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On 1/11/2018 at 11:25 AM, orionburn said:

I think this is one of the key takeaways. I don't consider myself to be on a "diet" any longer. In days of old being on a diet meant cutting out junk food, eating more salads, etc. It was always intended to be short term. Now that I've cut out so many things of old I don't consider myself to be dieting. What I eat now I consider to be normal.

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It’s NOT a DIET!

Then why do so many patients treat it like one? Fault of the treatment team because they seem to treat it too often like one, too?

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On 11. Januar 2018 at 4:52 PM, FluffyChix said:

@Connie Stapleton PhD With all do respect, while I have mad respect for your PhD and knowledge, this is just folderall and semantics. Lifestyle Changes are simply the fad term for today as is "mindfulness." 20 years ago it was called CBT, but few embraced it because it didn't have the right spin.

I agree. You take a look into the box that has a label stamped on that reads "lifestyle changes" and when you take a look inside the box you see something in there that would have been called "being on a diet" some years ago.

Too many lifestyle changes are really diets in disguise (maybe that is why they don't work longterm - just like diets).

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On 1/12/2018 at 8:38 PM, Tealael said:

Nice, are you still Protein oriented like most surgeons want or do you not focus on that. I know vegan lifestyle and wls is tough...

Protein? What’s that??? Lol i don’t focus on any macro or micro nutrients, just good wholesome foods.

I’ve also read the book by bariatric surgeon Dr Garth Davis, called Proteinaholic. He’s got loads of sources and science behind the western diet craze of protein, specifically animal Proteins. It’s a great read if you’re interested.

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56 minutes ago, Newme17 said:

I’ve also read the book by bariatric surgeon Dr Garth Davis, called Proteinaholic.

I read his "WHEAT BELLY" series of books and online contributions a couple of years ago.

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3 hours ago, Rainbow_Warrior said:

I read his "WHEAT BELLY" series of books and online contributions a couple of years ago.

I’m not sure if it’s along the same lines of where he’s at now, I’ll look in to it. I know he wrote some books previously that he had to backtrack and say he was wrong (obviously after the science proved he was).

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On 1/13/2018 at 6:35 AM, summerset said:

Then why do so many patients treat it like one? Fault of the treatment team because they seem to treat it too often like one, too?

1

I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet! It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery. It's really about a healthy lifestyle to include a healthy diet (meaning the foods you eat, as opposed to a diet like Jenny Criag or the like).

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10 hours ago, Connie Stapleton PhD said:

It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery.

I don't know if some members of treatment teams really view it as a permanent, lifelong diet but I sometimes get the impression that they do, e. g. when patients are given instructions like "eat only x amount of calories a day, don't eat more than x grams of fat and x grams of carbs a day and exercise x times a week" - that sounds like your usual dieting advice (since a view years all "dieting advice" seems to be marketed as "lifestyle changes") and a surefire way to obsession and burnout in the long run.

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I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet!

Maybe you're right with this.

I can remember after post-surgery nutrition class was over and the nutritionist clearly said to ditch the low-fat stuff that two patients were talking about "buying skim milk, low-fat cheese and low-fat curd". I was thinking "WTF?? What exactly did the nutritionist talk about only 15 min ago?? Why aren't people just glad that they will never have to eat this awful stuff again?"

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I believe the issue is rooted in the fact that the word "diet" has two separate meanings.

di·et1
ˈdīət/
noun
noun: diet; plural noun: diets
  1. 1.
    the kinds of food that a person, animal, or community habitually eats.
    "a vegetarian diet"
    synonyms: selection of food, food, foodstuffs; More
    • a regular occupation or series of activities in which one participates.
      "a healthy diet of classical music"
  2. 2.
    a special course of food to which one restricts oneself, either to lose weight or for medical reasons.
    "I'm going on a diet"
    • (of food or drink) with reduced fat or sugar content.
      modifier noun: diet
      "diet soft drinks"

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My NUT is a lowfat textbook nutritionist basically. This bariatric office is only a year old and while the physician is an accomplished surgeon the staff is fairly young and inexperienced with this genre of patients, in my opinion. I just emailed last week and basically received no suggestions as to breaking my month long stall. Also I was not impressed by the group meetings - I kept asking 6 months prior to surgery and never received the information on them until the month of surgery. I went once and there was no interactions with each other - there were 2 testimonials from RNY success stories, nothing for GS and no discussions amongst attendees. And at that mtg the NUT was more interested in whispering to a colleague while the Psych led the program. He was VERY enthusiastic and engaged. I will try again in March, I have a conflict in February.

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19 hours ago, Connie Stapleton PhD said:

I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet! It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery. It's really about a healthy lifestyle to include a healthy diet (meaning the foods you eat, as opposed to a diet like Jenny Criag or the like).

While I absolutely know that there are things I can't "know" until I've had the surgery, such as how it feels to have little interest in food...the afterlife of post-WLS eating might potentially be one of these "you won't know til you're there times." So maybe my position on having an established isocaloric maintenance diet based on my individual metabolism might change.

However, I still look on this statement as being a little--mmm, I don't know--sanctimonious in nature? Here is why I say this...most of us do not "magically" arrive at 300+ pounds overnight. Most of us have a LIFE long issue with having "appropriate" and balanced relationships with food. Most of us are relatively ignorant about "proper" human diet composition, and the few hours we spend in classes with our RDs or support meetings are not enough to educate us thoroughly. Most of us do not really believe we have to make healthy choices after surgery. Most believe that magically, everything in moderation will work for them despite the fact that because of issues--they were never able to understand the whole idea of moderation. Moderation got me all the way to 325lbs. I'm lying to myself if I think operating on my gut is going to magically change how I process thoughts, emotions, cravings, etc.

As I've been harped at, this surgery operates on my guts--not my head. Seems to me, that it's somewhat magical thinking that a surgery that is meant to rearrange our digestive system, can magically restore a natural order of things with what goes in our mouth or down our gullets. This surgery does not operate on our minds--other than that it will alter the whole gut-brain neurochemical pathway. But this surgery is not about brain surgery. It's gut surgery.

I support this position with the dismal statistics that we as a surgical whole will only maintain 50% of our weight loss. While I agree that's way better than only 5% maintaining a 10% weight loss over 2 years, maintaining only 50% of our weight loss after substantially mutilating our digestive tract is rather SUCKY odds. Super sucky odds. It seems to be expected by our surgical team that regain WILL happen in the 2-3rd years (maybe 15-20lbs or more). Again, suckage!!!! I for one am not willing to go quietly into that good night. I want to be proactive and if that means I have to be on a lifelong diet--then a-the-forking-men to that. I certainly won't santimoniously sit and judge if someone else chooses to do "healthy choices in moderation." I will just wait and watch and review the situation in 3 years.

So then I look at the stalwart members of this board and other forums who are maintaining the initial post surgical weight losses at 10-15 years out and beyond. They share a common trait. Despite different levels of activity, ALL and I do mean without exception, ALL--every last one of them, maintains a rigorous diet protocol where carbs and calories are still measured and logged every day. ALL stay within a diet window. If they're up 5lbs, then eat like very lightly until they are back down 5lbs.

Sincerely,

Cranky and Pis*ed Off With Semantics in Houston (by the way...if the king's is nekkid, then someone ought to tell him his new suit sucks)

Edited by FluffyChix

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