Doctor Prescribed Weight Loss Homework

DeLarla · February 2, 2005

Most of you know I spent the weekend in the hospital having another port-removal surgery.

While I was there, Dr. Billy got hardcore with me & Penni about sucessful weight loss. When he mentioned the need for us to count calories, I rolled my eyes at him and told him I refused to ever count calories again.

Yes, I lost half my weight, but Billy seems to think I have the capability to lose all my excess weight (I guess I never dared dream that before.) He's one of those evil doctors that requires morbidly obese patients to lose 40 pounds prior to giving them a bypass or Band. I used to think that was really messed up, cuz if we could lose weight that way, we wouldn't need a Band. But he was firm in explaining that the Band isn't going to save us till we save ourselves. We have to be willing to WORK at losing weight. We have to accept the fact that we are not normal, that we don't have normal metabolisms, and that we will always have to make wise food decisions. We cannot compare ourselves to anyone else. I'll use Penni as an example since we just spent the weekend together: Penni and I weigh exactly the same but she's 14/16 and I'm size 20. I eat large meals a few times a day, she eats small stuff every couple hours. She has 1.8 cc, I have 1.7 cc.

We are obese, which means we can never, ever expect to eat like a normal person. Most normies don't have to think about eating, we will always have to think, and plan, and be accountable - if we want to lose weight.

All that said, and after all Dr. Billy has done for me, I have agreed to complete the homework he assigned. Most people eat about the same their entire adult lives, so I have to write down 50 foods I eat on a regular basis. He said I probably won't be able to get to 50. I am to start with one food at a time and learn it intimately. For example, I love quesadillas so today I might work with cheese. I'll have a quesadilla using one slice, or two slices. Once I have the calories figured out including a little sour cream, then I'll add that to my list. Next I'll learn a stick of string cheese. Then I'll learn 2 tablespoons of shredded cheese, then cubes of cheese. Heck, maybe I'll work on cheese all week. When I've completely learned cheese, I'll never have to learn cheese again. I'll simply know that a grilled cheese has "this many" calories, a quesadilla this many, shredded for a salad this many.

Then I'll have completed one food on my list. Next I move on to tuna since it's one of my staples. I like tuna salad with crackers, or on a salad with thousand island and pickles.

When I'm done with the whole list, I'll have the stuff so memorized that "counting calories" isn't this horrible chore that makes me scream and pull my hair out.

I am NOT happy about having to do this. I resisted for a long time. But Dr. Billy is right - if I want the Band to work, I gotta work the Band.

He does not believe the Band is the answer. Diets have failed us in the past, but the Band was designed to restrict our hunger so that limited calories will keep us full and happy for life.

I won't call this a diet. We can't call this a diet. This is limiting our caloric intake to cure ourselves of obesity. We will always eat less than normies unless we build more muscle mass to increase our metabolisms.

It's in my hands now. If I want to break the plateau, I have to consume 1200 calories a day - and I have to like it (hurl.) BUT... if I stop eating when I'm full, that's all my Band will LET me eat!

It's all so simple. I hate it, but it's all so simple.

Alexandra · February 2, 2005

This is really interesting, Lisa, thanks for posting it! I like his approach--knowledge is indeed power.

I think that's sort of what I've been doing without knowing it by using Fitday. It instantly breaks down the foods you enter into their constituent nutritional parts, which can be very eye-opening. Of course, I haven't been acting on the information, but that's the next step.

So that list of 50 foods is supposed to reflect what we eat on a regular basis? Unless I can include things that are ingredients in other foods I sure as heck won't get to 50. My routine probably includes no more than 10 or 12 on a rotating basis.

donali · February 2, 2005

He's one of those evil doctors that requires morbidly obese patients to lose 40 pounds prior to giving them a bypass or Band. I used to think that was really messed up, cuz if we could lose weight that way, we wouldn't need a Band. But he was firm in explaining that the Band isn't going to save us till we save ourselves. We have to be willing to WORK at losing weight. We have to accept the fact that we are not normal, that we don't have normal metabolisms, and that we will always have to make wise food decisions.

I will be the first one to agree that we HAVE to change our eating habits, and we HAVE to change the way we think about food, and we HAVE to take responsibility for making wise choices.

However, I have to respectfully DISAGREE with his protocol of making his patients lose 40 pounds FIRST - before being banded, to "prove" to them that they have to make changes. Losing 40 pounds without the help of surgery or medication is NOT any kind of lesson. We have ALL done that, and more, with few exceptions. Losing wieght with the band or medication is TOTALLY different than "dieting". Making the healthy choices we need to make is 500% easier with the tool of banding/medication.

I do not know of one single banded person who does not at least occasionally indulge in non-healthy choices/quantities - not one. The difference between being banded and being not banded is that the band helps do damage control, reduces our appetites, creates feelings of satiety earlier, and limits the overeating we can do, and often limits or eliminates the ability to eat the types of food that put us in binge mode in the first place.

Only someone who has been morbidly obese, and then helped by banding/medication can understand what I am saying. Willpower and commitment can rarely stand on their own for long in the face of this obsession/addiction/physical defect we suffer from - we all have more willpower and commitment than non-MO people will ever understand. Banding/medication levels the playing field, so we are all on the same page.

The day that FOOD is ALL Dr. Billy can think about, and when the compulsion to eat it, even when full, is impossible for him to resist, will he ever have an inkling of what it's like for most of us EVERYDAY. Counseling/therapy is invaluable, but the physical aspect remains without the further help of surgery/medication.

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Penni60 · February 2, 2005

WHEW!! Ducking from Donali LOL!!! I see your point about the losing 40 lbs prior to surgery and understand your way of thinking. Billy was using a patient of his as an example of why he requires them to lose prior to surgery. He has a 400 + lb patient that was in the hospital for testing or something. When Billy visits him he sees candy bar wrappers and 4 empty pizza boxes in his room. This tells Billy that this patient is not stable enough to be considered for the lapband certainly and maybe not for the bypass either. The patient in order to be serious about wanting this change has to prove that they can at least follow a regime of cutting back on the food intake. This guy wasn't even trying. That is really all Billy wants his patients to prove to him is that they are trying and willing to make the change.

DeLarla · February 2, 2005

OOPS, I have to clarify what I wrote earlier. Billy doesn't make all his patients lose 40 pounds before surgery. He was talking about one specific patient that weighed 500 pounds or so, and the guy figured the bypass would fix him. Billy probably read a lot into the guy's personality, and the guy probably displayed signs that he wasn't willing to do any work other than lying on the operating table.

DeLarla · February 2, 2005

Another OOPS, I responded before seeing Penni's post. I meant WHAT PENNI SAID!

Remember, I was on lots of pain meds so the brain wasn't too observant or absorbent that day!

DeLarla · February 2, 2005

Alex, as far as ingredients, for example: Make a can of tuna salad. Count the calories in the tuna, count the calories in the mayo, count the calories in the bread. If you make 2 sandwitches, divide the calories in half. Then you'll always know what a tuna sandwhich is. We can never be 100%, but his lesson was to get to know tuna on many levels. In your best Forest Gump, "plain tuna, tuna boat, spicy tuna roll, tuna casserollllll, etc."

And Donali, did you actually doubt me? I interupted him plenty of times to discuss the sheer obession and compulsion. That's the "WORK" part that we gotta do. Breaking bad habits, working it. For example, I told him my recent binges were nervous eating over all my recent band problems, but he shot me down. Ouch, but he was right, cause what kind of excuse is that considering I've been obese my whole life? On another post, Bright talks about the food calling her like nails screeching down a chaulkboard. Billy said we gotta get rid of the chaulkboard. So I told him I would try to break my nightime eating by having cucumbers and carrots marinated in vingar instead of goodies. Easier than it sounds, but what it all boiled down to is that I won't lose any more weight unless I account for what I eat. Can I do this? I don't know. He seems to think I can.

Like I said, I hate what he said, but I have to try. Deep sigh.

And he said I should be having 1200 calories a day until I lose weight, and from there we'll reassess what my body needs. He also said nobody will actually eat 1200 calories (we'll eat more.) And one thing I was glad about is that we don't have to count veggies, they're a freebie.

donali · February 2, 2005

I'm glad Dr. Billy isn't one of "those" who make EVERYONE lose weight before banding, but we all know "they" are out there, and my post applies to ALL of "them."

Yes, absolutely, we need to make good choices - having other options besides high cal/low nutrition foods to eat when we're having one of our "moments" is a key strategy. All the things I've posted in my "Tools to deal with emotional hunger" are strategies. We have to be willing to try them. We have to be willing to work towards making the best choices 100% of the time. But being human, 100% can only ever be a goal - if you are one of those humans that is 100% ALL the time, I applaud you, but I am also a little suspicious about the veracity of your claim.

I think I am one of the biggest advocates for behaviour modification on this site - I take complete responsibility for my choices. But I will tell any one who will listen: I made better choices more often when I was banded, because it was easier. Sometimes I had no choice. And the times I didn't make the best choices, I was limited as to how much damage I could really do. That 400 pound guy CAN'T eat four pizzas in a sitting after being banded - whether he wants to or not. Does he need a wake up call? Yes. Will dieting give it to him? No. Does he need emotional counseling? Absolutely. Will that "fix" him in and of itself? Highly unlikely.

Again, my two cents. We really are on the same side of the fence when it comes to behaviour modification, but I resent the implication that it is ALL about that. For me, anyway, there is a definite physical component that banding "fixed", that is once again broken...

Penni60 · February 2, 2005

FREEBIES!! Those are always a good thing. I realized I "graze" all day long. I gotta just stock up on fruit and veggies for my grazing. I have to get a trash bag and go around the house and throw away all the high calorie Snacks.

I too am on the 1200 calorie diet. I was telling Lisa that I was eating under 1000 when I first was banded. Oh and Alex the Fitday.com software program is a good start to counting the calories but it isn't very accurate and you don't work with the food and see what a serving is and how it all breaks down. So use it as a guideline not an absolute. I was using it as well and I will continue to use it but just adapt it to my needs. I love that you can add a food and then add in the dietary specifics of that food. Pretty cool!!

vinesqueen · February 2, 2005

The surgeon required that my husband loose about 50 pounds before they would install his band. Of course, he is the biggest person they had ever done...

The last diet program I tired used this same food method, after putting us on liquids for a week, we were alowd to add one or two new foods a week, and we had to count everything, watch how every new food affected us. That's how I discovered my sensitivy to corn...

DeLarla · February 2, 2005

I must have been really woozy, cuz stuff Billy said is still coming back at me. I told him I used an on-line program similar to Fitday, but he said that's not good enough. He wants me to use a regular notebook. Got it on my desk now.

It still boils down to one thing: THIS SUCKS!

leatha_g · February 2, 2005

I love www.fitday.com, but I never use the foods already listed unless I absolutely have no packaging of my own. I always take what I've eaten and enter it as a custom food according to what I've really eaten. It's a great way of tracking not only your calories, but how it breaks down into Protein, fats, carbs etc.

good info girls!

Alexandra · February 2, 2005

Make a can of tuna salad. Count the calories in the tuna, count the calories in the mayo, count the calories in the bread. If you make 2 sandwitches, divide the calories in half. Then you'll always know what a tuna sandwhich is.

This is what Fitday does for me. Penni, I trust their calculations, as long as I'm honest about entering the actual amounts and ingredients of whatever I've eaten. I mean, why would its calorie counts be any less accurate than what is available in a book? Remember, I'm talking about the home version of Fitday, not the online one. What I have lets us customize each food to the nth degree. For example, I wouldn't enter "a tuna sandwich" without breaking it down to the ingredients that *I* personally use.

Lisa, is tuna considered one food and Mayonnaise another (for the purposes of counting to 50)? Or is tuna, in general, one food and all its various incarnations just offshoots of that? Not that it matters, I was just curious how Billy was getting to "50."

Penni60 · February 2, 2005

Alex, I was confused about the programs. I have the home version and not the online version as well. I love that you can put the actually contents into the program. The online version you can't, I think that is one of the things he was referring to. Some people won't know that you can and should include every ingredient in what you eat down to the salt and pepper. LOL!!

The "50" items were a general comment. He wasn't implying that everyone only eats 50 items he said most times we can only come up with 50 and of that we can only remember on average 10 of those 50. So use that as a general statement and not literal.

Tuna is a food item

Mayo is separate

That is my understanding anyway.

Maurice · February 2, 2005

I love the information that you girls share. Thanks for being so generous with your experiences.

Our M.D. suggests Atkins for one month prior to banding, but at the end of the day, the only requirement was to have not gained any weight over that month. I was bad as usual and only dropped 10 lbs. (some final food "send-offs").

I truly agree that it becomes a behavioral issue when we get banded. I have a friend who was banded and never filled and lost 110 lbs over the past year. It seems as though for her it was a behavioral kick-off to discipline.

I, of course did not have near that discipline and have had three fills to get to my "Sweet Spot".

I've chosen to continue counting carbs rather than calories, and I chose to replace daytime meals with Atkins shakes. When I do sit down to eat, the band has allowed me to fill up after about a cup of food or so.

The new years resolution has also gotten me to exercise about 40 minutes per day 4-6 times a week.

Without the physical restrictions of the band, I could never have gotten to this point.

For me, the limitations has bred the behavioral changes.