VSGAnn2014

Thanks, Susan. I can honestly say I don't feel like her. Yes, I have some sagging skin. But I am so grateful to be normal sized, even with the sagging skin. I just feel so much better physically. I can do so many more things now than I could 90+ pounds ago. Some of those things are "little" -- but to me they're really big, like bouncing up and down the stairs to our porch without even thinking about it, much less worrying my knees won't support me either direction. My poochy tummy isn't even CLOSE to negating the value of my new, easy mobility. I'm sorry she (and maybe others of you) are having your WLS benefits overshadowed by sags and bags and skin. I wish I could POOF! those bad feelings away. And make you feel more of the good feelings I know you also have.

Ah, real life! It's a bitch. But it's real.

Just to offer my opinion, I don't think a BMI of 36 is particularly low BMI. Anyone with WLS insurance or Medicare and 3 co-morbidities will qualify for WLS. Just sayin'. I'm glad you have the chance to have WLS. Very best to you.

Three words: Half pound weights. In your pockets, bra and underwear. You didn't hear it from me.

Here's some encouragement about the PPIs. My surgeon had me use a PPI (Protonix) for three months post-op. After that I tapered off Protonix and went back to my pre-op Rx of 40 mg. Ranitidine twice a day. No problemo. Then one day (after I hit maintenance) I got stuck in a car with fast-food-eating relatives traveling to a family event far away. That day (which lasted nearly a dozen hours) I wound up drinking 30 ounces of diet coke (I let the bubbles dissipate, but the acid content was still there), eating a huge ice cream cone, a McDonalds sandwich, a Subway sandwich, and 250 cals of Sun chips. NOT my best maintenance day ever, eh? And for a full week thereafter I had horrible acid reflux. I then went back to using my Protonix for 10 days, then went all the way back to my old Ranitidine Rx. I'm fine now. That led me to realize that I can't get away with violating all the rules of eating for reflux patients in the same day. And I have NO plans to ever drink a diet coke again, with or without bubbles. So you can hope it's possible to taper off your PPI in the near future. Good luck.

Whoa! @@BariatricGirl ... those are both great references. Thank you.

@@gowalking ... I feel just like you. What a miserable life I had just prior to WLS. What an amazing difference from my life today. Why would any of us risk going back to that hot mess?

I don't dispute the weight control aspects of the pick it and stick it approach. However ... if we eat the exact same foods most of the time, we're also choosing to limit our nutrition to those foods' components (including their trace elements) and failing to realize the benefits of a broader diet (with additional trace elements and other nutrients). Obviously, I'm not talking about expanding our diets to include a variety of slider foods. Right now I'm entranced by apples. But I'm also trying to eat other fruits that are currently in season and vine-ripened, like peaches, strawberries, blackberries, cantaloupe -- foods that are delicious and nutrient-laden that I don't have access to year-round. So every week I'm trying to focus on one new fruit and one new veggie. One thing I've observed is that for decades I haven't devoted much attention to my food choices or put much effort into choosing foods for their nutritional benefits. I just ate what was handy and what I was used to eating. I'd now like to introduce much more healthy variety into my menus. Thoughts?

I'm confused. What does that conversation have to do with YOUR goal for yourself? Lots of people at your starting weight have lost ALL their excess weight. How much weight you lose is totally dependent on your behavior -- the choices you make, the attitude you maintain. For the record, my surgeon never gave me a goal. He asked me what my goal was (150 pounds) and then he said, "You're going to do GREAT!" I started at 235 pounds. This morning I weighed 143.4 pounds. You can reach YOUR goal, too. And by the way -- if you ever have this kind of unsettling conversation with a doctor again don't sit there like a knot on a log and then later go cry in your car. Ask him if he's serious or kidding. Tell him about YOUR goals. Say, "WTF?!" Be your own healthcare advocate. Otherwise, you'll just wind up drifting away and avoiding the support that your surgeon and his team could provide to you in the future.

What fun! How cool it must feel to be so physically active and capable. Love your pix.

Honey, you're in one of the many primes of life. Grab that brass ring and have a blast. Create your look and your life. Ain't nobody gonna do it for you.

Nope. No doubts. It boils down to this: How badly do you want to be healthier?

I agree with you -- losing only 15 pounds in 23 days is awful. Horrible!

I could eat a lot of foods early. But not salads. They didn't work for me until about three months post-op. Your stomach will know.

Young thing ... Do yourself a favor and measure out (with an actual tablespoon measuring tool) how much a tablespoon of Peanut Butter is. Don't guess at it -- actually measure it. That's 95 calories. You'll have to walk a mile to burn up the calories from that alone.

I am not a cottage cheese fan either. There's plenty of other protein-rich fish in the sea. Metaphorically speaking.

Not Indian here either, but I've been to India four times. You sure have the right attitude toward WLS and how to be successful long-term. I think you're doing great.

Straight-up question: Are you tracking your food intake? Do you know how many calories you're eating? How many Protein grams you're eating?

Depends on the comparative skills of your surgeon with and without the robot and (if you choose the robotic approach) the operational maintenance on the robot. I'd skip the robot.

The more reliable research findings I've seen in this area support the consistent conclusion that individuals' differing genetic "instructions" convert calories to more or fewer pounds, depending on a wide-ranging calories = pounds equation. For example, these summarized findings at http://spectrum.diabetesjournals.org/content/20/3/166.full ... One study examined the effects of overfeeding on weight gain in pairs of monozygotic twins.24 Although all of the individuals in the study consumed the same amount of calories for the same amount of time (approximately 3 months), there was a large variation in the degree of weight gain, from 8.8 to 29.3 lb, among different individuals. However, the amount of weight gain was very similar within each twin pair. The reverse also holds true. When moderately obese monozygotic twins were kept on a low-calorie diet, the amount of weight loss varied greatly among different pairs of twins.25 However, within each pair of twins, the amount of weight loss was quite similar. These results indicate that the body's response to changes in caloric intake is dictated at least in part by genetics. Another line of evidence supporting the role of genetics in body weight regulation came from comparison of metabolic differences in individuals belonging to different ethnicities. In one study, a group of overweight women (average BMI ∼ 29 kg/m2) were kept on a low-calorie diet for a period of time until their BMI decreased to < 25 kg/m2, the defined upper range of what is considered normal weight.26 When these age-, weight-, and BMI-matched women were separated based on ethnicity (in this case African-American or white), differences in resting energy expenditure were apparent before and after weight loss. Although this study involved only a limited number of subjects, the results nevertheless suggest that individuals belonging to different ethnic groups differ in metabolic efficiency; those with lower energy expenditure while maintaining the same body weight are more efficient and therefore more prone to weight gain. Interestingly, African-American women had larger decreases in resting energy expenditure after weight loss, suggesting that they may be at higher risk to regain the lost weight. In addition, children belonging to different ethnicities also have different resting energy expenditures.27

This "new 7,000 calories per pound" story is getting a lot of traction in the popular press. However, it's getting excoriated in academic circles. A few days ago I ran both models (3,500 cals/pound and 7,000 cals/pound) using my own 91+ pound weight loss and my MFP calorie records over the past 13 months to see which one worked best. And lo and behold -- the 3,500 calorie model is right on the button (predicts within 5 pounds how much I would have lost, given how much I actually ate). But the 7,000 calorie model was super-off. So I'm not impressed by this new "finding." In any event, it doesn't predict my own body's weight-loss behavior.

Yup. Real life. Put a little on. Take a little off.

You're making me LOL. You seem to think you've earned a weight loss of greater than one pound a week the last three weeks because you're eating so little. But by your own "logic," you also didn't earn a 30-pound loss the first five weeks post-op. That was "too much" for you to lose, given all the calories you were eating those weeks. Big protip: Our bodies don't lose weight in a straight line. The scale moves in fits and leaps. It doesn't drop predictably like a car's fuel gauge. It simply doesn't work that way for anyone. The universe isn't picking on you. Your body is adjusting right now after a huge weight loss, some of which was fluids. It sounds like you've lost 33 pounds (?) in 8 weeks. That's an average weight loss of over 4 pounds a week, which is great. FYI, I lost 10 pounds the first month post-op and 11 pounds the second month. Here's the bad news: You're not going to lose 4 pounds a week every week for the rest of your WLS weight losing career. It's going to slow down. Here's the good news: If you follow your surgeon's instructions and eat what you're supposed to and don't try to get so creative you screw things up you will lose all your excess weight. Just. Follow. Your. Surgeon's. Directions.

Uh, yeah ... the obvious first: get rid of all candy bowls. Permanently. I'll offer a little different take on this: Y'all are being very sweet to ease his way into post-op life. Way to go! But eventually (very soon, actually), your father must be responsible for his own reactions to the food discomforts and temptations that life will put in front of him. Just sayin'.

Here are my responses. They're valid for now -- and could change in the future. 0. What type of weight loss surgery have you had? Gastric sleeve 1. How long have you been in maintenance mode? 3.5 months 2. What's your current height and weight? 5'5" and 144 pounds 3. How many calories do you eat daily (on average) to maintain your weight? I recently found my sweet spot for now - 1,650 calories/day 4. What kind of focus do you put on Protein -- number of grams or anything else you want to say? I eat 100-120 grams of protein a day. I eat protein first at mealtimes. I get my protein from fowl, fish, meat, dairy, grains and legumes. I don't eat many nuts because they're so high-cal for just a little protein. I do drink a Protein shake most mornings for breakfast; otherwise all my protein comes from "regular" food. 5. What kind of focus do you put on carbs - number of grams or anything else you want to say? I never went low-carb even during the weight loss phases. These days I eat 150-200 grams of carbs a day. I aim for 5 veggies / fruits a day and make that target about half the time (I need to focus on that more). I am eating more whole grains and very seldom eat processed or white flours. I have dessert about 2-3 times a week and only small amounts. 6. What other nutritional tips / tricks are working for you that help you maintain? I plan each day's menus and track all my food and drink using My Fitness Pal, so I am very aware of what I really am eating; no guessing going on here. And I measure my food well, too; again, no guessing going on here. EDIT: I also weigh every day, but keep my eye most focused on my weekly and monthly weights, which give me a clearer view of my weight trends. 7. Which foods, if any, do you avoid altogether? So far, nothing's on the NEVER list. That could change. But I'm VERY leery of chips and crackers. Those crunchy things are dangerous to me! 8. What exercise regimen (exercise types and frequency) do you follow? I do a lot more housecleaning and walking than I used to -- on treadmills, outdoors, in malls, etc. Right now (summertime) I go to the gym only once a week for weight lifting or a bodypump class. This fall I hope our travel schedule calms down a lot and makes a gym schedule easier to follow. 9. What role, if any, has counseling or therapy played in your WLS success? I see a therapist once a month (started a couple months pre-op). He's been great for me in keeping me focused on what I need to pay attention to and become less impulsive. 10. What advice would you offer WLS patients to help them be successful? Don't expect your new sleeve's restriction will change your life permanently. It's a great tool and gives you a great advantage in losing weight fast. But if you don't learn how to make better food and nutrition choices, eat differently (protein first, eat slower), stay well hydrated, choose to move your body a lot more, stop using food to numb your discomforts, stay positive and focused on your goals, etc., you won't be successful long-term. It's not hard to learn these new things. You just have to continue the commitment you made when you decided to have WLS. This is a miracle opportunity to change your lifestyle permanently and be healthy the rest of your life. Please don't waste this miracle.