Sojourner

I like to make home made quiche...and then only eat the inside of the quiche and leave the crust. The egg inside has more of the consistency of custard...and has never gotten stuck. I usually add spinach, a small amount of Swiss cheese and onion. Though I realize this may have some additional calories from other choices, it does keep me from getting hungry for 4.5-5 hours, and works for me.

No, this diet requirement is not a move by the insurance company to deny you approval for the procedure. Generally the medically supervised diet is to substantiate your claim that your repeated attempts at weight loss have not been successful or sustainable. You also need to show your level of commitment to adhering to a diet, and have this documented by your physician. My PCP included in his letter of medical necessity that I had been his patient for 10 years, and during that time I had not been successful to both loose and maintain a lower weight. You need to show that you are not capable of maintaining the degree of weight loss necessary to improve your health. You did not mention any weight related comorbidities you may have...these are also important to be stressed to the insurance company, as in the long run, they will save money if you are able to loose the weight which contributes to them. Though my BMI was "only" 38 when my letter of medically necessity was submitted, I was approved because of my 4 weight related comorbidities. If you only have to do a 3 month diet, you are fortunate...mine was 6 months. I did loose some weight, but not enough to improve my comorbidity issues. Best wishes...

Getting obsessed with one's scale does contribute to unnecessary negative feelings imposed on oneself...depending on what the almighty scale says. Trying not to weigh yourself everyday is healthier...and your mood doesn't need to reflect any negative thoughts of no progress or even a small weight gain. Small fluctuations in weight are normal, and if you can accept them for what they are that's great. I've read too many posts from individuals lamenting about their lack of progress or weight gain when it was only a small fluctuation and not indicative of a trend. Other's mileage may vary...I just feel it's important for one'e emotional health and well being to stay on the positive side of thinking.

I agree with elcee...menopause does not need to include weight gain, despite the gyrating hormones and possible feelings of depression. What can easily cause weight gain during this phase of life is antidepressant medications and a lack of exercise due to the depressed mood. Menopause is another phase of life...accept it for what it is...I experienced daily hot flashes which caused my skin to get flushes and my hair to become wet from perspiration within a matter of only a few minutes. HRT did help, though I was only on it for a minimum amount of time. Try to continue your daily structure of exercise and monitor what you eat. Any mood changes you experience will be tied to the chemical changes in your body. It's going to become even more important for you to get your Calcium daily.Likely your metabolism will also be slowing...so look for ways to keep that as active as possible. Menopause is life changing, but it doesn't need to be weight changing as well... Best wishes...

As some additional thoughts...just prior to my surgery, after over 20 years of being dormant my asthma flared up again. I was experiencing significant airway restriction, and my PCP did mention that this could force a postponement of the surgery. He treated it aggressively, and though I was by no means "normal" by my surgery date, I did not have to have the surgery postponed. Drinking plenty of fluids will also help with breaking up some of the congestion. Best wishes...

I agree with you...though I have had only 2 fills to date, I needed to learn how to eat again after each of them. We do need time to adjust, both our eating patterns and the tissues near the band. I've also learned that both feelings of stress and the outside temperature will tighten my band (high outside temps = tighter band). The post fill adjustment is like a learning curve to me; as you mentioned the more experience you have, the more you understand your body and your band. A valuable opportunity to learn, if we choose to take advantage of it. This transfers some additional responsibility for my weight loss to me, however I'm willing and able to accept it.

My surgeon will refuse to do a fill more frequently than every 6 weeks...no exceptions.

It's very important to know what your daily Protein goal is, and try your best to meet it every day. A protein shake is an excellent substitute for a meal if you do not feel like eating. Another concern is eating more food at night...night is not the time to make up for what you have missed during the day. That would definitely be the time to have a protein shake. You need to have the protein to avoid loosing your muscle mass.

I've never hear of that brand of shake...and also never heard of a bariatric surgeon not requiring their patients to be on Protein shakes during some portion of their time...i.e. for liquid diet phases and/or post fills. It's essential for proper nutrition for you to have some protein daily...and while you are on a liquid diet how else could you manage?? A bandster will need to be on a liquid diet from time to time. Protein shakes are not necessarily only for body builders...I need them occasionally to make certain that I reach my daily protein goal. And they are not necessarily considered to be high in calories...especially if you consider that they serve as a replacement for a meal.

I've not experienced a band that is too tight, but this does sound like what may be going on with you. I'd get in contact with my surgeon ASAP and let them evaluate your situation. Not only is this situation possibly interfering with your nutrition and hydration, but you may also be harming your band.

There is an entire psychology behind understanding the automatic thinking we engage in, versus the reality of what is. I recently wrote a post about it...the Psychology of Size. I've had a difficult time to stop shopping in the plus size section in clothing stores...and my sister has actually had to physically steer me away from purchasing the same item in plus size that fit me in misses sizes. I have a difficult time believing that the smaller size is the correct one for me. We see the same dynamic at work when we work with anorexic eating disordered patients...you ask them to draw a life size image of their body and then compare their actual size versus their "psychological" size...invariably they see themselves as larger than they really are. I believe that the head does catch up with the body...it just takes time and awareness of the automatic thoughts which keep us a different size in our minds.

I was advised by my surgeon to stop drinking coffee, and if I must have coffee to make it decaf...no way could I do that. He said it was because of the potential of caffeine to irritate your pouch that you should avoid caffeine. So, I still have a glass of iced coffee every morning (yeah, I know that's odd, but in the South we drink iced coffee...when I lived in Seattle I drank hot coffee), flavored with dark chocolate Stevia and a splash of 1% milk. It really tastes just as good as the sugar free options Starbucks offers now.

SHHHH!!! I'm really very compliant with my diet and all medical instructions...but when raspberry infused rum is mixed with raspberry Jello...just couldn't say "no"! We won't mention this...what's written in the forum stays in the forum...

You will not be able to swallow pills without crushing them for the first few weeks post op. My surgeon prescribed a liquid form of hydrocodone prior to my surgery. I had all of my prescriptions that came in a different form changed to either liquid or chewable form. The rest had to be crushed...and no matter what I did, I was unsuccessful with disguising the horrible bitter taste of the pills.

I was pleased to read that your surgeon is providing you with so much informative and helpful nutrition education both for the pre op and post op phases of your diet. It will make a major positive difference in your level of confidence and understanding as you move through the phases of your new life with your band! Best wishes as your journey continues...

As others have said, make certain to achieve your protein goal every day, and take Biotin.

Learning the psychology behind the reasons for your loss of control with food will be helpful and add to the success of your weight loss journey. Your journey will present challenges every day...and emotionally if you are strong enough to meet them it will enhance your success with weight loss. Best wishes as you begin your journey...

My surgeon said no alcohol of any type for a full year post op...but that's difficult to follow when there are so many family celebrations. The major concerns are the empty calories you have in the wine or other alcohol...and definitely less tolerance for the amount of alcohol you consume. Last month I attended a party and had 2 Jello shots over a 2 hour span of time. I'm glad I did not need to drive...before the band this would not have affected me...post band, I was not safe to drive. Definitely avoid any carbonation...your band does not like carbonation...

The hospital you are having your surgery done at may have an active support group that meets there, so check into it. Pre op is the best time to have any residual issues you may have with PTSD addressed...and also to be certain that your mood disorder is stable with counseling and/or medications. Post op there will be numerous chemical and physiological changes that you will be coping with, so you want to be in the best possible emotional health prior to surgery. It's always sad to read that individuals have unsupportive family members...ideally they should be the "go to" people for emotional support. There may be other options...the hospital support group, and even this forum. There are many participants here who are very knowledgeable and willing to share their insights and best practices with others who are on similar weight loss journeys. You are doing something positive for yourself...best wishes as your journey begins...

Much smaller meals of a cup by volume is not a myth or an exaggeration...that's what a bandster meal consists of. If you are in your "zone" that amount should keep you from getting hungry for at least 4 hours between meals.

Your concerns are normal...but as others have mentioned eating with smart food choices and in the right sized portions will be the keys to your weight loss success. If you follow the rules, you will loose weight. The band is very self empowering, as your perseverance and complying with your diet will determine your weight loss. You should be aware of your daily Protein goal, and strive to meet it every day. If you have too little protein, you will slow your weight loss. If you have too few calories, then you will also stall your weight loss. You will need to do some experimenting to identify what types of exercise, and understand the proper food choices that will work for you, and be compliant with the portion sizes recommended by your surgeon to be successful with your weight loss. I've been advised to never count calories, only to make wise food choices and to measure my portions. Every surgeon will have slightly different diet requirements, so it's always a good idea to begin with understanding and following your surgeon's recommendations. Best wishes...

As tmf wrote, insurance policies have many variations in their requirements and coverage...and the surgeons do have variations in their treatment protocol for their patients. You will need to find out specifics with your surgeon for their treatment protocol after you have chosen which one you want to do your surgery. As for the psych eval, if your mood disorder is stable with the medication you are taking, it should not interfere with the approval process. The psych evaluation is looking for realistic expectations on the part of the patient, tendencies towards eating disorders, and history of substance abuse/dependence. All of these conditions can negatively impact your treatment outcome with bariatric surgery. Having any of these conditions does not necessarily mean that you would not be approved for the surgery, however you might need to be treated for it, and have a qualified professional sign off on their approval for you to proceed with your weight loss surgery. Though my surgeon wanted me to stay in the hospital overnight, I was able to have the surgery and leave the same day. Best wishes...

I'm pretty certain that the psych eval provider who conducted your evaluation was speaking outside of the scope of their practice. Your choice as to the type of weight loss surgery you ultimately have done should be a decision you make with your bariatric surgeon. ALL WLS require the patient to revise their relationship with food and make an effort to control what and how much they eat, and to make a commitment to get some regular exercise. As for the statistics, they don't hold much relevance for me. I believe that you can be successful with your weight loss no matter the path you take if you are sufficiently motivated to achieve that success. I know of several by pass patients who have been less successful that I have been to date because they were not compliant with the diet they are supposed to follow. My weight loss goal total is 106 pounds. I understand that this will take me over a year to achieve...but this journey has taught me the virtue of patience and perseverance. I could not see the need to reconstruct my GI tract...and both my PCP and bariatric surgeon agreed. Whatever WLS procedure you choose will come with risks; and the band in general has less of them. I have experienced some medical complications since having my band placed, but these were not caused by the band. I would self assess your level of motivation for success, and discuss these, along with your weight loss goal with your bariatric surgeon and PCP. Believe in yourself...and don't allow opinions of those who are not qualified to render them to impact your thinking. Best wishes as you consider your options...

I can relate to your disappointment...it took 14 weeks for me to have my first fill due to medical complications. The time will pass quickly...

Another key point that I read while doing some research is that those who actually measure their portion sizes rather than "eyeball" the portion for accuracy are more successful with weight loss. Another example of the eyes being larger than the stomach (or pouch)!