BurgundyBoy

Sleeves are about 90% as effective as bypass when it comes to weight loss. When scientists look at large groups of people who have had surgery, this small but real difference consistently comes through. When it comes to remediating diabetes, bypasses are hands-down much superior to a sleeve gastrectomy. I had a sleeve, but if I had had diabetes I would have had a bypass.

Wow! A family habit! More seriously, may Papa Trish have as much success as you have had!

@KarenBos You have hit the nail on the head. You are quite right. DEXA scans are the way to go. The scales that calculate bio-impedence can give you relative measurements or relative changes over time are not that accurate. BIA uses a 2-compartment model - fat containing tissues, and non-fat tissues, which each conduct the tiny amount of current that the BIA devices run through you. DEXA scanning uses a 4-compartment model, and calculates your body volume and measures your skeletal mass too. @Rob_VSG recently posted on this... he lives in Texas ... he posted saying that a DEXA scan cost $150 where he lives, so the $175 you mention here (Boston area) may be reasonable. For what it is worth, my surgeon told me that the average person has about 6 pounds of excess skin after bariatric surgery. Am sure the actual amount varies by person and by how much they lost... others have posted that they have been told that their excess skin is 2 BMI points, which seems too much... for me that would be close to 15.5 pounds! and that number is not closely similar to the 6 lbs. my surgeon quoted.

That is an understatement. @Michael_A 's dedication is a legend here. Thankfully most people don't need such a long period to address their enlarged livers. There have been people who posted here who already had damaged livers, which complicated their path to surgery...

Lisa, can't comment intelligently on feeling yucky - - - but not having any appetite is normal at this stage. One of the ways this surgery works is by decreasing appetite (and this is only partly understood). This decrease is most pronounced right after surgery. Your sense of nausea should pass! Your post makes me think about nausea and hunger ... I used to mix up physiological hunger, e.g. the hunger driven by your body's needs, and head or hedonistic hunger, the pleasure-seeking hunger driven by the pleasure of well presented, tasty, food that speaks to our emotional needs... Now these two are very clear to me. I still get hungry, but the amount of food I have to eat to address the hunger is much less than what I used to eat. When your after-surgery smaller stomach (or pouch) is full then the stretched-out wall of your (much smaller) stomach turns off the hunger response. There are times when I do eat from an hedonistic desire, but usually it is just a bite that I need to know what something tastes like - My recollection is that I did not have much nausea after the surgery, but I did have nausea when I tried to eat portions that were too big. It takes a while to figure out what your new portion size should be; the guidelines we get from our medical providers and nutritionists are helpful but I found myself still serving myself too much for some time. Just thinking about your post now - I used to eat 3 hot dogs at lunch with buns and all the condiments. Today I had one, my hunger was gone, and I was full. Eating more would have led to a sense of discomfort, which I experience as lower chest pain, and then (had I continued to eat) nausea. Are you drinking high-protein drinks or something else to keep your protein intake high enough? And, a lot of people who are eating a lot of protein become ketotic - and have little hunger! - seems that high carbohydrate diets lead to a lot of hunger...

My understanding is that the major reason for this relative contraindication is that it is more likely that the surgeons will accidentally nick (damage) the liver during surgery if it is big.... and a fatty liver is bigger than a non-fatty liver. @Michael_A 's surgeon measured his liver via ultrasound and he had to go on a liquid diet for some time, I think close to 6 months, to get his liver shrunk down to the size she set before she would do his surgery.... but I think his was an extreme case. Most people do not have to spend so much time getting their livers smaller. Having a fatty liver is really common if you are obese, would bet that **all of us** with obesity had a fatty liver. It's just a matter of the degree... the risk of this condition is that having a fatty liver (a reversible condition) can increase your risk of developing cirrhosis (which is not reversible).

@cindynels Sounds like the loss of your Dad was a big blow and am sorry for your loss. So often the strength of our foundation is dependent on a couple of keystones. Those critical relationships provide strength, but if they are lost we can lose our way. Would like to echo @Jen581791's idea of getting ahead of the game now - am sure you will be successful with your clear-eyed analysis of why you regained. This is such a head game! Am fond of saying that the surgery changes your intestinal plumbing but it does not change what goes on in your head. You are so very smart to be in therapy and to go into the surgery with the inner strength that will help provide. Would be sure to line up your social support - the people who will have your back when the motivation / will power is needed. Am sure that real, living, breathing people are better than the internet, but would just say that reading and posting here on the Thinner Times Forum has been very helpful to me. It has helped me to stay honest about my bad habits and failures, of which I have many. The other things (besides social support) that I have found helpful is to try to get exercise every day, which combats depression and anxiety as well as keeping me physically healthy, and to keep the cocaine-quality carbohydrates out of the house. That means potato chips, New England-style blueberry muffins, and the like. You deserve much admiration for your persistence, your honest look at why your first try at this did not succeed, and your willingness to have surgery again and not give up on yourself. We are rooting for you!

@LadyDay My wife was initially opposed to my having surgery. she was concerned about side effects and surgical complications. She had to independently speak with a bariatric surgeon that she knew socially to come to terms with the surgery. The complication rate was once fairly high for bypass / roux-en-Y surgery and it is now lower than the elective gallbladder removal rate. Now my wife is delighted and tells me how glad she is that I lost all this weight.

@LadyDay Not sure I have a comprehensive response but this is my take - Your eventual loss after surgery is NOT directly or principally related to the caloric intake guidelines. My guidance was to make sure I got in at least 700-800 calories a day with at least 60 grams a day of protein. I am nearly 2 meters tall and I would not have made it on that few calories a day. I aimed for at least 90 grams a day of protein. Within a couple of months I was eating 1200-1600 calories a day. You can get to your goal weight after surgery quickly (severe dietary restriction after surgery) or less quickly (less restriction). I have friends on the TTF who got to their goal weight in 6 months, and others (me) took a little less than a year or so. While I am glad for my friends I have not one iota of regret about my own pace. The downside of the very low caloric intake route is that it can, in theory, reset your metabolism to a lower set point. That has been shown in people who lost weight (without surgery) with severe caloric restriction. This concern does not appear to apply to people right after their surgery. There are lots of people on the TTF, though, who got to their goal low weight pretty rapidly and successfully with caloric intakes of 700-800 a day. They were quite careful though to get enough protein and to take their vitamins and minerals. (In order to maintain weight they have upped their calories significantly when they got to their goal). To get back to your concern, though, --- there is some data that after surgery your metabolic weight "set point" gets re-set much lower. Your body WANTS you to get to your much lower weight. see: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485884/ Your body will move heaven and earth to get you to the lower weight set point. The medical group and their expert nutritionists that I see will not even engage in a discussion about 700-800 calories vs. 1500 calories a day. They say both work, it is only the pace of the loss that is a bit different. I was never a person who could eat only 700 calories a day and other than for a transient period after surgery, I never had an intake that low. Would I have gotten to my nadir faster? Yes. I also would have been driven crazy (well, crazier). My personal opinion is that if you want some kind of "insurance" then be cunning and and coldly rational. First, bariatric surgery works for everyone unless they continue to eat 30,000 calories a day for emotional reasons. It will work for you, and no despite your anxieties you are not weirdly special and the only person in the world that it will not work for. (Many of us have this irrational fear). While we are all different, as a group we lose weight in highly reproducible ways after bariatric surgery. It works. Second, get exercise. Exercise is not CRITICAL to weight loss surgery success BUT (1) it will up your caloric demand for each day (2) is linked to very major health benefits (metabolic, psychological, other forms) and (3) is associated with greater weight loss after surgery. A review of exercise after surgery found that people who exercised had a BMI 2.1 points lower than persons who do not exercise. By this it is meant that if the group without exercise got to a BMI of 27.1, a comparison group that did exercise got to a goal BMI of 25.0. For what it is worth the way exercise was defined it included people who walked a mile once a week, so it included many people who minimally exercised, so this estimate is likely an underestimate. ---------------------------------------------------- Just to mention - The other common thing I have seen people complain of is hair loss, which is common when you eat very little including lower levels of protein. In many studies, hair loss after surgery is minimized when you eat more protein. This makes sense since hair is almost pure protein. (No doubt getting enough of key vitamins and minerals is also important, but inadequate protein intake is probably the key driver of hair loss). I would not prioritize weight loss and caloric restriction if all my hair was falling out! That would be your body's way of saying it needs help and is protein-deficient! There are lots of studies showing that hair loss is minimized when you eat 90 grams of protein a day, compared to 60 grams....

@delilas What a cutie! Thanks for the pictures!

@Dtrain84 - new posting topic: "How shirts get turned into dresses." ... or, "How weight loss surgery led me (a guy) to wear dresses." For sure I have some clothes in the back of my closet that look like dresses now too!

How you doing? just thought to check in after a while! Best wishes BB

bioimpedence The scale sends a little current through you. Your particular mix of bone, water, and fat provides resistance to the current. The device then tells you what the predicted mix of constituents is that leads to that much resistance for someone of your weight. It's not very accurate BUT you can track relative changes in your composition with it. BIA is particularly inaccurate for obese people or very fit people. DEXA (sometimes called DXA) scanning is much more accurate. The study done to measure bone density can also measure your fat-free and fat compartments.

Dastardly weight loss gremlins at work again.

Nah. Not too old. 69 is the new 29, right? For what it is worth, I had my surgery near my 62nd birthday. When I enter my health information into online calculators, I now have an average lifespan of 94. It was less than 75 in the past when I had to include my higher former weight, hypertension, sleep apnea, "borderline" diabetes... I essentially doubled my expected remaining years by having surgery.