recovery period from food addiction would be based on therapy, heretofore more a matter of coaching than peeling back the layers of self. My psychiatrist’s and therapist’s offices became the places I could air my feelings about myself and the hopes I could change my self-perception. “There’s no point in getting depressed just because I’m depressed” I told my psychiatrist, who increased my morning meds anyway. That October, on a blue-and-gold afternoon, I had Indian food with Lanie, a friend visiting from my hometown, Missoula, Montana. I described how depressed I was by my weight gain until she preempted me. “You’ve been very fat, Frances, and you’ve been very thin. Welcome to where the rest of us live.” I twiddled my fork in my plate of saag panir. I think of Lanie as being very tall and very thin, but a few months earlier I’d helped her pick out a dress. Her dress size was similar to what I was wearing that day. The event we shopped for had been a gathering of Montana writers, many of them old friends, all middle-aged. One had a rounder face than I remembered; another wore layers of a truly terrible print in the style that catalogs and store clerks describe as “flattering”. Someone else was still very thin but looked drawn and brittle as age caught up with her bone structure. These were woman I’d long envied for their pretty thinness, and yet I’d been less like them when I was a size 8 than I was now. At size 8, I had to admit, I was so self-conscious (and secretly, overweening proud of it) that often that was all I was. I could have programmed my answering machine to announce, “Hi, you’ve reached a size 8. Please leave a message and either the size 8 or Frances will get back to you.” None of the women at that party, or Lanie savoring her lamb jurma across from me, claimed their identities from their weights that night. They wanted to gossip, compare stories of their kids and discuss what they were writing, tell old jokes more cleverly than thy had at the last party, and sample the Desserts weighing down the potluck buffet. I was not unlike them. Smaller by a size than Lanie, larger by a size than Laura, a little fresher looking than Diane. Of the Americans who lose weight, 95 percent gain it back within five years. I had gained a third of it back. Not all of it. To some extent, I had beaten the odds. I was stronger than the echoes of the boyfriend and boss allowed me to hear. I was determined not to repeat the mistake of being, rather than having, a thin body. I’d lived through my size all of my life, so acutely aware and ashamed of my obesity that the likable things about me—my sense of humor, my intelligence, talent, friendliness, kindness—were as illusory to me as a magician’s stacked card deck. As long as I defined myself by my body size, I would not experience those qualities for myself. As fall turned to a snowy winter, I picked through the spiral of relationships that had unglued me the year before. I didn’t blame the boyfriend or my boss for my relapse. I had been half of the problem; healthier self esteem would not have collapsed under their judgments of me. In obesity, I had clamped my arms to my sides to keep from swinging as I walked. I craned my body over armrests in theaters and airplanes, stood in the back of group photos to minimize the space I took up. I got thin and continued to hide. Whatever reasons the boyfriend had come up with for not seeing me, I met with amicability and sympathy. Had I reacted honestly, even to myself, I might have ended the relationship. Instead I’d gambled all my sweetness only to find out I was disposable. Likewise, I had not pressed my boss for an agenda of responsibilities from the start, nor had I clarified with her that her work and recreation styles frustrated and frightened me. Slowly I began to find toeholds in the avalanche of food and doubt. I worried about how fat I looked to potential readers and what I could possible wear to flatter or disguise the 40 pounds I’d gained. At the same time, however, I had become the canvas of makeup artists, stylists, photographers and publicists. They weren’t looking at my stomach. “Give me a hundred-watt smile,” commanded a photographer whose censure I thought I’d seen when I walked in. I licked my teeth and flashed a grin only somewhat longer than her camera flare. “Wow.” She straightened up at the tripod. “That really is a hundred watts. These are gonna be great.”. When I saw myself in the magazine, my smile was, in fact, the focal point. When I began dating, at the age of 45, my smile was an attribute men commented on, but I hadn’t really seen it until it was emblazoned on glossy paper. It was bigger, it seemed, than my face itself. I’d been a size 8 in my author photo, taken as my food plan was wobbling but not yet in smithereens, in June 2003. I was surprised to see I still looked like….myself, apparently. The power of my smile fueled me through more publicity, giving me a sense of authentic attractiveness that allowed me to enjoy the process. When I had a couple of days in Santa Monica between readings, I had a chance to assess and absorb at my own pace. Walking along the Palisades, I admired the sea-twisted pines and pearly mist funneling out of Malibu Canyon. I felt as lucky as I had once felt by being hired, by being loved, and I felt worthy of my luck because I appreciated the prettiness of the place, the serendipity that brought me there and my particular grateful awareness that knitted the moment together. I’d tried to rob myself of that by punishing myself for the boss and the boyfriend. You should not have treated me that way, I thought. The emphasis was on “me”, and just then I knew who that was. I looked around carefully. There was a family reunion going on, or so I assumed until I got closer and realized it was cookout hosted for the park’s lost and unfound citizens. I smiled to myself. How…California. No gritty, iron-shuttered Salvation Army outposts here, no Soup and Jell-O punishment for being a bum. No siree Bob. In California, the homeless are just one more variant on the Beach Boys. I laughed out load. I’m here, I gloated. I like my own company. I was tired of the games—with food, with hiding what I looked like under big clothes and my big smile, with waiting until I was a size 8 again to like myself. I recommitted to chipping at my food addiction, but I let go of some of the rigidity I’d had in the first years of losing and maintaining my weight loss. “I want to be praised when I do things right, and I want to be forgiven when I mess up.” I told people closest to me. “And I want milk in my coffee.” It was a small list, but significant because it allowed me to fumble as I gained my momentum of eating sanely. Esteem, kindness, patience, forgiveness: By cloaking myself in these qualities, I could build a self that was not afraid of authority figures and charming men who have one eye on the door. Maybe these attributes will curb the millions of things that make me want to eat, starting with seeing my parents or returning to Montana. I turn into the kid whose mother had to make her school uniform, whose big tummy stretched the plaid into an Etcher cartoon; I became the sad, joking fat college student who was reading The Fairy Queene while her girlfriends were soaking up the half-naked wonder of being 20 years old. I think of my parents’ kitchens, and my mouth waters for gingerbread and well-buttered toast. I regress when I let people like Lanie, whose struggle is different, comment or take chare of what I eat. “That’s two Entrees, Francis,” Lanie pointed out when I said I wanted goat cheese salad and roast chicken for our first lunch together in Paris. “Oh, Well, then, I’ll have the salad I guess,” I settled, grumpily. That’s the way I eat, that’s how I lost 188 pounds; vegetables and Protein. I was allowing her to limit me to a smidgen of cheese, or insufficient vegetables, and allowing her supervision is how I got so mad--the fatal elixir of anger and crazed desire—that I bought all the chocolate in Charles De Gaulle for my untasting delectation. I am the kid who, when told not to put Beans up her nose, heads directly to the pantry. “I have got to learn to tell people to stay out of my food,” I reported to my therapist back in new York. Then again, perhaps this is an evolutionary process rather than a one-time miracle cure. In 2003, I denned up for two months in Montana and ate. In 2004, I struggled again in Montana but I also did a lot of hiking, alone with my dog and with my niece. My slow pace didn’t frustrate either of them. I went horseback riding and got a terrific tan while swimming every afternoon. My thighs did not chafe in the August heat along the Seine, and I was thrilled to cross the Appalachian Trail later that autumn. I had spells of disappointment and fear from the way I ate, but I was living in my body, on my body’s terms. It’s a small world I’ve pulled from the wrappers, boxes and crumbs in the past two years, but a very human one. I’ve seen my family, close friends and therapists hold on to the stubborn believe that I would come through this. They loved me enough to countenance my mistakes and let me start over. Each day, I venture a little farther from the safety of food, and my courage comes from understanding that I am a lot like a lot of people—a family member, a friend, a dog owner, a recidivist, a middle aged woman, a writer who got a good rhythm going and forgot to brush her hair. There is safety in numbers. Depression and relapse would have to wait for a different excuse than my size. I am ready to hope again. Frances Kuffel is the author of Passing for Thin: Losing Half My Weight And Finding My Self (Broadway books, 2004). Her website is • Frances Kuffel • author of Passing For Thin - Home

I just gotta throw this out there. These drugs taken for appetite suppressant are not entirely "without serious side effects". Pherntermine is an amphetamine that has very similar effects on your heart and central nervous system as cocaine. Would you take cocaine to lose weight? At the very least, you are getting high each time you take one, and Long term use of appetite suppressants can result in convulsions, heart arrhythmias, heart disease, high BP, and death...even when taken at the prescribed dose. As for the antidepressants, my mom was rushed to the hospital twice for tachycardia and fainting. Turned out it was the anti anxiety medicine they prescribed for her. My younger brother died from a heart arrhythmia that the medical examiner attributed to the Adderall he was taking for ADHD. The amount in his blood stream was normal, therapeutic levels, but after an extensive autopsy and toxicology screen, that was the only plausible finding. He was 42. And, BTW, he was adopted so this is not a "genetic" thing. The other point I'd like to make is that appetite suppressants simply do not work as a long term weight loss solution. We KNOW this or we wouldn't have needed surgery. Sure, you'll feel great (why not, you're stoned) and lose a few pounds. But as soon as you stop taking them you are right back where you started, fighting your appetite and weight gain. Sure, drugs are another "tool" we can use, but all the tools in the world can't build a house without lumber. Our heads and ability to make good choices is the concrete foundation AND the lumber required for our lifetime fight with obesity. That is what we need to work on, not short term, temporary Patches.

Hi there. I'm new to this forum and your post was the first one I read. I'm 5 yrs post op from a lap band to sleeve revision. I was doing fine with my weight loss, but this year I've started gaining weight back rather quickly. I'm having surgery on Wednesday for an unrelated problem, but truly want to get back on track. I've lost approximately 85 pounds total, but I've gained 35 of that back this year. I know what I should be doing, but find myself grazing on unhealthy foods and not exercising. It's depressing to look at pics when I was at my lowest weight after surgery and then look at current pics where I can clearly see the weight gain. I wish you much luck in getting back on track. Maybe we can encourage each other?

When I got banded, I had all the feelings of "maybe this isnt necessary, I really SHOULD be able to do this on my own". But it was a major reality check to really consider the fact that statistically, it was 99.9% certain that I wouldnt and couldnt do it on my own. I really think I'd try to have the same reality check post banding. Statistically, the weight's likely to go back over time. I really would consider another surgery personally if I possibly could. But in the meantime, I think exercise really comes to the fore as a tool to prevent weight gain. The times in my life that I've been successful in the medium term in keeping off a reasonable weight loss - like over 20lb which is all I had to lose in the old days before babies - were the times when I exercised - and I mean hard - like an hour of hard cardio like running almost every single day. Whenever my life changed and the commitment to exercise waned, that's when I gained weight. Same after I had my babies. First baby, no problem, I continued with a really vigorous walking routine with him in the pram. Second baby, and a toddler as well, the exercise fell by the wayside, and I ballooned. Exercise really is your best defence.

Went to a local WLS support group meeting tonight. Out of thirty or more people, there were only two bandsters--three including me who has yet to me banded. The leader of the meeting pretty much said I would fail at this band thing--that most banded she's seen convert to the RNY eventually. She said that most of the lap band folks are not happy with their slow weight loss--and she said that there are so many things that can go wrong--slippage, erosion, etc. She said that I'd have a higher chance of having more surgeries than if I were to have the RNY. She said that if I have a sweet tooth, then the band is DEFINITELY NOT FOR ME. This bummed me out for a---SECOND--then I came to my senses. This is the best and safest way to go. Eventually, I am going to have to come to terms with the type of and amount of food I eat, and even if I were to get the RNY, I'd have to come to terms with eating sugar eventually. From what I hear, the "dumping" gets less and less severe as time goes on. I do have some what of a sweet tooth, but I don't care for sugary liquids at all. I do love cookies--cakes, etc., but I willing to say good-bye to them to regain my health. The main thing I'm looking for in the band is to help control real, physical hunger--not head hunger--but physical hunger--that's all my expectation of the band. It just frustrates me that she (leader of WLS meeting) tried to talk me out of the band. She even mentioned how she's struggling with her weight gain (after 5 years out/RNY) and that she still vomits a lot--and that her teeth are chipping easily (possibly due to a mineral deficiency). Ahh--I don't know. I just want SO BADLY to be successful. I don't expect a miracle cure. I just want help with this journey. Am I asking too much of the band for that--help to curb the ravenous physical hunger? Thanks all for listening...

Sleeved 1/29/2013 Pre-Op diet weight: 193 Surgery weight: 186 Day after: 192 (damn water weight gain) 1.5 weeks out: 181.8 I am 1.5 weeks out from Surgery and things have been smooth. -- No major pain after surgery, other than my wrist arm swelling from the vein they blew -- still hurts -- No major gas pain -- No nausea -- No close calls with throwing up -- Able to drink fluids relatively easily, albeit slowly -- Moved to full liquids per my Dr's plan easily -- I am getting 60+ grams of protein, and close to the 64 oz of fluid (remembering to sip water and waiting the 30+ minutes after is annoying) -- Since moving to full liquids, I am been getting 600 to 700 calories in, is that too much? -- Finally lost the water weight gain plus, and an additional 4.2 lbs since the surgery for a total of nearly 12 lbs -- Traveled to my client site and worked pretty much my same routine of super fulls days, i.e, 10+ hours (yes, I did crash as soon as I got back to the hotel) Now, for the minor complaint, when will my wrist along the vein stop hurting? It hurts to stretch the arm out and to touch it. OK, I know I will hit a stall, I am thinking moving to more solid foods might present a problem, I just know I will hit a road bump at some point and will be on here asking for help. But, until then, pre-op patients, please know that the ride can be smooth. I know so far I have been one of the lucky ones. Thank you to who ever is watching out for me, I really appreciate it. Mary

I am a jolly old soul. Love to eat, cook, and did I mention eat? I long for that full feeling. It comforts me. I have lost weight off and on over 12 years. Most successfully by starving myself. Once lost 70lbs eating one meal a day. Weight Watchers and Adkins worked for 20-40lbs. I gained it all back a few months later. I always thought bariatric surgery was too extreme and that no matter how bad things were, there was always the possibility that some day I could lose the weight and be healthy by exercising and eating well on my own. Years later and heavier than ever, I realize that I am going to die on this path of gluttony. I cannot pretend to be a better person than those who take the surgical road, because in truth, it is an illness of willpower. I am sick. Those who have pursued surgery have done something. I have done nothing. Too often I speak with people I respect in my life and they view bariatric surgery a failure, because one could not diet effectively. It's a stigma that is just wrong. Why attack a person for doing what they can to survive? At the end of the day, no one can save you but yourself. These same people who will look down upon you are not going to work out with you at the gym, take time to ask how you are doing losing weight, or try to motivate you. They will say nothing until you fail, and then they happily take the opportunity to point out your lack of result. I think LAP-BAND® is a gift from God. The concept, and staff in the medical field using this option are saving lives. I only hope the insurance games are eventually prohibited. I am pursuing this surgery and will have a few more months before my insurance will consider paying for 50%. My wife is not supportive. She loves me, but with a Christian Science background in her family, she is quick to judge the medical field as a monster to be avoided. I recently explained to her I was doing this without her. I will take the money from my 401k if necessary, because I deserve to live and must do anything possible to defeat my obesity and lack of willpower. She thinks I am selfish. I think dying would be selfish, and with two kids I have to do this for them also. I am walking a lot right now. I have a 5K on Thanksgiving morning to kick off my endeavor. Small goals...one day at a time. Hoping to lose some weight on my own while I wait. I would like to think in a year it becomes easier. I would like to think the naysayers will look how happy I am, healthier and thinner, and admit they were wrong about my decision. I would envy a day in which my spouse would thank me for not giving up on this when we fought so hard over it early on. However, at the end of the day, I have to do this for me. No one else will. I am not a victim. No one else is to blame. I am just a guy with life choices, and I cannot pretend that what I have been doing will prevent more weight gain. I cannot assume a day will come where I will magically have the willpower and strength to change on my own and never abuse food again. I cannot pretend I am exempt from diabetes and heart disease. Already my health is starting to slide, and I am only 33 years old. I cannot pretend that when I do succomb to an early death on this path of denial, the people who did not believe in bariatric surgery will obstain from making aloud comments at my funeral...that I made the choices that led to my demise. So...this is a choice I make for me. A choice to live. A goal of survival and no one will bring me down or stop me. I will be happy. I will lose this weight...I will live...and this is the choice I make. I pray God will help me and make LAP-BAND® available to my life. Without this, I don't think I can change or prevent what is coming. With it I have a good shot to lose the weight and keep it off. Wish me luck! -Christopher

Well said! This is the sensible approach to a lifestyle you can maintain for the rest of your life. This panic over the holidays and the "inevitible" weight gain - that's fat thinking. That's all or nothing, food controls me and my lapband should do ALL the work thinking and whilst you indulge in that, you are never going to truly beat obesity. You can keep your band ultra tight so that it controls you with an unpleasant hard stop - until it slips or erodes or something forces you to unfill it. Or you can exercise some self control, allow a bit of indulgence on Thanksgiving day, eat healthy the rest of the week and do some extra exercise - put your shoes on and go out for a walk every day if that's all that's available while you're away. There is really nothing to stop you doing any of that. The only reason why a whole ton of extra food and alchohol make it down your gullet and cause a weight gain will because you choose to allow it. Christmas is a hard time, but normal people gain a couple of pounds occasionally too, and a couple of pounds is easy to lose. But a bit of self control and some extra effort around the difficult days will probably net that out. whilst I was unfilled and afraid of the same lapses in judgement, I would start my meal with a fairly large serve of raw vegies - carrot, cucumber, capscicum, mushrooms and a big glass of Water. It really did take the edge of enough to keep me to a bandster sized portion of the less healthy foods that were put in front of me. And despite having chemo, and feeling crap, I still ran and went to the gym almost daily. If you want it bad enough, you can do anything. Keepign it up long term is pretty hard, but you will get some fill eventually.