I had VSG surgery on August 18, 2014 -- one year and two weeks ago. Today I met with my bariatric P.A. for my one-year post-op review. She's extremely sharp and keeps up to date on bariatric surgery post-treatments, nutrition, behavioral issues and emerging news. She attends bariatric conferences often and reads all the new studies.

She was the one who encouraged me at four months post-op to move from 800 calories/day to 1,000 calories by Month Six and to 1,200 calories by Month Eight. She said that would help me to prevent my metabolism from accustoming itself to the very low calorie post-op menus we are restricted to with tiny, swollen stomachs.

Apparently, it worked: I am maintaining a 143 pound weight and eating 1,700 calories a day.

I've had an exceptional Year One. I've reached my weight loss goal and am 7 pounds lower than that. I feel great. My blood panel test results are 100% great. No shortages at all. In my opinion I've done everything right. I eat 3 meals and 2 Snacks. I don't graze. I eat nutritious food. Most days my Protein grams hit or exceed 100. I typically eat 5 healthy vegetables and fruits each day and eat at least 21 grams of Fiber (the daily requirement for women). My muscle mass is exceptional for my age (I'm almost 70). I no longer need knee replacement surgery. I walk most days, do yoga and strength training.

So today what I really wanted to know and what I asked her were these questions, along with her answers:

1. What should I expect during Year Two?

You've done really well with weight loss surgery. You've already been maintaining your weight for the last 4 months. In Year Two you can expect more of the very same challenges you've already been dealing with since you reached goal -- planning and eating nutritious meals, focusing on regular exercise, not overeating, and staying focused and motivated. It's important to stay connected to us if you have any questions or changes in how you feel or your health. Staying connected to us is one of the best things you can do. All the research shows that you're much more likely to be successful long-term if you don't "fade" away and try to deal with all the challenges you're having by yourself.

(That made me feel pretty good. )

2. During Year Two, will my body start to produce and release more ghrelin and will my pre-op hunger levels return?

No, the ghrelin doesn't come back. Yes, I know that myth is out there and considered to be true. But it's not true. Yes, you may experience "head hunger" or boredom that could lead you to start eating food full of empty calories that don't help you achieve satiety. And eating those empty "slider" calories will make you want more of them. That's the same "head hunger" challenge you've always had to contend with. Again, no, the ghrelin doesn't "grow back."

(Needless to say, her predictions about ghrelin not coming back just thrilled the hell out of me!)

3. Will my metabolism lower for any reasons, requiring me to eat less?

Not unless you stop exercising or your muscle mass goes down significantly. Also, you're already eating "good" foods, not high-sugar, high-carb foods. The nutritious foods you're eating (protein, veggies, fibrous fruits, whole grain foods) require your body to work harder to digest them. A diet high in slider foods (chips, Cookies, candy, ice cream, sugary drinks) wouldn't make those digestive and metabolic demands of your body. Just keep doing what you're doing now, and your metabolism should remain the same.

(Whew!)

I know that only time will tell how I do. But I now feel like I have a very good chance of keeping my weight down and remaining slim and healthy going forward. BTW, she told me about patients of hers who are 5 and 6 years out who are as slim now as they were when they first reached their weight goals.

So take that, b*****s!

:)

@@proudgrammy enjoy your FAGE with pride, this is where I first saw the Protein absorption idea on a non-body building site: http://www.scientificamerican.com/article/how-much-protein-can-the-body-absorb/

This is an interesting explanation of how the body utilizes food over a day: http://www.marksdailyapple.com/dear-mark-how-much-protein-can-you-absorb-and-use-from-one-meal/#axzz3kFd67qjP

This is a good explanation of the origin of the high protein will hurt the kidney's myth: http://www.biolayne.com/uncategorized/myths-surrounding-high-protein-diet-safety/ If you have kidney disease, follow your doctor's recommendation, but for the rest of us, that recommendation doesn't apply.

You can have rice I can't wait lol I was told rice is a no no..

It's not that rice is a no no. Eventually, you will have room in your stomach for rice. Right now, you should be concentrating on getting all your Protein in. Protein first, and veggies if you have room. I am not sure when you had your sleeve surgery.

Rice expands in your stomach. So be careful. You can eat a small amount, and get really full as it expands while it's sitting in your little tiny stomach.

You can have rice I can't wait lol I was told rice is a no no..

It's not that rice is a no no. Eventually, you will have room in your stomach for rice. Right now, you should be concentrating on getting all your Protein in. Protein first, and veggies if you have room. I am not sure when you had your sleeve surgery.

Rice expands in your stomach. So be careful. You can eat a small amount, and get really full as it expands while it's sitting in your little tiny stomach.

.. Thanks yea I have a ways to go I'm only 18 days out. I am still trying to focus on eating slower lol.

@@proudgrammy - There are some myths out there about too much Protein at one time hurts your kidneys and somehow a 25g shake is supposed to make that happen. But some myths die hard ...

Not so sure about this. I mentioned to my 86-year-old Mother's doctor that I was giving her a supply of 30-gram Protein shakes. The doc said that was a bad idea. My Mom's kidneys are weakened from diabetes, and that much concentrated protein could overwhelm them and have bad results. So my suggestion would be to check with your doctor if you have any reason to worry about your kidneys. That being said, I drink my protein shake for breakfast every single morning, and have no intention of stopping, even in maintenance.

@@proudgrammy enjoy your FAGE with pride

@@OKCPirate

i did thanx

i tasted everyone of those 20 gr Protein

thanx for your post and help again

unfortunately the links you show-won't pull up for me

hope we can figure those links out

if you sent them, they must be great - worth reading

i'm probably gonna be up all night worrying about the prob

congratas on loosing 89 lbs!!!

now i understand why i've been "seeing less and less of you"

kathy

my doctor believes to get your Protein from solid food instead of shakes because shakes won't keep you full for long since they are liquid.

@@Boombalatty

thanx for your response

i do agree that liquids/protein shakes might not keep you as full as for example chicken

in my case, i drink Premier Protein shake (swiss chocolate) 25 gr protein

i drink/SIP slowly (20 minutes)

it does make ME full

Proudgrammy, my doctor believes to get your protein from solid food instead of shakes because shakes won't keep you full for long since they are liquid. He thinks that if you drink them that you'll still eat solid food later to get full, thus consuming more calories than you need. I kinda understand that, but I still drink them on some days, especially if I do some strength training.

He also thinks it's some kind of dangerous precedent, drinking a liquid with calories. I just look at it that he deals with all sorts of people and comes up with rules 'for the masses' and puts them out there without worrying if people have any common sense about what they are doing... so sometimes I apply common sense (and other advice from this board - since he doesn't give protein gram requirements, either) and not necessarily the letter of his rules.

@@Boombalatty

@@Rogofulm - I mentioned later that this myth was misplaced to people with normal kidneys. It is VERY different to those with kidney disease.

@@Rogofulm - I mentioned later that this myth was misplaced to people with normal kidneys. It is VERY different to those with kidney disease.

Yes you did. I saw that after my post. That's okay, doesn't hurt to reinforce it. Cheers!

@@VSGAnn2014

Loved your post! It makes so much sense that our bodies would get used to a set point, and if that set point is 1000 calories, eventually we could gain weight even on that.

Would you mind sharing what a typical day's meals look like? I'm just 23 days out and having a hard time visualizing how I'll ever be able to eat 100 grams of Protein, 5 servings of fruit and veggies, and 21 grams of Fiber. I'm struggling to get my 60-80 grams of protein (hitting it, but have to work hard at it) and I am WAY under on fiber. My only veggies right now are in V8. Which I can drink a 5.5 oz can of!!!

More worrisome, I can eat 5 ounces of mushies/puree no problem. And if my stomach is empty, I get nauseated. I'm finding I eat a small something every couple of hours just to keep from feeling nauseous and having a feeling that my tummy is gnawing itself away. As a result, I'm eating about 800 calories a day. I'm worried that's too much this early. I'm starting soft foods tomorrow (which my Nut distinguishes from pureed, although I'm not exactly sure that the difference is!)

I'm right at 8 mo's out. In the beginning I couldn't eat/drink much of what I was supposed to at all. Very frustrating when you're told to meet this goal and that goal. I figured out....after a long while...these are guidelines and guidelines only. Not everyone is going to be able to meet this quotas. And I'm fine with that. I'm still losing! I'm down 101lbs so I must be doing something right. I still don't get my total protein in...but I quit worrying and stressing about it. I do what I can and make it work for me. You'll do great!

@@Graciesmom04 wow, 101 pounds. That is impressive! Congratulations!

So good to hear. I am coming up on my one year anniversary. Since I have a longer weigh loss course than most sleeve pts I want to talk about what I can do to continue to lose during year two. I am determined to get to a normal BMI! I'm going to write out some questions to ask.

Congrats on your successful journey! I will be 2 years post op with the sleeve on Friday of this week. It's been an amazing journey as well for me. I've lost and maintained a 150 pound weight loss. I will add for me that the second year was more about doing work on myself emotionally and working on the underlying emotional-eating issues that got me to a place where surgery was my only remaining option. Without doing that hard work, I don't know what my long term success would look like. Good luck to you on your continued successful journey!

Kind of embarrassing to do this, but I'm bumping my own thread for those who want to hear my surgical team's predictions about Year Two post-op and beyond for gastric sleeve patients.

I posted the OP almost 6 months ago, and (so far) my bariatric physician's assistant's predictions of Year Two of sleeved life are certainly holding true for me.

Since I posted this nearly 6 months ago, I've very slowly lost another 8 pounds and now weigh 135 pounds. Today, I decided it's time to raise my daily calories from 1, 700 calories to 1,800 calories. At 135 pounds and 5'5" and 70 years old I don't want to lose anymore weight. So I'm going to suck it up and eat another 100 calories a day.

I'm still feeling great, looking great, love eating really healthy, delicious food and wearing small, attractive clothes that I haven't dared to wear in decades. Happily, I have no health problems at all (that I'm aware of).

Earlier today I posted something very wise I recently saw on a health blog -- that the two magic ingredients of a healthier lifestyle are patience and consistency.

I think that statement is very important information for anyone who is considering WLS or is working hard to get the maximum health benefits from their own WLS.