audaciousmarie

The two biggest "stats" I noticed were 1) those that lost the most, the fastest had the biggest drop in their metabolisms (remember this, all you newbies that whine about being slow losers) and 2) the guy that had WLS not only relost weight, but his metabolism actually went up. I think this is good news to all of us lucky folks that had WLS.
If you've ever noticed, WLS specialists, studies and organizations are often lumped together and labeled as "bariatric and metabolic surgery". Having surgery changes our metabolism in a way that was not discussed in this article. One example is the fact that so many diabetic patients get off their medications so quickly after surgery. Their insulin resistance/diabetes actually resolves long before they experience any significant weight loss. The surgery changes more than just restricting our capacity or creating malabsorption. We get extra benefits that traditional "diet and excercise" methods don't provide. I have no doubt that's part of the reason WLS patients are able to maintain their loss so much more successfully than those doing it the "old fashioned way". For some reason our metabolisms don't take as big of a hit.

You bring up a very interesting point because the surgery is done on our stomachs and not our brains. I think its quite interesting insurance only requires one visit to a psychiatrist and that is before surgery (nothing after). I completely agree that patients are monitored and cared for as far as any physical changes after surgery (i.e. complications) but what about mental changes? Complications can occur there too. If a person doesn't understand why they have a problem with their weight (and how to fix or properly cope), having surgery or going on a diet is only putting a band aid on a gunshot wound.
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Well thats awesome and very brave. I have heard nothing but positive things from people who go to Mexico for surgery (and its so much cheaper). Sent from my SM-G925T using the BariatricPal App

You bring up a very interesting point because the surgery is done on our stomachs and not our brains. I think its quite interesting insurance only requires one visit to a psychiatrist and that is before surgery (nothing after). I completely agree that patients are monitored and cared for as far as any physical changes after surgery (i.e. complications) but what about mental changes? Complications can occur there too. If a person doesn't understand why they have a problem with their weight (and how to fix or properly cope), having surgery or going on a diet is only putting a band aid on a gunshot wound.
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I'm curious about this too Sent from my SM-G925T using the BariatricPal App

Hello Everyone,
I thought I'd introduce myself on the site. This is my second go round at weight loss surgery (I was approved in 2013 for gastric sleeve through UHC but I chickened out the morning of surgery). This time I'll be getting surgery through Kaiser (the Fremont location and my surgeon is Dr. Hahn). In comparison to my experience last time I feel more ready for the lifetime changes I need to make in order to succeed with this surgery. I have been overweight all of my life. I've managed to lose 90 pounds twice, through low carb dieting and exercise, but each time I gain it back. I am really grateful to be able to participate in this support board as it has made my journey to surgery so much easier because I see there are people out there going through the exact same things I am.
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You are very welcome! I can't wait to hear about your appointment. Always remember..you are not alone in this journey:) Sent from my SM-G925T using the BariatricPal App

Hi @@audaciousmarie!
Thank you for posting this! Your timing was perfect! I was struggling with one of my bad habits when I saw this and it helped me get passed it. Hearing about the appointment made me excited for my next step and reminded me why I am doing this.

Hi @@Phoenix40! So last Thursday I went for my Nutrition/Surgeon/Coordinator appointment. I'll describe each appointment below:
First you are weighed in and your height is taken
Nutrition: The nutritionist is a very nice lady and she will ask you about what type of diet you have been on (I started following the 1200 calorie diet after orientation). You will have to describe what you usually eat for Breakfast, lunch, dinner, Snacks,etc. She also talks about Vitamins and what type you will need post op (this will depend on if you get the sleeve or bypass) and what to expect as far as diet goes in the first weeks after surgery (i.e. liquids, soft foods, etc) She also informed me about the different types of Protein drinks and answered any questions I had.
Surgeon: Dr. Hahn was very patient. He went over my BMI, co morbidities, medications, etc to ensure that I would be a good candidate for surgery. He said it would be my choice whether to go for sleeve or bypass as I would be great candidate for either (I don't have acid reflux). We talked about the differences between sleeve and bypass (right off the bat he discouraged from the lap band so we were in agreement about that). He reiterated that regain was possible with either surgery and so is dumping (so it really comes down to the patient being willing to put in the work to not only lose the weight but keep it off). He went into detail about possible complications withe each procedure (ulcers, reactive hypoglycemia, reflux, etc). He then set a weight loss goal for me. Normally they ask the patients to lose 10% of their body weight but Dr. Hahn only requires a 7-8%, of total body weight, loss. For me 7-8% was 19 pounds (I had already lost 9 pounds since orientation and he credited me so I needed to lose 10 pounds to get a surgery date and 5 pounds to get a psych appointment). The only other requirements Dr. Hahn set out for me, besides weight loss, is attending at least one support group, and an EKG (I already finished my bloodwork).
Coordinator: She was very pleasant. She informed of what my next steps to surgery are (support group, psych appointment, etc) and that to be sure I call monthly to update them on my weight and progress. Before the psych appointment each patient must fill out a surgery quiz (located in Chapter 9 of the Bariatric binder) and send it in before the appointment.
Overrall it was an interesting yet quick appointment. I was told to expect to be there for 3 hours but for me it was more like 2 hours.
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You look awesome. What lipstick are you wearing? Its so pretty:) Sent from my SM-G925T using the BariatricPal App

OK, different thought:
I was very successful during the weight losing phases of WLS. And coming up on 10 months of being at goal and beyond I've been very successful at maintaining my weight.
When I was losing weight I eschewed sugar and most starches, focusing instead on Protein (of both animal and plant varieties), healthy (colored, fibrous) veggies, whole grains and a little fruit. My calories the last two months I was losing weight averaged 1,200/day -- upon advice of my surgical team who explained that if I ate at 800 cals/day for all of my weight-losing phases I might wind up with a body that became too accustomed to those low cals to burn later (in maintenance) at a higher metabolic rate.
Well, now that I've been at or below goal for nearly 10 months and am eating 1700 (and lately 1800) calories/day to maintain at 135 pounds, I have a new eating philosophy: I now eat all the healthy things I used to eat -- as well as wine, some dark chocolate, and other simple carbs.
So far, that approach is working out well. If it stops working well, I'll change how I'm eating.
What we're "supposed" to do really does vary a lot from person to person -- depending on their metabolism, their activity levels, their genetic contributors, etc. I have women friends my age / my size / my activity level who can eat only 1,000 calories a day and maintain their weight. A few people I've met online can eat even more than I can and maintain their weight.
This is all very, very personal. We have to take responsibility for understanding what will work for us. I'm so much less of a zealot than I used to be about what everyone should eat to maintain their weight -- because I've watched my own expectations about my own body's responses be shot down by reality.
Live and learn! Seriously, it's a good philosophy.