ouroborous

It is common to lose hair after any surgery, it is called telogen effluvium (see for example: http://www.follicle.com/section2/5.html). This is unfortunate, but unavoidable. The good news is that it is completely reversible; if you can live with its effects for a few months, your hair should come back as thick as before. It's also possible to have thinning hair (technically a slowdown in the regrowth portion of the hair cycle) after weight loss surgery due to Protein and Iron insufficiency. This is avoidable as long as you make sure that your blood levels are sufficient; generally speaking, if you follow all of the doctor and nutritionist guidelines to the letter, you should be able to minimize this variety of hair loss. Biotin and silica, unfortunately, don't do much for telogen effluvium, which is the initial hair loss after surgery that most people complain about. They MAY help (studies are inconclusive, IIRC) long-term after WLS to keep your hair healthy. But they won't really slow down that initial, alarming hair loss. Best thing is just to try to cope with it and realize that it's temporary, and adopt an attitude of "okay, my hair isn't as pretty right now, but that's just temporary, and every OTHER part of me is improving in health and appearance." And also try to take good care of yourself

I find this particularly interesting because sleeve surgery can produce some disruption to the vagus nerve. Feels like there's a connection here... http://www.scienceda...20509123854.htm Hot Sauce Ingredient Reduces 'Beer Belly' Fat as a Weight-Loss Surgery Alternative Ali Tavakkoli, MD, BWH Department of Surgery, and his team have published a study investigating whether two surgeries called vagal de-afferentation-which uses capsaicin, the component responsible for the chili pepper's burning sensation-and vagatomy can achieve weight loss and reduce the risk of obesity-related diseases with fewer side effects when compared to today's bariatric surgical options. The study is published in the May issue of Digestive Diseases and Sciences. The study is accompanied by an editorial by Edward A. Fox, PhD, Purdue University. After testing the two surgeries in the lab, the researchers found that vagotomy significantly reduced total body fat, as well as visceral abdominal fat-the "beer belly" fat that pads the spaces between abdominal organs. Vagal de-afferentation also reduced these fats, but to a lesser degree. However, according to the researchers, the reduction is still remarkable.

I have to say that living in Seattle is very kind to atheists; we even have a monthly meet-n-greet that is pretty well packed. I can't imagine living in Small Town, USA or in God's Country with my (non) beliefs. I would want to strangle someone, quickly. And yes, the whole "you don't believe in God, so you must be amoral!" thing gets old. Fast.

Thanks for all the replies, guys. What I'm reading from y'all is that if I want to break into the low 20's BMI (or, more interestingly to me, the <20% bodyfat range), I need to ramp up the activity yet again. I'm pretty heavily muscled (at least in my upper body... see my "yoga" post for my trials and tribulations re my lower body and core) so I'm sure that throws the BMI ratings off a little, plus I still have some loose skin. But I know there's fat there, too, and I want to ditch more of that. Thanks again.

As long as you can work out to exhaustion with them, it doesn't matter if it's a giant stack of weights, a tiny "girly" weight, or a thick sheaf of rubber bands... all that matters is the effort expended over time.

So, I'm happy with my weight loss -- let me start with that! I'm not complaining. But at this point, the weight loss has really started to slooooow dooooooown. I'm at the point where I MAYBE lose a pound a month. I am not as active as I could be -- I know that. I'm moving, and with the move I'll be much closer to work; about a 20 minute bicycle ride down/up a steep hill. I'm determined to use the opportunity to start some new habits instead of always being a car commuter. That being said, I've hovered around a BMI of 28-ish for a long time now. To reach a "normal" BMI (25 or under) would require me to lose almost another 20 lbs., which at this point seems rather herculean. I can't imagine myself at 190 lbs.! I also want to make sure that I stay lean and fit and muscular, and don't start losing muscle mass. So -- how many people (especially guys, especially guys in my age range -- 40's -- who started around my BMI -- mid 40's) have been able to reach and maintain a BMI of 25 or less? Even more interesting to me than BMI (because BMI is a sort of primitive measurement, given how different our bodies are!), how many people have been able to get to and maintain a body fat percentage of 20% or less? I'm just trying to figure out how realistic my goals are. I suspect that with my present food/activity level, I'll eventually plateau around 210, which would put my BMI in the high 26 area, and would definitely still be a huge improvement over my original 340 lbs./44 BMI! But I'd really like a shot at getting really trim and muscular at least ONCE before I'm a senior citizen, and I'm trying to figure out if that's in the cards, or if I'm just too old/started too fat for that!

Yeah... the science is becoming pretty conclusive. I think the reason that I (personally) keep harping on it is that I've been bodybuilding for a long time, and I'm continually amazed how resistant bodybuilders are to actually listening to science and research. Every year, at least one of my bodybuilding friends and colleagues injures themselves (sometimes quite seriously) trying to lift a huge stack of weights (often, as you intimate, with improper form). It's ironic and frustrating that they could be getting just as effective of a workout using a light stack, proper form, and more reps. But I guess that (especially for the guys) a little weight doesn't look as impressive. That's one reason that I work out at home now -- nobody to impress except myself

Thanks for the encouragement. I'm signed up for an "absolute beginner's" class for a few weeks. I wish I could find individual instruction, at least until I start making progress!

So, I REALLY want to stick with yoga, despite my struggles with it. Now that I've read numerous studies confirming that you don't have to lift heavy to get strong and toned (and even bulk up -- see my other post this morning), I'm more convinced than ever that the kind of core strengthening and balance work in yoga could be really good for me, especially as I get older. But, I get really frustrated with it! The two things that I notice are that my lower body and core seem to be really (relatively) weak. I'm all upper body/chest/arm strength, and very little in my midsection/legs/core/stabilizers. I've also noticed that I have real problems with balance... when I'm supposed to be perched in some pose on one arm and one leg, I really wobble and tend to fall over. I get frustrated and self-conscious about it! I wonder if the two issues are related; is it possible that my balance issues are due to weak core/lower body/stabilizer muscles? Also, I wonder -- hope -- that these things will improve over time; any yogis care to comment -- did anyone out there graduate from klutz to graceful with enough yoga practice? I just want to know that there's some light at the end of the tunnel -- if I stick with it, I *will* see improvement... right? Or am I just doomed to be wobbling and falling over forever?

I've been saying this for a while: low weight/high reps is the smarter choice for building strength and toning/bulk. It's far, far safer -- not only are you at less risk of catastrophic injury, you're at less risk of the kind of ongoing, degenerative injury that eventually sidelines all champion bodybuilders. The idea that muscles somehow "know the difference" between being worked to exhaustion via low weights and lots of reps or high weights and a few reps is ludicrous... and the research is confirming that: Protein. So they took a group of 21-year-old men who were weight lifting novices. Three times a week, they had them do knee extensions on a weight machine. That isolates and strengthens the quadriceps muscles on the front of the thigh. "Those are the most important muscles for standing up and getting out of a chair," Phillips points out. With one leg the study volunteers did the conventional 80-percent-of-maximum lifts until they reached fatigue, at 8 to 10 reps. The other leg lifted 30 percent of maximum until fatigue set in, around 25 reps. At the start of the study and 10 weeks later, the researchers put all the volunteers into MRI scanners to measure their quadriceps. There was essentially no difference between the heavy and light lifters. The results appear in the Journal of Applied Physiology. ... But the findings are controversial in some quarters. As word has begun to get out, Phillips says he's "been deluged with emails from trainers" who challenge the results. "They're very resistant to these types of findings. It challenges dogma." [emphasis added] Of course, you DO need to use enough weight and reps to work out to exhaustion; if you're not using enough weight and reps to actually get to failure (the point where you literally cannot lift the weight again), you're not really pushing yourself hard enough. The only thing this study confirms is that you don't need to use HEAVY weights to achieve the same results, as long as you work till failure (and trust me, you power lifters, even a 15 or 20 lb. dumbbell will eventually turn your biceps into useless rubber if you do enough curls with it... I promise you.)

Thanks! Maybe I need a cosmetic/plastic surgery buddy just like some people have sleeve buddies! Oh, and I peeked at your photos -- you already look great, so... you're gonna look great in that bathing suit

My ASS we get better looking with age! All I see is how my face is getting all sideshow mirror and collapsing in on itself! It is true that women are much kinder to a "middle aged" man than men are to a "middle aged" woman, however!

Thanks again!

Thanks for the replies. I'm not sure I'm really ready to get a shot of poison into my forehead every 90 days just to look a teensy bit younger. Maybe I'll just try to keep my skin tone up and stay healthy and frown less/smile more! As an aside, anybody know who I'd go to see to get a, uh, "male makeover?" Like maybe see about dermabrasion or whatever to improve the quality of the skin on my face, and/or grooming my crazy eyebrows, and so on? I really don't even know what sort of terminology to use a straight male (I'm sure if I were female, or gay, I'd know exactly what to do and who to see) -- I just want to "take care of myself" in appearance as well as weight/body composition, ya know? Too bad I'm not in my 20's still, when beauty apparently just comes effortlessly!

So, I think that in most respects, I'm aging pretty gracefully. I'd like to think that despite being 41 (going on 42), I could pass for a man in my mid-to-early 30's except for ONE thing: the stupid crease between my brows. I'll attach a picture so you can see, but I'm curious if people know of anything that can be done about that. Botox? Makeup? I'm only... sort of kidding. I know that getting older happens, and you can only hold it off for so long. But now that my body is FINALLY starting to look GOOD, I'd like to keep my face looking good for a few more years, at least, so that I can enjoy it!

Serious complications are extremely rare. If you have a competent care team and follow their instructions to the letter, the odds of anything going wrong are very slim. I know it's easy to be nervous about the unknown, but for those of us who've "been there, done that," we can definitely say that the first couple of weeks to a month are the hardest. After that, you just need to learn how to eat to please your new, smaller stomach, and enjoy all the "free" weight loss!

The 12-step folks have a saying: "compare and despair." While I don't hold with all of their sayings, I think this one is a good one. Holding ourselves up to any yardstick except our own goals is a game that you are pretty much guaranteed to lose. And it will make you crazy. Please understand that losing nearly 40 lbs. in ten weeks is incredibly good progress. That would be 4 lbs. per week; they say that for "regular" people losing weight, the most you should ever expect to lose, even if you are dieting like a monk and exercising until you puke every day, is 3.5 lbs. per week (not counting Water weight here). You've beat that by 14%, and you're not done yet! Cut yourself some slack, give yourself some credit, and quit comparing yourself to anyone else. I'm sure that advice isn't exactly rocket science, but sometimes I think we all just need to be reminded of "common sense."

The point about obesity-related comorbidities is very good! Very fat people tend to be very sick -- fat-acceptance aside, obesity is really a disease state, on so many levels. That being said, here are the biggest "real" risks of the sleeve: Patient non-compliance. The doctor said only slushy food until 3 weeks out, but you knew that didn't matter; your cousin had the sleeve and she was eating a whole pizza at 3 weeks, so you know better than your stuffy old doctor. Next stop: the emergency room! Facilities! I hate to say it, but you are at more risk from the cleaning staff than the surgical staff; if you get a hospital-acquired infection, you're in trouble. And even if there ARE complications during surgery, it's more likely to be anesthesia-related than surgery-related. Plain old bad luck: you're one of those higher risk patients, or you just have a common anatomic abnormality. It's a roll of the dice -- sure, a doctor with more sleeves performed will see more of the common abnormalities, but nobody's seen and dealt with them all. You just can't protect against those three, and they are by far the greatest risks to you during and immediately following your sleeve surgery.

GasX helps a lot, but it DOES go away after time. Or at least, it gets easier. Also hot foods really helped me a lot after the surgery. It does something with relaxing your stomach muscles, I guess... but it helps!

I've had an odd, similar reaction. The last few times I went down to visit my family (my father has been very ill, and sadly just passed away), my mom and dad were just blown away at how skinny and "buff" (Dad's words) I was. I felt embarrassed, but proud -- I've worked very hard to lose weight and go to the gym, so it's nice to have some praise! My sister chimed in, but not much. And then, as I was sitting at the family computer trying to fix it (amazing how Mom and Dad can wreck it every single time!) she's behind me and says "oh my god, you're going bald, little brother!" Now... I'm not going bald; I have a thinning spot at the crown of my head, like just about every other guy my age (and besides, I shave my head, so who cares). It doesn't bother me that much, since I know about it and am honest, but my first reaction was -- what an odd, cruel thing to say! My sister is probably in excess of 300 lbs at this point, and since she's a heavy smoker she's just not... looking good. In fact her skin is horrible because (I suspect) she's in early stage diabetes. I've offered to help her get the sleeve surgery, if she wants, I've been a great evangelist for it -- making it clear that it's a great tool for losing weight. But I DON'T preach about weight loss, and I have NEVER criticized her appearance. So this -- and other, similar -- jibes about my appearance were really weird and off-putting, until I realized something: She's jealous! It finally clicked a few days ago (I was telling my mom about the house I just bought, and my sister's comment? Not "congratulations" or "way to go!" but "It's kinda OLD..." I mean WTF?) that she's just jealous of me and all the attention I've been getting lately. So all of a sudden all those little mean comments start to make sense; they're still mean and hurtful, but now I can think "ah, that's just her issues popping up, ignore it." It sucks when friends and family and loved ones are cruel to you, but the older I get, the more I feel that when it happens, I have to realize that that's the monkey on THEIR back. Their insults and mean comments aren't about ME, they're about THEM; when someone says something cruel to you, be nice to them -- it means that THEY are having a hard time with YOUR success, and are taking it out on you. That's the way I TRY to be, anyway. I don't always succeed... the last few times when my sister was insulting to me, I really had to bite my tongue to avoid saying something incredibly hurtful back at her.

So -- you've lost 53 pounds in 3 months. That's just over 4 pounds a week, which is an admirable weight loss rate for someone with your starting BMI (I was in the same area) for the first few months. It's quite common to see this in the first 1-4 months, after which it usually slows down to about 1-2 pounds a week for maybe 4-6 months, and then 1-2 pounds a *month* after that for a LONG time, eventually see-sawing to a steady state. Losing 4 pounds a week implies that you run a caloric deficit of about 4 lbs * 3500 cals/lb / 7 days or 2000 calories per day. This is possible because in the first few weeks after surgery you're typically on a very restrictive diet which significantly limits the calories you can consume (plus, most of us are riding a bit of loss from the pre-op diet, and usually we're still being very mindful of carbs, which tend to be among the most calorie-dense foods). Sadly, after the first couple of months, this rate of 4 or even 5 pounds of fat lost per week slows down dramatically. Even so, you were talking about losing 3 pounds in a weekend, which is just not possible if it's fat we're talking about. Losing 3 pounds of fat would require you to run a deficit of about 5200 calories per day. Your resting metabolism is no more than 1700-1900 calories per day if you're very physically active. You'd have to burn another 4000 calories every day to sustain a 3 pounds in 2 days fat loss. That's simply impossible; you'd have to do about 10 hours or more of intense cardio every day -- we're talking about 80-90% max heart rate -- to burn 4000 calories, and I'd guess that you would die long before you burned the calories. No, whether you believe me or not, if you lose 3 pounds in 2 days, the bulk of that is Water lost. You are right, everyone's body is slightly different, but what you're talking about is not a minor difference between body types. It would be a miracle of modern science. I'd guess that most of your 52 lbs lost IS fat, because it's reasonable to lose 52 lbs in 3 months. Breaking the habit of looking at the scale every day is part of how we can train people to have realistic, healthy expectations of weight loss. Daily weigh-ins are not useful for weight loss, and they are actively harmful to some people who obsess over single-pound fluctuations that are utterly out of their control.

IANAD (I am not a doctor), but... this sounds like possible anemia to me. Have you had your blood Iron levels checked recently? Anemia is a serious concern -- but correctable. It's definitely important to stay on top of it.

With respect, you cannot lose 3 lbs of fat over a weekend. It's simply not physiologically possible. I'm not saying you don't see the scale move by that much, and I'm not saying you don't lose SOME weight. But I will flat-out guarantee you that it is not 3 lbs of fat. You would need to run a calorie deficit in excess of 10,000 calories (cf: http://www.caloriesperhour.com/tutorial_pound.php) to lose 3 lbs of fat, which is simply not possible in a weekend. You would have to eat NOTHING, and be basically doing flat-out cardiovascular exercise at your max heart rate to run this much of a deficit, and you would collapse and likely die if you even tried. This is why I don't recommend paying too close attention to the numbers on the scale. Almost ALL of the short term (less than one week) fluctuations are Water weight.

I'm sorry, I didn't mean to offend. You didn't say that you considered yourself overweight; I just assumed it when you said that you weren't in "maintenance" yet -- my assumption was most people who aren't in "maintenance" think they're overweight (why would anyone want to lose weight if they don't at least think they're overweight?). Obviously I was mistaken! Again, sorry for any offense, it's none of my business.