Are they making you do liquids? If so and you want to "cheat", just eat high protein, low carb. Because that's what clears out the slime in the liver, not being on liquds.

And don't get me started on the whole mandatory pre-op diet thing...

A LOT of the programs say #2. What I have found is that hunger is HIGHLY individual. So a protein shake may hold you or it may not. Only you can decide, not your surgeon and not us. I find that one for breakfast and a protein hot chocolate at night really holds me. But that's me.

For #3, again I think that depends. Our stomachs start to empty sooner than they used to. So eat too slowly and the next thing you know, you will be eating more. But eat too fast and your brain doesn't register the fullness.

For #5, snacking (grazing) is different than planned snacks. Planned snacks are basically meals. You can eat 3 meals a day or you can eat 6 or something in between but as long as they are planned, I think you should be fine.

For #7, I think it depends on how far out you are. For the first 6-12 months for everyone and all the time for people who maintain on 1000-1200 calories a day, you need to keep your calories under 800 to lose. But as you get farther out from your surgery and you aren't a tiny gal who doesn't work out, it begins to feel like depravation and it's hard to keep up. I think once you are more than a year or two out from surgery and are used to eating 1500 calories a day or more, that dropping down by 500 calories a day works better. Heck, you may want to drop down by 250-300 at first. Because that's doable.

123

Well the scale measure our mass -- how much gravity pulls against us. So in that sense, it does not lie. But it doesn't measure how fit I am or even how good I look. I have been all sorts of weights in the past 4 years and knowing my weight would not tell you how i looked. In fact, I wrote a blog post about complete with pictures:

http://fattyfightsback.blogspot.com/2013/04/this-is-what-nor mal-bmi-looks-like.html

When you look at the pictures you can see that I've been 125 and pudgy and 125 and ripped. So I can't get too excited about the actual number. I get excited about how my clothes fit and how I look in the mirror and I use the number to support my other data points.

I think forcing ourselves to eat more than our tummies comfortably hold is always a bad idea. It's setting ourselves up for trouble latter when we can eat more. It's certainly not part of mindful eating to force more food in than fits comfortably either and I think mindful eating should be the ultimate goal.

I also have seen in my 5 years on the forums that programs that push more than 800 calories in the losing phase are not as successful on average. Especially for some of us lightweights. Many of us are SHORT. And we will end up maintaining on a small amount of calories. Maybe only 1000-1200. So doing 1000 at 3 months out? Bad idea IMO.

Now maybe later, especially if you are working out intensely and need more protein. More protein is going to bump your calories up IME. I think I was doing 900 a day when I was doing 90 g of protein and then 1200 a day when I was doing 120 g of protein. But I was also working out 6-8 hours a week at that point. And also at a normal BMI.

Some surgeons think it it's a gimmick but they are the surgeons with "magic hands". For the mere mortals, I think it helps. 

ALL WLS gives you hunger control. Bypass, sleeve and DS all do that. Lapband even does for some.

If you look at the data, long term results with sleeve and RnY are about the same so I suspect they give similar hunger control. 

However, VSG removes the part of the stomach that produces most of our ghrelin, which is the hormone that make people feel hunger. In some studies, they've found that long term RnYers have ghrelin levels that are the same post-op as before but with VSG ghrelin levels are almost always reduced. OTOH, with a lapband, ghrelin levels *increase*.

Of course ghrelin isn't the only thing that makes you hungry or lapbanders wouldn't have hunger control and some of them do (the ones who find their sweet spot). But I knew pre-op that most of my hunger was driven by ghrelin so I was very sold on having it removed. I'm 4.5 years out now and I have below average hunger levels. I still have to make myself eat sometimes because if I ate to my hunger, I would be too thin.

Since I didn't have RnY, I have no idea if that would also be true of RnY but I know a lot of my RnY friends talk about the hunger coming back "the same as before". Honestly, I don't really believe that. I think their hunger must be reduced from before or they'd gain all their weight back. But the studies show their ghrelin levels are the same so maybe they do have the same amount of hunger and it's other things that are keeping their weight off.

OTOH, Dr Roslin just wrote this article for OH that talks about this and he seems to think all long-term weight loss success is hunger control and he says sleeve and bypass end up performing about the same so I suspect the hunger is about the same in the long run.

Here's Dr. Roslin's article where he talks about all 4 surgeries and about how hunger control is what makes WLS work:

http://www.obesityhelp.com/articles/choice-of-bariatric-proc edure-a-philosophy-obtained-in-20-years-of-bariatric-practic e-2/

123.

 

I agree with LadyTazz that it's unlikely that insurance in the US will pay for bypass surgery with a BMI under 35. However, I don't agree that it's not done in the US as a self-pay with a BMI under 35. It's done *all the time* and many surgeons in the US will do it if you are willing to pay for it. Many. Mine does and so do most of the top surgeons. They are just QUIET about it.

That is probably because most countries have a protocol to do it if your BMI is 30-40 and you have co-morbidities while in the US, the protocol is 35-40. But a BMI of 30 is OBESE. That's a lot of weight and studies show that it's unlikely to come off and stay off with diet and exercise. (In case you can't tell, I think the US standards are lame and agree with the rest of the world that it should be 30 and not 35.) So it seems like the surgeons will do it but they are quiet about it since that's not the official standard.

 

And, yes, the standard was lowered for the lapband so that insurance might pay for that with a BMI between 30-35. However, just because the FDA gave approval for lapband use in that BMI range doesn't mean insurance companies have changed their policies.

There are definitely some people who frequent this Board who had WLS with a BMI lower than 35. Hopefully they'll see this message and chime in.

Here's what I did the entire first year:

http://fattyfightsback.blogspot.com/2010/07/calories-protein -carbs-exercise-weight.html

I was freaking out all day even after I figured out all my friends were okay. It just felt so personal. Is that how it felt when they crashed a plane into the Pentagon, Major Mom.

Me too! Only it's 6 hours later. LOL