The following is an excerpt from a response I made to someone who asked about getting back on track. This person has been very successful in her weight loss journey, but has recently experienced some regain. Statistically, her regain is within the norms for 'bounce back' weight, but it was how she regained that distressed her and it was nearly a mirror image of what happened to me a few years ago. I really felt her distress and fear and wanted to reassure her that all is not lost, that we always have our tool and we can get control of it now, even when we couldn't for so many years before. So if you have have arrived at maintenance and are struggling with some unwanted regain or if you are only thinking about WLS or in the process of losing and want to know if you can and will be able to maintain your weight after you lose it, read on...

Okay, so the real question is how to get back on track and if it's a realistic possibility and probability. I'm here to tell you that it is both possible and probable that you can reverse the tides and get back to where you are happy and be able to stay there. I have to tell you that I too was just terrified because I knew from my previous experience that 'diets' just don't work for me. I'm an overgrown 3 yr old and if you tell me I can't have something, then.... I will. That scared the proverbial pants off of me. After mulling it over a bit, I decided to try a new tact. One to get the unwanted extra pounds off and another, related tact to keep my weight where I want it to be.

So, to take off the weight, the two biggest things I did were to log my intake and activity and to cut back on simple carbs... cut back, not cut out. I made sure to 'take care of business' with every meal and snack, making sure I was eating 5 to 6 times a day. When I say 'take care of business' I mean that I made sure that I got in  4 to 6 ounces of protein, then followed that with colorful, complex carbs. I also made sure that I wasn't drinking any fluids within that 30 min window before, during and after my meal so that I could allow my tool to work for me and help me really regulate my intake to ensure I wasn't taking in more calories than I needed. I maintained a caloric intake of about 1000 to 1200 calories a day when I was working on losing the weight. Logging really helped me think about what I was ingesting and if it was supporting my goals or undermining them. This helped think of things in a positive light. Is this choice going to help get me to where I want to be or submarine my attempt to achieve and maintain a healthy and active life? If not, I often would think twice and let it go without the burden and baggage that comes with feeling deprived. I have to say that I did occasionally indulge while I was losing, but not often because I had my eye on the proverbial prize and I was delighted at the result I was getting; most of the time the 'indulgence' I wanted at the moment faded when I 'weighed' it against my goals. To be honest, the weight came off relatively easily. Much more so than I thought it would.

Now that I've taken the excess weight off, I don't really log anymore unless might weight ticks back up out of it's normal range. If that happens, I start logging again and am able to easily trim off the few pounds.

I honestly think that losing the weight and then maintaining it all comes down to awareness and accountability. If you think about it, I'll bet that you've been playing a bit of 'hear no evil, see no evil, speak no evil' as it relates to what you are consuming. You 'know' you are going off track, but tend to not want to see the evidence of it. We all have to find ways to be aware and accountable and to be honest what works when we are losing is not necessarily what works in maintenance and I think that this is one of the main reasons we tend to falter in maintenance. Whatever we did to maintain awareness and accountability in our weight loss phase doesn't really work for us anymore and no one has told us that we need re-evaluate how we are going to remain aware and accountable as we work to maintain or new found weight and it's resulting health and quality of life benefits. It took me a while to find what works for me. It may take you a while to find what works for you, but I'm sure that you can and will.

Hi, I'm seven days post-op from what was to have been a "revision" to my Fobi Pouch which was performed by Dr. Fobi in 1992.  Although the whole weight gain, etc. was NOT due to the Fobi procedure (Bless Dr. Fobi!) but due to a fistula forming that reconnected the pouch to my former stomach and caused the  hunger hormones to be released (I consider that a matter of sh*t just happens and get over it), I am walking your path. 

Kuldeep Singh, MD did my procedure and was the only one of three with any "familiarity" of the Fobi pouch in the mid-Atlantic *****turned my calls. He'd never "revised" a Fobi and just flew by his brilliance and the seat of his pants, CT scans, an Upper GI, and my complete faith in him.

My procedure ultimately involved the repair of a huge hiatal hernia (undiagnosed by Kaiser), the removal of my gall bladder (there was sludge and surgery would eventually become necessary), and the disconnection of the tissue.

I have about six incisions, it only looks like stitches were required in one but the steri strips still cover all but one.  The drain came out on day 3 and I was sent home sans drain (thank God).  On Day 1, post op, I felt like I'd been hit by a car, Day 2, a Mack truck, Day 3, car, by Day 4, smaller moving vehicle.  The worst of the pain seems to come from my lower right abdomen and happens depending upon how I move which makes rolling over in bed something awful.

Diet wise, I am NOT hungry and the cravings are gone - hurray for the hormones being gone.  I'm being kept on liquids for two weeks to be on the safe side but I really don't miss much.  I've got my supply of Whole Foods 365 protein powder, soy milk, and Naked Protein Zone or whatever it is called.  I've learned how to make refried bean soup (little beef bouillion, taco bell hot sauce).  I am sticking to the same things I am sure of and adding little by little.  I would like some Whole Foods Tomato Bisque - maybe I can get my son to go pick up some tomorrow.  If I feel up to it, I may venture outside the house and take a walk down the block to the store tomorrow. 

The pain is the hindrance to the physical activity but I am home alone so I do have to do much on my own.  I've gone downstairs to visit my neighbors a couple of times.  I've done some minor household chores according to how I feel.  My biggest frustration is related to the pain and the limitations that come from it.  I'm on morphine which limits my ability to think which means I can't THINK. If I can't THINK, I can't RESEARCH, I can't WRITE.  So my "real" life is put on hold.  But thank God for morphine.   

I am still quite swollen although nothing like when I came out of surgery.  I know I've lost weight but the weight loss doesn't show in my mid section where I needed to lose it yet. 

I'm using myfitnesspal.com to log my food which is a requirement prior to my follow up with Dr. Singh next week.  I haven't had any dumping, no nausea. I will give you one very useful bit of advice. You can have STOMACH FREEZE.  It's akin to BRAIN FREEZE over cold? LMAO.  Since I can only drink down so much which makes the protein requirement had to do, I've been using less liquid in the shakes but really really wanted lots of ice yesterday.  I took a blessful swig and just wanted to cry.  Oh well, trial and error. Ha Ha  It could be worse. I AM laughing.

Kate

I had my Fobi Pouch surgery nine years ago and now have a leak.  Also, my ring is enbeded into my pouch/small intestine.  I am in the process of scheduling surgery.  I hope I can afford it. 

Pam Tremble has it on her blog. Here is the link to it on her blog: http://pamtremble.blogspot.com/2011/01/bariatric-emergency-chart.html

I hope that helps.

{{Updated 11/13/2011}} 

Good news.... After researching this, it was confirmed that the above is a misunderstanding. 

That's a self pay rate for patients who do not have insurance or who have an insurance exclusion.  The total self pay rate is approximately $17,500.  

Dr. Jossart is a Center of Excellence surgeon and is contracted with most insurance companies including Blue Cross, Blue Shield, Aetna, United, Sutter Select and others. Depending on the patient's insurance policy, the usual co-pays and deductibles would be paid. 

Insured patients with Dr. Jossart as their surgeon have had co-payments as low as a few hundred dollars, depending on the health plan. More information can be found on his profile here: www.obesityhelp.com/profiles/bariatric-surgeon/dr-gregg-joss art-coe/

Patient Reviews of Dr. Jossart:
www.obesityhelp.com/profiles/bariatric-surgeon/dr-gregg-joss art-coe/reviews

Patient weight loss success:
www.obesityhelp.com/profiles/bariatric-surgeon/dr-gregg-joss art-coe/reviews#profile_patient_progress

Upcoming Seminars
www.obesityhelp.com/profiles/bariatric-surgeon/dr-gregg-joss art-coe/reviews#profile_seminars