Seastars

@@hats123, congrats on your progress! I agree with your summary of life 5 to 6 months post-sleeve: you just don't think about it (or food or dieting or self-loathing or obsessive exercise).

For me, eating 4 good Protein "doses" per day and fitting in all my Vitamins (morning and afternoon Multivitamin with iron; then 3 500g Calcium doses spread through the day) is now habit. Weight comes off slowly now - I just got off a long stall - but I am still losing. I'm back to all my old clothes and feel like "me" again. Such a relief.

I eat about 6 to 8 bites the size of a nickel. chicken feels me up more than tuna or ground beef.

I still can't get myself to put canned tuna in my mouth, and it was one of my very favorite foods pre-op!

Have you tried those 100-calorie packets of tuna or salmon, with flavors like lemon pepper, Thai seasonings, ranch? They are in the canned-tuna area and really easy for lunches. Or there's raw tuna - since you are in Seattle (too) you know that poké is huge here now, at restaurants and even grocery stores.

I am a slow loser but am now down 75# and almost to first goal. I found that once I got to a normal BMI, I got lazy... dawdling over meals so I could eat more, skipping workouts. So I stalled again, and it was my own fault! But after reading a few sleever blogs, I realized that could be the start to a big regain. Now I'm re-committed. I want to reach my stretch goal of135#! Glad this thread is reviving so we can keep supporting each other.

Here's a 2012 analysis suggesting that bariatric surgery (of all types) does change body shape, but opposite to what we're experiencing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307505/ Those authors conclude that patients lose a greater percentage of abdominal weight - becoming more pear-shaped instead of Apple-shaped.

Wow, guys, thank you for affirming that it's not just me dealing with this! I wonder if it's our hi-protein/low-carb diets causing this pattern (of bodies holding on to abdominal fat and evicting our behinds), or something to do with the surgery itself?

It is weird seeing myself Apple-shaped. Even though I'm happy to have lost weight, I don't like this new body shape.

Update: my 6-week stall eventually ended, as did a recent 3-month stall. The hunger pangs are definitely back to pre-op levels, and my doctor again recommends appetite suppressants (specifically, the legal half of phen-fen). He says almost all sleevers see a return of hunger at 6-9 months, and some (me) sooner. I'm just relying on the restrictive tool of my surgery now.

Thanks, all, for the input!

Like many sleevers, I had years of roller-coaster dieting (down 40, up 50 etc) before opting for surgery. On those pre-op diets I'd lose weight in a specific order: first my face, then waist, and lastly thighs. But post-op it's different. I lost in the face, yes, but then most of my backside and hips, and some off the thighs. This is the first time in my life that I've had a flat butt (I miss it). My waist meanwhile is still thick with an obvious layer of fat (not just skin). My arms are still dimply, too.

Has this happened to others? My cardio is less than on those pre-op diets (where I would overexercise, often 3+ hours per day) but I'm doing ab/core work daily in addition to regular cardio. Eating a lot less carbs and sugar than pre-sleeve, of course.

Ugh, Shelterdog, sounds awful!

FWIW, Dr. Google says...

"Known as “frothing and foaming,” this spit-up is the white frothy liquid caused when the new pouch no longer contains stomach acids to break down your foods. This thick mucus mixes with the food to move it through your new pouch and into the rest of your digestive tract. Try drinking warm fluids first thing in the morning, throughout the day, or when you have found the spitting up is the worst. This helps to break this mucus down."

Hey, sleeve comrades. I've been posting in my own thread (in the stalls section) about my frustration with a two-week stall and the return of hunger pangs (yes, real hunger). I'm glad for the restriction of the pouch, but being hungry often (like we all had pre-surgery when dieting) makes sticking to plan difficult. This last week I've had a couple of big Greek salads (taking all day to eat them) and, once, a piece of pizza. But otherwise toooons of Protein including at least two shakes per day, still.

I'm not losing as fast as the rest of you (only 22 pounds in about 6 weeks), but I'm still losing. I have a reward planned when I reach normal BMI (14 pounds more to go), so I'm focusing on that instead of my farther-away goal weight.

I've started taking Optifiber (the costco version of Benefiber) to improve regularity, and I really like it. Entirely tasteless and no grit; I just throw it into a shake. It's amazing how much better regular bathroom visits make you feel!

Your clinic may offer one (mine does, in Seattle & Issaquah).

There's also a Seattle-area FB group.

Back to the OP: I had a BMI of 30 when I was sleeved, almost 6 weeks ago. I was - and still am - very fit,but kept gaining weight. You can see my resulting stats. Glad i did the WLS.

@@Seastars Holy crap! Your doctor offered you appetite suppressants??!!?? I'm blown away. Your hunger will ebb and flow. It will go away for a while and then creep back in. For some people, it stays away, for others, not so much. But I have never heard of a doctor offering up pills. Or am I naive? Does this happen but nobody talks about?

I have no idea if this is normal/usual. This is my first adventure into WLS. It's a weird world to be sure, questioning everything I ever knew about nutrition and health. I'm... baffled. But desperate to lose weight, so time to follow medical advice instead of what I know myself.

Oh, and hunger pangs while trying to keep a 800-1000 calorie diet SUCKS ROCKS.

(I know this thread has moved off from my specific stall and context, but just to close the loop: I saw my doc on Monday. He agrees that my calorie range of 800-1000, with occassional up to 1200 on very heavy hiking days, is appropriate. He likes my 100-125g Protein intake. Loves that I cut way down on legumes and fruit. He said I don't have acid reflux - that I am having actual hunger pangs and should eat more when these occur. He offered appetite suppressants if I want them - I don't yet, figure I can willpower this through for a while more yet. And most of all, he thinks I'm overtraining and need to cut back on exerciise. According to him, I can't keep up my pre-surgery level of workouts without overstressing my body. So go figure: I get WLS surgery and am told to REDUCE my exercise and continue avoiding whole foods. Oh, and my pre-surgery hunger is back. Oh goody! But most importantly, I guess, I'm losing weight. Post-sleeve life is weird indeed.)

Chiming in to add: my team calculates one's Protein needs based on one's lean mass. The studies I've read online suggest that this is slightly better than calculating based on BMI, and much better than calculating based on overall weight.

I've got 125 pounds of lean mass that I'd like to preserve as much as possible, so while I'm dieting my Protein goal is 100-125g/day. In maintenance mode it may go down some.

Today, having broken my 2-week stall by reducing calories a bit, I'm down 20 pounds since surgery! I'm 6 1/2 weeks out. 16 more pounds until I'm normal (not obese, not even overweight) and 30 pounds to goal.

candy and OKC, thank you so much! OKC,I think you are right on both points. (Underweight = longevity and better health, and I am not burning as much through exercise as my dietician calculated.). Candy, I was humbled by this stall, how very upset I got, and how relieved when I started losing again. I knew I had emotional issues around my weight and dieting, but yikes - way to get melodramatic. I'm also surprised at how surprised I am that my dietician is wrong. An R.D. degree doesn't make her perfect. (And I am finding that my clinic's "one size fits all" post-op rules DON'T fit everyone, especially people who had a high level of fitness - and "efficient muscles" - pre-op.)

I also really appreciate the tips on acid reducers,how my current dosage might not be enough and how acid release can seem like hunger pangs.

@@Seastars With regard to the hunger you're feeling, when you follow up with your team about the ppi you're taking, maybe you can also look into taking a probiotic. The one I take is a pre and probiotic and really helps with gut health. I take one in the morning and then take my ppi when I get home from work. I'm not a doctor but it might help you.

Yup, I take a double dose of Probiotics every evening. But I think you are on to something about my acid reducer not being strong enough - and the resulting acid activity resembling hunger pangs. Very glad for that pointer (cuz I really dislike feeling hungry). Will ask my clinician when I see her on Monday.

I wouldn't expect a lower BMI patient to lose 18% in the first month, not pure fat, anyway. For me, that would have been 31 pounds, and there is no way in hell I got close to that number. My BMI was 34 at surgery. Everybody is different, but that is still a lot of weight to lose in one month. I am losing steadily now, thankfully, but I sure had a slower start. I don't expect any certain result by any certain date, because it makes me crazy trying meet a predetermined expectation. I am just allowing my body to take care of itself while I eat the right things and get my exercise. And of course--Protein and water!!

The percentage is of excess weight, not overall weight. Your ticker suggests you had 95# excess weight. On average, a person with your stats would lose about 18# in the first month with the sleeve.

My team had said that the first month you lose the most weight and then the loss percentage reduces. I just found this to support that general rule:

Findings in the October-December 2013 issue of the "Journal of the Society of Laparoendoscopic Surgeons" suggested that people having sleeve gastrectomy lost more of their excess weight in the first few months after surgery. In this study of 100 patients, on average, subjects lost about 18 percent of their excess weight in the first month. Average weight loss by the end of 6 months was 50 percent of the excess body weight, and by the end of the first year, they had lost about 63 percent of their excess weight.

(And by that average percentage, I'm doing ok - I lost 24% of my excess weight in the first month.)

@@Seastars

This is just food for thought (pardon the pun). When you are speaking of carbs, I get the impression you are taking about whole grains mostly.

Good carbs like Beans, legumes, vegetables and even fruit are a good part of a low carb diet. My nut has said from the beginning that I must included veggies and fruit daily so she had me follow this simple rule. 2 bites of Protein for every 1 bite of good carbs like veggies or fruit.

I would not be afraid of using Beans and legumes as part of your diet while losing. I would worry about adding whole grains just yet because you are in the lose phase.

Again, this is just my opinion and you may already be eating veggies and some fruit. I just wanted to ensure that low carb doesn't mean no carb.

I lost 151lbs eating meat & cheese Proteins, veggies and fruit over a period of 18 months. Now, I lost slower because I had restrictions after having 4 surgeries in a year but I did it with a 2 bites of Protein to every 1 bite of good carbs. I stayed away from Pasta, bread, cereals, rice and sweets. I allowed potatoes once or twice per week max.

I still drink one 30gram protein shake a day because I struggle to get enough. I believe a still have a really good restriction. I am lucky if I can get 2 oz of dense protein.

Thanks, DJ. By "carbs" I am talking about ALL carbs (other than nonsoluble fiber) - anything with calories. My dietician has different rules for me than yours does for you, sounds like. I am definitely supposed to keep ALL carbs - including fruit and legumes, my former staples - reduced very low. Basically I can get a small amount of either one in a day if I don't have any carbs at all for a couple of meals. Definitely no more than once a day, and frankly, even once a day gets me pretty high in calories. Carbs add up fast 10 almonds are 1/4 carbs (and 1/2 fat), for instance - not a good protein source. People may talk about fruit and legumes being "good carbs" but I am supposed to keep them very reduced because they are still carbs, regardless of micronutrients attached. They still have non-protein calories, so they are not good for me.

Of course I'm not supposed to eat ANY Pasta, potatoes, grains, sweets, junk. I did cheat & have small amounts of pasta a couple of times, brown rice once (in sushi), small amount of quinoa yesterday, but those are all treats. Technically they are all off-limits.

I'm allowed/encouraged to eat green veggies but only after I've finished all my protein portion at a meal.

In better news, all that extra exercise this weekend maybe moved me off the stall! I'm down three pounds today.

Oh, so they measured you. I see. I'm so glad you're losing again. So proud of you! <3

Thanks! This is just from my own scale - I don't have another clinic appt until next week. Hopefully I'll find out then that I'm mostly losing fat, not muscle. (My clothing fits the same so I know I'm not building muscle. Hoping to maintain what I've got, though.)

ETA: they do require lots of supplements to make up for the Vitamins I'd otherwise be getting in "healthy carbs."

@@Seastars It depends on the professional - there are varying opinions. Whatever works for you but it seems that you are extreme dieting (eliminating all carbs) and exercising more than most people can rather than using your sleeve. I am having this surgery to help me limit the quantity of food but still be able to enjoy a balanced meal (Protein and produce). Healthy carbs are necessary in our diets.

Glad you are back to losing.

Yes, my dietician has me on very low carbs. (Not none, but very low.) My clinic is very, very much in favor of high-protein, low-carb for weight loss. "Healthy carbs" was what got me obese.

In better news, all that extra exercise this weekend maybe moved me off the stall! I'm down three pounds today.

You asked us why you're having a stall, and taking in so many calories might be the reason. 1200 calories was the amount of calories I would have to take in to lose weight WITHOUT the gastric sleeve. That's to keep me from starving since my stomach is big. The point of having the sleeve is to shrink your stomach in order to be able to handle a low calorie diet (i.e. 500-800 calories). Most gastric sleeves are performed in a way that only allows you to hold a 4 oz meal.

My clinic team measured my resting metabolism (sounds like your team measured yours, too). I need a little over 1800 calories per day - without factoring in exercise - to maintain my weight [specifically, to maintain at 201], because I have a high muscle mass. Part of the reason my dietician wants me at up to 1200 on heavy workout days, is to maintain as much of that muscle mass as possible.

So in theory, my eating 800-1000, and sometimes 1200, plus exercising, should have me dropping weight. But we all know that weight loss doesn't follow an exact mathematical formula, alas!

@@Seastars Hummus should not have alot of carbs. Try things like tuna (with mayo and could add avocado), chicken salad, egg salad. I would also add some veggies to your diet (be sure to eat Protein first). Good carbs should be part of your diet. Beans are a great source of Protein and Fiber. Don't rule them out as high carb (and the reason you got obese pre-surgery).

Hummus has nearly twice as many carb grams as protein grams. Other Beans have twice as much carbs as protein. Alas, no way that beans can regularly fit into a low-carb life.

I became obese in large part because I figured if I exercised a lot, ate healthful whole foods (including "good carbs"), and listened to my body, I'd be fine. Turns out that the whole foods were very high carb and my pre-diabetic body was sending my an overdose of hunger messages. So part of surgery, for me, is starting over with NON-whole foods (lots of supplements and shakes with artificial sugars), NON-plant foods (lots more chicken and fish now; cut out almost all grains, beans, fruits). As I realized, the way I was eating wasn't working - so time to listen to the professionals. Which gets frustrating because the professional dietician is telling me to eat a little MORE now while you guys are mostly saying eat less!