Alex Brecher

@@Porkchop911, Ditto what everyone else said. You’re doing fine! You’ve lost a ton of weight, and you’re due for a stall. Your body is just adjusting. During this stall, why not take the opportunity to take your focus off of the scale and put it on something you can control a little better? Maybe you can up your calories a little bit, make sure to hit your Protein goals, and get in more fluids if you’re not hitting your recommendations. You’re doing great, though, and a plateau is normal. Just be patient, even though it’s hard.

@@Medowsweet, Have you ever lost weight and gained it back? Many of us (weight loss surgery patients) did, many times, before getting surgery. For me, it was the result of going back to old habits. I would gradually stop being as careful as I was when I was dieting. Or I would go off of my diet, which often was some extreme diet plan that was completely unsustainable, like drinking a bunch of shakes instead of eating real food. Since I didn’t develop healthy habits, I didn’t keep them up when I went off the diet. Post-op, it’s easy to gain weight back if you move away from the strict diet rules. At the beginning, you’re probably super careful to eat slowly, measure your portions, track your Protein and calories, and avoid all high-calorie foods. As time passes, it’s easy to gradually become less strict – maybe only log food on some days, eat the occasional serving of pizza or another high-calorie food, have a bite here and there while you’re cooking… Eventually, these tiny changes in your strict habits can become more normal and become bigger, and the weight can creep back on. That’s especially true if your sleeve isn’t as powerful a tool as it was in the first year or so post-op. Yes, ghrelin can go back up after weight loss surgery and make you hungry again. It’s definitely something to consider before getting surgery. You might also want to ask yourself if you’re overly hungry now, or if you’ve been eating for other reasons, like boredom or comfort or poor choices.

@@mmy, I am surprised that your surgeon specifically recommended Ensure. I assume it is Ensure high Protein with 16 grams protein and 4 grams sugar? Even though there are only 4 grams of sugar, there are 19 grams total carbs – including some from maltodextrin, which can cause diarrhea. Also, some WLS patients have trouble with lactose and also with milk protein solids, which is the source of protein in Ensure. Sometimes whey and milk protein concentrate cause problems. If you think that’s a problem, you might want to try a shake with a different protein source, like soy, egg, or even pea. Also, drink slowly! Remember, there’s a good chance you’ll become less sensitive soon.

@@sweetdarling1983, Don’t be scared of the gym! Everyone is at the gym for themselves – to get healthy, to be fit, to reduce stress, to lose weight…they’re not there to worry about other people. Everyone who goes to the gym knows how hard it is to get there and the commitment it takes. They respect each other for being at the gym, and they will respect you. @@B-52 is absolutely right. If they even notice you at all, the gym regulars will appreciate your efforts. And if you’re not sure whether people at the gym are nice or not, just nod and smile at them as you pass by. You’ll be encouraged that they’ll return the smile, and you’ll feel more welcome. If you don’t know where to start, walking on the treadmill or cycling can be a good place. There are tons of ways to get ideas. Asking a trainer is best, if you can afford one. Most gyms have policies that include staff who can show you how to use the cardio and weight equipment – just ask the front desk. Go with a friend who can show you some exercises. Check out the internet for ideas. Take a group fitness class so you can learn new techniques and have fun. Don’t worry – you can always go at your own speed so you don’t push yourself too much. If you’re self-conscious, just stand at the back of the room.

@@LindaLena, Great questions! About foamies, I agree with the others. If you eat right, your chance of vomiting will drop a lot. Also, they’re likely to only last for a short time. For GERD/reflux, that’s a bit of a toss-up. As far as I know, some studies show that GERD tends to go away after the sleeve. Some show that GERD tends to start after the sleeve. So I think it’s a bit of a question of luck, but like the other members said, you can ask about medications and also how to eat to reduce GERD. For both questions, though, ask your surgeon. Ask about the risk, and the effects, and what you can do to prevent them, and what you can do if you can get them. Don’t automatically just cancel your sleeve surgery – get the answers first! Good luck.

@@mmy As far as I know, it doesn’t matter whether your Protein comes from food or shakes if you’re getting all that you need. You don’t need to keep up the shakes forever unless you’re having a hard time getting enough protein from food. By the way…I don’t know what size servings you’re thinking of for your chicken, cottage cheese, and oats, but I doubt if that’s enough for a day. A 4-ounce portion of chicken has about 30 grams of protein, a half-cup of cottage cheese has about 14, and oats have about 5, so that’s only 49 grams. Still, though, that would be close, and I’m sure that wouldn’t be your whole day’s intake! But back to your question: if you can get in your protein goals with food, you won’t need shakes.

@@Megall9 Good luck!

Wow, lots of good thoughts here. I do have doubts about the psych evaluation. While, as @@2goldengirl said, she wouldn’t have passed the psych eval with a lot of evaluators, I do believe, as @@CowgirlJane brought up, the occasional unscrupulous or pressured or even incompetent evaluator might pass her. @@Valentina raises a good point, too, that those questions are available online now. Yes, ideally an evaluator should go beyond standardized questions, but do they really always? Does her young age matter? It’s something to consider. I think there is a difference between a young 20-something who is still living at home and has never had the opportunity to be the head of household and set up her or his own healthy environment and may still be under the influence of an unhealthy environment because of parents, versus a 20-something who has already had the experience of being completely in charge and was still unable to lose the weight. @@Tommy Joe I lost 88 lbs.

Results from Gastric Balloon & Endolumenal Bariatric Procedures.

Overview Now that 2016 is underway and routines are getting back to normal, your healthy intentions may be back to normal, too. Whether or not you slipped up a little during the holidays, you may be more determined than ever to eat right. Breakfast may get the most attention, but lunch can make or break you, too. Think of burgers and fries, cheesy beef burritos with nachos, and meatball sandwiches from the fast food restaurant down the street from work. Think of pizza that shows up in the lunch room. Think of the chips, candy bars, and cheese crackers from the vending machine down the hall when you skip” lunch. Lunch can break you if you’re caught unprepared, costing you hundreds of extra calories each day. But it doesn’t have to. If high-calorie, low-protein, low-nutrient lunches are regular for you, it’s time to healthify your lunch! This week’s challenge can help you do just that. Getting Started: In most cases, packing a lunch is the best choice. It lets you control exactly what and how much goes into your mouth. The first step is to make sure you are set up for taking your own lunches. You need some small containers with tight-fitting lids, a set of cutlery – small-sized if that’s what you are using at home to help yourself eat slower – and a lunch bag, preferably insulated. Think of some ideas for healthy lunches. They can be as simple or gourmet as you like, as long as you stick to the basic weight loss surgery guidelines: start with protein, go for veggies or fruit next, and consider a small amount of starch. To get you through the day, you can also pack a few healthy snacks with protein, such as hard-boiled eggs, string cheese sticks, and celery with non-fat cream cheese. Then get ready to make your healthy lunches. You may need to go shopping for any ingredients you may need for this week’s lunches, especially if you’re used to going out. Don’t forget foods such as yogurt or salad dressing that you might want to keep in the workroom fridge. The Next Steps Do whatever prep work and cooking that you can ahead of time. That could include cooking and dicing chicken breast, boiling a dozen eggs, and peeling, washing, and cutting carrot sticks, celery sticks, cucumber coins, and other raw vegetables. You could also make some recipes such as three-bean salad or tofu broccoli stir fry so they’re ready to go during the coming week. Each night, plan your lunch for the next day and pack as much as you can. Don’t forget to put your water bottle next to your lunch bag so you remember to take it, too. Finish the packing in the morning, and enjoy your lunch every day this week! Make It Last: How did you like this week’s challenge? Did you feel that planning ahead led you to making healthier choices at lunch? Did packing your lunch help you avoid going to fast food or sit-down restaurants? Did you feel proud of yourself for making the healthy choices? If you think packing your lunch might be something you want to keep up, you might be able to improve on the process as you get used to it. Maybe you’ll find that you need a specific size container, or maybe you’ll realize you need to set aside some time on the weekends and a few minutes each night to get your food together. Whatever it is, practice makes perfect! Keep those lunches healthy, and you’ll be sure to feel better and get a little closer to your weight loss and health goals this year. Happy New Year!

No worries! Didn't make sense you didn't receive a response from us. Here's some information from the company on how long to wear the patches: "Wear the patch minimum of 8 hours, remove after 9 hours. After 8 or 9 hours all ingredients have been used up."

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100Lbs give or take 5-10Lbs (depending on the day )

@@JamieLogical, Congratulations! That takes a lot of commitment and shows some serious progress…which we already knew, but this is one more thing to be proud of!

@@mom2wils, It’s a tough decision that only you can make. As you know, there’s no single right answer for everyone. Weigh the pros and cons of the sleeve and bypass, like you’re doing. You mentioned that you know the band failure was partially your fault; you might want to think about why you didn’t always follow the rules, and whether the sleeve or the bypass will be more likely to help you follow them. Also ask your surgeon. It’s in your surgeon’s interest for you to succeed, so he or she should be willing to help you decide on the best option for you. If you’re still not 100% sure, ask several surgeons. You don’t need to go behind your own surgeon’s back. You can even ask your surgeon for recommendations on whom to ask. Depending on the different surgeons’ policies, you might need to pay for the consults, but you’re making an important decision and the money is worth it if it helps you come to the right answer. Good luck!

@@girl4god77, Good luck! It’s so normal to be nervous, but you’re ready for this! You worked hard. You researched your decision, found a surgeon, and went through the pre-op approval process. You completed the pre-op diet, which is HUGE! It shows you can follow the meal plan and you’re truly motivated to make this work. Now, it’s out of your hands. All you have to do is get yourself to the hospital and the professionals will take over from there. Good luck! Let us know how it goes.

Looks like you have a pretty good list here! Definitely don’t forget the phone and charger. If you like books, music, crosswords, or anything else to entertain you, pack a few of those. You might also want an extra sweater if you think you might get cold. Good luck with surgery!

@@vandernoordh, I am sorry about this. You have every right to be beyond upset! It sounds like you clearly meet the requirements that your health insurance policy has. Your doctor should be able to get involved on your behalf. It’s also in your doctor’s interest, since your doctor wants to keep you as a patient. Good luck, and try to stay positive, and don’t give up!

@@Womanvsmirror, That definitely is interesting – thanks for sharing the results of your research with us! That makes a lot of sense since most of us are only buying cheap digital home scales rather than high-quality industrial ones, but it still is a bit jarring! I know so many of us let the scale dictate mood, even if we know it shouldn’t, and we read the scale to the nearest 0.1 lb…now we know it’s likely to be off by about 2 lbs! It would be funny if it weren’t such a big deal to us…

@@Maggie Journey, I agree you can just tell your coworker you’re dieting again which is why you’re on a liquid diet. If you feel silly saying that, maybe you could say your doctor has you on a long-term diet (or weight loss) plan that starts with liquids to clear your system (or whatever excuse you want to give!) and then progresses through pureed and then solid foods. That can give you a good excuse that will cover you all the way up until you are back to eating normal solid foods again. If you have vacation time coming to you and you’re planning to take it for the surgery, I see no reason to say why you’re taking vacation. It’s nobody’s business. The only thing I would say is someone else’s business is if you need to take time off later if you ever feel sick suddenly. That may be something you need to think about ahead of time so you know what to tell your boss if you ever need to leave work early.

@@LadyJustice007 I am sorry you’re regretting getting the sleeve. If you are dehydrated, that can really make a difference. It can make you less tolerant to pain, so your post-op recovery is harder, and also dehydration gives you headaches, makes you tired, and takes away your energy. Being dehydrated can also make healing slower so you’re in pain for longer and it’s harder to get in enough Protein. All that makes everything seem worse, and I can see why you’re regretting the surgery now! But hang in there. Know that you are in the post-op period that’s hardest. Lots of sleeve patients wonder why they got the surgery. Just push through until you can get back to some real food and your weight loss gets on track. Also know that you don’t have a choice. The only thing you can do is look forward and do the best you can with what you have – your sleeve. You can do it! Keep letting us know how you feel.

Thanks for all the great comments and for keeping this discussion positive and constructive – it could easily have gone the other way. I agree with many of you that The Biggest Loser does not do enough to help contestants make sustainable changes. You’re right: working out 5-6 hours per day is not realistic long-term. I also fault the show for implying that working out that much is necessary for weight loss. It is not. As you all know, losing weight is far more closely tied to what and how much you eat than to your exercise, although exercise can support weight loss and is of course important for health. I think the show could still be popular while being a little more helpful and humane. It could, for example, focus a little more on eating, since that is the key to weight loss. It could include psychological counseling – or if it already does, it could actually show us that part! I am very pleased to see how much thought so many of us have put into maintenance and sustainable healthy changes. I think that’s a good sign for keeping the weight off!

I’m sure most BariatricPal members have heard of, if not avidly watched, The Biggest Loser on NBC. It's a reality show in which overweight contestants compete to see who can lose the most weight during the season. The show largely focuses on extreme workouts. I just came across this article reporting that the winner of Season 5, Ali Vincennt, gained back all of the 112 lbs. she had lost on the show. She started at 234, weighed in at 122 lbs for the finale, and is now back at 234 lbs. Her regain includes a year in which she gained 70 lbs. Like the show or not, and agree with its methods or not, you have to feel for Vincennt. All of us who have fought obesity know how hard the fight is. Keeping weight off is often harder than losing it in the first place. Regaining weight is embarrassing and discouraging, but all too common. As a weight loss surgery patient, what are your thoughts on this? Do you think the show could do more to help its contestants keep the weight off for the long term? How will you learn from Vincennt’s situation to help yourself keep the weight off after you hit goal weight?

Thanks for the feedback!

No matter how much you want to get your nutrients from “real foods,” you may not be able to, especially if you get the gastric sleeve or bypass. There may be a few days pre-op and several days or a few weeks post-op when you depend on Protein powders and shakes to hit your protein numbers. There are a million different low-sugar, high-protein powders and shakes out there, but your choices are way more limited if you’re vegan. You may go for pea or hemp or soy Protein powder, but there aren’t that many choices. My question for you is: which brand(s) and flavor(s) do you use, and where do (or did) you buy them?