It's really pissing me off because I got cleared by both dietician and bariatrician, I just needed the ok from the psychologist. Ever since I started the program I haven't gained a pound and have lost every visit. I've increased my activity by a great deal yet, it feels like she makes it seem as if it's no effort. I exercise for 45mins and I'm very independent, so I clean, cook, etc. while standing. Anyways she's saying that ppl who get the surgery are encouraged to exercise up to 2hrs and 1/2....Has anyone else been told this?

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I have a step counting application that counts if for me daily and I reach 10000 steps daily. Maybe your job is different than mine but have you tried counting your steps?? I am
Sure you can easily reach 5000 steps. It may seem like a lot but it's not.
After the surgery, I honestly stopped going to the gym because my life got super busy. I lost the weight within one year with 10000 steps and a proper diet. On the days I was behind on my steps, I would read while walking back and fort or put on some nice music and jump around to it. It's very very easy and fun.

I use the timing method because I can't constantly walk. So when I get tired I turn my timer off, and switch it back on till I make about 15mins. I also do other exercises to make up for my steps. The reason I was asking was because I'm in a wheelchair And I'm making an effort to do my steps, but I'm getting an ultimatum basically that if I don't reach 5000 steps by my next visit I'm not getting cleared. Even 3000/4000 is a no no. I'm cleared for surgery by everyone but her. I'm not riding on my disability, I just feel that with ppl in my state she should be realistic. I'm one of the lucky ones that can move all and use my limbs, what about those that can't use their legs? Are they gonna have to overwork their upper body? I just want to be able to help others like me, that want to do surgery.

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I use the timing method because I can't constantly walk. So when I get tired I turn my timer off, and switch it back on till I make about 15mins. I also do other exercises to make up for my steps. The reason I was asking was because I'm in a wheelchair And I'm making an effort to do my steps, but I'm getting an ultimatum basically that if I don't reach 5000 steps by my next visit I'm not getting cleared. Even 3000/4000 is a no no. I'm cleared for surgery by everyone but her. I'm not riding on my disability, I just feel that with ppl in my state she should be realistic. I'm one of the lucky ones that can move all and use my limbs, what about those that can't use their legs? Are they gonna have to overwork their upper body? I just want to be able to help others like me, that want to do surgery.

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That's unreasonable for a person who is on a wheelchair.. you could injure yourself. See if you can talk to someone about changing her. [emoji4]

I gotta ask, how the hell will the psych know how many steps you really took? Expecting a wheelchair bound person to walk that much is psychotic. I am against dishonesty, but if there ever was a good time to lie about something...

I gotta ask, how the hell will the psych know how many steps you really took? Expecting a wheelchair bound person to walk that much is psychotic. I am against dishonesty, but if there ever was a good time to lie about something...

[emoji23][emoji23][emoji23] that is soooooo true! I would be dishonest and fake it, but that defeats my whole purpose. My reasoning is that they are actually looking at my weight, even though they're not talking about it. For instance...seeing if I'm either gaining or losing. So far I haven't gained any weight and every time I go in, I'm losing. I've lost 17lbs as of 4/11/17 so when I go in on 5/2/17, I think she's expecting me to lose at least 3-5lbs with the increase of activity. I'm just thankful that I don't have to pay for her visit out of pocket, unlike the dietician that's burning a hole in my pocket because ins. doesn't cover it. So everyone just wish me luck...I found some good seating exercising/yoga videos, tension bands, and my good ol' green balance ball

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Like the others, my psychologist didn't say anything of the sort....now my surgeon/doctor did say to me that he would like me walking from 1 mile a day to 2 miles a day since that will help lessen any complications during surgery....other than that, you do your 2 week liver shrinking diet prior to surgery and you should be golden...best of luck to you!

The surgeon's reasons are completely reasonable for any patient that is mobile, but for a shrink to be acting like a nutritionist/dietician that believes that small amount of exercise leads to weight loss is actually 'nuts'. I agree I would have to lie, but after surgery, I would be writing letters to the administrators of the program - everyone has a boss - because it might save the next person this anxiety.

On 14. April 2017 at 7:25 PM, Navigating the Wilderness said:

In fact if they are forced to exercise I would be willing to bet there would be a subconscious negative feeling toward exercising in the future.

This. All this pressure makes a lot of people say to themselves "to hell with it" after they got what they wanted and I can understand. Rebellion is not that uncommon and I'm glad nobody demanded something like this.

How are you supposed to prove these steps taken anyway? Do you have to wear something like a fitbit?

This. All this pressure makes a lot of people say to themselves "to hell with it" after they got what they wanted and I can understand. Rebellion is not that uncommon and I'm glad nobody demanded something like this.

How are you supposed to prove these steps taken anyway? Do you have to wear something like a fitbit?

I'm thinking that she's looking at my weight charts. Because all she gave me was logs. So I'm really going on the weight if I lose about 3lbs, I have a feeling she'll clear. This facility is supposed to be the best on the island because its part of a trauma hospital...I think level 3 or 4, besides Kaiser. My very first visit, I met with PT and he was satisfied with the level of activity I could do. Its just the shrink

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Fun fact:

You can lose weight without regular exercise, but you most certainly won't keep it off.

The number may be a bit arbitrary, but they are correct in trying to have some kind of movement part of your daily routine. It's all part of the complete lifestyle change that's required to make this surgery successful. And when I say "successful" I don't mean losing the weight, I mean keeping the weight lost off. People seem to forget about that part.

Edited April 17, 20179 yr by Greensleevie

That seems a little excessive. My psychologist focused on reasons for over eating and possible depression, emotional eating, etc. She did ask how I planned on keeping weight off in the long run and what would motivate me to stay on track

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No one is forgetting that exrrcise plays a role, but in this instance according to the OP, the psych doc was requiring it from a person that primarily is in a wheelchair in order to be approved to proceed for surgery approval. I have seen morbidly obese patients in seminars that could not possibly meet that requirement. And to me that is at cross purposes for wls in order to improve health to the extent that they can exercise at some point but postop but could be denied the very thing they need to achieve that.

1 hour ago, Greensleevie said:

Fun fact:

You can lose weight without regular exercise, but you most certainly won't keep it off.

The number may be a bit arbitrary, but they are correct in trying to have some kind of movement part of your daily routine. It's all part of the complete lifestyle change that's required to make this surgery successful. And when I say "successful" I don't mean losing the weight, I mean keeping the weight lost off. People seem to forget about that part.

It's not really a "fact" even if it is fun, though, and even if exercise is a very good idea (I'm pro-exercise, really!). Granted, you probably won't keep it ALL off without changing your lifestyle to involve more physical activity, but you will probably keep the large majority of it off.

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Studies DO agree that exercise is necessary to keep weight off in non-surgical weight loss and to avoid regaining everything. It also results in about 4kg extra weight loss over sedentary in post-bariatric surgery weight loss. (Pub Med PMID 22038571)

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A study this year also found that exercise intervention in sedentary post-op bariatric patients between 12-24 months post-op resulted in a 5.6kg difference in weight between sedentary control and an intervention group who did 60 min of relatively low intensity aerobic workout and resistance exercises 3x/wk for 12 weeks. (Break it down, and that's far from cross-fit, or the amount OP's psych is talking about. (Pub med 28262676) In most of the studies I looked at, the mean regain we're talking about is around 5-15%. It's not ideal, but it's also not a return to pre-surgery days.

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In fact, studies are showing that diet QUALITY along with post-op time are the most (some studies: ONLY) correlated with weight regain after the honeymoon stage following surgery. (27544005) . Interestingly, there's a high correlation between having plastic surgery and keeping the weight off, too. (PMID 24076675)

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What is a fact is that exercise helps you lose a bit more, makes it easier to keep all of the weight off, and, most importantly, improves your cardiovascular health and helps you overcome the "obesity paradox" where your likelihood of surviving a heart attack DEcreases with weight loss.

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Hopefully the extra info helps clear things up. It really comes down to: eat nutritiously, take your vitamins, don't spend all day inactive, and remember to avoid the kind of eating that got you to the point of surgery in the first place.

Excellent evidence based post.

Quote

20 hours ago, HeatherS. said:

It's not really a "fact" even if it is fun, though, and even if exercise is a very good idea (I'm pro-exercise, really!). Granted, you probably won't keep it ALL off without changing your lifestyle to involve more physical activity, but you will probably keep the large majority of it off.

.

Studies DO agree that exercise is necessary to keep weight off in non-surgical weight loss and to avoid regaining everything. It also results in about 4kg extra weight loss over sedentary in post-bariatric surgery weight loss. (Pub Med PMID 22038571)

.

A study this year also found that exercise intervention in sedentary post-op bariatric patients between 12-24 months post-op resulted in a 5.6kg difference in weight between sedentary control and an intervention group who did 60 min of relatively low intensity aerobic workout and resistance exercises 3x/wk for 12 weeks. (Break it down, and that's far from cross-fit, or the amount OP's psych is talking about. (Pub med 28262676) In most of the studies I looked at, the mean regain we're talking about is around 5-15%. It's not ideal, but it's also not a return to pre-surgery days.

.

In fact, studies are showing that diet QUALITY along with post-op time are the most (some studies: ONLY) correlated with weight regain after the honeymoon stage following surgery. (27544005) . Interestingly, there's a high correlation between having plastic surgery and keeping the weight off, too. (PMID 24076675)

.

What is a fact is that exercise helps you lose a bit more, makes it easier to keep all of the weight off, and, most importantly, improves your cardiovascular health and helps you overcome the "obesity paradox" where your likelihood of surviving a heart attack DEcreases with weight loss.

.

Hopefully the extra info helps clear things up. It really comes down to: eat nutritiously, take your Vitamins, don't spend all day inactive, and remember to avoid the kind of eating that got you to the point of surgery in the first place.

So.....your chances of keeping the weight off is better with regular movement/exercise.

Yeah, that's what I said.

I'm a Psychotherapist and just recently I was asked to clear one of my patients for WLS. My only focus was on this patient's mental health and whether I felt this patient would be able to follow a strict plan. For me to comment on a patient's "exercise" would be completely out of my scope of practice - that is the law! I don't know of any Psychotherapists or Psychologists that also has extensive training in exercise physiology and how it affects the body. Although I suppose it's possible.

I would have a discussion with your physician and ask about the excessive exercise that's being required from your Psychologist.

AND let me add... I'm not saying there shouldn't be any exercise as that's not for me, as a psychotherapist, to comment on. My focus is on the brain. I would think that the Physical Therapist is the qualified person to comment on the persons ability to exercise.

Edited April 28, 20179 yr by ShelbyMoore