Sleevie May

Regarding doing restrictive dieting after WLS. It's important to note that WLS is just a tool and really only works the first year or 2. The rest is up to you and in fact, if you don't find some restrictive way of eating, or at least eating based on the plan they provide, you will gain weight back. You could potentially gain a LOT of weight back. Really really easily. Scarily easily. So, while the idea of Keto, etc. make me nervous, at the very least, it is keeping you aware of what you are eating or should be eating and that is a good thing.

I'm 4 years out also. In complete transparency, I fell off the wagon bad about 16 months out. I went through major life changes (moved, changed job, lost a parent, went back to grad school, graduated and went back AGAIN for a PhD, hubs changed jobs, etc.). Yes, major changes.
When I fell off, it was very gradual and I hardly noticed it until I had regained almost 40 lbs and got some seriously sobering health news last fall. It kicked my butt into gear and I went strict Keto and have lost all of my regain and continue to lose even more.
While I never even reached goal the first time around (I think that I had so much change during my honeymoon phase that I lost focus) I know that at this point I WILL get there and I plan to have my plastics done next year after I graduate for the FINAL time!!!
For me, I don't count macros too closely, I just focus on Protein, Water intake, moving every day, good sleep hygiene, supplements and I TRY to manage my stress so cortisol doesn't go sky high (I get serious belly gain when my cortisol goes up, and I have it clinically monitored every few months).
Yes I fell away, yes I regained, but YES I have figured it out and am making it happen. Even if I'm 4 years post op, I'm proof that it's never too late for anyone!!!

Success can be many things. We all have our own goals and walk with surgery. My advice is to follow your plan. Repeat until this lifestyle becomes habit and feels normal. Be your own amazing. The first few months is your best surgery restriction and weight loss. Take advantage of it. As you progress out you will notice that your restriction is less and weight loss slows down. Keep your food within your calories and macros even when your surgery restriction becomes less.
Comparing weight loss stats will make you crazy. Habits and behavior changes will make a difference in your weightloss outcome and long term success.
My surgery was June of 2014 - HW 254 - SW 234 - GW 140 in six months. I maintain in the 130's I had a sixteen pound gain in my third year. I worked it back to my maintenance weight.
What did you do for food?
Nothing magic. I followed my plan. logged my food, stayed hydrated, and exercised to goal.
What's a sample of your diet like today?
Maintaining weight looks different for each of us. What works for me and my choices may not work for anyone else.
Did you do low-carb or follow everything in moderation?
You will make choices that will affect your long term weight loss success. I am carb sensitive pre surgery and post surgery. Low carb works well with my body physiology. I eat things in moderation now that I'm in maintenance mode. Everything moderation in weight loss mode depends on the person. For me, It's a slippery slope. Sugars carbs can slow/stop my weight loss.
What were your portions like ~3 months out, 6 months out, 1 year..etc?
Portions and calorie intake will increase with time. Keep things within your calories and macros to stay in weight loss mode. My maintenance does not look like others. I would hate for anyone in weight loss mode read my food log and think they are going to lose weight. My diet changes during racing season. (carb loading) When I choose to indulge and gain, I go back into weight loss mode to keep my weight in range.
What about exercise, when did you start it (if you did), and what kind did you do?
Started the day after surgery walking. Helps with the healing process. Your surgeon's office will give you a release to exercise more. Give them a call. I walked, did elliptical a bit of lifting for the majority of my weight loss. My choice to become athletic after weight loss is not for everyone. I lift and distance run. I'm a bad @ss grandma. *laughing*

Hey , mashed potatoes sounds so good right now lol
But I thought we need to eat Protein first and then the vegetables and then the carbs.
Anyway that’s why doctors are telling me and that’s what I’m sticking to.

I don’t mean to be a “Debbie Downer” but can I say that I am tired of logging on and hearing about cheating and going back to eating whatever you want, I haven’t even had surgery yet and I already feel like a failure when I read posts like this. I love hearing inspiring stories and how people have overcome their demons, is there a thread like that 😩

*you're
My progress is great
Not miserable, or two weeks out of surgery telling people people eat what you want

Peace and blessings

I personally have had a life time worth of absent mindlessly giving into cravings, time to try something new, especially after surgery. Otherwise what's the point...

The Sleeve only gives you a short window to change your eating habits before regain is a possibility. At Six months out I thought I had it mastered and could introduce small amounts of Carbs and Sugar back into my diet but Once a month turns into once a day and then you find your self on the road to where you started. I have faith in you and Hope you realize that no food tastes as good as being Healthy. This is just my Personal experience but it is one that I see posted on this forum day after day. I fight regain daily and have come to realize that I have to keep choosing Healthy over that warm fuzzy lethargic feeling that comes after I have ate something that I know I shouldn't.

Exactly this. We can’t tell ahead of time what surgery will work for whom. Hopefully one day science will advance enough that we will have better predictors.

I chose the sleeve because I didn’t want the possible nutritional deficiencies that a bypass is more likely than a sleeve to leave you with. I also wasn’t comfortable with the increased risk of other side effects that both DS and RNY have over the sleeve.

I had considered RNY for almost a decade and had never been convinced because of the risks and side effects. As soon as a learned about the sleeve I knew that was something I could get behind.

I was a binge eater. Obese from early on. Snacky slider foods were my jam. As I’ve said I still can’t let Cheez its in my house.

The sleeve has worked wonderfully for me for five years.

So today is August 19th and I am now over 4 months post VSG. I thought I would write an update on a few things that I regularly see asked on this forum.
1. hair loss-
I am definitely shedding more, and it is pretty annoying, but not alarming. I noticed it start at about 3 months out, and decided to add another Protein Shake to my daily intake. I figure it will last another month or two, based on what I have seen other people post. Honestly, though, it is not something I am worried about. I am not having huge clumps of hair fall out, and thank goodness for that! I have really fine hair already, LoL.
2. Vitamins and water-
I take my vitamins and drink at least 64 oz of Water daily. Those are two things I don't mess with. The one supplement that is not included in my Vitamin is Iron though, and it tends to give me stomach issues. I am able to regularly eat 1200 calories per day, and my blood tests have come out normal, so I am on kind of "wait and see" pattern for that one.
3. Caffeine and soda-
The food police will not appreciate my moment of honesty here. I do drink caffeine but it doesn't bother me at all. I drink the grape flavor of crystal light, and the small amount of caffeine helps me get going in the morning. Yes yes, I know that not all doctors approve of it, but I need a boost. And for soda, even before surgery, I had a calorie-free soda at night as a "bedtime snack". It was always my reward for drinking at least 100 ounces of water (I miss being able to chug water, lol). Well, I now have a small glass of sprite zero at night, as long as I hit my water goals beforehand.
4. Portion sizes -
I feel like I can eat decent size portions, similar to a kid-sized meal. I see people post that they can only eat 2 or 3 bites of food, and that just is not me. For example, we eat Breakfast tacos (with low carb tortillas) often. I can eat just over half of a breakfast taco. If we are eating crispy beef (or turkey) tacos, I can eat one whole one. I can also eat a small chicken breast, turkey patty, fish, etc. Honestly, I eat just about everything, although I make it a habit to make healthy choices most of the time (I am totally eating half of a strawberry shortcake cupcake as I write this, but don't tell anyone, lol). I still don't like rice (nothing new), and definitely can't eat fried foods anymore. I had issues with that after I had my gallbladder removed (5 months before surgery), and it is even worse now.
5. Daily caloric intake -
I am eating roughly 1200 calories per day and I am losing weight really quickly. I have lost 45 pounds since the day of my surgery, which is a good amount considering I started with a lower BMI (38). Today I weighed in at 184 and my personal goal is 170. My doctors think I will easily surpass that, but I would be content at just hitting that weight. I worry about that though, because my doctors want me to lose more. At a height of 5'6, they prefer that I weigh 140-150. If and when I get to 160, I will increase my calories to maintenance , and hopefully stay between 160-170.
6. Excess skin-
I am doing ok with this right now, although my arms look like wings at this point. Saying that, they have looked this way for years from previous weight loss and weight gaining patterns, so I don't contribute it to my VSG. I may consider having surgery in the future, but not until we are done having kids and I build my muscle back up. As for the rest of my body, I am doing well, no issues to report. I hope that it remains that way, but time will tell. I think at this point though, even losing 20 more pounds will not make enough of a difference to justify plastics (outside of my arms).

One year out! 157 pounds lost.
I (generally) consume about 1400 calories. It does vary, but I wouldn’t have gone under 1100 in several months.
I am pretty tall - 5 foot 9, but I do very little exercise. Like a bit of yoga and barre. I’m in my thirties.
This is something that you have to play around with. During a stall, I freak out and drop to 1200. Then I might go up again.
Ive has an excellent month (down about 10 pounds, which is great for me at this stage of the journey). Even so, I do think about dropping my calories down to speed things up but there’s no guarantee it would work. I also eat fruit as a snack and I would have to stop doing that. Also, I want to be able to maintain my weight. I can’t live forever eating only 500 calories a day.
Its not just about calories though in my experience (I’ll brace for some people to respond with the usual calories in vs calories out arguement). It really is about what you eat. I avoid bread, Pasta, too much processed food, high sugar food, milk chocolate. I do eat dark chocolate every single day. So although it’s a high calorie diet, I generally follow a pretty moderate Mediterranean diet. I have messed around with the Keto diet, but I like eating fruit. My body feels healthier.
The bottom line is that you have to talk to your nutritionist and come up with something you can comply with.

4.5 months out 1200 calories a day. Down 85lbs.

This is great.

Balance DOES mean different things to different people. Just as no 1-size-fits-all-diet will suit everyone. There's so much that goes into play when figuring out what formula works specifically to meet your needs.

What I have the biggest issue with is being told that "my personal way" is wrong. It may certainly be wrong for you. But I can assure that if it didn't work well and comfortably for ME, I'd be the first person in there hacking it to find a better fit. I DO focus intently on my menus. So what? I like it. It works for me. I'm a happy little loser exceeding the average outcomes and feeling good physically, emotionally, spiritually. So for ME, that IS balance.

I love my meals. I look forward to them. I still get joy from food. I find I crave lean meants and veggies and although I don't do Dr. Weiner or the mayo Clinic Diet, or Dr. V's or Dr. Davis' plant based diets, I still manage to get my 74g Protein in + 3/4-1lb of low glycemic veggies + a small amount of healthy fats + an even smaller amount of berries in daily. And I thrive on that. I CRAVE it.

Do I have a meal (not days) where I eat something that is higher carb? Sure. It's about 1% of my diet. No big deal.

I don't seek to actively add gut flora in via grains, legumes, and massive fructose bombs of fruit? Nope, the flora just happens. I also love lacto-fermented veg so why not include those as Condiments. Again, I think of that as balance.

We all have a unique fulcrum that balances the teeter totter.

I believe there is one common denominator we all have with weight loss surgery, It is easy to lose the weight, the hard part is maintaining the weight loss. I guess that can be said about dieting as well, It's easier to lose the weight than to maintain the weight loss. There are many different opinions on how to successfully maintain the weight loss but only you and maybe your healthcare professional can make it work for you. No matter what path or technique you use remember it will always be your choice to make. If one succeeds or fails it will be on the merits of the choices that one makes. There is no one plan that works or as some say no one size fits all. If there were we wouldn't have so many options to choose from and we would all be successful. While someones plan might not work for me I'm glad to see we have a forum so that others can get that vital information as it might just work for them. My approach isn't for everyone but, I don't expect to it be. I just want to let others know that it's out there and they can make the final determination if that's the path for them. I'm sure everyone here wants everyone to succeed and to be healthy. We can always agree to disagree but we must always be able to put the ideas and tips out there so we can at least give others options they might not have considered. Everyone, I wish you continued weight loss success and good health.

Plenty of us who eat that way aren’t retainers either though. It’s not a road that’s doomed to fail.

I think as we study and learn more we will be able to tell by your genes who will do well on what diet. But we are still in the dark ages.

There isn’t any one size fits all. I did the high carb low fat diets in the 90’s and those always ended in me falling off the wagon and regaining. I was quite strict on the low carb train till I got to goal. I’m still pretty low carb but I don’t stress about them a bit here and there.

I’m five year out and it works just great for me.

I know your plan is working for you (so far). Can’t we just all realize that there is no one size fits all answer? I know you’re certain your plan will be the answer for you. And time will tell, but since I think a big part of this is mental, I think it will.

But you make it sound like being a “carb nazi” means you’re doomed to fail.

I didn’t.  It’s not a stop gap measure for me.  It’s a lifestyle change and it works just fine. 

The best place for information about Keto is probably Ketogains.com. They have a Facebook group and a webpage with a very good macro calculator. They're very science based and won't take any BS. They don't promote macro percentages or super high fat. Instead they track their macros in grams. Essentially keeping carbs below 50 grams per day or rather 20 grams will put your body into a ketogenic state. Then you have to have your adequate Protein. Not too much, not too little, actually their protein recommendation is the same as the bariatric one. If your body is already high fat you don't need to consume extra high fat. Which is also pretty much the post op bariatric diet anyway. Eat your protein first, then have some vegetables and in the case of keto, if you have room left in your post-op sleeve/pouch, you fill it with good fats, not starches. Some olive oil or butter for cooking the vegetables, meat or eggs, half an avocado, a handful of nuts or olives etc.
I'm keto since 2013 and I find the true and real keto very healthful and good nutrition. The problem is, keto has become very mainstream and lots of people want to make money on it and start spreading these absurd versions of keto that won't get you closer to your goals. "Eat fat to lose fat." You really don't have to eat 85% fat to make ketones aka be ketogenic, you just have to limit your carbs, eat adequate protein and non starchy vegetables. For example my macros today, 8 weeks after having the sleeve are 21 g carbs, 94 g protein, 48 g fat, 896 kcal. 37 lbs lost so far.

@sillykitty No, quite the contrary, these 3-4 years in maintenance on realfood Keto have been the longest time in my adult life that I’ve been able to live without binge eating. Which is why I’m sure it’s the best woe for me also now after having the sleeve.

Um, your response is incredibly rude. You don't know me AT ALL. How could you possibly get from my original post that I have an alcohol dependence problem?? I gave you ONE day of information and not even full information of what I ate, just the calories. I had white wine, on one night. Not a nightly thing at all. I've read a lot of your posts and they've always been friendly and you've always given good advice or feedback to questions. I'm truly shocked and disappointed by your judgmental response.

Actually I started in January 2013 with the simple Dietdoctor.com protocol. I started at 251 lbs and by October 2013 I was down to 178 lbs, (height 5'7") which I was able to maintain for 3-4 years with no major effort on my part. My high blood pressure normalized within months after startin this woe, my skin got better, my moods got better ect. I just followed the Dietdoctor's keep your carbs low and eat real food protocol. But as years got by my underlying binge eating disorder got the best of me and first I started binging on keto foods and soon even eating junk-food again and of-course I gained some weight. I found ketogains last summer and was able to lose 25 lbs in a month or two, but started binging again until I was back up at 224 lbs when I decided to have my sleeve in May this year. I'm a self pay patient and live in a European country. Now, 8 weeks post op I'm down to 187 lbs, my goal is to get to 154 lbs.
Although my binge eating failed my life's so far best weight loss effort aka keto, I can't blame this on the diet. Obesity and food addiction is a complex disease. Sensible keto is a great way to eat healthy nutritious real food and my sleeve is a great tool to help me keep myself on track.
2keto dudes actually have a great podcast episode dedicated to weight loss surgery and keto, where three lovely ladies share their experience with keto and sleeve surgery: http://2ketodudes.com/show.aspx?episode=52

@sillykitty No, quite the contrary, these 3-4 years in maintenance on realfood Keto have been the longest time in my adult life that I’ve been able to live without binge eating. Which is why I’m sure it’s the best woe for me also now after having the sleeve.

I eat very much the same at this point except for rice and bread. I can't eat gluten (horrible rash called dermatitis herpetiformis) but I do bake some almond and coconut breads that are pretty good. I can take them or leave them...haven't made them since surgery. My RD @ the bariatric clinic told me it was not necessary to eat fruit or non vegetable carbs (starch and sugar) if I did not want to. She said it is actually good to avoid potatoes and rice as much as possible. I am fine with that. I do not worry about fats too much but because of the overall restriction they are about 35-40G per day. I aim for net carbs <30 and protein is about 60-70G per day. About 750-850 calories per day.
Health wise, all my labs preop were perfect, my cardiac workup was perfect and the surgeon said my liver looked "perfect" at surgery. My blood pressure and heart rate were normal. My PCM even told me he had never seen a 60 year old with a BMi >45 that was in such good shape (on paper anyway) and I think that is from avoiding carbage while overdoing it on nut, cream cheese, regular cheese and those dang low carb protein (candy) bars. This is why I need the restriction.

@sillykitty No, quite the contrary, these 3-4 years in maintenance on realfood Keto have been the longest time in my adult life that I’ve been able to live without binge eating. Which is why I’m sure it’s the best woe for me also now after having the sleeve.

@sillykitty No, quite the contrary, these 3-4 years in maintenance on realfood Keto have been the longest time in my adult life that I’ve been able to live without binge eating. Which is why I’m sure it’s the best woe for me also now after having the sleeve.

Thank you !

VSG2017 HW 249 SW 238 CW 167

My diet is pretty similar to Fluffy's, and I simply don't understand @CreekImp13's continuing insistence that a healthy diet can't be lowish carbs. Heck, with our tiny stomachs, our diets are lowish everything! I aim for <50g carbs a day in veges, fruit, cottage cheese, greek yogurt. There's room there for occasional Beans, rice, lentils and hearty bread, but I do keep those portions small of necessity in order to meet Protein and vege/fruit goals (only so much room in the new tummy!). I find that I don't have the volume to rely on beans and legumes as a major source of protein, unless I supplement with Protein Shakes, which I feel isn't a good long-term solution for me. My plates are full of delicious, healthy stuff and my food plan feels very sustainable.
ETA: I also think we should all as a rule at least aim to be in the "normal" weight range as there is amply evidence that "overweight" carries significant health risks.