BetsyB

He's a bariatric surgeon. What he does best is bariatric surgery. This is one thing for which I'd smile and nod, and do the EXACT OPPOSITE of what he recommends. Haven't you spent enough of your life in a disordered relationship with food?

If your Protein intake is adequate, I think you have less cause for concern regarding exercise and losing lean muscle tissue. That's why I'd want a Protein shake that had LOTS more protein bang for the buck! Your body will burn stored fat for energy if its protein needs are met. I really like Inspire Protein drinks from Bariatric Eating. They are low carb, and have ~30 grams of protein per serving. But there are lots of higher-protein alternatives to what your doctor is recommending. (And I agree: if they're offering them in the pharmacy as a convenience, but you're encouraged to shop around, it's probably not a situation in which the doctor is looking to make a buck; OTOH, it may be one that indicates that--while he's brilliant at surgery, he's not a good dietitian :cursing:)

My doctor said something similar, but then qualified it by saying that "most likely" isn't destiny--that people who are committed to following through can achieve greater losses. Most of his patients seem to lose far more than average with the band; there are many, many who've lost 100% of their excess weight. While the doctor'd be happy if I hit that 50-60%, in terms of health gains, I know I will not. I do have an adult frame of reference, having been normal-weight for many years, and know where I'm most comfortable--and that is on the low end of the weight range for my height. I will not be satisfied with mediocre results after surgery--I didn't have surgery to remain in the overweight (or even obese) category! But that's just me--I have orthopedic issues that just feel better when my weight is really down. At 5'5.5", I'd aim for WAY below the doctor's 60% level---your progress to date has been astounding, your rate of loss is great, and I think that attaining a lower, healthier weight is achievable. Your body will guide you--there will come a time when your weight loss tapers off. If you like where you are at that point, you can work on maintenance. If not, you can re-tool your eating a bit, bump up your exercise, and work the band for a while longer, until you reach that point. There's no rule saying you can't stay at a certain weight for a while, stabilize, and then decide, "Hey, you know what? I think I'll go ahead and try to get another 10-15-20 pounds off," either---so no decision you make is written in stone.

She's disappointed, and the news is fresh to her. I know you say you'd be right there for her, but that might not be as true as you'd love to think. It's a BIG blow to her---and just as you wish for her to be there for you, you need to remember to be empathetic to her. You haven't LOST this friend--she is having difficulty with your upcoming surgery. Be a good friend and allow her her grief. That is "being right there for her." With her, focus on other things. You would not expect someone who'd just lost her partner to revel in conversations about love and marriage, would you? Or someone who'd just lost a baby to submerge herself in your baby shower? It's kind of the same thing. She's grieving. And good friendship does NOT require her to submerge herself in something that causes her additional pain.

This is off-putting to me. You can get good-quality Protein shakes in myriad places; I am always put off when a doctor suggests purchasing on-site. Then, the motivation is not health (as is indicated by the lower protein content), but profit. If my liver were appropriate in size, I would not do an optional liquid diet at all. You've lost a substantial amount already---your loss does not require jump-starting, IMO. ETA: My surgeon recommends the 2-shake, 1 protein/veg meal a day for 2 weeks prior to surgery; that was livable and sensible--and I was happy to comply. But an optional, possible months-long (what doctor doesn't know how far out he's booked? It sounded almost like he was coercing you...) liquid diet? I would have walked out the door. Losing weight IS the aim of the whole thing---but it doesn't all need to be accomplished preoperatively!

Bandtastic recently sent samples to my surgeon's office, and his staff gave it RAVE reviews. You can order frozen meals from them online

I think I'd be very careful about adopting a chew-and-spit habit; it's is a feature of a form of bulimia, and heading down that path might not be an approach you want to take. It might be a better idea, in the future, to find a good alternative---and actually eat a bit. (I admit: I'm having a hard time imagining "discreetly" spitting a cup and a half of food into a napkin at a party!) I totally understand the craving for pizza; I'm so glad that a local pizzeria makes a crustless pizza--it's a lifesaver. The "crust" is a thin layer of very lean sausage, and the nutritional info on it is surprisingly good.

It's really common, post-op--particularly if you're on Clear liquids. Part of it is a response to the trauma of the surgery, but it's also a basic liquid in/liquid out sort of thing. I had diarrhea until I started solid food. I was told to expect this--it was included in the preop educational materials. It's generally not a cause for concern--and if your surgeon isn't worried, I'd try not to worry, too. I know it's uncomfortable, though---so since your doctor has okayed it, trying to slow it down isn't a bad idea. Better still is using skin barriers (ointments, etc.) to protect the tender, sore skin that can develop. That was what was most bothersome to me.

If you're uncomfortable telling them, don't. I understand your concern that no one will know "if something happens" to you. You can take care of that with a medic-alert bracelet (laurenshope.com has very pretty ones; if you wear the tag part on the inside of your wrist, no one who's not specifically looking will know it's a medic-alert, but first responders WILL). You've been cruising along, doing really well, without them knowing. Nothing catastrophic has occurred due to their being in the dark. I think it's probably safe to assume that this pattern will continue--that things will STILL be okay if you don't tell them.

You've moved from a no-residue diet to one that lingers in your gut--which in and of itself can account for a bit of extra weight. In addition, you've upped exercise. While it's too soon to be seeing muscle gain, it's very likely that your muscles are holding onto some Fluid. This happens when the muscles cells do not get enough oxygen from the air you breathe. In order to stay well-oxygenated, they revert to lactic acid fermentation--a process that produces oxygen and the metabolic by-product, lactic acid. When the lactic acid level in your muscle cells increases, the body strives to maintain homeostasis by equalizing this concentration differential. Fluid moves into the cells---causing them to swell. The body is usually very efficient when it comes to flushing out this fluid, but temporary weight gain can be expected, post-workout. Keep doing what you're doing---and don't be scared to eat. The weight IS going to come off. In fact, you're losing fat now. It's just that the number on the scale doesn't tell the whole story

That's a GREAT way to start the week! And it's just going to keep going down, down, down.

I think that, by tweaking the way you eat, you can achieve your goals, though 50 pounds by July is a pretty lofty goal. My doctor recommends a low-carb, high-Protein regimen until at least 75% of excess weight is lost. It involves focusing on lean Proteins and non-starchy veggies, with fruits and legumes in moderation. After 75% of excess weight is lost, whole grains are also introduced, in moderation. Is there a way to limit the amount you eat in restaurants? If so, that will help you a lot. If not, spend some time researching the nutritional information of the foods at the places where you eat. Even if you're eating the way I've described, it's not too hard to find something that works --- at almost every restaurant. It's even easier if you know, ahead of time, what you're going to order. (It's easier to resist temptation if you don't even open the menu.) When you can, eat at home or pack a meal you've prepared. You'll find you come to prefer this--good-quality food is more satisfying, and you'll feel SO much better when nourishing your body well. Have you seen your doctor recently? Don't let what you perceive to be a small loss deter you from checking in regularly to ensure that you have appropriate restriction.

Elfie, I'm not the least bit offended by your post; I don't agree with it, and stated why--for ME--it doesn't hold Water. I'm glad you can do it without exercise. I can't. I'm okay with that--I like exercising. You're okay with your approach; all's good. But I don't think it's splitting hairs to point out that exercise doesn't HAVE to mean lacing up shoes and heading to a gym. I would define your activities (gardening, etc) as exercising. Saying that you are losing without exercise, then, is inaccurate; going a step further to say that exercise isn't necessary for loss is not fully responsible in that light. You're losing--AND you're exercising. I realize that not everyone CAN exercise. (I actually have physical issues that have required HUGE modification in what I do, so I truly, truly understand this.) I also realize we all have different definitions of exercise. The main thing I wanted to share is that, once upon a time, I was as convinced as you are that exercise was not a huge part of the equation. And that, as I've gotten older, and my body has changed, that has changed. While I once could lose without exercise, I now cannot. Body composition changes---i.e., weight loss combined with lean tissue loss due to inactivity--crashed my metabolism. This is something I'd like to see others avoid, because it's caused me such trouble. Jachut really summarized the benefits of exercise well. I can't begin to tell you how much better I feel ---and how much better I lose--when exercising. But YMMV--and that's fine. Everyone is different.

AWESOME! Great job!

I voted for telling family, friends, and coworkers---but with a caveat: I tell on a need-to-know basis. It's fairly personal information, so like any personal information, there's no need to share with most. However, when circumstances dictate, I do share. Most of my family knows. Some friends, some coworkers.

My husband wanted to be supportive, but really couldn't bring himself to get behind the surgery---UNTIL I took him to my surgeon's seminar. That really, really helped put his mind at ease. My daughter, when home for the holidays the month before my surgery, showed a lot of wariness, as well--so I took her to another seminar, the nutrition and exercise one. There was a fair amount of review from the first seminar, as well as other information that put her mind at ease. Really, just being in the same hospital and meeting the doctor and nurses made a HUGE difference for them both. Their comfort levels skyrocketed, and they have been very, very supportive since. (My youngest, 13, never had any issues with it; a good friend's father and grandfather had the same surgery by another doctor in my surgeon's group, so he was very comfortable with it right off the bat. That, and he watches Big Medicine with me---he had a different level of comfort.) ETA: I have to agree that I feel the surgery was 100% necessary. My insurance company agreed that it was a medical necessity. If others object based on perceived necessity, they simply do not understand the nature (and risks) of obesity. We can try to educate them, but we can't always make others understand; if they have not battled weight, they do not know that it isn't simply a matter of willpower (which turns it into a moral issue rather than a health issue). The surgeons' seminars tend to address this well, with statistics about long-term weight loss that illustrate the very real benefits of surgery.

Mine involved 2 Protein shakes and 1 protein/veg meal (4 oz. protein, 1/2 cup nonstarchy veggies). I was also allowed broth, SF Jello, and SF popsicles. My calories never went much above 600. In terms of breakdown, it was primarily protein, a fair amount of fat, and not more than around 25-30 g carbohydrate each day. Yes, the calorie intake is very low--but it serves a purpose. Low intake, along with low carb, stimulates the liver to release its store of glycogen, which causes it to shrink and makes surgery safer and easier to carry out. Still, the first few days are rough---but it's worth it in the end

Different doctors have different recommendations; mine does recommend high Protein, low carb until at least 75 percent of excess weight is lost. This does result in ketosis. Be sure to get enough fluid---it helps flush the ketones out with urine, so less are lost in your breath.

With chicken, dime-sized is waaaay too big for me--and I don't have anything resembling restriction at this point. The size comparison I've read the most, in terms of "good" bite size, is the size of a pencil eraser or pinky fingernail. I can tolerate that if well, chewed. Still, chicken breast is no longer my go-to Protein, like it was before surgery. It is just hard to take.

Mine was billed just shy of $23k, including an overnight stay at a bariatric center of excellence.

I can relate completely. For much of my life, I was of normal weight, and viewed myself as fat. This made it very difficult, as I gained, to really see that I was gaining. It was almost a self-fulfilling prophecy---becoming what I thought I was. But the result was NOT a woman who saw herself as fat. My eyes still saw the thinner woman. Our heads play really weird games, don't they?

It sounds as though you're feeling your port. It does tug and pull quite a lot, and is palpable beneath the skin.

I'm glad you can lose without exercise. I can't. Not a pound, not an ounce, not a gram without vigorous, daily exercise. I'm fine with whomever wishes not to exercise, but really take exception with the sort of blanket statement that its necessity is a myth. It's necessary for optimal health. It's essential to a balanced, healthy life. And for many of us, it is crucial to weight loss. If I'd accepted this 20 years sooner (you know, back when I was insisting the same thing you're saying now), I would never have yo-yoed up to the point of requiring bariatric surgery. Exercise is a critical part of the equation, health-wise. For some of us, it is critical to weight loss. (And really, skipping it WILL ultimately affect yours, whether its while losing, during maintenance, or as you see the scale climb back up because you've lost muscle mass as you've lost weight, and therefore have a far lower metabolic rate.) You don't have to believe it if you don't want to. And you don't have to do it. But it's a truth, not a myth. Also equally as true is that ANY physical activity = exercise. If you're not considering your gardening, etc. to be such, then you're not only passing on faulty information, but also shortchanging yourself, by using inaccurate labels.