summerset

This. You basically start to eat like "normal people". For some that's ok when it comes to maintaining. Others don't maintain on it. No idea why that is. Maybe the ones who gain don't eat like "normal people" after all but like they ate before surgery. "People live". Well, hopefully they really do. I personally think identifying as "a WLS patient" for the rest of my life is not something to strive for. It's interesting that some people seem to be eager to identify themselves with their medical conditions: "diabetic", "sleever", "food addict" etc. - gives me a weird kind of feeling somehow.

Well, it's definitely something to consider to say when looking at the dramatic impact an ideal diet and best medical treatment has on coronary heart disease.

I don't know if some members of treatment teams really view it as a permanent, lifelong diet but I sometimes get the impression that they do, e. g. when patients are given instructions like "eat only x amount of calories a day, don't eat more than x grams of fat and x grams of carbs a day and exercise x times a week" - that sounds like your usual dieting advice (since a view years all "dieting advice" seems to be marketed as "lifestyle changes") and a surefire way to obsession and burnout in the long run. Maybe you're right with this. I can remember after post-surgery nutrition class was over and the nutritionist clearly said to ditch the low-fat stuff that two patients were talking about "buying skim milk, low-fat cheese and low-fat curd". I was thinking "WTF?? What exactly did the nutritionist talk about only 15 min ago?? Why aren't people just glad that they will never have to eat this awful stuff again?"

Don't know what people on this thread are regarding as healthy but this is what I made recently: - cut up tempeh in thick slices and fry it brown in a bit of coconut oil - add sweet soy sauce and bake until it starts caramelizing - take tempeh off the pan, add frozen green beans and cook until done - add a bit of sate and let it melt I was too lazy to cook rice so I ate it without, lol.

I can't get use to almond milk somehow - I always use soy. I only use almond milk (don't want to use soy in everything) if the taste of the other ingredients definitely overpowers the almond milk.

Why lie to people if they ask?

Are you hungry or do you have an appetite? If you never feel satisfied - do you eat the foods you really want to eat or the foods you feel you should eat?

Maybe the surgeon will tell you that with a BMI of 29 you're out of the obese category and everything's fine. Surgeons seems to have more modest (more realistic?) goals for their patients than the patients themselves.

After I saw her posting pictures of the vitamins I thought this might be a sales thing.

I agree. You take a look into the box that has a label stamped on that reads "lifestyle changes" and when you take a look inside the box you see something in there that would have been called "being on a diet" some years ago. Too many lifestyle changes are really diets in disguise (maybe that is why they don't work longterm - just like diets).

Then why do so many patients treat it like one? Fault of the treatment team because they seem to treat it too often like one, too?

I think nutritionists should ditch the standard advice - if the nutritionist is going to dish out standard advice the patient can as well refer to a high gloss booklet. Costs less money and might be more informative as well in some cases. IMO nutritionists should give out tailored advice. For standard advice: see a booklet. When visiting a nutritionist when it comes to bariatric surgery I demand that the nutritionist is able to do a few things: - different surgeries and the challenges that come with them, this includes supplement advice according to bloodwork - different dietary approaches (e. g. the low carb approach vs. the pound of cure) - being able to advice patients of different cultural backgrounds when it comes to food choices - being able to change gears when one approach obviously doesn't work instead of scolding the patient and telling him to "just try harder" - being able to cater to different dietary preferences of patients (might not be a good idea to advice patients to eat more fish when the thought of eating fish makes the patient want to gag, you maybe also shouldn't advice "lean meats" to a vegetarian) - being able to incorporate the patient's activity level and lifestyle into the dietary advice (e. g. shift workers, patients with high activity levels)

That's like asking "Do you like having a constantly nagging spouse in your life? - Yes or No?"

Of course there are people beating addiction. But there are more of them that lose the battle. Look up the relapse rates when it comes to addiction. They're devastating.

Profit? Can't think of another reason. Btw, I think we need to post more in the Proteinoholic thread I guess.

Because people are different and have expectations/wishes that vary a great deal.

Partly. They also use their own experience. If you are into WLS since e. g. 15 years and have performed hundreds of surgeries and followed up hundreds of patients you will also have your own experience that tells you what's most likely and what's rare. I don't know though if these experiences are very different from the numbers you can read in studies or if they in general match up.

I'm currently reading Karen Koenig's latest book "Helping Patients Outsmart Overeating". It's a book for both patients and health care providers. While no magic wand I think it's a little gem. It's definitely an interesting read on this subject. I think people make these changes to different extends. The more you change towards healthy behaviors, the better the outcome will be, both physically and psychologically. However, people are people with different personality traits and ailments and histories etc. - and a lot of people may simply not be in the position to make all the necessary changes to reach and maintain a normal weight or reach and maintain a normal weight without much hassle. I have ADHD. I will most likely never be this organized, constantly calorie tracking accountant like person who follows plans to the last minuscule detail. So I have to operate within certain limitations and adapt to it. Don't get me wrong - I'm quite good at making plans and organizing stuff, but I absolutely suck at following through, so I'm glad I get to delegate certain things at work. (That said I'm proud of myself being able to function at work at high level without side-effect having medication but I have to be careful with energy levels so I simply won't prepare elaborate meals everyday.)

I dislike shopping as well (do I really have to do this after I come home from work?) and I don't like cooking (do I really have to do this after I come home from work?) and cleaning up after (do I really have to do this after I come home from work?). I also dislike preparing food for the next day (do I really have to do this after I come home from work or before work in the next morning?). My compromise is that I keep it as simple as possible. I buy ready made soups that only have a few ingredients listed, even though they're relatively expensive. In general I think of warm food as more satisfying than cold food (e. g. warm oats are more satisfying IMO than cold oats) so I usually don't eat a sandwich/bread on its own but with soup. Soup and sandwich is a go-to for me when time is scarce. I also use frozen vegetables a lot. Saves both shopping, preparing, cleaning up and cooking time. Rice I cook in batches with a microwave rice cooker and freeze it in batches. After I started my new education my working times have changed (including 24 h shifts which are draining as hell) I'm struggling a bit as well, though it's more with regular exercise. I never got into the real groove again after my shoulder injury so far. Ok, I usually bike to work and I have been lucky with the roads not being icy so far but that's about it. Interestingly enough I haven't gained an ounce so far, even though I didn't feel I ate less food (though I must have anyway?). That's kind of a liberating observation. Convenience food (like sandwiches from the cafeteria) or eating lunch at the cafeteria even though they have a salad bar makes for less than ideal choices too often. I don't notice it in terms of weight gain (even lost a bit since starting my education), but I feel tired and drained a lot which I think is only partly because of different working hours. So even though I don't might like it, I will see to preparing oatmeal in the evening to grab in the morning instead of simply buying a sandwich at the cafeteria. There's no way though that I'll be nibbling on a piece of cucumber at 2:30 AM when I want something sweet. Protein bar for me then.

If that's really the case I wonder why you don't go back to a diet that really satisfy you. I always went back to "eating not ideal foods" because this clean eating didn't satisfy me. Add on top of this that I don't like to cook and I knew I had to come up with creative solutions. IMO these are perfectly fine foods to eat. (Well, maybe not that kind of bread that has a gazillion chemicals as ingredients.)

Me neither, but just as every other medical therapy on this planet doesn't work in 100% of the cases with 100% success it's not realistic to expect 100% of WLS patients being 100% successful. I think most surgeons have a way more distant and neutral view of this treatment method than most patients. The patient's view seems to be loaded with emotions (no surprise here) and that is reflected on this board as well. It's never the treatment method that fails, it's always the patient who isn't strong enough, disciplined enough, motivated enough if goal weight isn't 100% or 100% maintained for the rest of life. This is very interesting because we used to be the same with diets. Then came the "diets don't work" movement along, backed up scientifically. And then as a last resort there is WLS - it's kind of depressing to accept that this last resort treatment isn't 100% fool proof either. It's easier to blame the fellow patients because it's quite frightening to think about the fact that you yourself might be one of the patients where it doesn't work 100%. And this sword of doom looms above your head for a very long time, if not forever. You always worry and if it's only in that little chamber in the back of your brain: "Will I be able to get down to a normal BMI?", "Will I be able to maintain my weight loss?", "Will I regain everything I lost or most of it?", "I simply can't accept even a slight gain or I'm a failure", "Will I be able to function on this high level of discipline and vigilance for the rest of my life?", "What about my 15 h per week exercise program when I suffer a serious injury and have to pause for several months?", "Am I really doomed to always follow a rigid diet for the rest of my life?" I dunno - maybe after having had surgery almost 17 years ago now and having had one revision and adhesiolysis I tend to see things differently than I had 10 or 15 years ago. I went through quite a few things during these years, including some regain when I stopped smoking, being obsessed with clean eating, exercise addiction before several sports related ailments stopped me in my tracks and being just burnt out from all the above. This is why I'm convinced that we should strive for a sustainable middle ground when it comes to eating and exercise and I can't see that much on the various WLS boards so I'm still searching for a place to settle down. Maybe it's because there aren't much people around whose surgery lies back so many years. Here you are a "veteran" after you're - what? - 18 months out IIRC. I personally think this is not a very long time out. Also being 2 or 3 years out is not much. I'm not sure how I can bring my point across without sounding like a total ass. Think about long term relationships maybe. All the couples who're together for 5,10,15,20,25 years or longer will know what I'm talking about when I say "that's not a very long time".

In the end that's no surprise. Before WLS we couldn't adopt these new and oh-so-healthy habits - why should the whole bunch of WLS patients be able to do that after surgery? What tremendously helped me changing behaviors (though I have enough "bad" ones I guess, lol) was reading books about normal eating and it was also the fact that it's easier to maintain the weight when you're close to your goal. When I look into the mirror, being fully clothed I can say to myself "Well, that's not bad - don't mess it up!" - I think I should really look into plastics even though I dread the whole procedure (I fear I will have to shell out the money because I don't have any inflammation or what not in the skin folds) but it seems to be a fact that patients who had plastics do better at maintaining a low weight. Might be because of "Well, that's not bad - don't mess it up!" but also be because empty fat cells are removed that don't scream to be filled or most likely both.

But... but... the CARBS!!!!! Regarding the artificial sweetener: I think a lot of protein powders are actually already too heavy on sweeteners, depending on the brand (unless you buy powders without flavor that is). ... Anyway, I used to mix Syntrax Peanut Butter Cookie and Chocolate with milk and then pour it into my coffee. I haven't had that in a while now - will give it a try again because I have so much of it left and it's still good.

I can't believe that some people seem to hate about every protein shake (or protein bar) on the planet. Ok, this stuff gets olds like any other food you eat often enough but I'm sure there is a protein shake or protein bar out there for every taste. If you don't like the pure stuff, there are several ways to jazz up a protein shake though not everything will agree with everybody of course. Same with protein bars. There are good tasting ones out there (at least IMO).

Never. May I ask why you want to eat raw vegan instead of a mixed vegan diet?