Photos

Carmelita's Denouement
Journey of a Well Worn Fat Suit


Stalls and Plateaus


                               
To help tackle EMOTIONAL EATING online...SHRINK YOURSELF  visit  
http://www.shrinkyourself.com/?bhcp=1

Coach Calorie Ultimate Fat Loss CHEAT SHEET http://www.coachcalorie.com/weight-loss-cheat-sheet/

For IRL OVEREATERS ANONYMOUS group in your area.. visit  FIND A MEETING



For online, IRL meetings n help FOOD ADDICTS ANONYMOUS ...visit 
http://www.foodaddictsanonymous.org/

For VSG emotional eating testimonial & strategies Kellawanda's YOUTUBE videos I highly reccommend them ALL


Are you familiar with the PHYSICAL SIGNS OF HUNGER? stomach rumbling, being lightheaded, shaky, poor concentration and headaches. 
                                        
Are you familiar with the NON-PHYSICAL/APPETITE signs of hunger? - emotional, boredom, taste, "scheduled time to eat" and social situations.

On distinguishing between HEAD HUNGER and REAL hunger please take a look at this post
http://www.obesityhelp.com/forums/vsg/4368324/HEAD-HUNGER-8-signs-emotional-eating/#36096100

Identify YOUR  head hunger/emotional eating patterns by doing this simple Shrink Yourself exercise
www.shrinkyourself.com/get_instant_help.asp


DOCUMENT YOUR JOURNEY!! 
Concrete evidence your SLEEVE is WORKING even though the scale doesn't say so!


**** MEASURE YOURSELF ****
Take your Baseline measurements 1 week before or after VSG
Everything inc. foot width and head width. Record them
Re-measure yourself every 1-3 months. 


****WEIGH YOURSELF**** 
Weigh daily (if you must) but please record your weight ONCE a WEEK only.  Allow for periodic hormonal flux (menses), IV fluids, travel, i.e. contributors to water retention/re-gain up to 5 pounds



****TAKE PICTURES****
front, back, side profile, arms out 
Thereafter once a month
--------------------------------------------------

You may read or hear about VSGrs sayin they don't get hungry, and that they have to remind themselves to eat.  Wondering why not ME!! It will be YOU!  Someday....but few VSGrs report this LASTING long term.  I lost all physical and non-physical signs of hunger at 10 months out. You may experience this event at some other point, before or after.  EVERY*BODY* is different.  
You must keep your calories at proper levels based on such things as activity, gender, BMI even though you do not feel true hunger. Setting your clock to every 3 hours to get some calories (energy) in during this mode. Your body will go into "famine mode" :  your resting metabolic rate decreases.  One of the biggest culprits of Re-gain, poor weight loss, and over-eating at meals...is SKIPPING MEALS!


DO NOT get in the BAD HABIT of comparing your weight loss journey to anothers. It is self-defeating behavior. 
                              _____________________________________________________________

A Stall is no weight loss in LESS THAN 4 weeks
A Plateau is no weight loss in 4 weeks and OVER

Classic (common) VSG stalls during the 1st year post op. occur around 3 weeks, 3 months, 6 months, 9 months and may last anywhere from 1-6 weeks. The 3 week stall is the TOUGHEST to break imo, due to post op dietary guidelines/restrictions. Frustrating! and definately can cause unfounded worry that your VSG is not working!  So important to keep measurement logs as during VSG stalls often notice we've lost inches NOT pounds, concrete evidence our sleeve is indeed working even tho the scale says otherwise! These INCHES LOST are gone forever!  Technically it isn't a STALL/PLATEAU during our 1st year ..as our bodies are STILL WORKIN on changing ... those adipose fat globules shrink, take up less space, redistribute, and get ready for the NEXT BURN PHASE...once we're out of that stall, the scale moves on down and so it goes.  Majority of VSGrs report their weight loss.. as a STAIR STEP DESCENT...note the word DESCENT...we lose , we flatten out (stall) ....we lose, we flatten out (stall)...down each step during the rapid fat loss phase of VSG. 
PATIENCE and sometimes downright EXTREME PATIENCE is needed to get down that next step.

Majority of time there are reasons why our stalls/plateaus last as long as they do, and many times WE KNOW WHY we're at a standstill in our weight loss. We ARE or ARE NOT doing something that prolongs them. .  

     
                                                      MY PERSONAL WEIGHT LOSS GOAL



Optimize this fat-burning PHASE! because AFTER the initial 6-8 months of VSG.... weight loss slows considerably. 
1 year post op.. stalls/plateaus are usually elective or your body may have reached  " the set point:"..is tellin you.....Im done, Im ok, this is me, love me or keep workin on it! .....Documented studies show individual VSGrs actively losing weight into 2 years post op. 


OPTIMIZE this rapid fat loss phase  ( first 6-8 months post VSG) to get to YOUR personal goal by staying and caring to be accountable to YOUR individual

NUTRITIONAL NEEDSfood: quality, choices, and portion size inc. water intake, vitamin and mineral supplementation
ROUTINE EXERCISE
and SLEEP !



             *****KNOW THAT THIS STALL WILL PASS!  THEY ALWAYS DO***** 
                                IF you want them to by changin it up! that is ,-)



IT IS GOOD TO HAVE AN END TO JOURNEY TOWARD...
BUT IT IS THE JOURNEY THAT MATTERS IN THE END

                                                                        Ursula Leguin

  YES to  POSITIVE... NO to NEGATIVE  your attitude on this journey makes ALL the difference in the world!

                                                
                                               ___________________________________________

Our bodies are very complex and adaptable machines, food ruts, and exercise becomes mundane  
                                 WAKE IT UP, SHAKE IT UP, BOOST YER METABOLISM

Best stall breaking tips....  


1. UP YOUR CALORIES, 4-5 measured portions/ mini meals a day. Mini MEALS...every 3-4 hours. This goes against everything we know or are told by our surgeons. Calorie shifting to break these stalls WORK!  (see link about calorie shifting below).  Eventually limiting calories intake does work but sometimes 'stall breaking!" , ya got to TRICK yer brain out of starvation/famine mode (adaptive thermogenesis for all you scientists out there!)

2. SHAKE UP your exercise routine... body adapts quickly to the mundune ...break a sweat, change routine for a few  days, and you break yer stall. Aerobic exercise FIRST very important! BRISK walking, jogging, sprinting then slow walking repeat. SWIMMING (aquacize! yes it IS possible to SWEAT IN WATER!) Stength/weight training is very important in ^weight loss. Ladies..up the weight..we get too used to using small weights, which wind up having little to no effect on burn. SAUNAS! 30 minutes great to help eliminate TOXINS (like adipose fat!) that accumulate in our bodies.

3. INCREASE  water intake (a simple reminder/trick-divide your current weight in half. That number is the amount of ounces of water to AIM for)...If your pee (AFTER the first morning void) ...is not a pale yellow or pale neon ,-) greenish-yellow (vitamin B2-riboflavin supplementation) ..you ARE dehydrated!!  Use tall wide cups, and a straw ...can get more in throughout the day

 

...please consult with yer NUT when you are permitted to use a straw so you aren't swallowing any more air that can cause increased pain for a newly post op.
  
PLAIN COLD FILTERED TAP (local) WATER is best. HIBISCUS, GREEN, ROOIBOS, WHITE or BLACK TEA great too! 

SUGAR
 SUBSTITUTES: Use STEVIA, LUO HAN GAU Extract, XYLITOL i.e  vs. other artificial sweeteners that can CAUSE sugar/carb cravings later on!!



4.  Get NUTS** about PROTEIN and VEGGIES!!    
        
       LEAN PROTEINS  FISH!  CHICKEN, TURKEY, GAME MEATS (AVOID SKIN!!) 
       Meal needs to be ~75% protein based. At each meal eat PROTEIN FIRST.
       
Still have room?....veggies next. Protein is the log on our metabolic furnace. Keeps us full for longer. Thermogenic takes more energy to burn than the kindling (carbohydrates) on our metabolic furnace.  Little affect on insulin. Saves and builds muscle  (major calorie burner!!)

       Use Protein MR (meal replacement) or Protein Whey CONCENTRATE supplement SHAKES (avoid whey isolate-isomers rancid protein-acid processed not alkaline like reg whey!!)
   
       FIBROUS VEGGIES best!  
       Veggies and Nuts as close to RAW as possible, lightly steamed.boiled  
       Almonds, Walnuts are great source of fiber too!

      Avoid  ALL fruits** except avocados*, olives, berries, coconut  & small citrus*
       LIMIT  starches inc bananas  (unless green), potatoes, corn, rice  and grains
      LIMIT refined and processed carbs - flour grain containing products
       Cooking??  Use coconut oil!!  vs. hydrogenated & partially hydrogenated oils    (note smoke point of cooking oils) 
             Organic Coconut Oil at WalMart is about $5.oo  A little goes a LONG way!  
                http://www.organicfacts.net/organic-oils/organic-coconut-oil/health-benefits-of-coconut-oil.html

    
                           
         * If watching calorie counts and strict lo carbing it  limit or omit these items from your diet

 **IF the liver toxin sugar: fructose in fruits/vegetables/sugars is a concern please research "fructose charts" online to view content.

 interesting articles on effects of fructose and levels in fruit chart & fructose in carbs effect on fat storage and leptin resistance
articles.mercola.com/sites/articles/archive/2012/05/07/the-sweetener-that-is-more-dangerous-than-alcohol.aspx


http://articles.mercola.com/sites/articles/archive/2012/08/18/fructose-and-the-fat-switch.aspx?e_cid=20120823_NewWNL_art_3      

                     ~~~~~~~~~~~~~~~~~~~~~~~~~~~~

       Lo Carb recipe/menu/food planning ideas inc: 

ATKINS  http://www.atkins.com/Recipes.aspx?searchmode=all  +  Atkins LoCarb Recipe Forum 

Linda'sLoCarb  http://www.genaw.com/lowcarb/recipes.html                  

Coach Calorie Healthy Foods http://www.coachcalorie.com/healthy-recipes/             

Eggface   http://theworldaccordingtoeggface.blogspot.com/ 

LighterSide http://yourlighterside.com/your-lighter-side-cookbook/       

Paleo Diet    http://www.paleoplan.com/recipes/                                

Bariatric Foodie    http://bariatricfoodie.blogspot.com/  

SkinnyTaste   www.skinnytaste.com/    

Maria Blogspot Weight Loss    marianutrition.com/                                                        

 DETOXONISTA (vegan vegetarian) http://detoxinista.com/recipes/most-popular/                                                  

and  20 Protein Powder Recipes
                     
                                                                          

5.  
AVOID most types of refined processed  CARBOHYDRATES in LATE AFTERNOON/EVENING...keep meals heavier on protein meat/meatless/complex carbs-higher in protein content side. higher protein as your evening meal will help you sleep too (amino acids tryptophan, arginine, lysine, glutamine i.e) ....WAKE UP to liquid PROTEIN breakfast within 1 hour of waking, pre workout or if intermittent fasting (12-16 hours no solid food) ....solid protein/ carbs ok thereafter


6. GRAZING /Snacking??     Catch yourself...YOU ARE THIRSTY NOT HUNGRY.  DRINK INSTEAD
ANY time you think of grazing/snacking grab that water!! carry a water bottle around like its your baby! 


  
Give your body at least 3 days trying these techniques to break the stall..does or doesn't work? ... go back to calorie restriction 
Our post op dietary manuals say NOTHING about stalls & plateaus. Only about calorie restriction, i.e. 600 to 800 calories until goal reached,  then 1000-1200 calories thereafter with emphasis that its individualized requiring follow-up with your nutritionalist.

CALORIE SHIFTING
 http://www.articlesbase.com/nutrition-articles/diet-plateau-avoided-by-calorie-shifting-1034944.html           

Calorie Shifting Breaking a Stall   http://www.coachcalorie.com/how-to-break-a-weight-loss-plateau/     
                                              
                                             __________________________________________
                     
                                                    ****  5 DAY POUCH TEST ****
                                                           (link below)


FOR VSGr's at least 6 months post op or further.......THE 5 DAY POUCH TEST (5DPT) may be helpful. Developed for RNY but useful tool for us VSGrs as well. 
It is a back to basics program and I have found it useful in breaking stalls and jump starting my weight loss. You will get that restriction tightness feeling in your pouch/stomach back..CONFIRM your restriction is STILL THERE and NEVER LEFT!!

There is no need to purchase the manual. All the information you need to jump start your weight loss is there! Be sure to prepare for each subsequent day in advance, to ensure your success.  The recipes tab...is quite helpful! 

You must adhere to it as IT IS WRITTEN! Do NOT deviate. ITS ONLY 5 DAYS!!. It is basically a carb-detox schedule of 5 days. ALL CARBS are SUGAR/STARCH...yes even good healthy complex carbs!

Carb withdrawal symptom most common is a severe headache, or irritability ~day 2, as you go into ketosis. This resolves by day 3...as your brain adjusts to using ketones (fatty acids) vs. glucose as the primary fuel.  By Day 3 you'll also find you aren't as hungry anymore! 

Our bodies take ~48 hours to CARB DETOX and go into ketosis (strictly adipose fat burning mode).  Greatest weight loss  (typically 5 in 5 .... 5 pounds in 5 days) normally occurring on 4th and 5th day  Please pay xtra attention to what you are eating on day 4&5  that makes this so! 


I highly rec. that on Day 4...for possible constipation 
...add 2 TBS SF Metamucil /psyllium generic to your sf pudding  ...will give vanilla flavor an orange creamscicle taste. Thin with milk/  almond milk. ...Do not add water/make a drink of sf metamucil.  The water you drink between meals will be sufficient.

or ...Senekot laxative ( vegetarian friendly-senna/sennosides) ~17mg before bed      
or... Epsom salts..1 TBS. in 8oz of  warm water ..stir till dissolved...use a straw cuz it tastes nasty!! suck on a lemon or tomato slice right after.  lots of water between meals
or...Miralax..follow directions ~ 17gms, lots of water thereafter
                                  
Day 6 and beyond  ..don't lose your momentum!! ...continue these principles......and  slowly start to incorporate HI FIBER veggies into your diet...I highly recommend ATKINS induction phase 6 days and beyond as a starting point/guideline since you're still in ketosis "fat burning" mode following the 5DPT. 
    
                                             
                 http://www.5daypouchtest.com/plan/theplan.html   5DPT the plan
                       

                 http://www.youtube.com/watch?v=-12I8ziXSPE   5DPT video by author

IF the 5DPT is just too much to handle. I highly recommend doing the FIRST TWO DAYS ONLY.  A liquid protein based FASTING (NO SOLID FOOD!!) for 2 DAYS. Slowly incorporate HIGH FIBER complex carbs higher in protein into your diet.
                  ______________________________________________________

                                             OH MAGAZINE ARTICLE link ON PLATEAUS

                                    http://picadmin.obesityhelp.com/magfiles/pdf/Plateaus.pdf

                                          _______________________________________


 
DOCUMENT YOUR JOURNEY!!
Concrete evidence your SLEEVE is WORKING even though the scale doesn't say so!


**** MEASURE YOURSELF ****
Take your Baseline measurements 1 week before or after VSG
Everything inc. foot width and head width. Record them
Re-measure yourself every 1-3 months.


****WEIGH YOURSELF**** 
Weigh and record your weight ONCE a WEEK.


****TAKE PICTURES****
front, back, side profile, arms out
Thereafter once a month
_____________________________________________

SOME AREAS TO LOOK AT:

Are you tracking your food intake in a food journal? or online (links below)

Are you tracking every single calorie that passes your lips? (flavored water, vitamins,
fiber, supplements, gum, single pieces of candy) Even if you aren't keeping track
of calories, your body is

Are you eating too MANY calories?

Are you eating too FEW calories?

Are you taking in enough protein? 60-80g/day

Are the fats you're eating healthy (polyunsaturated and monounsaturated)

Are you eating too many simple carbs (bread, pasta, potatoes, sugar, pasta, rice)

Are you eating enough veggies and fruits? (fruits are Hi fructose a sugar, which can inhibit weight loss also avoid starchy veggies like potatoes, corn, rice.

Are you drinking 64oz of water daily? (water flushes fat toxins/ketones from our body)

Are you grazing? (Break grazing by drinking more water! you're thirsty NOT hungry)

Are you eating the right quantity? Measuring and weighing foods?

Are you eating on a schedule?  (EVERY 3-4 hours)

Are you exercising hard enough? Long enough? Fast enough? Break a sweat periodically

When's the last time you changed your exercise routine? (The body becomes
efficient and doesn't burn as many calories after we've done the same thing
for 4-6 weeks)

Have you added weight/resistance training to your workouts? (muscle burns more
calories at rest)

Are you taking DAILY vitamins and supplements..so important for a VSGrs first year especially?
Multivitamins, B12/SuperBcomplex, 1200 mg of elemental calcium citrate w/D3

Are you taking medications that might promote weight gain, insulin resistance, ^blood sugar

Menses age: expect monthly water weight gain of up to 5 pounds, limit salt and processed carbs

Are you getting a good nights SLEEP?  influences metabolism, check if Melatonin (also ++ influence on digestion!!) supplementation 1 hour before bed may help vs. other hypnotics/drugs
__________________________________________


 Helpful Suggestions
 

1. Make sure you really are stalled. Take your body measurements with a tape. Check how your clothes fit. Try on a piece of clothing that was tight before you started low carbing.

2. Don't go hungry. Eat smaller more frequent meals, and make sure you have some protein with every meal and snack. Avoid going more than 5 hours without eating (except overnight, then make sure you have a protein-containing breakfast).

3. Don't restrict your calorie intake, it will just force your metabolism to slow down to "starvation mode". Increase the amount of protein and fat with your meals. Eat some cheese, fried pork rinds or a handful of nuts as a snack. Use good olive or flax oil on your salads. Use heavy cream and egg yolks to make sauces for fish, eggs and vegetables.

4. Bump up your exercise level. Increase the duration and/or the intensity. Change your routine. Add weight lifts if you are just doing aerobics. And if you're not exercising yet, get moving!

5. Avoid eating carbs before bedtime. This will trigger insulin, which will inhibit fat-burning while you sleep and in fact, will initiate fat STORAGE. ^ Protein prior to bedtime will also help you sleep!

6. Drink more water and other zero-carb fluids to enhance fat hydrolysis, and to flush ketones.

7. Keep a diet diary. Record the time and amount of what you consume. No one else will ever see it, so be brutally honest. Get a good food counts resource, or at least a pocket-size carb gram counter.


To Break A Plateau:

BEFORE DOING ANYTHING-
Realize many, in fact Most Post-Ops
Share this common experience-
Done everything right and lost weight steadily,
Suddenly- the scale won't budge.
Like many others, you've reached a plateau.
When weight loss slows and comes to a stop.

Before you get discouraged and abandon
Your long-term weight loss Strategy of life-style change,
Understand that plateaus occur in any slimming-down process.
Stick with the program and your weight loss will kick in again.

Before you rush to "prosecute,"
And take drastic action,
Do some investigation.

Figure out if you really are on a plateau.
The scale may be a less than least reliable reflection of fat loss.
Look at other indicators. Are you feeling better?
Do your clothes feel looser?
If you're losing inches but not pounds,
Your fat cells are still shrinking.

Figure in the duration of the stall.
You're only on a "plateau" if there's NO change at all
For more than four weeks.

And even at 4 weeks, don’t "assume" anything.
There may be a very Tangible Reason
For the slowdown and Plateau.
If you Truly want to BREAK a Plateau,
Identify and understand the true "Culprit"
Before you just "Open Fire!"

Get this one out of the way first
By being scrupulously honest with yourself.
Are you "Cheating?"

Cheating? It’s not a Diet!
Correct,
But weight loss is directly the result of –
Calories in versus Calories Used.
Are you putting in any "unplanned" nutrition?
Empty Calories?
A little thing will be the "tipping point."

Emotional and compulsive behavior
May allow you to "sabotage" yourself.
It certainly does so many Pre-Op.
Yes?
Look at what you are doing with extreme scrutiny.

Then-
Check for hidden sources of –
Calories / Carbs / Sugars / Un-wanted Fats-
Read Your Labels Carefully!
Sugar goes under many different names
And in some cases does NOT appear as "sugar" on the label.
Many vitamin tablets have sugar fillers. CHECK!

Conversely, Are you taking in too Little Nutrition?
Many times you carry over habits from other diets & eat too little.
EAT UP... Food is Necessary Fuel, not the Enemy!
Don't skip meals. Just eat Protein First,
Higher nutrition, Lower Calorie Foods.

Don't cut your caloric intake to less than 1200 calories per day.
Increase the amount of protein in your meals.
Don't starve yourself.
Cutting calories to an extreme will Not help you.

Try cutting excess fat and calories to a reasonable level
(usually 1000 to 1500 calories a day, but determined by YOUR Size, activity level.)
And divide these up into frequent small meals
(of about 200 to 300 calories each) every few hours.
Eat a decent amount of protein with each meal
To help you feel satisfied longer.
If you keep your carbohydrate intake to no more than 20 grams a day
Your body will go into a state of Ketosis and it will be Hard Not to lose.

A frequent eating schedule will provide a constant source of energy,
Keep your metabolism higher without the insulin rebound.
Six small feedings a day are better at maintaining level metabolism
Than 3 large meals.
(notice I did not say that 6 meals are better than 3, just better AT...)

Perhaps aim for foods with a lower glycemic index.
Check into it at- "http://www.glycemicindex.com/

You may have a mineral imbalance.
How’s your blood-work?
Such as zinc/copper. Or a trace mineral shortage.
Such an imbalance can definitely slow the metabolism
Reducing your "resting consumption" of calories.
Certain nutrients are often recommended to aid in weight loss,
Including chromium, pantethine, selenium, vanadium
And biotin to help stabilize blood sugar and metabolize fat.

Getting enough Potassium?
Potassium shortages are common
For early out Post-Ops. How’s your blood-work?

Exercise? Exercise can improve circulation,
Stabilize blood sugar & other important metabolic benefits.
If you’re walking, great.
But at some point in your loss,
Walking becomes just Activity
And no longer "Exercise."
Are you Breaking a Sweat?
If you have been only walking or cycling,
Try doing some weight lifts and vice versa.
If you are not yet exercising
Try to add some sort of activity to your regular schedule.
At least 20 minutes a day is recommended for beginners.
Walk, Walk, Water, Water...
There’s a reason for that "Mantra."

Increase your water consumption to stimulate lipolysis
(The breakdown of fat stored in fat cells )
And clean your system of excess ketones.

Many Nutritionists recommend
Avoiding eating within 3 hours of bedtime.
Especially avoid any foods that are higher in carbs
As this can trigger insulin production which in turn
Will inhibit fat-burning while you are asleep.

Have you considered Food Allergies?
These may cause all sorts of problems, fatigue, headache, etc...
Check possibility of such causes by dropping out one food
From your diet and checking for changes in how you feel.
The most common culprits are-
Milk, Eggs, Nuts & Peanuts, Fish, Shellfish, Soy and Wheat.
Perhaps checkout- "http://www.foodallergy.org/allergens/index.html


Maybe you have issues with food additives.
Some food colorings cause metabolic responses
Such as sluggishness or hyperactivity in some sensitive children.
Example- YELLOW 5 ... Artificial coloring found in
Jell-O, baked goods, etc... Causes mild allergic reactions,
Primarily in aspirin-sensitive persons.
Check some of the food additives that show up on your labels.
Perhaps a look at- "http://www.cspinet.org/foodsafety/index.html


Caffeine? Yes, it’s a "fence sitter" when it comes to "Dieting"
But- Coffee, cola & tea stimulate release of insulin
With a temporary lift in energy followed by hunger,
Fatigue & slower weight loss.

Are you Drinking Alcohol?
Empty Calories and Alcohol stimulates insulin.

While we’re on "the bible-belt vices,"
Smoking? Smoking uses up vitamin C & stimulates the adrenal gland.
Although quitting smoking is classically
A cause for weight increase,
Long term non-smoking, actually aids
The metabolism to remain a constant fat-burning, healthy machine.

None of the above?  It may be medications you are taking.

Many drugs, even aspirin, can cause or increase incidence of hypoglycemia.
Watch out for hormones, amphetamines, diuretics, antihistamines,
Anti-inflammatory drugs, analgesics, anticoagulants, anti-diabetics,
Antibiotics, tranquilizers, clofibrate, acetaminophen, and propanolol.
Beta-blockers, can make your body extremely resistant to weight loss.
Sometimes it isn't what you ARE taking
But what you WERE taking that slows you down.
Different meds last month?

Hormones? They can slow down weight loss
And stimulate the production of insulin.
Estrogen (used in birth control pills) and
Testosterone have much the same effect.

Too much Salt? Typically early on this is not an issue,
But later, excessive salt can cause some water retention.

What about ‘plain old’ portion sizes?
Many people misinterpret the instructions regarding
Eating as "Just Eat till you are Full!
The pouch size will ‘tell you’ when it’s too much."
That assumes you have "re-learned" the feeling of Satiety
As opposed to "Full."

You may need to track your caloric intake and exercise more closely.
Many people find "tracking at fitday.com" a very useful tool.
Check it out at- "http://fitday.com/

So you’ve made it through this long list and EVERYTHING
Checks out. Perhaps you have a metabolic resistance to losing weight,
And if that is the case, you must consider EVERYTHING –
EXCEPT GIVING UP AND ADMITTING DEFEAT.

Your Plateau, if it continues, could possibly require
Medical attention.
Continued thyroid problems would definitely call for medical solutions.
Excessive yeast infestation may be part of your problem.
Overgrowth of yeast in the digestive tract has been shown
To provoke food intolerance, headaches and immune-system weakness,
And can keep you from losing weight
By causing unstable blood sugar.

If your plateau WON’T Break,
Enlist your physician to help find the problem.

Done all of this and still looking for the "short list?"

Then
"Eat Meat, Cottage Cheese and water for 10 days!
– NOTHING ELSE! NO EXCEPTIONS!
Just try Not to Think of it as a Diet."

You will most likely get a "Bang!"
That will jolt your metabolism into losing.

But if you want more than a bang,
If you want a real "Chernobyl Nuclear Disaster"
To make your system Un-inhabitable for excess fat,
For generations to come,
Then adjust your "Life-Style for Life."

                     _____________________________________________________

STALL CONSIDERATIONS:

1. Carbohydrate level is too high- the number of carbs you can consume per day to continue to lose fat and weight varies from person to person. Some lucky individuals may be successful at 50 or more grams per day. Others are metabolically resistant, and must keep the carbs at no more than 30-40gs per day.

2. Hidden carbs - Carbohydrates can sneak into your food without you really noticing! A gram here and there; pretty soon they add up to an extra 10 or more grams a day that you may not realise you're eating. Herbs, spices, garlic, lemon juice, bottled salad dressing - these foods are not carb-free. Processed lunch and deli meats, bacon, ham and sausages often have added starch, crumbs, sugar, dextrose etc. Make sure you are accurately measuring the "known" carbs. A whole stalk of broccoli is more than 1/2 cup. And keep an eye on the coffee. It is not carb-free - a 6 oz cup of java has 0.8 carb grams. That's a small cup too. Add some cream, and a packet of sweetener, hmmm.... 3 or 4 mugs a day can add up to significant carbs. Also, beware of foods made in the US - their labelling laws allow manufacturers to list the carb count as zero if it's less than 1 gram, even if it's 0.99 gram! Get a good carb counter, and look up the foods you're eating. Keep an accurate food diary, and maybe you will spot a trend.
Atkins website is pretty good. See it at: http://www.atkins.com/Program/FourPhases/CarbCounter.aspx 

3. Undereating- Most of us choose to follow a low carb WOE after unsuccessful attempts to reduce with the standard lowFAT, calorie-restricted mythologies. It's difficult to grasp the idea of a "diet" that instructs you to EAT when we are so used to restricting, cutting back and denying hunger. Avoid the tempatation to eat less, thinking that this will boost your efforts and speed up the process. In fact, undereating is one of the surest ways to stall your efforts and bring your weight loss to a grinding HALT. When you go for more than 4 or 5 hours without eating, your body interprets this as a fast, and will adapt very quickly by slowing down your metabolism and conserving your stored energy, ie. your fat. This is exactly what you DON'T want!

Also, make sure you are eating adequate amounts of protein. In general, an average sedentary woman requires a minimum of 60 grams per day. If you are large, do strenuous exercise or are male, your daily protein requirement is even higher. Ideally, the protein should be distributed throughout the day in several meals and/or snacks. Protein is required by the body to provide the building blocks of all our muscles, organs, hormones, enzymes, etc..... if we do not consume the protein in our diet, the body will use the only available source - your muscle tissue - to get what it needs. Less muscle tissue further contributes to a slowed metabolism, and reduced fat-burning. So, eat up!!

4. Overeating - In general, it's not necessary to restrict or even count calories.. You should eat when you are hungry, and eat until you feel satiated. But don't go overboard; it's not a license to stuff yourself to the point of being OVERfull. Studies have shown that eating smaller but more frequent meals lead to more weight loss success than eating the same amount in 2 or 3 larger meals per day. Eat slowly, and chew your food thoroughly. Listen to your body, and learn to recognize when it says "enough". Overeating can sometimes be a consequence of meal-skipping as well. You are just so hungry when you do get around to eating, or you may feel you need to "make up" for the fact that you haven't eaten all day. It can really work against your weight loss efforts if you fast all day, thus forcing your body into slowed-metabolism "starvation" mode, then eat and eat all evening. This night-time eating will trigger the release of insulin, which will cause your body to make and STORE fat while you sleep.

5. Lack of Exercise - If you have not been exercising regularly, this may be a reason for your stall. Exercise will boost your metabolism and burn fat. Exercise, especially weight-training, will build muscles, and muscles are more metabolically "active", thus will increase fat burning as well. If you have been exercising, and have hit a plateau, perhaps your body is signaling for you to change your routine. Increase the duration and/or the intensity. If you've been jogging or cycling only, try adding some weight-lifts to your workout - and vice-versa, if you've only been weight-training, you should add some aerobic activity as well.

6. Not Drinking Enough Water - Adipose tissue, ie. fat, is mobilized through a process called hydrolysis. As the word suggests, hydrolysis requires plenty of water. Insufficient amounts of water in your body will hinder effective breakdown of fat. If you're exercising, or if your environment is warm and/or dry, you need to drink more water. If you are in active ketosis, you need to drink more water to flush the ketoses out of your system. How much is enough? A bare minimum recommendation is 64 fluid oz (that's 8 - 8 oz glasses) of water a day. Some experts suggest you should divide your current weight in pounds by 2; this number is how many ounces you should drink each day, but no less than 64 oz.

There is no disagreement on the need to drink sufficient amounts of fluids every day, but there are some arguments that it's not necessary to drink only plain water. If you choose to not drink large volumes of water, you should ensure that you are consuming adequate fluid in the form of calorie and carb-free liquids. Note that coffee is neither calorie nor carb free. Three small 6 oz cups of coffee yield 12 calories and 2.4 carb grams. Add in the cream and packets of sweetener .........hmmm. Teas and herbal teas are generally close to zero carb, as well as diet sodas and mineral waters. Be careful that some diet sodas contain citric acid as a flavoring, as this has been known to stall some folks. It's best to strive to drink as much plain water as possible; at least half of your day's intake, more if possible.

7. Medications - There are a number of medications that can and will hinder your weight loss. Most notable are diuretics ("fluid pills"), both prescription and over-the-counter types. These will initially seem to make you lose MORE weight, as you lose excess body fluid. But when you are in active ketosis the LACK of fluid will inhibit fat-burning. Many antidepressants cause weight gain as well. Steroids and hormones, such as cortisone, birth control pills and estrogens will cause weight gain. So too will some seizure medications. Unfortunately, medications that are intended to lower your cholesterol will inhibit the liver from converting fat to glycogen, thus decreased fat-burning. And insulin and many oral diabetic medication will decrease fat burning and increase fat storage. DO NOT STOP OR DECREASE YOUR MEDICATIONS WITHOUT A DOCTOR'S SUPERVISION AND FOLLOW-UP.

8. Food Allergy & Intolerances- A significant percentage of low carbers report that over-consumption of cheese and dairy products will put them in a stall quicker than anything else, even when the carbs are not "hidden" but are accounted for in the daily total. There is some suggestion it may be an intolerance or allergy to the casein protein in cow's milk dairy products. If you have been eating a lot of dairy foods lately, try cutting way back, or even eliminating altogether for a week or two, and see if this breaks the plateau. Food allergies and intolerances are difficult to pin down, but are known to trigger weight gain, fluid retention, sinus congestion, skin rashes, and digestive upsets, diarrhea etc. The most common food allergens are - wheat and wheat gluten, cow's milk dairy products, corn, soy and chicken egg whites. Again, try eliminating any or all of these from your diet for a few weeks. Then, add each food back gradually, and see if symptoms return and your weight stalls again. You may have to avoid the offending food permanently, although many people find that after a few months they may cautiously eat a small amount of the food once in a while, without adverse effect. 
                
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A FEW WEBSITES THAT MAY BE HELPFUL include:

 

IIFYM.com (if it fits your macros) IIFYM macro calculator  xlnt macro calculators based on YOU and your diet of preference  

http://www.obesityhelp.com/morbidobesity/information/post+op+planner.php 
OH WL goal planner BMI based

http://www.healthyweightforum.org/eng/calculators/calories-required/

Caloric Intake for Weight Loss Goal Setting

http://www.halls.md/ideal-weight/body.htm   BMI Ideal BW calculator Halls

http://easycalculation.com/health/body-adiposity-index.php   BAI Calculator

http://www.calculator.net/bmi-calculator.html  Calculator.Net  BMI, BMR, Body Fat Mass

http://www.halls.md/body-mass-index/bmi.htm      BMI calculator Halls

http://www.nhlbisupport.com/bmi/  BMI calculator  NIH

http://www.caloriesperhour.com/index_burn.php                                    
BMR calculator (cals expended)

http://calorielab.com/burned/                                                               
Calories burned by exercise


http://www.atkins.com/Program/FourPhases/CarbCounter.aspx             
Atkins Carb Counting
http://diet.lovetoknow.com/wiki/Category:Diet_and_Fitness                     
Diet & Fitness
http://www.carbs-information.com/                                                       
Carb Counting & Nutrition
http://www.glycemicindex.com/                                                            
Glycemic Index
http://www.mendosa.com/gilists.htm                                                 
Glycemic Index & Glycemic Load

TRACK INTAKE!
 www.choosemyplate.gov/SuperTracker/Home 
SuperTracker!  find out YOUR nutrient needs/what your lacking. INDIVIDUALIZED

http://www.myfitnesspal.com/   
 Fitness Pal ....TRACK intake


http://www.livestrong.com/thedailyplate/                                                
Daily Plate  ... TRACK intake

http://www.fitday.com/                                                                          
Fitday .....TRACK  intake
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NUTRIENTS IN FOODS   look up NUTRIENT CONTENT, ingredients of foods

http://nutritiondata.self.com/tools/nutrient-search    NutritionDatabase

http://www.nal.usda.gov/fnic/foodcomp/search/index.html   USDA Nutrient Database

http://nutrientfacts.com/       NutrientFACTS

__________________

BURN THE FAT, FEED THE MUSCLE

http://idreamz.nl/fileshuttle/d28136ea.pdf

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20 HEALTHY WEIGHT LOSS TIPS... QUIT "DIETING"  

http://www.coachcalorie.com/healthy-weight-loss-tips/



_________VSG ONLINE DIETS_____________

www.muhealth.org/documents/bariatric/Bariatric%20Booklet%20VSG.pdf
Missouri Bariatrics XLNT dietary AND VSG  answers to FAQs


http://xnet.kp.org/misg/bariatrics/after.html                
Kaiser Cali 

www.muhealth.org/documents/bariatric/Nutrition_Guidelines_Before_and_After_Vertical_Sleeve_Gastrectomy.p
UM Bariatric

www.surgicalassociatesvhc.com/Nutrition-and-Exercise-following-Sleeve-Gastrectomy-82011.pdf
Surgical Associates Virgina VSG diet


http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf  
CORNELL VSG DIET

http://www.hopkinsbayview.org/bin/c/a/nutrition_sleeve.pdf         
JOHN HOPKINS VSG DIET

http://www.bethesda.med.navy.mil/patient/health_care/surgery_services/bariatric
_surgery/bariatric%20nutrition%20guide-sleeve%20gastrectomy.pdf
                           

NAVAL VSG DIET

http://www.northwestobesitysurgery.com/pdf/sleeve-gastrectomy-diet.pdf                      
NORTHWEST VSG DIET

www.sleeveguide.com/uploads/1/7/9/4/1794785/dietguidevged42006feb.pdf
search-pdf-files.com/pdf/1978173-facs-weight-2006-resered-manual
  LapSF VSG DIET

www.laplose.com/Media/Forms/SleeveDietGuide.pdf
Institute of Bariatric Surgery VSG DIET