VSGAnn2014

Here's what I was advised about calorie intake by my medical team. The first four months or so it's difficult for most people to average much more than 800 cals/day. At least, that was true for me. But after four months post-op, my surgeon's Physician's Assistant who is wonderfully conversant with all the latest research about bariatric surgery and nutrition, strongly advised me to start raising my daily calories to keep my body's metabolic rate from stalling. She advised that I raise my daily calories to 1,000 for Months 5 and 6 and then raise my daily calories to 1,200 thereafter until I reached my goal (150 pounds), which I hit at 8.5 months post-op. I then used my own My Fitness Pal calorie records, which I'd kept since 2.5 months pre-op, to estimate that a maintenance calorie budget of 1,700 calories would keep my weight stable. I gradually raised my daily calories up to that level, which took a couple of months. Interestingly, during the next 8 months I lost another 15 pounds. And now I'm maintaining at 135 pounds while averaging 1700 - 1800 calories a day. I always know that things could change. I weigh myself every morning and still plan and track my daily menus in MFP, which takes no more than 5-10 minutes a day. I figure this is a lifetime dealio, and that doesn't bother me at all. BTW, I was sleeved at 68 years of age and am now 70 years old. I'm a lot more active than I was pre-op, but I'm not a gym rat. Most of my "exercise" is achieved through walking, hiking, housework and gardening. I do a little yoga / stretching / weight resistance, too. BIG CAVEAT: People's bodies vary a lot in their caloric needs after WLS. But no matter what it is, it is what it is. If you read the recent NYTimes article about what happened to the 2009 (Season 8) Biggest Loser contestants' metabolic rates as a result of their participation on that program (ugh!), you know that their extreme caloric deficits while losing weight made their metabolic rates fall dramatically, and they've never come back up. For that reason, I am so grateful that my weight loss rate was less than heroic and that my surgeon's P.A. advised me to raise my calories gradually while I was still in the weight loss phases. Very best to you!

@@FinallyFree! ... good point about portion sizes. When someone says, "I eat only small portions ...." I know I don't know how large or small their portions really are. When someone says, "I ate 3 ounces of chicken ...." I assume they either (1) actually weighed the chicken they ate or (2) they guesstimated how much chicken they ate, in which case they were either right or they were wrong. Portion creep happens. I have to periodically measure everything to keep creep from happening on my plate. And the one food I ALWAYS have to measure (or I will always under-guesstimate how much I'm eating) is cheese. Damn, cheese. I love it so much. And that's why I keep weighing it.

Below is the gist of what I posted on my first year surgiversary. I'm now 20.5 months post-op, have lost 100 pounds and am now maintaining happily and easily at 135 pounds. Very best to you! Ann A year ago yesterday I was sleeved at age 68. I knew I had the energy for one last shot at getting healthy. Like so many of us, controlling my weight was the one thing in my life I’d been unable to manage. Failing at that was a tremendous embarrassment and disappointment to me, not to mention the cause of mounting medical comorbidities that had almost sidelined me from life. A year ago I’d already been on WLS forums for 9 months. I could not WAIT to get my WLS show on the road. I’d already lost almost 20 pounds on a 2-month 1,400 calorie diet of my own and, later, my surgeon’s 14-day pre-op diet. I’d been practicing for months the behaviors I’d learned here—eating slower, chewing more, no more soda, a lot less coffee, no NSAIDs (ouch!), walking more (yea, Fitbit!), and my favorite tool of all—planning meals and tracking my food and drink on www.myfitnesspal.com. Fast-forward to yesterday morning, my first surgiversary. I weighed in at 143 pounds. I feel great, physically and mentally. I look so much younger (I’ll be 70 years old in December). And I truly feel like I’ve been reborn. How I Lost the Weight I was lucky—had no complications, had a great surgeon and team, healed well and recovered fast, and have had more non-scale victories (NSVs) than you could shake a stick at. I’m full of gratitude and amazement at all of WLS’s benefits for me. Below is a list of things I did (mostly pretty well) that led to my success. As always, your mileage may vary. This was my experience. Yours will be yours. • Ate the minimum amount of protein—at least 60 grams to start with (hit that target on Day Five post-op) • Ate Protein first at every meal • Drank 8 glasses of Water daily (or at the very least 8 glasses of liquids daily) Protip #1: Dehydration slows weight loss and makes you feel like crap. Protip #2: Our kidneys work overtime when we’re losing weight rapidly and need lots of water to function well. Protip #3: You can actually die from dehydration. • As healing happened and restriction eased, added healthy (colored) veggies, then non-starchy fruits, then whole grains • Took my vitamins/minerals and Rxs daily and on schedule • Ate 3 meals a day • Chewed my food well and ate more slowly • Didn’t drink 15 minutes before or 30 minutes after a meal • When I got hungry (not bored), I added one or two Snacks of healthy food • Didn’t graze between meals (note that “a snack” and “grazing” are different things) • Avoided / minimized highly processed, high-carb foods and slider foods like potatoes, white rice, white breads, crackers, Cookies, chips, ice cream Protip: These foods slow weight loss and, for some people, trigger binge eating. • Moved more than I used to move and gradually kept moving even more • Followed the Number One Exercise Rule for Old People: Don’t injure yourself! • Got some sunshine daily, which kept me full of happy thoughts and Vitamin D • Tried to sleep 8 hours a night • Minimized stress—for me, this meant I stopped sweating the small stuff and learned that most stuff really is small stuff • Am seeing a shrink to understand better why I couldn’t or didn’t care for my health better prior to WLS and to learn how to do better in the future (as the saying goes, they operate on your stomach, not your head). Unsolicited Advice: I’ve been at or below goal for 4 months now. Here are some things I learned while losing weight and during maintenance (at which I’m still a newbie). Some of these things have surprised me. And as always, your mileage may vary. • Don’t feel pressured into telling the world you’re having WLS. Do what is best for you. Just know that “telling a few people” may not be the best way to keep your WLS private. There are a lot of mouthy people out there. I'm on the down-low about WLS; other than my medical team, only my hubby and two good friends (who don't live anywhere near me) know about my WLS. • Don’t overeat, but don’t starve yourself either. As your healing continues, eat more healthy food and raise your calories gradually. Otherwise, you may wind up reaching your weight goal but only able to maintain it eating 1,000 calories/day. Ugh! At 143 pounds, my daily maintenance calorie budget is 1,700 calories/day. I am over the moon about that. I think it’s because I didn’t starve myself while I was losing weight. I ate 800 calories during Months 1-4, 1,000 calories during Months 5-6, and 1,200 calories during Months 7-8. As my calories went up, so did my protein grams. I still aim for 100 grams of protein daily. • Post-op, don’t just eat to lose weight—also eat to become healthier. Learn more about nutrition—macronutrients, trace elements, vitamin and mineral supplements. Read articles and good research. As smart as I thought I was, turns out I didn’t know nearly as much as I needed to know to care well for myself. • If you’re craving sugar, you’re probably already eating sugar. The only way I know to kill those cravings is to cold-turkey the sugar. • Don’t let anyone pressure you into having WLS. This is a life-changing deal. A year down the road you’ll probably be able to eat pretty much anything you want, although not in massive quantities at one time. And you’ll need to always be vigilant about your nutrition, meal-planning, eating behaviors, etc. • WLS won’t prevent binge-eating or emotional eating. It will discourage it, but it won’t prevent it. There are plenty of WLS patients who’ve learned to eat and drink around their tools. I personally know folks who’ve wasted their sleeve, bypass or band with (sigh) sweet tea, Mountain Dew, beer, Wheat Thins, ice cream, chips and dips. What those drinks and foods all have in common, other than being high-calorie and lacking in nutrition, is that the sleeve cannot challenge them. They move rapidly through the sleeve and into the small intestine. You can eat that crap all day long and never start to feel full. Remember, it’s a shame to waste a sleeve. Very, very best wishes to everyone out there considering a VSG or other form of WLS. You can change your life with WLS if you use your tool well. But you must understand it’s only one tool in a bigger healthcare arsenal that you must acquire and use daily.

Surely, you know about HIPAA? Any therapist you see is bound by HIPAA rules.

I would urge you to seek professional help sooner rather than later -- and if you can find a therapist who also works with bariatric patients that would be a great resource for you. Very best wishes to you. And welcome to the board.

What has caused the ulcers?

I found a good therapist who's been a great resource to me. I encourage you to find one who can help you process everything you've been through and are going through.

Daisee, bodies are different from one another. A LOT different. There's a recent thread here about how many calories people who are one year (or more) post-op are eating. It's at: http://www.bariatricpal.com/topic/366690-a-year-out-from-surgery-what-is-your-daily-diet-consist-of/ It's got lots of good info for you and will show you the variety of eating programs people have developed to maintain on. In my instance, I was eating 1,200 cals just before I hit goal (150 pounds) -- about 8.5 months post-op. I hadn't been a fast loser at all, but that was no problem as far as I was concerned. Anyway, I've always recorded my calories and other macronutrients on My Fitness Pal. So using that data I calculated that 1700 calories would be a good maintenance spot for me. So I started GRADUALLY raising my calories up -- no more than 100 calories/week. Honestly, it took me at least a couple of months to get the cals up -- restriction and all that. Anyway, I kept losing weight -- averaging 1.5 pounds a month -- until 8 months later I was 135 pounds. The last 5 months I've averaged between 1700 - 1800 calories, depending on my activity level, and I've maintained at 135 for the last 4-5 months. Some folks are maintaining at 1,000 calories/day, others at 1,200, others at 1,500, others at 1700-1800 like me. Others are eating even more. (Those are all women.) And men seem to be about 300-400-500 calories higher along the same range. At least, that's how it seems to me.

@@wondering1 ... I think 1200 cals/day sounds great. I averaged 1200 cals/day during months 7-9 post-op. And I averaged a monthly 5 pound weight lost during that time. Sounds like you have found a great sweet spot.

LOL! Yeah, you're gonna be fine.

Not that there's anything wrong with looking butch!

@@Lucilla ... just saw this thread .... My first month post-op (which is where you're at now) I lost 10.4 pounds. I started at 235.6 pounds, was sleeved, have lost 100 pounds and now weigh 135 pounds. I'm 20.5 months post-op. Don't worry about how fast you lose (by the way, I think you're losing pretty darned fast). And also realize that the first month made a lot of us pretty "tetchy" and emotional -- while the old hormones stored in fat cells are being pushed out into the blood stream. You're doing fine.

Why is this person still allowed to post here? I've seen people banned here for less abuse than she/he has exhibited in this thread.

One point ... if you are one of those for whom alcohol does not give you much of a buzz anymore you are probably in more danger. You *might* have a tendency to drink more than you once did to find that buzz. The extra drinks would put your liver under strain at a time when it's working hard to detox your body. No judgment. Just info.

@@LaDivaDev ... you rock! You're going to continue to do great after surgery. Best wishes for a perfect surgery and easy recovery.

It's an oldie, but a goldie ....

Absolutely true.

I love romaine lettuce hearts! Took me a long while to be able to tolerate lettuces / salads. But they're back on my play list now.

And this is why Thanksgiving Day dinners with extended family and friends are so popular! More seriously, those who are into mindfulness based cognitive therapy would suggest that you are allowing your thoughts (which are, frankly, pretty darned meaningless) turn into obsessive meditations that are now controlling your behaviors, your decisions, and your peace of mind -- even your happiness. Thoughts really aren't very important -- unless we think they're the most important thing in the world. "Analysis" is seldom as high-level as that word sounds. Mostly, what we consider "analysis" is the process of becoming fixated on "facts" which aren't actually facts but just -- right, again -- thoughts. This is sometimes referred to as "chasing your tail." I recommend this book: Mindfulness: An eight-Week Plan for Finding Peace in a Frantic World by Mark Williams and Danny Penman.

Message boards are communities. They all have their "personalities." Not everyone is comfortable in every community. I notice you haven't been active here long. My experience has been that the more I contribute to a message board, the more benefits I get. The bottom line (for me) is that I come here because of community, because of the people here whom I enjoy. I have made friends here. And I make more all the time. If I didn't enjoy the people here, I wouldn't stay here. I hope you find some friends here whom you enjoy and continue to make more. And @@Christinamo7 is right -- if there are people here (including me) who consistently irritate you, put 'em on ignore. Life's too short to be constantly irritated. You've got many more important challenges now, two weeks post-op, than dealing with people on a message board who irritate you.

From what I've seen here about how kids react, they do just fine. A year in their lives is nearly infinity, so I predict they'll just get used to you. To wit, I remember reading one mother's post here in which she said her kids looked at pix of her when she was heavy and said, "We don't remember when you looked like that." Re the other people in town ... if your townsfolk have a dominantly fit/active lifestyle, I predict you'll find a lot of new friends. Fit, active, slim people have been the most supportive of my new bod. Heavy folks are the ones who lean in and whisper, "Aren't you getting too skinny?" No matter how it plays out initially, a few years post-op, you'll be more comfortable with your slimmer, healthier body and lifestyle. And others will be getting used to it, too. P.S. I've lost 100 pounds and weigh 135 now. I'm 20.5 months post-op.

I'm confused -- how did your PCP actually diagnose that you had diverticulitis -- using what evidence? Did he/she do a colonoscopy, for example? Are there any specific tests he/she did to determine you suffer from diverticulitis?

I know that for me life's serious stresses and justifiable angst don't inspire me to overeat. But celebration, partying and being overserved certainly do. And then there's the simple power of a new *habit* -- eating and drinking in a new way over a month's time -- that can be either positive or dangerous for my weight maintenance. Consistency in one's behavior can be leveraged for good or evil. Examples: The holiday 8, the freshman 15, the newlywed 20, the quitting smoking 30, etc. Check out this interesting article about life events that contribute to weight gain: http://www.thedailybeast.com/articles/2011/11/09/will-i-get-fat-15-signs-you-ll-gain-weight.html

There are already two recent threads about this article.

Geez. And I thought things were going well lately. If you have a specific issue with someone, why not approach them directly with a PM?