I met with the psychologist for the first time on Friday. The very first thing he asked me was “what is your comfortable goal weight.” My current weight is 223, BMI of 38. A perfect BMI is 20 with a weight of 120 lbs (which was my weight before I had kids). I told him my comfortable goal weight is 140 lbs. He said that is too low and I should set my goal to a reasonable weight of 155 lbs. It kinda bugged me afterwards because he is a therapist, not a surgeon or dietitian. When I met with the surgeon on Monday, he didn’t mention a goal weight, but I figured HE would decide on my goal weight when I have the pre-surgery visit (no surgery date yet). Who decided on your goal weight?

I just looked at the BMR calculator and formula. It is based on weight, height and age. It’s hardly any different than the BMI. They just added AGE.

Just now, suzannethemom said:

I just looked at the BMR calculator and formula. It is based on weight, height and age. It’s hardly any different than the BMI. They just added AGE.

And it’s not any more accurate than the BMI is. The only way to get your actual BMR is taking a BMR test and breathing into the tube.

But your insurance company is going to insist on seeing your weight in order to keep paying the surgeon follow ups, which means your surgeon will be weighing you.

it’s just a number. A data point. It doesn’t define you, but it does have value.

On 01/30/2022 at 16:49, Spinoza said:

Sounds like your psychologist may have dealt with a lot of disappointed patients in the past. I have never had an ideal weight suggested to, or discussed with me by surgeon, nutritionist, or psychologist. I've been told repeatedly that the average loss at 5 years after sleeve gastrectomy is 70% or thereabouts of excess weight. Big ballpark. I want to be much lighter than that so I have set my goal for a weight I have been at various points in my life and felt suited me. If I don't reach that, or anything near it, I might be be a bit miffed, but I'll still have lost loads of weight and be way healthier than when I started out, and that's what really matters to me. My body has a new set weight as of surgery day, and my job is to find that and make my peace with it, or consign myself again to a life of fighting my own body to lose weight it wants to hold on to!

I have not heard that so thats great information. Do you know the percentage or where i can find it for 3 months, 6 months 12 months out? Thanks

3 hours ago, suzannethemom said:

I just looked at the BMR calculator and formula. It is based on weight, height and age. It’s hardly any different than the BMI. They just added AGE.

So, BMR is basal metabolic rate which is how many calories you're likely to burn while doing nothing. It's quite accurate but not completely. But there isn't a human on earth who consumed 600 calories that day a didn't lose fat at the end of it. It's simply impossible. Weighing yourself genuinely isn't necessary. And as for the latter post: I'm not in the US, I neither have nor need insurance, and in any case, all the follow ups are included in the original package price. I just don't see why a "dietician" would be weighing me. If I choose to weigh myself, fine. I would let someone else do it just to monitor me. My progress is mine.

Treat BMR & BMI as guides only. We, the human race, have too many differences for there to be a single one size fits all approach (bad pun I know). Age, height, gender, weight loss history, genetics, frame, muscle mass, health issues, etc. could mean that one of those numbers may be right or wrong for us. But it’s good to have a starting point. Just be flexible & realise that you may be more or less than those numbers & be perfectly fit & healthy.

Whether you weigh yourself or not is up to @Pollito. You know you best. But don’t be surprised if your surgeon or dietician does want to weigh you. You don’t have to look & could ask they not tell you what the scale says. My surgeon & GP weighs me every time but my dietician never weighed me. She said it was obvious enough to her I was losing weight. Doctors like facts & figures so they can monitor change. Hence why we have blood tests & our BP, heart rate, etc. are recorded.

4 hours ago, Arabesque said:

Treat BMR & BMI as guides only. We, the human race, have too many differences for there to be a single one size fits all approach (bad pun I know). Age, height, gender, weight loss history, genetics, frame, muscle mass, health issues, etc. could mean that one of those numbers may be right or wrong for us. But it’s good to have a starting point. Just be flexible & realise that you may be more or less than those numbers & be perfectly fit & healthy.

Whether you weigh yourself or not is up to @Pollito. You know you best. But don’t be surprised if your surgeon or dietician does want to weigh you. You don’t have to look & could ask they not tell you what the scale says. My surgeon & GP weighs me every time but my dietician never weighed me. She said it was obvious enough to her I was losing weight. Doctors like facts & figures so they can monitor change. Hence why we have blood tests & our BP, heart rate, etc. are recorded.

I agree with everything you've written. And I like your dietician. Mine is the same. But beyond that, I do expect various medical professionals I encounter in the future to want to weigh me. And I'll decide whether to let them at the time. But with this surgery, only the dietician would be in the business of weighing me anyway, and - like yours - declines to.

On 2/6/2022 at 1:18 AM, ms.sss said:

…but how will you calculate your (hopefully decreasing) BMR without weighing yourself?

By approximation in theory but in practice I don't need to. There is no weight I could be, where eating 1000 Calories per day wouldn't cause weight loss. The other problem with weighing oneself is seen on this forum which is replete with hand wringing regarding the "three week stall" and many other issues which aren't issues at all with regard to fat loss. They are scale related aberrations.

4 minutes ago, Pollito said:

By approximation in theory but in practice I don't need to. There is no weight I could be, where eating 1000 Calories per day wouldn't cause weight loss. The other problem with weighing oneself is seen on this forum which is replete with hand wringing regarding the "three week stall" and many other issues which aren't issues at all with regard to fat loss. They are scale related aberrations.

I agree that these are scale related aberrations, but as long as you are aware of that, and of the daily fluctuations, and you are patient, it can be very satisfying to see the numbers go down. However, if you have a history of weight-related psychological issues, I can see that it might be necessary not to use the scale. You can always judge your weight by how your clothes fit. I'm not sure if DEXA scans are available in Spain, but that's a great way to check your lean mass to fat mass ratio.

Just now, lizonaplane said:

It can be very satisfying to see the numbers go down.

This is my fear, yes. My goal is to leave diets and counting and caution behind and adopt an intuitive and healthy lifestyle, using this bypass as a tool for portion control. Indeed, losing weight was never particularly difficult for me. My problem was keeping it off and not letting the entire endeavour consume me.

6 minutes ago, Pollito said:

This is my fear, yes. My goal is to leave diets and counting and caution behind and adopt an intuitive and healthy lifestyle, using this bypass as a tool for Portion Control. Indeed, losing weight was never particularly difficult for me. My problem was keeping it off and not letting the entire endeavour consume me.

Yes, this is a great way to do portion control... at first. Eventually, you will be able to eat more, and it doesn't stop you from eating "slider foods", things like chips, cookies, etc that you can easily eat a lot of without feeling full. I also never had trouble losing weight; keeping it off was my problem, too. I can see how much I still have to be extremely diligent to ensure I don't gain this weight back.

2 minutes ago, lizonaplane said:

Yes, this is a great way to do portion control... at first. Eventually, you will be able to eat more, and it doesn't stop you from eating "slider foods", things like chips, Cookies, etc that you can easily eat a lot of without feeling full. I also never had trouble losing weight; keeping it off was my problem, too. I can see how much I still have to be extremely diligent to ensure I don't gain this weight back.

I definitely intend to be very diligent with what I eat. My main food rule is: no labels.

I think some of the tension here (and on the forum in general) is between those who've accepted obesity as a complex chronic disorder comprising mental, hormonal, habitual, gastro-intestinal topographical components - and then the more common view; namely, obesity is a moral failure with a Good and a Bad side to it.

Advice for the newcomers, and I mean this in the kindest way possible (but keep in mind I'm not American, so my direct manner may be abrasive):

There's almost never a good reason to tell others what to do, or judge if they're right or wrong. Being pre-op and telling others what BMI they should have will make you feel embarrassed once you get to a year after surgery. Believe me.

This is a journey, and man there's a lot to learn along the way. Why not listen more, especially if you're taking the first steps on a road others have traveled already with success?

I'll be happy to tell the stories of some of the people in my 'batch' from late 2020, who humblebragged for weeks about how few calories they ate, how much control they were able to exert over themselves etc, who dished out condescending advice (kinda like mine here, but I earned my wings) based off of the honeymoon weeks post surgery.

Well, they're not here anymore. Because it got hard. They had to re-adjust their ideas of 'Good' and 'Bad'. The drama they created stopped being reacted upon.

We're all here to deal with a debilitating chronic disease. Be excellent to each other, listen, but also stand up for one another when someone is using this space to project their inner chaos onto us.

15 minutes ago, Pollito said:

By approximation in theory but in practice I don't need to. There is no weight I could be, where eating 1000 Calories per day wouldn't cause weight loss. The other problem with weighing oneself is seen on this forum which is replete with hand wringing regarding the "three week stall" and many other issues which aren't issues at all with regard to fat loss. They are scale related aberrations.

That’s cool.

Sounds like you have a solid plan for yourself and the resolve to follow through.

There is another fella on here (can’t remember his handle at his moment) who is also of the No-Scale persuasion that hasn’t/hadn’t weighed himself in years who was/continues to be successful.

You know you best, and recognizing triggers and situations that may lead you off course is awesome.

Good Luck! ❤️

1 minute ago, ms.sss said:

That’s cool.

Sounds like you have a solid plan for yourself and the resolve to follow through.

There is another fella on here (can’t remember his handle at his moment) who is also of the No-Scale persuasion that hasn’t/hadn’t weighed himself in years who was/continues to be successful.

You know you best, and recognizing triggers and situations that may lead you off course is awesome.

Good Luck! ❤️

Thanks. It's been a long road for me, my first WLS was back in 2006 and l, frankly, I have an eating disorder and scale and measurement obsession is a part of that. That's why I need to take care with these things.

Just now, Pollito said:

I have an eating disorder

Like most people here. How do we have a subforum for plastic surgery but not one for mental health?

There's no shame in tackling one of the root symptoms of obesity (not necessarily root cause, mind you).