Conflicting Information From Doctors/Patients And My Fears

[Hey Man 30]

I am definitely on the moderation band wagon. I eat pizza and wings and drink alcohol and have cake and Bagels and ice cream cones in the summer. I eat crap from convenience stores and fast food places. But I do so in moderation while eating healthy, bariatric friendly food 80% of the time. Too much sugar or fried food or alcohol or coffee will give me gastritis and carbonation is impossible.

But I didn't do any of these things until I was under my goal weight. And although I don't track or count or measure my food I am mindful of what I do eat and how it affects my weight. I get 60-80g of Protein everyday, at least 80oz of fluids, I take my daily Vitamins and I have my bloodwork checked regularly. If I pop even one pound above my bounce range I go back to strict Protein and veggies or even the preop liquid diet until I am back down.

You should also know that after a years or two your restriction will lessen and you will not be able to rely on your sleeve for Portion Control. Anyone can learn how to eat around their sleeve and if you don't address and change your eating habits early on then you WILL regain. You will likely have a harder time than your wife because of her malabsorption I have a couple friends that have had bypass and if I ate like they do I would be right back where I started.

There are many ways to be successful after WLS..... VSGAnn and I are nearly identical in our starting weights/heights, final goal weight and maintenance success. But the details of our success are different in a lot of ways. And I'm sure there are a hundred other versions of success out there. But there are also a hundred ways to fail. There are common denominators in the successes and failures, and only you can figure out what works for you if you decide to have surgery. In the end, postop life is about choices, not rules.

I am glad that someone understands what I am talking about when it comes to moderation.

It's interesting what you say about the bypass. Even though I can't have one - the sleeve has been sold to me as the much less restrictive, not as intense surgery and somewhat "easier" to manage option - because there are more healthy foods that I will be able to choose from that she won't be able to tolerate - she can't eat certain meats, fruits, veggies and breads for example - they make her sick.

In addition, I will never get dumping syndrome or vomiting if a food doesn't agree with me. That I can somewhat still live a normal life when it comes to food compared to my wife - where a piece of beef might make her run to the toilet.

You hit the nail on the head - I still want to be able to make the choice as opposed for things to be forbidden. And I may make the choice that I don't want the things that you are still eating, but absolutes scare me. I don't mean this literally, but there is part of me that sort of has the feeling that life isn't worth living if you can't enjoy life's pleasures - like pizza. AGAIN, in moderation like you are doing.

[Hey Man 30]

There is conflicting information because Everyone is different, and there is no real answer to your questions....for you. You have no way of knowing how your body will react to surgery until you're there.

My experience has been, yes, I can eat spicy good just fine. No I can't drink carbonation. It's not that I'm not supposed to, it's that I CANT. the bubbles have nowhere to go so more than a sip or two is painful. And no, I never lost a strand of hair. Didn't take any supplements, just got in all my Protein and Water and never stressed about it. But you have no control over it. It's just gonna happen it not.

I guess you just have to ask yourself if you want to be thinner and healthier even if you can't drink soda or eat spicy food or if you go bald. My answer was yes. If your answer is no then perhaps surgery is not for you, cause you can't take it back. Besides, surgery alone will not make you successful. It's not JUST about Portion Control. There are a lot of lifestyle and diet changes you must commit to....forever.....or the surgery will be a waste of time and money.

What she said ^^^^

I find it a little disheartening when people think they don't have to change their eating habits just because they can eat less. This thinking is why over 50% of people gain some or all of their weight back. The hardest part of this whole process is realizing our love affair with food really has to end. It really has to turn into more of a respect for food by understanding what we eat can either make us or break us. Mindful eating, not eating less, is they key to our success. Understanding that is half the battle.

I know I have to change my eating habits and I never said otherwise. I don't think it's unreasonable for someone to ask - can I have a slice or two of pizza once in a while instead of my usual 10 slices two times a week.

I feel maybe I haven't explained myself properly. I am not looking for a quick fix and I don't view surgery as the easy way out - I have seen what my wife has gone through, I just want to know if I can somewhat maintain a normal life when comes to food as long as I make smart choice, eat the things I love in moderation as some of you are doing and exercise.

Part of the problem for me is that I am just overwhelmed at 450 pounds to do anything - I can't really work out very well and I can't catch my breath. If I was 250 pounds, I think I could lose the weight with healthy eating choices and working out. Surgery would restrict my intake and obviously provide faster weight loss as opposed to doing it myself. My wife is already at her goal weight 8 months later. She wouldn't be even close to her goal weight if she just trying to diet and exercise. If I was at my goal weight tomorrow or in 8 months or longer - 190 pounds, I would never allow myself to get fat again.

[jaxmom 644]

Frankie's girl rocks in responses..... Thanks for honesty!!!! :)

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[Hey Man 30]

My weight loss journey has definitely shown me very clearly that much of the advice offered by Western medical professionals after sleeve surgery is outdated by at least 20 years, much of that is based on initial studies that were not connected to other studies over a long period of time. That is, their data is incomplete and not integrated with other data, newer data, and data that comes from other areas, including nutritional and food-based approaches that are well documented, well used, and well studied from all over the world that lead to not only the balance of weight, but the balance of all systems in the physical body with the use of food, supplements and other holistic approaches that take into account the individual body, not just some overgeneralized partial study taken 30 years ago. The most powerful and simple advice from my experience, is to attuned to what your personal body needs, and not blindly follow the bariatric gospel, which is very very outdated.

I am curious to know what you are referring to. Please get back to me.

[Hey Man 30]

So the real question is. .. is getting to a healthy weight more or less important than buffalo wings and diet soda? I am not saying you can never have them again...but if you had to choose between a healthy weight and crappy food - which would it be?

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The answer is a healthy weight, but I don't think that one has to make such a choice. Yes, at 450 pounds - I am too far gone, but there are millions and millions of people at healthy weights that enjoy buffalo wings for example and maintain that healthy weight through proper eating, moderation on "bad" foods and exercise. I want to be one of those people eventually.

[tgun25 29]

A lot of good advice and outlooks here worth listening to.

I haven't had my surgery yet, I'm about a month and a half out, but I've been working now to change many of my habits that have gotten me to where I am today.

Like the OP, I was addicted to diet soda like crazy. Now, I haven't had diet soda in two months and have no desire to go back to it. Diet soda is just as bad for you as the fully loaded stuff. Aspartame is basically poison, so obese or not, people should steer clear. Remember, when food companies take the sugar out to make it diet, they put something else in that's created in a lab and market it as healthy. The same goes for light and fat free foods - they take the fat out and they dump sugar in and market it as healthy. My NUT has told me many times feel free to eat full fat things. Simple rule of thumb, eat real food. A great documentary on food in our society is Fed Up (it's on Netflix).

I've come to complete grips that I must change my relationship with food and what sold me on that was being told by my surgeon that people with BMI's over 40 can expect to lose 10 years off their life. That was it...game changer! I'm only 41 and I'd like to see my grandkids get married, so I'm willing to give up the crap processed high sugar foods. I also love beer, but now? Bye bye.

If I'm going to have 85 percent of my stomach removed I'm going to make it worth it.

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[Hey Man 30]

A lot of good advice and outlooks here worth listening to.

I haven't had my surgery yet, I'm about a month and a half out, but I've been working now to change many of my habits that have gotten me to where I am today.

Like the OP, I was addicted to diet soda like crazy. Now, I haven't had diet soda in two months and have no desire to go back to it. Diet soda is just as bad for you as the fully loaded stuff. Aspartame is basically poison, so obese or not, people should steer clear. Remember, when food companies take the sugar out to make it diet, they put something else in that's created in a lab and market it as healthy. The same goes for light and fat free foods - they take the fat out and they dump sugar in and market it as healthy. My NUT has told me many times feel free to eat full fat things. Simple rule of thumb, eat real food. A great documentary on food in our society is Fed Up (it's on Netflix).

I've come to complete grips that I must change my relationship with food and what sold me on that was being told by my surgeon that people with BMI's over 40 can expect to lose 10 years off their life. That was it...game changer! I'm only 41 and I'd like to see my grandkids get married, so I'm willing to give up the crap processed high sugar foods. I also love beer, but now? Bye bye.

If I'm going to have 85 percent of my stomach removed I'm going to make it worth it.

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You saying that you are going to have 85 percent of your stomach removed scares the crap out of me.

I must be getting the wrong information, because I have been told that the sleeve is a much less intense surgery ala what they take out of you than the bypass.

I have a lot of thinking to do and decisions to make....

Edited April 24, 2016 by Hey Man

[lifeofblair 308]

I don't have the sleeve, but carbonated drinks make me feel weird after a sip. I can't even think about drinking them. But, as you said many people have different issues after surgery. I haven't had any issues on food. I can eat spicy, bread, etc. just very rarely and smaller amounts

[DeletedMember 715]

With all due respect, and I truly mean that, I believe you are in denial about your eating habits largely based on this statement:

Greetings,

I am primarily obese due to lack of Portion Control. It isn't that I eat the wrong things or unhealthy things per se, but I eat enough of it to feed a whole family at once and I never feel full.

Nobody has ever gotten to 440 pounds by overeating healthy food. I don't pretend to know you, or know how you eat, but if you have been eating gigantic portions of vegetables, fruit and lean Protein sources you would not be super morbidly obese. You just wouldn't be.

Interestingly, you posted a video from Dr. Weiner who happens to be my surgeon. He does not even believe in calorie counting. He always wants you to be satisfied, and feels if you are truly hungry you should eat. He also advocates eating a minimum of a pound of vegetables daily, preferably 2 pounds.

Prior to surgery I followed his diet for 6 weeks and lost 45 pounds. And I was never hungry. In fact, I often couldn't even finish all the food I brought with me to work.

The reason I bring this up, is that if you are telling yourself you became obese from overeating healthy foods, you are not being honest with yourself. If you are not being honest with yourself about that, how honest are your going to be with yourself about eating bad foods in "moderation"?

I myself started at 333, and I was not a binge eater, I was not an emotional eater, and I often ate healthy food. But I got obese because I ate large portions at every meal and most of what I ate was terrible. Sure, I'd have a chicken breast for dinner, but I'd also have a monster side of stuffing or Pasta. And maybe going out for a huge, decadent ice cream after. Did I fit the stereotype of the morbidly obese? Maybe not, but I ate crappy and got myself to this point. I do believe my body is a lot more sensitive to processed food than thin people and after many years of dieting I know I need a lower than normal calories amount to maintain my weight.

But I also know I didn't get here by eating too many vegetables.

I hope this is taken in the way it's intended. As someone who cares and is concerned. But I think you will be best served taking a hard, honest look at your behaviors. And be willing to accept major changes going forward. It's not that you can't ever eat a slice of pizza again. But you do need to completely change your relationship with food. This surgery is an amazing tool to help you do that if you are committed to it.

Edited April 24, 2016 by msujester

[2goldengirl 2,076]

You saying that you are going to have 85 percent of your stomach removed scares the crap out of me.

I must be getting the wrong information, because I have been told that the sleeve is a much less intense surgery ala what they take out of you than the bypass.

I have a lot of thinking to do and decisions to make....

The sleeve is a much less intense surgery than the GBP. Only your stomach is involved. There is no rerouting of the intestines, no removal of either the esophageal or pyloric sphincters. No postop malabsorption of nutrients. And with rare exception, no dumping. But yes, about 80% of the stomach is stapled off and removed.

I find that a lot less scary than rerouting my intestines.

[tgun25 29]

Something else I want to touch on about food, is that IMHO having this surgery doesn't mean I can never have pizza again. In fact, I absolutely freaking love pizza! It's my numero-uno food! But instead of eating highly processed garbage pizza like Pizza Hut or Dominos, I make my Pizza Crust out of cauliflower or zucchini. There are some great, healthy low-carb pizza crust recipes out there that certainly satisfy my pizza cravings. And I also know I'll probably only be able to have just a slice...and I'm good with that.

I'm a huge believer in eating real food, eating organic, buying food from our farmers market, and most importantly, reading nutrition labels and ingredients.

Whenever I get to the point of being able to eat solid foods again post-op, I feel very confident that based on the work I'm putting in now pre-op to learn to eat healthier and cleaner, that I will have long range success. If that means giving up some of the bad foods from my crap eating habit days, so be it, I'm willing to do it because it was those foods and my habits that got me to where I am today.

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[Hey Man 30]

With all due respect, and I truly mean that, I believe you are in denial about your eating habits largely based on this statement:

Greetings,

I am primarily obese due to lack of Portion Control. It isn't that I eat the wrong things or unhealthy things per se, but I eat enough of it to feed a whole family at once and I never feel full.

Nobody has ever gotten to 440 pounds by overeating healthy food. I don't pretend to know you, or know how you eat, but if you have been eating gigantic portions of vegetables, fruit and lean Protein sources you would not be super morbidly obese. You just wouldn't be.

Interestingly, you posted a video from Dr. Weiner who happens to be my surgeon. He does not even believe in calorie counting. He always wants you to be satisfied, and feels if you are truly hungry you should eat. He also advocates eating a minimum of a pound of vegetables daily, preferably 2 pounds.

Prior to surgery I followed his diet for 6 weeks and lost 45 pounds. And I was never hungry. In fact, I often couldn't even finish all the food I brought with me to work.

The reason I bring this up, is that if you are telling yourself you became obese from overeating healthy foods, you are not being honest with yourself. If you are not being honest with yourself about that, how honest are your going to be with yourself about eating bad foods in "moderation"?

I myself started at 333, and I was not a binge eater, I was not an emotional eater, and I often ate healthy food. But I got obese because I ate large portions at every meal and most of what I ate was terrible. Sure, I'd have a chicken breast for dinner, but I'd also have a monster side of stuffing or Pasta. And maybe going out for a huge, decadent ice cream after. Did I fit the stereotype of the morbidly obese? Maybe not, but I ate crappy and got myself to this point. I do believe my body is a lot more sensitive to processed food than thin people and after many years of dieting I know I need a lower than normal calories amount to maintain my weight.

But I also know I didn't get here by eating too many vegetables.

I hope this is taken in the way it's intended. As someone who cares and is concerned. But I think you will be best served taking a hard, honest look at your behaviors. And be willing to accept major changes going forward. It's not that you can't ever eat a slice of pizza again. But you do need to completely change your relationship with food. This surgery is an amazing tool to help you do that if you are committed to it.

Eating Pasta isn't deemed to be unhealthy. Eating chicken breasts isn't deemed to be unhealthy. But when you eat enough pasta or rice at one sitting to feed a small village or eat 3 or 4 chicken breasts at one time - then yes, you are going to gain such weight, because you are doing the same thing with everything else you eat - be it lean beef or a pizza.< /p>

I never said that I don't eat bad foods - I was just indicating that portion sizes and feeling full is my primary problem and that is absolutely the case, which even my doctor would tell you as I have made food plans for him per what I have eaten all week and he's pretty fine with most of it - just not the portions I am eating.

That's interesting that Doctor Weiner is your doctor? So how do you feel about some of the myths that people believe here that he says are just not true. Like the stretching of stomach through carbonated drinks? Does it mean that you don't listen to him when it comes not calorie counting? Do you always eat when you are hungry?

I appreciate your comments and advice. I think it's better to be concerned and worried - have a million questions as opposed to jumping into things and realizing that surgery wasn't the best option for you.

[Hey Man 30]

You saying that you are going to have 85 percent of your stomach removed scares the crap out of me.

I must be getting the wrong information, because I have been told that the sleeve is a much less intense surgery ala what they take out of you than the bypass.

I have a lot of thinking to do and decisions to make....

The sleeve is a much less intense surgery than the GBP. Only your stomach is involved. There is no rerouting of the intestines, no removal of either the esophageal or pyloric sphincters. No postop malabsorption of nutrients. And with rare exception, no dumping. But yes, about 80% of the stomach is stapled off and removed.

I find that a lot less scary than rerouting my intestines.

I have to be honest - I think my wife is so desperate for me to have the surgery, because obviously she wants me to be healthy and live a long life with her, that she is somewhat sugar coating the sleeve so to speak. That instead of having 50 to 60 chicken wings (baked) at one siting, I will be able to have 5 to 10 just fine after a month or two, which is certainly a huge difference in calories, but allows me to still have the things I love on some level.

I am probably spelling it wrong, but my wife told me that they also remove something called Greenlan? - something that sends messages to your brain that you are hungry. Not really sure about that.

[DeletedMember 715]

That's interesting that Doctor Weiner is your doctor? So how do you feel about some of the myths that people believe here that he says are just not true. Like the stretching of stomach through carbonated drinks? Does it mean that you don't listen to him when it comes not calorie counting? Do you always eat when you are hungry?

I suppose what is healthy and what is not is as debatable as anything else. I feel Pasta and rice are extremely unhealthy in the fact that they are packed with refined carbs and calories and offer no real nutrients. A chicken breast has about 150 calories, so even if you ate 4 chicken breasts 3 times a day, that's 1800 calories. And that's a lot of food!!

But again, I'm really just trying to help, not to argue. You know what you eat better than anyone.

As far as Dr. Weiner goes, I really like him and trust him so I follow his plan. There are certain things like carbonated beverages and straws that are always debated, but generally there are a lot of people that fall on both sides of the argument.

From my opinion, the thing that he believes that is the biggest hot button out here is his views on Protein. I see a lot of people that think 90g is a minimum and that 100g+ is better. Dr. Weiner feels 60g is enough for a male and 50g for a female. That upsets people on the forum. He also believes long term in "veggies first" as opposed to the oft repeated mantra of "protein first". He believes in Protein first when you are starting out only.

But like I said, I follow my doctors plan. Others should absolutely follow their doctors. I think where people get in trouble is when they start mixing and matching. A lot of people limit carbs and take in more fat via dairy. I will end up eating more carbs than most as Beans and fruit will be a large part of my diet. I think both plans could work. But if I follow my diet and then think "well, those people eat a lot of dairy, so I can too" well now I'm eating more carbs than most and eating more dairy/fat than I'm supposed to. That could of spell trouble. I always advise people to follow their doctors program.

[Alex Brecher 10,512]

@@Hey Man,

These are great questions.

Unfortunately, nobody that you’ve asked is necessarily wrong. It is true that nobody knows exactly how things will turn out after the surgery. It’s a different experience for everyone.

Portion Control is a major, if not the biggest, problem for many pre-op sleeve (and other WLS) patients. Some patients find that the sleeve solves this problem. They really can’t eat big portions anymore because they get uncomfortably full. A few patients have an extreme response: they have trouble getting in enough calories from healthy foods, and need to turn to shakes for supplementation.

The most likely is that you will feel the restriction, especially in the first year, but it will not do all the work for you. That is, you will still need to measure your portions and end your meal when you have eaten the pre-measured portion, and not necessarily when you are satisfied. There is probably going to be a certain amount of “head hunger” that remains. That’s the desire to eat even if you don’t need it physiologically. That’s something that you may need to fight forever.

Chances are good that you could theoretically eat around your sleeve if you choose slider foods.

I completely agree that an occasional wing or piece of pizza should be part of your life (at least several months after surgery, anyway) if you want it. There’s a good chance it will take a while for you to be able to tolerate certain foods, but chances are you eventually will be able to have the occasional junky choice and the spicy foods you love. There’s no guarantee, though. There’s also a chance spicy foods could cause heartburn.

Some patients find that they are able to have a small amount of a treat, feel satisfied, and move on. Others find that they need to stay away completely to avoid going overboard. If you’re that second type, eating a few wings could turn into a big problem. If you’re the first type, you should be able to indulge the occasional craving.

I think you are very wise to be thinking about “forever” and not just a year or a few years.

About hair loss, you can’t really control it. You can do your best to lower your chances of Hair loss by getting enough Protein, taking Biotin and your other supplements, and doing other things to stay healthy like reducing stress.

Good luck with your decision! I am so glad you are weighing everything carefully and reaching out with your questions.