Maintenance behaviors that keep you successful?

[PinkPolkadot619 337]

Rog,

Thanks for quoting all that. Really appreciate it.

However, those findings don't identify or even hypothesize *why* weight loss ends and weight stabilizes after 18 months.

My own (untested) hypothesis would be that it's due to a combination of these factors:

* Weight has lowered to the point where the amount of food eaten is at the maintenance level for that weight.

* People get bored around 18 months with their high-Protein diets and start nibbling or eating higher calorie foods.

* Or something else.

I will offer this -- I've been eating 1700 calories on average for months and months, while still losing 1-2 pounds a month for nearly 6 months. And now around 139-140 my weight is finally holding steady. I've weighed 140 for the last 4 Monday mornings. So I think I've finally found my maintenance level. (Of course, that's the level for the amount of exercise I'm doing now.)

Jeez ... this is just one long old science experiment!

I am at the same point but I can maintain 135-140 at 1100-1200 calories any more and I gain........there in not exact formula, we are all so different.

[WL WARRIOR 690]

0. What type of weight loss surgery have you had? Gastric Sleeve Oct. 6, 2014

1. How long have you been in maintenance mode? Since June 2015

2. What's your current height and weight? 5' 6” (I have lost an inch in height since VSG), 127 pounds

3. How many calories do you eat daily (on average) to maintain your weight?

1800-2000 daily calories, I’ve been eating this amount of calories daily for the past two months and have consistently weighed 127 every morning. Even if I go over or under 1800-2000, I still stay at the same weight. Therefore, I’m pretty sure that 127 pounds is my set point. I’m happy with this and hope my metabolism doesn’t slow down over time.

4. What kind of focus do you put on Protein -- number of grams or anything else you want to say?

During the weight loss phase, I focused on getting in at least 100 grams of Protein in a day. Once I hit maintenance, I started adding in lots of fruits and vegetables and decided to change to more of a plant based diet. I still get in at least 65 grams of protein everyday by drinking a Protein shake for Breakfast and eating 1-2 servings of fish.

5. What kind of focus do you put on carbs - number of grams or anything else you want to say?

During the first three months post op, I limited carbs to fewer than 10 grams daily. I gradually increased my carbs and calories every month after that. I no longer count carbs because I’ve eliminated breads, Pasta, rice, grains, and starch from my diet completely.

6. What other nutritional tips / tricks are working for you that help you maintain?

I eat the same food for lunch (and sometimes dinner as well) everyday. This is known as the “pick and stick” strategy. I wrote a post about it last summer: http://www.bariatricpal.com/topic/346081-pick-and-stick-a-post-op-eating-strategy/

I eat lettuce and cucumbers everyday and believe that green vegetables such as these increase your metabolism because your metabolism has to work harder during digestion. Plus, they prevent Constipation and keep my body hydrated.

Another strategy I find helpful is apple cider vinegar: I haven’t been one of the lucky ones that can eat anything they want and still lose weight. Nor am I one of those patients that are full after three bites. I realized this after 6 months and decided to put more of a rigid eating structure in place. Fortunately, I’ve learned that your rate of success is not determined by the size of your sleeve or even choice of procedure. The quantity of food you eat is not near as important as the actual food choice. When I learned this, it finally became clear to me why I had lost more weight than others in my clinic support group that were boasting extreme restriction.

7. Which foods, if any, do you avoid altogether? Rice, potatoes, bread, pasta

I’ve walked 45-60 minutes a day for the past year. It relaxes me and is a regimen I can stick to and enjoy. I know weight lifting would really help tone my body, but I keep putting off going to the gym.

I continue to attend a CBT (cognitive behavior therapy) therapy group every three weeks.

<a href="http://www.bariatricpal.com/topic/344943-i" data-ipb="nomediaparse" "="" data-cke-saved-href="http://www.bariatricpal.com/topic/344943-i" m-an-apple-cider-vinegar-junkie=""> 10. What advice would you offer WLS patients to help them be successful? Someone told me that the first six months after surgery are the most important. I took this advice to heart and lost almost all my excess weight (125 pounds) in that time frame. I’ve observed many other post ops slow down with their weight loss after the first six months. So, my best advice would be to take advantage of those first six months and kick your willpower and adherence to the bariatric guidelines into overdrive.

Edited November 6, 2015 by WL WARRIOR

[VSGAnn2014 12,992]

@@WL WARRIOR ... your maintenance metabolism (1800-2000 calories/day) at 127 pounds is awesome!

Truth is, I'm still losing weight (1-2 pounds a month) on 1700 cals/day. I'm going to have to raise my cals again to stop losing. The focus you're putting on fibrous veggies is very interesting. Also, you're eating less Protein now than I am.

Hmmmm. I have to give this some thought.

[Rogofulm 2,440]

Okay maintenance gang, I have some "experience" to share. In October, roughly 16 months after my surgery, I had been maintaining within 1 pound either way of my goal weight of 145 for nearly 6 months. At a kid's party, I avoided all the sweets, but ate a bunch of breaded chicken nuggets over two days - and nothing else out of the ordinary. My weight went up by 3 pounds, and I decided to get a handle on it immediately. BUT..... It wasn't so easy this time. For three weeks I tried to knock it back down, doing just what I had been doing before, but my weight wouldn't budge, except to bounce in the 148-149 range. No need to panic, right? Yeah, but 3 can lead to 5, which can lead to 10, and THEN you might have a problem because now it's not coming off as easily as before. that's when I figured out that my "honeymoon" was over, and I'd have to work harder than I did before. So I decided to give the 5-day Pouch Test a try.

I followed all the rules of the 5DPT to a tee, and at the end of 5 days my weight was only down about a pound. But I found that my sleeve was getting full sooner and I was staying satisfied longer. Which is exactly what the website promises! And it helped me break some bad habits (tons of peanuts and pistachios) that had crept in. It also reinforced the "no drinking for 30 minutes before or after meals" rule. It's been a little over a week now, and the restriction is still working. My weight is still bouncing around, but it's starting to work it's way back down. This morning I saw 145.9 for the first time in about 6 weeks! One more pound and I'll be happy. I'm going to put a copy of this in the "Sleeve reset was successful" thread too. And I'll keep you posted on how it goes.....

[VSGAnn2014 12,992]

Congrats! Will definitely remember the tip. Thank you.

[CowgirlJane 14,259]

Your hunger increases over time.

Mine started increasing at about 8-9 months post op, before I got to goal. I figured out the need to go low carb and got to goal 14 months post op...lost 150# to weigh 158#. I lost another few to hit 150# and stayed there a good long time. I maintained pretty well... later.. actually about 29 months post op when I started dropping weight and just couldn't eat. Turns out I was lonely and for the first time in my life negative emotions interfered with eating. I didn't mind being thinner but felt like carp. Anyone that far post op that loses 10# in 3 weeks is in trouble. Instead of embracing anorexia...oh so tempting...I worked hard to regain an appetite and to choose health. I give myself a pat on the back now in reflection.

This year, I bounced 10#or so over goal...but now..almost 4 years post op...am spot on back at goal. Yeah, I kinda liked being 15-20#

What do I make of all this? Complicated. I like being trim, I liked being skinny ALOT, but mostly I like being healthy. I like being healthy more than I like food.

Anyway, I think the reason for regain is because if you don't keep eating small portions of (mostly) healthy low carb food your appetite and cravings are triggered.

My lessons...eat SMALL

Listen to your body and avoid foods that trigger hunger.

Focus on the rewards that good health and fitness bring...make that MORE important in your mind.

Since I didn't hear it myself, I don't want to put specific words into anyone's mouth. My guess is that it has to do with statistics showing that weight loss tends to slow after 12-18 months.

For what it's worth, I copied the following from diabetesjournals.org:

"The vast majority of weight loss after gastric bypass is accomplished at or around 1 year after surgery ([/size]1,[/size]2). Twelve to 18 months after surgery, some patients continue to lose a small amount of weight while others begin to maintain their lower weight. At eighteen to 24 months after surgery, almost all patients have stopped losing weight and most patients are maintaining or regaining weight."[/size]

And this from the American Society for Metabolic and Bariatric Surgery:

"Following weight loss surgery, patients may lose weight fairly rapidly at first, and then as time passes the weight loss becomes more gradual. Commonly, weight will stabilize at about 18 months after RYGB and DS."

[CowgirlJane 14,259]

Your hunger increases over time.

Mine started increasing at about 8-9 months post op, before I got to goal. I figured out the need to go low carb and got to goal 14 months post op...lost 150# to weigh 158#. I lost another few to hit 150# and stayed there a good long time. I maintained pretty well... later.. actually about 29 months post op when I started dropping weight and just couldn't eat. Turns out I was lonely and for the first time in my life negative emotions interfered with eating. I didn't mind being thinner but felt like carp. Anyone that far post op that loses 10# in 3 weeks is in trouble. Instead of embracing anorexia...oh so tempting...I worked hard to regain an appetite and to choose health. I give myself a pat on the back now in reflection.

This year, I bounced 10#or so over goal...but now..almost 4 years post op...am spot on back at goal. Yeah, I kinda liked being 15-20# under goal and real "skinny chick" territory but not worth it.

What do I make of all this? Complicated. I like being trim, I liked being skinny ALOT, but mostly I like being healthy. I like being healthy more than I like food.

Anyway, I think the reason for regain is because if you don't keep eating small portions of (mostly) healthy low carb food your appetite and cravings are triggered.

My lessons...eat SMALL

Listen to your body and avoid foods that trigger hunger.

Focus on the rewards that good health and fitness bring...make that MORE important in your mind.

Focus on health and fitness.

Since I didn't hear it myself, I don't want to put specific words into anyone's mouth. My guess is that it has to do with statistics showing that weight loss tends to slow after 12-18 months.

For what it's worth, I copied the following from diabetesjournals.org:

"The vast majority of weight loss after gastric bypass is accomplished at or around 1 year after surgery ([/size]1,[/size]2). Twelve to 18 months after surgery, some patients continue to lose a small amount of weight while others begin to maintain their lower weight. At eighteen to 24 months after surgery, almost all patients have stopped losing weight and most patients are maintaining or regaining weight."[/size]

And this from the American Society for Metabolic and Bariatric Surgery:

"Following weight loss surgery, patients may lose weight fairly rapidly at first, and then as time passes the weight loss becomes more gradual. Commonly, weight will stabilize at about 18 months after RYGB and DS."

[enjoythetime 1,457]

0. What type of weight loss surgery have you had? Lap-band

1. How long have you been in maintenance mode? Maintaining below my goal weight for 1 1/2 years

2. What's your current height and weight? 5' 1.5":-) 130-135

3. How many calories do you eat daily (on average) to maintain your weight? 1,000-1,300

4. What kind of focus do you put on Protein -- number of grams or anything else you want to say? I always eat my Protein first. My goal is 60-80+g per day- aim towards 80+

5. What kind of focus do you put on carbs - number of grams or anything else you want to say? I try not to exceed 40 net carbs per day.

6. What other nutritional tips / tricks are working for you that help you maintain? Staying focused mentally

7. Which foods, if any, do you avoid altogether? Potatoes, pizza, Pasta, Rice, bread, chips

8. What exercise regimen (exercise types and frequency) do you follow? This is my down fall for sure! No regiment. I realize this is something I have to be diligent about adding for long-term maintenance and overall health.

9. What role, if any, has counseling or therapy played in your WLS success? N/A

10. What advice would you offer WLS patients to help them be successful? Believe in yourself and never give up! Throw the scale away; stay positive; stay focused on why you made the decision to have WLS in the first place, remember that every NSV and every # and every " is a victory; remember how far you've come; remember the place you were in prior to WLS; love yourself where you are RIGHT NOW don't start until you're X amount of lbs. down or in a size ???? enjoy the here and now it will be this attitude and approach that will allow you to keep going!!!!

[Katrinakit 139]

I haven't even had the surgery yet and I am enjoying this thread! It is giving me a window into my future. I wish more RNY peeps would reply.

[BCs 1000 364]

@@enjoythetime 1000-1300 calories a day is low. We have almost identical stats, so this worries me. I have been consuming way less than 1000 per day, but this is in weight loss mode. Having to be below 1300 calories forever is quite daunting I suppose I won't know until I get there.

[VSGAnn2014 12,992]

I'll do a quick catch-up here about my maintenance story ...

After I reached goal (150 pounds) and calculated I could eat 1700 cals to maintain, I continued to lose 15 pounds over the next 8 months.

I'm now maintaining (these last 5 months) at 135 while eating 1700 - 1800 cals/day.

I'm still using all my other behavioral "tools" learned and practiced these last 21 months since WLS and even before then as I was awaiting my surgery date.

Everyone's maintenance calories vary a lot, depending on so many things. I have been a devoted My Fitness Pal user, so I know how much I'm eating and what kind of macronutrients my foods contain. Makes it a lot easier for me to be both mindful and accountable to myself.

This is just one big ole science experiment with a sample of one -- you. Good luck to all.

[PinkPolkadot619 337]

@@enjoythetime 1000-1300 calories a day is low. We have almost identical stats, so this worries me. I have been consuming way less than 1000 per day, but this is in weight loss mode. Having to be below 1300 calories forever is quite daunting I suppose I won't know until I get there.

Each person is so different, if I eat more than 1,000-1,100 I gain :-/ but now its hard to go back to the 800-1,000. It is all about figuring out what works for your body. If you gain at 1,000 go back down or if you are able to maintain at 1,300 then stay there. But your bodies are forever different and need to monitor so we don't slip back and gain. Each body is different some are fine at 800 and some need more. The first 12 months of this journey were hard, but wow the second 12 months has its own challenges and I am sure that will be life long if I want to stay healthy.

Good luck to you all

[VSGKirk 855]

0. What type of weight loss surgery have you had? VSG

1. How long have you been in maintenance mode? 2 years

2. What's your current height and weight? 6' 1" 213 lbs

3. How many calories do you eat daily (on average) to maintain your weight? Unknown (Not tracking)

4. What kind of focus do you put on Protein -- number of grams or anything else you want to say? Unknown, but I try to only eat items that are at least double digits in Protein.< /span>

5. What kind of focus do you put on carbs - number of grams or anything else you want to say? None

6. What other nutritional tips / tricks are working for you that help you maintain? My habits did not change drastically from the losing phase into the maintenance phase. I eat very similiarly, but it either larger quantities or more frequently. The type of food hasn't changed.

7. Which foods, if any, do you avoid altogether? Doughy - it's just too uncomfortable and unsatisfying

8. What exercise regimen (exercise types and frequency) do you follow? None, but I have enrolled in a program recently to help change that!

9. What role, if any, has counseling or therapy played in your WLS success? Huge role - I go to 1:1 therapy bi-weekly.

10. What advice would you offer WLS patients to help them be successful? Understand (and believe) that goal is not a number, remember that success is a sum of many small decisions, everything in moderation, progress not perfection, eat real food, move as often as you can, reach out to your WLS family whenever necessary!

[Wendyfm 494]

I'm almost two years out and eat between 1,100 to 1300 calories a day. I eat between 60 and eighty grams of Protein a day. I try to eat no more than 120 grams of carbs a day. When I go over 150 grams, I gain. That said I have maintained my weight within a two pound variation for a year. I am still considered obese, but am a size 16 down from a size 26/28 and 100 pounds down so am happy.

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