JamieLogical

No matter how you break it down, weight loss still boils down to energy in versus energy out. By putting protein first, relying on your restriction, avoiding grazing, not eating slider foods, not drinking your calories, not eating and drinking at the same time, and staying as active as possible, things should even out pretty well for most people. If, however, regain or stalls become an issue, it is DEFINITELY a good idea to closely examine calories and macronutrients to see what might be going on. In a perfect world, we could all eat our protein, walk a couple miles a day, and happily maintain at our ideal weight. Unfortunately, we don't live in a perfect world and it is easy for things to go awry. So having as much information as you can to be able to identify the problems and work to improve them is the way to go.

If you have pre-existing health issues, such as acid reflux or diabetes or anythign that would require you to lose the weight extremely quickly, then RNY might be the best option. Otherwise, I would go with sleeve. Since I didn't have any comorbidities and my starting BMI was just over 40, I felt like I didn't need as "extreme" a solution as RNY. Here were my main concerns about RNY for myself: low starting BMI, no real need for the malabsorption hated the idea of my intestines being rerouted hated the idea of my unused stomach staying inside my body where it could get ulcers or cancer and not be accessible with a normal endoscopy more joins meant more potential for leaks didn't want to lose the use of my pyloric valve saw no need to commit to a lifetime of malabsorption, when restriction would be sufficient didn't like the idea of dumping syndrome the idea of my pyloric valve still being over there attached to my old stomach and opening and closing based on signals from my pouch really weirded me out higher risk of late onset complications years down the road

Okay. Some of you who know a little about me, know that I have already been kind of struggling to maintain my weight as I was training for a half marathon (now training for a marathon). Throughout the course of the 14 week half-marathon training program, I managed to keep my weight pretty steady around 160 with only mild fluctuations. I got a FitBit and tracked all my food to make sure I was eating back the extra calories I was burning. But now I have a whole other problem. My husband and I are going through some serious marital challenges. It has caused me a lot of stress and sleepless nights and I am just not wanting to eat AT ALL. I want to be training for this full marathon in September, but I am eating maybe 1500 calories a day if I REALLY push it? On Saturday, I had breakfast at like 8:00, then I met my sister in the afternoon. Driving home from meeting my sister at about 4:00 I realized I hadn't eaten since breakfast! I am way off of my game. Yesterday I was down to 157 pounds, the lowest number I've ever seen on the scale. I don't know how to force myself to eat. It was one thing when it was just a matter of fitting in enough "feedings" to get in my calories with the marathon training. Now it's not only that, but I just feel constantly nauseous from the stress, worry, anxiety, and grief. I know there are others of you who have gone through rough times post-op. Whether it be relationship issues, job issues, a death in the family, etc. How did you stay on track and stick to your eating schedule through those tough times?

I definitely think it was worth the pain and money and I even had complications that made my life miserable for a lot longer than most! Those are all a distant memory now and I only have two more payments left on the loan I took out for plastics. So it is definitely well worth it now that I an clear of the pain, almost clear of the financial stress, and still enjoying my results every single day!

@@reallyrosy The way in which you lose weight and how quickly you lose weight definitely impacts your metabolism. The contestants on the Biggest Loser lose weight incredibly quickly by having a MASSIVE daily calorie deficit. We are talking calorie deficits of 7000-9000 a day! That is insanity. Of course that's going to wreck your metabolism! Unless you are starting at 600+ pounds to where your Basal Metabolic Rate is something crazy, like 10,000 calories a day, there is no way that a WLS patient is going to have the same kind of calorie deficit Biggest Loser contestants do. I don't know how old you are, but I plugged your other stats into a BMR calculator and, if you are sedentary, you're BMR is only 2101. In that case, you are in absolutely NO danger of having the caloric deficit of a Biggest Loser contestant post-WLS. You will likely have a much more modest deficit of 500-1000 calories a day unless you drastically increase your level of activity. A deficit like that is going to allow you to lose slowly and not wreck your metabolism.

@@Sandi73 I am so so sorry to hear this news. If it's true that WLS just can't be in your foreseeable future, then there are still steps you can be taking (like you already have) to lose weight and improve your health. Will it be hard? For sure! But you have such a great attitude that I really think, if anyone can do it, it's you! I also want to say that you should never say never. Right now, the situation looks grim with your current insurance and the changes in your policy next year. But things change. Who knows what might happen down the road. More and more insurance companies are seeing the long-term benefits of covering WLS, so their policies may change over time. You might get access to new insurance at some point. Hell, eventually you'll be on Medicare which can/does cover WLS. So don't think that this is the end of the road. It's just the beginning of a different journey. It may not be the journey you had in mind, but it's still within your power to make the most of it.

It doesn't matter HOW you lose weight... if you lose over 200 pounds, you are going to have loose skin. Most people will have loose skin even if they only lose 100 pounds. I had skin removal surgery after only losing 90 pounds. There are a lot of factors that come into play, but with that much weight to lose, you are definitely going to have some loose skin. As you are losing weight, here are some things you can do that *might* help: stay hydrated... Water is very good for your skin moisturize daily... ideally twice daily take your supplements... Vitamin C and E are shown to help with skin elasticity strength training.... building muscle can help "fill in" loose skin a bit But your age, genetics, how much weight you have to lose, and how quickly you lost can all play a role in how much skin you'll end up with. The thing you REALLY need to keep in mind is that, while loose skin isn't desirable, it's not going to kill you. Carrying around an extra 200+ pounds WILL kill you.

I didn't only because I knew I had to go cold-turkey with the caffeine for 30 days post-op and I figured it would be easier to make that transition as part of my pre-op diet. As long as you aren't putting sugar in your coffee or using sugary creamers, you should be fine.

I'm just going to back slowly out of this thread.... you lost me at "cosmic rays"....

The argument is that you might swallow air. But that seems silly to me. I've still avoided them for the most part, but the few times I've drunk from straws without thinking about it, I've suffered no I'll effects.

@ The restriction with liquids is temporary and due to internal swelling and trauma. Not everyone even experiences it at all and some people take longer than others to heal up. But once you are healed, liquid passes through your sleeve as quickly as you drink it, so it will no longer be a problem.

You just have to keep working at it. I was able to get mine in more easily once the internal swelling went down by the two week mark.

8 Fluid ounces of water weighs pretty much exactly 8 ounces. Since Gatorade and G2 are both like 99% water, I'm comfortable just weighing them in ounces for the purposes of calorie tracking.

I weigh my Gatorade too. Not that I drink it often, since I don't want to drink my calories. But when I do long runs for my marathon training, I have to drink G2 to replenish my electrolytes and I do weigh it so I can accurately track it. This seems redundant for me. I track Fluid ounces for liquids. Well yeah, but unless you are pouring them into a marked container or filling a specific size container, how do you figure out ounces other than weighing? I buy the big bottles of G2 and fill my hydration belt bottles with G2 and ice. So weighing the bottles as I fill them is the only way to track the calories.

I weigh my Gatorade too. Not that I drink it often, since I don't want to drink my calories. But when I do long runs for my marathon training, I have to drink G2 to replenish my electrolytes and I do weigh it so I can accurately track it.

Typically, the requirement for WLS approval is a BMI of 40. Some insurance will approve a BMI of 35 if other comorbidities are present (diabetes, sleep apnea, high blood pressure, etc.). Since your BMI is over 40, then the existence of comorbidities shouldn't be required. Your BMI right now is over 50, so it definitely shouldn't be an issue.

The quickest route to ketosis is to stay under 20... that's why 20 grams is the first stage of Atkins and then you gradually add carbs back. But every surgeon's pre and post-op plans are different. Best to stick to you surgeon's plan so if anything comes up, they will have a better idea of how to handle it.

I didn't. I just found that picture on google. You could easily make your own with a clear plastic bottle and a Sharpie.

I got you. Just finished my reply.

Be sure to post back and let us know how things are going. I should have listed "Stay active on the forums" as one of the keys to success. It definitely helps motivate me and keep me accountable!

But your liver will shrink by just putting your body into ketosis, which you do by consuming under 20 grams of carbs per day. Clear liquids is not a requirement for shrinking the liver. The VAST majority of us are able to drink low carb Protein shakes while on our pre-op liver-shrinking diet.

It actually gets "easier" after day 4 or so. By then your body will be in full ketosis and the headaches, lightheadedness, and moodiness should pass. It will likely still really suck, especially your energy levels because of the restricted calories. But at least transition into ketosis will be over. Whatever you do DO NOT eat carbs. If you have to cheat (please don't) make sure you are doing so with protein only. Carbs will kick you back out of ketosis and you will have to go through the whole process of headaches and misery all over again when you get back on track.

I just went on vacation with my husband, parents, sister, and brother-in-law last month. I had fits trying to convince my parents and sister that I am still technically overweight and they don't have to freak out about me maybe losing a couple more pounds while I'm training for a marathon.

Yep! You are definitely not alone. Trust and believe that there is likely someone (possibly lots of someones) here and active going through the exact same issues you are currently. And most of us have been through them or will be going through them soon!

You should start with the "5 Day Pouch Test", which you can google for the specifics. It's basically an abbreviated version of post-op food stages to help you identify your restriction and kick your carb habit. From there you should do the following: Aim for 80-100 grams of Protein per day Always put protein first at every meal/snack Drink at least 64 oz. of Water per day Take your Vitamins Eat probably 5-6 times a day, but include protein every time Don't worry about stopping drinking before eating, but definitely DO NOT eat and drink at the same time Don't drink your calories Avoid slider foods (anything with a high liquid content or anything that begins "desolving" in your mouth) Avoid grazing. Make sure you eat a set number of times per day on a regular schedule. Track your food Start walking or some sort of daily exercise/activity Might also be worth putting in a call or email to your original nutritionist. And I would also recommend getting/using an activity tracker to start keeping track of your steps/activity each day.