SpartanMaker

I love the outdoors, so hiking/backpacking and trail running are my main cardio exercises right now. I also strength train 2-4 times a week, depending on what routine I'm doing and what else I'm doing cardio-wise. Before surgery, I would have been pushing it to walk to the end of the block, so I mostly just didn't bother. To me, I don't think of any of the activities I do strictly as something to help me lose or maintain weight. Honestly, fat loss mostly comes from the kitchen, Instead, I partake in these activities because I enjoy them, but perhaps even more importantly, they make me healthier and will hopefully lead to more time here on this planet. Regarding loose skin, I have been able to "fill in" some of it on my arms and legs with muscle. I attribute this to my overall workout plan, not to any specific thing. You didn't really ask, but I wanted to share a few additional things with you: While as you've seen in this thread not everyone is active post-surgery, the data is clear on this: those bariatric surgery patients that partake in at least 60 minutes of moderate physical activity 5-6 days a week are significantly more likely to reach their goal weight and maintain their weight-loss long-term. That does not mean you can't be successful without exercise, but it does mean you can greatly tip the odds in your favor if you're active. Both cardio and strength training are important. While cardiovascular exercise has obvious heart-health benefits (that's why it's called cardio after all), it also helps with your overall physical endurance and energy levels, so everything else you do physically just becomes a lot easier. Strength training, in addition to helping you look and feel better physically also increases your metabolism so that you burn even more calories even at rest. It's hard to argue with the benefits of that on weight loss. Strength training will have no direct effect on loose skin. As I implied above, what it can do is help fill out that loose skin with some muscle instead of fat. This is probably going to be more in the arms and legs than in your belly for obvious reasons. Keep in mind though that your ability to add muscle mass is highly impacted by age, genetics, epigenetics, diet and biological sex, among other things. My point is that while some people can "fill in" that lose skin by adding muscle mass, it's by no means assured or even realistic for most of us. It's sometimes misleading to think of strength training as the only thing that builds muscle. Even just walking can help, depending of where you're starting from. Like all exercise, the key is continuing to progress. Once you stagnate, you'll stop improving your health. In short, I highly recommend partaking in both cardio and strength training. If you need help knowing what to do, seek out the assistance of a reputable trainer.

As always, @Arabesque is spot on. I see that you are are only a few days post-surgery, so the one thing I'd add is that everything you're feeling is 100% NORMAL at this point. We all start second-guessing our decision early on because having WLS is HARD! How you eat, how you feel and how you look is radically changing every day. It's physically and emotionally challenging. The good news is it gets easier as you progress. I told my wife she only had one job post-surgery. When (not if), I started doubting my decision, she needed to remind me of all the reasons I decided to have the surgery in the first place. I tell you this because I feel like you may need a similar reminder right now. You know your own reasons for taking this journey. It's easy at this point to think the challenges you're going through are not worth the hoped for end goal, but they are. Remember that it WILL get easier over time and you can absolutely reach those goals you set for yourself. Right now, it's all new and confusing and frankly most of us worry this is how life will be forever. It's not. You will make it past this, just like the rest of us did.

Honestly I don't think it matters if it's related to the surgery or not. Your surgeon just isn't going to have the requisite knowledge and experience to diagnose and treat you. If this is something that recently started (and not something you had since surgery), my guess is this is related to a systemic change in your body, possibly related to an adverse change to your gut microbiota. Regardless of cause, you really need to see a dermatologist ASAP. They'll be able to diagnose the actual dermatological condition (and there may be more than one), and devise a treatment plan. If you need to go through your PCP to get that derm referral, then go that route, but I really recommend finding a dermatologist ASAP. In the interim, you may get some relief from OTC allergy medications and/or topical creams. Good luck.

I'm not sure motivation is what you need. I think you need better habits. As you said, old habits die hard. You're just not going to wake up one day and suddenly start following your plan, track your intake religiously, exercise regularly, etc. Instead, you have to pick one teeny, tiny change to make at a time. Pick something that seems almost insignificant, and do JUST that one thing for 2-3 weeks until it becomes the new normal for you. Once that becomes habit, then pick another small change to make, and do that one for several weeks until it's automatic as well. Keep building new habits until the old bad habits have been replaced by the new healthy habits you actually want. As an example, maybe you've found yourself having a glass of wine every evening. Instead of trying to quit cold turkey, try drinking three ounces instead of four. Or if it was two glasses a night, maybe a few days a week, you only have one glass. After a few weeks of that, maybe you skip it entirely one day a week. You get the idea. The changes need to be so small you don't really notice the change. Another strategy that can really help is to play mind tricks with yourself. Maybe you really LOVE chocolate. Convince yourself that you hate the taste of chocolate. Go ahead and eat it, but the entire time, think of all the sensations about it that you don't like, such as the weird melting sensation, the earthy flavor, etc. You may find after a while of doing this that you really don't crave chocolate much anymore. The mind games don't even have to make much sense, what's important is that you actually start to believe it over time.

Can you better explain what you mean by "help me"? Do you need to lose weight? How much? When you say you eat very little, do you know how many calories you're consuming now? Do you know your Resting Metabolic Rate? Do you exercise? What types and how much? Do you have any other medical conditions other than your digestive disorder? Especially disorders that impact your metabolism such as PCOS, Hypothyroidism, Diabetes, etc? Sorry for all the questions, but details matter.

There's nothing wrong with setting a higher goal for now and reassessing once you get to that weight. If 170 is all you can invision, make that your goal and once you get there, you may have a much better sense of exactly how much lower you can go. If anything, I think way too many people set an unrealistically low goal and then find themselves disappointed when they can't get there. Keep in mind that obese people have heavier bones, enlarged hearts, more blood volume, etc. You may find that at 150, you look and feel as healthy as someone that was never obese is at 135.

+1 on this. There are lots of benefits to strength training, but the most germaine here is the fact that it will increase your metabolism.

I feel like you may have a misunderstanding here? (Unfortunately a very common one!) From the sound of it, you're expecting restriction to be the thing that keeps you from gaining weight, but that's rarely true for most post-surgical patients. A cursory glance at these forums should be proof enough of that. Look at all the posts from people asking for help because they gained a bunch of weight back and don't know what to do now. Some recommendations: Consider finding a therapist that specializes in eating disorders and work with them to reset your relationship with food. As long as you have a desire to be "full" and keep pushing the envelope, regain is going to be a real possibility. Talk to a nutritionist to get a handle on proper amounts and types of food that will work for you to maintain your weight. Track your calories and macros. If you don't know how much you're really eating, it's hard to know how much is enough, and how much is too much. Find a way to have your Resting or Basal Metabolic Rate tested (Google it). This will tell you how many calories you're actually burning per day. Use this, along with your food log to make sure you're not eating more than your burning.

In addition to the great advice above, I'd recommend creating a diary or log to help you track this. There are lots of different potential causes, so the more you can document, the more likely you can find the cause. Some things to document: Start by making note of the following: Any specific symptoms. "Shaky" can mean different things to different people, so you want to be more descriptive. Are you having any other symptoms that either occur at the same time or shortly before or after? The time it starts and the time it stops. Whether this comes on suddenly, or if it's more gradual. Other daily things such as the when you eat, when you drink, when you get up, when you go to bed, etc. what specifically you were doing when it started. What if anything you did to make it stop and how effective it was. After a while, you may start to see some patterns emerge such as Whether or not this happens only once a day, or multiple times a day. Maybe it happens at roughly the same time every day or maybe it's more random? If it's more random, are you noticing any other patterns? Maybe you are more likely to be in a particular room or participating in a specific activity when this occurs? maybe it's correlated with meals? (Up to 30-60 minutes before or after.) Perhaps it happens after eating something specific? I think you get the idea here. The more details you put into your log, the more likely you are to find help. Once you have this info, I think it will really help your medical team find possible causes. Also if you have access to a blood pressure monitor and a blood sugar test kit, checking those things multiple times a day, but especially when this issue occurs, would be a really good idea. If you do have access to those, add the readings to your log. I hope you figure it out. I know from experience that having no idea what's going on with your body is super annoying.

Regarding medications, I take 30 different medications or supplements per day and really don't have any issues taking them at this point. I obviously don't do them all at once, but it's not like I take them one at a time either. Right now, it's roughly five to seven at a time, spread throughout the day. I was pretty challenging the first few weeks to get everything in because at that point, I was having to take maybe one or two at a time. I'd say I did that for 3-4 weeks, and slowly started upping the amount I take at once. I'm hopeful I'll eventually get to just twice a day (because some of my meds are BID), but that may be a bit longer still.

I tend to just say "eating less and moving more". It's factually correct and avoids any judgements or follow-up questions I might get if I went into more detail regarding surgery or my specific diet & exercise routine.

Ah, but that's an entirely different issue. I 100% agree that many of these plans are not always easy to follow, but someone's ability to follow what they were told is independent of my recommendation to stick to the plan. Full disclosure, like @ms.sss, I have been paving my own way, rather than blindly following the generic plan I was given. I have a strong scientific background and understand human nutrition better than most, so I feel comfortable deviating from what I was given. I understand the why behind the recommendations and understand how to bend the recommendations without breaking them. There are a lot of people that have WLS and just don't have that sort of background or knowledge. As a result, I think it would be irresponsible of me to tell them anything other than "follow your plan", or at least "talk to your team". Also, don't even get me started on what I think about some nutritionists and the advice they sometimes give that has absolutely no scientific basis other than what they were told in undergraduate school 30 years ago. At least those nutritionists have a working relationship with their patient that I just don't have. Plus, to people here, I'm just some rando on the interwebs and as a general rule, forums, as good as this one is, are not the right place to be getting medical advice.

Full disclosure: I still eat fast as well, but like you know my limits. This has worked for me and though I'd love to slow down, I'm just too old of a dog to learn this new trick.

Fair point. I mostly put it that way to keep from going down the rabbit hole regarding whether it's okay to deviate from the plan you were given. Especially since advice given here on this forum (or elsewhere online), may well be even less beneficial than the admittedly sometimes marginal plans many of us received. I look at it like this: Can you eat off your particular team's plan and still be successful? Absolutely. Can you also be successful if you follow their recommendations closely? Certainly. Unfortunately what is also true is that if you don't know what your doing, or not monitoring closely, you can also get into trouble eating off plan. Thus my real point is stick to the plan your were given and your odds of success are good. Deviate from that plan and you may or may not be successful depending on your own personal experience and knowledge regarding nutrition and your ability to keep from falling into old bad habits. Simply put, following the plan you were given is the safe choice.

I certainly understand why you'd say that, however I do worry that you and others are beating yourselves up over this concept of "willpower", when self control/willpower isn't actually what separates those that are successful at weight loss and those that aren't successful. I mean, I get it. We've been told this over and over again, but there is a growing body of research that shows it's not self control that's actually at work here. In reality, your ability to resist that tempting food is no different than successful dieters, or even people that have never had a weight issue at all. What those folks do differently is reframe the problem. For example, instead of thinking resisting a particular food comes down to "being strong", they might mentally tell themselves that it actually tastes bad, or maybe they visualize the lousy feeling they tell themselves they'll feel after eating it. Over time, these sorts of approaches help them develop new habits that replace the old unhealthy ones. It's not an instant process, but it is something that anyone can do. For those that need the help, this is something a qualified therapist can assist with. I mention all this, because beating yourself up for being "weak" is counter productive and just makes the problem worse. Obese people are not weak or lacking in self control. Some of us just lack good strategies for replacing bad habits with good ones.