Nepenthe44

I would be most concerned with whether you're hitting your protein over the course of the day. You may need to focus extra on protein if you're lifting. I wouldn't go for extra calories, but more of your macro split coming from protein. You're most likely to build muscle when you start weight lifting. I noticed that a lot of the recommended protein foods, especially during the early diet stages are actually pretty low in protein compared to calories and ended up focusing a lot more on protein drinks and lean meats rather than "normal" type eating that was suggested where I was filling up on mixed macro foods like beans or dairy.

Absolutely not in the slightest, at all. Not even a little. There are occasional bits of medicine that are sciency in that way, but they are rare and WLS is absolutely not one of them. And when science is applied to medicine, the results don't necessarily take. A lot of the advice given to bariatric patients hasn't been researched at all, but some of it flatly contradicts research results.

1. F (with an asterisk, NB on low dose testosterone), 35 now, 34 on surgery date, 5'7" 2 . 27.2 lbs (I had lost 54 lbs in the 6 months prior to that, but stalled due to last supper eating, losing 20 pounds in my 2 week pre-op) 3. 276.0 4. 256.6 5. 228.0 6. 188.0 7. 147.0 8. Roux-en-Y Gastric Bypass I'm a few days short of a year out, but I don't want to forget to post.

You will look lighter than you are. A few weeks ago i was talking to a coach who's been working with strength athletes for decades, a guy who knows what weight looks like on bodies. He looks at me and is like, you're what 120 pounds now? I was just barely into the 150s. I'm in the 140s now and I'm practically skeletal. I'm much, much thinner than when I was this weight as a teenager. I had initially set a goal of the highest calculated ideal weight for my height and am now thinking that if I actually reach it I'll need to buy clothes from the kids section. Which.... I mean, there's way more dinosaur print options so I'm not necessarily complaining. So let that influence your goals.

Yep. I'm always freezing. Invest in layering and thermal clothing. Handwarmers are nice, I put them in my boots during the winter too.

I don't follow the liquid rules. They don't make sense, biologically, and, as you've noticed, they make getting enough fluids in almost impossible. I don't drink much while eating because it's uncomfortable and usually I wait 5 to 10 minutes after eating, again for comfort. When I was closer to surgery, I generally waited longer after "eating" out of an abundance of caution to limit discomfort or dumping. I've broken down all of my team's advice this way. (Also a biologist.) Most of it doesn't add up. They don't care for me. The feeling is mutual. I suppose they can blame my lack of compliance for the utter failure of my surgery. 😂

The best exercise is the one you will keep doing. For me, I used VR games like Beat Saber when I was at the top of my weight range. Being so physically debilitated, moving was painful, but if my brain thought that not moving meant I would get smacked in the face with a flying block, I was able to do it. Plus, the music is a lot of fun. When I was about 50 lbs down, I started CrossFit, which is a combo of high-intensity intervals of constantly varied movements and weight lifting. It was perfect for me. I get a lot out of the intensity, the group/community aspect and the constant variety. The post-exercise "high" that a lot of people talk about? Never experienced it in years of being an endurance athlete when I was younger, but every CrossFit workout makes me feel like I just did a bump of cocaine. I would never be able to go to the gym alone and do the same workout circuit everyday at low intensity. My dad does it almost everyday; I don't understand how we're related. I've also supplemented that with walking/hiking, which is nice for cardio capacity development and getting outside, and a lot of stretching and strengthening exercises to rehabilitate my body. (Turns out that being livestock-sized and totally sedentary for almost a decade leaves you with weird muscle imbalances that leave you susceptible to injuries! Who would have thought!) Lately I've started to get back into endurance sports (cross country skiing and running). I love getting outside and find training for an event very motivating. (I find it very funny that most of the other athletes at my CrossFit gym absolutely drag their feet when running is part of a work out, but I'm so bloody thrilled to be able to do it at all, I'm stoked every time. Wish I felt that way about burpees!) But that's all what worked for me with my brain. Experiment and see what works for you.

Yes, I absolutely did this. I was (and still am to some extent) a binge eater and I literally made a spreadsheet of all my favorite binge foods to "check off" before surgery, spreading them out over a couple of binges. The thing that really amazed me is that most of them... weren't very enjoyable. I had lost about half of my excess weight before surgery and although I was having occasional binges throughout, they were generally the same few foods. So trying the old favorites, some of which were hard to get, I thought that they would taste amazing. But, frankly, junk food is usually disappointing. I also traveled to the city where I lived for a long time to go to some of my favorite restaurants and have some of my favorite non-binge meals. Again, sort of disappointing. The city was still amazing and I really enjoyed the non-food portions of the trip, but the food part was just sort of meh. I'm glad I did it. I was very worried about being one of those people who can't eat anything after surgery and literally never being able to eat any of my favorite foods again. The thing I was most worried about was salads. I had a big restaurant salad nearly every day up until my pre-op diet. That was the only thing that wasn't disappointing. I'm very, very glad that I can eat salad again!

@ms.sss I love your spreadsheet system so much! Beautiful.

I've had moments of yay each time I was able to fit into the old clothes in my closet that didn't fit anymore. This week I took out my favorite pair of jeans from high school (during my restricting phase no less) and they were perfect. I was also happy when my waist dropped below 40 and 35 inches, which are considered cutoffs for disease risk for men and women respectively, at least in the US. I didn't start taking measurements religiously (once a month) until pretty far into my weight loss, but I ordered an eShakti dress for a wedding in 2018 at about 30 pounds below my highest weight and my measurements were 61-57-70 (chest-waist-hips). The day before surgery, my waist was 46 inches and hips 57 inches. My last measurements, from about a week ago, were 38.5-32.5-39.5. I've lost 30 inches from my hips, 24 from my waist, and 22 from my chest. (Yes, my WHR actually increased, but I've also been taking low dose testosterone for about 2 years.) Things have started to plateau, but I still have a sundress that I want to be able to fit into and I imagine I'll get there.

Like isn't the correct word. I curse the gods nearly every moment I'm doing workouts, but I'm addicted. If you like high intensity activities and are disciplined enough not to injure yourself, then it's great and I highly recommend it, especially if you have a gym nearby with a well-trained coaching staff. (More than the level 1 certification, which is essentially nothing.)

I'm in quite a different situation, but maybe the anecdote will be helpful. I'm trans and had been taking testosterone for a little over a year before surgery. 9 months out, I got my T levels tested and they were double what they had been when I was tested a few months before surgery. I have no real insight as to why and it's possible that I was just absorbing the topical gel better through paper thin skin rather than an inch of fat, but perhaps it has to do with the mechanism @Arabesque mentioned.

I was cleared to go back to CrossFit at my one month follow-up, which ended up being 5 weeks out. My team acted surprised that I had waited and told me that I could have started sooner, just not to do anything that hurt. Now, I couldn't actually lift anything heavier than a 15 lb training barbell and my goal remains, almost a year out, simply not to pass out. But I was allowed to do it very soon after.

I really don't understand how my weight is distributed. I'm still in the "obese" category and definitely overweight. But I have visible ribs already when I move, including the ones below my collar bones. I didn't see these until I was very thin back in the before times. If I lose another 50-70 pounds, am I going to look like a walking skeleton wearing a leather cloak?

This is really good to hear. I'm genuinely baffled by the way my body is right now and very frustrated, especially since I have significant weight to lose to reach my goal. The chorus of "don't lose more weight" has started from all corners but I'll just ride through and have faith that my body will settle. (The chorus is especially annoying since I'm not even sure I can stop right now. I'm already not following virtually any of the weight-loss focused nutrition recommendations. Short of adopting an all-ice cream diet, I don't know that I could maintain.) Still don't love it though! Over the weekend, spent some time snuggling with a new crush and he started counting my ribs. 😣

I was an hourglass when I was young, carrying weight in my chest and hips. Always had a relatively slim waist. Have built quite a significant amount of muscle (or retained much more than expected) through a combination of weightlifting and testosterone therapy. Definitely planning on significant skin removal, which should help unveil the few bones that aren't clearly visible due to swaths of skin.

I'm another 40 pounds down or so and it's... bad. I don't have to stretch or flex, you can just count my ribs all the way down, except for where there's a fold of loose skin (I think these are technically called breasts?). This isn't "I'm so used to my obese self I don't understand what healthy is" type skinny, this is "I can play the xylophone if I wear a low-cut shirt", tabloid speculation about drugs and anorexia type skinny. On some level, I'm stoked, my ED self is absolutely thrilled to be able to see every bone, but I just don't understand how I can have so much hanging fat on my lower body and look like a skeleton on top. I do have a small frame by wrist size, but my rib cage apparently did not get that memo. Because, again, I'm still overweight. My bodyfat percentage was assessed at over 30 a few weeks ago. Where the #%@! is it? My weight loss also hasn't plateaued, or even significantly slowed. I'm still losing around 1.5-2% of my bodyweight per week. I am absolutely not following the diet plan given to me, eating much larger portions of much more calorie dense food but I continue to diminish. On one level I'm thrilled, but on another I'm worried this won't stop and I'm going to have to wear turtlenecks to stop birds from nesting inside my torso.

One note on long distance hiking: I'm having to do serious rehab on my hips and core in order to increase my walking capability. While my aerobic capacity and endurance are very good, my hips start to physically give out at about 3 miles. My physical therapist isn't really sure what the issue is, but thinks that it's a combination of weakness and poor flexibility from the postural adaptations that happen with extreme obesity (my legs literally point in a different direction than they used to!) and some effect of fast weight loss on the muscles themselves.

In the same vein as @hills&valleys, we all start out wildly different. The most comparable metric between people is percent excess body weight lost. Your "ideal" body weight is around 145 lb, assuming you're a man. You started with an excess body weight of 164 lbs and you've lost 76 lbs of that or 46%. At the 18 month mark, for RNY, you expect to have lost around 70% of your EBW, so you seem to be doing fine. I'm at about the 6 month post-op mark and I've lost 64% of my EBW from when I started my pre-op diet, and 79% of my EBW counting from my highest weight a few years before surgery.

Update: no more nice squeezing sensation. They're so loose that I don't even have to unzip them to get them on or off.

I find it very comforting that you're able to raise your hand after that.

Genuinely weird one, not really a victory, but it's a thing: For a few months, I've been noticing that my sheets feel like they're bunching up in bed when I roll over. Which doesn't make sense because they're stretchy jersey sheets and don't really have any give. Plus, when I sit up and check, there's no loose fabric there. ... because it's not my sheets, its the loose skin on my back folding up. 😐 Also, I finally figured out what everyone on this thread means by "don't have to do yoga to wipe". I didn't realize that it was possible for regular-sized people to reach down without twisting at all. Wild. (I wasn't fat as a kid or a teenager. Have I just been doing extra yoga my whole life for no reason? I guess so!)

It used to be that MFP had a lot of features that didn't work for bariatric patients, which is still true to some extent, but they've made updates. Like, it used to scold you if you ate fewer than 1200 calories in a day. You couldn't set goals of fewer than 1200 calories, so some of the tracking counts wouldn't really work, especially if you're focused on macros. Now I can easily set my daily goal to 800 and go from there. They've added more macro focused features and the ability to turn off "eating back" exercise calories. MFP still isn't great. You can't have more than 4 meal categories, for example. No tracking for mood or bowel movements (I def. track the latter on a separate form because of some experiences early on that I am not repeating). If I were starting food tracking anew, I'd probably use Baritastic, but after a decade I'm not switching from MFP.

I woke up in severe pain, 9 out of 10 on the pain scale. (I don't believe that it's possible to experience a 10; I define that as "passing out due to the pain".) Within an hour or so, that was controlled with patient-controlled analgesic (I think it was Dilaudid) and I did a lot of hall walking throughout the rest of the day. But when they took me off the PCA, the pain was back up to severe. The hospital staff worked with me and took the pain seriously. I almost stayed an extra night in the hospital for pain control, but managed to get it down enough to get home with oxycodone, acetaminophen, and heat/cold packs. I continued to take oxycodone and acetaminophen for another 6 days and timed doses of acetaminophen for another few days after that. Most people on here and elsewhere seem to report little to no significant pain, but that might not be the case. That being said, it sucked but it only lasted a little while and I felt pretty much okay within a week. Worth it. Don't let the pain sneak up on you. If you are having significant pain, take analgesics on a schedule, before you absolutely need them. For the first few days at home, I even set alarms at night to wake up, walk around a bit, have some water and have a dose of acetaminophen. Like a lot of things (hydration, nutrition), it's much easier to stay ahead of pain than to control it after you have fallen behind.

Just because your surgeon (or dietician) told you do something, doesn't mean that it's actually possible. They usually don't think about their guidelines that hard. You kind of have to work through it yourself. To meet these requirements, you need to get 80 g of protein in 12 oz of food max, but realistically more like 9 oz to accommodate the volume of your veggies. You need protein food with at least 8.9 grams of protein per oz. If you go for the most protein dense solid foods, you can do it, barely. 3 oz of chicken breast or egg white (not the whole egg!) has 27 grams of protein. So you eat 3 oz of egg whites for breakfast with 1 oz of veg, and 3 oz chicken breast + 1 oz veg for lunch and dinner. You can't really afford to eat protein foods that are less dense (like shrimp, tuna, lean beef) unless you give up on the veg, so chicken breast and egg white are pretty much your only options. (If y'all know of another food with 27 g of protein per 3 oz, please let me know!) If you cut back to a half an oz of veggies per meal, you might be able to get away with some of them. Does this sound absolutely awful to me? 100% But if you want to follow your surgeon's recommendations, this is, mathematically, pretty much the only option. And you can do a lot with cooking methods, spices, and mixing up the veggies to make this a little more tolerable. It is unlikely that the surgeon has thought through the practical requirements of their recommendation and done the math. (Less than 350 cals per day at over 3 months out seems a little severe, even to me.) It's unlikely that they expect you to actually follow their recommendations. It's much more likely, imo, that they think that protein shakes equals processed and processed equals bad, that they had a patient once who liked cheese who didn't lose weight after surgery, and that they expect you to eat utter garbage at least 25% of the time so a strict, highly restrictive diet the remaining 75% of the time you're compliant is the only way to succeed.