Introversion

I am two years out. Since the beginning, I never counted anything other than protein and water ounces. My bariatric program didn't give a rat's patooty about carbs or fat grams. They didn't require me to count calories or track. Their theory: if you exceed 80+ grams of protein and 64+ ounces of water post-op, you will not have enough room to eat that many grams of carbs or fat in the first place. Therefore, there's no need to count the other macros. To this day, I still don't count carbs or fat. Also, cutting back on fat is misguided because dietary fat is not what makes us fat. Actually, fat is satiating and satisfying, causing us to eat less than we normally would have.

This is a normal phenomenon in gastric bypass patients. It is called intestinal adaptation. Over the years, the small intestine of a person with a gastric bypass adapts to the malabsorption by increasing villi height and absorbing more calories. Enhanced caloric absorption = Weight regain (if you eat crap) It should be noted that those who strictly adhere to the "protein first" dietary mantra do not regain, even after 15 or 20 years out. However, consumption of sliders (crackers, chips, popcorn, etc.) spells trouble. I met someone who had gastric bypass in 2002. In 2011, during prolonged immobilization after fracturing her ankle, she regained 25 pounds in 6 weeks by grazing on potato chips. The weight regain was quizzically rapid. She got back on track and lost the weight, but her diet today consists strictly of lean meats and veggies. My point: once intestinal adaptation has occurred, a revision will not help if you consume snacky slider foods.

Although I resumed exercising at three months post-op, I concur with about 80 percent of what Dr. Vuong has said. Contrary to popular notions, exercise alone does not drive weight loss. Dietary choices are 90 percent of the equation. Exercise is important for weight maintenance, but carries far less importance for weight loss. Here is another tidbit that the vast majority of bariatric surgeons do not reveal to their patients so as to not discourage anyone: the speed of weight loss during the first year is based on genetics. During the second year it is 50 percent genetics and 50 percent lifestyle. By the third year it is all about lifestyle choices. One of the aforementioned surgeons (Dr. Weiner) mentioned the genetic component in one of his videos. He refers to those with the two beneficial markers on chromosome 15 as "super responders." These people lose rapidly in the first year regardless of what they do because favorable genetics drives their weight loss. These people can lose 20 to 35 pounds monthly eating Krispy Kreme donuts and chili cheese fries and reach goal weight in less than a year. These people can also lose 20 to 35 pounds monthly eating cleanly and exercising and reach goal in less than a year. It does not matter. However, the genetically blessed super-responders who lost all their excess weight in the first year while eating junk are often the ones who start regaining in years two and three. In the second year and beyond, the genetic advantage diminishes and lifestyle choices such as food choices becomes critical. People with only one beneficial marker on chromosome 15 will lose at an average rate in the first year regardless of what they do. People with no beneficial markers on chromosome 15 are the non-responders who lose less than 30 pounds regardless of strict adherence to diet and exercise. Genetics drives weight loss during the honeymoon period, folks. Most bariatric surgeons read the peer-reviewed articles and already know this. Nonetheless, bariatric surgery teams advise patients to exercise for health benefits and as part of a comprehensive lifestyle change toward the better. Exercise is important for body recomposition, cardiovascular health, and weight maintenance. I love exercise and run an average of 30 miles weekly. Still, it is not as important for weight loss. https://intensivedietarymanagement.com/exercise-is-not-total-energy-expenditure/

I notice you have a gastric bypass while I have a sleeve. My starting weight of 218 pounds on surgery day was also considerably lower than your starting point. It took me 18 months to lose 100 pounds. The first 80 pounds came off in 12 months whereas the final 20 pounds were gradually lost over the next six months. I lost 15 pounds the first postop month, 12 pounds the second month, and an average of 3 to 6 pounds monthly thereafter. Yes, my weight loss was slower. I should also reveal that I am hypothyroid. However, I am thrilled with the end result of being able to maintain a fairly low body weight on about 2000 calories a day.

I weigh approximately 118 pounds and maintain my weight on 1900 to 2100 calories per day. Who in their right might would want to restrict to the 800-1000 range for maintenance? As the previous poster mentioned, those who restrict for too long destroy their metabolisms. The term is called metabolic derangement. At 3 to 4 months out I was eating about 1000 calories daily. By 6 months I had bumped it up to 1200, and by 9 months I was eating about 1400 to 1500 calories. By 12 months out I was up to 1700, and by 18 months I got up to 1800 to 2000. I am so glad I gradually raised my caloric intake in increments because it kept my metabolic rate in high gear. I am figuratively dancing on a cloud about being able to maintain on 2000+ calories a day.

Nope. A sleeved stomach is expected to relax and stretch somewhat. For a more detailed explanation, watch some of Dr. Matthew Weiner's YouTube videos. That tight postsurgical restriction does not last forever. He states that, by three to five years out, a typical sleever is able to eat two-thirds of a plate of food. Compare that to the three to five bites of food we were eating at a couple of months post-op. At two years out I can eat volumes of food that had been impossible during the first couple of months. I can eat two slices of pizza, although I choose not to. I can eat an entire 6-inch sub sandwich, although I choose not to. I can eat two small fast food cheeseburgers, although I choose not to. The further out you get from surgery, the more critical your food choices are. People regain weight from slider foods such as pizza and chips, not from dense proteins such as chicken breast and turkey. Even if your stomach has stretched to a 16-ounce capacity, a resleeve will not help if you eat crap. The size of the stomach does not matter nearly as much as what you put into it.

I tolerate popcorn with no adverse issues, but ain't nobody got time for that. Since popcorn is carb-laden and lacking protein, I do not eat it these days. You love popcorn, but do you really need it? For many people in the bariatric community, a love of certain foods got them to the point of needing weight loss surgery in the first place. Popcorn is a slider food, a.k.a. slurry food. And in sleevers, slider foods are the root of most weight regain. It is a phenomenon that most surgeons do not discuss with their patients. Sliders (e.g., chips, popcorn, crackers, bread rolls, pretzels, pastries, cookies) are low-nutritive, carb-laden 'snacky' types of foods that 'slide' through your stomach and into your small intestine without inducing fullness or satiety. You can literally graze on several pounds of popcorn without ever feeling full. The predictable result is weight gain. Popcorn is a wondrous food for dieters with normal sized stomachs. It can, however, spell disaster for sleeved folks who need to prioritize protein and fluids over snacks with minimal nutritive value. I will repeat that the road to weight regain in sleevers is paved with Doritos, Lays, Ruffles, popcorn, Chips Ahoy, crackers, pretzels, and donuts. There are 475 calories in a bag of Orville Redenbacher popcorn. You can eat the whole bag and still be hungry for more due to the lack of protein, or you can get incredibly stuffed eating four chicken drumsticks for 475 calories and 45 grams of protein. To maintain whatever weight you lose with a sleeve, the "protein first" lifestyle is imperative. Popcorn will not get you there.

Slow loser? Ha, ha! You lost 100 pounds in 9 months. I am considerably younger than you (age 34 when sleeved) and it took me approximately 18 months to lose 100 pounds. You are doing beautifully.

It is called transient hyperlipidemia, a.k.a. transient hypercholesterolemia. Do not worry... During the weight loss phase, our bodies are burning off masses of molecules of stored fatty acids. For some people, this results in a temporary rise in blood cholesterol levels. The same thing happened to me. Click on the link below to read more about this phenomenon. http://www.wheatbellyblog.com/2012/06/i-lost-weight-and-my-cholesterol-went-up/

I know of someone who was sleeved at 395 pounds on surgery day, lost 140 pounds during the first post-op year, then proceeded to regain it all plus more in the second year by eating copious amounts of slider foods. She is now exactly 400 pounds. I am two years out and have maintained my 100+ pound weight loss with decent food choices and exercise. However, I know I could easily regain everything if I resort to grazing on too many sliders. It is amazingly easy to eat around a bariatric surgery after one year out: just eat a slice of pizza every 45 to 60 minutes, and in a few hours you will finish the entire pizza. Slider foods, a.k.a. slurry foods, are the root of most regain problems in the weight loss surgery community. I have mentioned previously that the road to weight regain is paved with Pringles, Fritos, ice cream, fast food milkshakes, Doritos, Chips Ahoy, Oreo cookies, bread rolls, donuts, Lays potato chips, crackers, and popcorn. Since slider foods do not create that feeling of fullness or satiety in a sleeve, a sleeved person can eat unlimited amounts of chips and cookies. The result is fast weight gain. A sleever can eat a dozen glazed donuts and never feel full. Guess what? That dozen contained more than 2400 calories and you are still hungry for more. However, you cannot eat a dozen turkey burgers because you will feel full after eating one. The one turkey burger had 250 calories at the most. My capacity has tripled since those early days. At a month post-op I had no appetite and could eat maybe 3 ounces at the most before feeling stuffed. At two years out I can eat 8 to 9 ounces comfortably. My appetite returned full force during the 8th and 9th month post-op. At this stage in the game, it is all about good food choices for me.

I am exactly two years post-op since I was sleeved in April 2015. Losing a regain after undergoing bariatric surgery involves no special insider secrets or magical sorcery. My personal mantra is this: "The road to regain with a sleeve or bypass is often paved with snacky slider foods such as Lays, Pringles, Fritos, Ruffles, Doritos, popcorn, pretzels, crackers, breads, Oreos, Fig Newtons, and ice cream." Sliders (a.k.a. slurry foods) do not produce that important feeling of satiety or fullness in the sleeved stomach or bypass pouch, so we can eat unlimited amounts of them. They slide rapidly out of the stomach and into the intestine, promoting fast weight gain. If you eat sliders, I suggest you cut them out your life cold turkey ASAP. Revert to what you did during those first post-op months. Eat abundant lean protein such as chicken, fish, and beef. If you are still hungry, eat non-starchy veggies until full. Due to its high thermic effect, protein cranks up your metabolic rate because it requires more calories and energy to for your body to digest than slurry carbohydrates. Consider this: after eating 10 yeast dinner rolls you will never feel full. However, you cannot eat 10 tilapia fillets or 10 chicken drumsticks. You will be stuffed with one or two servings or fish or chicken. The 10 yeast rolls had 1200 calories and you are still hungry for more. The one tilapia fillet or chicken drumstick had 110 calories and you are feeling full in relatively short order.

I am also two years post-op. I was sleeved in April 2015, so we have something in common. There is no magical secret to losing a regain with weight loss surgery. I like to say that the road to regain with a sleeve or bypass is often paved with sliders such as Lays, Fritos, Ruffles, Doritos, popcorn, pretzels, breads, Oreos, and ice cream. Since sliders (a.k.a. slurry foods) generate no satiety or fullness in the sleeve or bypass pouch, you can eat unlimited amounts of them. They slide rapidly into the intestine and promote fast weight gain. If you eat any type of slider, it is time to cut this type of food out out your life cold turkey. Again, there is no secret to getting back on track. Return to what you did during those first few months post-op. Eat plenty of lean protein such as chicken, fish, and beef. If you are still hungry, finish the plate with non-starchy veggies. Due to its high thermic effect, protein revs up your metabolic rate because it requires more calories and energy to for your body to digest than slurry carbohydrates. Think about it: you can eat 50 tortilla chips and your stomach will never fill it. However, you cannot eat 50 chicken breasts. You will be stuffed with one or two breasts. The 50 tortilla chips has 500 calories and you are still hungry for more. The one chicken breast has about 175 calories and you are feeling full in 20 minutes or less.

You started at a lighter weight. Generally, the heavier a person is, the more rapid the weight losses will be during the first few months out. Certain groups of individuals (e.g., males, people under 35 years old, and the super-obese with BMIs greater than 50) are normally the faster losers. Likewise, others (older females, menopausal women, certain racial/ethnic minorities, lighter people with less than 70 pounds to lose, bariatric surgery revision patients, and those with metabolic problems such as diabetes, hypothyroidism, PCOS, and severe insulin resistance) sometimes end up in the slow-loser camp after weight loss surgery. Also, genetics is an issue that bariatric surgeons often do not discuss with patients to avoid discouragement. However, you had a gastric bypass, and a chromosome 15 genetic variant predicts the speed of weight loss after bypass. Those with two copies of the beneficial variant of chromosome 15 lose rapidly. Those with one variant copy lose at an average rate, while people with no copies of the genetic variant often have poor responses to the bypass and lose less than half their excess weight. https://hms.harvard.edu/news/genetics/gene-variant-linked-weight-loss-surgery-success-5-2-13

I just wanted to mention that the calorie counters on exercise machines tend to be notoriously inaccurate by overestimating caloric burn. Generally, most people burn about 100 calories per mile through walking unless there's plenty of inclines and hills. Heavier people burn slightly more and lightweights burn a little less. I attached a screen shot of the walking exercise routine you described below. I guessed your age, but overall, nobody comes close to burning 400 calories with walking at 2.4 miles per hour for one hour unless he/she is one of those super-obese people appears on the program "My 600-Pound Life" prior to getting bariatric surgery.

My scale(s) at home always displayed a lower weight than the ones at my various doctors' offices. At the doctors office, I usually weighed in at 3 to 4 pounds more than my home weight that same morning. Anyhow, insurance companies differ on how they proceed with an insured person's weight gain prior to surgery. My insurer apparently did not care because they still paid for my procedure although I had gained 25 pounds in four months while waiting to be sleeved (combination of food funerals and lack of self-control).

You cannot afford a $7 bottle of Centrum chewable vitamins that will last approximately three months? Do not get me wrong. I do not intend to come across as harsh at all. However, I also do not understand how an individual could undergo a malabsorptive bariatric surgery such as a roux-en-y gastric bypass that requires lifelong aftercare without being able to afford the costs associated with the aftercare. Ditch the applesauce, toast, and mashed potatoes. High-glycemic carbohydrates that are devoid of much protein should be avoided by someone who is less than four weeks post-op.

I have five surgical scars that are less than one inch in length each. For me, it was a trade-off: accept the minimal scarring or remain obese. I was not about to stay fat, so the scars were not a major issue for me. However, remaining obese is the bigger issue here. Obesity will cut your life short, whereas a scar or two will not. Obesity leads to diabetes, high blood pressure, high cholesterol, heart disease, arthritis, sleep apnea, and multiple types of cancer. Also, obesity is socially stigmatized: people would rather look at a surgical scar than gawk at one's badly overweight body. The obese are less likely to be hired, offered less pay for the same job as their thinner counterparts, and so forth. Society makes lazy judgments about the obese. Worrying about a scar appears to be a hyper-focus on the aesthetic aspect of surgery. Bariatric surgery is not about aesthetics; instead, it is about regaining one's health and living a healthier lifestyle. If a surgical scar is needed to add happier years to my life, then so be it.

It makes things easier when you lose weight prior to getting sleeved. Firstly, your liver is less congested when you lose weight, so it is more apt to be out of the way and less likely to be inadvertently nicked or scraped by the surgeon during the procedure. Finally, losing weight before surgery gets you that much closer to your goal weight. Do not be like me: I actually gained 25 pounds while waiting to be sleeved due to maladaptive food funerals (a.k.a. overeating all my favorite foods one last time before saying "goodbye"). My initial consultation weight was 200 pounds and I was up to 225 pounds one week before the surgery. Thank goodness my surgeon and insurance company had no issues with my substantial weight gain. I did reach my goal weight, but the weight gain prior to the sleeve was a setback. If I could do it all over again, I would have ensured my head was into the right mindset earlier in the process. Good luck to you.

You are not doing anything wrong. Look up the 'three week stall.' It happens to most sleeved people. You lost 24 pounds in less than three weeks. You lost more in 2.5 weeks than most gastric sleeve patients lose in a month. I would be walking on sunshine if I ever lost 24 pounds that fast. It is seriously time to adjust your expectations. You did not gain the weight overnight and will not lose it overnight. With my sleeve, I lost an average of 5 to 6 pounds per month (yes, very slow loser), yet I made it to my goal weight. It took me 18 months to lose 100 pounds. The rate of weight loss does not matter. What matters in the long run is your ability to keep it off for life. There's no point in being a lightning-fast Speedy Gonzales loser if you end up in the majority of sleevers who regain significant weight. Good luck to you. And stay off that scale for several weeks. Hide it!

You can still 'cheat' with weight loss surgery. In fact, you can gain all your weight back, even with a sleeve or gastric bypass. Slider foods (crackers, chips, popcorn, cookies, pretzels, pastries, ice cream) are the root of most weight regain in bariatric surgery patients. A small, surgically-altered stomach will not stop a person from 'cheating.' I know of someone who lost 140 pounds after gastric sleeve who proceeded to regain 150 pounds by snacking off the rails. Since slider foods don't generate satiety or fullness, you can eat unlimited amounts of them. And look at Carnie Wilson: she's a celebrity who underwent gastric bypass, yet regained two-thirds of her lost weight. Meanwhile, you can probably lose all your weight on a low-carb diet. Here's the lick: you will probably regain all those pounds you lose, plus more. Most of us can/could lose weight without surgery. I conjecture I lost several hundred pounds over the past couple of decades (for example: lose 50 pounds then regain 75 pounds, lose 60 pounds then regain 100 pounds, etc.). For most obese people, losing weight is not the main issue. Keeping the weight off long term is the problematic issue. A formerly fat person who loses all excess weight with diet and exercise only a 5% chance (or less) of keeping it off long term. In the vast majority of cases, the body fights to get back to its set-point and all weight is regained within five years. For those who are/were obese, bariatric surgery offers the only glimmer of hope to maintain whatever weight is lost.

Another afterthought...I want to provide the actual numbers associated with glycogen stores that results in weight gain. The important thing to consider is that you are likely NOT gaining fat. Your body stores 2+ grams of water for every 1 gram of glycogen stored in tissues. This results in increased body weight as well as potential bloating. However, it is water weight. You are not gaining fat. Remember that 1000 grams of glycogen needs 2000+ grams of water for storage in your tissues. Also, under-eating can result in weight gain. You are more than two years out. You should not be restricting your intake to the 600 to 1000 kCal range each day. You are doing metabolic damage by restricting so low and combining it with exercise. read the article below if you have the time. http://strongfigure.com/why-under-eating-is-making-you-gain-weight/

Glycogenation is the most common reason people see weight gain when starting a new exercise program. The new exercise program increases your muscle’s energy storage capacity. An active body demands more fuel, so it adapts by storing more of the carbohydrates you eat as glycogen in your muscle tissue. So you may be losing fat when you start a new workout program. However, the progress you make is cloaked by water weight gain. You have possibly lost a couple of pounds of fat the first week but gained several more pounds of muscle glycogen during that time. So you weigh yourself, see some notable weight gain, and conclude your hard workouts were all for nothing. Therefore, stay off the scale for a few weeks. Measure your progress during these first few weeks by how your clothes fit, not by the number on the scale. Also, 600 to 1000 calories a day is not nearly enough intake for an active lifestyle. The less you eat, the more your body retains water. The more water you retain, the bigger that number is on the scale. Give your body the food it needs, and it will eventually shed fat. For example, I am a 36-year-old hypothyroid female whose weight fluctuates between 117 and 120 pounds. We were sleeved in the same time frame (early 2015). I am two years out and consume anywhere from 1800 to 2100 calories per day. You are causing your body to hold on to fat and water for dear life by restricting so much. In other words, eat the food and stay off the scale.

I had a sleeve and needed to lose 100 pounds. I was a slower loser than most people in my age range (30s), losing at an average rate of about 5 pounds monthly. I eventually lost the 100 pounds in 18 months. Based on anecdotes, RNYs seem to lose somewhat more quickly than sleeve patients.

I was sleeved two years ago. I lost all my excess weight, so take my words and apply them as you wish. I never counted fat grams. The only two things I ever paid attention to were/are grams of protein and ounces of fluids consumed. Fat provided me with a feeling of satiety and fullness during my weight loss phase, so I did not cut back on it. Contrary to popular beliefs, dietary fat does not make people fat.

Most of us have lost substantial weight by ourselves without surgery in the past. However, the main problem is keeping off the weight. For me, the sleeve has offered a glimmer of hope for keeping the weight off long-term. What is the point of losing 100 pounds on your own through diet and exercise when you always regain it in a year or two? I have no regrets about bariatric surgery. I prefer being normal-weight over the ability to wolf down a large meal or oversized salad. Good luck to you.