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I feel like I need to share my experience with others, as I wish someone would have shared the same with me years ago. My weight loss started over 20 years ago, never stopped since, culminating with a gastric sleeve in 2017 (SW 360, CW 250, GW<200). After the WLS I've lost about 70 lbs and hit the plateau which lasted a few months. I tried breaking it with intensive gym, calories counting, but no real impact. As a result, I've lost motivation, and over the next 2 years gained about 30 lb back (late night snacks, sugary treats), which was a huge frustration. Having a sleeve - the best WL tool one may ever have - I felt like being a "regain" statistics, not an individual with life and willpower. I still had my "pouch" restriction, but after 30-40 minutes after having a meal I was ready to eat again. It lasted till last November, when I hit 290 lbs. The frustration turned into anger. I spent days to research diets and practices. As a result, I'm back on track, losing rapidly about 3-4 lbs a week, full of energy. Here are my 3 key pillars, which brought me back: 1. Low carb diet. After researching multiple trendy diets, KETO seemed to be the most promising one. But I didn't like the idea to consume lots of fats, and avoid vegetables. I'm an old-fashioned guy. So I adjusted the KETO idea by adding a decent daily portion of green veggies (zucchinis, asparagus, green pepper, kale - those which have nearly no sugars, but lots of fibers), and limited my fats to avocados, brazil nuts, eggs and fatty fish (salmon) - no huge amounts of bacon, butter, cheese and oils. For protein those above also provided enough, plus I have some lean pork, beef or chicken. That type of diet keeps my in permanent ketosis, while I still have a decent amount of fibers and healthy protein. My nutrients are around 50-60% of fats, 25-30% of proteins and 10-15% of carbs. 2. Intermittent fasting (IF), 18:6. It means my eating "window" is 1pm - 7pm, during which I have 3 meals. Personally I believe that low carbs diet and IF are made for each other. Being in ketosis I feel no hunger at all, as my insulin is very low. That makes IF a simple task. Also once a week I do a 42 hours fast by skipping meals on Sundays - right before my weight check on Monday morning! ). IF is also a solution to plateaus. I adjust the fasting time to 12:12 for a few days and do a long fast after (48+ hours) to reset. 3. CICO (calories in, calories out) is the 3rd pillar. Keeping everything written down is not just a good habit, but also makes me feel I control the process better. My daily intake is around 1,100-1,300 calories, which creates a huge weekly calories deficit for weight loss. One may consider it's a bit too low, and I would rather agree. I'll certainly increase my calories after hitting my goal. A few more tips from my experience: - After 40+ gym can't be the only solution. Keeping yourself active (especially with this pandemic) is important for general health, but unless I'm a professional athlete, 1-1.5 hour walk every day (outside or a treadmill) is good enough. - Staying hydrated is a must, healthy weight loss won't work without it. Tracking water was always a pain for me, I was forgetting to do that. Now I have 6 magnets next to my water cooler. Each time I refill my bottle, I move one magnet to the other side, which helps me to see how many refills left. No fuss with writing down, takes a fraction of a second to move the magnet - while keeps me fully informed. Helps a lot! - Supplements!!! Lots of them! Since I'm restricted and have rather a distorted diet, I need to fill the gap of minerals and nutrients. Multivitamins, husk fiber, omega-3, collagen, cumin, ox bile, Vitamin D, electrolytes etc. It's 18 pills per day, in 2 batches! My latest blood work returned perfect results - no deficiencies, and the lowest sugar level I ever had in my life. As a conclusion - no hunger, no frustration, no cravings, energetic, clear mind, active, positive - and still losing weight! I even think that it would be very doable without my WLS, but in fact a restricted stomach makes everything much easier. So much easier, then it feels sometimes I'm actually cheating in this weight-loss game! I do hope someone will find it helpful. I wish I knew that years ago, but better late than never.

I feel for you. I am exactly where I want to be with my weight and still have some belly fat. I think it's mostly some loose skin but it looks a lot like a beer belly haha. I am at 160lbs now but even when I was very underweight, 130lbs, I still had it. I think the only was to completely get rid of it is plastic surgery. Also, while crunches are great for your core, it is my understanding that they don't actually do anything to get rid of belly fat specifically. Honestly, it is probably more noticeable to you than to anyone else. That's how it seems to be for me at least. Good luck though!

I’m almost 3 years out, and recently noticed hair loss at my hairline. I suspect I haven’t been getting enough protein. Anyone have experience with hair loss this far out? Do you know what caused it?

I'm 61, so my skin probably can't bounce back as quickly as yours. Give it time and you may be surprised. And there's always plastic surgery if nothing else works. (I'm still considering it, but I would like to talk to other men who have had it before I make a decision.)

Yeah, get a new PCP ASAP. Mine was very supportive, very on the ball with it, (both of them, actually- my PCP left the clinic a month before my surgery, so I got in with a new one right before.) This guy is a jerk. I wish you the best with your surgery- you got this!

I'm so sorry he treated you like that, he's about thirty years behind the times and the obesity research, to say nothing of surgical interventions. Time for a new doc!

Yeah, I’d fire this loser ASAP. Not only is he being an asshole, his views aren’t even supported by evidence, and that is a huge concern from a medical professional standpoint.

They probably want to reach out to the insurance to see what the requirements are so they can tell you exactly what to do when you do go in. No need to go in if you don't know what is necessary after that visit.

So my program said that I could drink the Isopure waters but my fluid intake and wouldn't count towards my protein goal. It seems that my program has alot of those kind of rules. For example I can only drink Whey Isolate protein shakes. I'm not able to eat anything spicy until 3 months to avoid ulcers. Just different things. I am really trying to heed their advice, but it is somewhat difficult in this learning phase. I am 5 weeks post op today. 1 more week t regular diet! Wooooo Sent from my SM-N981U using BariatricPal mobile app

I tend to hang on to clothes way too long so as my sizes have gone down from XXXL to XXL to XL over the past 6 months until recently, I could find things to wear. However, I am now wearing L shirts and I haven't been this size since college, so I have had to go out and buy a whole new wardrobe. The good thing with the pandemic lockdown is that I can wear sweats every day and only clothes to work out in and maybe a few pairs of jeans to go out in public with. I'm not buying expensive stuff though- Walmart and Costco are fine for now. I'll save the more expensive things for later when my size is stabilized. To answer your earlier question- I have kept a few of my fat clothes, gotten rid of a bunch of them, and will probably throw the rest out after I have proven that I can keep the weight off. Maybe I'll do another purge of the closet this weekend. It feels good to move past that long chapter in my life.