ouroborous

So, I've really been trying to work on strengthening and defining my legs, without too much success. My upper body has gained a LOT of muscle and definition, and, I dare say, I'm getting pretty "buff." Even my abs, under the last little layer of fat (and, sadly, loose skin) are getting pretty darned muscular and solid. But I just cannot for the life of me seem to gain the same definition and bulk in my lower body. I've been trying to go back to basics with my lifting (squats on the smith machine instead of the press machine/extensions machine, etc.) with the thought being that involving my stabilizer muscles might help me focus on the legs more. However, now I'm at a place where I'm stuck -- I'm at just over 200 lbs on the bar when I'm doing squats; that's as much as I currently feel safe doing without a spotter. I don't want to wreck my back or my knees. And it's close to my current limit. But I don't feel like I'm really GAINING that much doing that weight; yes, the reps are hard and I'm huffing and puffing once I do 3 sets of 8 squats w/200, but I don't feel that wobbly legged "burn" that I can get in my other muscle groups. For instance, tonight I also did military presses and rear delt flies, and I can STILL feel it in my deltoids, but my legs aren't even sore! One more thing to throw into the mix; I've been starting some beginning yoga classes to try to improve my flexibility and balance (and tone my stabilizer muscles and core even more) and I've noticed that when I'm holding a leg-centric pose (say, warrior pose) for a long time, my legs get really wobbly and tired. I'm not sure what this means; maybe I'm lifting wrong, and my legs are still pretty weak? Any advice would be appreciated. My legs are pretty muscular, it's just that compared to the rest of my body they're not in balance, and since I've lost so much fat I'm hoping to beef up my quads and butt to fill out some loose skin!

I'm two years out, lost almost 130 lbs. Definitely considering the tummy tuck; I don't NEED it, but when you've lost this much weight and feel as generally good about yourself as I do lately, it sucks to have that one last area that you're embarrassed for other people to see. All the other "problem areas" of my anatomy can be corrected with just exercise and hard work, but the tummy isn't going away without a visit to the good doctor.

To switch off my "wannabe doctor" mode for a moment and put on my "regular human being" mode -- I felt a LOT of the exact same emotions as you, leading up to the surgery. In fact, even AFTER the surgery for about a month, I had lots of "oh my god, what have I done to myself!" moments. But that passed quickly and the weight just started falling off effortlessly. And this time, it's STAYED off. And if you had to ask me what my biggest regret about the sleeve is, I'm sure lots of people here would have the same answer: my biggest regret is that I didn't get this surgery a long time ago!

It's important to remember that every surgery carries risks, and this surgery is no exception. However, as far as I can tell, in the array of WLS available, sleeve is one of the safest. I know, that seems weird; they're cutting your stomach in half! But remember that scar tissue and a reduced stomach size is something your body can deal with; it's a "natural" result of -- say -- an injury. On the other hand, cutting off your digestive tract and rerouting it around your stomach (gastric bypass) or implanting an artificial item in your body (lap band) are NOT things that your body has natural healing mechanisms to deal with, and these two surgeries (which are, IIRC, the most popular alternatives to the sleeve) seem very likely to cause lifelong complications. With the sleeve, once you're past the first three months (to be conservative; for most, it's past the first month) you're pretty much out of the woods. There are exceptions and horror stories, of course, but again -- those exist with EVERY surgery. If you have a good, competent doctor and supporting team (how many people know that one of the most important members of your surgical team is your anesthesiologist? And yet, nobody ever thinks to check up on THEM...), and if you follow the doctor's pre- and post-op advice to the letter, your chances of successful recovery (IE, no complications) are in the 95%+ range. And your chances of losing a TON of weight and keeping it off are extremely high (I don't remember; it's something like 75% or more... probably higher but those statistics are always conservative). When you compare those (very good) numbers against the (very bad) numbers for weight loss "the old fashioned way" (diet and exercise), and when you remember that unlike the surgery, obesity will almost certainly kill you (not to mention making your quality of life horrible in the meantime), well... you have to make up your own mind, but when I did the math, it was far more dangerous NOT to get the surgery. It's still a scary prospect -- any major surgery is. But you have to be realistic about the outcomes, and the realistic outcome from sleeve surgery is, frankly, very, very positive.

It's not the losing that's hard. It's the keeping it off. Studies show that, without surgical intervention (ie, the sleeve), only about 5% of people who lose weight through dieting and exercising alone are able to keep it off for more than a year. So, if you're confident that you'll be one of the 1 in 20 who manages to switch to a lifetime of dedication* to diet and exercise, good for you -- you should skip the sleeve! But if you're like the remaining 95% of us, who would have struggled and yo-yo'ed with weight, shaming ourselves and harming our bodies until we likely died early of an obesity-related condition, I suggest you reconsider. The sleeve is not trivial, but it's still a very, very good weight loss surgery. *Because it DOES take a lifetime. You can't just do it until you lose the weight, and then stop. You can't ever take your foot off the accelerator. Every single moment of every single day, for the rest of your life, you will have to focus on diet and exercise. And let's be honest, if you're in a situation where you're heavy enough to consider WLS, you haven't had much success with that in the past. That's not intended to be an insult -- I was in exactly the same boat, as were almost all of the people here. It's just basic facts; if you really, truly, honestly believe that you'll win the lottery, and magically change your entire personality and eating habits and keep the changes for the rest of your life, then you should absolutely skip the surgery. But as someone in the community you asked for advice, I have to tell you the same thing I tell everyone; while it's fun to fantasize about what would you do if you won the weight loss lottery, I wouldn't cash in your 401k (so to speak) just yet.

You won't go bald. It'll grow back. There's really nothing you can do to stop it or slow it down, aside from taking care of your overall health. That's about all you can say... Of course, you COULD take a page from my book and shave your head. I didn't notice any loss at all

The energy gain was startling for me, too. I've been a lifelong obese/sedentary person, and within days after the surgery I felt like someone had hooked an IV drip full of caffeine into my veins. I HAD to keep walking (around the living room, around the block, around the neighborhood) just to burn off some of that extra energy! Now, at 2 years out (almost) it's become the new normal, but I remember how amazingly full of energy I felt at first! Congratulations on your first month out from surgery!

The first month is the hardest, and buyer's remorse during this time period is very, very common. You just have to keep reminding yourself that the goal is very much worth it, and keep doing the things that you know are right -- eat healthy foods that the doctor recommends, sip, sip sip water as much as you can, and walk as much as you can -- and keep your eyes on the prize. It will get better... much, much, much better... even better than before the surgery. Trust us on that

The statistics still show 60-70% EWL as the median. I wouldn't focus on pounds lost or pounds in the first month or whatever, since that varies wildly from person to person (a person with more to lose will lose more, at first, plus Water weight loss and gain can COMPLETELY muck up the weight loss curve). Focus on overall health and well-being. EWL means "excess weight loss" -- weight above a "normal" BMI. The implication of this is that most obese people who get the sleeve do not ever reach a technically "normal" BMI. That being said, "slightly overweight" (again, technically, according to the BMI charts) is vastly, vastly better (in both medical and psychological terms) than "grossly obese," the so-called "average American" is trending past "overweight" and into the "obese" or "morbidly obese" category (meaning: you'll likely be thinner than most of your peers), and it IS possible to get to a normal BMI post-sleeve, it's just that unlike the first part of the weight loss -- which seems effortless and almost "cheating" -- getting rid of that last 20 pounds (or whatever it is for you that takes you into the "normal" weight range) is a lot of work and requires dedication. Long answer to a short question, but I think it's good to have realistic expectations.

As long as what you're choking on/throwing up doesn't look like blood (red or brown and tarry) or pure bile (bright yellow), I wouldn't call 911 just yet. Of course, as always, talk to your doctor. Note that significant nighttime reflux is also a symptom of sleep apnea, which is something that heavier people tend to also have problems with. sleeping elevated can help with reflux, too -- put a few pillows under your back, sleep in an easy chair, or buy a bed wedge (or if you're rich, get a Kraftmatic adjustable bed!)

As someone who's been (in the past) a "boy toy" I would say that I resent this discussion but.... nah. I don't

Alcohol can irritate the sleeve scar and inhibit healing. Even long post-op, the alcohol can cause problems with the scar. It's best to keep it to a bare minimum. And yes, the metabolic differences of alcohol post-op are almost entirely due to a lower BMI (there are some concerns with increased pancreatic load during the active loss phase). I went from being able to have... too much alcohol without noticing it much, to being pretty much a lightweight. Since it's all just empty calories and is really bad for you, I don't see a great reason to drink (you can have just as much fun without it as with it, and if you don't make a big deal about it, nobody will even notice or care that you're drinking iced teas instead of Long Island iced teas). Obviously, to each their own, but PLEASE be aware of the "lightweight" effect; I've heard of sleevers getting DUI's or worse due to not realizing just how dramatically their tolerance had changed. All that being said: drinking alcohol at only six weeks out is very foolish; I'd wait at LEAST six months. Ultimately, however, it's your body and your risk to take.

Well it's hard to work up the desire to hit the gym when it doesn't feel like it makes any difference, ya know? It wasn't until I was 100 plus pounds down that I started really being able to see the difference and enjoy it; and that's when I started LIKING the gym. Well, maybe not liking the gym, but liking the results

Howdy, fellow rain city sleever! At least during the long, gray rainy winters up here, going to the gym gives us something to do when it's gloomy outside, right? And then during Seattle's epic "six weeks of summer" we get to go outside and show it off!

Thank you! I work out a lot (like, every day!) so I appreciate any positive feedback I can get!

Oh, and I should say (to whoever the "anonymous" reply is) -- thank you!

Definitely hard to know what the right thing to do is, since the surgery. I have to deal with what my body says I should do (and trust me folks, it's unmentionable in a PG forum like this!) versus "the right thing to do" which is often very different

Thanks for the replies I'm going to Hawaii in a few months, and I'm glad I don't have to feel TOO ashamed to go snorkeling without a shirt (aside from the pale Caucasian skin glare factor! I *do* live in Seattle, after all...)

I wasn't sure whether or not to post this as a success story, but here's a (cropped, bad) photo of me as of today. You can see that I'm definitely bulking up, but you can also see where I still have a LONG way to go fat-wise, and a lot of loose skin... Sorry for the bad image quality, but it's off the cuff, and I really didn't want to get into the horrorshow that is my tummy right now -- just a horrible mess of loose skin!

You're only done when you give up. I thought I was done at 250, then I switched it up and cut out the carbs. Then I thought I was done at 240, but I kicked up the exercise. Now, at 216, I know that I have a LONG way to go before I'm "done." It has much more to do with my head than with my body.

Yeah, about a year after my surgery, once my hormones started normalizing, I actually got *ahem* "morning wood" for the first time in just about EVER. I was like "now what the hell am I supposed to do with THIS?!" It's far less fun than it sounds. And yes, exercise helps! Except for all those gals at the gym... don't think about that, just do a few more reps... wow, she's got a really nice... NO, ONE MORE REP! ...and on it goes...

Trust me, it's worse for us guys. About six months after surgery, I started getting seriously horny for the first time in... ever, really... and it's just kept on from there. At 41 years old, it's slightly embarrassing, but at least I'm old enough to know how to handle it. Er, that sounded bad. You know what I mean... Bottom line, once your body starts working correctly -- once every heartbeat and breath isn't a struggle against fat that's trying to kill you -- it starts saying "oh, sex, right... yeah... I LIKE sex!" It can be... unnerving...

I had a friend with cholesterol levels in the >300 range, and she was trim and fit. In her case it was genetic; her liver simply produced too much of the stuff (we make our own, since we need SOME cholesterol to live). You should talk to your doc about genetic causes and see if there's some kind of treatment.

*laugh*