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  1. #1
    Gastric Sleeve Member Skycosmo's Avatar
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    08/14/2019
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    Dr. Cameron Askew
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    Default I'm only a few days out from surgery - Laurie's journey.

    On August 14th I had the sleeve surgery. All is going well so far. I'm down 15 lbs with the pre surgical diet and the few days after surgery. I am able to drink more than I thought I would be able after the surgery. I got in one whole protein shake yesterday (although it took quite a while). I may aim for two of them tomorrow so I'm in the window of the right number of protein grams per day.

    I was wondering how you knew you were "full" so soon after surgery? I don't want to overeat but realized I packed away a 4 ounce container of pudding without a problem too two days in a row and I was wondering if that is too much to consume so soon after the procedure. My doctor said pudding and shakes were okay to add to my diet when I got released from the hospital.

    What advice would you give to a "newbie"?


  2. Gastric Sleeve Surgery With Weight Loss Agents
  3. #2
    Gastric Sleeve Member Dutchie's Avatar
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    Simonne
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    Dr. Pablo Enriquez Valens
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Hi, welcome here.
    My advice: don't worrie.
    Liquids (clear or thicker) run smootly through your new sleeve.
    It is probably not until your reach the solid food stage that you will feel full after one or two bites of chicken/fish/meat.
    Then you can work on recognizing your full signals.
    For now all you have to do is sip, walk, rest, and repeat.
    Don't worry about nutrition right now, you have plenty of reserves.
    Here is a link you may find helpful: https://www.gastricsleeve.com/forum/...t=full+signals
    Good luck and ask away!
    English is not my first language anymore, so I may and do make mistakes in my spelling, or say things oddly. Please ask me, if you want any clarifications.



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  5. #3
    Gastric Sleeve Member Skycosmo's Avatar
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    Dr. Cameron Askew
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Thanks, Dutchie.


  6. #4
    Gastric Sleeve Member
    I have had a gastric sleeve.
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    04/29/2019
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    Dr. Foreman
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Congratulations on your sleeve Laurie! Glad to hear things went well. I only drank liquids for the first 2 weeks so I can't really offer any advice on the pudding, but I can tell you that when I started adding pureed foods, it was VERY easy to tell when I was full. I literally could not swallow another bite. It felt very restrictive and, for me, almost painful. My biggest adjustment was eating very slowly. Whew, I seriously mean SLOWLY.

    I found that measuring my food was also helpful in understanding portion sizes. Obviously being 100 pounds overweight I was lacking in that department LOL. Your tummy will do a lot of communicating to you through different signs, just try and stay in touch and listen to it.



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  8. #5
    Gastric Sleeve Member WANAGL's Avatar
    I have had a gastric sleeve.
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    Cyndi
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    Dr. Robert Marema
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Welcome to the sleeved side! I’m happy to hear that you’re doing well.

    I Ditto the above ^^

    You will definitely know your restriction soon. The unofficial “rule “ is no more than a palm’s worth. I say that because everyone is different, every Dr/Nutritionist/Bari Team is different.

    Bottom line...listen to your body, it’s your best friend ;-)



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  11. #6
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
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    Christie
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Yeah. I did not feel full until I started eating real foods. I couldn't drink or eat that much (when on pureed) but I always felt hungry. Even when I first started eating was always hungry. I think in part bc I could only eat a 1-3 spoonful's at a time. So I had to either have a bite of a low carb, high protein bar, a small piece of jerky, or a few nuts. If I did not have those things between my "meals" I felt like I was starving. Also some of that was due to acid reflux. I had to take Prilosec and tums for several months.



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  13. #7
    Gastric Sleeve Member sraebaer's Avatar
    I have had a gastric sleeve.
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    I didn't feel full until I started solid food, like a piece of chicken. Then is was there full force! Don't worry, you're doing great. Liquids and really soft foods will pass right through your stomach and you may not feel full.



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  15. #8
    Gastric Sleeve Member AnnieG's Avatar
    I have had a gastric sleeve.
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    Annie
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    Dr. Ryan Heider
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Hmm. I didn't try the pudding. I had a penchant for sweets prior to the sleeve, and just didn't want to start back that direction out of my anxiety.

    I could not eat much at a time (even now) and 6 ounces of anything is my max. I do measure. And if I go further, the dreaded "toad froth". But everyone is different.

    Just make sure you follow your doctor's program, and WATCH that you get enough protein & water. The rest resolves the best way for your body.
    [I]HW: 240 lbs SW: 199 lbs GW: 140 lbs

    1 MO = 167.0 2 MO = 156.4
    3 MO = 148.4 4 MO = 140.6
    5 MO = 136.0 6 MO = 130.0 (GOAL)
    1 YR = 122.0 2 YR = 140.00

    Happy with my weight; happy with my size; over-the-moon with my health!

  16. #9
    Gastric Sleeve Member KiwiGal's Avatar
    I have had a gastric sleeve.
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    Lisa
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    Stephanie Ulmer
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    As all above - you will definitely know when you are full.

    The restriction doesn't go away and your body will let you know when you are full don't worry.

    I am days away from my 2 year surgiversary and even last night my stomach told me that I had either eaten too fast, too much, or some food that my stomach really didn't like. These episodes are very rare but they do happen occasionally. I actually think it was some rice. Not something that I normally eat but I had cooked a lamb curry and added a spoon full of rice to soak up some of the yummy sauce. I didn't even eat all the rice, just a couple of small forkfuls but that was obviously enough. I will now avoid rice. I live and learn!



  17. #10
    Gastric Sleeve Member jerzeygirl's Avatar
    I have had a gastric sleeve.
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    07/20/2011
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    Dr. Louis Balsama
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    I read a very interesting article about regain and how patients who eat more after they feel "full" have a higher risk of regain. It's a very interesting article that I'll try to share with the group.



  18. #11
    Gastric Sleeve Member jerzeygirl's Avatar
    I have had a gastric sleeve.
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    AUGUST 25, 2019

    Study Identifies Culprits in Weight Regain After Bariatric Surgery

    Sedentary Lifestyle, Certain Eating Habits Counteract Effects of Surgery






    By Christina Frangou

    Why do some people regain weight years after bariatric surgery while others do not?

    The answer may lie in how people spend their leisure time and how often they eat, particularly how often they eat fast food, according to a new report published online in Annals of Surgery.

    In the largest study to date to examine a wide range of patient behaviors and characteristics related to weight regain after Roux-en-Y gastric bypass, sedentary leisure time was closely associated with extra weight gain. Independent of eating behaviors, participants who were in the highest quartile for spending their recreation time watching television, playing video games and using a computer regained, on average, an additional 3% from their maximum percentage of overall weight loss.

    “This study provides the best support to date for the role of free-living physical activity in the maintenance of surgically induced weight loss,” wrote the authors, led by Wendy King, PhD, an associate professor in the University of Pittsburgh Graduate School of Public Health.


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    Bariatric patients should be encouraged to decrease television and recreational computer time, as well as other sedentary behaviors, to maintain their weight loss, the investigators said.


    image
    The frequency of consuming fast food meals was independently related to weight regain.

    The findings come from the National Institutes of Health–funded LABS-2 (Longitudinal Assessment of Bariatric Surgery-2), a prospective, observational study of patients undergoing weight loss surgery in six U.S. cities. In this study, 1,287 adults underwent Roux-en-Y gastric bypass surgery between 2006 and 2009, and their weight was measured an average of 8.3 times over an average of 6.6 years. Prior to surgery, participants had a median age of 46 years and a median body mass index of 46.2 kg/m2; 80% were female and 86% were white.


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    The participants lost a median of 37.2% of pre-surgery weight at their maximum weight loss, occurring a median of 1.9 years after surgery. At the last assessment, median weight regain was 25.2% from the nadir.

    In addition to sedentary activities, some eating behaviors and patient characteristics were closely associated with long-term weight regain. People who ate fast food more often, ate when full more than once a week, ate continuously throughout the day, and had binge eating or loss-of-control eating put pounds back on after surgery. People who continued to weigh themselves at least once a week better maintained their weight loss.

    In a behavior model, on average, a participant who ate two fast food meals per week, ate when full more than once a week, ate continuously throughout the day, had binge eating, had at least 4.5 hours daily of leisure computer or television time, and did not self-weigh at least once a week regained 20.7% more of maximum weight loss compared with a participant without these habits.

    Several patient characteristics also were associated with weight regain. Patients at risk for regaining the most weight were younger, and had high fasting triglycerides, venous edema with ulcerations, worse physical function, poorer general health and more depressive symptoms. Several of these symptoms contribute to poorer motility and a sedentary lifestyle, but the younger age was an unexpected finding.


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    Based on their results, investigators said patients with these characteristics may warrant enhanced monitoring in the years after bariatric surgery.

    Bariatric surgeons who were not involved with the study agreed. Shaneeta M. Johnson, MD, the director of minimally invasive and bariatric surgery and an associate professor of surgery at the Morehouse School of Medicine in Atlanta, said the report will not change how she counsels patients for bariatric surgery, but it highlights the need for long-term follow-up with behavioral and nutritional specialists as well as physicians and surgeons. “While our bariatric center currently employs nutritionists, psychologists and other behavioral medical specialists who address these eating and lifestyle behaviors, it behooves us to pay closer attention to these often hidden patient behaviors to foster improved behaviors and continued lifestyle change.”

    Significant weight regain after bariatric surgery is an uncommon but concerning issue for patients and surgeons, and surgeons need more information on what contributes to weight gain, she said.


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    It’s difficult to follow patients long term after bariatric surgery, and few studies have looked at the many factors that can influence weight years after surgery.

    The psychological evaluation often required before bariatric surgery might not be useful for predicting who will struggle to maintain weight loss after surgery, the study showed. Here, mental health and eating habits prior to surgery were not associated with long-term weight regain.

    This study reinforces that there are few helpful clinical predictors for weight loss success prior to undergoing bariatric surgery, said Anita Courcoulas, MD, the senior author of the study and chief of minimally invasive bariatric surgery at the University of Pittsburgh Medical Center.

    But it does highlight that patients are at highest risk for weight regain within one year of their weight nadir, she said. “This is a potentially important time to intervene, to be sure that some of the postoperative factors identified in this study, such as eating behaviors and self-weighing, are on track for success in weight maintenance. In essence, clinical follow-up is necessary even after weight nadir is reached, and it can help to guide behaviors that may contribute to better weight maintenance.”

    A limitation of the study is it looked only at patients who underwent Roux-en-Y gastric bypass. Although still one of the most common bariatric procedures performed in the United States, gastric bypass has declined in popularity over the past decade. A little more than 40,300 gastric bypasses were performed in the country in 2016, down from 57,986 procedures in 2011. That’s despite increasing numbers of Americans who underwent bariatric and metabolic surgery in that time.

    Over the same period, sleeve gastrectomy became the procedure of choice, with 125,318 such surgeries performed in 2016—an increase of 346% from 2011 (Surg Obes Relat Dis 2018;14[3]:259-263).


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    There is no comparable study to look at the factors influencing long-term weight regain after sleeve gastrectomy or other bariatric procedures.

    This is the first study to examine the association between fast food consumption and postsurgical weight regain, and the association was notable. The frequency of consuming fast food meals specifically, but not restaurant meals, was independently related to weight regain. Investigators said this likely reflects the poor nutritional quality of fast food.

    Binge eating was uncommon, reported by 4% of the 1,200 participants, but it was a major predictor for weight regain, accounting for an additional weight regain of 8% of maximum weight loss. More common eating behaviors—such as loss-of-control eating, eating when full, and continuously eating throughout the day—also were independently related to weight regain.

    The study examined 12 widely recommended weight control dietary practices, including cutting out sugar-sweetened beverages, eating fewer high-carbohydrate foods, and increasing fruit and vegetable intake. None was associated with weight regain.

    Overall, the results indicate that “addressing where, how and why food is consumed may be more important than focusing on specific aspects of dietary composition,” Dr. King and her colleagues wrote.

    The study had several limitations, including that clinical advice and patient compliance with clinical recommendations were not available for study. The study was underpowered to evaluate an association of weight loss medication use with weight regain.



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  20. #12
    Gastric Sleeve Member jerzeygirl's Avatar
    I have had a gastric sleeve.
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    Long to post, but interesting reading in my humble opinion.



  21. #13
    Gastric Sleeve Member sraebaer's Avatar
    I have had a gastric sleeve.
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    OK, now I have to go take a hike.



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  23. #14
    Gastric Sleeve Member Bellagirl's Avatar
    I have had a gastric sleeve.
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    Lisa
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    03/27/2019
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    Corrigan McBride
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    Default Re: I'm only a few days out from surgery - Laurie's journey.

    and shut off my TV



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