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You hit it on the nail.......self destructive. For some it's alcohol, drugs, sex, and then for others it's food. It's about that mindset and it was clear to me that Pauline needed some serious counseling...probably lifelong....prior to surgery. Sometimes you have to see your behavior in others in order to get "it", I know that's what worked for me.....straight up, frank, & clear examples. That is what keeps my tail in line.

My name is Rachael. I am a mother, a nurse, and a very fat person. I was given my first diet pill at age 10 by my mother... I couldn't take pills so I struggled to get the huge pill down. I don't know that I ever did or that it worked or if I even really needed it! I see pictures of my self and I am a bit chubby but not obese at all at that age. I remember being teased about being fat and large at an early age. I remember carving the word fat into my arm at around 12 years old. I remember hating my body and thinking my life would be perfect if I weren't fat. Years flow by I am in high school I am 5 7 my wt a HUGE 155. In retrospect that isn't that tall or fat but at the time I felt unattractive. I had a period at age 16 were I had a lot of dates no sex but boys asked me out and told me I was pretty....... I did have big boobs and a full soft figure. I think I undervalued myself in some respects but was a fun, gregarious person. I met the man I eventually married he seemed to think I was attractive. We moved in together 2 years later. I did my first "successful" diet at age 20 . It was a liquid protein diet run by a doctor. My dad paid for it and I achieved my ideal weight of 130 lbs. I bought a tiny bikini short skirts and tight jeans. I went to community college for 2 years then nursing school. By the time a graduated in 1983 I had regained the wt I lost plus 30 or 40 lbs. I married at age 22 wt 170 ish ....continued to gain year after year hitting 270 when I got pregnant for the first time. I lost wt during the pregnancy but regained during breast feeding. Rinse and repeat x 2 more kids over 7 years. At age 33 I was 300 plus lbs but active and healthy. Years flow by my life hits a snag or two my husband developed into an alcoholic and we have marriatal problems. We split for the first time when I was 38 wt 345 lbs 3 kids ages 12, 7, and 5. Living as a single mom for a year was hard we got back together kind of to buy a nice house in VA and be a family. The difference was we kept separate rooms. I had become used to sleeping by myself reading if I wanted to and did not want to hear my husband snore or reek of alcohol. I am tired that's the beginning of my history more soon. A few days later I added a second installment : Today I am thinking about why I decided to have the surgery. I have become increasingly UNABLE. I can not: walk up stairs, walk any distance comfortably, fly comfortably, ride a bike, get up from a sitting position with anything like ease, and take care of myself alone. I have a laundry list of things I want to be able to do a BUCKET list if you will. Chase my grandson walk up or down stairs without a rail fly to Africa on a mission ride a bike take a hike buy a small car and fit in it ride a motorcycle Meet someone and be attractive enough to attract them I sometimes want to do a skit like Jeff Foxworthy (not that its very funny) YOU MIGHT BE MORBIDLY OBESE IF you can't wipe yourself without hurting your wrist you can't climb a stair without a reinforced rail get up out of a low couch without assistance well you get the idea i have a million and they all make me want to cry life as a fat person in America is not much fun .....the ridicule is one thing ......the discomfort of chairs that bind you is another...... and the comments people feel free to make is yet another. Yes I am responsible for my situation I know that but it does not make me sub human or less valuable as a person. I know I have lost friends, one in particular that I relate to my weight and my inabilities. This makes me sad and mad. A few days and thoughts later........ I find out my surgery date next week. Today I hurt my leg walking into work. I did not fall I was just walking and my right calf pulled or charley horsed maybe my Achilles tendon. Whatever it was it has crippled me worse then I have been ever! I so did not need another obstacle to exercising sigh. I am ready to do this. I have a lot of questions about the surgery itself How long will I be in the hospital? How much recovery time will I need before I can return to work? How my much pain will there be? How will my body feel inside? Will I have control of my bowels and will I vomit a lot? I think I will visit the blue point website and attend a support group this week. I must get ready to get ready I am a disappointment to my children though they love me they worry about me when they should not have to. They miss being able to do things with me or having to do things for me. They want a Mom they can count on and not have to worry about. I want them to have that as well. That's why I am doing this surgery to be ABLE.

The information abounds; it's so voluminous I hesitate to post it all here. Just do a quick google search on "abortion child abuse studies" and read up. Even if you skip the vast right-wing conspiracy of pro-life sites, the information abounds. I also found this interesting article from a non-pro-life source (Alcoholism Home Page Abortion, Substance Abuse Linked Women who choose to end their first accidental pregnancy with abortion, instead of carrying their pregnancy full term, are much more likely to end up abusing drugs and alcohol, according to research published in the American Journal of Drug and Alcohol Abuse. Many studies have linked abortion to substance abuse, but this study is the first to compare women who terminated their first unintended pregnancy with those who did not. The research included woman who had no history of substance abuse prior to their first accidental pregnancy. According to the published study: 18.6 percent of women who got abortions used marijuana, compared to 7.9 percent of women who did not get abortions. Five percent of those who had abortions abused cocaine, compared to only two percent of women who did not. 8.4 percent who had abortions reported they thought they were becoming alcoholics, compared to 4.5 percent who did not have abortions. "This is obviously relevant information to give when considering options in the face of an unplanned pregnancy," co-author James Cougle told the Washington Times. "I know that some women can be ambivalent about the decision when coming in at first for an abortion, so learning about different risk factors which would make them more vulnerable to negative emotional consequences is important."

Suggest you clean your wounds gently with sterile Water / alcohol wipe or similar, and replace the bandages with steristrips (3M make them, ask your pharmacist) for a week or so. Put the steristrips on so that they run perpendicular to the wounds. They will provide some support to help hold the newly knitting wounds together, yet still keep the wound clean and allow it to breathe and dry out. If your wounds are infected (inflamed, oozing, etc), or you are at all worried about them, go and see your local doctor.

That's a rather cavalier statement! It's interesting that people who've never had to see babies born with a dependence on drugs, fetal alcohol syndrome or work with abused children, have no compassion for those who have and refuse to even validate their point of view. It's their way or the highway. Kind of why this discussion will go nowhere. Yet, I always swallow the bait...

My mom is an amazing cook! When she and my dad were first married (pre VHS/DVD) she used to find out what was being prepared on that days Julia Child episode on PBS get out her cookbooks and measure and chop ingredients and then do the prep with the show so she got it just right. She said she'd go through 2 lbs of butter in a week cooking or just the two of them. Once as a child I had asked for a Twinkie like my friends had. I wanted to try one. My mom got so annoyed! She said she'd show me what Twinkies were supposed to taste like and bought me an eclair. When I was really young we lived overseas in a place where you couldn't even buy Pasta or cheese in the stores... so she made them by hand. Seriously, she can make liver taste amazing. All it takes is a mustard cream sauce. However by the time I was a little older there were five kids and my dad was seriously focused on not dying at 52 as his dad had. So the regular meal became salad, rice (often brown), a steamed vegetable, and broiled chicken. Liver for Breakfast on the weekends. Snacks and special recipes came out of the Pritiken Promise cookbook and my mom was miserable as cooking was her primary creative outlet. Weekly trips to a french restaurant after my piano lessons were a bonding activity for us and while my dad was at work we did eat a fair amount of fast food but by no means every day. My siblings never had weight issues as kids and I didn't really until I was in puberty. While the others occasionally have issues with weight as adults they seem to have had better luck with it just being a blip that happens in response to stress or injury that they then get under control whereas I have been overweight since my teens. I think that was in part because as the oldest and a girl I had to fight the hardest to be allowed to play sports. My parents were living over seas in a place gender equality is still an absurd idea during the whole get your girls playing sports things and holy crap when we got back I had to FIGHT to even be allowed to play soccer and didn't succeed until I was 10. All I had was swimming as that was a safety issue as we lived in a beach town so being a really good swimmer was very important. But food has always been how my mom comforted us and how she comforted herself. The same with several of her siblings who also have serious weight issues. So it was less about knowing what was healthy and more about not having a healthy emotional outlet.... at least it wasn't alcohol? Also she really hated being the only fat one in the family, so when I'd start to diet, the same woman who wouldn't buy Twinkies would buy double stuff Oreos which are my kryptonite.

@Allformyprincesas Welcome, Welcome, Welcome to sleeveland Liquid is liquid, is liquid protein shakes are made with milk or water - so i was told to count towards my liquid daily total - broth also counts as liquid - (alcohol does NOT count) sounds/looks you are doing great. keep up the good job good luck kathy

So do you also go to an alcoholics anonymous forum and brag about being able to drink booze? I mean, since we're talking about what works for you.

I've just had a bit of upsetting news and am in shock. It couldn't have came at a worse time. My dad has been sober for 23yrs and my mum phoned to say he has lifted a drink......I am numb He has been having a few health issues for a while and the Dr keeps reassuring him he is fine but he is getting so worked up about it that he suddenly hit a depression last week. I think he is worrying about my op too. I was 14 when he found alcoholics anonymous, so for 23yrs hes been going and doing great I cannot believe he's went back on it. I am absolutley floored I am on my own with my little girl of 3 and rely a lot on my mum and dad we are close. They were planning on looking after Hattie when I was going in for the op. Now I don;t know what to do. Do I cancel? My mum says no but there is just no knowing what state he will be in by next week. My stress levels are through the roof but I don't want to cry on my mums shoulder she's got enough to deal with. I'm trying to be a grown up. One thing though the thought of food is making me feel sick Am totally devastated

I was told by my surgery team to not drink at all. Due to the increased risk of ulcers, transfer addiction & alcoholism.

Yep flagyl definitely causes a violent reaction if mixed with alcohol. I can attest to that as when I was younger I was taking it and went to a party. I figured the alcohol wouldn't hurt it would just make the mediaction less effective(thats why you can't drink with most antibiotics). Well I think I had 2 drinks and I have never been so sick in my life. It was awful. Flagyl is quite a common drug. Its prescribed for recurrent/resistant yeast infections amongst other things.

For heaven's sake!!!! What's wrong with the truth???? "I am over weight," (doh you must be cus you are having surgery) "and I am on a very strict diet." "Alcohol drinks are empty calories and I must avoid it. I will be happy to raise a glass of wine as a toast your success in singapore" Why complicate things with such twists and turns with all these stories as suggested above? Regards Hal

Flagyl. If you take the antibiotic Flagyl (you can say it's for a urinary tract infection) with alcohol, it causes a VIOLENT reaction. Ha! Cathy beat me to it :thumbup:

Move ON .... sorry if that sounds rough or rude. but it would be like being a recovering alcoholic and your friend getting mad because you would not have a drink to celebrate his birthday. maybe youcould try to explain it in a way he/she would understand but I'm betting you have already tried that. Good Luck with what ever you decide

Weight Loss surgery is NOT A MAGIC PILL. You will HAVE to follow the rules, you will not lose 25 lbs a week, you will GAIN and you WILL LOSE, but you have to give your body TIME to HEAL.... Get in your WATER, and AS MUCH PROTEIN as you can.. do not come back in 3 weeks and say when can i drink Alcohol...........etc... you either WANT to do this (lose the weight) OR you Really just THOUGHT you DID....... Holler if I can help you!!!!! DO NOT COME BACK IN 2 4 5 12 weeks and say YOU are GAINING, THERE IS NO WAY.... you are gaining...... you are not drinking your water....... COME BACK in a year and THEN CRY you have gained weight, if SO , YOU are the reason........NOT the surgery!!!!!! Please if I can help ANYONE. Let me know, been there DONE THAT and some!!! ROCKING SIZE 8P... and FEELING & LOOKING WONDERFUL!!!!!!!!!!!!!!! Must remember I was pushing out or Women's 18P

Thank you for all your responses.... it does help. I am concerned as a close family member had gastric bypass and is now an alcoholic. I talked to him about it and he said he needed something else to replace the food. He had no counseling before or after ..... That is one advantage I have is that my insurance has also approved a years worth of counseling for me along with the surgery. I cant stand drinking so I am not worried that will be my addiction ....I think I am more scared of the feeling of having to find "something" to fill the void. Thanks for listening........:blushing:

LAPAROSCOPIC GASTRIC SLEEVE DIET Joseph E. Chebli MD FACS Introduction The following information provides guidelines for you to follow before and after Gastric Sleeve Surgery and for the rest of your life. Gastric Sleeve Surgery is a weight loss tool. After surgery, you will be required to make lifelong changes in your eating habits and to exercise on a regular basis in order to achieve and maintain your weight loss goals. Gastric Sleeve Surgery reduces the size of the stomach which restricts the volume of food that you can consume at one time. This means that you will feel full after eating a small amount. The surgery also induces hormonal changes which help prevent you from feeling excessively hungry. You should avoid drinking liquids with meals. This is to prevent overfilling of the stomach. Frequent snacking or grazing must also be avoided as this contributes to excess calorie intake and can slow weight loss or cause you to gain weight. Exercise is an important component of weight loss success. Exercise is recommended before and after surgery in order to maximize the amount of weight that you lose and keep off. If you have not been an active exerciser, always consult with your physician for clearance and recommendations before beginning any exercise program. It is important to follow the lifetime Gastric Sleeve diet rules, supplement guidelines, and exercise recommendations in order to achieve and maintain optimum weight loss success. In order to begin preparing for surgery, start implementing the pre-surgery diet goals listed on the next page. Pre-Surgery Diet Practice Tips 1. Choose low-fat foods, and avoid fried foods. 2. Stop using sugar. Use healthy sugar substitutes. (T) 3. Decrease intake of Desserts and candy. 4. Stop drinking sugar-sweetened beverages such as regular soda and sweetened Kool-Aid. 5. Start weaning off of caffeine and carbonated beverages. 6. Start cutting back on fast food and eating out. Begin making healthy meal choices when eating out and at home. 7. Eat 3 meals a day. Do not skip Breakfast. 8. Start decreasing portion sizes. 9. Eat more fruits and vegetables. 10. Practice drinking Water and other fluids between meals, not with meals. 11. Drink 64 ounces water a day. 12. Practice sipping liquids. 13. Avoid alcohol. 14. Begin some form of exercise. 15. Review the following information on the gastric sleeve diet. 16. Practice chewing foods thoroughly, 20 - 40 times or to paste consistency. 17. Purchase your Protein drinks or supplements. 18. Purchase your Vitamin and mineral supplements. 19. Begin planning a schedule for mealtime, fluids and vitamin and mineral supplements. Post Gastric Sleeve Surgery Diet Important Diet Guidelines: 1. Eat 3 meals per day. Avoid snacking and grazing. 2. Eat small amounts. Initial portion size should be no more than 1 - 2 ounces - approximately 2 - 4 Tablespoons - of food per meal for the first month. At first you may not be able to tolerate this amount. Over time, you will slowly tolerate more volume at each meal. Long term, the stomach will eventually hold about 4 - 8 ounces (1/2 - 1 cup) of food per meal. 3. Eat protein foods first. 4. Do not try to eat food and drink liquid together. • Consume liquid 30 to 60 minutes before and/or 30 to 60 minutes after eating meals but not during meals. 5. You are required to take a multi-vitamin with minerals for the rest of your life. 6. Eat slowly! • Each meal should last 30minutes or longer. • Avoid gulping foods and drinks. • All foods must be well-chewed to a paste consistency. • Using a small fork or spoon (i.e. baby utensils) can help control portion sizes. • Have one place to eat (such as at the table) and avoid reading or watching TV while you eat. This helps you to enjoy your food, concentrate on eating slower and to realize when your stomach is full. 7. Drink plenty of calorie-free, non-carbonated, caffeine- free fluids between meals. • Drink slowly-sip fluids, never gulp. • Calorie-containing beverages should be limited to skim milk and Protein Drinks. • Limit juice to no more than 4oz. per day. • Consume zero-calorie beverages throughout the day. Diet Progression After Surgery The diet after gastric sleeve surgery progresses through several stages. Your surgeon will let you know when it is okay to progress to the next stage. Day 1 - 2 after surgery: Clear liquid diet The clear liquid diet means fluids or foods that are liquid at body temperature and can almost be seen through. You will be on a clear liquid diet while you’re in the hospital. Examples of Clear Liquid Diet (No Added Sugar/ Sugar Free): • Clear (diluted) fruit juices without added sugar: apple, grape or white grape or diet cranberry • sugar-free Crystal Light drink mix or popsicles, Sugar-free Kool-Aid. (T - careful, usually sweetened w/Aspartame) • Herbal tea, caffeine-free tea • flat soda • Sugar-free Popsicles • Sugar-free Gelatin • Clear broth • Water �� It is best to dilute juices by 50% with water. �� Avoid citrus juices (orange/grapefruit) and tomato juice for the first three weeks. �� coffee and de-caffeinated coffee contain acids which are irritating to the stomach lining and should be avoided for the first few weeks for healing. Day 3 through Week 2: Full Liquid Diet The next stage is the full liquid diet which consists of sugar-free, low-fat milk products and the Clear Liquids listed above. You will need to supplement with protein (drinks or powder) after surgery. Remember to sip liquids, do not gulp. Examples of Full Liquid Diet (No Added Sugar/Sugar-Free, Low Fat): • Skim Milk or Lactaid milk • Soy Milk (non-fat) • Low fat, thin, strained cream Soup (smooth, no pieces of food) • Sugar-free instant breakfast • Protein drinks – Start daily when you get home from the hospital. (See section on protein and protein drinks) • Plain or “light” (no sugar added) yogurt with no fruit pieces • Sugar-free pudding or custard • Thinned cream of wheat or rice Cereal Week 3 through Week 8: pureed Diet You may now begin a pureed diet. This includes all items listed for clear and full liquids, and the items listed for the pureed (blenderized) diet. • Eat PROTEIN foods first • Make sure foods are well blended. • Start slowly. If you do not tolerate pureed foods go back to the liquid diet and try again in a few days. • Remember to drink liquids between meals, not with meals. • Continue protein drinks or protein supplements every day. Examples for the Pureed Diet (Sugar-Free/No Sugar Added, Low Fat): eggs cheese Pureed or blenderized scrambled eggs or egg substitute or cheese omelet; melted low-fat cheese, low-fat or non-fat cream cheese, ricotta cheese, very smooth/mashed soft cheese such as mozzarella, string cheese, low-fat or non-fat smooth or small curd cottage cheese meat, Fish, Poultry, Baby food meat or pureed meat or poultry moistened with broth or low-fat gravy Blenderized shrimp, scallops or fish Pureed tuna or salmon (canned in water) or pureed egg salad with low-fat or non-fat mayonnaise Potted meats thinned with broth; smooth deviled ham Starches Unsweetened instant oatmeal (strained), cream of wheat or rice cereal, mashed potatoes or sweet potatoes, smooth polenta, hummus, refried beans; low-fat or baked crackers or chips Vegetables Baby food vegetables or pureed cooked vegetables (no corn or peas) Mashed winter squash, tomato juice or sauce, pureed salsa, marinara Soup Strained, low-fat cream soup made with skim milk; fat-free broth Blenderized lentil or split pea soup or chili Fruit Baby food fruits (bananas, pears, applesauce, peaches, mango, etc) Unsweetened applesauce (smooth) Unsweetened canned fruit – blenderized Unsweetened fruit juice (diluted, no sugar added) Remember: IF YOU CAN CHEW IT, DON’T DO IT! Tips to Get Started Everything that you eat on the pureed diet should be sugar-free or no sugar added, low fat and blended to the consistency of baby food or smooth applesauce. • You will need a blender or food processor or you can purchase baby food. • Start with 1 ounce (2 Tablespoon) portions - no more than 4 Tablespoons at the most. Listen to your body and stop eating as soon as you feel full. • Eat protein foods first. Then if you are not too full, try vegetables or fruits. • Continue protein supplements (80 g protein per day from supplement). Helpful Hints for Blenderizing • Cut foods into small pieces before putting into the blender or food processor. • Remove seeds, skins and fat. • Add liquid for ease of blending. Add enough liquid to cover the blades. Options include skim milk, broth, strained low-fat cream soup, low-fat gravy, low-fat or non-fat sour cream or fat-free half & half. • Blend the item to a smooth, applesauce consistency. • Make sure there are no particles, seeds or lumps remaining. If so put through a sieve or strainer. • If you have leftover blenderized foods, try freezing in single serving portions in ice cube trays and put the frozen cubes into plastic freezer bags. Meats – Very lean and dry meats puree better by adding a small amount of fat (margarine, oil, light mayonnaise, gravy, etc.) Fish also tends to be dry. Improve the texture by adding small amount of lemon juice, light mayonnaise or strained low-fat tartar sauce. Starches – Try pureed peas, canned Beans, sweet potatoes. Starches puree better when hot. Rice and potatoes tend to puree into a gummy paste and are not recommended. Substitute cream of rice cereal prepared with a flavorful broth and seasoned with margarine. Pasta or noodles are not recommended as they are not well-tolerated. Vegetables – Cook vegetables until soft. If using canned vegetables, drain first. Add melted margarine and puree. Add a small amount of liquid until it reaches the smooth applesauce consistency. Fruit – If using canned fruit, drain first. Add a few drops of lemon juice to help prevent them from discoloring. Begin to take advantage of your favorite leftovers before surgery. Process these foods, and freeze them in an ice cube tray. (Each cube is approximately 1/2 to 1 ounce). When frozen, pop out into Zip-lock bag; label and date, and freeze cubes until needed. Meal Guidelines for the Pureed Diet (See Sample Pureed Meals listed in the Appendix) Once you begin to eat pureed foods (which are considered solids) you will want to start differentiating between liquids and solids – meals should include pureed foods, and so liquids (including protein drinks) should be taken separately from your meals. • You should eat 3 meals a day with protein drinks between meals. • Protein drinks containing at least 20 grams of protein per serving should be consumed as needed to meet 80 g/day goal. • Start with a portion size of 1 to 2 tablespoons of pureed food for the first month. At first you may not be able to tolerate this amount. Eat your protein source first, and then if you have room a small amount of fruit, vegetables or other foods may be consumed. Hints for Measuring Foods: Liquids or soft/pureed foods are best measured in measuring cups or spoons; they can be measured in ounces, Tablespoons or mls. 1 cup 8 Fluid ounces 240 ml 16 tablespoons 3/4 cup 6 fluid ounces 180 ml 12 tablespoons 1/2 cup 4 fluid ounces 120 ml 8 tablespoons 1/4 cup 2 fluid ounces 60 ml 4 tablespoons 1/8 cup 1 fluid ounce 30 ml 2 tablespoons 1 Tablespoon = 3 teaspoons 1/2 Tablespoon = 1-1/2 teaspoons Week 9-12 After Surgery: Soft solid food Diet If you have been tolerating pureed foods, you may now begin a soft diet. This includes all items listed for clear and full liquids and pureed diets plus items listed for the soft diet. Try 1 to 2 new foods a day. This will help you to learn what foods you tolerate. • Remember your stomach pouch empties more slowly with more solid or dense foods than with liquids, so you will be able to tolerate a smaller quantity of food than you could with liquids. • Go slowly. If you do not tolerate the trial of soft foods, resume pureed foods and try again in a week. • Eat protein foods first • Avoid foods high in sugar and fat. • Space meals 4-5 hours apart • Continue your protein drinks between meals • Drink other fluids constantly between meals Examples of Soft Diet (No Added Sugar/Sugar-Free, Low Fat): • Baked fish (no bones) • Imitation crab meat, baby shrimp • Bananas • Canned peaches or pears in water or juice • Well-cooked vegetables without seeds or skin (no corn or peas) • Scrambled, poached or hard boiled eggs • Tuna or egg salad (no onions, celery, pimientos, etc.) • Finely shaved deli meat • Baked, grilled or rotisserie chicken o Moist foods will be better tolerated. Moisten meats with broth, low fat mayonnaise, or low-fat gravy or sauce. o Fish and seafood Proteins are softer and easier to break down than poultry or red meat proteins. o Reheating foods tends to make them dry out and hard to tolerate. Common Problem Foods (Avoid for 3 months after surgery) • Red meat such as steak, roast beef, pork. Red meat is high in muscle Fiber, which is difficult to separate even with a great deal of chewing. Avoid hamburger for one month after surgery. • Un-toasted bread; rolls, biscuits. (Toasted bread may be better-tolerated.) • Pasta • Rice • Membrane of citrus fruits • Dried fruits, nuts, popcorn, coconut • Salads, fresh fruits (except banana) and fresh uncooked vegetables, potato skins. Month 4 After Surgery: Regular Diet • Problem foods as listed above can now be tried. • Rice, pasta and doughy bread may not be tolerated for 6 months or more. • Try fresh fruits without the skin first. If tolerated, the skin can be tried the next time. Salads are generally well-tolerated if chewed well. • Go slowly. Try a small amount to see how you feel. • Avoid high sugar and high fat foods to avoid a high calorie intake. Foods to Avoid: Hard/crunchy foods may always be poorly tolerated. Nuts and seeds are difficult to break down. Fried foods/greasy foods are hard to digest and are very high in calories. • Corn chips, potato chips, tortilla chips, hard taco shells • Nuts and seeds • Fried foods and greasy foods Points to Remember: • Solid foods will fill your stomach pouch more than liquids so you will be eating smaller quantities of foods versus liquids. • If you don’t tolerate a food the first time, wait a week and try again. • You may find that you tolerate a certain food one day and not the next. It is normal for this to happen. • If you don’t tolerate certain foods or notice nausea, vomiting or diarrhea during or after eating, ask yourself the following questions: o Did I chew to a paste consistency? o Did I eat too fast? o Did I eat too much volume? o Did I drink fluid with my real meal or too close to my meal? o Did I eat something high in sugar or fat? o Was the food moist or was it too dry? Steps for adding solid foods: • Try only 1 small bite of the new food and chew well. Wait awhile and if there are no problems, take another bite. • If at any time you feel too full, nauseated or vomit, stop eating and rest. Take only clear liquids at the next meal and add blended foods and liquids at the following meal. Try one solid food again the next day. PROTEIN Protein is the most important nutrient to concentrate on when resuming your diet. Because the volume of your meals will be limited, you should aim for a minimum of 80 grams of protein per day – this needs to come from your protein supplement. Why is protein important? • Wound healing • Sparing loss of muscle • Minimizing hair loss • Preventing protein malnutrition Remember to eat protein foods first at each meal, followed by vegetables and fruit. These are some good sources of protein: Protein Sources Serving size Protein (g) Skim or 1% milk 1 cup 8 Evaporated skim milk (canned) 1 cup 19 Soy milk beverage 1 cup (8 ounces) 7 Non fat dry milk powder 1/3 cup powder 8 Nonfat, sugar free yogurt 1 cup (8 ounces) 8 Nonfat or low fat cottage cheese ½ cup (4 ounces) 14 Nonfat or low fat cheese slices String cheese *1 ounce/ 1 slice 6 LEAN meats – skinless chicken or turkey breast, fish, beef, ham, Deli meats *1 ounce 7 Egg or Egg substitute 1 egg or ¼ cup subst. 7 Peanut Butter (creamy) 1 Tablespoon 5 Tofu ¼ cup 5 Legumes; dried beans peas or lentils Chili, bean soup ½ cup cooked ½ cup 7-9 6-7 Soy/vegetable patty (like Gardenburger) 1 patty 8 - 10 Hummus ½ cup 6 Measuring Hints: *1 ounce of meat is equal to about 3 – 4 Tablespoons of chopped or ground meat. 1 ounce of grated or cottage cheese, tuna or egg salad is ~ 1/4th cup (4 Tablespoons). A 3-ounce portion size of chicken or meat is about the size of a deck of cards. High Protein Ideas Chicken or Turkey Pureed – Use baby food or make your own. Try mixing it into strained low-fat cream soup. Breast – baked or grilled Thin-sliced/shaved deli slices Ground – meatballs, meatloaf Canned – works great for chicken salad

My 2-week liquid diet countdown is about to begin. In a way this is a fair test of my commitment to VSG and more importantly the post-surgery dieting necessary to achieve the weight loss. It is time to get serious, establish my commitment, and get a do-over dealing with my obesity. Yes, obesity, I have hidden from admitting my situation, much like an alcoholic denies being a drunk, I am a foodaholic which in many ways is worse. I am tired of looking in the mirror and "remembering" my lighter days. It is too easy to say that my weight problem began when I quit smoking; but, facts are - I simply enjoy eating and when my taste buds recovered - my oh my - did things taste better and we all know what happened next. My issue is more than just losing the weight (100 lbs.), its about dropping the associated health risks, diabetes, high blood pressure, more drugs than I care to list, cholesterol, and a family history of heart attacks. I bought an assortment of protein drinks, soups and vitamins to start a dietary journey to a lighter me. Having read what so many others have posted in their topics, I believe that I too can show the same determination and will be reading and posting often. Have a great week, and thanks for being out there and sharing your successes.

I swear, figuring out how to hack our bodies is cray, right? I think (especially in maintenance) that high or higher fat is where it's at as long as your carbs are low enough to put you into a ketotic state. Cuz if you're still a sugar burner and you combine high fat with high carbs, then it's a recipe for heart disease. The rule is kinda for health: higher carb + super low healthy fats OR low carb + high healthy fats to satiety (but no fat bombs need apply ) Fat bombs = keto candy. Ain't nobody got time for that! I hope you will try it and tell us your experiences!!! My experiments with it since about month 6 when the mean-hungries came back are that I can "choose" to have a cheat meal (didn't realize how terrible they are for our arteries at that point) of high carb (think pasta or pizza or mexican food out), but that I better be ready for the fall out. The fall out for me is about 4 days of terrifying hunger. Super hunger! Everything is woken up and I want to eat continually. Even in moderate portions (I'm talking at 6 months I was still maintaining about a 1/2-3/4c volume I think?) And when I do my low carb as I described to you guys and don't have any alcohol or wine or sugar free sweeteners/sugar free candies, omg. My satiety goes up up up and I'm happy with 1-2 meals per day (mostly of the proper size ) and I feel more peaceful. When I add IF in, it's even better. Until I started hanging out with Jason Fung's facebook group I had not realized the effect of even cephalic insulin response to things like liquid stevia. Thought that one was an "ok" one! But apparently not. Cuz when I dropped it too for the most part, my hunger level decreased even more. And I can tell the days I eat it, I'm hungry and looking for food.

Hi dear, it is hard to find that perfect fill volume once you do that it becomes better...its taken me 5 years to find that... but I know others are luckier they have lost all their excess weight in less than a year. In past 10 days I have lost 5 pounds. things I am doing differently now are, 1- No water 30 mins before or after meals. NO WATER OR ANY LIQUID WITH THE MEAL. 2- alcohol consumption stopped. i will have it only on special occasions now. 3-I walk everyday for 30 mins. Try this. See if it helps. Keep us posted.

We dont say alcoholics are taking the easy way out when they enter rehab, we commend them for it because quitting anything cold turkey is next to impossible when you are truly addicted. To me, WLS isnt any different. And although I havent been sleeved just yet, from all the posts I've read on VST, it's still a big struggle. You have 80% of your stomach removed, but the sad news is that our "fat brains" dont go out into the medical waste container along with it. We have to retrain and recondition ourselves on how to eat. We cant just pick any old piece of food up and eat it, we have to make conscious decisions which is certainly a battle when you're addicted to food. So although the weight loss stories sound phenomenal and seeing the before and after pics are mind blowing, dont ever think that making this major change to better yourself, your health and your quality of life "the easy way out". I wish you all the best and much success on your journey. I enjoyed this post, hope to read more from you soon!

I've settled in with my Isopure/Cranberry cocktail this morning to see if I can get a few thoughts down about what's been going on in (dun dun dun DAH)...The Battlefield of my Mind! Maybe you remember when you were a new parent and someone said, "Oh a baby changes everything." I do, I sort of was young and invincible, and so my response was a mental, "Duh." Of course, not even a week into child rearing and I was like, "Holy crap, this is hard! How do people do this?!! WAHHHH." Do you remember? Well this, THIS little sleeve of mine? It changes EVERYTHING--it truly is a game changer. Now, it's not bad...but change is not always easy (maybe NEVER for some of us certain personality types...you know who you are...). Maybe easy isn't the right word. Comfortable? Whatever, my point is it's not bad, but it's new and what makes it particularly uncomfortable is being at the bottom of this steep learning curve. Having head knowledge of how to change a poopy diaper is different than hands-on experience when you are getting the "full senses" tour. Don't get me wrong, I am all about having head knowledge and being as prepared as you can be. Doesn't mean I always am...and frankly, I have been known to leap without looking a time or two. I'm a cook. I'm a creator-cook. Cooking is what I do, so I have been cooking for my family since I was day 6 post-op. I've made Red Beans & Rice with Andouille Sausage, Arroz Con Pollo, Southwest Taco Chili, Salmon & Rice Pilaf, Beef Peppercorn Stirfry, Sweedish Meatballs... I mean, I like to cook! Now to some of you, that may seem like unecessary torture, but the truth is, I will always be cooking for my family, making lunches for my son's. Preparing delicious meals is what I take pleasure in doing. Now I just have to deal with not "tasting and partaking" like I did. But regardless of what we are exposed to, the fundamental truth to all of us is that we have an addiction (and I realize that not everyone here does...some have physical or chemical reasons for being overweight) but most of us do, and we have to cohabitate and live with our "poison". This isn't like removing all alcohol from our lives to avoid drinking. We still have to eat, period. I read a book some months ago written by the wife of a singer whose teenage son accident'y ran over their little 5 year old daughter. The book is entitled, Choosing to See, by Marybeth Chapman. I know it seems random, but sometimes concepts transcend topics. The books title has stuck with me...as much as the amazing story of healing and courage did. I am choosing to see. Choosing to see the truth of why I eat, why I have to stop, why it is OK to do this for me (this may be a foreign thought to some of you, but it seems to be a real stronghold for people of certain faiths), and that it really isn't just about me but about the impact I'm supposed to have on my loved ones. What I eat impacts others and it does matter. So I said all that to say, someone recently asked me if I still obsess about food. The answer is an unequivical YES. I'm not sure you heard me over there in Idaho, but YEEEESSSS. The motivation has somewhat changed...so I'll cut myself some slack. When you haven't chewed in 4 weeks, even gumming greek yogurt is almost euphoric. I am not overstating this fact. Eating half of a Ricotta Bake (by Shelly), is enough to make you cry. I did. I savored every little tiny miniscule particle that I put on my tongue...all the while knowing that this moment might lead to, gulp, constipation. What's changed is that I'm spending as much or more time on food now because I'm reading labels for a whole new sub-set of information. It's similar to WW with Fat/Fiber/Protein...and yet it's really all about the protein and the carbs. There is some mental gymnastics for hitting daily targets. It's not hard, it's just different. After some time, I expect to know quite a bit about a variety of foods...just as I use to know the point values of most of my favorites. Am I mourning the pleasure of snarfing? Yes. OK, if I tell you somthing, you have to promise it's just between us, ok? My son had McD's in the car (he's a brave boy...get's it from his mamma) and I asked him for a french fry. Just one. SHHHHHHHHH! Yes I did! And I ate it too!!!!!! And it was...G-0-0-D. And one was enough. My guilty pleasure was met and paid for and it was enough. Sure, I chewed it till it completely disolved in my mouth...and yes, I know that it could be a slippery slope....but I felt like I snarfed and it made my screaming mind shut-up. Seriously. I totally nipped my whiny mind in the bud by giving it a fry. It didn't bother me after that. I felt like a won. I certainly didn't feel deprived anymore and ultimately, I felt good about having just one! So, as I head into week 3...did I mention I hit that inevitable "STALL"? Yeah, the minute I introduced yogurt, cream of wheat, etc. I hit the stall. I knew it was coming and I also know that IT is not going to be a game changer for me. Mentally, I've won this battle because really, what the heck can I do? Haha Hopefully it's just a quick blip and I don't lose face on the bravado I'm feeling right now. As I was saying, as I head into week 3...I'm facing the constipation consideration: Not just having less frequent BM's, but actually feeling the urge to go but can't...so I'll increase my water, try to increase my activity a bit, add some fiber. Try to get my BP stabelized--which has dropped dramatically from 145/80 ish to about 95/70....I've had a reduction in meds so we're working on it. It's not just the 30 pounds, but it is the decrease in sodium, no doubt. So as you see...I'm not obsessing-free yet. I totally look forward to that day, but for now, I'll take things one salty slice at a time and try to keep things in perspective. Thanks for listening. May the Lord bless and keep you, Susan

Very sorry to hear that your wife is not that supportive. This certainly has to be a factor in your present situation. I, too, have a huge sweet tooth. I could stop eating fatty foods without a problem, but controlling intake of sweets is one of the hardest things for me to do. I changed over to sugar free candies. What that does for me is that it satisfies the craving for sweets, but I know that if I overdo it, I'm going to be hurting, in the form of gas pains and other short-term gastric issues from the sugar alcohols.

I personally use unhurt. I am allergic to most the others because they sugar alcohols Sent from my iPhone using the BariatricPal App

Linda, I was just taking care of a pt that was sleeved 5 years ago and was going through severe DT's when he decided to quit drinking. He ended up in my ICU intubated for 2 days. When he started coming around we talked for a while, said it started slowly because he was bored and didnt have anything to do with his time in the evenings and weekends and then it gradually escalated to a bottle of vodka a day. Good for you that you recognized it...I can see this being a problem for us nurses when we get home after a bad day and cant eat bad food to self medicate....so we turn to alcohol instead. Like I said good for you, thank yoi for sharing.