DLCoggin

Pacific Gold Teriyaki Turkey Jerky (Costco), Old Wisconsin Turkey Sausage Bites (Walmart), almonds are my favorite but almost all nuts are healthy (watch the portion size - they are high in calories), yogurt, cottage cheese, decaf coffee, fresh cauliflower, broccoli and/or carrots (love the idea above for making your own dip from cottage cheese!), just about any kind of fruit (have to be a little careful with the sugar - I dumped once on red grapes), cantaloupe, honeydew melon, pineapple, Quaker Popped Rice Cakes (they come in sweet and savory flavors) - Snacks do not have to be synonymous with unhealthy!

It is disappointing that inappropriate comments from healthcare professionals are more common than they should be. Although weight loss is typically more rapid during the first year following surgery, doctors often tell their patients that they can lose as much weight as they want to. The laws of science and the universe are absolute and cannot be denied. As long as you are maintaining a calorie deficit, burning more calories than you are consuming, you will lose weight. Sometimes you'll lose more quickly, other times more slowly and sometimes not at all for a period of time. But sooner or later, you will lose weight. And you will continue to lose weight as long as you maintain a calorie deficit. I've been maintaining a food log for well over two years and find it an indispensable tool. Not only for weight loss but, when the time comes, for maintenance as well. It's quick, easy and doesn't cost a thing. More importantly, at the end of every day when you make that last entry and you've met your goal for that day, Celebrate your success! Every day! Your frustration is certainly understandable - but it's also counter productive. Consider staying away from the scales for at least a week and two or three would be even better. Instead of worrying about that number, focus that energy on staying positive, staying patient, following the protocol as closely to the letter as you possibly can and maintaining a food log. Trust the process and allow your body to find its own way in its own time. Do those things and the weight will take care of itself. There is no limit to what you can accomplish. You may also want to give some thought to starting a moderate exercise program. You don't need a cape and the ability to leap tall buildings in a single bound. Exercise does not have to be synonymous with working your body to exhaustion. My exercise of choice is and has always been just plain ol' walking. You can literally do it anywhere - treadmill, neighborhood, malls, parks or even just walking across your living room. Walking is walking. Start with fifteen minutes a day three or four times a week. Gradually increase your walks as you feel comfortable doing so. Commit to it for ninety days and you may discover that it's really quite addicting! You're doing great! And you're gonna love the new you!!

Following gastric bypass, doctors generally recommend 60g to 80g of Protein for the gals and 80g to 100g for the guys. The average adult has about a trillion cells in the body. Every single one of those cells contain protein. Remove all of the Water from your body and 75% of what's left is protein. So why is the recommended protein higher following the surgery? Protein is used extensively to repair and replace damaged tissue. Carbs are king when it comes to energy. On a regular diet, about 60% of your body's energy requirement is met by carbs. But when you're on a low carb diet, your body will metabolize protein for energy. It is common to read posts from folks who are struggling to get in their doctor's recommended protein. And in the same post learn that they are suffering from low energy. No carbs + no protein = no energy. Protein is a key player in fighting off bacterial and viral infections. Protein will help minimize lean muscle wasting during rapid weight loss. Protein will help reduce hair loss. Terry has commented on the concern of possible kidney damage related to protein intake. The question of what, if any, association exists between protein and osteoporosis remains to be answered. This link - http://aje.oxfordjournals.org/content/155/7/636.long - is to a 2001 paper published in the American Journal of Epidemiology. Although quite technical in places, it highlights the conflicting results of various research studies. This link - http://www.johnshopkinshealthalerts.com/alerts/osteoporosis/protein-osteoporosis-prevention_5826-1.html - is to a 2011 study at Johns Hopkins which is much less technical but again stresses that results are inconclusive. And finally this link - www.who.int/.../public_health_nut8.pdf - is a study published by the World Health Organization and concludes that "...evidence of adverse consequences [from dietary protein] is lacking." At the moment, perhaps the best we can do is follow our doctor's recommendation as closely as we possibly can.

And by the way - welcome to the forum! This is a special place with tons of knowledgeable and supportive folks. We're always glad to have new folks join us!!

When it comes to energy carbs are king. On a regular diet, about 60% of your body's energy needs are met by carbs. So the fruit may help some. But if I read your post correctly, you're drinking four Protein shakes a day. Four shakes at 160 calories per shake would be 640 calories for the shakes alone. And on a big day, you're eating a total of 800 calories. Now deduct the calories that you're burning with an aggressive exercise program and your "net" calories have to be quite low. Perhaps too low? Our bodies are much more effective at maintaining or increasing our weight than they are at losing weight. Your body will respond to a calorie deficit by defending your current weight - what is sometimes referred to as "set points". In order to maintain the current set point, your body will reduce your heart rate, respiration and perhaps most importantly - slow your metabolism. I'm not a nutritionist or for that matter any kind of health care professional. But even calorie recommendations by doctors and nutritionists are educated guesses. And they make those recommendations knowing that there is no one size fits all. There are simply too many variables. But I am surprised that your nutritionist didn't recommend at least a modest increase in your daily calorie intake. That can be accomplished by increasing portion sizes or altering your food choices in favor of ones that offer higher calorie counts. Nice and easy. You might want to consider increasing your calorie count by 100 calories a day. Do that for a week or two and see what happens with your weight and your energy level. Repeat until you find the calorie number and macro nutrient percentages that work for you - i.e. your weight loss resumes and your energy increases. As mentioned by another member above, I believe that maintaining a food/exercise log is the most powerful tool that you can have in your arsenal following the surgery. It's quick, it's easy and it allows you to fine tune your diet to your body and your lifestyle. I've used My Fitness Pal for over two years and highly recommend it but other forum members are very impressed with Spark People as well. There are many other options and most apps do pretty much the same thing. Good luck and please keep us posted on your progress!!

I was truly amazed at how many great foods there are out there when you take the time to read labels. And they're not just healthy but delicious as well!!

I haven't read this thread for a while so I decided to go back to page 1 and read it through. I really cannot imagine a better example of what this forum is really all about than this thread. Congratulations to all of you! Your stories are truly inspiring and should be required reading for those just starting their journey!!

Welcome to the forum Amanda! I think you'll find this is a very special place. It is a simple truth that one pound of fat is equal to 3500 calories. So logic says that creating a daily 3500 calorie deficit would result in losing a pound a day. Even if creating that daily 3500 calorie deficit is theoretically possible, it isn't realistic, sustainable or healthy. Perhaps creating a 3500 calorie deficit per week is a more appropriate goal? But unfortunately, even with that change, there's more to consider than the deceptively simple math. Proper diet and exercise following surgery will result in weight loss. As long as there is a calorie deficit, there is no question you will lose weight. But all of that weight loss cannot be attributed to fat loss. Some of it will be loss of lean muscle. And some of if it will be loss of Water. And to further complicate matters, individual metabolic rates are different based on a number of variables including genetics, fitness levels, and size. A heavier person has more muscle mass and requires more calories. So a heavier person will lose more weight with a weekly 3500 calorie deficit than a lighter person will. That's one of the reasons that the rate of weight loss immediately following surgery is usually more dramatic on a weekly basis than it will be six months down the road. Now add to that the fact that as you progress in your journey, your metabolism slows in response to the lack of calories. Our bodies have evolved to be much more efficient at defending a higher weight, than at allowing weight loss. And every single one of is unique so our bodies respond differently and at different points in our individual journeys. The good news is that you don't need an advanced degree in nutritional science to lose weight. What you need is a plan. Stay positive. Stay patient. Follow the protocol as closely to the letter as you possibly can. Maintain a food/exercise log. Trust the process and allow your body to find its own way in its own time. The laws of science and the universe cannot be denied. Resist the temptation to second guess yourself. There are simply too many variables. No matter what your weight is doing, follow your plan. Keep it simple. You'll find your journey to be so much less stressful and so much more rewarding. Do these things and before you know it you'll be celebrating your success every day. You're gonna love the new you!!

My surgeon said no alcohol for one year post-op and that's exactly what I did. That said, I seldom drink anything other than a glass of wine before dinner and I've had no problem with that. Tropical drinks and eggnog with rum are definitely out - late stage dumping. A very high percentage of folks experience a dramatically lower tolerance for alcohol following surgery. Always a good idea to be at home the first time you try it and you never want to drive after even one drink. There are some real horror stories of patients getting DUIs after a single drink. It should be noted too that surgery patients as a whole are at a considerably greater risk for becoming alcohol dependent following the surgery. Moderation is more important than ever.

It is absolutely not my intent to be unkind. But the statistical failure rate of diet and exercise for folks with a BMI greater than 30 is well documented and well over 95%. Many doctors believe that it is closer to 100%. It very rarely works and doctors have known that for a long time. They simply did not have any option to offer. Now they do. Gastric bypass is the single most effective treatment known to medical science for obesity and more than 30 comorbidities associated with obesity including type 2 diabetes, hypertension and sleep apnea. The decision is an intensely personal one that can only be made on an individual basis. Perhaps your answer to the question "Which alternative offers the greatest promise of improving my health and my quality of life?" will help you to make the decision that is right for you. Whatever path you decide to take, we're all here to support you every step of the way!

I would second the suggestion to call your doctor. Clearly it's not fluids or protein. But low bp can be symptomatic of way too many things (many of them quite minor) to second guess. Time to call the big kahuna. Feel better soon and please keep us posted on your progress!

I think of the surgery as "quantity control" and the all important lifestyle changes as "quality control". It's all about control, not denial.

You might find the following helpful: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931293/ http://www.ratemds.com/doctor-ratings/2960812/Dr-CHARLES+Y.-KIM-Clackamas-OR.html http://www.vitals.com/group-practice/oregon/clackamas/clackamas/sunnybrook-medical-office/general-surgeon/

Welcome Belagia! It is unusual to have the benefit of the experiences of someone nine years out. I think you'll find this a very special place with a lot of very special folks!

It's surprising how many doctors there are named Charles Y Kim. What state or hospital?

I agree totally with bbdoodle and would also suggest considering contacting your insurance company. Explain the situation to them and ask that they enter the information into your file so that others will be able to see it down the line. The letter from the PCP is usually what is known as a "Letter of Medical Necessity". I would be surprised if your new doctor would be hesitant to write the letter given how far along you are in the process. If for some reason that is not the case, might be a good idea to find another PCP. We can all certainly appreciate your frustration but there's a very good chance this will just be a bump in the road. Be assertive and stay positive!

Kidney problems as a result of the surgery are not unheard of but are not common. You might find this article from the National Institutes of Health to be helpful. Get well soon and congratulations on your weight loss! http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931293/

Great article! Truly excellent!

There is a common misconception that bypass patients have a long list of foods that they will never be able to eat again. That is simply not true. I'm well over two years out and you could count the number of foods that I can't eat (so far) on one hand. It's not about what you can't eat. It's about what you choose to eat, or not eat. That's where the surgery comes in. You are going to be amazed at how good food choices very quickly become second nature - especially if you maintain a food log. And the good news doesn't stop there. Pre-op I could eat a whole sleeve of girl scout thin mints. After reaching my goal weight I'm totally satisfied with one cookie. I know that sounds hard to believe but many members have posted about the same thing. Between now and your goal - no cookies. Once you've reached your goal and your weight has stabilized, it's about control not denial. And... You're gonna love the new you!!

Thank you - good information to know!

Well it will come as no shock to anyone who has read some of my posts but I am a huge fan of MFP. Actually I'm a huge fan of logging period. Very, very powerful tool. MFP is great but many forum members love Spark People and there are other apps that do pretty much the same thing. Whatever app you choose - LOG!!

Jackie, is the blood work the reason you have to go back to the regular diet?

Absolutely! It is nothing short of astounding how precisely I can manage my weight with very little effort. Lose a few pounds - no problem. Gain a few pounds (yup, I've had to do it a time or two - lol) - no problem. I don't know about you guys but the key for me - monitor closely and react quickly!

Welcome Candy and congratulations on your success! Lots of great folks here who will benefit from your experiences. Looking forward to getting to know you!!

Good morning Tasha and welcome to the forum. It's always exciting to see new "veterans" join us. I think you'll find that there are a lot of really great folks here!!