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It doesn't matter how often I hear something, there's a moment at which I have to accept it and make it my own, that's when it finally becomes truth to me. I'm still 25 lbs from my goal, but my weight loss is slowing.  And if I don't fix things, it will stop short of my goal.

I had a meeting with Dr. Cirangle yesterday and he laid it on the line for me. First, he said - the numbers tell the story. You lost 61 lbs in the first 100 days and 25 lbs in the last 100 days. So I lost less than 6 lbs in the last month. At this rate he said, my weight loss will soon be over and then reverse.  And he cautioned that a goal of 200 lbs was not good enough. He thinks that I need to get to a BMI of less than 25 for maximum health effects and to give myself some headroom for possible weight regain.

Sigh. So I've reset my goal to 175 lbs  That puts me 50lbs from goal!  But I've started to think about why I'm slowing and I realize that despite all of the hundreds of hours of educating myself about the VSG and post-op regimens, I've failed to absorb some basic truths

1. Carb cravings returning is not "natural."  It's a consequence of returning to carbs. The more carbs I allowed to creep into my diet the more carb cravings I had. So I have to go back to being completely hardline on carbs. No fruit. No alcohol. No occasional sliver of cake because it's someone's special occasion. Not even a single tortilla chip because the guacamole looks good.  Yes, I have given in to all of those temptations over the last two or three months, and the scale has stopped moving and my cravings in the afternoon and nights are back.

2. Your BMR - basal metabolic rate - is lower than you think. Part of the reason I was over-fat was because I had a low BMR to start with.  If I look at tables online, they tell me I should be burning 2400 or more calories a day, so if I'm eating less than 1200 I'm fine, right? Wrong. Dr Cirangle tells me that my actual BMR is more like 1500-2000 calories a day. At 1200 calories I am closer to a maintenance diet than to a weight loss diet.

3. Calories count. And you have to count them! It doesn't matter where they come from. Finally, it's arithmetic. So even if I'm not doing carbs, and I eat nuts, or cheese, and add calories, the basic equation is the same. In other words, I either have to have a regimented routine, or I need to meticulously log my food. For the foreseeable future. I realized I have been avoiding logging because everytime I logged my food I would be dismayed that I had absorbed 900, 1100, even 1300 calories. Well, not logging your food intake doesn't make the calories go away. 

4. Exercise is not a weight loss tool. I've been exercising off and on over the last four months, and my weight loss has been slowest at those times! Why? Well, a half hour of hard running with my heart rate at the top of its aerobic range is only around 200 calories. But it made me hungry and I used it as an excuse to eat carbs. 

Certainly, exercise! Exercise for muscle mass growth, and for the daily hormonal benefits it confers, and for fun. But exercise has almost nothing to do with weight loss.  Recent studies have shown that people tend to eat more when they exercise; and they eat more calories than they burn.  So if you're exercising, make doubly sure that you are logging your food and not taking in more carbs. As any bodybuilder will tell you, sixpack abs are made in the kitchen, not in the gym.

5. Don't confuse cravings with things your body needs. I had been lying to myself about carb cravings, telling myself that I needed some carbs because my muscles needed glycogen to build mass because I've been working out. Simply not true. Dr Cirangle: "People are very good at justifying and making excuses so that they can do what they want to do."

The good news? My sleeve is perfect, I can't eat any more today than I could a month out from surgery, 2 oz. of chicken and I'm done. I still have the tool, I just have to start using it right again.

Good luck with all your journeys.

 

 So it's mixed, again. As I came up to the two week mark, I was riding high, had lost 16 lbs, was feeling ok energy wise, and felt ready to start the mushies.

Boy what a difference two days have made. The mushies are a difficult transition. First off, I am no longer sure of how much protein I am getting, because I'm eating parts of things and leaving the rest. I'm still doing a shake a day, but I can't be sure I'm getting my 70.  Then, my liquid intake has gone off the rails a bit because of the dry window - 15 minutes before and 30 minutes after meals: add in the time for the meal itself, that's over an hour per meal without liquids... 

Of course I made things harder on myself by eating three of six mushy meals in restaurants (work related networking, family birthday, guest from out of town). I think it worked out ok - e.g. at a sushi place I ate a small piece of tamago (basically an omelette), a bit of tofu, and a smashed up small piece of soft tuna; at a thai restaurant I had a few pieces of tofu and a soft cooked shrimp smashed up - but none of it tasted great, and I think I didn't eat too much, but it's hard to tell when you're eating tiny fractions of typical portions. I've decided to stick with home mushies for a while so I can be sure of quantities and content and have control of my food.

AND. I met the grazing monster and I see how powerful it is.  I was scheduled to have lunch with two work friends at 1 on Friday, but my boss dragged me off to a lunch with a vendor at 12. I decided I would just hang out with my friends at 1 anyway while they ate. So at 12, I ate the little sushi nibbles - egg, tofu, sliver of fish - and as expected started feeling satisfied after I ate about 2 oz of food - and packed the rest into a styrofoam box.  At 1 I went to see my friends, and I had the rest of my lunch and chopsticks with me. By the time we all sat down, my sleeve had emptied, and without too much thought, I opened up my lunch box and started in on it and before I knew it I had downed another 2 oz or so of food!  If I think about it, it wasn't hunger driven, it was just that I was sitting with two people who were eating, in a cafeteria full of food, and it just seemed natural to eat. Old habits die hard.I can see how one could do this all day long and completely blow it.  It's really important to stick to three meals and no more a day.

I suppose the fact that I had an apparent bounce of 0.8 lb up since yesterday helps to reinforce the lesson (though it's probably mostly water variation).  People, watch out for the grazing monster!

I'm also returning to anxiety about long term reflux (hearburn) problems. Last night I missed one of my two Prilosec pills for Friday and broke my rule about not eating too close to dinner, and boom, I was up with heartburn again at 4. Another sleever posted some information about Prilosec interfering with sleep, and I've been having sleep problems (waking too early and unable to sleep again) as well. I'm feeling a little like I've traded one set of problems and meds for another.. but I know, I know, it's much better to deal with lifelong reflux than it is to deal with diabetes and heart disease... no free lunch!

Thanks for reading my somewhat whiny ramble.. Onward!

Changes. Big changes. It's not the losing 7-8 lbs in a week, that's the least of it. It's that the entire structure of my life has changed overnight and I'm reeling.

Food was woven through every moment of my day. Threads around food formed the very fabric my life is made of.

My day used to start with a coffee ritual, making a steamed latte with nice espresso beans and whole milk for my wife and me. I got through the mornings at my job looking forward to lunch at the very, very nice cafeteria we have at work (I know that sounds like an oxymoron, but I'm lucky enough to work in one of those Silicon Valley companies that provides high quality food at work as a perk). Mid afternoon, I'd ramble over to the break room and look around for a cookie or cake that someone else had brought in, or get a hot cocoa from our Starbucks vending machine... next it was home, where my wife, who is a brilliant cook, would have me taste things that were on the stove as we got dinner prepped.  We always eat healthy, but the food is a focus, we are "foodies" as they say, and the evening dinner is a big deal.. After a couple hours, it would be time for a Trader Joes freezer dessert, or a piece of chocolate.... Weekends include an entire morning devoted to browsing the local Farmers' market, sampling food and fruit at the food stalls.

And then of course, for fun, there were restaurant outings. In the South SF Bay, there's a vast array of food choices for dining out... we are huge fans of Asian food, so once or twice a week it would be sushi, or Korean, or Vietnamese... or a local grill.  Even travel was focused on food. A recent trip for business and vacation to Asia was all about eating in China, Korea, and Japan.

And now.. and now, I couldn't give a damn about any of those things. The things that, until a week ago, formed the entire universe of my enjoyment. The problem is, that if I don't care about any of those things any more, I don't have a good answer to: what DO I care about now? It feels like I woke up one morning and all of the furniture in my house was unfamiliar and didn't fit my body any more, and I don't even know what I need to replace it with - if that makes sense.

Of course, I have other things I like besides food - travel, reading news and politics, art, movies.. etc. But none of these are a constant interwoven thing in my life like food has been. The questions are: what to do now with all this unstructured time, this open emotional space which I would normally fill with anticipation of things to eat and taste, this basis for connection with my wife and family.. when all food seems alien and unfriendly.. and what to do later, when it starts its seductive music playing in my head as my stomach and body adjust to this new normal.

Or, not-so-big day, the point of this is not to get so big.. haha.  Well, all the pieces are in place, I'm scheduled at 2pm, and feeling slightly nervous, and somewhat excited - change is always exciting, at some level - and dealing with the Milk of Magnesia rumblings.. y'all know the drill.  It's also kind of relaxing.. Work is very stressful for me and involves a lot of multitasking and at least for now I'm focused on one thing and it's all about me. Can't say that too often! 

See you on the other side..!

So I'm a dad and a husband and had my father go through two heart attacks and die from the second one before he was 70 after decades of pills and battling hypertension and gout. I'm determined not to go that way and stick around for my family as long as I can, and to have fun doing it!

So, two days to surgery, heading down from a peak of 331lbs last winter, now at 312lbs.  Dr. Cirangle and LapSF have been great so far, but I have some anxiety, some of which is  about silly things like "what if my stomach stays swollen?" (I know that won't happen) and some of it is about real things like, well, who am I going to be after I lose this stuff that's been part of me since I was a wee little lad? And how much pain am I going to be in post coming out of anesthesia? And.. being able to drink less than 20 oz. In a day?? 

Thanks for this forum. I'll be back!