Discussion: Maintainance

You said:

"How are bodies process nutrients is barely understood and then in fractured pieces.  While nutrients such as beta caroteen are studied in isolation, food isn't consumed that way.  Is it the beta caroteen that has the effect or it in combination with the foods other nutrients?  There really isn't that much knowledge or consensus.  Even the high protein/low carb issue is still debated more because it seems illogical than because the science doesn't support it.  Actually, the research does support it--but it doesn't seem like it sould!" That is EXACTLY why I choose to not eliminate any food group and try to get as much of my nutrients from food sources and not count on my supplements to supply all of my vitamin and mineral needs.  Thank you for saying this.   I don't want to come across as anti-high protein/low carb.  I think it  is valid for weight loss, but NOT for maintenance.  Our bodies need so much more than protein and the nutrients it provides.  All I'm saying, is that when we eliminate an entire food group, we also eliminate all the nutrients that go a long with it.  When I read about WLS patients who are deficient in thiamine, for example, my first thought is that they are not getting enough whole grain products, NOT that they are not taking their supplements.  I could be wrong, but it makes me wonder.  That's all. You had some really good insight.  Thanks for posting. XOXOXO, Sharyn

With this wls process, I have become more and more convinced of our need to educate ourselves about how our own bodies work and respond to nutrients.  In trying to do so, I've hit wall after wall due to lack of information.  I understand the challenges of creating general studies for such an individual issue, but that doesn't mean I still don't want answers!  There was a great article in the NYTImes about nutrition science I could send you if you are interested.   I do take my supplements, but I will always believe food is better for you than pills.  I have become a huge fan of the "local" foods movement.  I do pay more, but I get food that I know meets my criteria for production.  I may not get to eat a lot of variety of fruits and veggies since I don't eat many out of season products, but I do appreciate them all the more when they are available.   Here's to healthy eating not just dieting! Sally

You are SO right on about us needing to be proactive in educating ouselves.  As I stated earlier, I am writing a research paper on the long term nutritional needs of the gastric bypass patient for my nutrition class.  I can find all kinds of studies on protein-calorie malnutrition and vitamin/mineral deficienies, like calcium. B12, thiamine, iron, folate, etc.  And the long term affects of those deficiencies.  But NOTHING on what we need to be eating long term - like our carbohydrate/protein/fat caloric ratio.  So I just made my own food pyramid based on what I know of physiology and what I am learning of nutrition.  But am I right?  I don't know., but I feel that I have done my due diligence on this.  I, too, take my supplements.  I take into consideration iron and calcium competing for the same receptor sites for absorption, the fact that iron is better absorbed if taken with vitamin C and NOT with caffiene, calcium citrate vs. carbonate, etc.  There is so much to consider that it makes my head spin sometimes.  And I still do 1-2 protein shakes a day, depending on what I eat that day.  Just in case I'm wrong.  :lol: I am very glad to see that there are others out there who are taking the time and effort to educate themselves and not just take someone else's word. I am very much interested in the NYTimes article.  Please send it to me.  Thanks. XOXOXO, Sharyn

I have never been able to tolerate the protein drinks--tried a variety--so I do occasionally supplement with a protein bar.  But some of those have so many calories and/or high sugar content!  One definitely needs to read labels.  Thank goodness I can drink skim milk. I have developed a couple of quarter sized spots that my dermotologist thinks may be caused by one or more of my supplements.  He wants me off the stool softeners (here come the prunes) and then off the B12 and multiples.  I am just not ready to risk the lack of vitamins for some skin spots.  I'll be talking to my wl surgeon next month, so I'll see what he says.  But the point is that doctors specialize in one area--dermotology, surgery, etc.--and then see all problems through that lense.  It makes holistic treatment very challenging.  And for those of us who live in, shall we say less than progressive areas, it can be really tough to have access to very informed medical professionals. Good luck with your research and I'd love to read your findings. Sally

Hi Sally,   I understand your issues with drs. one says on the and another will tell you something totally different, yes we need to be proactive in our own care. It is sad that we don't have the research that we need to make the informed choices. Thank God for sites like these. I couldn't imagine going thru this alone, could you?   If you do so choose to not take the stool softeners, I was recently told about something natural with many other benefits. It is Blackstrap Molasses, It is great source of iron and great for constipation. Google it. You will be amazed at all of the benefits. Let me know what you think. Good luck and take care---Toni

I am sitting here with tears in my eyes.  Tears of gratitude for the all of the posts to this discussion.  These posts have been so well voiced, so deeply thought out, that I can't begin to thank you all enough.  I know this discussion has helped me, and I believe others as well. I would love to be able to summarize all I have read here.  However, I am a scientist by background, not a writer.  There have been posts by individuals who have reached their goal and maintained it through time, those *****ached their goal and regained, and some who never reached their goal. First, the issue of "goal" is still here.  It seems that what your goal is can only be defined by you.  It is not the scale number your doctor sets, the BMI that is normal, nor the dress size your friend wears.  It is whatever you determine it to be.  It can be any, or a combination of these things, or none of them.  For many of us, it is simply health, however you define that:  no longer needing medications, returned or increased mobility, etc.  We are talking quality of life as our goal.  You are the one who has to determine not only what your goal is, but how you measure it, i.e. scale weight, dress size, or simply how you feel.  You must be sure that this goal was realistic for your age, height, bone structure, underlying medical conditions. Secondly, if  you never reached your goal, again, however you define it, was there a medical issue involved  that prevented it, such as a thyroid condition or insufficient pouch/stoma size?  Maybe further medical testing or intervention is needed. Lastly, it comes down to personal behavior and responsibilty for our health.  Exercise still seems to be a common thread running through this.  The nutrition discussion here has provided some excellent information.  I think it clarified for many the need in our daily food plan for complex carbohydrates versus simple carbohydrates, and what those are. I am appalled at the lack of research that is being done on WLS patients.  Our numbers are rising, yet how and what we eat does not seem to be getting the study it deserves.  We are all frustrated by the conflicting information being given by the different surgeons and nutritionists across the country.  There are so many different protocols on WLS diet, for example, protein supplementation, should we do it, how much should we supplement, how much is absorbed at one time, etc.  Even the type of vitamins recommended is not consistent, i.e. an over the counter children's chewable as opposed to a chelated vitamin developed for bariatric patients. What I wanted to achieve with this discussion was this: why.  We know the what: weight loss and maintainance. We know the how: reducing calories and increasing exercise. You have to know the why.  If you never reached your goal, or didn't maintain it, you need to figure out why.  Then you can begin to do something about it. Thank you to all of you who took the time to respond to my questions, and thank you to all who have read through all these posts.  I hope it has helped you. Debra M.

Hi Deb,  You summed it up pretty well. I want to you and everyone who contributed to this thread. It has been very instrumental in helping me face some of my unidentified issues. It made me stop and think about what was REALLY going on with me. This has and will mean a lot to many. I will be using this topic for the Bay City Support Group this month. We have a wide range of people in various stages of there journey. I wish I would have had some of this info when I was in my beginning stages. Yes, Deb it saddens me that there isn't the research out there that SHOULD BE! We are the last excepted prejudice. Sad but true. Most believe that if your fat it your fault!!!! Sometimes it is behavioral, but there is so much more to it, as we are all coming to learn. If this thought process continues in this country we will continue on this downhill slippery slop of obesity that we are on. Thanks again for this amazing discussion----Toni

Debra, I have to say that this has been the absolute BEST discussion I have seen on this entire site!!  Thanks for starting it. XOXOXO, Sharyn

Well, I'll tell you I have spent the last 1/2 hour reading this post. Hooooray! Such sound questions, advice and musings. Despite everything, you guys have not lost your sense of humor in times of distress. Good for you and therefore, good for me to read and print all of this out. This has been one of the most informative posts that I have run across today (spent too much time from work. lol)

Thank  you all

Marilyn

I also wanted to say thank you - I left the US for Singapore 6 months after WLS and have pretty much coped on my own since then.  RNY is unheard of in Singapore except as a treatment for stomach cancer so no chance of any support groups here ...  I did cause a bit of a stir in the Radiology Department of my local hospital here when I had to have a barium x-ray though - I felt like a rock star!!!!!  Anyway, I use OH as my support group and its so good to realise that I am not alone in this struggle to maintain my weight.  I have always (post op) exercised religiously, but have had to really step it up recently as the pounds have crept on (#7 so far).  I don't want to eat any less than I do now as I do actually enjoy my food and believe that by and large I make good choices. I take my multivitamin, double iron (hope that's better this month) and B12 shots but have never taken any protein supplements, preferring to eat my way through mine!!!! Myrtle's post was particularly helpful (as they always are) - I was NOT overweight until an adult and not obese until my late 30's.  For this reason, I also believe that RNY has allowed me to become the person I always thought I was - not the one I hated to see in the mirror - who didn't look like me.  Hope that makes sense.  It was like I was in someone else's body and it hurt, both physically and mentally.  All of those physical woes have disappeared and I feel like the old Kim - not a new one!   Anyway, forgive my ramblings - just wanted to contribute! Kim xxx