Good info: how to prevent "stomach stretching"

Grim_Traveller
on 2/22/17 7:04 am
RNY on 08/21/12

There's more than one way to skin a cat. What I like least about his plan is that he is pushing one way. His way.

None of us got SMO from meat, veggies, or fruit. It was 100 percent crappy carbs. And I ABSOLUTELY think protein needs to be prioritized for the vast majority of people. I think most would be nearly 100 percent carbs if they didn't. And not good carbs.

I'm nearly the opposite of his plan. Five, or seven servings of veggies and fruits? One or two pounds? I may have had that over the last decade. Maybe 15 years. Do you think that's what he meant?

And that whole skin a cat thing. Were they skinning cats so often that it really needed its own aphorism?

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Jester
on 2/22/17 8:26 am
RNY on 03/21/16

Just to clarify he recommends 1-2 of veggies a day, NOT fruit specifically.  He is good with fruit, and thinks it should be part of a healthy diet, but his primary recommendation is veggies.  His ideal meal is a small portion of protein (if meat like 2-3 ounces) then a LARGE portion of veggies.

I take a bag of veggies to work every day (couple of baby cucumbers, 1/2 - 1 red peppers, and a handle full of grape tomatoes) - it generally ways 10-12 ounces.  So with a normal portion of veggies with dinner I easily hit the one pound.

Jester
on 2/22/17 8:32 am
RNY on 03/21/16

Also, from what I've read, don't most doctors/NUTS push their single approach?  I could be wrong, but I havent heard many people saying "my doctor/NUT says there are three or four different approaches that you could follow".  Granted his is different than the "typical" approach, but it seems most places have their single approach.

 

I will also say, having Dr. Weiner as my surgeon, he is VERY realistic about his plan.  And very flexible.  In fact, he doesn't want people to be 100% compliant as he feels people should have flexibility.  He thinks 90% is IDEAL.  And, for instance, although he is anti-grain, for me personally he recommended I add in steel cut oats and possibly brown rice as my weight loss was so extreme he thought it was the best approach for me, especially when I work out.

 

Even his oft repeated line about knowing where your meat, eggs, veggies, fruit, etc come from - know your local farmer.  I asked him where he gets his food, and he replied "Meijer".  I laughed.  He said that it's ideal, and he will try to souce as much as he can from farmer markets, etc during the summer, but it's not realistic to do it every time.  It's just the ideal approach.

 

And last item - he doesn't just promote this plan to his patients - he lives it.  This is how eats.  Even as a very busy surgeon he participates in preparing the meals in his household and talks about the need for convenience and easy prep meals, etc.

 

Again, I'm biased, but it has worked for me.  And Dr. Weiner really is just a great guy that cares deeply about his patients.

Travelher
on 3/1/17 5:51 pm
Revision on 10/04/16

He isn't the only one with this approach.  Dr Vuong also advocates a mostly vegetable diet because of the nutritional depravation of our surgery.  Dr Vuong recommends 50%raw veg and fruit diet.  For protein he recommends mainly pescatarian.  I now eat as he puts it "a big ass salad" for lunch every day (not that big really, still only 5 months post op).  Plus I love salad!!!. He also recommends consuming cooked food within 3 hrs because the nutritional content degrades after that (especially protein).  Makes sense to me. 

My doctor recommends a balanced diet.  I'd say I do a blend of all three, but probably closest to dr Vuong...except I hate shakes..so won't do the green shake, but I do try to make sure I get a healthy potion of veg and some fruit in every day.   Like both dr Vuong and dr weiner suggest I avoid processed food as much as possible and have severely cut my dairy...sigh...I miss you cheese...

i get in 90 grams of protein a day...so think I'm good there.  

Band-RNY revision age 50 5'4" HW 260 SW: 244 (bf healthy range 23-35%) bf 23.7% (at 137lbs) cw range 135-138.lbl with butt lift and mastoplexy March 23, 2018...2.5lbs removed.

Pre-op-16lbs (size 18/20...244) M1-16lbs (size 18...228) M2-15.6lbs (size 16/18...212.4) M3-10lbs (size 16..202.4) M4-11.4lbs (size 14...191) M5-10.8lbs (size 12...180.2) M6-8.4 (size 8/10...171.8) M7-6.4 (size 8...165.4 lbs) M8-11.6 (size 6...153.8) M9-5.6 (size 4/6...148.2) M10-5.8 (size 4....142.4) M11-4 (size 2/4...138.4) Surgiversary -1 (size 2/4...137.4) M13-2.6 (size 2/4...134.8) M14 (size 2/4...134.8) M15 (size 2...135) M16 (size 2...131.4) M17 (size 2...135) M18 (size 2...135) M19 (size 2...138) M20 (size 2...135) M21 (size 2...138)

califsleevin
on 2/24/17 6:27 pm - CA

I think that the main takeaway from this is that between stretch, growth and our increasing inclination to eat around our WLS over time, that our capacity is going to increase, and we should be prepared for that. His approach may not be for everyone, but it is a viable approach given the large bulk to calorie ratio of vegetables. While I am not quite attuned to the de-emphasis of meats to the extent that he is, there is compelling evidence that we overall consume more meat than we need to (same with dairy and grains - not coincidentally major lobby groups in Washington along with the meatpacking industry.) I worked into a somewhat similar approach to this doc after the first month or so when I figured out that if I cut back the meat portion of my lunch from my nominal 3 oz capacity to 2 oz, I had room for another 3 oz of salad veg. That's been one of the few consistencies in my diet ever since (and actually for years pre-op as well), though the veg portion of the salad is now a fair bit bigger now. No real harm in "eating around your sleeve" if you are doing so with high nutrition, low calorie fruits and veg.

For reference, my normal goal is 10 nominal servings per day, which I rarely hit, but am consistently in the 7-8 range and rarely under 5. Satiety-wise, I find that a combination of meats, beans, cheese, fruits and veg to be quite satisfying, and this seems to me to be a very workable long term solution for weight control, rather than simply chasing satiety with increasing amounts of protein, the excesses of which beyond our biological need just goes to fat and more expensive urine.

1st support group/seminar - 8/03 (has it been that long?)  

Wife's DS - 5/05 w Dr. Robert Rabkin   VSG on 5/9/11 by Dr. John Rabkin

 

(deactivated member)
on 3/1/17 3:49 pm

I like his videos - find him sincere well meaning and informative. 

Of course he's not one of us ... but he has operated and followed up with a lot of bariatric patients. 

I have to say I totally agree with him about the vegetables - I personally put away a whole bagful of something veggie every day with a fat free sauce sometimes warm sometimes cold as salad sometimes hot in a cooked dish - but never over cooked. 

As a result I don't even know what Miralax IS ... 

I don't think low glycemic index veggies should necessarily be counted as carbs - green beans for instance do a great job of cleaning you out . And they're not very calorically dense. 

(deactivated member)
on 3/1/17 3:58 pm, edited 3/1/17 7:59 am

These worrisome ( or creative take your pick ) days I wake up a lot at nite and watch TV  pondering how to best solve the next days problems. 

It easily leads to snacking fatteningly in the wee hours . 

I used to make a big pot of ( fat free) cheesy air popped popcorn whose high salt content bloated me the next day and made me feel like cr... p . 

Now my pattern is to snack on saucy leftover veggies from dinner ( again fat free ) . I usually don't graduate to anything else . 

BETH6536
on 3/3/17 12:02 am - Beaverton, OR
RNY on 04/19/17

I did watch the video and about 3 more. Found them all very informative, but i'm a month pre-op. All info is good info at this point! But I appreciate the link.

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