PWMDMD

I was given the clear to start lifting within reason at 4 weeks (no heavy core stuff) and by 6 weeks was back at it including light deadlifts and squats. My surgeon said if I lift it and something hurts on my abdomen then put it down. This seemed reasonable. FWIW at 4 weeks out I never had any issues lifting for beach muscles and when I started dead/squats at 6 weeks no pain or issues. All this said I would simply ask your surgeon and follow what he/she says.

18 hours ago, BigViffer said:

Yep, once I stopped doing "silly-****", I've followed the Starting Strength and subsequent Barbell Prescription programs. Typical male ego is just the issue now. I should be grateful for the lifts I accomplish honestly. Prior to surgery I couldn't even lift my left leg nor carry a gallon of milk. Whining about a 260 deadlift and 250 squat just sounds like petulance given where I started from!

2500-3000 calories?! I just checked my records, I have only hit 3,000 calories 6 times since surgery, and 2500 calories 33 times!

You should be proud of those lifts! Most people in this world can't DL and squat anywhere close to that weight.

Yeah...my calorie intake is an experiment. The only thing I'm really tracking is waste size. The idea being regardless of weight changes as long as my waste size doesn't increase and I'm lifting more this week than last week the weight changes should be mostly lean mass. So far I'm on week three of 3000 calories and weight has not changed and waste size is the same. This week I should hit new PRs so I'm just trying to feed the furnace - within reason. My main reason for increasing calories though was I'm trying to put on more muscle and build more strength.

I'm also trying to see if it's possible to come back from all the adaptive metabolic changes associated with weight loss. Like many I lost 70lbs on my own in 2012 - pretty easily as up until that point I was eating a huge calorie excess and just going to a normal calorie intake was enough. I lost my 70lbs and slowly, while still exercising and tracking my calorie intake all the weight came back plus some extra. There's decent literature on adaptive thermogenesis as one possible cause for the dreaded weight loss relapse. After that point it was much harder to lose weight again and even going 500-1000 calories under what I did the first time wasn't enough to lose weight again.

The question for me is with very intensive training to build lean mass can I change my body composition and can I somewhat restore normal metabolic levels? The first weight loss I went to 3000 calories to lose the 70lbs and still found myself hungry all the time but it was doable. Subsequent weight loss attempts 3000 calories did nothing for weight loss and going to 2500 or 2000 calories meant I was starving all the time. A year out from surgery I naturally want to eat about 2200-2500 calories per day and getting 3000 calories in per day often feels like a chore - very different than prior to surgery. If I for whatever reason stop heavy lifting I will happily go down to 2200-2500 calories per day as I believe this to be my average daily expenditure without lifting.

So far so good!

I know you were kidding with the cardio comment but no, lack of cardio is not what got you to where you are now. A caloric excess is responsible for that and the surgery will help with that aspect. I still wholeheartedly believe lifting heavy is the best thing post-op. It doesn’t have to be the only thing and cardio is better than doing nothing but in my mind lift heavy, gain muscle, keep the metabolism going and change body composition. I didn’t want to go from strong muscular fat to skinny weak fat. You’ll lose lean mass size but there’s a few of us on here that are proof you can come back after that initially weight loss. I’m in the best shape of my life at 40y and just slightly under being the strongest I’ve been in my life too. Good luck!

7 hours ago, Zjasso said:

That's good to know. Is there any supplements you found to help you on training days besides the required bariatric Multivitamins?

Pre Op
5' 11"
#360
>50 BMI

I use a pre and post-work out supplement, good old Gummy bears just after lifting and Protein powders. My goal for protein is 235g/d.

Pulled 330lbs for 9 reps yesterday and then banged out 195lbs for 50 reps on deadlift. Decently sore this morning and will take today off, tomorrow is bench and won't squat until Thursday or Friday...I find I have to separate deadlifts from squats by as many days as possible now whereas before surgery I could squat the day after deadlifts and be reasonably comfortable and certainly could squat two days later with no problems. Now I try to get at least 3-4 days between the two.

I use the Jym supplements Post-workout matrix which has BCAAs/Creatine and the Jym L-Acetyl-Carnitine supplement as well. Minimal sugar and the post-workout matrix comes in many flavors and some are really good!

You will lose strength and muscle mass. It's is inevitable being in a massive caloric deficit and you can not separate fat and muscle catabolism...you just can't. The best you can do is try and minimize lean mass loss by getting back into the gym as soon as you're cleared to do so and once weight stabilizes - by definition you will at this point be at your maintenance caloric intake for whatever weight you're at - increase caloric intake and rebuild lost strength/muscle.

I spent 6 long years in the gym prior to surgery with 1RM in the +300-450lbs range for the various main compound lifts and after weight loss stabilized I started with just the 45lb bar. I'm less than a year out, down 90lbs and my current 1RM's are almost back to where they were prior to surgery - I'm just a WHOLE LOT healthier. My biggest issue now is over-training - without the large caloric intake from prior to surgery my recovery is definitely not what it used to be but I've greatly reduced the chance I'm going to die at 44 and 48 like my sister and father so I'll take it!

Actually, it wasn't a bad thing. I started with Strong Lifts 5x5 and used the early weeks and months to really dial in my form...I'm a better lifter now than I was prior to surgery and my strength is much more balanced - my DL before was way ahead of my squat and my overhead press really lagged my bench - now they are proportionally right where they should be. I doubt I would've been able to achieve this without essentially starting over.

On the bright side...lots of people go into surgery without any real lifting background. You're already stronger than most and I believe that strength was the key to me doing so well post-op - when others just want to walk unassisted again and you want to just get back to picking up 300+ pounds you can see you're already at an advantage!

Good luck!

On 6/3/2019 at 9:18 AM, BigViffer said:

@NurseMichael & @Albus - you guys are badass! That cinches what I have long suspected. I cannot get my deadlift over 260lbs and have tried for 3 years. I could not decide if it was from lack of caloric intake or from a lifetime of spinal and leg injuries. Seeing you guys killing it pretty much say that it's not my food intake.

Congratulations guys, truly fantastic work.

I've found the popular strength programs to be very helpful - many have apps and you just plug in the numbers and do what the app says. It will systematically increase weight over time until you plateau - they even know how to deload when you hit plateaus.

On Monday for deadlifts I'll pull 330lbs for 8+ reps which puts my 1RM around 400lbs. I started at 180lbs after surgery and followed Strong Lifts 5x5, 3x5, 3x3, then Madcow 5x5 and now Wendler 531. My goal was a base level of strength with 1RMs of bench 315lbs, Squat 350lbs, overhead press 200lbs and deadlift 400lbs. Now I'm moving to adding more size. Most of this I did with a caloric intake of 2500-3000 calories and 180-230g of Protein per day. I've found with this intake getting the lifts done is not the issue but recovery the next day is the issue. I'm still working through this stuff myself. I'm sure non-bariatric surgery lifters doing my programs and weights are probably up around 4000+ calories....

Keep up the great work!

Just an update. In April I moved from Strong Lifts to Madcow and now I'm doing the Wendler 531 with the four day split and the optional Big But Boring sets. Basically divides lifts into four separate days of overhead press, deadlift, bench and squat. I like this program because you only do each compound lift once per week compared to Strong Lifts and Madcow where you are squatting every workout. The core lifts are not too bad but the Big But Boring (BBB) lifts for squat and deadlift SUCK! You basically go to failure on the last set of the core lift for that day and then deload to a lighter weight but do 5 sets of 10 reps. So for Monday I'll deadlift 330lbs as many times as possible until failure, give myself about 3 mins of rest and then reload to 195lbs and do a 5x10. It's brutal and I just finished the first cycle and I'm on day 6 for a "rest week" before starting the second cycle.

This rest week coincides with vacation and I was starting to feel really run down with some minor but nagging aches and pain (tennis elbow in left elbow and left knee stiffness). Six days in those aches and pains are all gone but man I still feel fatigued and tired. I figured by now I'd be dying to get back to the gym but to be honest I have no desire to go at this point - I'm very surprised by this. I'm also consuming about 3000 cals per day now and I've changed my macros to 230g of Protein and 250g of CHOs. Still eating well - mostly Whole Foods and complex carbs. Since April I've put on about 10lbs but my waste size is the same - waste size is basically the only measurement I take on a regular basis.

I've definitely put on significant size in the past 3-months and I'm stronger but I still feel like I'm tippy toeing on the overtraining line and based on this rest week I think I've clearly fallen into overtraining. I really thought by day 6 of this rest week I'd be dying to get back it. The weird thing for me is I have ZERO issues at the gym - I feel strong and motivated when I'm there and bang out these workouts no problem. This is followed by the post-workout euphoria feeling for the rest of the day and it's not until the next day that I feel profound fatigue (some muscle soreness but minor) - drained - empty in my core.

Any guidance is appreciated! I know, I know...reduce volume, reduce intensity or reduce both....

Besides some hiking every now and then it's all I do with great results! From the start I wanted to lift and keep lean mass while I lost weight. I started with StrongLifts 5x5 and now I'm doing Stronglifts 3x3. After surgery and a 90lbs weight loss I lost a lot strength. The Stronglifts 5x5 has you start with just the 45lbs barbell but you add weight every workout. I've gained about 10lbs during that time but my waist size is the same (Waist size is all I really measure now). Obviously, I feel much stronger! I think heavy resistance training is a great option for bariatric patients!

47 minutes ago, Sheribear68 said:

Can not agree MORE with all of this!

Nobody ...... and I mean nobody can be “healthy” at a BMI of 41.

At the age of 40, it’s still possible to fool yourself into thinking you’re healthy, but the harsh reality is that damage is being done to internal organs and other systems that you’re not aware of and it WILL catch up.
Damage that isn’t always reversible with traditional diet and exercise.
There’s something almost magical about the metabolic reset that comes with these surgeries and I’m sorry but if diet and exercise without this reset really worked long-term, then many of us would’ve never needed the surgery.

Yes your relationship with food will be different now, but that’s the whole point.
Without my metabolism screwing me over every day, I’m actually not hungry anymore when I eat.
I’m not chronically wondering when the soonest possible time is that I can eat again because I feel as if I’m starving. The reason for that is in insulin resistance (or lack thereof) and the fact that my body is now mobilizing fat stores for energy— as it should have been doing all along, but didn’t because of insulin resistance.

The first couple weeks are tough. Your body hasn’t moved beyond the initial shock of surgery and you’re tired and sluggish and cranky because it’s been a few weeks since you’ve been able to BITE and CHEW any food.
By the time I went for my 2 week post-op I hadn’t chewed anything for 18 days and I was cranky as hell, even though even then I was not once remorseful. I can only imagine how awful it would’ve been had I had a negative attitude.
Being able to finally eat something (1/4 cup cottage cheese) was blissful.
I knew I was finally “there” when in week 4 I was able to eat a few bites of salad— the food I missed the very most during that process.

It gets better, but you’ve GOT to change your relationship to food and understand that however bad you’re feeling now will only be multiplied exponentially by continuing to carry an extra 50-100 pounds around every single day of your life.

I’m barely 5 months post-sleeve today and I’m “only” down 63 pounds since surgery date. I still have between 30-40 pounds yet to goal, but even if my loss stopped right here (I know it won’t) I’d be happy with my choice and would choose to do it all over again a million times out of a million.

I'm being kind of obtuse here because you are absolutely correct for 99.9% of the people on here and as nothing more than a point of interest there is a group of people known as the "metabolically normal obese" who are resistant to all the obesity-related comorbidies in spite of their increased adiposity.

That said....to everyone reading this....don't count on being this person! Lol....

https://www.ncbi.nlm.nih.gov/pubmed/25555214

I have not had any regret but that may be a function of my attitude going into surgery. My father died at 47 and my sister at 44 - both from heart attacks and both lived very unhealthy lives. I turned 40 this year - I'd really just like to see 50 and I know the likelihood of that happening without the surgery was very small.

Preop, peri-op and post-op I keep reminding myself while this surgery was a big deal and my life is forever changed by it my life depends on it.

Pediatric dentist here....I took 2-weeks off completely even week #3 back at work was really sort of half-speed with no operative. My biggest issue wasn’t physical - it was mental. It took me two weeks to really adapt to 800 calories per day and feel like I had good judgement. After two weeks the fog lifted. I had a particularly uneventful post-op...ZERO pain or nausea even the day after surgery - many aren’t as lucky and this was part of why I was able to get back quickly. I also have a partner and an associate so everything didn’t fall on me once I was back and I could slowly ramp up seeing more patients. 

My wife and I both had gastric sleeve last year (Sept 2018 and Nov 2018) - my surgery was ~3 months before hers - it's been unbelievably successful for both of us as far as weight loss. That said, our post-op course has been very different.

I went into surgery having been an avid (albeit morbidly obese) weight lifter for 5+ years while my wife dabbled on and off but was not consistent with exercise. Post-op I got back into lifting as soon as I could while my wife was diagnosed with a non-invasive ductile cell carcinoma of the breast which turned into lumpectomy/breast reduction - she's totally fine but it has resulted in her being in recovery for a significantly greater part of the past 6 months. She is just now finally cleared for lifting.

She looks great but even she is itching to get to the gym because she can't ignore the difference between the two of us. I look and feel better at 40 than I did when she met me at 19. My energy levels are high, my physical abilities are high (we "hiked" a mountain this week and I basically ran up the mountain) and she couldn't keep up. She looks great but she has clearly lost significant lean mass, strength and endurance. She's interested in weight lifting because she's watching my transformation and while it hasn't been her thing in the past she clearly sees the change with me. Time will tell if she sticks with it but I've come to believe strength training, in some form, should be a central focus for those of us who can tolerate it. Not saying everyone will be squatting body weight, but some form of resistance exercise is important IMO.

Great job!

This is a great idea because as you know to a large extent the data do not exist. At least, not for younger and/or more able-bodied people.

There's a compensatory physiological process than occurs in severely calorie-restricted individuals called adaptive thermogenesis. This was partially brought to light with The Biggest Loser since they had so much data pre, peri and post-weight loss. Turns out after server calorie-restriction the body decreased it's resting metabolic rate by a very significant amount. Rough numbers as it's been a few years since I read the study but the person who won the biggest loser and who eventually regained all the weight had a resting metabolic rate that was ~800 calories less after weight-regain compared to the same weight pre-weight loss.

Whats' my point? None of us are operating anywhere close to our estimated basal metabolic rate based on the standard equations - at least not in the year or two after surgery. There was some suggestion that as time goes on adaptive thermogenesis normalizes but to be honesty I haven't followed-up on this in a few years.

Ex. I'm 6'5" and 260lbs and I eat 2500 calories per day while lifting heavy and working hard at the gym. Based on standard equations I should be about 200 pounds by now or said another way I should be losing 0.5lbs per week but here I sit on my plateau some 60lbs more than these calorie estimation tools would suggest.

I eat 2500 calories per day on average because that's what it takes to not be hungry all the time. When I listen to my body on non-lifting days I may only eat 2000 calories and on heavy lifting days I may eat 3000 calories - I absolutely get ravenous on heavy lifting days. I'm going to start to add some more calories....the ONLY thing I really care to measure anymore is waist circumference 1x per week.

IMO the only thing these calorie counters are remotely good for is to compare day-to-day calorie expenditures (did I do more or less than yesterday) but the actual number is meaningless.

5 hours ago, belikewater said:

Finally managing to get enough calories in to see some gains 😂😂 most days I'm around 1200 calories sometimes up to 1500....I have a lot of discomfort eating more than about half a cup of food, so basically eat all day! I cant keep Protein Shakes down so that sucks (my surgeon mentioned dilating my sleeve...ahhh no chance lol). I'm 9 months out from vsg and 34.5kg lighter. Would like to lose another 3-5kg of fat then focus on gaining more muscle (fill out my spare skin with some!). My bench is up to 50kg (used to be 70kg) and deadlift at 90kg (was 120kg+) so is a slow road, am also nearly 47 years old so that not helping 😄😄 have added in Olly lifting for fun, and managed to box jump 75cm (30 inches) which felt great (did 40 reps just cause so happy I could but wow my calves on fire the next day lol). So this year my goal is to bench more than I weigh, and squat and deadlift 1.5 x my weight. I'm stuck on a 45kg clean and jerk but I think that is all mental cause I know I can lift more than that. Anyway, love reading your posts, hi from New Zealand 😀

You're killing it! I've been lifting for 6 years now including during my heaviest pre-surgery weight. I lost a TON of strength with the 90lbs weight loss post-surgery but it's coming back. Squat and deadlifts have been most affected and I never used a weight belt before - there was plenty of adipose in my omentum to add support to my spin...now I feel "deflated" in the middle unless I can press my abdomen against a belt..lol.

My plan now is slow and steady! Looks like you're doing great! Keep up the good work!

Never. There is nothing about my life that is not better now.

I'm very lucky too that at no point (even immediately after surgery) did I have any significant pain. I've never vomited. Once or twice I've eaten too fast or overeaten and was uncomfortable for 15 mins. I have no food intolerances.

I know many aren't as lucky.....

On 6/1/2019 at 12:48 PM, insta_adventurer said:

Just chiming in as a fellow post-op fitness fan... I’ve personally noticed that as the weight has dropped and training has made me fitter, I actually need to train harder to get the same results that I used to get. Why? It takes a lot more effort to get my heart rate up and keep it up now. I really need to push myself to get to 140bpm during a workout. What’s your heart rate at during your workouts?

However, building muscle is supposed to increase metabolism, so whether or not you’re burning calories during the workout, your metabolism should see a boost from the muscle mass you’ve built up.

Good luck!

The gains of beginner vs intermediate vs advanced are real and very predictable. The farther you go in fitness the more difficult it is to see any gains/increases (in what ever you're measuring - strength, running time, exercise capacity, distance, etc).

OP...I don't think you're eating nearly enough. Over-training is real and counter productive and there is only so much the human body can do on a 3600 calorie per day deficit before it shuts down non-vital processes and goes into extreme preservation mode.

Even if at my greatest weight loss rate I was at a 3500 calories deficit it was in the beginning during recovery sitting on the couch and doing almost nothing. As my activity level increased I had to increase my calorie intake. At the moment I'm at my lowest weight....I've been stable for 5 months...lifting heavy and consuming 2500-3000 calories per day and I'm battling the beginning stages of over-training. At 1400 calories per day....forget about it....I wouldn't be able to get out of bed in the morning with my currently workout routine.

On 5/26/2019 at 3:22 PM, AngieBear said:

On the high end, depending on his actual muscle mass. Which is FAR different than the 4500-5500 his watch is claiming. 800-1800 cals a day different. Also of note is that your body will become more efficient at certain exercises - like walking, lowering your calorie burn while doing it.

Unfortunately, adding muscle does not increase your rmr like what we would like. This article by James Fell breaks it down pretty well. https://www.latimes.com/health/la-xpm-2011-may-16-la-he-fitness-muscle-myth-20110516-story.html

I think this article both makes and misses a couple of great points.

What it gets right:

1. Muscle mass does not increase RMR as much as people believe it does.

2. It is not easy to add significant amounts of lean mass - especially in a calorie deficit - especially with age - especially with other comorbidities.

What it get's wrong:

1. The goal for us post-op should be to reduce muscle loss as much as possible. It is far easier to keep what was already there supporting our greater pre-op weight than it is to lose the lean mass and then try and get it back.

2. The contribution of muscle mass to RMR does not have to be that large to be beneficial. Rough numbers of course but assuming 3500 calories in 1lb of adipose tissue and a 50lb weight gain over 5 years is a 175,000 calorie excess over 1825 days or an average daily excess of just 100 calories. Could preserving 20lbs muscle during during a 100lbs weight loss be beneficial? Using the article's 6 calories per pound of muscle per day that equals an additional 120 calories per day.

3. The best way to maintain muscle mass is lifting weights. The benefit is not only during the actual exercise but also in the post-exercise period where metabolic rate and Protein synthesis remain elevated. This along with HIIT gives you 'twofer" as far as calories burned and also maintains muscles mass. I know people's abilities here vary greatly but resistance training has been shown be beneficial across the board for those who can tolerate it.

The fact is many of us gained weight over a sufficiently long period of time that while in a calories excess (and yes I know there are compensatory changes to metabolism both in a calorie excess and deficit but let's keep it simple) that actual excess was not huge. Just 100 calories per day over 10 years will give a 100lbs gain.

So my point...I think maintaining muscle mass during weight loss is absolutely important to longterm weight loss and maintenance...evenif the contribution to RMR is not as high as what that charlatan Dr. Oz claims.

The scientific literature is pretty clear about weight loss...calorie restriction is a much larger part of weight loss than exercise. It's simple math...if you figure out how much exercise is required to burn 300 calories vs how easily you can consume an extra 300 calories in a day then you'll see my point - ex. one Boston cream donut can complete undo 45 mins of exercise. It's also psychological - if you could eat a perfectly isocaloric diet and exercise without any compensatory eating (eating more because you're exercising) then sure you can slowly lose weight with exercise alone. The problem is most of us do not know out isocaloric point and most of us can not maintain this lifestyle over months/years without seeing significant progress. With surgery it's also much easier to go into an extreme calorie deficit - how much exercise would you need to do to burn 2200+ calories per day? An immediate deficit many bariatric surgery patients experience pre vs post-op.

This is not to say exercise is not important. Most of the adaptive physiological changes working against us (loss of muscle mass and the subsequent decrease is resting metabolic rate) can be minimized with exercise post-op. It's also important to realize calorie restriction gets the weight off quickly but most of us didn't gain weight quickly - it was relatively slow over years/decades. If you gained 100 lbs over ten years that means an average excess of just 100 calories per day over that 10 year period. You can see how even moderate exercise post-op/weight loss can help to tip the scales towards weight maintenance.

Of course post-op diet is still king for long-term weight loss and maintenance....the old saying you can't out-train a bad diet is true.....

I do almost no cardio - just lift heavy weight. Not suggesting this is best choice for you...just letting you know there are many different ways to exercise.

FWIW...I had chronic metatarsalgia in both feet prior to surgery and it's a non-issue now...so yes weight loss can help chronic pain issues.

I agree....find a different surgeon.

Thanks for all the replies! Sorry, it's been a little while since I've checked the forum.

I'm at about 2200 calories (2500 on lifting days and 2000 on rest days) and doing ok but really feel like the tank is empty after a heavy lifting day. I have no problem with the actual lifting but later that day and into the next day feeling exhausted. Right now I just power through it but as my working set weights go up I think I'm going to have to increase calorie intake. There is some weird mental block as far as increasing calorie intake...I'm trying to just be logical about it.

The surgery program dietitian has been great. I went for a follow up recently and after the look of total disbelief that I was eating 2000-2500 calories per day (surgeon's recommendation is no more than 1300) she said I'm one of the best looking post-op patients she's ever seen and there's no data on calorie requirements for people like me and to keep doing what I'm doing. She was eager to share my case with the surgeon both for the benefits of lifting heavy and higher caloric intake.

I may bump up to 2500-2800 calories and see what happens.

Some recent photos...weight 260lbs.