ajmsp8879

For 20 years, I dieted, and lied to myself.
Went back and forth between two extremes. You might be familiar with them.
One was called....Screw it, you're fat, so what? I drank a two liter of Pepsi daily, loved bread, french fries, chicken tenders, and chocolate turtle ice cream pie. I also love food that was good for me. And food that had sprinkles. And grease. And sugar. And anything hot out of an oven. And....well, you get the picture. My husband laughed at me for putting excess bacon on my veggie burgers.
The other me was....The Fitness Nazi. I was the autistic savant of calorie counting. Like Rain man, I could look at a deconstructed plate of stuff and guess calories with the accuracy of a food scientist. I was all about counting my grapes, going from one fad diet to the next. This time, I'm going to find the answer to fast weight loss. Must be thin. Not healthy. Not strong. Thin. And I'd like to be thin as fast as possible, please. Need to go to the gym. I hate the gym. Go anyway, you're fat, you must repent and be punished by the gym to be excused of your sin of fattness. Must never again eat anything white, or carb, or that casts a shadow. I'm a perfectionist, dammit. I can DO THIS!
Speaking of Fatness. Remember The Hunger Games? I went to a costume party last year as the fat version of Katniss Everdeen: Fatness NeverLean. My flaming dress had porkchops on it.
For 20 years...I went back and forth between two lies. I'm not either of these people.
I'm not in denial about how bad obesity is for your health. I care. But I'm not a Fitness Nazi either. I don't care about being thin.
For me...I needed to make peace with food, not fight a war against it. And man, sometimes if feels like that's all we do. Just endlessly battle. I'm tried, man. Just really tired of the war.
What helped me the most...is escaping an extremist mindset.
I'm tired of extremes.
I don't want to binge on crap anymore. Screw that self destructive nonsense.
I also don't want to starve anymore or eat "healthy" things I HATE. Screw that self destructive nonsense, too.
I don't want to eat stuff I don't like..."because it's good for me." I want to eat stuff that I DO like that's good for me. Sometimes those things are hard to find! But they're out there. They're worth finding and taking the extra effort to make.
I'm tired of lying to myself. 20 years of dieting lies...up, down, up down. What's the point? I don't want to be either of those two people, I just kept running from both of them.
I had to find balance. I had to love my life, love my diet, love my self enough to stop the self abuse of both extremes. I HATE the fat binger. I HATE the thin fitness nazi.
Finding the plan that works for the individual is tough. And it's gonna be different for everyone. It's not one size fits all. (nothing one size fits all works for me...lol)
If I were doing low carb and crazy low calories, I'd probably shoot myself or others. I feel horrible on that plan...and I know from experience that I'll crash and burn on it eventually. It works great for some folks....but I'm not one of them.
These days I'm working on being really really honest with myself. I'm picking things for my diet on a new criteria...Do I genuinely like eating this? Is it good nutrition? Can it fit in a balanced day of healthy eating?
When I exercise, I don't think about how many calories it burns anymore, or how long I have to do it, or what gets me the most burn in the least time. I think....Do I enjoy doing this? Do I look forward to it, or dread it? Can I do this with a friend for support and have a good time?
I want to love my new life.
I want a Forever diet that I love.
I want a Forever exercise plan that I love.
I want balance.
I'm done with immediacy and urgency and extremes.
I'm losing weight slow and steady. If I lose 3-5 pounds a month, I am so happy with that. I didn't put all this weight on in a few months, I'm not gonna lose it in a few months.
They say you'll lose weight for 18 months or so after surgery. I've got 16 months to go. If I lose 2-3 pounds a month, I'll make my goal. I'm in no hurry, because I'm working on my forever diet that I can love and live with.......not my "until I'm skinny" punishment diet.
Sometimes I really think the key to this whole mess is finding a way to be honest with yourself...resolve the two extremes and find the middle ground.
Just some thoughts. Take what ya like, and leave the rest:)

How horrible. Dr. should have provided advice, and maybe most importantly, encouragement. Seems like an uninvolved doctor.

Trust your surgical group. This isn't their first rodeo. They've have seen notes like this from doctors many times before. And in your doctor's defense, at least she was trying to document a problem she hoped to find you help for, and she made the correct referral.....it's better than a doctor who doesn't pay attention.
There's no reason to be pissed. Your doctor was concerned about a possible eating disorder (and you were, too)...and sent you to a professional to investigate the possibility. They found you didn't have one.
So there ya go. Further investigation proved a suspected diagnosis was not correct. This happens in all areas of medicine. You go where the symptoms point, and you seek additional expertise.
Nothing in your history is wrong or inappropriate.
Also, the term "eating disorder" is vague as to being nebulous. http://www.anad.org/get-information/about-eating-disorders/eating-disorder-types-and-symptoms/
What is Other Specified Feeding or Eating Disorder?
When you meet some of the criteria for an eating disorder, but not all, you may find yourself in the category of OSFED: There are 5 categories of OSFED:
Atypical Anorexia Nervosa: meeting all of the symptoms of Anorexia with weight at or above normal range
Binge Eating Disorder that is less frequent or did not occur as long as needed for the full diagnosis
Bulimia Nervosa that is less frequent or did not occur as long as needed for the full diagnosis
Purging Disorder is when a person purges without bingeing
Night Eating Syndrome: this occurs when a person consumes at least 25% of their daily intake after the evening meal. Waking up after going to bed in order to eat may also occur.
Unspecified Feeding or Eating Disorder is for disorders which do not meet the criteria of any of the above disorders, but still cause great emotional upset or interferes with daily life.

I saw that my primary wrote in his notes that he doubted I’d be successful with the surgery. f**k him. I’ll prove that bastard wrong.

I understand the stress and frustration. Uggh the hoops you have to jump through.
My psych eval was pretty straight forward. Think of it this way. They need to know if you can change habits/behaviors.
They also need to know if your psychological state would be exacerbated with a major life change. It's a liability issues for the surgeons. Honestly, I think many of us have/had some type of disorder (stress/emotional eating) that got us to the point of surgery.
We have about the same height and weight. I wish you the best. I hope you hear good news soon.

@sleeve1stFitNext can you believe this? I'm allergic to chocolate so I can't use Palmer's Cocoa Butter. When I was carrying baby#2 something went weird with,my body and I developed off-beat allergies, chocolate being one of them. So I'm,left with Vitamin E. Used to,pop one of those little capsule type pills open. When I feel sorry for myself and I do sometimes I remember my skin such as it is , well it's still ntact . I could have flesh eating bacteria and losing big chunks of myself.
Sent from my VS880PP using BariatricPal mobile app

I have stretch marks on top of stretch marks. I have dark ones to light ones. I have them all over, I am a baby zebra with my stripes.
My hips and arms are light now. My stomach has a mixture of light and dark. My back is dark but that is because they are new. I do use Palmer's Cocoa Butter now.

It runs in my family, my first popped out when I was 5ft5in 110lbs and 11 years old, so you don't necessarily need to be obese to get them. I'm sorry to say I passed them down to all 3 of my children, developed at about same age on the outside of both hips. Between gaining and losing weight, carrying 3 9lb babies non of which laid the same way, my tummy looks like the roadmap of Indianapolis with all the county roads marked. I actually have an abdomen 5 little slits would only be enhancing. I heard someone was going to have ivy leaves tatooed to join the scars together, I couldn't do it. My skin is in too badly stretch marked, I'm not quite that frisky and most of all I couldn't afford it. Just think how much that would cost!
Sent from my VS880PP using BariatricPal mobile app

Something else to consider... My doc had me take a test to see which drugs I metabolize best. Turns out I'm a poor metabolizer of CYP2D6 medications. Doesn't mean I don't take 'em, just means that we adjust the dose to go with my genetics. Lots of tools out there to help these days. I get so mad when I hear medical doctors not using resources available. Insurance companies as the worst of all though... They make it damn near impossible for docs to give their patients the most innovative and evidence-based medicine available,

I wonder why they are only sticking to Zoloft when there are dozens of other options to choose from. I've been on the med merry-go-round before, and it sucks, but look at these options:
Effexor: LIFE-SAVING for me. I take 150 mg. I will take the regular release when I get sleeved to ensure no issues.
Celexa
Lexapro
Nefazodone (everyone freaks out of the liver failure possibility for this, but READ THE STATISTICS first. It's rare, rare, rare!!!)
Trazodone (great for anxiety, but knocks you out)
Cymbalta
Pamelor (older, but a works)
Moody stabilizers (Topamax, Tegretol, Trileptal, Lyrica, lamictal, Geodon)
Buspar
NAC - Amino acid available OTC that is being tested in clinical trials for anxiety disorders and addiction. Comes in liquid.
Memantine (used off-label for OCD, GAD, and migraines) It's a dementia drug that has found some limited mainstream success in off-label uses (doctors still get weird about this one, even though it's pretty benign, old, and safe).
Time to take a step back and put your mental health first. The rest will fall into place after the fact. Get stabilized, even if it means going inpatient. Fire the psychiatrist who "can't help you." That's absurd. Getting stable can take a few months, but you'll get there. I believe that you can reap the benefits of your gastric bypass and still take meds.

No, they just want to make sure that, if you have sleep apnea, you’re aware of it and it’s under control.

I didn’t have to do another one. My sleep doctor just went over what to expect as I lost weight. I will need another one as I get closer to goal weight however.



HW-292 • SW (6/29/17) 256.6 • CW 175.0

I have my first appointment in March with my nutritionist. I'm nervous, because I've gained about 4 pounds since my initial consult with the surgeon in early February. I fluctuate between 240 and 250, depending on what is going on in my life. I haven't started any nutritional plan yet, and I have three appointments scheduled in total with the nutritionist (March, April, May). I am moving this week into a new apartment, which is why I intentionally waited to start the entire process until after the move to make sure that I didn't have that going on in my life. I haven't been cooking much as most everything is packed up, which means a lot of take out. I've been tracking everything I eat for my first appointment, and I have been using my fitbit and tracking that info too. 100% honesty about my current lifestyle to give them a clear picture of how things are at my baseline in order to start making the changes to be successful. I'm just very nervous about the gain.... I don't want to lose this opportunity. I'm also a lowish (38-39) BMI patient, so on the flipside if I lose too much and I no longer qualify. Thoughts?

Hello! Welcome to the first step of a big journey. Some insurance companies require a referral so it would be a good idea to get one from your PCP. From there, you usually attend an information session, and if you're still interested, you begin the process with your first visit with the surgeon. Your surgeon will most likely order blood work, an abdominal ultrasound, and an upper G.I study. You will also have somewhere between 3-6 months of medically supervised weight management which is often an insurance requirement. In between this time, you'll meet with a psychologist and get tested for sleep apnea. You may also get a stress test and a lung function test. If you are diabetic, generally-speaking, you must have your A1C below 8% to be considered safe for surgery.
Hope this helps you somewhat. The process is long but it is ultimately worth it. I think it taught me a lot of patience. I start my two week pre-op diet on Monday, February 26th and surgery arrives on Monday, March 12.

Everything will be fine. Just talk to your nutritionist about everything that's been going on and your concerns about your BMI disqualifying you. S/he will have a solid answer about that...or will be able to get one for you.

I'm on a trajectory for a mid-May sleeve (could be June as well) if all goes according to plan. Minnesota here. Doing lots of research (reading books, forums, etc.) as I want this to be a lasting lifestyle change for health.

Hi. I'm taking liquid effexor which treats anxiety disorder and panic attacks. Had gastric bypass on the 23rd. I am also on liquid wellbutrin for depression. I had both meds mixed at a compounding pharmacy. Just got the scripts for the pills and the oral liquid compounds from my primary care.

I am not facing the anxiety or panic attacks so far. Today I did start having some depressive thoughts but my body is changing and adjusting to the meds and I am off many meds that I was taking.

Sure there is the malabsorption issue but I know there are people who have had the gastric bypass and are doing well on anxiety and depression meds.

If a professional has no clue then ditch them and find a doctor who will help.

I will say though that I had to figure a lot of it on my own. For instance, I was on cymbalta which is an SNRI and it worked well for me for anxiety and panic attacks. I then looked up other SNRIs and found that effexor is one and can be compounded into liquid for. Cost $30 per month.

Hope this helps!

Sent from my SAMSUNG-SM-G891A using BariatricPal mobile app

Hello Jaz - I'll join you on your journey. I'm starting the process now. I have the info session in a week and then I'll be scheduling a consult. My insurance is a little less strict about the dietary requirements. I believe it's 2 meetings with a nutritionist. When I spoke to the intake person, they said we would be going through all of that. My goal is an April or May surgery date.
AJ

The other thing that my nutritionist went over with me was my qualifications for surgery such as having an A1c below 10.0 within the last 3 months and she was also able to answer questions about what my weight needed to be when my paperwork is submitted to remain eligable, for me that is 250lbs which will keep my BMI above 35 with several comorbities. While im losing weight i dont think i will hit that mark in the next 6 weeks when my paperwork will be submitted. As orionburn noted they will also help you with what and how much to eat both now and in the future after your surgery.

But you've been honest with yourself. This will help the dietitian help you. The more data they have to go on, the more they can do to make suggestions and offer tips and ideas.

They'll basically give you the standard speach on what foods you should have, what to avoid, etc. Also will probably be a list of foods to avoid altogether after surgery, the stages of what foods you'll be allowed to have, Protein requirements, Vitamins to take, etc.
Journals really are good to see exactly how many calories are in certain foods/meals. Even some "healthy" options can be loaded with calories or carbs that aren't needed. I've always loved salads, but if I pile on croutons, use regular Salad Dressing, and other toppings my "healthy" salad just became as bad a Big Mac meal.

It's always tough to look at a food journal the first time. Just remember the chances are they've seen way worse!

Hello,
I have been journaling my food in anticipation of my upcoming first visit with the dietitian. I'm a little mortified by how poor my diet is. It's one thing to know you don't eat healthy, but it's another thing to see it documented for a full week.
I have to have between 2-3 appointments with the dietitian in order to be able to schedule my surgery. What can I expect a these appointments? I'm open to all suggestions and really want to make solid lifestyle changes. I'd be most interested in hearing about your experiences.

I finally finished all my requirements! Everything has been submitted to my insurance..... The wait begins! This is going to be the longest 2-4weeks lol. To be honest before I started this process I never thought about WLS, then my doctor recommended it due to my PCOS, insulin resistance my heart condition (leaky valve), family history of diabetes (I'm pre diabetic) and heart attacks (my dad and uncle had one last year, both my grandfather's died of heat attacks) . I always thought it was the 'easy way out' but seriously since going through the last 5 months of nutrition visits, Trainor visits, changing my eating habits, logging my food, all the tests, the support groups ect... it's def not easy, its a complete lifestyle change. You gotta be 100% committed. I'm glad I started this journey. I'm thinking surgery will be sometime in April. Anyone else waiting for approval!?.... Impatiently haha

If your doctor called you a "fat pig" RUN- don't walk - to a new doctor. I would never want a doctor to cut me open who treats their patients like that. That's not firm; that's abusive.
I like the firm approach form my doctors. Not mean, but straight to the point without sugar coating anything. However, I would be mortified if my doctor called me a "fat pig."

One should always take conversations about which diet is best with a grain of salt. This choice is as personal as they come.
Diet is a hot button issue and we're still learning a lot about it.
In particular, we're learning about the kinds of bugs different diets grow in your GI tract and how they contribute to defense against disease and weight maintenance. I think those bugs....our gut microbiota....will hold the key to future developments in nutrition and the treatment of dozens of illnesses, including obesity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433529/
Did you know that you have about the same number of bacteria cells in your GI tract as human cells in your body? We're complex symbiotic organisms who count on those bugs for our health. Half man...half bacteria....here we come:)
Keto works. You lose weight fast, and it helps to control your appetite.
However...diets high in animal Protein and fat are correlated with increased risk of cancer and increased mortality from other causes. Keto does a spectacular job of wiping out your gut microbe diversity. This isn't a good thing. Thinner people, and healthier people...are documented to have higher gut bug diversity. People who die young and have chronic illness...have low gut bacteria diversity.
The people in cultures who live the longest on the planet, with the lowest rates of cancer and heart disease....eat diets high in complex carbs, dietary Fiber, fruits, nuts, legumes and vegetables...and are more sparing in Proteins and fats. People in these cultures also exercise. And again...they have highly diverse gut microbiota.
If you want to look at it from an evolutionary perspective...what diet have millions of years of adaptations prepared us best for? Look at the natural diets of the great apes. They eat a ton of fruit, veggies, and very fiberous foliage. They eat legumes and insects (a terrific source of fiber)....and only opportunistically and sparingly... eat eggs and meat. Their fat sources and most of their protein comes from plant sources. Their gut microbiota is also very diverse. And they exercise. Interesting pattern, no?
My personal feeling is that keto is an effective tool that can be used for short period of time because the benefits outweigh the risks....sort of like chemotherapy. Ketotherapy? Being morbidly obese carries risk.
But for a maintenance, lifelong diet......I am convinced that a diverse gut microbiota is the key to good health, and will eat a diet that supports it.
At this stage in my obesity recovery...for me...I believe that keto carries more risks than benefits.
Best wishes to all...and respect meant for everyone's choices. Everyone has a right to eyeball this choice on their own and make the decision that makes the most sense to them.
food for thought: https://www.medicalnewstoday.com/articles/273533.php