Airstream88

I've never experienced dumping since my RNY in October 2016. For the first 7 months I was very careful about what I was eating and hardly ate anything over the 6g of sugar recommended to me by the Nutritionist. Now I have found I can eat a small cookie, chocolate or a bit of cake and not suffer any consequences. I have not eaten a full-size dessert of any type. I have stayed away from most fried foods. I have noticed high fat items can cause me to feel yucky but they don't cause dumping. I recently tried corn on the cob and suffered a week of indigestion so sadly it won't be in my diet from now on.

Go back to eating your Protein first. If you do that, there is no room to drink or eat too much of anything else.
The July 4th weekend was full of wonderful food and I found myself putting too much on my plate. I then slipped on the eat protein first rule and ate too much of the side dishes before finishing my protein. So the new rule for me at party like events will be to get the protein first and eat it, then go back for the side dishes.

Go back to eating your Protein first. If you do that, there is no room to drink or eat too much of anything else.
The July 4th weekend was full of wonderful food and I found myself putting too much on my plate. I then slipped on the eat protein first rule and ate too much of the side dishes before finishing my protein. So the new rule for me at party like events will be to get the protein first and eat it, then go back for the side dishes.

Go back to eating your Protein first. If you do that, there is no room to drink or eat too much of anything else.
The July 4th weekend was full of wonderful food and I found myself putting too much on my plate. I then slipped on the eat protein first rule and ate too much of the side dishes before finishing my protein. So the new rule for me at party like events will be to get the protein first and eat it, then go back for the side dishes.

Go back to eating your Protein first. If you do that, there is no room to drink or eat too much of anything else.
The July 4th weekend was full of wonderful food and I found myself putting too much on my plate. I then slipped on the eat protein first rule and ate too much of the side dishes before finishing my protein. So the new rule for me at party like events will be to get the protein first and eat it, then go back for the side dishes.

Protein First, leave out all the rest until you are getting that protein in per day (cept for fluids of course). I think that's a key reminder, being that we are used to eating multiple things during our meals. This is a whole new ballgame. Things just don't work the same for us any longer, so we have to adapt. Sure, I'd like to grab for that nice banana, or apple sauce, but I have to stop myself and think... have I gotten in at least 60 g protein yet? If not, I grab the yogurt, or anything else with some notable protein.
I have a small dry erase board on my Fridge, everything I take out of it, I write down. It has an area for my protein, fl ounces, fat, carbs, and calories. This isn't forever, but until my "muscle memory" changes from blindly grabbing and eating, to focusing on my new way to eat, this is my go-to. I take a photo of my board every night before bed and that's my log. Clean slate every morning, and I try to add a few new things each week.

In the first 3- 6 months before you can eat enough real food, you have to force those Protein Shakes down. I hated them with a passion but I knew it was supremely important to weight loss and maintaining muscle mass so I drank them anyway, gagging all the way. You can also try the Premier Protein Clear Protein waters - 90 calories and 20g protein. I generally don't tolerate drinks with artificial sweeteners but I actually like them. Also Fairlife milk has 13g of protein per cup. Make your protein shakes with Fairlife and you get an extra protein boost.

I found this article on another WLS site. It's old but makes sense:

By: Cynthia Buffington, Ph.D

Did you drink carbonated soft drinks prior to your Bariatric surgery? Do you still consume carbonated soft drinks? Were you advised by your surgeon or his/her nutritional staff NOT to drink carbonated drinks after surgery? Do you understand why drinking carbonated beverages, even if sugar-free, could jeopardize your weight loss success and, perhaps even your health?

A carbonated beverage is an effervescent drink that releases carbon dioxide under conditions of normal atmospheric pressure. Carbonated drinks include most soft drinks, champagne, beer, and seltzer Water. If you consume a soft drink or other carbonated beverage while eating, the carbonation forces food through he stomach pouch, reducing the time food remains in the pouch. The less time food remains in your stomach pouch, the less satiety (feelings of fullness) you experience, enabling you to eat more with increased risk for weight gain.
The gas released from a carbonated beverage mat "stretch" your stomach pouch. Food forced through the pouch by the carbonation could also significantly enlarge the size of your stoma (the opening between the stomach pouch and intestines of patients who have had a gastric bypass or biliopancreatic diversion). An enlarged pouch or stoma would allow you to eat larger amounts of food at any one setting. In this way, consuming carbonated beverages, even if the drinks are diet or calorie free, may cause weight gain or interfere with maximal weight loss success.
Soft drinks may also cause weight gain by reducing the absorption of dietary Calcium. Dietary calcium helps to stimulate fat breakdown and reduce its uptake into adipose tissue. Epidemiological and clinical studies have found a close association between obesity and low dietary calcium intake. Recent studies have found that maintaining sufficient amounts of dietary calcium helps to induce weight loss or prevent weight gain following diet.
The high caffeine in carbonated sodas is one way that drinking carbonated soft drinks may reduce the absorption of calcium into the body. Studies have found that caffeine increases urinary calcium content, meaning that high caffeine may interfere with the uptake of dietary calcium into the body. Keep in mind that one 12 oz. can of Mountain Dew has 50 mg of caffeine, and Pepsi and Coke (diet or those with sugar) contain 37 mg of caffeine each.
Colas, such as Pepsi and Coke (diet or with sugar), may also cause calcium deficiencies from the high amounts of phosphoric acid that they contain. Phosphate binds to calcium and the bound calcium cannot be absorbed into the body. Both animal and human studies have found that phosphoric acid is associated with altered calcium homeostasis and low calcium.
Drinking carbonated beverages may also reduce dietary calcium because these beverages replace milk and other nutrient-containing drinks or foods in the diet. Several studies report inverse (negative) relationships between carbonated beverage usage and the amount of milk (particularly children) consume.
Carbonated beverages, then, may reduce dietary calcium because of their high caffeine or phosphoric acid content or because drinking such beverages tends to reduce the consumption of calcium-containing foods and beverages. Such deficiencies in dietary calcium intake may be even more pronounced in Bariatric surgical patients.
Calcium deficiencies with Bariatric surgery have been reported following gastric restrictive and/or malabsorptive procedures. The reduced amounts of calcium with bariatric surgery may occur as a result of low nutrient intake, low levels of Vitamin D, or, for patients who have had gastric bypass pr the biliopancreatic diversion (with or without the duodenal switch), from bypass of the portion of the gut where active absorption of calcium normally occurs. Drinking carbonated beverages may further increase the risk for dietary calcium deficiencies and, in this way, hinder maximal weight loss success.
For all the reasons described above, including calcium deficits, reduced satiety, enlargement of pouch or stoma, drinking carbonated beverages, even those that are sugar-free, could lead to weight gain. Carbonated beverages that contain sugar, however, pose a substantially greater threat to the Bariatric patient in terms of weight loss and weight loss maintenance with surgery.
Sugar-containing soft drinks have a relatively high glycemic index, meaning that blood sugar levels readily increase with their consumption. The rapid rise in blood sugar, in turn, increases the production of the hormone, insulin. , that acts to drive sugar into tissues where it is metabolized or processed for storage. High insulin levels, however, also contribute to fat accumulation, driving fat into the fat storage depots and inhibiting the breakdown of fat.
Soft drinks with sugar are also high in calories. An average 12 oz. soft drink contains 10 teaspoons of refined sugar (40g). The typical 12-oz. can of soda contains 150 calories (Coke = 140 calories; Pepsi = 150; Dr. Pepper = 160; orange soda = 180; 7-up = 140; etc.). Soft drinks are the fifth largest source of calories for adults, accounting for 5.6% of all calories that Americans consume. Among adolescents, soft drinks provide 8%- to 9% of calories. An extra 150 calories per day from a soft drink over the course of a year, is equivalent to nearly 16 pounds and that weight gain multiplied by a few years could equate to “morbid obesity”.
In addition to the adverse effects that carbonated drinks have on weight loss or weight loss maintenance, carbonated beverages may also have adverse effects on health. Soda beverages and other carbonated drinks are acidic with a pH of 3.0 or less. Drinking these acidic beverages on an empty stomach in the absence of food, as Bariatric patients are required to do, can upset the fragile acid-alkaline balance of the gastric pouch and intestines and increase the risk for ulcers or even the risk for gastrointestinal adenomas (cancer).
Soft drink usage has also been found to be associated with various other health problems. These include an increased risk for diabetes, cardiovascular disease, kidney stones, bone fractures and reduced bone density, allergies, cancer, acid-peptic disease, dental carries, gingivitis, and more. Soft drinks may, in addition, increase the risk for oxidative stress. This condition is believed to contribute significantly to aging and to diseases associated with aging and obesity, i.e. diabetes, cancer, cardiovascular disease, liver disease, reduced immune function, hypertension, and more.
From the above discussion, do you now have a little better understanding of why your Bariatric surgeon or Bariatric nutritionist advised you NOT to consume carbonated sodas after surgery? Your Bariatric surgeon and his/her staff want to see you achieve the best results possible from your surgery – both in terms of weight loss and health status – and so do YOU. Consider the consequences of drinking such beverages now that you understand more clearly why such drinks are “Bariatric taboo”.

In the first 3- 6 months before you can eat enough real food, you have to force those Protein Shakes down. I hated them with a passion but I knew it was supremely important to weight loss and maintaining muscle mass so I drank them anyway, gagging all the way. You can also try the Premier Protein Clear Protein waters - 90 calories and 20g protein. I generally don't tolerate drinks with artificial sweeteners but I actually like them. Also Fairlife milk has 13g of protein per cup. Make your protein shakes with Fairlife and you get an extra protein boost.

I think everyone worries about having surgery - no matter what type. You just have to keep your eye on the prize. It's been the best decision I've made in my life to have RNY. Wish I had done it years earlier.

I'm 8 months out and have averaged a weight loss of 16 pounds per month. I eat somewhere between 1200 - 1500 daily.
At 3 months I was told to be beteen 800 - 1000 calories. The way you get it in is to eat 5 small meals a day - every 3 hours or so. That's the plan I was given by my NUT and it seems to be working very well for me. Don't forget to eat some good fats - nuts, olive oil, nut butters. I'm allowed 3 servings daily. They are good for you and help get that calorie count up.

It's possible you are not eating enough calories. At six weeks you should probably be trying for at least 600 calories a day. At two months I was at 600-800 calories a day.

My NUT allows us two whole grain servings daily. I eat Whole grain crackers and breads (toasted). I've had some Farro which is an ancient whole grain with high Protein. And every now and again I eat popcorn. Eating whole grains and fruits has not affected my weight loss. I'm still losing about 10 pounds a month.

I take the Nutrametrix (or Isotonix) powder multi-vitamins and Calcium. You have to drink them on an empty stomach but can eat 15 minutes later. The are more expensive but are 95% absorbed so you only have to drink the Multi-Vitamin once a day. I generally do it in the morning. I use the Bariatric Advantage Lemon chewables for the rest of my Calcium, they taste like starbursts to me.

That's a really good question. I'm 2.5mo out from surgery and 46% of the way to by weight goal of 180. That's the lowest I've ever been as an adult(which is part of why I made it my goal), and while still on the high side of normal for 5'9", I think I could be happy there. I was a size 10/8. At first, I was dead set on 150(which I haven't been since 6th grade), and in a panic that I may never get there. But the mind is the real struggle in this journey, so if I get to 180 or 150 and my mind is not fixed, the results won't last.
So, the number is just a number, and I like watching it go down, but I try to document and Celebrate other things about myself that I discover along the way. I'm 250 now, and I can fit in size 14, and it feels really good, I'm happy with my body as it is, which doesn't mean that I've given up working for my goal, but that I can love and accept myself as I am. I walked with friends up a hill and kept a conversation without huffing and puffing. When I eat out, I don't pick food by it's size, but rather by what I enjoy eating. I enjoy eating different things than I used to. I have a lot of non-weight goals, that I hope will contribute to my long term success. These are personal to me, and yours may be very different, and working with a counselor has really helped with that.
1. I hope to get to a point where I don't have to get on the scale every day. (This is sort of a compulsion for me, would like to get to 1x/wk)
2.I don't want to think about food, unless I'm hungry. (I currently obsess about food and exercise almost every free minute of the day, it's too much brain energy being used up when I could be out solving world peace.;) (this is a big one, and hard)
3. I want to fit in an airline seat without worry about who I'm inconveniencing. (I travel a lot, so this really makes a difference to me. It also goals along with being less insecure and more confident.)
4. I want to be able to do any activity without worrying about the weight limit. (being picked up, rides, being below my scooter weight limit, buying a ladder, etc.)
Good luck on your journey, and I hope you hit all of your goals! Remember, all the ups and downs are going to be totally worth it. And get a support group, see a counselor, or find someone you can talk through as you go through this.

It's possible you are not eating enough calories. At six weeks you should probably be trying for at least 600 calories a day. At two months I was at 600-800 calories a day.

My NUT estimated I would lose between 70 - 80% of my excess weight which would leave me weighing between 198 and 222.If I get to either of those numbers I will be perfectly happy. I have no desire at my age, 55, to weigh 145 pounds. I would look sickly and have so much skin hanging off of me that I'd be unhappy. I'm going to be living with that skin a long time since I'd rather retire and travel with my husband than spend 50K or more on plastic surgery. At eight months I'm still losing about 10 pounds a month.

Depends on what it is. I tend to measure things like Cereal and milk until I can judge how much is a serving (3/4 cup, 1/2 cup, etc). I rarely measure meat as I pretty much can only eat 3 - 4 oz tops before I get full. I think it's good to measure once in a while to make sure you are staying within your Nutritionist's guidelines because I can definitely eat way more at 6 months than I could at 3 months. Don't want to stray too far off the norm.

I had a sudden change in life when I decided, in one day, to go to Dr. Thomas and begin my journey for a Gastric Sleeve. I was excited and nervous and had no idea what I was getting into at the time. We discussed my options and decided on the Gastric Bypass to achieve my goals. I spoke to my wife and we watched hours of videos on surgeries and blogs, WebMD, etc. to learn about these procedures. None of the side effects were worse than not being able to play with my boys (10 and 12), mow the yard, be intimate with my wife, and just feel "normal" when going out.
On Feb 7th, 2017, I had my gastric sleeve. I was at 412 lbs., and was scared I would never wake up. I did, and then went through 3 days, as many of you have, in a lot of pain. I had two tubes hanging out of me and couldn't walk very far for about a week. Then, things got better, I got one tube out after the first week and didn't care I had only lost 3 lbs. lol.
After the first 4 weeks, the feeding tube was removed and I was able to begin taking longer walks with the wife. we started at a 1/4 mile and it was hard for me. By the end of that 2nd month, we were walking 2 miles a day, 4 times a week. (which we still do today).
I am almost 5 months post-op and I am down 115 lbs. We just spent 4 days in Gatlinburg, TN in the mountains and we walked and played laser tag, rode coasters, and did things I would never have done 5 months before. I am just over halfway to my goal, but my life has already changed so much. I am so thankful to those who have helped me and continue to be my support team through this process, especially my wife and kids, who help make my meals, try new foods and exercises with me, and amaze me everyday with their support and love.

My surgeon does not talk about goal weight until around 1 year post op. So I've picked a somewhat arbitrary number for now just because I like to calculate things like percentage of excess weight lost. But as others have said - my real goals are much less number focused and more quality of life focused (reduced knee/ankle pain, mobility, buying clothes in real stores....). I don't know where I will end up as far as numbers go but if my quality of life goals are met I'm pretty sure I will be happy whatever the number is. I've been overweight as long as I can remember from childhood so I have no frame of reference to pick a weight where I think I would be happy. I don't really even have a good frame of reference for some of my quality of life goals to be honest so I'm just going with the flow for this first year and then will figure it out

Some WLS patients still feel like there is a missing element to their long term weight loss. Healing old psychological wounds can be key. Author of Full From Within, psychologist Dr. Colleen Long, explains just where to start.


“ The wound is where the light enters you.”
- Rumi



When I work with pre and post-op bariatric surgery patients, I consistently go over this idea of being "full from within." Many people question, "what does that mean for me? What does that look like?"
My response is that for one to be truly full, we must first clear out the old toxicity, wounds, and hurtful schemas we've picked up throughout the years. How does one get over a hurt? There is not "getting over." You go through it. You have to feel it to heal it.
If you have underwent gastric sleeve, bypass, or balloon surgery and still feel like there is a missing piece- it is likely that there are some deeper psychological toxicities that need to be cleared. The first step to doing so is sitting still, sitting with the feelings, and it is in stillness that our heart finally starts to answer the questions our mind has failed to thus far.
Yet so many have been taught not to feel. That there must be an easier way- a shortcut. 1 in every 8 Americans is on some form of psychotropic medication. 1 In his book, Anatomy of an Epidemic, science journalist Robert Whitaker states that since 1987, the percentage of the population receiving federal disability payment for mental illness has tripled; among children under the age of 18, the percentage has grown by a factor of 35.1

While Whitaker recognized that in the short-term, these medications help people to feel better, he started to realize that over time- drugs make many patients sicker than they would have been if they had never been medicated. 1 He does not make the argument that all people should stop their meds. He believes in the utility of them, just more sparingly than they are currently utilized.

However, throughout my years in the practice of therapy- I have noticed a trend of moving people away from feeling. Crying is actually a symptom in the DSM-V. We have pathologized a human feeling! When psychiatrists and therapists witness a patient tearful too many times in session, their next conclusion is that something must be wrong and they must be medicated.

This frustrates me so much as a clinician and as a person who has done her share of work in her own personal therapy. When we are broken, we are broken open. Being broken is a starting point, not a symptom that something has gone awry.

It is at the point of our deepest pain and grief that we have the greatest opportunity for growth. I find myself telling patients over and over- “you can’t “get over” it, you must “go through” it.” Yet, so many of us have been indoctrinated to think that if we spend more than a day being sad, we must have depression, or if we feel nervous a little bit longer than we’d like to- we must have an anxiety disorder. We definitely “are Bipolar” if we have a mood swing.

We have been taught to not feel the yin, only the yang of our emotions. It’s societally acceptable to talk about how happy your weekend was, or how much fun you had on vacation- but watch the uncomfortable shifting in chairs that takes place when you open up about how you just haven’t felt like yourself lately.

In our world of quick fixes, where we can have a conference across the world, over a computer, communicate a message in two seconds via text, or post a picture that all of our family can see instantly- we also want instant relief for our suffering. Yet, suffering is part of the human condition. It is through experiencing our deepest sorrows, we are able to appreciate our greatest joys. But we must first be willing to sit in the muck.

"Out of the mud, grows the lotus." -Thich Nhat Hanh

Part and parcel of any addiction (food, drugs, alcohol, etc.) is that the addict is particularly uncomfortable with being uncomfortable. However, the cure is right there for the taking.

“So what does this look like in real life?” you ask. “How do I open the wound, bring in the light, and clear out the infection that started all of this in the first place?” You start with presence. You start with a still and open heart. You start with a spiritual vulnerability that allows you to be at peace with not knowing what will happen next. You sit broken open and wait for the light to enter over time.

The most important piece in all of this is being able to create a consistent forum where you hold the space. This could be a therapist’s office, it could be a weekly walk with a friend, a journal practice, or it could be as simple as a prayer every night.

You set the priority to hold the space and to sit in the muck. Maybe it starts with emotions that have no words? Maybe it starts with visceral, physical feelings, that you have to simply sit with for a while? Maybe you are lucky enough to immediately put in words where your wound all started and its just floating around in your thoughts, waiting to be articulated? Perhaps it starts with a behavior you tend to do all of the time that you know comes from a place of pain?

Case Study:

I had a client who continuously posted on social media sites. She had a constant need to feel recognized and admired. She knew there was something behind it and wanted to get to the bottom of where this was coming from.

Session over session, we sat with that need. We talked about what she wanted to get from each of those posts and why she was still “on E,” left with an empty psychological tank.

The short story of Narcissus goes that he disdained people who loved him. After Nemesis noticed this he lured him to a pool that cast his own reflection. Narcissus fell in love with this pool, not realizing it was merely an image. Unable to leave the beauty of his reflection, he lost his will to live. He stared at this reflection until he died. 59

Growing up, this client never quite got the love and admiration we all need from our parents. When we love something so much and don’t get that back- it is that unrequited love that leaves a narcissistic wound. It doesn’t necessarily always start with parents. It can be a formative romantic relationship, but it usually starts with parents.

When we are flying from couch to couch saying “look at me mommy I’m superman!” and our mom says “get off that couch now!” instead of “look at how strong and powerful you are,” we begin forming the wound. Unfortunately, without recognizing this- many people will go throughout their life trying to heal it through other people or other things instead of within themselves. (recall the wizard of oz’s moral of the story).

It was up to this client to stop the instinctual need to post and each time she had this inclination to look within for what she needed. Eventually, she developed a muscle for self validation, and the posting behavior stopped.

The lesson in this case study is to hopefully help guide you to your wound. If we have a food addiction and feel out of control, you can bet we have a wound. Instead of distracting through bad habits, addictions, unhealthy relationships, or external wants- it is time to finally create a place of presence to start the healing process.

Mind Meal: Sit in silence for at least 15 minutes. Visualize in your mind’s eye your heart with a bridge of white light to your head. What does it say? Where is the pain? Where is the wound? How might you start filling yourself up for good?

Want to learn more about how to be truly full from within. Check out Dr. Colleen's latest book aimed at helping one focus on why they eat vs. what they eat, and stop the "diet yo-yo" for good. You can also sign up for her free course : Full From Within, here.
1 Retrieved: June 2, 2017 https://www.madinamerica.com/author/rwhitaker/

Yes I started to feel hunger after the first month - but only after about 3 hours. Any hunger during that 3 hours is usually because I need to drink more Fluid or I didn't eat enough dense Protein or I'm bored. My NUT has her patients eating 5 mini-meals a day - that really helps with not getting that starving hunger feeling.

This is really interesting. I'm three weeks away from my bypass and was chatting to my nutritionist about my expectations and hopes for weight loss. In all honesty I couldn't say.
A number feels terribly arbitrary and not very helpful. A big motivation for me is to be able to play and run about more with my five year old as he grows up. My weight gain really curtailed my physical activity and now I'm so keen to live more of my life outdoors that, for me, success will feel like being able to cycle and climb hills without wheezing and sweating (actually walking up stairs without wheezing and sweating would be a good start). Beyond that my self image is important, but I have no idea what weight corresponds to when I look great again.
Watching the numbers is clearly invaluable in terms of what you eat and how much exercise you do - but when you use numbers as your sole measure of success I imagine there's a danger you disappoint yourself even when your achievements are immense.

Everyone's body and journey is different. I didn't lose much prior to surgery (I didn't have to do the pre-op liquid diet). I lost 37 pounds the first month and then lost 9 the second. It's a long journey and you will only torture yourself if you worry about how much you lose versus others. Make sure to follow your plan - try your best to make your Fluid and Protein goals. The weight will drop off.

Dr Matthew Weiner has a great video about this topic, and states that carbonation stretching the stomach (especially a sleeve) is a myth. My surgeon also concurs.
The problem with soda are the CALORIES, NOT the carbonation. Empty, non nutritious calories are the fastest way to gain weight for a WLS patient because they go down so easily. It's silly to think the pressure from a few carbonation bubbles will "stretch" anything. Aside from the natural stretching that happens years out, it would take years of systematically over eating to the point of sickness to stretch a sleeve significantly because the fundus, or stretchy part, has been removed during surgery. Dr Weiner has no issues with carbonated waters or selzers as tolerated.
At 3.5 years post op, I drink carbonation periodically and can eat just as much as any one else as far out as me. It has not stretched anything. It's really time to put that myth to rest.