Trillium

Surgery on December 29th. So excited! Just saw this TEDx lecture on how to psych yourself into successful habits by keeping your eye on the prize. If you watch it, I'd love to hear your ideas for how to apply these techniques post-surgery. http://www.ted.com/talks/emily_balcetis_why_some_people_find_exercise_harder_than_others

In my experience, the materials given to bariatric patients and "support" from paraprofessionals and insurance company nursing consultants have not caught up to the science. (The welcome brochure from the hospital has a scale indicating "calories in / calories out." Bogus!) They are still talking about emotional eating and obesity as a failure of self-control. This is not only dated but cruel, and counterproductive. My surgeon is the only one among her staff that is apparently willing/able to discuss the complex mix of genetics, gut microbes, hormones, and obesogenic factors that may underly my BMI. Imagine a breast cancer patient being forced to walk a gauntlet of people who assumed her morally culpable for her DNA, toxic mattress, drinking Water, medications, stress levels, etc, and asked her on every form, in every conversation, "what have you done?" and "what are you doing?" to prevent these cells from invading your body. This is not trivial, as our ideas about our own obesity appear to be critical to success after surgery: http://esciencenews.com/articles/2014/10/23/how.people.view.their.own.weight.influences.bariatric.surgery.success I view my excess weight like it's a cancer, a growth I do not want, did not ask for, and YES, may have encouraged through any number of life choices. (For starters, I should have refused all those antibiotics. I should have been eating anti-inflammatory foods, not low fat, in my crazy youth. I should have married someone who cooked, and moved to a bike-friendly city. So many wrong choices!) If some day, in spite of our efforts to protect them from cancer and obesity, my children end up seeking treatment, I hope they get it from professionals whose prejudices do not infect their care. Who give them facts, not unsupported ideas, about the best route to health. Oh, and about all those inflammatory processed bariatric "foods" my clinic is pushing? Don't get me started. /endrant

People vary. I am scheduled for a sleeve in late December and have been taking phentermine for five weeks now, prescribed by my bariatric surgeon. I feel great, and love seeing the scale move in the right direction. I've been asked why I don't forgo surgery and stick with phentermine, as it is doing the job. But I know it isn't a permanent solution. My brain will find a way a work around to rev up my hunger hormones and fight weight loss. Meanwhile, it keeps the rabid rodents of hunger from gnawing at my insides and invading my mental space! It helps me stick to 1400 calories and gives me energy to exercise. Almost 20 years ago, I lost 50 lbs while on phen/fen before it was yanked by the FDA for causing heart problems in some users. I was heartbroken, as it was the only thing that kept my hunger in check. However, if I'd continued taking it, it would probably have lost its effectiveness in time, even if my heart had stayed healthy. Now for a little rant! A lot of the materials given to bariatric patients and "support" provided by paraprofessionals and insurance company "consultants" (I talked to one yesterday who is supposedly an expert) have not caught up to the science. They are still talking about "emotional eating" and assuming obesity is a failure of self-control. This is not only ridiculous but counterproductive. My surgeon is the only one among her bariatric staff that is apparently willing or able to discuss the complex mix of genetics, gut microbes, and obesogenic factors that underly obesity. Imagine a breast cancer patient being forced to walk a gauntlet of people who thought she was morally culpable for her DNA, her toxic mattress, drinking Water, medications, and stress levels before she could get life-saving surgery. This is not trivial, as our ideas about our obesity are critical to our success after surgery: http://esciencenews.com/articles/2014/10/23/how.people.view.their.own.weight.influences.bariatric.surgery.success How do YOU talk to yourself about your obesity? Do you think it makes a difference?

I guess that's what I mean by deny (I should have been more specific!). I have no comorbidities unless hypothyroid is considered as one.

What a strange pickle I'm in! My surgeon warned me that if I lose too much between now and my projected sleeve date in December (still waiting for approval letter to set the date), I will drop below the minimum BMI required by my insurance. Has anyone here been qualified at first weigh in and later denied for losing too much?

I like your sense of humor. The pot industry IS well organized. Travel guru Rick Steves helped get the votes here in Seattle, and I was persuaded to vote yes to legalize to reduce crime, bring in public revenue, save billions on enforcement, etc. etc. Also, my sister really needs it for pain management, and now she can stop freaking out when the doorbell rings. I noticed that our local Jack in the Box has been advertising a "munchies menu." Maybe junk food sales will go up? Washington State doesn't cover bariatrics in its insurance exchange, either. We fatties SHOULD organize and persuade states that surgery saves lives, reduces lifetime insurance costs, and (this is the tougher sell) brings in revenue. What do skinny people spend more on?

How crazy-making is that? Can you get your doc to prescribe an appetite suppressant? I have been eating 1200 calories a day with the help of phentermine, prescribed by the surgeon who is going to do my sleeve. I am still waiting for insurance approval, and was cautioned by my doctor that if I lose too much, I risk dropping below the threshold (40 BMI unless comorbitidy, then 35 BMI). Damned if you do, damned if you don't! I am tempted to show up at my next appointment with rocks in my pockets.

I am getting my sleeve done in early December by Dr. Judy Chen at Swedish. Currently trying to lose weight with phentermine and protein shakes (which I hate). How much did you lose before surgery?

Hi Pamela, I am going in next week for my last appointment before setting a date for surgery, and I'm excited and nervous. Not sure yet if my surgery will be in October or November (I have a family reunion to schedule around), but would love to support you through yours. How is it going? Julie