Yesterday I watched Bariatric surgeon Dr. Vuong's video explaining his advice that people not exercise for six months after surgery. His reasons were not very clear from a physiological perspective. From an emotional perspective, he thinks that we aren't really ready and will just see it as a chore and beat ourselves up when we don't do it. He suggested working with a therapist to fix emotional eating issues, getting the nutrition straightened out, and waiting until you can afford a personal trainer first. People were asking good questions like what about exercise that you really like and what do you do at six months and beyond. He didn't answer the questions because he didn't appear to see them pop up. He seemed like a really dynamic and caring guy, but he also seemed kind of like a snake oil salesman. I've looked him up on Bariatric Pal and there's not much here except reference to a lawsuit and one time he introduced himself and hawked his books/ program and got negative feedback for it.

Does anybody know of a physical reason not to exercise? He said something about it inducing cravings and screwing up your efforts. I've been exercising regularly since week three (I'm now in month five). It seems to lift my mood quite a bit. I've stalled and been fighting cravings, though. Last week I was pretty exhausted and didn't exercise much (two days got to 10-11,000 steps). I also dropped my calories back to 1,000 and am eating keto. I lost eight pounds in a week and the cravings aren't as bad. I'm contributing this to keto, reduced calories, and coming off of a stall. But I'm curious about this exercise bit. Should I stop for a while to see what happens? Or is Dr. V a quack? I have recently hired a personal trainer, but I hate it. I don't yet have the nutrition thing all figured out, but I've been in therapy for a long time with great results in all but emotional eating.

Do any of you have a response to this video? Are any of you losing rapidly without exercise? Anybody a patient of Dr. V or gone through his programs or read his books?

Here's the video:

@hermione53

I lost all my weight with walking for the most part for the first 9 months. I added in Yoga, I did CrossFit for a little while (really just to meet men), and I do weights at home. I found I can't do a lot of really vigorous exercise because I can't eat enough calories to support it, plus it stresses my body out and I cling to weight (everyone is different so you have to do what works for you). Walking 2-5 miles a day is enough to lose weight.

Anything that is really going to make you sweat or burn a lot of calories before 6 months is pretty dicey imo. Just because you can't drink water fast enough to replace it and you are still healing and it is hard to get enough calories in to support an increased calorie deficit cause by exercise beyond the deficit you are already running because of decreased intake.

If you want to do something intense I think you should wait until you can consume at least 1200 calories a day and drink water at a pretty decent pace. That is going to vary for everyone.

Dr Matthew Weiner is a bariatric Dr I respect. One things he talks about is working out and injuring yourself, you end up back tracking. So instead of having your normal level of activity, now you are hurt so not only are you not exercising, you also are not doing your normal level of activity just moving around the house or the office. At Minute 8:57 he talks about injury.

I think being active is really important, but I think people can lose a lot of weight with walking, something simple. It has a lot of benefits and if you like that is great. I hate being inside, I will run, walk, play any sport, swim, anything if I am outside. I can't stand being in a Gym longer than an hour, but I will walk outside 10 miles at a time. So you have to find what you like.

The goal in the first 6 months should be healing and learning your sleeve, not burning calories to the max.

I hate personal trainers too. LOL I'll never pay for one, and most of them look like they need trainers themselves. I lost my weight with keto and walking with a little yoga tossed in here and there. I think you will like what Dr Weiner has to say, I hope you watch the whole video.

Edited to Add: I am watching this video now. I love this guy. I have never heard of him until this video. He is right and I like his logic. I need go walking before it gets dark but I am going to watch this whole thing and reply. What he saying about fat brain and skinny brain is totally right. He might be my new Dr crush, lol.

Edited May 2, 20179 yr by OutsideMatchInside

Ok. I watched it. The only thing that made sense to me was not eating enough calories in the early stages to sustain a workout without feeling crappy. Other than that I felt like he was a bit nutty. Idk. I don't want to be a jiggle fest. I'm going to listen to my surgeon and see what he advises about exercise.

@hermione53

I'm not sure why you thought he was a quack. He lays it all out very exactly why you shouldn't go to the gym in great detail with explanations

YOU CANNOT CONSUME ENOUGH CALORIES.

That is pretty much it in the nutshell.

He also explains that increasing your activity increasing your hunger. Which is why we always see these people here talking about they are starving post-op when you shouldn't be hungry post-op and stalling while working out 6 days a week.

Not only does he go into explaining why people shouldn't go in the first 6 months in great detail, he addressing weight loss and life post-op holistically by going into emotions and feelings.

When I started working out doing yoga and other things after losing my first 70 pounds I felt to so much better. Not only could I do things like a normal person. I got more out of my poses etc. I also was going to working out not to lose weight, I already knew how to lose weight at that point with my diet. I was doing it to be stronger, feel better and improve my skin elasticity. Instead of trying to burn calories, I was just trying to be healthier, be better. Totally different attitude. And the heavens opened. I enjoyed being active like I did when I was younger.

Also after I had already lost weight, I felt so much better physically. I had a ton more energy and I could move better, I didn't ache. I could stand on my feet and not hurt.

Dr Vuong is my boo for life. He is telling the truth about loose skin. You can't fill real loose skin with muscle. Going to the gym isn't going to save you from loose skin. I have awesome biceps and triceps but I still have a 1/2 an arm of loose skin that I am never going to be able to fill with muscle unless I suddenly become a man and can build as much muscle and Arnold. I have lost an entire person in weight, I am literally 1/2 the person I was. I have a lot of loose skin. Most people never have loose skin like this because they were never as large as I was and they never lose low enough. He hit that nail right on the head. Most people lose some with surgery but never enough to really have loose skin even though every fat person uses loose skin as an excuse not to lose weight. Lose the weight and get their first then worry about it. Dr Vuong I love you!

Edited May 2, 20179 yr by OutsideMatchInside

Although I resumed exercising at three months post-op, I concur with about 80 percent of what Dr. Vuong has said. Contrary to popular notions, exercise alone does not drive weight loss. Dietary choices are 90 percent of the equation.

Exercise is important for weight maintenance, but carries far less importance for weight loss.

Here is another tidbit that the vast majority of bariatric surgeons do not reveal to their patients so as to not discourage anyone: the speed of weight loss during the first year is based on genetics. During the second year it is 50 percent genetics and 50 percent lifestyle. By the third year it is all about lifestyle choices.

One of the aforementioned surgeons (Dr. Weiner) mentioned the genetic component in one of his videos. He refers to those with the two beneficial markers on chromosome 15 as "super responders." These people lose rapidly in the first year regardless of what they do because favorable genetics drives their weight loss. These people can lose 20 to 35 pounds monthly eating Krispy Kreme donuts and chili cheese fries and reach goal weight in less than a year. These people can also lose 20 to 35 pounds monthly eating cleanly and exercising and reach goal in less than a year. It does not matter.

However, the genetically blessed super-responders who lost all their excess weight in the first year while eating junk are often the ones who start regaining in years two and three. In the second year and beyond, the genetic advantage diminishes and lifestyle choices such as food choices becomes critical.

People with only one beneficial marker on chromosome 15 will lose at an average rate in the first year regardless of what they do. People with no beneficial markers on chromosome 15 are the non-responders who lose less than 30 pounds regardless of strict adherence to diet and exercise.

Genetics drives weight loss during the honeymoon period, folks. Most bariatric surgeons read the peer-reviewed articles and already know this. Nonetheless, bariatric surgery teams advise patients to exercise for health benefits and as part of a comprehensive lifestyle change toward the better.

Exercise is important for body recomposition, cardiovascular health, and weight maintenance. I love exercise and run an average of 30 miles weekly. Still, it is not as important for weight loss.

https://intensivedietarymanagement.com/exercise-is-not-total-energy-expenditure/

@OutsideMatchInside

Thanks for the replies and the videos. I'm not sure why I thought Dr. V might be a quack. I guess it's his informal presentation and the fear that being told not to exercise is too good to be true. I saw his video again and caught more this time. The first time was on Facebook live and there were tons of messages popping up and likes/ hearts floating across the screen so it was a bit distracting.

I decided to cut my exercise down to walking (I was trying to pick up a wee bit of running). I thought I saw all of Dr. Weiner's videos right after surgery, but I didn't remember the exercise one. I must have been hopped up on the Oxy because all that sounded familiar was his recommendation to do yoga. I wish I'd paid more attention because I did injury my knee in the first two months and am starting physical therapy soon.

It's hilarious that Dr. V is your new surgeon love. He is pretty adorable!

As always, thanks for your thoughtful replies! You're generous to stick around and advise people :-)

9 minutes ago, hermione53 said:

@OutsideMatchInside

Thanks for the replies and the videos. I'm not sure why I thought Dr. V might be a quack. I guess it's his informal presentation and the fear that being told not to exercise is too good to be true.

Yeah I will be honest. I was prepared for him to be a quack just by the setup, how he looks and I hate facebook live.

He reminds me of my surgeon though. Young, charming, skilled and confident.

If you hate the gym and the trainer just don't do it. You don't want to do something that makes you feel bad about yourself. If you are rehabbing, try Yoga, there is restorative Yoga etc. My studio has a variety of classes to address a variety of needs. the stress relief from yoga is amazing and you use muscles in yoga you did not even know you had. Aerial yoga is also a great place to start.