drmeow

The key really is to know your farmers. I buy organically raised, pastured eggs, chicken, beef and raw milk (though I rarely have milk anymore, just occasionally heavy cream) from a farmer that I know, I've seen all of his animals and talked extensively with him, etc. (He follows Joel Salatin's type of farming) I am very lucky to be 30 min away from this, and another farmer for beef (I just put 87 lbs of pastured beef in my freezer last week), strawberries and blueberries (pick your own) that I've been buying several years. I realize many people don't have those options.

I think, in addition to BigAg going for profits, is the fact that people still want food to be cheap. With all the govt oversight for "safety" and various middlemen for slaughter, packaging, transport, etc. it adds costs, and in the case of milk, there are govt price controls to keep it below a certain cost b/c it's considered a mandatory food for everyone (so not true).

Buying a gallon of milk or a dozen eggs straight from the farm eliminates so much of those costs, and if everyone could do that, the prices would sort themselves.

Not to mention make much healthier food for everyone.

makes sense b/c it breaks down Protein

I have read that some people have delayed dumping, where the feeling happens an hour or more after eating. have no idea for sure.

I'm not post-op yet but as someone who has always had a sweet tooth and cravings, this is something I do worry about after surgery. I know that when I've done very low carb diets, the cravings went away, but as soon as I allowed myself the smallest amount of something creeping in, they came back with a vengeance. So maybe look at what you are eating and see if there is something a little too carby that could be triggering this. Even the Protein shakes (and esp bars) sometimes have too many carbs. Even some artificial sweeteners can raise blood sugar in some people, acting just like sugar.

Right now, pre-op, when I crave something sweet after eating (years of dessert have conditioned me) I eat a small dill pickle. The sourness does cancel out the sweet cravings.

Ultimately each person and their doctor has to decide which is the best procedure for their individual case. However, I wanted to point out a couple of myths I've seen here and there - many people seem to think the sleeve is less invasive than RNY. Both procedures are usually done laparoscopically now. In the sleeve, a large portion of your stomach is stapled off and then removed for good. it is not reversible for that reason. In RNY, yes, your small intestine is moved to connect at a different point, but the stomach is only stapled off, not removed. It is fully reversible if there are extreme complications that require it. I know we should all assume this is going to be our one surgery and hope that's all it takes; I just didn't want someone to have the idea that the sleeve is like "bypass lite"

I started a list several months ago with my major goals for WLS. None of them are numbers on a scale, a clothing size or for looks. Most of them are activities I want to do, some are health goals. I wanted to have very specific things to work towards: (in no particular order)

I have done both Atkins and paleo in the past and find that a mix of them work best for me (still pre-op but it's what I plan for post-op eventually as well). I try to avoid most artificial sweeteners but on occasion will use them, and I cannot eat as much fruit as many paleo people do. If you consider that in paleolithic times, fruit would have been available only seasonally and was MUCH less sweet than it is now (having been selectively bred for higher sweetness over many generations) and it required more work to collect it vs washing an apple from the fridge, I can see how fruit could be way overused in modern times. Same with things like honey - lots of work to collect it and would have been very sporadic in getting it.

So low carb, as natural as possible, but I'm not afraid of healthy fats. We'll see what I tolerate after bypass

Also, if you are considering more surgery, you may want to look into revising to bypass rather than making your sleeve smaller. There are a lot of people with sleeves on these boards who end up revising to bypass (I'm not saying the sleeve doesn't work for lots of people!) It seems you still have a lot of weight you want to lose and that may work for you better.

Oh, that makes sense!

@@KarenLoh, are you required to lose a certain amount before your surgery? It all depends on both your doctor and your insurance company. Mine doesn't care if I don't lose, as long as I don't gain any more (in fact I can't lose very much or my insurance may not cover me, as my BMI was "only" 39.7 at the start but I do have some comorbidities)

My nutritionist at each appointment makes some goals for me to meet - mostly these deal with "how" I am eating, less so on what I eat. So, for example, I'm supposed to be working on stopping the grazing and eating only meals and a planned snack. Can you focus on something like that first, and not beat yourself up over what you're eating? I've been trying to break down my overeating into different habits and work on them one at a time

snacking, esp grazing all day long

eating while I'm on the computer, reading or driving

wanting something sweet right after I eat

grabbing candy when I'm out shopping.

I gave up candy for Lent, so that part is taken care of. I am hoping when Lent is over I will have broken that habit for good.

I am still working on the snacking but have made progress on not eating while on the computer or reading.

If I want something sweet after a meal, I either have a pickle (sour sort of counteracts the sweet craving) or part of an Atkins bar.

I have been successful at increasing my Water intake, but have not yet worked on not drinking with meals - next thing to do!

hth

Apologies if I missed something but why did you already have a Tummy Tuck if you still have more to lose? I thought people generally waited until they'd been in maintenance awhile. Was there some physical reason you had to go ahead sooner?

btw, you look awesome!

@@Daisee68, I couldn't agree more. I've only been looking into WLS for about 4 months but I've been in counseling for almost 2 years to get to the bottom of my eating issues. (and yes, some of it does go back to childhood issues!) Along the way I've gained the courage to finally separate from my husband, which I should have done long ago but forced down my anger and abandonment feelings with food. It's taken quite awhile but I can finally say that when I get stressed or angry now, I don't even think of grabbing sugar, which used to be my automatic response. I still haven't lost my sweet tooth, but I'm not using it for emotions now. So now I'm working on habits (snacking, grazing) while waiting to get approved for surgery, but I'm so glad I've done the mental work ahead of time. My family has a history of alcoholism and I was scared I'd move from food to alcohol after surgery but I think the work I'm doing now will prevent that if I'm careful.

@@Sunshine_Gal

I use myfitnesspal so my fat grams are automatically tracked, but I don't necessarily watch them in everything I eat. I try to keep my fat less than 3% of my calories but that doesn't always work. And I haven't seen any correlation between the amount of fat grams I eat and weight loss. I see more with calories & carbs than fat. I'm actually about to drop my calories back down to 800 to see if that gets me out of this slump. Seems like every 10 pounds I lose I hit a stall and this one has been going for 11 days.

I am still pre-op so take this with a grain of salt, but I have done a ton of research into low-carb, high fat, moderate Protein eating. I realize you have to get the high Protein in b/c it's needed to maintain/build muscle, keep hair from falling out, etc. and there is less room for it as well as less absorption for bypass patients. But, when you keep fat very low, your body can use protein and turn it into glucose (sugar), which then gets stored as fat. If you can tolerate a little more healthy fat (coconut oil, olive oil, real butter, grass-fed beef, etc) in your diet, keep the carbs low, you may start seeing the scale move faster. Low-fat products automatically have more carbs to improve flavor.

Also even after bypass I believe the body hangs onto fat when it thinks you are in starvation mode. So cutting calories back further can have the opposite effect of what you intend.

YMMV

It does sound like you've tried other things and have been overweight a long time, so this may indeed be the right time for surgery. The only other thing I can recommend is to start seeing a therapist who specializes in eating disorders, to find out why you overeat. IMO if you don't do this, your chances of longterm recovery are lower. I always thought that I just liked the taste of food, esp sweets, more than other people, even as a child. I was always wanting more, even before I became overweight. It wasn't until my marriage started falling apart that I went looking for answers on the eating, b/c by then I knew there were emotional reasons that I ate. And I found, surprisingly to me, that those reasons went back to childhood. I've had to work hard on letting go of some of those emotions I buried deep inside, and find ways to express anger and disappointment without using food. Two years ago, surgery would not have been successful for me, I know, b/c I would have found another crutch, possibly alcohol. I've heard others become shopping addicts, using the excuse of needing new clothes at first, but later it's a new addiction.

Geneen Roth has some books on Emotional Overeating that I found very helpful, too.

Best of luck!

Do you guys think 20 is too young for WLS? Im tired of wasting my life being unhealthy, but ppl seem to think im too young to have tried other methods.

That depends on your overall history. How long have you been overweight, by how much, and what have you tried so far? If you've only been this heavy a few years, I would strongly encourage you to try other things first, or if your BMI is less than 40. OTOH, if you've been on multiple diets, have been significantly overweight since childhood, then this might be an excellent opportunity for you.

No healthy eating plan, with or without WLS, is going to say going out drinking frequently is a good thing. Most healthy plans allow things like that once you reach goal, occasionally, but that's not what my college days were like LOL!

You do say you're tired of wasting your life being unhealthy, but I believe you have no co-morbidities yet, right? So who says you are unhealthy? You may be very different from me, but when I was that age, it was all about looking good, not health. And while I'm not judging you at all for that, it's understandable, but it can definitely affect your commitment to something this huge. I really don't think I was emotionally mature enough then to really take on something lifelong.

Maybe you could commit to trying 3-6 months of low carb, high Protein meals, without the very low calorie counts and portion sizes required by WLS, to see how committed you could be with this. If you do something like Atkins, you can also eat high fat and it keeps you full, while still losing weight due to the extremely low carbs. I was successful at that several years ago, but could not sustain it longer than 8 months in the end. So even I am worried about how I will do post-op, just counting on the hope of not wanting sweets and possible dumping.

My weight loss center has partnered with Johns Hopkins University in a study on the cardiovascular effects of WLS on patients. They submitted my name and i just got a call saying I'll qualify to be in it. They do an EKG, lab work, echocardiogram and limited sleep study (you wear an oxygen sensor overnight at home) beforehand, then repeat these 6 mos and 18 mos after surgery. I'm happy to do it just to get a little more pre-anesthetic info like the echo, since I'm in my 50's and have hypertension. But they pay you a bit at each visit too, all the better! I go next week for my first visit with them. I'm in month 2 of my 3 month supervised weight loss trial so hoping for surgery in late May or early June.

My PCP is against it as well (luckily I don't need a referral). He said he only recommends it for people who are basically dying unless they have it. Why would I want to wait until I'm in that bad a shape? I'm 100 lbs over ideal weight and already have hypertension, asthma, reflux and pre-diabetes.

I don't think he really knows much about it, though, b/c he also said he had seen many patients with the "sweater" regain most of their lost weight. Sweater - sleeve?

I like him otherwise and he's been very helpful with many things but I decided that in light of what is obviously ignorance in that field I need other opinions based on real fact.

My therapist (not a psychologist) has been mostly positive, b/c she's seen me work on the emotional issues behind my eating for several years. She does keep reminding me that at my age (52) I'm liable to see a lot more wrinkles and chicken-neck after I lose a lot of weight, but I'm not doing this for looks. I just want to be more active and healthy, and get decent-fitting clothing easily.

I've been using Isopure zero carb powders for about a year while doing Atkins (on and off) and I like it. I get it from Amazon. I've had the vanilla, chocolate, strawberry and banana. I like the first three a lot, the banana is oK for a change but it tastes like banana popsicles, that fake banana flavor. I can't imagine I'd like it after surgery.

Just be careful when ordering that you make sure it's the zero carb- Isopure also makes one called Mass, which is high carb/high calorie. I ordered a 3 lb can of it by mistake - didn't realize til I'd opened it but gave it to my Marine son who can use it for his workouts.

Ditch the margarine and use real butter. It's a very healthy fat as long as your stomach tolerates it, and margarine is nothing but vegetable oils and chemicals, neither of which are healthy (with the exception of olive oil, but usually there are still lots of chemicals added) Even the ones which claim zero transfats - they are allowed to claim that if it's less than a certain percentage but it's not really 0.

also, lowfat cheese often has added stuff to improve taste which often add carbs. Try a full fat strong-flavored cheese and you can use less.

I have http://www.amazon.com/FoodSaver-V3240-Vacuum-Sealing-System/dp/B003U738ZE?ie=UTF8&*Version*=1&*entries*=0

I think the main difference is that it has settings for moist foods, as well as ones you don't want completely collapsed, like chips or bread. I rarely use either of those settings anyway, as most of what i seal is meat or cheese.

I also buy the generic bags from Amazon, WAY cheaper, and work just as well. I'm very happy with it.

Exactly! My thought when I read your first post was that - you don't even know what this guy's job is at your company, so obviously he's not a close friend. People like that don't even deserve a response other than something like - "I don't recall asking for your opinion"

I was the first on the schedule. I am calling in the morning, but the scheduling person is hard to reach.

I know you were in the first slot, but it's possible others actually scheduled their surgeries before you did, and they would be given priority when rescheduling. I hope you get it straightened out; I know how disappointing it must be.

It sounds like you're in kind of a vicious cycle - heavy work schedule/commute making you tired, which impairs your judgment about eating, and less protein/hydration makes you more tired. Can you take an extra day off work to give yourself a long weekend, and really get rested up, along with doing some basic walking for exercise, and eating well?

Also, maybe during your commute you can listen to some positive affirmation type stuff (you can find things online with a google search, or even record your own), as well as keeping Water or other beverage handy for sipping while commuting.

Maybe the doctor is going out of town in the afternoon, and needed to move several patients who were scheduled prior to yours, into earlier slots (ie perhaps you were one of the last ones to schedule?)

Hopefully there is a reasonable explanation, and I definitely think you should call and ask them to explain it to you.

I'm currently 52 and in the middle of my 3 month supervised weight monitoring. I hope to get my surgery either late May or early June, and my 53rd birthday will be in late May. This will be the best birthday present I've had in a long time!