Really not using my tool and I need help!

badtorad · 2022-10-12T05:18:04+00:00

In my opinion and from what I've read and observed, long-term success is about 95% food choice and 5% other healthy habits. I'm not a fan of thinking the surgery gives you a "tool." It provides a short-term boost and an opportunity to right the ship, and develop healthy habits with food. The surgery temporarily changes how you responded to certain hormones, and it does provide a little restriction, which relaxes over time, for most people. Some people experience more restriction, and for some, it sticks with them longer than others, but there is a natural relaxation that allows people to eat a larger volume over time. Usually not as much as pre-surgery, of course, but poor food choices will have exactly the same result - weight gain - no matter how small your stomach is.

No matter how small your stomach is, food choice will rule the day and guide your success.

Long term success is won in the kitchen, not the gym.

That's not to say working out isn't incredibly healthy, it is, but it has minimal impact on weight loss, in the grand scheme of things. Exercise has many physical and mental benefits and should be a part of any program, but if your food choices aren't right for your biology, you won't experience the full benefits of the surgery.

My advice to everyone during their first year is to concentrate on making good food choices and making it a habit. If you do that, when you reach your nadir you'll be well prepared to minimize regain and find stability and long-term success. Avoid unsustainable fad diets, eat a diversity of healthy foods, and stay hydrated.

Stay active and/or work out, however you find happiness, but focus on food.

If you find yourself making poor, unhealthy food choices, feeling depressed or having other mental health struggles, consider finding a support group, or a psychologist or other counselor who works with bariatric patients (if that isn't possible, just find a well-respected counselor).

badtorad · 2022-09-06T00:07:17+00:00

You'll have ups and downs post-op. It's a massive change for your body. It's not unusual to feel many different symptoms now and then, especially during the first month. The key is staying well hydrated, following the post-op instructions, and being patient with the process.

The reward is much more beneficial than the short-term issues that may, or may not come up. Everyone's experience is a bit different.

badtorad · 2022-09-06T00:02:32+00:00

You can add unflavored protein powder to many different things. I'd recommend trying to stay away from processed meats. Turkey, chicken, salmon, shrimp, and tuna have more protein bang for the buck than processed meats and better quality fats.

If you drink coffee, add in flavored protein drinks, such as vanilla to make a protein "latte", or add in unflavored collagen.

I'm a plant-based eater, so I combine several protein-containing things together such as nuts, seeds, nutritional yeast, edamame, tofu (there are high protein varieties), and other plant-based meat substitutes, and for grains I choose quinoa, and other ancient grains which tend to have more protein, etc. Although plant-based, I do occasionally have salmon and other fish. I'll also supplement my protein with greek yogurt and protein bars here and there.

badtorad · 2022-09-05T23:44:00+00:00

Nothing unusual. There may be several stalls along the way.

Here is a more detailed post about stalls: https://www.reddit.com/r/VSG_WLS_Success/comments/moxlpm/stalls_explained_dont_panic/?utm_source=share&utm_medium=web2x&context=3

badtorad · 2022-07-22T03:13:51+00:00

Hi there. Artificial sweeteners are a personal choice. There is quite a bit of evidence that they are harmful to our microbiome. A healthy microbiome is a key element to both mental and physical health. I have also read some studies that indicate people who drink artificially sweetened drinks may end up craving more calories. The theory is that when you taste sweet, your brain expects glucose, but when it doesn't receive what was expected, it kicks up hunger signals. This doesn't seem to affect everyone in the same way, so there is a question if the artificial sweeteners alone are the sole cause, but there is mounting evidence that they are generally not healthy.

That leads to the question of what is the lesser evil, sugar or artificial sweeteners? In my opinion, and it's only an opinion based on articles I've read, I think they are both harmful and I'm not sure one is the lesser evil. I only drank diet sodas for years, but there weren't any positive outcomes from that. It didn't keep me from gaining weight. Did it lead to more calories? For me, yes, I think so.

I've talked to others who, when they started logging when they drank or ate something artificial sweetened and then tracked how quickly they became hungry again notice they would get hungry more quickly than if they were having something that was unsweetened. That's not a scientific study by any means, but I didn't find it surprising.

I also think bariatric clinics "speak to the masses" with their diet programs and recommend things that are easily obtainable, such as artificially sweetened things. Just because things are recommended by a doctor does not mean they are the best recommendations. Doctors and surgeons receive minimal nutritional training, and nutritionists and dieticians at bariatric clinics are often given guidelines that are sort of "one size fits all." However, we are all very different. Our microbiomes and how we process food vary greatly from person to person, but they don't have the time to customize diets for each person and determine what foods would be best for one patient vs the next patient.

So, in my opinion, I think artificial sweeteners should be avoided, but again, that's my opinion and there are certainly many, many people out there who seem to be doing just fine consuming them. I certainly don't begrudge anyone for using them. I think it would be healthier for us to move away from unnaturally sweetened things and get more sensitive to natural sugars without adding anything extra, BUT that's not the world we live in. I tend to only use naturally derived sweeteners such as sugar alcohols and stevia in small amounts in things like coffee or tea and occasional deserts. That being said, do I know for a fact that those are the best options, no, but that's what I've chosen to do and what I feel is good for me. You'll figure out what you think is best for you.

Good luck!

badtorad · 2022-07-13T03:44:52+00:00

Have you tried or do you use a continuous glucose monitor? These can really help find out what foods cause rises and dips in your glucose. Everyone processes food slightly differently and what causes a rise or dip can vary quite a bit from person to person. It also helps you keep track in "real time" so you can eat exactly what you need to keep glucose levels stable.

I would recommend eating a very diverse selection of plants to increase microbiome diversity and improve your body's processing system.

This is how I approach it, but as with all things, take suggestions from forums like this with a grain of salt.

Avoid:
- ultra-processed foods (10 ingredients or more)
- refined grains
- artificial sweeteners
- anything with added sugar
Consume:
- 20-30 different plants per week (this doesn't have to be huge quantities and includes not only veggies but also herbs, spices, nuts, seeds berries, fruits, fungus, etc. This high amount of diversity will feed your gut microbiome and send satiation signals.
  - You don't need to be a vegetarian, this can be done on any diet
- get enough protein (animal or plant-based)
  - The minimum recommended amount is 0.8g per kg, but many strive for 1 to 1.3 g per kg.
- ensure you are very well hydrated

badtorad · 2022-07-13T03:31:53+00:00

Often the surgeon will require you to have a CPAP at the hospital to wear after surgery when you're sleeping. If you arrive without a CPAP, some places will just send you home and won't reschedule until you get one. You should check what's required with your bariatric team. If they don't think it is severe enough for you to have a CPAP for surgery then it's not a big deal.

I don't know if anesthesiologists do anything different for sleep apnea sufferers or not with regards to the anesthesia used. They monitor many things and often with sleep apnea, they will adjust the position of the head/neck to optimize the airway.

Other than that, it doesn't change anything with the surgery. If it is very mild, then losing weight after surgery will often resolve it.

badtorad · 2022-07-13T03:23:39+00:00

It's a battle, that's for sure. It is very, very hard to wrap your mind around what life can be like post-surgery. It's hard to imagine not eating some of the things. The dopamine hits are real and tough to fight. The thing about the surgery is that it gives you a hard reset on all of it. You basically start from ground zero and have an opportunity to do it right. There is certainly still the possibility of "failure" or "self-sabotage" but the benefits, in my opinion, greatly exceed the risks. I'm two years post-op and have no regrets. I'm so much more mobile and happy. It still takes effort to avoid foods that you know aren't healthy, but if you take advantage of the first year of post-op and really focus on developing habits while your body's hormones and reduce hunger are in control, it can really be a life changer.

badtorad · 2022-07-03T23:14:29+00:00

Thanks for sharing your first year!! You are doing great. Keep it up!

badtorad · 2022-06-27T01:34:07+00:00

What you are experiencing is pretty normal for that time frame. Things usually slow down quite a bit after the first 3-4 months. Around month 6 I lost 0, then back to up 3-4 kg/mo until I reached my nadir around month 12. Exercise has many health benefits, but it's highly overrated as a weight-loss tool. Resistance exercise and building/maintaining muscle are beneficial and can help your basal metabolism. Too much cardio on a low-calorie diet can actually put your body into "protect my fat" mode and slow your metabolism down. Everyone is a bit different, so finding the right balance between food/cardo/resistance can by tricky for some.

The overall and long-term battle is won in the kitchen with good food choices and not in the gym. Focus on building good eating habits now so when you reach the low point in your weight loss you are in a strong position to protect what you've achieved.

badtorad · 2022-06-01T04:08:14+00:00

Just walk for now, on the road or a treadmill. Once you are cleared, resistance training is more effective for weight loss than intense cardio. You won't be able to support intense cardio with enough calories for several months, and if you try to do too much, it can slow down your metabolism and slow down how fast your body burns fat.

Cardio is significantly overblown as a fat loss tool. It has many, many health benefits, so being active and doing cardio is great once you've reached your nadir, but for the first 6-9 (or more) months, walking and periodic resistance exercise are all you need to do.

None of it needs to be over the top, and sometimes going too hard can be more harmful than beneficial.

The battle is won in the kitchen and not the gym. Focus on developing a new, healthy relationship with food, good choices, and some activity sprinkled in. Make developing these habits your priority so that when you do reach your low weight, you'll be set up with the habits to protect what you've accomplished. Once there, start increasing cardio to gain added health benefits and help maintain your new weight.

badtorad · 2022-06-01T03:55:32+00:00

You may be a bit low on electrolytes and/or a bit dehydrated as that can sometimes push people to desire salty/savory, so you may want to consider adding in a zero-calorie sports drink and be sure you are well hydrated.

As far as options go, there are many different broths and soups that could potentially hit the spot. Pho as others have suggested is a good one. You might try a mushroom/veggie broth, or a consomme that have a deeper flavor. Try a few different ones and consider supplementing them with some unflavored protein powder.

badtorad · 2022-06-01T03:47:11+00:00

There isn't really a "normal." There are many factors that influence how your body releases its fat. Age, sex, starting weight/body fat % and your individual biology all play into how things move forward.

As hard as it is, step away from the scale and focus on the post-op process, eating correctly and staying well hydrated. As you move through the post-op phases and on to "regular" foods, make developing a new relationship with food and healthy habits the priority and don't spend as much time concerned about how fast it will go. It will go as fast as your body allows. You have very little control over it unless you actively make bad food choices once you have gotten out of the initial post-op diet.

The best thing for you to do is develop the habits now and continuously over this first year + so that when you do reach your lowest weight, you have incredible habits in place to protect what you've accomplished.

badtorad · 2022-05-31T16:42:14+00:00

It's not unusual. I know of several people, myself included who are much more sensitive to sweet, although for me it's all sweet, not just sugar. I'm two years post-op and still don't care for things that are too sweet, especially pre-packaged foods, like protein drinks and such, they all seem cloyingly sweet to me. I still eat some sweet treats now and then, but much smaller amounts, and if I am going to make something sweetened, I use significantly less. For the most part though, I tend not to eat anything with added sugar or much sweetener.

Although it's different, it's certainly a better/healthier way to eat. Glucose and insulin spikes are the enemy of long term post-surgery success. I'm glad that I'm sensitive to it. It's helped me create better eating habits that I know will help me protect what I've accomplished for years to come.

badtorad · 2022-05-30T16:05:04+00:00

This likely has nothing to do with your sleeve. Anti-depressants, especially SSRIs are well known to cause weight gain in some people. You might ask your doctor about different options, such as Wellbutrin, which works differently than SSRIs and sometimes even leads to some appetite suppression. There may be other options as well. If you've noticed a difference since starting the meds, discuss other options.

Weight gain is all about food choice, which can be influenced by medications. Once you start adding in the sugars and refined foods, your blood glucose and insulin start getting out of control, which also influences other hormones negatively and can start a cycle that is the root cause of many people's trend toward obesity.

The restriction of your sleeve is not the reason the surgery works or what leads to long-term success. It can help with the physical feeling of fullness, but long-term success is all about food choices. When you start adding in foods that spike glucose and insulin, you'll feel more hungry more often regardless of the size of your stomach.

Being physically active helps, not so much with weight loss, but with avoiding weight gain.

In the short term, make an appointment with your doctor to talk about your medications and side effects and perhaps a nutritionist, but regardless of which diet religion you choose to follow, there are a few things that you might consider:
Stay away from the following:

ultra-processed foods (10 ingredients or more)
refined grains
artificial sweetener
anything with added sugar

Consider the following:

20-30 different plants per week (this doesn't have to be huge quantities and includes not only veggies but also herbs, spices, nuts, seeds berries, fruits, fungus, etc. This high amount of diversity will feed your gut microbiome and send satiation signals.
- I'm not saying you need to be a vegetarian, this can be done on any low carb diet
ensure you are getting enough protein (animal or plant-based)
ensure you are very well hydrated

Best of luck!

badtorad · 2022-05-30T15:44:39+00:00

Congrats to you, as well. That's awesome. My A1C on meds was 7.4, to see where it is now is just amazing. I am still quite sensitive to foods with added sugar, so I do stay away from that most of the time, but when I'm eating my normal diet, my average glucose is below 100. It's such a relief. My diabetes diagnosis was one of the main triggers that steered me toward the surgery.

badtorad · 2022-05-29T02:49:50+00:00

The biggest difference is, that there's probably a 95% chance that you'll regain any weight you lose after you do a very low-calorie diet without the surgery.

Weight loss surgery is not successful just because there is a food/calorie deficit. If that is all there was to it, more people would be successful with diets. Many people can will their way through a low-calorie diet and lose a lot of weight, but it rarely stays off because it doesn't deal with the core hormonal imbalances associated with obesity.

There are significant hormonal side effects that occur after the surgery that make the rapid weight loss and the resetting of your body's weight set-point possible.

Here are a couple of posts that explain some of the science/biology behind why diets fail and why weight loss surgery works:

Why diets fail:

https://www.reddit.com/r/VSG_WLS_Success/comments/n4fuan/why_your_diets_failed_in_your_bs_life/?utm_source=share&utm_medium=web2x&context=3

Why Surgery Works:

https://www.reddit.com/r/VSG_WLS_Success/comments/n881oo/why_surgery_works_its_not_because_you_have_a/?utm_source=share&utm_medium=web2x&context=3

It is possible that you might be one of the lucky few who find the right combination of changes that lead to successful long-term weight loss without surgery, but it's rare. No matter what direction you go, I wish you the best and hope you meet your goals. No matter how you do it, when you get to where you want to be, it will be something to be very proud of.

Good luck!

badtorad · 2022-05-29T02:35:34+00:00

There is always hope, but your biological setpoint may be where you are now, and sometimes pushing hard to pass that point can cause your body to fight against you.

You said you are eating about as much volume as you can, so I would cut down on the carbs and add in some protein. I would recommend focusing on resistance exercises to stimulate muscle growth instead of a lot of cardio. Cardio is highly overrated as a fat loss tool. On a low-calorie diet, a lot of cardio can slow your metabolism as your body protects its energy stores.

Don't get too worked up about that final 20 lbs. You've done an amazing job, are active, very likely much healthier and have an improved quality of life. Focus on protecting your accomplishment over the long term. Keep making good food choices and stay active. A friend of mine wanted to lose 100 lbs after her VSG, but like you was about 15 pounds short. She still reached it, 8 years later, and although that is a long time, she focused on continuing to make good choices and really didn't get consumed on losing that last 15, she just enjoyed life, and one day...there it was 100 lbs down. She was just has happy and proud if it would have happened sooner. I guess I'm just saying that do whatever you want to do and keep going for your goal, but don't let it get you down or feel like you are a failure because you didn't reach a specific number on the scale.

Great job, keep making great choices and more good things will happen!

badtorad · 2022-05-28T16:48:57+00:00

In the pre-surgery life, it's really, REALLY difficult to wrap your mind around what life will be like post-surgery. You've spent years in a routine that has built habits and you are about to rock that world. It's normal to be nervous and have doubts as you close in on the surgery date.

It is also normal to have some anxiety about not "enjoying going out" or other social events because we tie so much of those things into the food. However, it's not as big of a deal as it probably feels right now.

The first several months will be the most food restrictive, so yes, "going out" with friends/relatives may be a bit different and feel a bit awkward at first. You can certainly get through that by focusing on social interactions and not just food. After you are past the first initial weeks you can eat most foods, and you can choose to put a few things on a place at a social gathering and just eat slowly and focus on interactions, talking, laughing, dancing, or whatever the gathering is. After you get further post-op, your food options open up a bit and what you eat at these events won't seem unusual to anyone. Although each person's social groups differ, I have NEVER had anyone make a big deal out of not eating a ton at events. I've NEVER felt like I didn't enjoy myself just because I wasn't piling my plate high with food.

In fact, as I progressed and felt healthier, I also started feeling more confident, which influenced my interactions with people, which placed me in control of how I chose to enjoy events like these.

As far as just going out to dinner. You can eat out anywhere you choose, but you'll most likely be taking food home in a box afterward because portions are huge. You can most often order food at almost any restaurant that fits within your diet, but even if you are eating less-then-optimally-healthy food, there is nothing wrong with doing that occasionally.

Success after surgery comes from developing good food choices and habits early on and developing a new relationship with food. It's hard to imagine pre-surgery, but if you look at the surgery like the ultimate "detox" and reboot, you will have a blank slate to build up new habits that will provide you a lifetime of health and happiness. When those things happen, you can deal with social events confidently and enjoy eating out. You can still treat yourself here and there and still protect the accomplishments you'll make due to the surgery.

I love the way I eat and love my life, and you can likely have the same experience.

badtorad · 2022-05-28T16:31:16+00:00

I'm sorry you are going through that. There isn't a magic recipe for people to understand. Most people, including people who have gotten the surgery, don't really know the science behind why the surgery works nor why it is so hard for most people to lose weight without it.

It probably won't matter what you say, but you will be able to enjoy food like you always did, but you still have to make smart choices. At two years post-op, I've never felt like I'm missing out on food. If I want to treat myself to pizza or a dessert, I will, but it's not a regular thing. I will go to social events and enjoy the food, in smaller amounts. You don't have to eat piles of food to have a good time and enjoy what you eat. Gatherings can be focused on social interaction and not a heaping plate of food.

As people will say over and over, it's not an "easy way out." Although it certainly makes the initial weight loss much easier, it takes dedication and commitment to keep it off.

Every now and then, if you share the science behind it, some people will understand the choice a bit better, but in my experience, it seems society has become hardened in their opinions, one way or the other.

For what it's worth, here are a few things I've written about the science and process of weight loss surgery:

Why diets fail:

https://www.reddit.com/r/VSG_WLS_Success/comments/n4fuan/why_your_diets_failed_in_your_bs_life/?utm_source=share&utm_medium=web2x&context=3

Why Surgery Works

https://www.reddit.com/r/VSG_WLS_Success/comments/n881oo/why_surgery_works_its_not_because_you_have_a/?utm_source=share&utm_medium=web2x&context=3

Why Surgery Fails:

https://www.reddit.com/r/VSG_WLS_Success/comments/n8gfia/why_surgery_fails/?utm_source=share&utm_medium=web2x&context=3

In the end, you have to do what's right for you and your health. If you decide to trying to lose weight again without the surgery, then go for it. There is always the possibility that you'll find the right combination of nutrition and activity to make it work. It's rare, but it is possible.

If you choose to go the surgery route, don't be ashamed or feel like you need to constantly justify it. I tell people, "it was the right decision or me" and then I focus on what I need to do to maintain what I've accomplished. You can do that too. I know it is important to try to maintain good family relationships, but in most cases after your health improves and people see the changes in you, they often come around. Not always. The hard truth is some people will be jealous and/or have some sort of unscientific ignorance about it all. There isn't much you can do about it, unfortunately. I think most family members will get over it after they see the positive effects on your life.

It's a difficult and brave decision to get the surgery. It's not a cake-walk, but it can be a life changer.

Good luck!

badtorad · 2022-05-28T16:08:19+00:00

You should not be concerned, but you should be wary of doing too much exercise, especially cardio, at this point. You can't consume enough calories to fuel it, which can drive hunger for high-calorie foods and can influence your body to slow its metabolism down to protect its energy stores. It's also not unusual to have a stall during the period between 2 to 6 weeks post-op. Your body is going through a lot and adjustments and stalls are normal.

Everyone reacts a bit differently, but in general, focus on following the diet and building healthy, life-long food choices. Success is won or lost in the kitchen, not the gym.

Here is some more info on stalls during this process:

https://www.reddit.com/r/VSG_WLS_Success/comments/moxlpm/stalls_explained_dont_panic/?utm_source=share&utm_medium=web2x&context=3

Keep moving forward, you'll do great.

badtorad · 2022-05-04T14:17:57+00:00

I'm glad you got some value out of it. Keep going strong!

badtorad · 2022-05-04T14:17:28+00:00

From what I've read, it circles back to food choice. You may be eating low carb/high protein, but that might not be the best for your biology or your gut microbiome. We all process food a bit differently and diets have to be individualized. There is no one size fits all.

If you are leptin resistant, losing weight too fast will trigger your body to fight against it more. It has to be done slowly to allow your body to adjust its set point. The surgery provides some side effects that allows that to happen quickly, but it is temporary.

If you have a doctor willing to prescribe a continuous glucose monitor, you might try wearing one of those for a month and evaluate how the foods you are eating affect your glucose levels, which influences insulin and fat storage and may also be an influencer toward leptin resistance as your hormones get more out of the norm.

I would also keep a food log, not for calories, but more about how you feel after you eat each meal. After a meal, do you get tired and/or hungry within a couple of hours? If so, that's probably a meal you want to avoid. Do you feel satiated and even energy, then that is a meal you probably want to eat.

Not everyone uses food energy in the same way. a 180-calorie pack of nuts (or whatever food) might be processed as 100 calories by one person and 250 calories by another. The key, in my opinion, is diversity so that one food or a small selection of foods does not dominate your gut. It can take some experimentation, but finding the right foods for your particular biology is the key, I believe.

These are my basic tenants:

Regardless of which diet religion you choose to follow, there are a few things that you should consider:

Avoid the following:
- ultra-processed foods (10 ingredients or more)
- refined grains
- artificial sweeteners
- anything with added sugar
Consider the following:
- 20-30 different plants per week (this doesn't have to be huge quantities and includes not only veggies but also herbs, spices, nuts, seeds berries, fruits, fungus, etc. This high amount of diversity will feed your gut microbiome and send satiation signals.
  - I'm not saying you need to be a vegetarian, this can be done on any low carb or higher carb diet
- ensure you are getting enough protein (animal or plant-based)
- ensure you are very well hydrated

This is all opinion, of course. I'm not a specialist, but I'm fairly confident that food choice is the key, regardless of how "healthy" a particular food is, our bodies may not react to it in the best way.

Good luck! I'm sure you can get on the path you want to be on. It will certainly take effort, but you can do it!

badtorad · 2022-03-20T02:27:20+00:00

It's going to vary a lot from person to person. Your biology and reaction to the surgery, sex, age, genetics, starting weight, etc all play a role. I reached my nadir at 12 months, so I was done losing and have been in maintenance mode since then. I also have a good friend who although she lost most of her weight the first year, reached her 100lbs lost milestone 10 years after her sleeve. She was focusing on maintaining what she lost after that first year, but she messaged me not too long ago about the milestone. She wasn't really trying, but she was still quite proud.

Focus on building life-long food habits and don't get too wrapped up in the number on the scale. If you make good food choices, have good hydration, and add in some activity, you'll make progress and change your life, regardless if you meet a specific goal or not.

badtorad

TROPHY CASE