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Hi all,

I'm 14 weeks out and just had my second follow up appointment. I'm doing excellent on all fronts, my bloodwork and rate of weight loss are great. So, yay!

However, my PA says I will likely never reach my goal weight. This pissed me off to no end!

I've been wanting to be in the 120s for many years. I was 145 at my lowest (after losing 120 pounds the old fashioned way), and I felt that 20 more pounds down would have been comfortable for me, I still felt blah and overweight at 145 (I'm 5'5). I prodded to understand why she thought I wouldn't get to my goal, recognizing that I know there is a point where surgery alone not get me all the way there (it would stop around 180 she said). She said that once you're obese, your hormones change, so it's not likely that I would get to my 120s goal.

Sure, I am aware of the metabolic studies on previously obese people (NON-bariatric patients mind you) that showed their metabolisms are 20% less than that of a never-obese person. I'm assuming this is the hormonal shift she was talking about, but my medical team will only discuss things with me on the most basic, third-grade level so I'm not completely sure. I've done further research and can't find anything else that makes sense that would prevent me from reaching my goal. I have no problem eating 20% below a standard 120-pound woman, I'm doing that already!

I recognize that I CAN be healthy at a higher weight and that I might not want to maintain a low weight once I get there. I realize that. But I want to GET there to make that choice for myself.

Does anyone on here have any other research to point me to? Have you found this to be true in your own journey? What have your doctors said about goal weights?

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First, I'm not sure this early out your PA should be saying things like that - it seems like she's trying to discourage you, although she may mean well and not want you to be disappointed if you don't get to that weight. I don't think her method is great. That said . . .

When was the last time you were successfully at that weight and what is your frame and muscle composition like? (Also, what is your age - if you are at an age where menopause is approaching or ongoing, that creates its own set of issues.) So there may be some reason she made her statement - maybe seek a clarification. I'm shorter than you are, but was an athlete before I gained all my weight. When I was competing in my sport at an Olympic level, I had to fight to stay at 125 on 2000 calories a day plus training 4 hours a day. I know I'll never see 125 again, and frankly, I don't want to because I didn't really like the way I looked at that weight.

I've lost 75% of my excess weight but I'm still about 30 pounds from my personal goal. However, I blew through clothes I hadn't worn since before my kids were born (oldest is graduating high school in 3 weeks) because my body is leaner now than it was then because I'm back to being more athletic. My wedding gown is even too big.

I know that I'll never see anything below 140 mostly because I'm putting on a tremendous amount of muscle right now.

But, numbers aren't everything. You may realize when you get closer to what you think is your goal that you are happy with how you look at a different number.

To be honest, this time last year I was squeezing into size 22 pants and right now I'm at my desk in my office in size 10 pants. Would I like to be less jiggly - sure, but I'm felling a whole lot better now.

Best of luck on your journey.

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With surgery you'll lose about 70% of excess weight but anymore will be up to you. Your goal weight is very low see how you feel after a year you may be happier and healthier at a higher weight. Just from my experience my nutritionist said I wouldn't get to a healthy bmi but I did.


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Thanks both @Diana_in_Philly and @blondie66!

I've been overweight since I was 6 years old, so I have never been near my goal weight. However, according to the body frame size tests, I'm very slender--I can wrap my fingers nearly halfway overlapping around my wrist. I work out a lot, but I'm not a big muscle builder. At my lightest adult weight (145), I was working out 7-8 hours per week, but didn't gain very much muscle. I'm fine with that, but it guided me on my goal to be in the 120s. I was still overfat even though I was doing serious weight training and HIIT. I'm many years away from menopause, so I shouldn't have issues in that department!

I totally recognize that every time losing is different and maybe when I get back to 145 this time I will be fine with my body and how I feel. If that's the case, that's fine with me, it's not really about the number for me, it's about how I think I will feel and look when I'm in that range.

Just really not pleased to have her try and keep me from believing in my goals. I am not the kind of person that just stops because it might be kind of difficult. And if there's no scientific reason why I can't reach my goal, I really want to try--even if I decide I don't want to maintain that low!

Thanks for your thoughts again! :)

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I'm the same height and small frame. I was told I would only get to 170. I just ignored them. When I hit a normal BMI I was told I was one of a handful who had done so. I was also told not to lose anymore but am hoping to get to 135. Like you I want to see what it feels like but may adjust it up or down depending on how it feels. Hang in there and trust your body.

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You should go for whatever weight you want. I'm sure your PA was just trying to give you a realistic goal so you wouldn't be disappointed if you can't make that goal. I'm in the opposite situation. My surgeon has my goal weight at 140 pounds. I haven't been that since I was 16 years old. My NUT has my goal weight as being 199 - 222 (70 - 80% of my excess weight). I was actually pretty satisfied weighing around 200 so if I get there then I will be thrilled.

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only about 10% of SMO people make it to a normal BMI, so she was probably just being realistic and didn't want you to set yourself up for disappointment if you can't make it. That said, some of us *do* make it.

I'm 5'6" and currently weigh 140 (give or take a couple of pounds). I'd wanted to lose another 10 lbs, but my PCP said she wouldn't advise it - she'd prefer I stay in the 140s. Shortly after I saw her, I had one of those commercial DEXA scans that does the body compositions. My fat percentage is 22%. The tech said that was fine, but advised me not to go much lower, else I'd just be consuming muscle. And I know that less muscle = lower metabolism = fewer calories. I do know a few people who are our height and weigh in the 120s who maintain on 1000 kcal or less (WLS patients). No thanks. I can eat 1500-1700 calories and still maintain my weight, and that feels very comfortable to me. So I decided to listen to the advice I got and quit once I hit 140 (which is about a 23 BMI, so very healthy). So anyway, my point is, you might want to have a DEXA scan when you get down to 140-150-ish just to see if it's feasible to keep going. For me it was not.

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I'm kind of in the same boat. The goal they gave me is 190, which is a little disappointing. My lowest adult weight was 132, which didn't last very long because I quickly went back to my old habits. I think I would be happy around 150, but the surgeon doesn't seem to think that's realistic. I'm 281 now.

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I've really been thinking about this. The # on the scale means nothing to me. For health, the female waist measurement (around the belly button) should be under 35 inches. This is a jean size 14 or smaller.

I was once a size 8, but a size 10 or 12 is good too. If I get to size 14, I'll evaluate what is going on then.

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IMG_0285.JPG
This is an old table I have and I have posted it previously but it might help some. It takes age in to consideration too.


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Thanks everyone for your thoughts! Good to see I'm not alone in this.

@j16, you are inspiring! Did you find there was a point where the WLS stopped "working"? Or did you do anything different to get to a lower weight?

@Airstream88 Thanks! I agree, as long as it's healthy for me I don't see why I couldn't go lower. I'm sure she was setting the bar really low, but man that's so dis-empowering. My mom was the same way as you with her WLS, she would be and has been happy around 180-200 and it works great for her!

@catwoman7 I wonder why so few of us make it to normal BMI. Just the same issues that got us up to an unhealthy range maybe? You are an inspiration! And that is a great idea to get a DEXA scan. Wish I had done one before the surgery to get a before and after!

@briski Glad you can relate. I really don't like that doctors set such low bars of "success." It's so depressing!

@rachel_babe I bet if your bloodwork is good you will be able to settle at a higher weight!

@Berry78 So true! Even when I was 145, I wasn't under a 35 inch waist. That's why I figured that being in the 120s would be more healthy for me.

@UK Cathy Thanks for posting! So according to that chart, my goal is totally reasonable. I don't see why they would have these numbers if doctors thought they were "too low."

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My surgeon's office uses a computer program that figures in age, height, gender, co-morbidities, and starting weight. My data gets compared to others of similar stats who are post-op to get an estimate of how much weight I'll most likely lose. I'm 5'8, 264 lbs and he estimates (based on data) that I will lost approx. 90lbs which would put me at my wedding day weight. My lowest adult weight was 155. 175 wouldn't be the end of the world but I do hope to get a bit lower. But who knows, I could be completely satisfied there.


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Thanks both [mention=291533]Diana_in_Philly[/mention] and [mention=312924]blondie66[/mention]!
I've been overweight since I was 6 years old, so I have never been near my goal weight. However, according to the body frame size tests, I'm very slender--I can wrap my fingers nearly halfway overlapping around my wrist. I work out a lot, but I'm not a big muscle builder. At my lightest adult weight (145), I was working out 7-8 hours per week, but didn't gain very much muscle. I'm fine with that, but it guided me on my goal to be in the 120s. I was still overfat even though I was doing serious weight training and HIIT. I'm many years away from menopause, so I shouldn't have issues in that department!
I totally recognize that every time losing is different and maybe when I get back to 145 this time I will be fine with my body and how I feel. If that's the case, that's fine with me, it's not really about the number for me, it's about how I think I will feel and look when I'm in that range.
Just really not pleased to have her try and keep me from believing in my goals. I am not the kind of person that just stops because it might be kind of difficult. And if there's no scientific reason why I can't reach my goal, I really want to try--even if I decide I don't want to maintain that low!
Thanks for your thoughts again! [emoji4]

I was also told that getting to a healthy bmi was unlikely. But I did reach and am maintaining but I have to diet and exercise to reach and maintain it I can't rely on surgery. Also, my stretched out skin adds extra weight that I won't lose under I have skin surgery....it's flabby wrinkled skin which can't be dieted off but probably is about 5 extra pounds. If you want to reach a healthy bmi go for it and do it for you! The drs just want to keep our expectations realistic and they're thinking what is the expected weight loss from surgery they don't include what we are willing to do with diet and exercise to get the remaining pounds off.


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