SteveT74

FYI, I just turned 45. I know that being a 45 year old guy trying to get back into shape has some unique challenges. We can't train the same way we did in our twenties, nor should you even try. What worked then, will not work now--not for the long term anyway. I am kicking my ass like you are. I am up around 4am to get to the gym by 4:30-4:34. I take a spin class five days a week (twice on Wednesdays). I then weight train intensively 5-6 days a week, mixing and matching supersets and drop sets. Focusing on compound lifts most days and then having one day of just isolation and "Big Lift Day" once a week when I do squats, deadlifts, barbell rows, bench press, kettle bell swings, lat pull and mix in pushups and rowing machine as part of a circuit. I keep the weight challenging but not max by any means. i have to focus on trying to perfect my form--I can't get way with sloppy form like I could 20 years ago. I always use a heart rate monitor so I make sure that I keep my bpm up into the high 130's low 140's on average. I'll spike in the 150's the end of a super set and then rest until my rate drops in the 120's and then start a new set (usually that means waiting 1minute to a 1:30 seconds). Forget what the scale says, I think just adding this one "Big Lift Day" into my routine really kicked my body into gear and got my muscle mass growing and definitely kicked up my testosterone a notch (which is great for getting rid of belly fat). If I didn't have extra skin around my mid-section from years of being obese, I would have a six pack now. August 2018: This week:

Thanks for the support guys. I guess these types of dreams are fairly common occurrences. They never told us about these during those pre-op meetings and classes. I guess I am really happy where I am and where things are going that losing this would be just awful. Even when I lost weight in the past, in the back of my mind I knew it would eventually come back (since that's how it's always been for me as an adult). This has to be the time that it stays off!!! As bad as it was looking morbidly obese, the feeling of having no control over myself and feeling like crap all the the time. I had issues sleeping because breathing ward hard when I laid down. I would often sleep sitting up like a bear. Living with diabetes sucked in so many ways. I had issues with ED because of it (and the meds I took for it). I had gastroparesis due to neuropathy in my stomach. Heart disease. I was 44 and I felt like I was 70. Last year when I met with my cardiologist after my 44th birthday, he was really worried for me (not in that BS way that some doctors have when they feel obligated to read us the riot act). He was sweet as sugar but he told me that based on my blood work, stress test etc. and family history, if I don't make a major change right now I will probably have my first major heart attack in the next five years. I CAN'T ever live like that again!!!! I owe it to my wife and kids to be super healthy Dad--not fat dad that will be dead before they are in high school.

If you're only eating 6 or 700 calories a day and almost all of that is coming from protein, it sounds like you're not eating enough calories to support a healthy nutritional balance. You're also eating so much protein that you're excluding important micronutrients. I am a big believer in going ultra-low carb (love Keto), but to cut out carbs AND fat is definitely going catch up with you. You can live without carbs (except for fiber, which we really need a lot of), but fats and protein are both essential. Protein is very important--particularly in the month or two after surgery when you're recovering since amino acids are required for tissue growth, neurological repair and growth, hair growth etc. However, you can't really live long term on protein alone. First off, your body will convert protein to glycogen to compensate for the reduction in available glucose that you might ordinarily get from carbs. Protein molecules can be converted to glucose by your liver in a process called glyconeogenesis. It's an inefficient way to create glucose--which is a good thing in most instances since it means that your body consumes about three time the amount of energy to create glucose from protein than it does from carbohydrates. However, this process also creates a lot of unpleasant by-products and waste that needs to be processed by your liver and kidneys. If this is your primary/only source of energy for a long enough period of time, your going to risk liver and kindney damage and possibly failure. This is one of the things your Surgeon is checking for when they do your blood work every three months (it shows up in your creatine, thiamine and protein level reports). This will tell him or her if you're eating to little or too much protein. Second, you need to have fats in your diet. I am not talking about cheese burgers and bacon. We can all live without that crap. However, healthy fats are very important for neurological function, heart health, liver function and hormone production etc. You need to also be eating the right kinds of fats from things like avocado, fatty fish oil (wild caught sockeye salmon), extra virgin olive oil, ghee etc, nuts (pecans, macadamia, brazil nuts--all great). These are all great sources of omega-6 fatty acids, which are also very important for your immune function and will help you suppress free radicals and mutations that can cause cancer and other health issues. Third, even though I am a Keto evangalist, you do need to some carbs in your diet. Those carbs need to come mostly in the form of fiber along with some nutrient rich foods that will help improve your micronutrient profile. Sure, we can take supplements but most of those pills only mimic the vitamins we would otherwise get through a healthy diet. There not one in the same. That said, 20 net grams of carbs is more than enough to live on---but your total carbs (including fiber and sugar alcohols does not require any limitation). Depending your choices though, you can certainly have more than 20 net grams of carbs and still be very healthy and lose lots of weight. You just have to monitor your calories a little more carefully. Finally, even with your tiny tummy, you can easily get your calorie (nutrient) consumption up to 1000 to 1200 a day if you add in fats. A small handful of brazil nuts, macadamia nuts, pumpkin seeds or pecans will get you plenty of healthy fat, protein and fiber to fuel you through the day. Sure, these are calorie dense foods, but if you can't eat food in quantity, you should still try to get your calorie consumption up near 1000k a day. It's not going to really change your rate of weight loss significantly (it might slow things a tiny bit), but it will help you prevent regain to get yourself to a point where you can eat a sustainable amount of calories daily. You don't want your body to adapt to 600 calories a day and base your new set point on maintenance at that level. That's not a recipe for long term success.

I started the process with a BMI of 37.5 last April and I weighed in at 256 during my first bariatric consult. On the day of surgery (12/17/18), I weighed 234 and I had a BMI of 34.5. By New Years Eve, I was down to 224. On January 15, I was down to 212. By January 30, I was down to 204. On February 15, I was down to 197. On March 1, I weighed 196.7. March 15, I weighed 196.1. Today I weighed 193.2. So you can see that it came off fast and has leveled off. I have lost 2 inches off my waist since March 1, so the inches are coming off if the weight isn't. I follow a strict diet and exercise program--which is pretty intense, but I am really enjoying it. I feel awesome. Here's some photos documenting the journey. Last Summer this is me at 255 or so: This is me on Surgery Day (12/17/18) (weight: 234): This is me on January 17, 2019 (Weight: 210) This is me on February 28, 2019 (weight: 197.8) This is me on March 23, 2019 (Weight: 192.1): So, the weight loss has slowed up, but that's ok. I want to lose another 10-15 pounds, but I don't "need" to lose that weight. I am more concerned at this point with improving my physical conditioning and strength. The weight came off so fast that I didn't really "see" the difference in the mirror, but the photos show a dramatic change. I still hasn't really sunk in yet, but it's kind of like winning the health lottery. I am look healthy and fit. I am no longer diabetic according to my doctors. My BP is normal and my blood tests look great 3 months post op. Huge improvements. Honestly, having this surgery is the best thing I ever did for myself. I wish I had done this sooner--but better late than never. Obviously, the surgery helps get the ball rolling and gives you the tool so that the rest of the changes you make in your lifestyle will actually work for you. I have tried to do this before with hardcore dieting and exercise and I would just hit a wall and then lose ground. Not anymore!! If 191 is my wall, that's ok for me--but I think I'll still lose some more weight over the next few months, but the changes won't be as dramatic or noticeable (on the scale or otherwise).

Fortunately, we have muscle memory, so the strength will come back quickly. Even if strength stalls your weight loss as far as the scale is concerned (there's a good chance it can), the results will be worth it. Losing weight is great, but being and feeling strong, fit and healthy is even better!

Sounds like good advice to me, but I just don't know how to put this on auto-pilot. I am conscious of everything I eat, drink and the physical activity I need to do to get and stay in shape. I still only 3.5 months out from surgery, this healthy lifestyle and change in my body is very new. I guess I worry about slipping back into bad habits and I don't really trust myself unless I am being strict in following my rules (which are not entirely the same as my doctor's rules).

Wow, you're down to 180???? That's amazing!!!! Good for you!!!! I know how you feel about the changes happening so fast. I am in the same position, although the scale is stuck around 191-194 for me--and has been for a while. I still want to drop at least 10 more pounds, but it's not going to be easy at this point. I have significantly improved my physical conditioning---cardio and strength in the past three months. Fortunately, my strength and conditioning continues to improve while the scale stays the same.

I had my VSG on 12/17 and I enjoyed a few drinks on New Year's Eve. I definitely got drunk, but still not as much as my wife who drank less than me. I had one vodka and soda with dinner this past weekend (out at a restaurant for my wife's b-day). It went down fine and I didn't feel anything from it--although I did nurse that drink for an hour. I am working so hard to get into shape and lose weight, why drink liquid calories that are just going to make it that much harder for me to stay on track?? I am sure I'll have drinks in the future, but I don't see myself drinking for the purpose of getting drunk any time soon. I will never say never, but it's just not something I want for myself right now. Same goes with weed. I have smoked a couple of times since surgery, but I really only took a couple of hits and I don't want to consume anything that is going to make me want to eat more.

Hi there, First off, you can't compare your progress to others. The fact is, if you weren't training hard, you'd probably be losing more weight on the scale--but you wouldn't see it on your body the same way. The scale is BS-just an easy metric to track. You should be more focused on losing inches--which is really the whole point anyway. As long as that's happening (as you said), you're doing the right things. The weight loss on the scale will eventually catch up. Second, you may want to get a body fat monitor, like the handheld one that Omicron makes. I have only lost 3.5 pounds in the past month, but I lost 1.5 inches off my waist and 1.8% of my body fat. I don't consider that a stall by any means. If you want to experiment with increasing your calories or changing up your diet by cutting down on carbs or increasing the amount of healthy fat you're eating (something along those lines), you might give your body a little kickstart by confusing it. Bottom line is you lost 137 pounds since last June. That's f---ing amazing. That last few pounds are always going to be the hardest.

The answer is both! First off, you don't count total carbs because the carbs that you eat in the form of fiber and sugar alcohols generally pass through undigested and don't contributed to weight gain or energy productiion. You have to deduct them from your total carb intake--so the focus is on net carbs. I am personally follow an ultra-low carb diet and try to keep my total carb intake under 30 net grams (usually under 20). I also count calories and track what I eat. I budget 1500 calories a day, with 45 percent come from protein, 45 percent from fat (healthy fats) andn 10% from carbs. It's working for me.

I have so many non-scale victories--which is fortunate since I only lost 3.5 pounds in the past month. I am, however, only 17 pounds from my goal weight (maybe I should just change my goal??). So, my non scale victories are as follows: 1. I went from wearing size 44 pants on December 1 to now wearing 32 pants! 2. One of the other kid's mom at my daughter's nursery that I used to talk to all the time saw me this past weekend and introduced herself as if she had never talked to me before. She didn't recognize me!! 4. I had to buy slim fit shirts and suits because standard fit is too loose around my waist. 5. My wife says I am not snoring anymore!! 6. I am no longer taking medication for T2DM, high blood pressure or high triglycerides, 7. My surgeon asked me if I would be willing to be in advertisement where I show my before and after and talk about how bariatric surgery changed my life (haven't decided if I want to do that though). 8. Most importantly, I feel great. I have loads of energy and I am not embarrassed of my appearance or being the fat guy in the room. I am actually looking forward to wearing a bathing suit this summer!! I feel like i didn't just lose weight, but like I turned the clock back 15 years. Even if I don't lose another pound, I am thrilled with the results. My only regret is not having had the surgery sooner.

Hi there, Congrats on doing a great job losing that weight. That's outstanding work. None of us are in a position to really know how much you're still capable of losing. However, given that you have already lost more than 70% of your excess pre-op body weight, it's fair to say that the days of rapid, seemingly effortless weight loss is over. You can still lose more and reach your goal weight, but it may take longer to lose the weight than in the beginning and it will probably require a lot more work on your part. The last 20 pounds is always the toughest. I am at that point too (although I am only 3.5 months out--but different situation). I am only 15 pounds away from my goal weight, but I only lost 3.5 pounds over the past month. It's better than nothing, but even losing that 3.5 pounds required hard work on my part (strictly following my diet and hitting the gym daily). You may need to go over your diet with your nutritionist to see if there is areas where you can improve. How much exercise are you getting each week?

Lolo, I know I am preaching to the converted, but you know when you loose a lot of weight quickly you inevitably loose muscle along with the fat. The only way to counter that is strength training. I know you have been working out a lot, but if you're finding that you're really losing a lot of upper body strength you may need to reallocate your gym time to strength training even if it means less time on cardio--although when strength training is done right, it's a cardio workout too.

It's not that long. My doc had me eating solids in 4 weeks. I still follow all my doctor's instructions, but I choose to eat keto foods and skip the carbs. That said, my macros are not really keto because I am 45 percent of my calories come from protein. That's way too high for keto. I am more of an extreme low carb diet if I want to get technical. I am not consuming enough calories for a true therapeutic keto diet nor can I do intermittent fasting. However, my blood glucose levels are very stable now. I am never over 120 even after eating. I am generally under 100. My BP is normal. If I ever see adverse effects on my health, I would change my diet. So far so good though! Sent from my SM-G965U1 using Tapatalk

Thanks for the response. I agree with most of your comments. Keto definitely is not for everyone. Although Keto does not require calorie counting, it also isn't a license to ear as much as you want as long as it's on the diet. I track my calories daily and stay at or below 1500 a day at this point. I will eventually go up closer to 2000, but this is working for now and I am only 14 weeks post-OP. I will sit down with my nutritionist in three months after I have my next round of bloodwork to see if I need to make any changes. I will say one thing that should apply to any health diet---stay away from commercial, processed foods and beverages. Don't eat anything that l, when you look at the ingredients, sounds like it was invented in a lab. Stay away from simple carbs and sugar. We don't need them. You can't go wrong with a whole foods diet, with or without keto. Sent from my SM-G965U1 using Tapatalk

Thanks! Sent from my SM-G965U1 using Tapatalk

That's awesome!!!! I am definitely not losing two pounds a week, so that's great! I would like to lose another 10, but that might take a few months. I am not sure I really need to really lose anymore, but I wanted cushion against regain. I am lean now and would love to get a six pack for the first time in my life. I think I have some loose skin that might make that difficult though--not sure if it's fat or skin. I wish I could afford a tummy tuck!!! Sent from my SM-G965U1 using Tapatalk

I have my wife to do that for me. [emoji3] Sent from my SM-G965U1 using Tapatalk

Hey guys, I haven't checked in for while. I hope everyone's doing well. I know I am doing great. I am sticking with the modified Keto and exercise routine. The scale hasn't moved much in the past six week--only down about 5 or 6 pound. However, during that time I lost: 1.5% of my body fat (down to 16.5%); 1.5 inches off my waist; inch off my chest (down to 42 from a 50) and a quarter inch off my neck (down to 16.5" from 18.5" in the fall). My pants size is now a 32, down from a 44 this past summer. I have gone from wearing XXL shirts to M slim fit shirts (sometimes large slim depending on the brand). At this point, I am not really sure how much more weight I am going to be losing. I am ok where I am. Aside from the number on the scale, all of my aesthetic goals have been met (or are very close to being met). More importantly, I just had my 3 month follow up last week. My blood work looks great. My triglycerides are down to a 54 (they were over 450 last summer). My good cholesterol is up three fold to 96. My A1C's have dropped from a 6.3 (with 1000mg of MetFormin and 1.8mg of Victoza) in November to a 5.1 with no medications. As of now, all my nutrional numbers look good and are well within normal ranges, including vitamin D, B12, B6, Calcium, Iron etc. Of course, nutritional deficits can take a while to show up in blood work, so we'll see how they look again in three months. So, far the only downside is that my once very thick hair is thinning a bit. Not loving that, but no one can really tell yet except me (hope it stays that way). I am taking my biotin, but not sure how much it really helps (can't hurt though). I would still trade lush hair for a slim body any day. Anyway, here's a picture from this past weekend (3/23/19):

I disagree with with Dabeyhive and RickM's comments above. Sure, keto isn't for everyone, but it's great for many people. I love the fact that it gives me some firm rules to follow and it happens to fit my eating preferences. First, I don't believe Keto is a fad diet at all. It's been around in various forms since the 1920's and became the basis of the original Atkin's diet in the early 1970's. It works very well both for weight loss and general health benefits. The problem is that some people don't really understand the diet or follow it correctly--and that's where people into problems. Following a proper Keto diet doesn't mean you should be chowing down on cheeseburgers without the bun eating bacon with every meal. While cheeseburgers and bacon are not prohibited on Keto, those aren't recommended either. You should stick to things like organic eggs, lean organic meats and wild caught fatty fish (like sockeye salmon). Stay away from fatty meats, since the fat is bad things the animals consumed are stored. You then add healthy fats to your food, like avocado, MCT oil, extra virgin olive oil, ghee etc. The idea is to "prime the pump", so you body burns off its excess glycogen stores and then converts stored fats into ketones for energy. This is important, especially if you're insulin resistant. For me, I am really happy with Keto and I can definitely stay on keto long term. My surgeon and nutritionist are on board with my keto choices. I just had my blood work done after 2 months on Keto and everything was perfect. I am no longer diabetic (A1C dropped from 6.3 on multiple meds to 5.1 on no meds). My triglycerides dropped to 54 (they were 450 this past summer on meds). My cholesterol is 190, but my good cholestrol is 97 (which is outstanding)--so that's good. Some of these may be from the surgery, but diet and exercise are equally critical. I suggest that you don't do keto on your own, but you do with with the guidance of a doctor or nutritionist that has a lot of knowledge about keto. I personally keep my net carbs down to approximately 20g a day and close to a 1:1 ration of fat to protein. At this point, I am 14 weeks post op (99 days). I am eating between 1200-1600 calories a day. Those calories are made up of 45% protein, 45% fat and 10% carbs. The carbs I am consuming are mostly from vegetables--even green veggies have some carbs. I don't eat any bread, starches, potatoes, sugar etc. I avoid high carb fruit, but I am allowed berries. I avoid processed foods to the greatest extent I can. I also work out daily--at a high intensity (and have been since I had all physical restrictions removed 1 month after surgery). I have lost 70 pounds since my highest weigh in. My pants size has dropped from a 44 to a 32. My body fat has dropped from 28% to 16.5%. Weight loss surgery is only a tool (a good one), but I would say it gives you a head start and helps prepare balance your body's hormones and stomach so people like me (morbidly obese, with a trifecta of co-morbidities) can lose weight like a normal person without insulin resistance/diabetes and other issues that get in the way. Once I had those issues, in check the rest of it was up to me--with keto and serious exercise making the big difference in getting me to where I want to be. I'll let my pictures speak for themselves: The was me on July 4, 2018 (weighing around 255-260) : This is me on the day of Surgery (weight 235): This is me on March 23, 2019 (weighing 190): As a 45 year old man with diabetes etc., no way I could have done this without VSG. However, I really believe Keto and exercise (45 minutes moderate to high intensity cardio 5-6 times a week and 1 hour of high intensity weight training 4-5 times a week) have changed my health and my life. I can't imagine going back to the life I had before surgery, nor could I imagine not living a keto lifestyle at this point.

Shopping sucked!!! I never felt like I looked good in anything. It's hard to look good when your belly is hanging over your pants and pushing them down. It was like my tummy was fighting a tug of war with my belt and my tummy won every time! Nothing was ever comfortable. Selection sucked because the "cool" designers do not design clothes for horizontally challenged people. I could never find a dress shirt that fit me right because I had to get a shirt with an 18.5 inch neck. You can't find those off the rack. At a B&T store, you can find them, but then I had the opposite problem because they were cut for an person even heavier than me so they were too big on me and made me look even heavier than normal. Being a normal weight opens up a whole new world for shopping. Finding something something to wear is no longer a challenge---well, not the same challenge. I now never know what size to buy so I have to try everything on. No problem---but that's not a great thing for shopping at costco (which I where I have been buying my clothes since you can get decent pants there for $20 a pair and they only last me a couple of weeks. It will be nice to reach a healthy stable weight so I can actually buy really nice clothes. I am just going for cheap and passable for now.

Thanks Shanza! I'll take these types of "problems" any day!!!

I had to make the same decision between sleeve and bypass. Most studies show that bypass patients loose faster and have great % of excess weight loss at 1 year post-op, but by year three the weight loss is the same for both procedures. The risk of regain is also pretty close for both procedures (although a lot of it is up to you and the choices you make). However, if you do regain weight down the road (which can happen), the options for a revision from a bypass are limited. If you have the sleeve, you can always convert to a bypass or SIPS/modified DS down the road (I think SIPS is going to be the revision of choice in 5 years). I originally was leaning towards the bypass, but my surgeon pushed hard on the sleeve. I took his advise and I don't regret it.

But you’ve lost the dad bod!! You look fantastic and I bet it’s easier to keep up with your kid/kids now! Congratulations on your transformation Thank you!! Yes, it definitely is easier to keep up with the kids and doing small things like tying my shoes, picking something off the floor, walking up stairs etc. I don't sweat when I am not suppose to be sweating (that was a big deal for me)!!!

The ins requirements for 6 month weight loss program is BS since there is no science to back it up. It's a barrier only. Since you're at a 39 BMI, you don't want to actually loose much weight on this diet. If you have co-morbidities you probably have to keep your weight so that you are over 35 when the request for ins. approval goes in. If you don't have co-morbidities, you're on the bubble as is and you don't want to lose any weight or you'll be at risk for rejection. You also don't want to gain weight since that can be a disqualifier too. The irony of all of this was that for my 6 month diet, I was worried about losing weight and getting disqualified. That says it all when it comes to this stupid requirement.