etc. etc. etc.

My stomach disrupted a meeting at work the other day.

I am four months out from surgery and can eat a small appetizer sized portion of food already.

Some folks may be offended or have their feelings hurt by this rant. And I get that. We're vulnerable after this surgery, and in general as fat people who are struggling. And sometimes, we wring our hands and worry and just want people to listen. But I don't read this rant as unkind at all. There's a lot of truth here that people should try and reflect on. Everyone loses weight differently. That's one thing. But another, very specific one is about calories. I do feel like a sizable chunk of the people fretting over not having lost enough describe themselves as eating amazingly low amounts of calories, say... 500-600. It might seem like if you would lose weight at 750 calories (or whatever number your doctor assigns you) that you should lose even more if you eat less. But that's not how metabolism works. We're playing a trick on our systems with surgery. We're lowering the level of calories we can get by on without triggering a starvation response. But even though that number is lower, that response can still happen. You may need to eat more to lose more. I had a stall a few weeks back and got out of it by shifting from 750-900 calories a day to 900-1050. Other folks can explain with great emotion how hard they are trying, but do not actually log their intake, and so their assessment of what a great job they are doing is nothing more than a guess. People who do not even check their bank account balance should not claim they are great at saving and budgeting. The real message though is just to follow all of the instructions given by your physician and nutritionist as well as you possibly can. This is a wave you are trying to ride and the instructions they give you are for how to stay on it. It is not a good idea to try and outdo what they ask of you to see if you can get even better results. Do what they tell you to do. Eat what they tell you to eat, not less. Exercise mildly like they advise. Do not take up marathon running or something like that. Take your vitamins. Drink your water. And log everything you eat/drink/take in into some kind of app, so that you can hold yourself accountable. Anyway, I think you're all great and I'm glad you're here. Thanks for listening. We're all rooting for you.

In some states in the US (like Illinois where I live) insurers are required to approve weight loss surgery if you meet certain criteria (BMI alone if it's high enough or BMI of a slightly lower level with certain comorbidities). A clinic seminar is your best way to find out.

I was sleeved in August and it was the best thing I've ever done for myself. I've lost 104 pounds, I'm no longer pre-diabetic, I don't have high blood pressure, I don't have high cholesterol, I've gone from #XL to L shirts and from 48 inch waist pants to 36 inch waist pants. I don't get tired as easily or sweat all of the time, I feel better, I look better. I even smell better. I have some loose skin now on my thighs and under my arms, but honestly, that's small potatoes. Compared to all of the stuff we go through as morbidly obese people, it's nothing. You shouldn't let that worry you. That's like not being sure you'd want to win the lottery because you're not sure where you'd keep all of those new cars. Loose skin is an upper level problem. Don't sweat that at all.

I had my surgery on Friday and was back to work on Tuesday for a half day. I did another half day on Wednesday then was back to full time by Thursday. I have an office job that isn't too physically demanding and my recovery went really well, though.

I've taken over the meal planning for Xmas Eve and Xmas Day to make sure there is stuff I am okay with. For Xmas Eve, we'll be having some small lobster tails that are on sale at the grocery near us. They're like little 4 oz. tails for $5, but that will be perfect since my kid and I will only eat one each. my wife can have two. If I broil those, I can get a bunch of protein and feel like I'm having a treat without too many carbs. On Xmas Day, there will be apps around while friends are over but I've arranged for one of the apps to be those light Aidells chicken meatballs. So I should have stuff to eat both days. I am going to have some "chocolate" on Xmas Eve while my family does, but I picked up some of those Atkins bars and I figure one of those won't be so bad, as its carbs that hurt me more than anything and they're low in those.

I take in a bare minimum of 85 grams a day of protein, usually more like 100. I'm also meticulous about my vitamins. I do not seem to have lost hair since my surgery in August.

People say my face is the biggest difference...

As of this morning: 100 POUNDS LOST!

Is anyone else cold all the time? I used to be very warm-natured. Heck, I was sweaty, even in winter. But now I'm freakishly cold-natured. My fingers are ice cubes. I went from not always bothering with a winter coat to needing to wear hat, scarf, and gloves to leave the house. I drive with gloves on sometimes, because the steering wheel is too cold. I'd heard this happens to some people after bariatric surgery, but it's still been surprising.

Is anyone else hooked on these? Taste great (even cold), barely any carbs, not bad on calories. I've been buying them in bulk at Costco.

I have developed a technique for dealing with people I don't want to tell about bariatric surgery and it works so well. Here's how it goes... There is a particular pattern to most conversations about weight loss that goes like this. Observer: Wow! You've really lost a ton of weight. Person who lost weight: THANKS! [explains how they lost weight, how much they lost] All I do is when people I don't know/like enough ask me about my weight loss, I just politely say "Thanks." That's it. I don't give details on how much I lost, how I lost it... nothing. I then either smile and move on to something/someone else or I flat out change the subject. You would be amazed how well this works. People don't know what to do when you won't play the game. When they give you the opening to tell them about your weight loss and you don't take it, they just freeze. It works like a charm.

Hunger comes in waves for me. It depends on what is going on. I will have three or four days in a row of being able to eat exactly on plan without blinking then people will come over or my family will have something great for dinner/snacks/dessert or we'll spend all day at home or whatever and then it's a struggle. A lot of tiny temptations. I fight them off but it's tougher sometimes than others. I am finding though that if I feel like cheating a little bit, I do less damage and create less of a setback if I cheat on calories but not carbs. I'm shooting for 950 calories, 55 carbs per day. I seem to lose less ground eating 1200 calories/45 carbs than 1100 calories/75 carbs.

There is no set order that anything goes in. It's practically random and it's certainly different for everyone. I had a big round belly that started from my love handles and went all the way across and up to the middle of my ribs. I've lost most of the top part, weird divots a few inches out from my belly on each side, and now the area below my belly button is shrinking and pinching upwards, while the parts beside still sag. And the damn love handles have barely changed. There's not always rhyme or reason.

My skin is a little loose underneath my arm, kind of like a small web/wing between my triceps and body. My gut has no real loose skin, though it does have some fearsome stretch marks. Not sure how my legs will turn out, as they've gone from fat but firm to being like two sacks full of jelly. Mostly, I'm doing well. I eat very sparingly for breakfast and lunch most days then have something marginally more interesting for dinner (not like junk food, but something with some carbs like a wrap or with more calories like a burger without a bun) or maybe have a glass of wine with the extra slack I have left over. I track positively everything all the time and try hard to stay under 950 calories, 55 carbs, and 85+ grams of protein. I walk 5-8 miles a week, usually. Thanksgiving was tricky. I had a great plan for the actual day of Thanksgiving that I mostly kept to, but the night before I ended up grazing through some junk while cooking and getting ready and as a result of that and a semi-stall earlier, last week was something of a wash. I'm back on track now and am back to walking every day, so I hope to make the needle move again this week.

You were sleeved about seven weeks after me, Patrick. You'll get there, too!

And here's a before/after pic in the same jeans...

Non-scale achievements... I was cleaning out my closet this weekend and I threw out/donated about 2/3 of the stuff in it. Even some of the jeans I'd been so proud to be able to wear again after surgery are too big now. I also found a sweatshirt in the closet I didn't remember and tried it on. It fit great, so I went to show it to my wife and she told me it was hers... she'd bought it to stay warm while at her old job a while back. It's an L. (I was a solid 3XL before weight loss.) Most of the stuff I wear is XL now, but being able to wear even one L sized thing feels terrific. And here is a picture of me wearing the suit that used to fit me this time last year. My kid is wearing it with me this time.

So how are you planning on dealing with all of the food related temptations of Thanksgiving? I'm planning on being strict about eating the right portion sizes and focusing on protein the same as ever... and letting other stuff (total calories, carbs, etc.) slide. I figure I'm entitled to a little joy for Thanksgiving, but if I eat a light breakfast and lunch and fill my plate mostly with protein, small portions of carb and calorie heavy stuff for one meal won't kill me. I did ask my family to make fewer side dishes than usual this year, so that I won't feel the need to try as many things. And we're going to roll with just one dessert. I don't need four pies and cakes hanging out in the fridge all week taunting me. I'll have a small bit of the one dessert, but no other sweets. What are you planning?

Hey thanks! With so many sub-sections here, it's easy to miss stuff.

I knew it would happen to me eventually, but here it is: I'm stalled now too. I've only lost 1 pound in the last week. I'm not upset about it or anything. And it may have more than a little to do with me having been sick this week, both in terms of it being a strain on my system and in terms of me not being up for walking every day like usual. I also sort of have a paranoid suspicion that because I'm now at my lowest weight in ten years, my body is fighting me to hold steady. Nothing to do but wait and be extra careful with what I eat, tracking, etc. I do have a doctor's appointment tomorrow so I will see if they have any thoughts on how I might tweak my macros.

I've had a cold/cough this week and it's really slowing me down. I went to a movie marathon Saturday and I didn't want to ruin the movies for everyone, so I bought a bag of Ricola Sugar Free cough drops. Over the course of about 6 movies, I ate about twenty of them. Thing is, those are sugar free, but they have a bunch of sugar alcohol in them it turns out. I realized this the hard way, way too late. Sugar alcohol, as you may know, is pretty much a laxative. I will spare you the details but it was a rough 24 hours there.

Hang in there! It's all just science and patience. Science... because every time you hit a stall or a slowdown, it's a chance to look at what you might be doing differently, or what you might consider doing differently from then on, to tweak your results. Patience, because sometimes no amount of tinkering will make the needle move and you just have to ride it out. Are you logging everything? Maybe give your nutritionist a call and see if they have some thoughts about what might be different, or what you might want to change. The main thing is: you're doing great. Only 28 pounds from goal? DANG. Feel good about that and hang in there!

I was really just trying to talk to other people about what's going on. Even when this goes "well," it's nerve-wracking and weird. I certainly wasn't trying to brag, let alone make anyone else feel bad.