ouroborous

Yeah, I've learned (the hard way) to limit alcohol intake since the sleeve. Among other things, these days I'm a light weight -- literally!

Nope, just an interested layman I read science news every day (http://www.sciencedaily.com/news/) and have a subscription to Scientific American. How geeky is that??

So, looking at this diet, it seems very "paleo" -- if you're eating like this, you're eating: Very high Protein -- a good thing, especially for us sleevers. Not to the point of Atkins -- which is bad, and taking a good thing too far -- but maybe South Beach-y, which is a good, solid, sensible plan Very high complex carbohydrates -- another good thing. Most Americans do NOT get enough vegetables (and no, potatoes don't count!) Very high Water (more on this in a moment) Now, dramatic short term weight loss is only possible in two cases: Significant anorexia. "Anorexia" is actually a medical term, not a disease (technically, the disorder is "anorexia nervosa" -- or "mental" anorexia). Anorexia just means that you're eating too little, medically speaking. And it's not healthy! When you're anorexic, your body begins to do all sorts of things to conserve energy, including switching from burning fat stores to burning muscle stores. It will even begin to metabolize brain matter over time, if the anorexia is significant and prolonged enough. Medical anorexia is not a good thing. Fluid loss. Yup, good old "water weight." My guess is that if you lose more than a pound or two over five days (on this diet or on ANY diet), it is primarily water weight. Five days is simply not enough time for your body to become anorexic enough to have burned any significant amount of fat (especially the stubborn superficial fat that most of us are concerned with). With this diet, since you're eating almost no highly-processed food, you're eating very little salt (at least compared to "normal" Americans, who eat way, way, way too much salt). And as a result, your tonicity -- water/mineral -- balance will shift. In an attempt to maintain homeostasis (fancy medical speak for "keeping things in balance"), your body will dump water so that your salt concentration doesn't get too low. Drinking lots of water will flush out more minerals, but you have to be careful. Over the long term, I believe that drinking double the daily recommended water (64oz is recommended) coupled with this very low-sodium diet might be dangerous (I'd ask a doctor about it); it could introduce a hyponatremic state -- dangerously low sodium. This can kill you (google "hyponatremia" or "water intoxication" if you don't believe me that drinking too much water can kill you). Over the short term, what you'll do is DUMP water in order to maintain your salt tonicity, so if you drop a lot of weight in five days due to this diet, I'd suspect that it's almost entirely water weight. That being said, minus the excessive water intake -- my nut. was emphatic that over the long term I was to consume no more than 60 oz. per day -- I think that this would be a Very Healthy Diet. You'd have to introduce some fruit (a low level of fruit intake is important for maintaining levels of Vitamin C and some flavanoids), and you'd want to make sure that your Fiber intake balanced the protein intake for bowel health, but if you could stick with it, I think this diet would be a great way to keep steady healthy fat loss. Couple it with a good exercise program, and you'd be on track for a very healthy body.

Well, I'm going to Hawaii at the end of March, and I've been meaning to take some "after" pictures for a while, so maybe I'll take the fun in the sun as an opportunity to snap a couple. I have a "before" shot of me in boxers, and it's just... horrific. I'm hoping to get down to 215 by then... should be doable if I stick with the program!

Well, I've been frustrated with the fact that since the end of last summer I'd gained ten pounds. My weight at the end of the summer was 215, and by September it had shot up to as high as 225! What's worse is that this weight has been stubborn to lose again. After six months, I'm back down to 219, despite doing cardio every day, going to the gym five days a week for weights, and being mindful of my food. The frustrating thing is that I was at 219 on the same day in November, so I'm just treading water! But it turns out that that's not entirely the whole picture. I use the scale at the gym, which measures body fat and skeletal muscle percentage. It's pretty accurate, so I usually just pay attention to the weight numbers and ignore the BF% and so on. Yesterday I actually wrote down my body fat and muscle percentages, and compared them to November. When I looked at the numbers and did the math, things looked much better. My body fat percentage dropped from 24.2% in November to 22.7% yesterday. My skeletal muscle rose from 35.5% to 36.3% during the same time period. I did the math, and that means that since November 18, I've lost about 3 lbs of fat and gained about 2 lbs of muscle. So even though my WEIGHT didn't change, my body composition has changed significantly from fat to muscular. And the nice thing is that that change will synergize; more muscle will make it easier to burn more fat, etc. So, the moral of the story is, I guess, don't just look at the numbers on the scale (or your BMI, which is really just based upon your height and those same scale numbers). If you're not measuring body fat percentage with something like an electroresistive scale or (better) a dunk tank, you may actually be doing better than you think!

Yeah, this sort of stunned me, too; now I feel like men take me a lot more seriously. Dunno what that's all about, but it's not unwelcome, either. People really see you as a completely different person when you're in shape vs. obese. It shouldn't be that way; we should judge everyone by their merits (brains, humor, kindness, etc.) But the cold hard facts of the matter are: looks -- and weight is a huge part of "looks" -- really are important in this society. My feeling is that I can either rant and rave about how that shouldn't be the case -- and achieve nothing, and be miserable -- or I can just do what I can to look the best I can, and enjoy the rewards.

Thanks for all the kind replies, folks. I just felt like I needed to post a little positive thinking after realizing today that I don't stop to smell the roses often enough...

Ah, well, I guess that's the difference between men vs. women. Before I lost the weight, women would always be friendly, but never show any interest of their own. I would never get a woman "making the first move." Now it happens regularly. I don't want to act like I'm some kind of swingin' super stud -- I'm not; I'm still basically a shy, nerdy guy who's far happier with a book than at a sports bar. But just because I'm not "Austin Powers" doesn't mean I don't want a hint of "James Bond" in my life... On the other hand, men are socialized to be aggressive and make the first move, so I can see where going from zero to... full on over-the-top male attention might be... overwhelming. But hopefully you'll get used to it; do what I do, just smile, enjoy the attention, and move on. And, I guess, if they don't take no for an answer, tell them where they can shove it...

I would say that the hardest part of this entire journey is really getting used to the fact that I'm just not that guy anymore (ya know, that fat, depressed, invisible, un-sexy, out-of-breath, exhausted, sick guy; if you substitute "gal" in there, I bet it might hold true for some of you ladies, too!) That's what really amazes me most, and that's what I have to fight with, literally every day. I'm not that guy anymore, and I'm never going to be him again.

How bizarre. In 18 months, I've gone from an XXL (bordering on XXXL) everywhere with a 46 (going on 48) inch jeans waistline, to XL in the shoulders, L bordering on M in the waist, and M for undershorts. And my jeans are 36 inch waist, and that's getting a little baggy; I can now fit into 34's without too much work, and I expect to be comfortably wearing 34's by the summer (doubt I'll get much smaller than that, since that's basically my hip bones!) I've basically gone from being shaped like a giant jiggling amorphous blob to having the classic male "inverted wedge" shape with a tiny little stubborn tummy roll (I HATE you, jelly roll, I hate you! I do crunches and obliques EVERY SINGLE DAY and yet still you persist...). I seriously NEVER expected that I could look in the mirror and LIKE what I see. It just didn't occur to me. I find that my self-criticism is having a hard time lately; since it can't point at all my rolls and rolls of fat, it's having to do things like point out that I'm getting older (see! you have a sprinkling of silver at your temples! see! there's a faint visible line on your brow! old man!) and the last little bits of fat (see! there's a jelly roll at your tummy and especially on your flanks... FATTY!). In some ways that's sad that I talk like that to myself (but don't we all, secretly?) but in some ways it's kinda comical that this little sad cynical part of me is having a harder and harder time finding things to complain about! I've gone from being utterly invisible to the female gender; an "LJBF" (let's just be friends) kinda guy -- friendly, smart, nice, but sexy? no... To having the very cute 20-something barristas at the local coffee shop openly flirting with me (a 40-something guy!) whenever I go in. In fact, that's one change I have a hard time dealing with, since -- at the tender young age of 41 -- I have almost zero experience in dealing with women reacting to me physically -- you know, as a male -- as opposed to simply emotionally or mentally. The idea that some woman might think I'm physically "hot" -- well, that's a completely new experience to me. I'm not Brad Pitt, but you know... I'm not bad looking! That's an utterly novel feeling for me. But I like it, and better late than never! I went from being unable to walk more than a couple of blocks without being in excruciating pain from sore feet, sore knees, and chafing thighs... from being unable to stand up for any length of time because it made my lower back hurt... from being unable to run for more than a couple dozen feet without becoming EXTREMELY winded... to being a guy who hits the gym five days a week for weights. A guy who walks 2.5 miles every day without breaking more than a light sheen of sweat (and that's at about 4mph, up a rather steep hill half the way). A guy who runs -- RUNS! -- for five minutes to warm up for his workouts, and is seriously considering whether or not he could actually, you know, RUN for exercise in the mornings (when it's not so goddawful cold, anyway). I mean, who IS this guy? I've gone from a heart attack waiting to happen, high blood pressure on the border of needing medication, diabetes any day now, zero energy, zero libido, always sick to never sick, perfect blood pressure (104/68!), perfect blood sugar numbers, almost zero risk of heart attack, high energy with the libido of a teenager. All this is in the course of 18 short months. I haven't worn a 34 inch waist since elementary school. I haven't been a "normal" weight since, well, ever. It's easy to lose track of it since it's the new normal (oh and, hint to guys getting older: the gym is your FRIEND!) but when I look back on how much things have changed in less than two years, it's just... astounding. It's like I've lived my life as two different people -- and folks, that first guy sucked. I just had to share that because I know all too well just how easy it is to become so focused on the negatives (and let's face it, if you look hard enough, you'll ALWAYS be able to find something about your body that you don't like) and overlook the incredible, unbelievable, amazing positives.

Well, I live "here" (WA state) and I think we wasleevers have to stick together.

Thank you for the replies. My current weight this morning is 223. According to the BMI charts, "ideal weight" for a 6'1" man with a "large frame" tops out at 192 lbs (! this seems crazy-skinny for a large-built 6'1" man, but maybe having been at 335 skewed my perception!) According to some sources I've seen online, I should be at "ideal weight + 10%" before considering a TT, so this would be around 210 max. Unfortunately, 210 is the magical "goal" I've been shooting for for some time; I got close towards the end of summer at 213, but then "something happened" (I swear, i didn't face plant into cakes and ice cream, and I actually ramped UP the exercise!) and now I'm up 10 lbs. I've stopped the gain, but now my weight is plateaued again at the higher weight. So, long story short, getting to and maintaining 210 seems almost unattainable. It's not like the beginning after VSG where I could fart and lose 20 lbs! Mini-Me: I'd love to believe that it's all loose skin, but it's not pinchable, if you know what I mean -- when I pinch a fold of it, there isn't just loose skin between my fingers, there's actual fat that I can feel. Obviously nothing like before the VSG, but still fat. And on my "flanks" (now I know what to call that area; apparently it's a really common trouble spot for me... the back "love handle" area) is the worst, that's where I'd like to slim down the most right now (it's the main reason I still wear "baggy" shirts, to avoid that "muffin top" look!), but apparently that area is just amazingly resistant to diet and exercise; either I have to go to almost superhuman weight loss lengths, or I have to think about surgical reduction. I know, I know, talk to a doctor -- it's always good advice. But just like with the VSG itself, I know that any surgery is a big deal, and I want to get as much input and advice from others as possible before I commit my body and 5-10 grand more of my money to an elective surgery. I really want to feel like I "look good" -- my health is SO much better now (my doctor is just speechless with how good all my results were from my last physical!), but now I'd like to really get to the point where I feel good about my appearance, not where I'm still feeling like I have to "hide" part of my body, ya know? I mean, I'm going to the gym five days a week and lifting weights, it sucks that I feel like I have to wear baggy clothes that hide all that new muscle, just to cover the stupid little "spare tire" that's left! (NB: also going through my mind is that I am "only" 41, and the younger I am when doing this surgery, the better the results will be from the standpoint of recovery, risks, healing, and final outcome.)

This is near and dear to my heart, but I think I may be the only man on this board talking about plastic surgery (I'm not sure if that makes me vain, or just more honest than most men!) I agree that getting the WLS and then not fixing the loose skin is kinda silly, from a vanity point of view -- of course, the WLS alone is still a huge win from a health point of view. Most of the fat that I have left is in my "spare tire," and most of the skin around my midsection is loose. I'm lucky that I don't have loose skin in almost any other area -- chest, arms, legs. I've been fortunate in that, as a man, I can pump Iron at the gym until my arms and legs and chest are full of muscle, not fat and loose skin. However, with the tummy, the more you work out, the smaller it gets and the worse things might look! So, at almost two years out, I'm trying to figure out if I'm going to do it and more and more, when I'm going to do it. I want to get the loose skin removed, but I also want to get the remaining fat around my midsection removed. Any comments on that would be welcome; is that a liposuction? Does it add significantly to the cost/recovery time/risk? I only ask because that's really the last, most stubborn bit of fat for me; I can't seem to lose it! Up until now, my default answer has been to wait, put it off, because I always thought I could lose more, or that my skin would tighten up on its own. But I think I'm hitting reality now; there's only so much skin can tighten up, on its own, and the last ten or fifteen pounds of fat are the hardest, so waiting until I'm at "perfect" weight means I could be waiting nearly forever...

I do cardio and weights five days a week. Before the sleeve, I was lucky if it was five days a year. Honestly, I need to ramp up and do more/more intense cardio, to break the stall I'm currently in (I have another 20 pounds to lose, and it's stubborn!)

Oil can help to moisturize skin, and when skin is both loose and dry it gets the "crepe paper" consistency that we all hate. Moisturizers don't "fix" loose skin, but they can make it look less... well... gross. But yeah, now that I'm approaching two years out from my surgery, I'm coming to believe that surgery is the only option to remove significant amounts of loose skin. Small problem areas may fix themselves -- skin DOES resorb over time, to an extent dependent upon genetics and age -- and you can build muscle underneath some problem areas to give the skin something to reattach to. But for significant amounts of loose skin -- like most of us have/had around our belly -- surgery is pretty much the only realistic "fix."

PSSC was amazing. Their level of care and follow-up was phenomenal; I can't recommend them highly enough. As to hotels, I don't know (I live locally, so I didn't look -- I just came home after the surgery). I'd just check on Yelp or something, I'm sure that there's something!

Yeah, I'm sure that -- aside from the little snack sources (which, honestly, I'm not that bad about, certainly not any worse than I was during the summer, when I was LOSING weight like crazy) -- the only real difference here is the cardio exercise. It seems amazing that my little 45 minute walk every day at lunch time could make such a difference, but that's the only significant thing that's changed since summer. I've gained 12 pounds since the end of October. I'm going to try to reverse that before the end of spring. It's just very discouraging to go from being on track to hit 200 lbs, to having to fight like crazy to avoid hitting 230 again! Edit: I should mention, about snacks: I really don't eat Cookies or brownies or whatever. I have one little 50 calorie piece of candy from the reception candy dish every day, but only one. I suppose I could cut that out too, but it really seems like if the difference between my gaining weight and losing weight is one 50 calorie mini-size bar of dark chocolate, then I'm doomed, because you can get 50 calories by *sneezing*...

So, after the nice weather of summer, my weight loss -- which was on track to put me at or under 200 lbs (for the first time in memory!) completely stopped and in fact reversed. Now I'm at 225 (!) and fighting that old "there's nothing I can do about it" feeling. I have been able to attribute this to two factors. First, with the nice weather, I was walking about 2.5 miles every day. Now that it's perpetually dark and rainy/icy (here in Seattle), I'm getting VERY little cardio exercise at all. Second, my calorie intake has been creeping up. All kinds of little things -- from food intake here at home, to a regular Starbucks yogurt parfait, to cakes and candy ever present at work -- were tanking me. Of course I never really SPLURGED, but it was a little bit every day. So, I've pretty much cut out the extra calories -- I'm watching what I eat very, very carefully, and I'm now eating the same or less than I was during the summer. The exercise thing is harder; I still go to the gym most days of the week, but most of my time is spent weight lifting.. I'm wondering; should I ditch the weightlifting and spend that time doing boring time on the treadmill/bike? I don't want to lose my muscle tone, but I don't have 1.5 hours every day to spend at the gym, and it's kinda either/or... Any advice or words of encouragement would be welcome...

So, I'm sure that the ladies have this problem, but more so... So now that I've lost 120 lbs, I'm looking and feeling SO much better, but I have some... trouble spots. Loose skin. Unlike the ladies, I have the option of bulking up to give my skin new adhesion points; if I can bulk up enough, I may be able to avoid plastic surgery. So I have loose skin in three places. On my tummy. Fortunately, not much. Barely enough to pinch. I can live with this, and if not, I'll get plastics. On my inner thighs. THIS, I can fix, by bulking my legs up to tree-trunk levels. I'm working on this with heavy weight squats/leg presses/extensions/leg curls. It'll take time, but I'm confident that I can fill this skin back in with muscle. On my lower pecs; this is where the ladies would have saggy boobs. Fortunately I'm not quite to this level, but I have a tiny bit of pinchable loose skin there, and it makes me self-conscious. I know I can build up my pecs, but all my workouts seem to be bulking up the TOP of my pecs (a LOT), so that I have a huge chest "shelf" now but I still haven't got this lower pectoral region filled out. Any recommendations? Will decline presses work? On my back in the "spare tire" area. This isn't really loose skin, but it's one of the last areas that I'm carrying any real fat. I know you can't spot reduce, but anyone have any good obliques workouts so I can firm up the supporting muscles? I'd like to have nice lean flanks when I go to Hawaii this winter! Thanks in advance for any advice I should take some pics so it'll make more sense...

I make sure to eat some CARBS before workouts, and Protein after workouts. The reason is this: the carbs give you a quick burst of blood sugar to help you power through the workout. If your goal is to lose fat/burn calories, this might be counter productive since you might consume more than you burn. But if you're trying to build muscle, you need the blood sugar to have the stamina to make it through the workout. Since I've been focusing on eating about 100-150 calories of mostly carbs (good carbs, like fruit or something) before I hit the gym, I've noticed that I have MUCH more energy for my workouts, and they're MUCH more intense. Simply put, I don't "poop out" halfway through my sets. AFTER the workouts, I make sure to pack on the protein. The reason for this is that studies have shown that 15-30 minutes after an intense anaerobic workout is the prime time when your body needs protein to aid in the muscle reconstructing and building phase. I don't know for sure that this is helping (unlike the carbs), but the science says it should help, and I'm a big believer in science YMMV. If you're only interested in burning calories, a pure protein snack before the workout might be a better choice -- tends to be lower calories, slower blood sugar release, and will still give you SOME "fuel" for the workout. But the odds are that with the sleeve, the difference between a pure protein snack and a "good" carb snack -- around 50-75 calories difference, I'd wager -- is trivial compared to the overall caloric restriction of the sleeve. And for me, at least, the extra energy during the workout is MORE than worth it. Instead of the workouts just WRECKING me and running out of steam halfway through, now I can power through them. I'm still tired when I leave the gym, sure, but I get a good solid workout without running out of steam, and I think that my progress has really accelerated as a result of focusing on my workout-related nutrition.

Oh, and another fun tidbit: my body fat was 24.8%. While this is still way too high (I'm shooting for the 15% "athletic" category) it is finally considered "normal" BF for men. I'm NORMAL! I'm not morbidly obese, not obese, not even overweight. NORMAL! (EDIT: I know that a BMI of 28.3 is still considered overweight -- 25 is the cutoff to "normal"... but given my build -- extremely broad and dense -- it's unlikely that I'll ever get much below 25, if I can even GET to 25... I'm more concerned about body fat than BMI, since it's a much more accurate measurement of fitness.) I need to shut up now... but... YAY.

Well, according to the body composition scale at the gym, today I weighed in at 214.8 lbs, making another straight week of around 2lbs lost. Amazing to be doing that at 17 months post-op, but who's complaining? Also, since 215 was my goal (adjusted downward from 225 originally), GOAAAL! Well, except that I've now adjusted it down AGAIN to 200. And in addition to losing 2 lbs in the past week, according to the body composition numbers, in the past month (ish, since 8/26) I've lost 2% body fat (4.4 lbs) and GAINED ~2% muscle (around 4 lbs). That's just amazing; my fitness guru at the gym was astounded, he said he's NEVER seen a guy in his 40's (ok, early 40's, but still) gain muscle and lose fat so fast. It's a VERY GOOD DAY.

Jeez, you guys are dedicated. All I do is weightlifting on M-W-F. But my routine is completely different; e.g. Friday is my "power" day when I put on huge stacks of weights, Monday is my "toning" day when I do different exercises, less weight, and more reps, and Wednesday is my "day of forgotten muscles" where I hit all the neglected little muscles like the calves, hip adductors/abductors, deltoids, traps, and so on. So I keep it varied and that keeps it from being boring. My current challenge is going beyond my own mental limits; I often don't HAVE to stop when I WANT to stop. I'm trying to learn how to keep pushing until I literally can't do another rep. Until I reach that point, I'm not "done" even if my wimpy mind SAYS I'm done! I must be doing something right since I've packed on 5 lbs of muscle (while losing 5 lbs of fat) according to the body comp. monitor machine at my gym!

I'm sorry your friend has had troubles with her WLS, but you don't know that carbonated beverages caused it. The fact that she had a GBP or a DS raises some red flags; the lap band and gastric bypass are very different, mechanically, from the sleeve. With the first two WLS'es, the tissue pouch that remains IS very stretchy and could conceivably be stretched out over time. With the sleeve, what's left of your stomach is the tough, muscular upper portion. The stretchy fundus (bottom) is removed entirely. What remains can be stretched, but only primarily by solid foods; ie habitually overeating can do it, but drinking some diet coke is very unlikely to. So I'll stick by my original assertion: there's basically zero chance that carbonation, on its own, is going to measurably stretch out a lap sleeve after it's fully healed with all the scar tissue. That's what my surgeon told me. That being said, you should ask your doctor, and make up your own mind. I avoid carbonated beverages because of the acidity, so it's not like I have some vested interest in promoting them

It's important to remember this, repeat after me: spot reduction is a myth! That means, you can't reduce fat in just one area by working out. Fat loss is a systemic, metabolic process -- you either lose it all over, at the rate your body "decides" on, or you don't. That being said, I highly recommend resistance training to firm up your "trouble" areas. As you lose the fat, you'll start to see the areas where you're weak. Do some weightlifting! Even women can benefit from weightlifting -- don't worry that you'll bulk up, without the testosterone, that's just not going to happen. And muscles help women get that classic "cello" shape, especially if you are flat-butted or flat-chested. Building the pectoral shelf, for instance, will lift your boobs and make them perkier. Building your hamstrings and gluteal muscles will give you a nice round butt. Building your hip abductors (or is it adductors? I can never get the two straight...) will help you get curvier hips. And of course ab work will help your stomach look flatter. Latissimus dorsi work -- your back -- will help you avoid "back flab" and will also perk up your boobs and help with that "cello shape." I am a HUGE fan of weight training, and firmly believe that EVERYONE should incorporate some resistance training into their regular regimen. You don't have to be a gym rat to get in some serious workouts; buy a few weights, buy a cheap home gym machine. Heck, do calisthenics -- crunches, squats, pullups, pushups... none of these take a single piece of equipment (well, except pullups).