Two months into supervised diet

[tomigyrl]

Hello All,

I am on month two of my supervised diet and doing...OK. I'm curious how folks out there who have been through this phase found it. Was it challenging? Or was the thought of surgery motivation enough to stay on track? Did you lose weight? How much, and what kind of activities did your nutritionist assign to you? I'm concerned about not making enough changes during this time to (a) quality for the surgery through my insurance, and (b) to be successful post-opt, for long-term success. What kind of changes during this period were most impactful for your success?

[bigguy]

May I asked why you have a supervised diet, as I only had to diet for 2 weeks to reduce my liver size so the surgeons had space for the surgery. I am not sure why you would need to diet longer than this?

[Ann2]

Tomi,

I wasn't on a doctor-supervised diet, but I put myself on a me-supervised diet for nearly two months prior to my surgeon's liver-shrinking pre-op diet. During those 7 weeks I lost 11 pounds and made some behavioral changes that I knew I'd have to make post-op anyway. The changes I made included:

* Ate 1,200 - 1,400 calories daily

* Eliminated all carbonated beverages (diet sodas)

* Reduced coffee to half a cup a day

* Chewed my food for much longer and waited 30-60 seconds between bites

* Didn't drink 15 minutes before meals and waited 30 minutes after meals to drink again

* Drank 64 ounces of water daily

* Started using My Fitness Pal and recorded all my food and water there (and also learned a lot about how much protein, sodium, etc. is in various foods)

* Walked a lot more (I also bought a Fitbit, which really encouraged me to move my lazy behind)

All these changes made me feel like I was taking back control of my life. It was really very satisfying. Before I started the me-supervised diet, I was going CRAAAAZY waiting to be scheduled for surgery and simply felt I could not sit around waiting for my life to begin again. Acting in healthy ways at that time helped to reduce my stress.

Good luck to you.

[tomigyrl]

Thanks, Ann. Those are all more or less things the nutritionist is having me do during this phase of the supervised diet. This diet is required by my insurance to qualify for the surgery because my BMI is under 40 and I do not have any weight related illnesses. I am, however, only 5' 2" and weigh 213 pounds, so an illness isn't necessarily far off. I will also go through the two week, low carb, diet to reduce liver size before surgery.

I was primarily curious about how people make these long term lifestyle changes before the surgery. I have a hard time believing the surgery alone is an ace in the hole. Some significant behavior modifications must happen, and it seems silly that a person would wait until after the surgery to start changing lifelong habits. Ann, your "me-diet" makes sense. Do you feel you'd have been successful without doing that for yourself?

[Numbers]

Tomigryl - The surgery is an ass kicker. This morning I tried to eat a very softly scrambled egg. Just one. I used to have 4 every morning. I got two bites in and WOW, that slow, but very real pain started. I was full, over full.

Back to clear liquids. But one thing I noticed, it was head hunger only. My stomach felt fine after a few sips of protein water.

I can not gulp any more, I just to gulp down EVERYTHING I drank. Now I frequently get to much in my mount, and have to swallow in a series of very small amounts.

I feel fine, healthy, just a twinge left from the largest incision. I am walking, just hung up a new deer mount I got yesterday, rearranged my walks, etc.

Biggest nuisance is my pants are getting to big already :-)

I hear tell if you WANT to defeat the surgery you can, but I am thinking it takes effort. MY plan is every week or so try that scrambled egg. When it starts going down, I will know I am okay there. A week later I will try putting something in the egg for flavor. Salsa anyone?

[Ann2]

Thanks, Ann. Those are all more or less things the nutritionist is having me do during this phase of the supervised diet. This diet is required by my insurance to qualify for the surgery because my BMI is under 40 and I do not have any weight related illnesses. I am, however, only 5' 2" and weigh 213 pounds, so an illness isn't necessarily far off. I will also go through the two week, low carb, diet to reduce liver size before surgery.

I was primarily curious about how people make these long term lifestyle changes before the surgery. I have a hard time believing the surgery alone is an ace in the hole. Some significant behavior modifications must happen, and it seems silly that a person would wait until after the surgery to start changing lifelong habits. Ann, your "me-diet" makes sense. Do you feel you'd have been successful without doing that for yourself?

Tomi, I'm only 19 weeks post-op. So I haven't proven myself successful at anything so far but losing weight. And losing weight the first few months post-op is pretty easy to do. Also, if you're like most people here, you have already proven to yourself many times that you can lose weight. It's KEEPING IT OFF that's the challenge, right?

To stretch your cards metaphor a little further, I do think that long-term my sleeve will indeed be my lifelong "ace in the hole" and give me an extra advantage when I need it. However, my long-term success will depend more on the other cards in my hand or that are showing:

* continuing accountability (I have this down for now, but don't know how I'll handle this 2-3 years out)
* daily meal planning
* an active lifestyle that requires me to exercise and walk and move a lot
* a positive, optimistic, responsible attitude
* support and positive reinforcement from my family, friends and medicos (through 2016, this will include a psychologist)
* new good habits (like eating more slowly) by practicing them consistently long enough that they replace my old, bad habits

For me, starting early (back in June 2014) was important to me. I didn't want to postpone anything anymore. I wanted so badly to achieve my eventual goals. I was just freakin' ready for this journey to begin already.

Also, I had started lurking here back in November 2013. Early on, I learned the big issues people were struggling with. It wasn't hard to tell those who were doing well from those who weren't. And those groups weren't based on who was losing fastest, but about how much they seemed to be fighting the process.

So I decided I was just going to be the most boring, uncreative, predictable, compliant patient ever and to do what my surgeon and his team told all their patients to do -- get in 60-80 grams of protein daily, drink 64 ounces of liquids daily, take my multi-vitamins and minerals, gradually exercise and move more (without hurting myself!), attend all my post-op consultations, call them if I had any questions, and carry out any other instructions they issued.

I also agreed to a request by my PCP, who'd seen me lose and gain over the years, that I would find a shrink to help me identify and deal with the issues that have kept me yo-yo'ing. And I have found a shrink and will see him through 2016--through the year of losing, the year of maintaining, and the year of boring real life (my terms).

Like everyone else here, I am only a work in progress. There is no end to this journey. We never get a final grade. But I do hope that in a few years this part of my life will consume a smaller amount of my energy and attention and that at some point I will feel like I'm "normal."

BTW, I am 69 years old. I'm so grateful to still have this opportunity to fix a part of my life I've struggled with for so long.

[tomigyrl]

You're pretty awesome, Ann!

I too am getting therapy now, and through two years post op. There is a lot of emotional sludge coming out already! I also have twice monthly nutritional appointments.... four months to go! Yes, I've lost weight on my own before, even keeping it off for four years. Keeping it off permanently is the challenge. My problem is the eating. I exercise faithfully, always have. But that's easy to do at 38 years old!

I guess what I'm learning, and the accountability required from the professional network supporting me, is all the right stuff. Guess I have to trust the process and not allow myself to get into my own way.

[Ann2]

Tomi, I think that old saw that "timing is everything" is particularly true about WLS. Just because many of us have had some success in the past, but couldn't succeed long-term, does not mean that this time with WLS we can't or won't succeed.

And this time, the stats are certainly in our favor, since the research says that 50% of WLS patients maintain all or a majority of their excess weight loss, compared to 5% or fewer of those who lose weight through dieting/exercise alone.

It comforts me to believe that if we never give up, we will eventually win the day.

[Robyn3]

I only had to do a 3 days pre-op diet. I hated it. I was miserable. I thought gee if I could do this I wouldn't be getting surgery. there were 12 people getting surgery on my day. Most didn't mind the pre op diet. But for me it was challenging. I am doing so well now. I am not hungry. AT ALL. This is the tool I needed. This is what has changed. I am satisfied with a cup of french onion soup. I am still the same. Same discipline, same emotional issues, but 85 percent of my stomach is gone. I really admire the work everyone is doing pre op but for me the tool of a smaller stomach without that strong hunger hormone made this very doable for me- That being said, I admire everyone's approach to being the best you can be!