SkinnyMalink

There is no expiration date on our surgery. You will continue to lose weight for as long as you consume less calories than you burn. If that were not true, there would be no such thing as anorexia. I am going on two years from the date of my surgery and will still lose more weight if I eat too few calories during any given week. Forty-five pounds in three months is a very impressive weight loss. Just make sure you are eating enough calories: trying to starve the weight off doesn’t work over the long haul because you will cripple your metabolism. The best way to end a weight loss plateau is to eat just at or slightly above your daily calorie burn for a day or two and then follow that with a few days of a 1200 to 1500 calorie intake. Dr. Mehmet Oz in his book “You: On a Diet” also recommends using a 7mg/24hr nicotine patch to temporarily boost one’s metabolism. I used that “trick” when I hit a plateau several months ago and it worked. Also, drink plenty of green tea. Green tea does help burn fat. If you are not on a tight budget, I would also strongly recommend purchasing and using a body monitor such as BodyMedia Fit (the same device used on The Biggest Loser) or the Up wristband by Jawbone (Jawbone now owns BodyMedia). Both devices are excellent and will give you a very accurate picture of how many calories you are burning over a 24-hour period. Once I started using the BodyMedia Fit armband, I had a lot more control over my weight loss because I eliminated all the guesswork. Of course, I am also a fanatic about entering everything I eat and drink (that contains calories) on MyFitnessPal.com. I am not nearly as strict about the types of foods I eat (pizza and other comfort foods), just as long as I stay within my calorie budget for the day. According to every authoritative source that I’ve read, you should not eat less than 1200 calories per day for any extended period of time unless doing so is specifically recommended by your physician or dietician and you are under medical supervision. Best of luck to you.

In the end, after the surgically reduced stomach has healed, is this not entirely true? Have you read of all the post-surgical VSG patients on these forums who, months and years after the surgery, gain back a good part of their weight because they started eating more and exercising less? Do we not lose weight after the surgery because we had no choice but to eat less? No matter how you slice it, it's still a number's game. It's not as if we had this surgery to correct some rare metabolic or absorption abnormality. Your cochlear implant example is not an appropriate analogy. VSG patients are not receiving a medical apparatus to replace a defective organ. We are electing to have 75 to 80 percent of a perfectly healthy organ cut out of us so that we are forced—despite our worst intentions—to eat less. Most people, with or without a history of weight problems, are not going to understand or agree with this decision. It is a radical move. This is not the same thing at all as a deaf person receiving a cochlear implant so that he can function with greater ease in the hearing world. For years my brother and sister-in-law could not have children. Finally they decided to get help from the doctors. Turned out that my brother had some sort of blockage in his seminal duct and two varicoceles. The varicoceles were removed and the seminal duct was re-sectioned. Nineteen months later, my nephew was born. At work and throughout other areas of his life, every colleague and casual acquaintance later asked him why he and his wife decided to have kids so much later in life. Do you think he should have told relative strangers about his seminal duct re-sectioning or was it none of their business? Typically, they just smiled and avoided the question altogether. Sorry, you have really lost me here. I am most definitely not a spokesman or representative of the “former semi-pro athlete who became injured and then became fat and then became thin again after VSG surgery” community. And if I was secretly nominated and elected to that position without anyone having informed me, I am respectfully declining that dubious honor. I represent only myself. I've been reading these "should we or should we not tell" threads for over two years. Bottom-line is that if you were morbidly or super obese (BMI > 40) before the surgery, most people will accept and respond to your decision as a forced choice. On the other hand, based on the reactions I have received from the handful of family and non-bariatric healthcare professionals I have told, if your starting BMI was less than 40, most will think (whether or not they actually say so to your face) that you’ve taken the “easy way out”. I’m not so sure I don’t agree with them. If you are a particularly sensitive person or if you're expecting people to pat you on the back for finally doing something about your weight problem, I personally wouldn't tell a soul. If you don't care what other people think and you find it easier, simpler, or more morally correct to tell everyone who inquires about your weight loss the truth, then go ahead and tell the world but be prepared for the fact that not everyone is going to applaud your decision. My orthopedic surgeon, the same man who had been hocking me for a whole year to lose weight to relieve the pressure on my bum knee, replied with "What, are you crazy?" when I first told him about my decision to have surgery. That's a true story. Besides my wife, only three other people know about my surgery and, two years after the fact, I wish they didn't. On the other hand, there are many here who did make a point of generally announcing it to anyone who might care to know and mostly do not regret that decision. Either way, please don't think that anyone of us has a moral responsibility to announce our healthcare history to the world for the sake of fat people everywhere.

Since this thread was revived, I’ll offer my two-cents’ worth. On this forum, we have an overwhelming number of self-assigned experts on weight loss, dieting, nutrition, and vertical sleeve gastrectomies based on a case study of one. For one year after my surgery, I attended a monthly support group of VSG patients in my doctor’s office. We would just go around the room sharing our experiences mostly. What amazed me was how different everyone’s experience with the surgery and recovery was. One guy reported he could enjoy steak at 4 weeks out and someone else would say that he couldn’t eat steak until 4 months after surgery. Some people can’t tolerate salad, I eat it with every dinner. I don’t think anything is more personal and individualized than weight gain, weight loss, and immediate and long-term responses to this surgery. I can tell you what worked for me and that’s it. As I see it, I have no right at all to instruct someone else about what they should be doing based on what worked for me or what my doctor advised me to do. Even with something like knee surgery, each recovery plan is very different based on the specific type of injury that was repaired. We all have different histories with weight gain, diets, and weight loss and different issues with food. I was a skinny kid and then a skinny adult until I had an accident. I didn’t get fat because I ate too much "junk food". I got fat because I ate too much food, period. I used to be a semi-professional athlete before a serious knee injury laid me up. When you are running 5 miles every day, you can come home and put away a 16 ounce steak and a big plate of spaghetti with no problem. I used to eat like there was no tomorrow and I never gained an ounce because I was always active. Problem is I continued to eat like that and even more after my injury because I got seriously depressed. I went from being a skinny guy to becoming a fat man in just two years. This surgery was perfect for me because it did what I needed it to do. It forced me to reduce my portions of food at each meal. I eat the same way now that I used to before the injury except just in much smaller quantities and I have been 8 pounds under goal for almost 9 months. Before my knee injury I was a young, healthy athlete and I occasionally ate a Big Mac, a piece of candy and a chunk of cake. Now, almost two years after surgery, I am a middle-aged healthy adult who still occasionally eats (a few bites of) a McDonald's sausage McMuffin with half an order of hash browns, a Baby Ruth candy bar, and a 3 oz portion of full fat ice cream. I am as physically healthy today as I was 5 years ago and I have the doctor's report and blood work to prove that. Still, I have no more right to warn forum members that they are going to fail because they are not learning how to eat all foods in moderation than someone else warning me that I am going to fail because I still eat chocolate and ice cream. Based on my sustained results, they would be 100% wrong. Even if there was a real doctor or licensed therapist on this forum, he or she would have no right to dispense warnings without at least reviewing that person’s medical file and then meeting with the patient. This is the real reason I am not a regular contributor on this forum. These forums appear not to be moderated and I have no interest in my posts being attacked or insulted by people who don't personally approve of my approach to weight loss and weight loss maintenance. I also don’t need or want lay medical advice. I have real licensed healthcare professionals that I rely on for that. Is strict calorie monitoring considered dieting? If so, then I will be on diet for the rest of my life. If eating everything I used to eat and want to eat now but in much smaller quantities means I'm not on a diet, then I can honestly write that I have never been on a diet even once during my entire life. From the first day I could start eating solid foods, I have been tracking all my calories. From one year ago, I started using the BodyMedia Fit Link armband to monitor my daily calorie burn. I didn’t have this surgery to leave anything to chance. I weigh myself every single morning as advised by my doctor and nutritionist and I monitor everything that I consume. I also keep records of my calorie intake and expenditures for each month and use them for review. What has made keeping the weight off effortless for me is following Dr. Michael Mosley’s Fast Diet. For two days out of the week (Monday and Thursday), I eat a 600 calorie high Protein diet divided into two meals and separated by a 12 hour period (like 250 calories at 7:30 am for Breakfast and then 350 calories at 7:30 pm for dinner). Then for the other five days, I eat 25% over my daily calorie burn to maintain my current weight. My nutritionist told me that a healthy diet is a well-balanced one and that includes carbohydrates, protein and fat, all three. I follow the percentages recommended by MFP. When I was still trying to lose, I would eat a little less so that I was running a 5200 calorie deficit a week, which comes to a pound and a half weight loss every week. Do a search on “Mosley Fast Diet” for free information about his Fast Diet if you are interested. This program has been very easy for me to follow. Please consult with your doctor before starting any type of fasting diet. I am not a doctor or a licensed psychotherapist so I can’t advise anyone about what they should be doing. I have seen members threaten other members here with failure, illness, an "unhealthy life", and even death if they didn’t follow the same program they had come up with for themselves. All I can do is write about what has worked very successfully for me. If you can relate to my story and reading about what has worked for me has you thinking or rethinking about what might work for you, wonderful. If not, please ignore what I just wrote and be sure to consult with your own healthcare professionals before trying anything new.

This July will make two years since my surgery. I have no regrets, mostly because I had an excellent surgeon and nutritionist who made sure I knew exactly what to expect after the surgery. I give them a lot of credit for that because based on what they told me, I almost decided against the surgery as I’m sure a lot of people do. I didn't expect to never feel hungry again. I was told that I would still experience some hunger but that it wouldn't be as severe or quite the same as before and that it would be easier to deal with by eating just a little bit of Protein. Not all the ghrelin in your bloodstream is produced by the fundus. Fifteen to 20 percent of ghrelin is produced by other organs including the brain. Aside from that, ghrelin is not the only chemical that regulates hunger. There are several other body chemicals that control hunger including neuropeptide-Y. These other chemicals are unaffected by the surgery. You will experience real hunger pains after the surgery. It’s just that they are a lot more manageable (at least they have been for me. Your individual mileage may vary). I didn't expect to lose my taste for food. My doctor did not remove any of my taste buds or surgically alter my cerebrum, the part of my brain that analyzes taste. He only operated on my stomach. Food still tastes as good to me now as it did before the surgery, maybe even better because I am attending to my food a lot more than I used to. What I mean is that because I am eating more slowly and a lot less, I am paying much closer attention to the food that I do eat and I’m enjoying it more than I did before the surgery. I expected to eat a well-balanced diet after the surgery. My doctor and nutritionist told me that eating "healthy" means eating a well-balanced diet and that includes carbohydrates, fat, and protein. I expected to eat all foods in moderation and I do, including pizza, candy, and an occasional glass of Scotch. I expected to gain weight if I ate more calories than I expended, lose weight if I consumed less calories than I used for the day, and to maintain my body weight if I ate around the same number of calories that I expended. This isn't a matter of luck. I leave nothing to chance. I wear the BodyMedia Fit Link armband (the same one they use on the Biggest Loser) to monitor how many calories I burn each day and I make sure I don't eat more calories than I use by monitoring every piece of food and drop of Fluid that goes into my mouth. It's really that simple. I have been following Dr. Mosley's Fast Diet religiously for the past year for weight maintenance and health benefits. Two days of fasting per week leads to reduced risk of cancer (due to reduction of the cells' inflammatory response), reduced chance of Alzheimer's disease, and prolonged life. I still go out to eat with my wife, friends, and colleagues, No one but my wife knows I have had surgery. At 18 months, I could eat six to eight ounces of food in one sitting so no one is the wiser. My friends from high school and I have had a tradition of meeting at McDonald’s for Breakfast on a regular basis. I still go. I can eat half an order of hash browns and about ¾ of a sausage McMuffin with cheese depending on how much coffee I drink. I am in excellent physical health mostly because of my weight but also because of the fasting. My blood work has never been better and my lean body mass is now at 82%, which is the best it’s ever been since I was a teenager. I do at times regret that I can't eat more in one sitting than I am able to but only as a mental exercise in comparison to how I used to eat. What I mean is that if my wife and I are going to go to our favorite buffet dinner restaurant, I know in advance that I will not be able to eat as much as I used to and I do feel some regret about that like in a nostalgic sort of way. However, once we're at the restaurant, I eat until I'm full. Once I'm full, I feel no regret that I can't eat more because I'm full. Only later, when I think about how little I've eaten, do I feel some regret over it... if that makes any sense. I am as thin now as I used to be before a serious knee injury turned me into an invalid who got fatter and fatter over the years because I was depressed and sedentary. I feel like my old self again. I was self-pay and even at four times the price, it would have been worth it to me. This surgery is not a miracle cure for obesity. It is a very valuable tool, but it's just a tool. Like any tool, it only works if you use it. If you are not willing to monitor your food intake and how many calories you are burning, you cannot expect an optimal result. The surgery will not do all the work for you. Based on my two years of reading this forum, if you are an emotional eater or a grazer (overeaters who pop a few Cookies or a handful of potato chips into their mouth every time they pass the kitchen), you will probably be very disappointed by the end result unless you get professional help for your food issues. Some forum members here try to deal with their food issues with sheer determination and will-power to avoid so-called “slider foods”. That approach seems to produce mixed results. Personally, I have successfully maintained my weight loss with the moderation approach but I don’t have the same kind of food issues that others do. In the end, everyone has to do what works best for him or her. Best of luck to you.

My doctor told me that I would still have some hunger after the operation but that it would be different in intensity and quality. He was right. Eight-five percent of the principal hormone involved in hunger regulation, ghrelin, is produced by the part of the stomach that is removed, but that leaves 15 percent that is produced by other organs, including the brain. In addition to ghrelin, there are several other chemicals that help regulate hunger including neuropeptide-Y and that is not affected by our surgery. I help maintain my weight loss through the use of the Fast Diet (5:2 Diet). I promise you that on the days that I fast, that is, on the two days that I limit myself to a maximum of 600 calories, I do experience real hunger. There is nothing psychological about it. However, the hunger pains are not nearly as severe as they were before the surgery and the quality is different in that the sensation is currently more of an empty feeling than one of starvation. Also, as someone else has written, eating any amount of Protein relieves the hunger sensation almost immediately. Dr. Mehmet Oz in his book, You: On a Diet, also recommends eating six walnut halves before a main meal to help fill you up. The walnuts contain a healthy fat that tells the brain that you are full. It works. You're not crazy or unlucky for feeling hungry. There is a real physiological basis for it even after surgery. The removal of the fundus does not eliminate all our ghrelin or affect any of the other chemicals that regulate hunger. However, the hunger pains are different and easier to manage. On my fasting days, I find it much easier now to distract myself from the hunger pains than I ever could have without the surgery. I'll just walk around, pick up a book, or turn on the TV and I stop focusing on the hunger. None of those distractions would have worked for me before the surgery. When your stomach is healed enough for you to tolerate them, try Dr. Oz's walnut trick. It really works.

Have you been specifically told not to eat chocolate (or foods with sugar) by your doctor, therapist, or nutritionist? If not, I think the biggest harm here is not the chocolate but your angst and guilt over it. I allow myself a certain number of "fun" calories per day. I am very strict about tracking my calorie consumption and expenditure and usually schedule up to 10% worth of “comfort food calories” every day. What I do to prevent going overboard is I enter all my food for the day into myfitnesspal.com in advance. What I mean is that I decide what I am going to eat every morning and then enter all my meals in the morning while I'm drinking my coffee. At that time (when I'm not too hungry), I decide what treats I am going to eat for that day. Sometimes it's Cookies, or cake, or even a Baby Ruth candy bar. But I plan everything in advance and I strictly stick to the plan for that day. Unless you have been specifically told by your healthcare professionals to avoid chocolate and all other sweets, you might want to rethink your position on this. My doctor specifically told me not to avoid comfort foods as this can lead to excessive frustration and binge eating. This moderation approach has worked for me for almost two years now. I have been 8 pounds under goal for over eight months. Also, I am not a doctor or nutritionist but it seems to me that 800 calories per day are not enough unless you are fasting (I follow the Fast Diet to maintain my weight loss and eat 600 calories on fast days only). You may be putting yourself into starvation mode, which would explain the stall. I suggest you speak to your therapist and nutritionist about moderation and what your optimal total number of calories per day should be. After my initial and quick weight loss of 35 pounds, I lost the remaining 43 pounds at about a pound and a half per week. I was very happy with that because I was able to eat around 1800 calories per day on that program.

Ditto. The change in my relationship to food is almost all about quantity, not quality. I'm a little less than two years out and the only thing I don't consume now that I used to drown myself in is Diet Coke (I drank it 'just for the taste of it'). I have taken a few sips of my wife's Diet Coke over the months but I was told to abstain from carbonated beverages and I do my best to comply with my doctor's wishes. My wife and I still go out for dinner together, all the time. We use the two-for-one coupons from the Entertainment book for buffets and, if we're ordering Entrees ala carte, we'll share a bowl of Soup or an appetizer and then one entree together. No one questions us or forces us to order more. Almost always, the restaurant manager or waitress will approach me and ask if anything is wrong with the meal when they see how little I've eaten and I'll either tell them that I had a big lunch or Breakfast (depending on which meal we're talking about). Sometimes, depending on the atmosphere and the people involved, I'll just tell them that I've had stomach surgery and can't eat as much as I used to but that the food is delicious (I don't go into details about what kind of stomach surgery I had or break out my before and after photos). They smile, thank me, and then walk away. I am 8 pounds under goal going on almost a year now and I eat all the same kinds of foods I used to before the surgery, except in much smaller portions. Today I am totally satisified with just one 54g candy bar or two 15.5g "fun size" Milky Way nuggets. Both my doctor and nutritionist strongly encouraged me to practice moderation in all foods and for me this approach has worked beautifully. In order to maintain control over my snack foods, I literally budget them in advance into my planned schedule of calories for each day. I stick to the plan and strictly monitor how many calories are going in versus how many I am burning (I use myfitnesspal.com and the Biggest Loser body monitor armband for that). Don't worry, you will still be able to eat socially and you won't be frustrated because you won't be walking away from the table hungry. If you're full after six bites, then you're full.

I had the same experience. The first person I told that I was thinking about the surgery was my orthopedic surgeon, the same man who had been telling me every month for over a year to lose weight in order to remove some of the pressure on my bad knee. His reaction? "What, are you crazy?" No kidding. I had such a long-standing relationship with him that I decided not to find another doctor but to try and understand what his concerns were about the operation. He explained that as a doctor it seemed crazy to him to remove a healthy and essential organ from anyone other than a corpse during an autopsy. That was more than two years ago. Based on my results, he is now a very big fan of the operation and recommends it to all his overweight and obese patients. Part of my doctor's negative reaction was based on the fact that I was not morbidly obese at the time of the operation. He felt that I had given up too quickly on dieting. If I hadn't had physical complications from the weight, I would have had difficulty finding a US surgeon to perform the operation. I actually gained a few more pounds deliberately to push myself from a BMI of 34 to just over 35 in order to qualify medically after the first surgeon advised that I didn't quality for a VSG but that he could give me the gastric band instead (and I knew that I didn’t want that). Unfortunately, exercise was not an option because of a serious knee injury. I went from being a trophy winning athlete to becoming an invalid overnight and I couldn't adjust to that mentally. The more depressed I got, the more I ate and the fatter I got, the more depressed I got. It was a vicious cycle. Seventy-eight pounds and one knee surgery later, I am no longer in pain most of the time and am able to walk slowly. Based on my orthopedic surgeon's reaction, I decided to tell no one except a few select members of the immediate family (and even that I now regret). I figured if an educated man had trouble understanding my decision than what chance did I have of regular people understanding it? Unlike others, I do care what other people think, especially if I have to work and deal with them every day. Because I was about 65-70 pounds overweight when I had the surgery, only my initial weight loss of 35 pounds was immediately noticeable. As I lost the rest of the weight, no one seemed to notice--at last no one made any comments. Everyone assumed that the weight I lost was because of dieting and that's how I left it (I had my surgery during my summer vacation, so I never missed any time from work). Weight loss surgery patients need to do what is in their best interest and what makes them most comfortable. Truth is I feel more comfortable telling restaurant managers, strangers I will never see again, about my surgery when asked why I hardly touched my meal than I would telling anyone I work with. The guys at work are not exactly what you'd call the touchy-feely types and I would catch a lot of crap from them over the fact that I took "the easy way out". I don't need that. I still catch grief from my wife's sister and her husband every time we get together for the holidays. "You're too thin now. That doctor should be sued for giving you the operation. You just should have cut back on the cake and ice cream". In the end, it's not really anyone's business but mine. I wouldn't go around volunteering that I had a vasectomy or tummy tuck either (not that I had these, I'm just saying). Everyone's situation is different. I have a strong feeling that people who are morbidly obese and super obese (BMIs over 40 and 50) before the surgery will receive a lot more understanding, encouragement, and support than those who enter the operation with BMIs under 40. Most people today struggle with their weight and may become threatened if they hear about your surgery and didn't think you were "that fat" to begin with. It's a lot easier for overweight people to call you crazy than to start asking themselves what they plan to do about their own weight problem. Just use your best judgment and do what's best for you.

It's an easy diet to follow, especially for sleeved people. This diet helped with those last 10 pounds to goal and then another 8 after that. This diet is great for maintenance because you get to eat the deficit you are creating on your fast days over the non-fasting days (if you want and if you don't, you will continue to lose weight). For example, in order to reap the health benefits of the fast, you cannot eat more than 500 to 600 calories two days out of the week. For me, this creates a calorie deficit of 1451 per fasting day or a total of 2902 calories for the week. According to my body monitor armband, I need to eat 2050 calories per day (without exercise) to maintain my current weight (much more if I walk around or if I’m even moderately active instead of just sitting around). If you divide that 2902 calorie deficit by five days and then add it to 2050, that means that I should eat 2630 calories on non-fasting days to maintain my current body weight of 167 pounds. That’s a lot of food to eat in one day and I can rarely do it, which is why I’m still losing weight and I'm eating freely without guilt or fear. There are lots of variations on the Fast Diet. The one that Dr. Mosley recommends and that I follow is to eat a breakfast of 250 calories at around 7:30 am and then a dinner of 250 (for women) and 350 for men 12 hours later at 7:30 pm. Then the idea is to hold off on breakfast until 7:30 am the next day so you’re getting in two 12-hour fasts in a 24 hour period. You should drink lots of Water with lemon or herbal teas. My fasting days are Monday and Thursday (you can switch at the last minute if something comes up). I will typically eat a mushroom and cheese omelet (half a slice of American cheese) with sautéed onions for breakfast with coffee, skim milk and coffee creamer, and then, for dinner, a hefty sliced smoked turkey and roast beef salad for dinner with one tablespoon of French dressing. The lettuce bulks up the meal and really fills you up, especially if you have been sleeved. It works and fasting two days out of the week for six months has done wonders for my blood work. My doctors can’t believe I’m the same person from even one year ago. Moderate intermittent fasting in this way prolongs life and doesn’t negatively affect muscle mass.

I’ve been lurking around these forums for over 2 yrs and decided it was finally time to post something. This coming July will make two years for me and I’m down 78 pounds, 8 pounds under my original goal. The last time I felt that I was losing control was when I made the decision to see a doctor about weight loss surgery. I had always been an extremely active (hyperactive) skinny kid and adult through my 20s and most of my 30s. My mother called me “Skinny Malink” when I was a kid. Then in my late 30s I suffered a serious knee injury from a soccer accident that led to gradual weight gain to 245lbs!!! (I’m 5’10”). As soon as I was able to start eating solid foods (14 days), I began tracking every morsel of food that enters my mouth on MyFitnessPal.com. I mean I track everything, from the 6 grams of coffee creamer I put in my morning coffee every day to the half serving of hash browns and ¾ portion of the Sausage McMuffin I have once a week at McDonald’s with the guys (a 10 year tradition for us that I wasn’t about to break). (I used to eat 2 orders of Sausage McMuffins without egg, 2 orders with egg, and 2 orders of hash browns in one sitting.) If my wife asks me to try a sample of a cake batter she is about to put in the oven, I figure out a way of entering that too. Everything. Strict monitoring is the key to successful weight loss and weight loss maintenance. I wear one of those body monitors that they use on The Biggest Loser. I track every calorie I burn 23 hours a day. Everyday my goal is to eat just under or around the calories I expend, which for me is around 2200 to 2400 calories a day. That’s with some light exercise meaning a 30 to 40 minute slow walk every day (I had corrective knee surgery about a year ago and today I can walk slowly, like 2mph). For the past six months I have also been following that British “Fast Diet” by Dr. Mosley. Basically you eat 600 calories of mostly Protein for two days out of the week (500 for women) and then anything you want on non-fasting days. This a very easy way to maintain weight loss for sleevers and the health benefits are truly amazing. Intermittent fasting lowers your chances of getting cancer and Alzheimer’s disease. I have a lot more energy now since fasting than I ever did. (I do track my food intake on non-fasting days even though you’re not supposed to). You can look up the Fast Diet on the internet or on Amazon.com. There is a U.S. version of the book and it’s available for Kindle. Because I’ve been using intermittent fasting for half a year, I guarantee that the hunger I feel is not just “head hunger” (if by head hunger you mean purely psychological). It is true that the docs remove a part of the stomach that produces the majority of one of the hunger hormones, ghrelin, but there are many chemicals in the body that cause the sensation of hunger, not just one. Besides, not all the ghrelin is eliminated from your system because 15% of it is produced in other parts of the body. When you have some free time, look up a protein called neuropeptide-Y. It plays a major role in hunger sensation and regulation and it increases during periods of stress. It is true that the hunger pangs I feel today are different in intensity and quality from what I used to feel before the surgery but not all sensations of hunger that I feel are in my head. Even after a vertical sleeve gastrectomy, there is a chemical basis for hunger, it’s just that the chemical composition is different for VSG patients. I eat exactly the same foods today that I ate before the surgery except just a lot less of them. That includes pizza, my famous homemade Texas chili, Red Lobster’s lobster bisque, and spaghetti with meat sauce. I don’t think of any food as “bad”, not even candy bars like Baby Ruth, my favorite. I just monitor everything I eat on MyFitnessPal.com and force myself to stay within my daily maintenance calorie intake of 2200 to 2400 calories. What is different for me today than from two years ago is that because I am tracking all my food, I am aware of how many carbs, Proteins, and fats I am eating for the first time in my life. I follow the nutritional guidelines recommended by MyFitnessPal.com (just select "guided" goals). If you’re in a stall or having trouble losing those few extra pounds, I encourage you to try the Fast Diet by Dr. Michael Mosley. It’s also called the 5:2 Diet. Especially for people who have had 75 to 80% of their stomachs removed, it’s a very easy way to lose and maintain weight and the long-term health benefits from intermittent fasting are awesome. IMHO, stick with the counseling and try to allow yourself to enjoy your comfort foods in moderation without guilt. The more you beat yourself up for eating foods you enjoy, the more stress you feel, the more your hunger proteins will surge, and the more you will crave those foods you are trying to avoid. That’s why will power alone never works over the long haul. I have more will power than anyone I know and I still got uncomfortably fat. Instead of seeing yourself as losing control whenever you eat comfort foods, try to turn that around so that you are gaining control. What I do is I take out one portion of candy or cake or whatever it is I feel like eating for that day and then deliberately plan on eating it at my usual snack time. For me, I take out my Baby Ruth bar and leave it on the end table for when I am watching TV at night. Every time I pass it, I smile in anticipation. I also make allowances during the day for that snack by monitoring everything I eat and by exercising so I know I have enough calories to “spend”. This way, I am gaining full control over these food choices instead of feeling like I am losing control every time I eat them. Anyway, this approach has worked beautifully for me. Everyone has a different history with weight and health issues so I don’t know if this method will work for everyone. I’ve been able to comfortably stay under goal for over eight straight months by using this system of intermittent fasting combined with strict monitoring of all the calories I eat and use. I wanted to share my experience with it in case others can benefit too. Best of luck.