gain goal regain How was your 5:2 day today?

[Globetrotter 1,340]

Kim- use salt, less toxic to other's, still super annoying to the craycray neighbor

Cathy - thank you for your as always comforting words, welcome back from vacation!

Cheryl - I agree with Kim, go with your gut on that guy, and wtf dude, the lady said NO, and set her boundaries, respect them! dick...

Your co-worker, that is so sad, is there any information coming forth? Any "reason"?

I know I "could" have a child anyway, without a partner, without giving birth, and I am a huge proponent of adoption, but unless I find independent wealth, going it alone is just financially illogical, particularly if I plan on adopting.

But, all the women in my family have in one way or another, had to pursue their motherhood alone; they were all married but were either literally or metaphorically, emotionally or financially abandoned by their husbands, and that makes me so sad, I really really wanted to be the one who was different, who had a real partner in child-rearing...

I went home for my birthday (16th), my Mom and I went camping in the old family camping spot, it was wonderfully soothing and I ate as I pleased; roasted marshmallows, french onion Soup, duck confit..yum!

I haven't felt beautiful in such a long time, I hate my fat face, my skin has been ravaged by rosacea, and I definitely haven't felt sexual in a long time, and have developed a serious anxiety over my ability or opportunity to "O" with a partner... I guess I will just paint instead. Paint and work and pay taxes and die by centimeters.

[Chimera 644]

I'm so sorry to hear about your co-worker Sheryl - one of our students took his own life during the school year a while back and its just not something that you can shake. My condolences as well.

Happy 16th Florinda sounds like yo had a fine time camping - I wish we had gotten to go this year, got to go see Cancun and Tulum so I am certainly not complaining.

I too am 5'3" and nicely situated in the obese range - so I am in good company with the rest of the gang in the same boat. Someone on FB yesterday posted a medical study showing the results of sleeve surgery were significantly less successful than bypass a few years out - I should go find it and post here.

The scale is being my friend - it is inching down ever so slowly - about 7 down from the highest regain point - I'll take it!

Finally really using My Fitness Pal to log rather than paper journalling.

[Chimera 644]

Okay finding an article on Facebook from a day ago on a very busy group is impossible - Googled it and found it right away -

http://www.medscape.com/viewarticle/849141

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[CowgirlJane 14,259]

Is there a way to see this without signing up?

Okay finding an article on Facebook from a day ago on a very busy group is impossible - Googled it and found it right away -

http://www.medscape.com/viewarticle/849141

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[CowgirlJane 14,259]

The woman who took her life - well, she had shared with me some problems in her personal life that were getting her down big time. I don't think it is fair to call that the "reason" though - people who have so much to live for don't end it all just because relationships are rocky etc unless there is some sort of underlying chemical imbalance.

I am doing oh so much better anxiety wise. Using a natural remedy, making myself do the things that make me feel better daily walks,, every other day ride on my trusty older horse, limiting caffeine, eating more consistently (I get anxious when my blood sugar gets low when i am in a bad time like now), taking remedies to ensure decent sleep - all the hygene things I know that help me.. Although i feel better, Viv's death has made me rethink my approach and I am going to try meds again. I guess I feel like I have "tried hard enough" on my own and I just don't want to have to put so much energy into managing/preventing anxiety. It reminds me alot of my weight loss journey - just reaching the point where you realize that wishing/will power just doesn't always work.

I have put a great deal of thought into how I want to move forward in life and I realize that fighting anxiety isn't really what I want in the forefront of my life. It really hit me as I contemplated things - I am HAPPY. I have so many things going right (work, kids, house and home, friends etc etc) and I like myself. You know what i mean - none of us are perfect but that hole in my heart (metaphorically) seems to be healing quite nicely and is no longer a cavern. I don't mind being alone so much - in fact I have been loving horseback riding alone the last few weeks. I feel comfortable in my skin and even though I am 10# over goal, I still love my body and my progress. I have plenty of room for further growth - no denying that - but I am happy with my life.

So, I think that my anxiety is the inherited disorder that my mother (had very severely) my full sister had (diagnosed with general anxiety order in her 20s), my niece suffers from etc. and it is not something I can "will" away. I used food and obesity to manage/mask it much of my life. The last few years I haven't been using food that way and all the replacements are temporary (hard exercise, etc etc) and stop working over time.

So, I called the counselor/ARNP I saw last year and she is on vacation for 2 more weeks. i am trying to decide if I should wait that long or go to my primary care because i just want relief and to move forward.

I have made some decisions about my horse life to that are "freeing".

I got funding for my mega project at work (woo hoo!)

I just got invited to join a wonderful group of ladies for a week in Maui next Feb

My home updating will start this fall

Many good things

[Chimera 644]

I have terrible anxiety and have powerful medicine for the worst bouts - but I cant take that all the time (used to, just to get through the day) - will talk about it more later - little privacy atm.

I did not realize that you need to sign up for that article - I was able to just read it earlier.

[Chimera 644]

I found a cached version - here it is below. Though I think that how one views the glass - as half empty or half full in terms of stats 5 years+ out...I have read stats that have EWL at 50-60% at 5 years and they feel that is still a great success.

Benefits of Sleeve Gastrectomy Wane at 5 years

The weight loss and diabetes remission achieved with laparoscopic sleeve gastrectomy (LSG) appear to wane by 5 years, a new cohort study suggests.

Sleeve gastrectomy has been growing in popularity as a bariatric technique, but data on its long-term effect on obesity-related comorbidities are scarce, with most findings reported so far limited to 2-year outcomes, explain Inbal Golomb, from Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel, and colleagues, in their paper published online August 5, 2015 in JAMA Surgery.

In their retrospective analysis of a prospective cohort study of 443 patients who underwent bariatric surgery at the university hospital between 2006 and 2013, the percentage of excess body weight lost had dropped from 77% in 241 patients with available data at 1 year to 56% among 39 at 5 years.

And of the 82 diagnosed with type 2 diabetes prior to surgery, the proportions achieving complete remission — defined as a fasting glucose level of less than 100 mg/dL and HbA_1c below 6% — were 51% of 71 with available data at 1 year and 20% of 10 at the 5-year mark. Total cholesterol didn't change significantly at all, and decreases in LDL cholesterol were significant at 1 year but not at 5 years.

"Undergoing LSG induced a reduction in [percent of excess weight loss] and a major improvement in obesity-related comorbidities in the short term," Mr Golomb and colleagues note. But the longer follow-up data "revealed weight regain and a decrease in remission rates for [type 2 diabetes] and other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient," they conclude.

In an accompanying editorial, Anita P Courcoulas, MD, of the University of Pittsburgh department of surgery, Pennsylvania, observes that there are "critical gaps in knowledge in this area," resulting from the "paucity of comparative trials, incomplete follow-up, a lack of standardized definitions for changes in health status (eg, diabetes mellitus remission), and the tendency to a rush to judgment in favor of surgical-treatment options."

Gastric Bypass Appears Better for Diabetes and Heavier Patients

Asked to comment, Philip Schauer, MD, director of the Bariatric & Metabolic Institute at Cleveland Clinic, Ohio, told Medscape Medical News, "This is a 5-year study that adds to our understanding of the durability of the sleeve gastrectomy. These authors show, like the others do, that some of that weight loss and improvement in comorbidities does retard over time."

However, added Dr Schauer, who was one of the first surgeons to perform LSG over a decade ago, "Even at 5 years, there is still significant weight loss, and even though the remission rate of diabetes drops from 50% to 20%, that's still remarkable. That's not achievable with medical treatment."

He noted that LSG typically works better — and with more durable results — for patients with a shorter duration of diabetes and for those with lower levels of obesity (ie, 50–100 pounds overweight, as opposed >100 pounds). And it has some advantages over gastric bypass: it's a shorter procedure, with less short-term comorbidity.

But, he said, there is growing evidence from his data and those of others that "when we look at longer-term and more important outcomes, we're now seeing pretty consistent reporting in favor of the gastric bypass over the sleeve, at least for diabetes and the higher-weight people, too."

Large Randomized Trial Comparing Surgical Procedures Impractical

In her editorial, Dr Courcoulas says that cost and feasibility issues will make a large randomized comparative trial among surgical procedures relatively impractical.

Therefore, she said, data on long-term outcomes will need to come from sources such as large electronic databases and "also by thoughtful inference that will be made through pooled analyses of data like that from Golomb and colleagues and from many other disparate randomized and nonrandomized studies of bariatric surgery.

"It will take time, patience, and a willingness to avoid a rush to judgment," she adds.

Dr Schauer said, "I agree with her; we have to dampen our enthusiasm a little bit until we see the longer-term results."

In the meantime, Dr Courcoulas writes, "clinicians and prospective patients will need to discuss and weigh the evidence in a dynamic exchange driven not always by final conclusions but by the most current available data."

The study authors have no relevant financial relationships. Dr Courcoulas reports receiving grants from Nutrisystem, Ethicon, and Covidien and serving as a project consultant for Ethicon and Apollo Endosurgery. D. Schauer has received grants from Ethicon, Covidien, Novo Nordisk, the National Institutes of Health, and a travel grant from Nestle and is on advisory board for Surgiquest.

JAMA Surg.Published online August 5, 2015. Abstract, Editorial

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[CowgirlJane 14,259]

Thank you for pasting that in Kelly. You know, I lost 150# to get to goal but lost more than that post sleeve. I worked my effing ass off though, so I suppose it can be misleading to think my results are "typical"

right now, I weigh 10# over goal and really want to be under goal, but, in truth, I look good/feel good so I am not stressing about it. However, it gets harder and harder and I have not even hit the 4 year mark (December!)

@@Chimera I would like to talk to you about your anxiety meds and any advice. I understand they won't prescribe xanax type drugs due to the addictive nature, so I am talking about going on something "like" Lexapro that I did for short duration last year. I got flulike symptoms from that drug, but the anxiety relief was incredible. Even after going off, it lasted a really long time, it was my recent health issues that triggered a "flare up". I am doing pretty good at the moment, but i am just tired of feeling like a tightrope walker, know what I mean?

I read on one of the BP forums a lady talking about how she got addicted to pain meds, and she figured out during recovery it was because it relieved her anxiety. I wonder if that is a common theme among SOME obese (formerly as well) that underlying anxiety is a key issue.

[Oregondaisy 2,021]

Sheryl, I hope you find the right medication without side effects. I've never been able to take any of the SSRIs because they make me feel like I am on speed. I've had horrible side effects from any anti depressant or anti anxiety medication that are not benzos.

John is a sweetheart and I keep wondering what he sees in me but I'm enjoying him anyway.

right now I am in a motel cause I have to be at the hospital at 5 am. Tomorrow they cut me open again. I'll post here as soon as I can. I sure hope this makes it possible to go for long walks and do my weight lifting routines again. I hate being a couch potato. It's very hard to keep the weight off, and it's depressing not being able to move and exercise without pain.

[UK Cathy 977]

Denise sending much love and hope it all goes well tomorrow, hoping also that you get the the results you want and need. XX

[CowgirlJane 14,259]

Thinking of you Denise!

[Globetrotter 1,340]

Positive vibes Denise!

Cheryl - Pfft, I heard so much hype about Xanax that when I had a terrible anxiety attack I was excited to take it, from all the talk I expected it to you know, HELP. It did not. My body did not register that I had taken anything special, I meditated and achieved a modicum of calmness but nothing beyond what happens when I meditate and practice cognitive therapy. The Xanax did nothing to unclench the fist of my mind, nothing to steady my thumping heart or racing pulse, it might as well have been a sugar pill.

Chimera, if you are willing, in a PM, to tell me the name of that medicine, I would be grateful. I believe that my anxiety is both hereditary AND experiential.

Thank you for posting the article Kim, the information is fu**ing devastating and nightmarish. I saw photos from my birthday camping trip last week and I'm just so fat, so so fat.... I don't look good at ALL, I look doughy and like I never had surgery v_v

I'm juicing now, a morning juice, a midday Protein Shake and an evening paleo meal. I recently crushed the marrow in my pinkie toe so can't exercise if that means bearing weight (also can't wear closed toe shoes), could take months to heal.

[CowgirlJane 14,259]

I am not talking about the xanax type - those are intended for short term relief of acute anxiety like people get when they are faced with a scary medical procedure or something. They are addictive and what is worse, they can cause a "boomerang" if you take it too long and start to create anxiety. I am talking about the class of drugs that you take daily, more like the anti-depressant/anti anxiety classes of drugs.

I tried very low dose of Lexapro last year and it worked but it gave me flulike symptoms after I had been on it a month or so so i went off it. The doc had suggested something called busebar because it apparently rarely causes the typical side effects but it is a bit of a sedative so I kind of worried about that aspect. The ARNP/counselor I saw last year is on vacation so I am just doing my natural things that are helping ALOt.

Taking melatonin before bed to help ensure a good nights sleep

Daily vigorous walk

Eating reguarly - no fasting or trying to lose weight right now

5HTP - the pill form never worked for me but I am using the sublingual tabs and feel it does help (some)

Doing calming practices like deep breathing etc.

I do feel better, and if I thought i could maintain like this, I would probably not seek out the meds but i am just tired of it and want to not fight it all the time. Also, i want to relose about 20# to get under goal again and I don't dare try seriously buckling down when I now know that it can contribute to that uneasy feeling I get.

The thing about anxiety is that there are a bunch of different types. I don't have social anxiety, i don't worry over an event, or a thing. It is more like an undercurrent of tension that isn't attached to anything. It does interfere with my ability to sit and concentrate at times as I tend to want to "move" when I am feeling this way.

It is hereditary - my Mom had it quite severe and other family members have had it to lesser degrees. On top of that, i have some traumatic events in life that are known to cause this condition, but i really think it is the hereditary element because i have been to talk and EMDR therapy for the trauma things.

[CowgirlJane 14,259]

I thought that 60% excess weight loss was "expected" from sleeve in long term. 56% is lower than that, but not crazy different. Is the big topic here about the diabetes remission rates not being as good?

I also think it is important to know what they use to calculate the "target weight" when they do the EWL calc. It is not the upper end of the normal BMI, it is somewhere in the middle. Speaking for my personal situation, when I got down to 140 which I believe was my target, even my doctor thought i was too thin. I liked being thin, but when I look at photos now I recognize that perhaps bones sticking out from your back is not all that lovely. My point is that people who were obese often wind up "heavy" on the scale for their size so losing 100% of excess may not be attainable or even completely desirable for all. Having said that, due to my joint problems, i would actually prefer to be lighter again to get pressure off my hip and knees... regardless of how I look.

From the article:

• In their retrospective analysis of a prospective cohort study of 443 patients who underwent bariatric surgery at the university hospital between 2006 and 2013, the percentage of excess body weight lost had dropped from 77% in 241 patients with available data at 1 year to 56% among 39 at 5 years

[Chimera 644]

Best of luck Denise - I hope things are going well and you are on the mend already!

I dont mind sharing what meds I take - not at all. I currently take Wellbutrin SR - the Sr stands for slow release I believe, I am supposed to take one in the am and another later in the day but oneseems just fine. I was prescribed this medicine when I wanted to stop smoking (which I did on November 1, 2010 after 28 years of a pack and a half a day habit.)

My doc prescribed Wellbutrin because I have anxiety issues - mentioning that the other popular smoking cessation drug Chantix, could send folks with anxiety into a tail spin ( meaning it can really ramp you up). I asked my GP how it works and she said with a chuckle that they really aren't sure why it works so well to help quit smoking. It is not an SSRI, I have a long and diverse history with those as well. The nice thing about the Wellbutrin is that it does not have the heinous side effect of killing the libido or making it so that one cannot reach climax - which I hear is common.

My docs at the WL surgery office have kept me on the Wellbutrin, as it also has a positive effect for folks trying to lose and maintain their weight, I don't notice a huge difference in how I feel with it - I do know that I seem to be on a much more even keel than in the past. I'll take it.

I also take a lot of anti-histamines for allergy and dermatological issues - I worked with accelerated solvents and oxidizing chemicals for decades and I am hyper sensitive to my environment. My skin, eyes, and mucous membranes are super easy to irritate - so it is a continual battle to keep inflammation at bay.

Interestingly enough - anti-histamines are also considered useful in the treatment of generalized anxiety symptoms - which I have along with PTSD/acute anxiety (i.e. panic disorder) in a nutshell, a brutally abusive childhood spent with a raging alcoholic stepdad and a horrifying car crash in my early 20's that put me out of commission for a year are big elements of where this all came from - 'hi, nothing, nowhere is a safe place to be.' and welcome to using food as a substance to soothe and disappear.

I take Klonopin when life is just too edgy, and when I know I will be in the passenger seat of the car for a long trip. I used to take this one daily just to get through the day in the late 90's when I finally found my way to the therapists couch.

The potent cocktail of drugs I used to take daily were Zoloft, Trazadone at bedtime, and Ativan and then Klonopin(Clonazepam) on a daily basis. I was in rough shape back then, confronting issues for the first time. I went to therapy 3 times a week and then was in an eating disorder group as well - which was challenging as most of the other members were anorectics and bulimics, which while very similar to bingers/compulsive overeaters (meaning that one can turn into the other pretty easily they say.) those folks can be very hard on those they few as inferior.

So now I just use Wellbutrin and the clonazepam as needed, and a lot of anti-histamines - hubby and I take the Safeway brand sleepy medicine - which is just Benadryl but a whole lot cheaper - if you look at the price on Zeequil, its the same stuff and they just charge an arm and a leg. Diphenhydramine is the anti-histamine. I have heard good things about L-methyfolate and ​Sam-e.

I recently went off of melatonin because once its built up to a therapeutic level in my system I get serious nosebleeds - which seems to have happened to a lot of folks. Sheryl I have also taken the 5HTTP, seemed like good stuff but I was using my other regular meds so I am not sure if it makes a lot of difference.

What is interesting - when I was in bad shape all that medication make me feel normal, My normal from waking until sleep was like being on fire without meds - I wanted to die - just dart out into traffic and have the pain just stop.

Now - one Clonopin knocks me on my ass - I really feel it - whereas before I was in such a state that it just made the day tolerable enough to get through - so I could do the work needed in therapy to get a little better. I know that I am permanently imprinted by the bad things that happened in my life, that I will always be afraid of things - but it is better than it used to be. I have considered trying that flashing light therapy to help with the PTSD - I have heard good things about it.