JAM72

Three+ months of no weight loss isn't a stall, it's maintenance. It means you aren't eating at a caloric deficit.
You have been really successful at losing weight -- you know how you ate when you were losing weight. That's what you need to do again. Exercise is great, but the battle to lose weight is won in the kitchen, not in the gym.
If you aren't already, carefully weigh or measure your portions and track your intake on MyFitnessPal or a similar app, at least for a few weeks, in order to get a clear picture of exactly how many calories you are taking in.
If you are like most people who have been morbidly obese, your maintenance calorie level would be about 2100 calories per day (current weight x 10).
To lose a pound a week, eat 1600 calories per day (do not count calories burned via exercise and try to "eat them back.").
To lose 2 pounds per week, eat 1100 calories per day.
If you are very confident about your calorie intake and tracking and not losing at those amounts, your resting metabolic rate may be lower than that and you need to drop your calories further.
As far as hunger goes -- yes, hunger comes back. You need to learn ways to deal with it other than eating. You can never out-eat hunger. It is okay to be hungry. Hunger doesn't mean you are about to starve to death. I did Cognitive Behavioral Therapy to learn ways of dealing with hunger other than eating. Some simple techniques are things like planning all your eating at the beginning of the day and writing down your food plan. Then when you get hungry, you remind yourself "I'm hungry, but that's okay. I can wait until 11 AM when I get my chicken breast snack."
Good luck!

I am also scheduled for November 18! I am more impatient than scared at this point. It's been a long road and I'm ready to get on with it already!

I started my 1-week pre-op diet at 237 and I went into surgery at 228 on Sep 9, 2013. By Christmas of that year I was 195- 200 pounds...so I lost 28-33ish pounds between surgery and Christmas (4 months). I then dropped again from January to May, at which point I was stuck at 177 for WEEKS. I added more exercise, improved my diet, and by September 2014, I was at 158 pounds. I averaged about 6.5 pounds a month for the first year, of which some of that time I barely lost anything. I then had my first plastics procedure, after which I couldn't workout, so I lost some muscle and I went into my second plastics procedure in November at 143ish. By the second Christmas post-sleeve I was 134, where I then stayed until April of the next year, which means it took me exactly 18 months to get to goal of 129, which was 108 pounds and works out to 6 pounds a month. It was NOT a speedy process.
I am now at 37 months post-op and I have been at goal (I fluctuate up and down about 3 pounds, so I hit 132.8 and I drop to 126 throughout the month) this entire time. Last Halloween I ate to much crap and I woke up November first at 137. It took almost 6 weeks to get back into my goal range again, so had I not been very cognizant of even a little weight gain, it would have taken forever to lose more than that. Since that time, November 2015, I have stayed within my 126-133 range, and I'm usually between 129-132. Once I get even a little over 132, that day I start making changes. I've been drinking a lot of coffee the last few weeks which involved milk and caramel and I noticed that my weight was getting very close to that 132.8. I cut out the coffee (and sugar and milk) and this morning I'm back at 130.
Although this is a long post, from the perspective of being over 3 months out, losing weight was not easy and it was not fast. It required waking up every single day and focusing on an end goal that didn't seem like it would happen. That doesn't change when you hit goal. I still weigh myself every morning and when my weight starts to creep up a pound or three, I login to MyFitnessPal and I am very careful for a few days until I get back into my goal range. If you want to be thin the rest of your life will be about being aware of what you eat and what you weigh, because if it's hard to lose now, it is an absolute B to lose weight a year or two out from surgery. Once you lose it, keep it off!
Slow and steady may not legitimately win the race, but it has worked well for me. Good luck!

(RN and comprehensive sex educator hats on)
There is nothing structurally different at any point in the intestines for a sleeved patient. For the lower intestines including the rectum, sigmoid, and descending colon (the parts that could potentially be involved), there is no structural difference for a RNY patient either. I don't know much about duodenal switch, but I wouldn't imagine that they've rearranged anything that far down the intestines.
So structurally, there's nothing changed that would affect the act.
However, there are bowel habit changes that may need to be considered. Many people have Constipation which of course can result in retained stool that you might want to address beforehand due to hygiene or comfort issues. Constipation also has the complication of creating or aggravating hemorrhoids which can cause pain and bleeding with anal intercourse. Other people have varying degrees of diarrhea post surgery, and sometimes with some stool incontinence (hence the warning "never trust a fart"). So this could create a hygiene issue which again you might want to address beforehand.
While I know the topic may be shocking to many, I believe it's important for adults to be able to discuss sexual matters and their bodies without embarrassment. Our societal discomfort with the subject of sex is a holdover from our puritan roots, and I believe it should be reversed.

Hi all!
I have had my surgery scheduled since August, but waited until November 17th so I wouldn't have to take too much time off work. I'm a teacher and am having the sleeve done just before Thanksgiving break. I am starting my pre-op diet this week and have been starting to have dreams about surgery and after surgery. I know this is anxiety, but I'm afraid to fail. Luckily I have a good support group and a good therapist. Did any of y'all have weird dreams? Do you have any tips for the pre-op liquid diet? I'm having my surgery through Kim Bariatrics, and I think it's a pretty strict liquid diet. Thanks in advance for any info you can share!
<a href='http://www.bariatricpal.com'><img src='http://www.bariatricpal.com/tickers/302718-carlyanncan/surgery.png?ts=1477243976' /></a>

http://www.bariatriceating.com/2015/07/the-truth-about-bariatric-surgery/
Anyone want to share your take on this article?
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It is hard to express the changes that has happened since my surgery, first, to be able to move so much more freely and pain free as well. Second, not to be driven by insane hunger. Third, to see light at the end of the tunnel, knowing the weight will come off as I go forwards step by step. Forth, knowing with each pound I lose, I add to my life expectancy, being more interactive with my children, grandchildren, and they will have memories of me doing things with them, not sitting on the sidelines. I commend your for facing your anxieties, that courage you already have will propel you towards these new challenges and you will succeed with flying colors.

@@JMill 72 - Thank you for your original post here. You articulated exactly what I was feeling but had not put into words yet. I too suffer from GAD which is part of the issue. We have to change the negative rhetoric we allow in our brains! In my research over the last year I have found lots to fret about. I think I am going to spend some time just looking at the positive stuff out there about bariatric surgery! Thanks everyone for your responses- I feel inspired!

Super inspiring! My surgery is scheduled for November 18, and I am counting down the days. I have also wondered about how to deal with what I call "trigger" foods - bread, Pasta, rice, sugar - and like your idea of not introducing them back into your diet post-surgery. Thank you for the inspiring and informative post!!

I chose not to tell most people. No negativity received!

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Great. One month out. Had a check up with my surgeon today and she was pleased. I'm still on soft foods but I'm satisfied! No complaints. Pounds are slowly coming off. Down 40 pounds since first day of liquid diet 2 weeks prior to surgery. Am exercising at cardiac rehab (had a stent over a year ago) I "graduated" but my hospital lets you continue if you want to so I do! Have NOT regretted any of this for even a moment!
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For most people weight loss isn't consistent on a daily or even weekly basis. Not just for the first few weeks, but throughout. That's why it is good to only weigh once a month or at your post-op doctor's visits, if the lack of consistency is going to stress you out. You can also use a site like Trend Weight to get the bigger picture.
A lot of people imagine their weight loss plotted on a graph will look like a smooth, straight line headed down to the right. Instead, imagine the outline of a staircase plotted onto the graph. And the staircase was designed and built by people who were drunk and couldn't see very well.
As far as expectations as to how much you will lose -- please, I beg you, put that idea aside. It seems like every day someone is on here, posting that they are freaked out because they aren't losing as much as they expected, and they always expect some insane amount of weight loss. Just get rid of the idea of expectations around weight loss and focus on your own expectations of how well you are going to comply with your post-op program. That's really the only thing you can control, and therefore the only thing that is worth feeling either good or bad about.
Good luck!

If you're taking your time when eating-- you'll get a "feel" for it. So you don't want to be full. Ever. You want to eat to the point of satisfaction. So try to get used to that feeling. Start paying close attention when you eat. When you can be present in that moment Small bites, chew thoroughly and when you start to feel satisfied even if its after 2-3 bites then that's it. You're done. PUT IT DOWN. This is a habit you want to develop asap. I was eating a piece of baked lemon pepper Cod last night. I weighed a 3 oz portion because I wasn't going to eat anything else but that piece of fish. after taking just a few small bites I started to feel satisfied. I was actually mid chew and decided to stop right there and I had only eaten 1 oz! I put it away and when I started to get a little hungry later that evening I went back to it. Still didn't finish it but I was satisfied. Which again-- is the goal.

My BMI was 35.4 at the time of surgery. I'm 10 weeks post op and don't regret it at all. The first few days were harder than I expected so keep realistic expectations since everyone is different. I thought mine would be a cake walk which set me up for quite a struggle those first few days.

No regrets. No complications. All excess weight gone. Maintaining loss for 7 months now. I changed my eating habits and like the way I eat now. I love that I will always have this restriction. I feel like I eat reasonably sized meals, I just can't overeat which is such a blessing.

I would do it again. Only 6 weeks out - hunger gone, down 40 pounds and more energy than I've had in years.
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My sleeve surgery was a freaking cakewalk.
Not thing to it.
I'd do it again tomorrow without a second thought.

I would do it again several times a year (not kidding) if that was what was required to maintain my weight loss. Thankfully, it isn't, but yeah I would do it again and again and again if needed.
I am a peaceful person but if a medical team showed up and said they planned to do a takeback on my surgery (not medically possible ofc) I would beat them to death with my clawhammer and not regret it.

Looking for others who may have felt the same way before WLS:
I suffer from mild, general anxiety and have been seeing a wonderful counselor for about 6 months. During that time, we started talking about my weight, whether I wanted to do something about it, and what that might be. This led me to finally move forward with WLS, which I had thought about on and off for a couple of years. I am 40 days out from my sleeve surgery.
However...
In my heart of hearts, I feel that something is fundamentally "wrong" with me. I am pretty driven and resilient and have been "successful" in other important areas of my life (school, career, marriage, family). But my weight is the ONE THING I haven't been able to tackle successfully on my own. Why?? How on earth did I allow myself to get this way? And why should I expect that this time is going to be any different than all the other times I've tried to lose weight?
I feel desperate and scared. WLS is my last chance - the "nuclear" option. I am so worried that I will fail again. I know the statistics are on my side in terms of success, but my many, many past failures make it really hard to believe this is going to work. I can't seem to shake this feeling.
Did anyone else go through this? Did it get better after the surgery when you started having success?
Thanks to all who reply!

@@butterfly23 - thank you for your reply and for sharing your perspective! I've read many of your other posts on this site and am really inspired by your journey and success.
I know the serenity prayer well (from my mom, who struggled with alcoholism). I haven't thought of it for a long time, but it's so appropriate. Thank you for the reminder!

@@JMill 72 I just saw your post and can really relate, especially to the part about feeling successful in most or all other aspects of life, but the inability to lose weight somehow invalidated all my other strengths, hence my anxiety that if WLS doesn't help, I'm an utter failure.
Sounds like you already are trusting the process, which for me was so important to not focus on the goal and outcome (but to have them, yet focus on the process instead). Like you said, focus on what you can control.
Since this is not a diet but a way of life, how we get there is more important as we need to do it for the rest of our lives, not just immediately before and after WLS.
I say the serenity prayer many times a day just for that reason:
God, grant me the serenity to accept the things I cannot change.
The courage to change the things I can
and the wisdom to know the difference.
Your surgery will be here before you know it, best of luck but seems like you have a healthy perspective!

@@Teagrrl - you are just like me! I have been working with my counselor on this over the last few weeks. What is helping me a little right now is reading about weight loss studies. The results are grim; only a small percentage of people are able to lose weight without surgery and keep it off for any length of time. This does two things for me:
1) it is helping me change my negative thoughts about myself. There are LOTS of people in my shoes who also can't lose weight on their own. And it's not because of a lack of willpower or that we don't know how to diet or because there is something wrong with our character. Our bodies are complex and, for reasons we don't understand yet, are incredibly resistant to weight loss.
2) it is reinforcing that I am making the right decision. I really, honestly want to solve this issue, and surgery is the smartest option. For me.
I am scared. So scared I will fail. But I have to try. So that's where I'm at today.
I'd love to hear about your journey as you go through your initial consults. Good luck!

@@James Marusek @@laceemouse @@WLSResources/ClothingExch @@shedo82773 - thank you so much for your replies! Hearing from people who have gone through the surgery is SO helpful, and I really appreciate you taking the time to write a response. I know the surgery is a tool and I fully intend to follow the rules laid out by my surgeon. I also know I am going to have to closely monitor my food intake and weight forever and continue to work through my food issues with my counselor - all part of the deal. I'm just struggling to comprehend how this tool will affect the desperation and hopelessness I have felt about my weight situation, watching my weight creep up and up for years despite all the diets and exercise routines I've tried. And that's where your insights are really helpful to me. Thank you again!

@@Cervidae - YES and YES!! Thank you so much for sharing your story! I also can't quite wrap my mind around the idea that this will actually work since I've failed 100% of my past attempts. This is also where the desperation comes from - the idea that I may be overweight forever. I love your approach. I read a post by someone recently who said they never actually set a goal weight. They just followed their surgeon's program, focused on making healthy choices, and let the chips fall where they may. And both of you have had tremendous success! I think I need to follow your lead and surrender myself to the surgery, so to speak. Focus on controlling what I can control, which are my choices but not the outcome. Thank you again for taking the time to reply! Your success is so inspiring!