ouroborous

Well, it's a strange one, but I finally tried on some smaller underwear I bought a month ago. Size large -- not XXL (where I started), not even XL, just large! -- boxer briefs now fit like a glove. Not too snug, not too baggy! And my size 42 waist jeans that I bought a month ago because my 48's that I started with were literally falling off me are now pretty baggy. I have some 40's that were hand-me-downs -- they're too long in the inseam -- and even they are starting to fit loosely. I should be in 38's before the end of the year. For me, getting below 40-inch jeans is a HUGE achievement, since I've been in 40+ inch waist jeans for more than 10 years now. Dare I dream that before this process is over, I'll be back in the 36-inch waist jeans I fit into back in high school? That would be 12 inches off my waistline... wow! Incremental progress, but it's all going in the right direction, and I'm starting to get excited about it. I'm feeling positive about my body for the first time in a decade or longer, and it's just going to keep getting better!

So I figured I'd post a (hopefully) short note on what my life is like about 5 months after my lap sleeve, for any prospective sleevers. First, the bad news -- this is forever, and it's not a decision to be made lightly. This WILL affect the food choices you make for the rest of your life. It's probably the safest WLS surgery around (when you total up operative and perioperative risks, long-term success rates, M&M stats, and so on), but that doesn't mean it's risk- or hassle-free. Now, let me soften the blow: it's really, really easy. Every day, I take some Multivitamins -- and I was taking Vitamins before the surgery, so this is no biggy. Every day, I drink a Protein shake for Breakfast -- not because I have to, but because they're tasty and it's quick (I'm usually in a rush in the mornings) and that way I know I'm not getting protein deficient. I have changed my eating habits dramatically -- I've slowed down my eating and drinking, and I don't eat breads any more for the most part, because I find that bread gets "stuck." It seemed like an imposition at first, but now I don't notice because I've sort of been trained. I don't even WANT bready stuff any more, and that's a HUGE change from my pre-op mentality (I was a HUGE fan of doughy, bready stuff). I exercise, but I haven't been to a gym since my surgery, and I'm not sure I'm going to be. What I've discovered is that my activity level (or lack thereof) has NOTHING to do with my weight loss. Now, don't get me wrong -- I still do a fair amount of exercise, but that's because 1) it helps in so many OTHER ways -- I sleep better, I think better, my sex drive is better, and my occasional spells of anxiety or mild blues are pretty much gone when I'm exercising, and 2) now that I'm 70+ pounds lighter, exercise seems so EASY. I can easily run up three flights of stairs without getting winded! At 330 lbs, that would have (possibly literally) killed me! So, when exercise makes me feel so good and doesn't HURT like it used to -- why WOULDN'T I exercise? But again, my exercise "routine" consists of some push ups in the morning to keep my chest and shoulders from getting flabby, some arm curls while I'm sitting reading the news in the morning to keep my arms strong, and a 30-45 minute fitness walk at lunch every day. Honestly, it doesn't feel like I'm having to "work out" at all -- it's all so EASY -- and yet my stamina keeps going up, my arms and chest are getting very muscular. It almost feels like I'm "cheating" since there's so little work involved, but I wanted to show you that this is not like you're used to! You don't have to sweat for hours and hours in a stinky gym just to "maintain" -- post sleeve, you just have to do enough to be healthy, and honestly your body WILL reward you. I still eat sweets -- just not very much. I still drink an occasional bottle of beer or (more likely) a mixed drink or two -- just not very much (volume or frequency). I still have days or whole weekends where I just lie around on the couch and do NOTHING at all -- no fitness walk, nothing -- and mostly munch on snack-y foods. It's not like I'm some slave to my sleeve. And the net result of my hard, hard life? I've lost over 70 pounds with little to no effort. My weight loss shows no signs of slowing. My doctor is amazed how healthy I am at 40 -- my last blood test showed that ALL of my numbers were "within range." My sex drive -- which vanished in my 20's-30's when I was so fat -- has returned with a vengeance. My face looks much more lean and angular. My bones and muscles now show where fat used to bulge and roll out. I can easily walk over 5 miles without getting winded or sore, and could probably walk 10 miles or more -- in the right clothes and shoes, I think I could walk for days. I don't get tired. I'm already out of the "morbidly obese" category; I'm looking to be out of the "obese" category near the beginning of next year, and by the middle to end of next year -- if my weight loss progress holds steady at about 1-2 pounds per week on average -- I should be near or under 200 pounds. I started this at 330, and I haven't been under 250 in my adult life. And all of this without any real deprivation, any really hard work (aside from meticulously following the doctor's orders), and any real cost aside from the up-front cost for the surgery. So, I don't want to make you think this surgery is completely cost and risk free. Like everything in life -- especially everything worth having -- it has trade-offs and consequences. But as someone who has literally struggled with his weight his entire life -- 30 years, probably, and I'm only 40! -- I can tell you that this is the best medical decision I've ever made. I would do it again in a heartbeat. In fact, my only real regret is that I didn't get a chance to do this when I was, say, 20, instead of 40. But still, I'm so very glad I made this choice. Hopefully that will help some folks who are on the fence realize just how "normal" life after sleeve is.

I second (third) these recommendations. Don't be impatient. Go to the gym, do your workout, and let your body do its own fat maintenance. I guarantee you that if you keep up with that, you'll lose a lot of fat -- fast -- without subjecting your poor stomach and digestive system to whatever's in those "fat burner" pills (most of them are just stimulants, which can be sort of hard on the sleeve).

Honestly, there are a lot of misconceptions over just how much control and influence we have over weight loss (or weight gain). When 1200 calories is a BIG day, like Tiffykins says, you're still going to lose weight or maintain. Consider that pre-op, most of us probably had NO IDEA how much food we consumed... but thumbnail guesses on my part, looking at portion sizes, what I ate, and how frequently I ate, would be that an AVERAGE day pre-op was around 3000 calories. So think about it again -- you've gone from 3000 calories (if you were like me -- and while I was obese, I wasn't even one of the true giants) a day to less than half of that on a "cheat" day. How could you NOT lose weight? Also, the plateaus and stalls are more due to the body's own homeostatic mechanisms -- trying to maintain blood sugar levels and so on -- than our actions. That's why you can literally do everything right and still stall for a week or two, and then stop exercising, start eating more (and worse) -- and then suddenly the stall breaks. Being human, we want to assume it was "something we did" that changed things, but considering the calorie margins involved (going from "good" to "bad" means MAYBE a 300-400 calorie/day change... maybe), it's far more likely that our body just finally "gave up the ghost" on hanging on to that bit of flab, and changed our homeostasis (blood chemistry/hormone balances) so that we started losing again. In short, the great thing about the sleeve is that as long as you "mostly" do the right things you know you're supposed to do -- avoid too many sweets/starchy white flour products, eat lots of good fruits, vegetables, meat, and whole grains, get in some kind of regular exercise, and drink lots of Water -- you're just about guaranteed to lose a lot of weight, if you're patient. It's not really under your control once you get on this roller coaster, so sit back and enjoy the (weight loss) ride!

Honestly, the sleeve is a MUCH better procedure than the band, because there is FAR less chance of re-dilatation (stretching), and because the removal of the extra stomach tissue reduces your hunger dramatically. I've dropped over 70 pounds in five months with almost no real work. I could keep this up for the rest of my life -- and I intend to! You'll do great! Not only will you get to your goal, you'll be amazed at just how EASY it is (compared to the other methods of losing weight).

No, this isn't a post about how a bathroom fixture couldn't hold my weight. My stall in the 260's finally broke. I had just about despaired of ever breaking into the 250's, and then I weighed myself this morning and I weighed 258.1. That's just over 70 pounds lost from my starting weight. It's not as fast as I want, but it's still coming off! At this rate, by the time I take my Hawaii vacation in February or March, I should be into the 230's! Swimsuit pictures FOR EVERYONE!

Dude, you're doing awesome. Congrats! You've always done my benchmark, considering that our starting weight and build seems so similar, and you're doing amazing.

You will lose a LOT of weight on the preop diet, but it's all Water weight. The point of the preop diet isn't really to reduce fatty liver, but to dehydrate your liver slightly, making it easier (and safer) to manipulate during the surgery. Metabolizing carbs requires a lot of water (I can't remember the old Krebs Cycle breakdown, but I think it's something like five waters per sugar or something like that), so naturally a shift towards carb metabolism makes you retain water, and a shift away is diuretic (it's a homeostatic mechanism). The bottom line is that low carb "diets" don't really do much aside from help you lose water weight (plus refined white flour is very calorie dense, so it's good to avoid in the long run), but in the case of the pre-sleeve diet, water weight loss is exactly what's needed. If you are following your surgeon/nutritionist's recommendations to the letter, you should be fine. If you have any questions, I'd give them a call, but just from reading your daily meals it sounds about right.

The ~60% figure, I believe, includes an older procedure that was not as effective. Also, Tiffykins is right (as usual :thumbup: -- the numbers quoted also roll in the VERY large Bougie sizes that were initially used.

I posted the study link, not just the headline :thumbup: The journal that the original study was published in would be VERY unlikely to let a study slip by peer review that had ignored these easy confounding factors. Again, I posted this more to fight against the "less carbs is better" meme than anything else. The study itself makes clear that the mechanism of causation is still unclear.

There was a statistically significant mortality increase in the high animal-Protein diets (P = 0.051, which is definitely enough to infer a correlation). However, I'd again like to point out that it's likely that the increased mortality is from the increased animal Proteins, not from the carb restriction. Carb restriction on its own is still net neutral, according to the bulk of research. So I guess the best diet choices are mostly vegetarian, high plant protein and maybe some supplementation with lower-fat animal protein sources like whey, etc. Still, I think it's important to keep abreast of current research, and not just blindly follow what the crash diet books tell you.

*laugh* Yeah, I've lost about 70 lbs of belly fat. I wouldn't say 2 inches, but a good 1 to 1.5. Again, it's all a perception thing (that particular part of you pretty much doesn't change size aside from the, um, natural size changes, no matter what the commercials tell you), but hey -- perception is EVERYTHING down there

Look, here are the cold facts (I'm not so good with being comforting, but I can sling science at you all day long!) If you are obese or morbidly obese and don't lose the weight, your odds of significant health issues up to and including death are very high, statistically speaking. Meaning that it's far riskier to stay heavy than to have this surgery. The long-term effects of the sleeve are unknown, however the likely risks are perioperative (things that happen during surgery) and diet. The perioperative risks are extremely low, and at five days out, you've already dodged most of them. Once you get to two weeks out, you can pretty much ignore that. The diet risks are unknown, but low considering that we have five years of data now. Think about that; choose one macro or micronutrient -- Protein, carbs, Iron -- and think about if you could NOT eat it for five years without serious health problems. Without iron you would quickly become anemic. Without protein you would have serious muscle wasting and other issues. In short, you simply can't go more than a few months without any other major health issues if your diet is significantly deficient. What this means is that with five years of safety data on the sleeve, we can be pretty confident that the dietary risk factors are a known quantity. Yes, there are some things you'll likely have to monitor forever, one of them being acid. But this is no different than diabetes, which many -- most? -- of us were heading for anyway. Now that we've established that QUANTITY of life shouldn't be shortened by the sleeve -- if anything, statistically, you'll have many more years on this planet -- let's talk about QUALITY of life. In this, there's no contest -- we all know how miserable it is being obese. Not just psychologically from rejection and mockery, but from little things like never feeling like your clothes fit properly, possibly avoiding social situations, and so on. Would you want your future children to know a version of you that is always obsessed with food and ashamed of her body, or to know a you that eats carefully, is happy with her body, and knows and is proud of a hard choice that she made in the past to live a healthy life? Which do you think sets a better example for your family? Finally, let's talk about this "be strong" and lose the weight through diet and exercise thing. This really annoys me because it's simply not true. Yes, of course, you can lose tremendous amounts of weight through willpower. I'd wager we've all done it. But the problem is that you have to keep up that level of dedication and willpower for the rest of your life. In short, you have to fight against one of your most primal urges -- to eat -- FOREVER. Every single day, your body would tell you "help! I'm starving!" and instead of lying down to rest and eating calorie-rich food like it wants, you'd have to say "no, I'm going to eat a stick of celery and go to the gym!" Sure, you might be able to maintain this for a month or six months or even a year. But for 5 years? 10? 20? 50? I doubt it. And the numbers back me up; the last study I read indicated that only roughly 5% of people were able to lose weight through diet and exercise and keep it off for more than a year. Most very quickly fell off the wagon and gained back all the weight lost and more. The studies are there (in the research and studies section), go read them. The bottom line is that the odds just aren't in your favor. And while you're doing this yo-yo dieting, time is ticking. You're getting older, your body is slowing down, and precious days that you could spend focusing on something BESIDES being overweight are slipping by. The longer you wait, the harder it will be to lose the weight, and the less your body will "snap back." In comparison, the last studies I read showed that at 2 years, over 70% of people with VSG had maintained at least a 50-60% EWL (excess weight loss). This is huge. This means that not only does lap sleeve make you lose weight, according to the research, it makes you keep it off. This is what made me decide to do it -- when you add "and keep it off" to losing weight, the fact of the matter is that diet and exercise alone simply do not work. Look around you and find a single person who has lost 50-100 pounds or more through diet and exercise alone (and make sure they're not lying; there are a lot of people who get bariatric surgery and then claim that they did all the work!), and has kept it off for more than a year. Go ahead. I'll wait. As to the "no data" issue with sleeve, it's actually not as bad as you think. We have 5 years of studies now, and all of them show it in a positive light. I still think, after reading all of the studies that a layman like me can get his hands on, that VSG is the best surgical procedure out there. New surgeries like gastric plication and "super sleeve" are mostly marketing gimmics. Yes, it's possible that something new and better will come along in ten years, but do you really want to wait ten more years while obese? The bottom line is that right now, bariatric surgery is the smart choice, and in my opinion, lap sleeve is the best bariatric surgery around (for a lot of reasons). You are feeling buyer's remorse and anxiety about the future. Trust us, however, once the weight starts dropping off, once you go to the doctor and he/she is amazed at how ALL of your health indicators have improved so dramatically, you'll learn to stop being afraid and love the sleeve.

Here are the things that you should consider emergencies in the first month or so: 1) Constant pain -- IE, not pain that comes and goes -- especially pain that radiates around to the back or jaw 2) Persistent vomiting (not just once when something is stuck) 3) Difficulty breathing (this is a 911 issue) 4) Persistent high fever (over 101) 5) Blood coming out of any orifice (and if it's in the stool, it will probably look black like tar) Of course, I'm not a doctor (I have to say that). But still, even not being a doctor, I'd say that if you have any of those issues, RUN don't walk to your gastric surgeon (if possible), or local ER (if not). If you're not having those issues (and remember, that's PERSISTENT pain, not occasional), I wouldn't stress out about it too much.

The interesting thing is that all these people who were so quick to tell me I was taking the easy way out with surgery (of course I am; just like NOT driving into a brick wall is the easy way out!) are now congratulating me on my weight loss. I would just try to pay it no heed, if you can. Society is absolutely insane about weight. We don't understand it medically, and yet we all want to judge others who don't look like we think they should. It's never going to change, so I say -- screw em. Live your life to make YOURSELF happy, because you'll never please the chattering masses.

It is almost inevitable from what I understand that you'll lose a fair amount of hair after a major trauma like surgery. The good news is that it's very unlikely that you'll go bald as long as your diet is healthy and balanced, and it WILL grow back. I'm lucky because I shave my head. Too bad that look never really caught on with you ladies

Don't be scared. As long as you eat slowly, you'll be fine. Look at it this way; you can get into trouble by eating too fast, but not by eating too slowly. So, to start out, just start with the smallest nibbles you can imagine of the foods your doctor recommends, and chew, chew, chew. This will give your courage that it won't hurt, and start to train you how much you can eat in one sitting. Be aware that different foods will fill you up quicker, and also your capacity will change (probably increase, possibly as much as double) as you heal and the swelling goes down. So budget the first 3-6 months as a learning process, because if you're like literally EVERYONE else, you'll have to go through it. It can be frustrating at times, and challenging, but it shouldn't be frightening. As long as you err on the side of caution, it's EXTREMELY unlikely that you'll hurt or damage yourself.

Yes, the constant stuck feeling is likely a little swelling from acid reflux. Make sure you're taking your acid blockers (I'm partial to omerprazole -- it's cheap and you can buy it bulk at costco, since you'll be taking it for a long time), and remember to eat and drink very, very slowly and in tiny portions. Also if the problem persists, it may be nighttime reflux -- try sleeping propped up on a pillow. I bought a wedge pillow from Amazon for around $20 that did more than anything else to cure my (thankfully occasional) nighttime reflux, and get rid of that permanent "stuck" feeling.

You can drink it after your incision is healed -- make sure you get clearance from your doctor -- but you may find that you don't want to. I know that may be incomprehensible -- I was a HUGE coke-head (heheh), drinking 8-12 cans of Diet Coke per day -- but it's true. You'll find that the acidity no longer treats you well (you'll be working hard enough to keep your own natural stomach acid in check without pouring battery acid down your gullet on a regular basis). Also, the carbonation means that you simply can't drink it fast; I tried one a few weeks back and I had to literally take one tiny (and I mean TINY) sip, then burp, burp, burp, wait, wait, wait, and then another tiny sip. In the end, it was too much work and discomfort for too little payoff. I started noticing that it didn't taste that great. Since I had to drink it so slowly, it no longer seemed refreshing or thirst-quenching. Ultimately I've decided that Water is my best choice if I'm thirsty, and if I need that caffeine boost coffee (now that I can have it again) is my best friend. I went from being a huge Diet Coke fiend who'd literally tried to quit a hundred times, to someone who just doesn't care for it anymore, almost overnight.

A lot of people (myself included) get occasional sore throats and hoarseness for a few months after surgery due to acid reflux. If you stay on top of your acid blockers and remember to eat and drink slowly (and separate your food and beverages), you can minimize or eliminate this. Also, as others mentioned, expect to be hoarse and have a sore throat for a little while after surgery because the breathing tube they use can irritate the walls of your throat.

I would wait till the doc gives you the all clear. I was almost three months out before the doc said it was okay.

Too bad they don't really make "foundation garments" for men (aside from the color black :thumbup: )

I wish you were wrong too, but you're not. Overweight people are treated like crap (at least that's been my experience). Which is sort of amazing when you consider that, in the US at least, most people are overweight or obese. In other words, we consider that the bulk of our population are targets for ridicule. No wonder we're so neurotic! I feel bad for the people still trapped in this cycle, but on a selfish level, I'm glad to be leaving the "fat barn."

Well, on the NSV front, I put on some hand-me-down size 40 waistband jeans today, and I was stunned to find out that they fit. Now, they're a little long for me (I'm only 6'1 and the guy these were from was 6'3) so I'll probably have to hem them, but I'm just tickled pink that they FIT. Four months ago, I was wearing size 48 waistband. Also my weight was down to 264.9 today; creeping down towards the 250's. A month or so ago, visiting the nutritionist, I was "joking" that I'd like to break 250 by the end of September. I may not quite hit that goal, but I'll probably be in the 250's, which is something I can't say in recent memory! Also I was thinking that I might be wearing jeans under a 40-inch waistband by the end of the year; at this rate, I should be firmly in 38's (if not 36's!) by the end of fall! What kills me is that for NORMAL men, 250 pounds and 40-inch jeans are still horrifically huge, but I have to keep reminding myself that it's not a competition. Edit: ah, I see that I've also cracked the 35 BMI barrier. Another first (in adult memory)!

Congratulations! You're looking and doing great! I can't weight to also leave the "obese" category for good. I've got a ways to go, however -- but I had more to lose, and I know I'll get there. Great work!