Hello fellow sleevers,

just thought I would start a thread for all those who want to get to goal in 2012, regardless of where we are in the process.

I posted it the 'Slow Loser' thread, because that is what I am!! (I am not complaining by the way, just pleased to be a loser...lol)

For me to get there, I know that at 18mths out I need to be strict, accountable and have support from those in the same 'place', who understand that the sleeve isn't a miracle but a tool.

I have done well so far, but the weight hasn't 'melted' off me and since 6mths post op I have had to fight for each and every pound. At first it made me a little bitter, frustrated and I started to get into a 'dark place' about it, now the scale victory tastes sooooo sweet!

I have taken the month of December 'off'... I needed to rest from the constant worry of food, cals, water, carbs and protein... my head was spinning and I was starting to feel very frustrated and overwhelmed at not being at goal again. I needed time out!

I have thoroughly enjoyed the Christmas period and I have eaten what I wanted and when I wanted it; this includes ALL foods, no food was off limit and I let my sleeve do its job! The quantity was low but I still enjoyed every mouthful. Interestingly, I found that my cravings were satisified very quickly... 1 or 2 biscuits/sweets, and so on, hit the spot, instead of 5,6,7,... you get the picture. Subconscious damage limitation? I don't know but I like it!

I have learnt a lot by doing this. I now know that I can eat a little more if I 'try'... I know that I can enjoy food again without feeling guilty and I know that food doesn't have to be the enemy. So, with all that, what was the outcome? Yep, I have gained 2lbs above my personal bounce! Oops!

I am not, in the slightest, worried about this because I KNOW what is the cause... sugar and salt! And this time, I am sure it will come off as quick as it went on!

So, what is the plan?

Per my surgeon's instructions: I am going back to basics... yep that ole one...lol

• 3 meals a day - no snacking.
  
• Weighing my meals between 6-8oz depending on what is on the plate.
  
• Protein first, followed by veggies.
  
• Plenty of water.
  
• A limit of 1000 cals a day.
  
• Continue with my exercise - boxing twice a week, gym in work 1-2 times a week (depending on work load) and walking my dog (just over a 2 mile circuit). The exercise is the only thing that I have stuck to in December... I actually enjoy it now!!
  

As a side note, and I ain't sure if my American friends can get this, but here in the Uk, on SKY there are a few fitness channels. I have recorded some aerobic workouts that are really good... they're free and can be done at home... this is saving me some money on classes and DVDs and if I don't like the workout I can delete and look for another!! Bonus!!

Ok, who is ready to join me on the final stretch to goal... hope on board and enjoy the ride my friends...

Well, Girls, it is definitely eye opening. I, like both of you, don't really see how I can eat much LESS calories or protein and still be able to walk upright! Lol. And Feedyoureye, it is hard to believe that only 1350 calories AND exercise won't get the weight loss it should.

Just to be clear, I eat 1350 plus the calories I burn during exercise... which may be from 100-450 more a day... So I may eat from 1350 If I do very little to 1800 if I exercise a lot (for me- dancing, weight lifting, some extra walking or heavy gardening such as shoveling and moving dirt, pruning and such). myfitnesspal and fitbit tall me how many calories to add...

You might enjoy reading Debra's Just Maintaining (justmaintaining -dot-com). Her blog is no longer active, but she's left it up, and I found it a wonderful resource for insight into what goes on with our bodies after a substantial weight loss. She's not a surgical patient, but it's a great resource, and if you check it out, be sure to read the comments as well - she really had a great group going, and I wish she was still actively blogging.

EP -- that is a great blog, thanks for sharing!!

I am right there in the fight with you ladies! Thanks FYE for the article. I've actually READ that article before, but this time I bookmarked it. TY!

Here is what I have found for me. I "average" 1,200 calories a day (I've been tracking my food since Jan, but not perfect 100% strict, there are days I don't track what I eat) and I have lost -9lbs of my almost 20lb regain from 2012. It is coming off painfully slow, but I think in order for me to get the weight off faster I would have to cut carbs and calories (I average 70-100 carbs a day) so I would probably have to do the Atkins method and go less than 30g carbs for quicker weight loss. I do have days where I'm around 40g or less of carbs but under 30 only happens on the rarest of days.

I have repeated asked my NUT about the final outcome of our surgery being metabolically ALTERED and she agrees that we are but I can't find statistical data showing what changes and how.

I'm interested in this (cut and pasted from the article):

For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

Since the VSG eliminates some or all of this hunger hormone, how does that affect our metabolism long-term?

I vascillate between annoyance at having to be so vigalent about what I put in my mouth to grateful-ness (is that a word?) that I can subsist on 1,000-1,200 calories a day and not be a raging angry b**ch. To me that has been the biggest benefit of the sleeve, is that I do feel full and (on most days) satisfied with a low-calorie diet.

One last mention...when I was about 15 months POST-OP I went and had a body scan done. Fancy equipment that you stand on barefoot, and hold on to, that will send a bioimpedance throughout your body and spit out a very scientific sounding sheet of info. It is a bit fancier than just the hand-held versions or the scale you can buy that tell you your fat or Water ratios. This actually broke down my muscle percentages in my left vs. right leg (arms, torso, etc.) And it said that my RMR is 1,450. Meaning I should be able to EAT 1,450 calories a day while doing absolutely nothing. Factor in working out and I ****SHOULD**** be able to MAINTAIN my weight loss on 1,700-2,000 calories depending on how hard I work out on any one given day. I'm not sure how accurate that is, and I've been wanting to go back and have a rescan done JUST to see if my RMR is the same or different. I will post if I am able to go back for a scan...maybe before or around my 3 year post-op appt in Oct.

Well, I am happy to say that I have been able to whittle down about 7 lbs as of this morning. From my almost 20 lb Regina also, M2G. But it has been by extreme LowCarb and vigilance. I admit, though, I am not an exerciser. I do walk. Some. . I know I should get physically better fit but, honestly, I am so tired at times after work that the thought of it just doesn't feel worth it yeah, I know, I'd feel better. Lol. I feel really good with my Jammie's on in my comfy chair or lying on the couch! Ha! Think I might be battling a little depression also. Going to read the blog. Sounds interesting. As to grehlin, I think the jury is out on that. Some thi gs you read say it is not as reduced as first thought. I have wondered why if at the beginning you're to really hungry sometimes at all and as time goes on, hunger increases. Restriction is still strong IFyou eat correctly and not junk. I do think as the articles/nut said metabolism is altered. Gonna keep working it. I'm trying to figure out HOW once I re lose my gain what I can do LONG TERM to hold it! I know they have said that for your body to hold a new set point it must be maintained for a long period of time. Hopefully, that will be true for me. Anybody know what the longest timeframe we have on VSG is and how they have maintained? I'm coming up on 3 yrs 6-10. Happy weekend to all!!!!

Here is one small study

http://www.nxtbook.com/nxtbooks/matrix/bt_supp0511/index.php?startid=3#/12

6 years out

53%EWL maintained at 6 years out

and

http://www.ncbi.nlm.nih.gov/pubmed/20622654

over 50% at 6 years + reflux return

Why is it that I seem to eat so much more than anyone else?? I always have I guess? I eat up to 2000 cals per day, haven't regained anything yet. Fingers crossed. If I start gaining, I will have to adjust I guess. I'm like 93% EWL at two years post op.

http://www.ncbi.nlm.nih.gov/pubmed/20622654

Intersting this article is the first one I've seen that has mentioned a resleeve. I know someone who once wanted a resleeve because she didn't feel like she ever lost her hunger. She woke up from the OR table starving and thus has battled it since (she will be 3 years post-op next month) But I have not heard of this being common. I wonder what it entails. I imagine that first your sleeved tummy would have to be at a greater size bougie perhaps than "normal or average" to work a resleeve. But then again I've heard of cancer patients who survive with little to no stomach at all.

Swizzly you are SO lucky! YAY! I have read on VST about people who have gone about RESETTING their metabolism but I'm not ready to tackle that yet. I would LOVE to eat 2,000 calories a day and maintain...

I have NEVER lost my hunger, though. I was only un-hungry for like two days LOL. So I didn't have some period of eating like a bird and feeling no hunger. I was HUNGRY and I ATE all along. I also had no liquid or puree phases, straight to normal food here, so I think I just felt sort of 'normal' all along and just couldn't eat very much. Also, if I'm completely honest, even before the sleeve I only ever ate mostly when I was actually hungry and stopped when I was full, so I wasn't a binge eater or anything. I do the same now, it's just less food at one go. I do choose healthy food and very low carb, though -- just so that no one's thinking I'm scoffing down pizza and maintaining like that. I also (usually, when not having back problems grrr) go to the gym three times a week and walk a lot as well. But really? I live a very normal life, for which I am EXTREMELY grateful.

Edit: my NUTs and Drs here are all very keen that you shouldn't stress your system or metabolism too much by going all starvation-y post WLS, so they also wanted to keep as normal an intake and metabolic rate as possible (also to keep the whole stomach/digestive system 'active' by eating real food, etc.). So it's not like I did something special, I was just following my local rules.

Well, reading that at 6 years I would be up approximately 50lbs (53% EWL) according to averages is NOT an option for me. So gotta get this remaining regain off and learn how to maintain. Per the article referenced.

Well, reading that at 6 years I would be up approximately 50lbs (53% EWL) according to averages is NOT an option for me. So gotta get this remaining regain off and learn how to maintain. Per the article referenced.

Yeah, seriously. I'm personally not gaining past 3-5 kg (my 'bounce' range) without some intervention. If I got to to 50lb suddenly? Somethign will have TRULY gone wrong. Not. happening.

Swizzle, how much have you lost and how long did it take you?

Sorry, Swizzly, didn't see your ticker

No worries, I got to my original 'goal' at about nine months, mostly been maintaining since then. Shape and composition still changing over time, but weight only changed another 5kg down after that.

I think there are SO many factors that come into play when it comes to maintenance. I think it's very different for people who have been overweight since childhood vs people who didn't get heavy until their childbearing years. I think it's very different for people who had 200 or more pounds to lose vs the lower-bmi patients. I think your pre-op eating habits also play a huge role - I'm back to battling binge eating habits now that the "honeymoon" stage is over. I think that's why we see such a huge range of experience when it comes to regain. But to me the biggest advantage we have over non-ops is that we can get by on around 1200 calories a day without being truly miserable.

Does anyone else read Dr. Sharma's blog? I could swear I've seen studies referenced on his site that people who've lost a large amount of weight on low calorie diets actually don't see long-term metabolic disadvantages beyond the decrease you'd expect simply due to lower body weight (by which I mean, it takes fewer calories to maintain a 130 lb body than a 300 lb body). Which suggests that a lot of it may really be due to ghrelin and other chemical factors. If you look at Debra's blog, there's a lot of info about how there's a lot more going on than just leptin and ghrelin.

I dunno.... it seems like when I look at Dr. Cirangle's successful maintainers, a lot of them are living off a LOT fewer calories a day than seems "normal", and I can't help but wonder if a year at 600-800 calories, effectively brought lower by whatever's burned in exercies, doesn't have a real impact long-term. But I haven't really seen the science to back up the idea that it's truly a reduction in base metabolic rate compared to someone of the same bmi who hasn't had a history of obesity and weight reduction.