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Everything posted by Rob_VSG

  1. Yes, it's interesting to watch, now getting to the lower end of the of the 170's, I haven't been here since grade school! It had felt like 176 is where I would stay but now it's drifted down some and is possible I will be into the 160's before year end. My goal weight was set by my surgeon and set according to some math based on average percentage weight loss for VSG patients. I had planned to blow past it from the beginning and that's why I put so much research time into diet and nutrition (and insulin control). Even with that plan, I figured some where around 190 would be a realistic point where weight loss would likely stop. I weighed in at 172.0 this morning which means I'm already 18 pounds below the more aggressive target I had set for myself. I feel really awesome (maybe even giddy) and am tracking percentage body fat and muscle to make sure I don't go too far. That way if anyone I know suggests perhaps I am losing too much weight, I have data to refute the claim and continue on with no self doubt.
  2. The last few months my focus has been on keeping a healthy eating style (whole foods, low carb + IF) and not gaining weight. Seems I'm still losing a pound or two a month. I'm wondering if our bodies can just "figure out" a weight to stay at.
  3. Stay strong, it will be worth it.
  4. Oh yeah, same here, if I'm going to go off plan it will be when I am away from home. That way it seems less likely to turn the off plan stuff into a bad new habit. Although I have to say, even when I'm away from home, I don't feel a strong attraction to less healthy foods and I hope that continues for me. As far as weight, I'm not really trying to lose at this point, just focused on healthy eating habits (quality foods and intermittent fasting). My weight seems to be stuck (or stable) around 175-179 although my percentage body fat is stable to slightly lowering. I'm glad you are healing! Rob
  5. Ahh, the journey is long from over! There are so many things left to try. Read @BurgundyBoy's suggestions above, they are good ones. I'm 13 months out and more often than not my body rarely lost weight how I expected it to. What I found worked for me was staying focused on protein first, then drastically reducing carbohydrate intake and shortening my daily eating time window as well as going for 20-30 minute walk 3-5 times a week. Shortening my eating time window lengthened my over night fasting time window and between that and reducing carb intake my surgeon measured a higher metabolic rate for me. That means my metabolism increased well over where it was pre-op. You will find what works for you!
  6. Congratulations on still killing it! I too am sticking with intermittent fasting while not tracking and it is very manageable for me. I finally touched 179 but then bounced up a couple pounds, but then the body composition numbers aren't showing more fat so I'm chill about it. Sounds like your plastics went well and I wish you good healing. Rob
  7. Holding steady and being flexible, that's huge! Glad to hear your recent surgery was a success. Keep up the great work! Rob
  8. I would like to call it "working out" but in my case, I am so out of shape, the personal trainer experience is more like physical therapy. The drastic change of weight has really thrown off my neuromuscular system and lost any sort of muscle memory I have had in the past. Only had 4 sessions so far but I can already see and feel improvements! Rob
  9. @AliPat You are struggling but hanging in there! I'm sorry to hear about your work injury and MS challenges but am really glad to see you working on your mind set and sticking to the plan. Have you made any diet tweaks to help with the MS condition? I don't know much about it but recently saw an article saying restricting trans fats, refined carbs, sugar, and dairy is something to consider when dealing with MS. The exercise really helps with mental attitude also, so awesome that you keep moving. The affirmations are great, make sure you are loving yourself every day! Rob
  10. Thank you! I've been inspired by a great number of your posts and I'm glad I can share back with the community. Rob
  11. I plan to march on as usual, will focus on getting to a "normal" BMI/percentage body fat and then trying to keep my weight in a stable range. Also started working with a personal trainer to build up my flexibility, range of motion, and muscle mass. Seems like a substantial weight loss has thrown off my balance and its time to build up some new muscle memory. I'm not expecting a let down since I probably have at least another year of things work on for myself improvement project. Perhaps by then self improvement will become a habitual process? Rob
  12. To learn about low carb noodles, I ordered "Miracle Noodles" from Amazon and then found youtube videos about how to prepare them. They aren't exactly the same as pasta but offer a great low carb alternative. After that, I went to the Asian market and found "Shiritaki" noodles from Japan in the refrigerated section, they are the same and cheaper but weren't available in the fettuccine form. I'm still losing slowly. I want to get to a "normal" BMI and percentage body fat. Interesting side note, my calculated daily caloric expenditure should be around 1800, but the BMR (basal metabolic rate) measured by my surgeon was 2500 calories. This seems to be consistent with the theory that intermittent fasting does not slow down my metabolism. If anything it has accelerated my metabolism. Probably just as well that I'm not tracking macros and calories for now.
  13. Thank you CJ, I wanted to share because I've picked up so many useful bits from all the others posting here so I hope maybe people will find some useful bits from my sharing. I see you are still doing very well on your progress so keep it up! My favorite line was "self pity demands cup cakes". Rob
  14. You make a valid point. I kind of assumed since I had both an elevated A1C and skin tags, a common indicator of insulin resistance (IR) that my body was likely working over time to create insulin which, I think is one of leading causes of the pancreas to give out and put one into full T2D status. So my conclusion was an elevated A1C is possibly an indicator of IR, but I should probably have pointed out that a normal A1C is not necessarily indicating normal insulin sensitivity. I totally agree that FBG and A1C are not really very good metrics to use for diagnosing complex metabolic syndrome problems. Currently I am working from the theory that if I can measure high ketone levels, then, theoretically, my insulin should be fairly low but I'm not sure how solid the science is for that theory, but you work with what you have. IR and hyperinsulinemia seem to be tethered by certain commonalities that lead me to believe there is something else that needs to measured even beyond glucose and insulin. Coincidentally, I did mention to my surgeon that it seems odd doctors only want to measure glucose and not insulin and that seems to only provide part of the picture. He agreed, but didn't offer any explanation as to why it's done like that. As always, I enjoy your thoughts. Rob
  15. I saw my surgeon for my one year follow up appointment. He was so thrilled with my progress (145 lbs) he asked if he could make me his patient of the month. So, what I have learned over this past year? 1. I was seriously physically, emotionally and chemically addicted to refined carbohydrates and sugars. The post-op diet was the best time to break that addiction since soon afterwards the focus gets placed on getting in enough nutrient dense protein. Basically, you don't have space for refined carbs. 2. Seems like the key to controlling weight is controlling insulin as this is your bodies master control hormone that rules all of the other hormones that affect your metabolism. Once your insulin goes up it signals your metabolism to store energy, which also means you won't burn fat. For me, I find that a ketogenic (protein first) style of eating combined with intermittent fasting works best. With the bulk of my food intake being nutrient dense protein and healthy fats, I feel full and satiated easily. Being in ketosis makes fasting for 14-18 hours a day fairly easy since my insulin stays low and blood sugar stays stable cravings are near zero. I measure my blood ketones with a home meter and if ketones are showing up, then insulin is staying low. 3. The expression "you will crave tomorrow what you eat today" is pretty darn accurate. While I may think about food during my fasting period, my brain has shifted from the "what can I eat now" mind set to "what tasty nutrient dense meal can I have later when my fasting window is done". Frankly, I didn't believe that mind set change was possible when I started this process, but I stuck to the post-op plan of protein first (lots of water too!) and slowly shifted into the keto style of eating and extending my nightly fasting window and over time, my mind set has changed. 4. Exercise for health: Strenuous exercise is not required to lose weight. For the past year, I've only been walking 20-30 minutes a day for 4 days a week and most of my effort is round working on my eating patterns and nutrition. I don't have any exercise I actually like to do, maybe one day I will find some. If you have a physical activity you enjoy thats awesome, but don't rely on it to help you lose weight because it's really more about controlling hormones. I am now at the point where I needed to line up a personal trainer to start making sure I am able to maintain or maybe increase muscle mass, improve range of motion and fine tune the neuromuscular system. In short, exercise for health, not weight loss. 5. Healthy replacements! It is worth spending time to find healthier replacements for foods you think you will still want. A month or two post-op I was wanting bread, so I figured out how to make low-carb "keto-bread" and that satisfied me, but then months later I haven't been making that as I don't have a strong want for bread. I was raised by an Italian mother and have been trying to find a pasta replacement and finally tried out Shiritaki noodles, like "Miracle Noodles". Now I can make an awesome low carb alfredo sauce with fettuccine Miracle Noodles and toss in chicken or shrimp and have an extremely satisfying meal. 6. Addiction transfer is a real thing. I regressed back to smoking cigarettes. This has now moved to the top of my list of things that need to change. This is the final remaining habit that is counter productive to improving my cardiovascular health and it has to stop and it will. 7. The benefits of changing my eating patterns and habits go so far beyond just losing weight I am highly motivated to make this life style permanent. Pre-op I was clearly having problems with insulin resistance. The key indicator of insulin resistance is your HbA1C blood test (mine was 6.2), if it is above the normal range, you are becoming insulin resistance. The issues I was having around this insulin resistance were joint pain including gout, skin tags, eczema, high blood pressure, poor sleep, low energy, brain fog, depression, degrading vision and increasing eye pressure (reaching glaucoma level). All those issues are all either gone or greatly improved. Incidentally, my eye doctor of 12 years told me there were no life style changes I could make to improve my eye pressure, yet at my December check up he measured the lowest pressure he has since I've been seeing him. I'm believing doctors much less these days. Seriously, get good at researching scientific and medical studies online. 8. I believe that if I were to merely be struggling through a diet for the purpose to reach goal weight and then go back to eating "normal" then that would be recipe for failure. Putting in the effort to form a new normal is what really has to happen here for long term success. Perhaps folks who are much further along post-op than me can explain this better than I. At this point I feel more like I am working on the new normal (permanent change mentality) and not like I am denying myself foods that I really want for a temporary period of time to just lose weight (temporary diet mentality). This might sound strange but I am trying my best to articulate the psychological shift. 9. Stick to the plan, success will breed confidence! Also, the plan isn't written in stone, don't be afraid to analyze and fine tune it. The plan should be your guide or "rule of thumb", not a bible. I have not deviated from the two cornerstones, protein first, and I drink LOTS of water. Think of it as sticking to the plan, not being restricted to the plan. Don't beat yourself up if you deviate every now and then because of it. Beating yourself up over plan deviation (falling off the wagon) begets self pity and self pity will demand cup cakes (or some other unhealthy food). It's a viscous cycle, break it now! Ok, I think I covered everything I wanted to. Hope you made it all the way down here! Remain calm and carry on. Rob
  16. I am still trying to lose. The surgeon set that goal based on some math but I have my own expectations. My BMI is currently hovering near 27 (as tracked by my fancy digital scale) and I would like to get to a BMI of 25 or below which hasn't happened since about 2nd grade. I'm not sure what the rules are on these forums so I left my surgeon's goal number on my profile despite my personal goal being much different. I am very comfortable where I am now and fasting 16hrs and eating for 8 feels normal to me now and requires less thinking about food than trying to get in 3+ meals a day. Weight loss is slow but steady and I will see my surgeon February 20th for the 12 month follow up and see what he has to say. My gut feeling is I should break below a BMI of 25 somewhere around 170-180 or maybe sooner if I actually make the effort to build some muscle.
  17. I'd like to congratulate you on your long term success. It seems you are experiencing a feeling of control that is so important for permanent success too! Best of luck on your future plastics. Hopefully someone will chime in. Rob
  18. Good points. I barely lost some weight in November and December, however I consider that, just not gaining weight in that time period is a victory because the majority of the general population gains weight in the holiday period. Despite very slow weight loss, I made it through Halloween, my birthday, Thanksgiving, Christmas and New Years without gaining any weight.
  19. On the subject of controlling insulin.  From the research I've been doing, specifically, comments by Dr. Bikman the PhD Insulin researcher/scientist, measuring blood Ketones is a useful surrogate for measuring insulin.  While there is no direct numeric correlation, the more your body is making the Ketones, the lower your insulin must be.  Even a Ketone number as low as 0.3 (without consuming exogenous ketones) means your insulin is fairly low.  The theory being when insulin shoots up your body will lower or stop making ketones.

    Something to think about.


    1. Aussie Bear

      Aussie Bear

      Oh believe me I've heard and read everything Ben Bikman has to say. You can't research insulin responses without him coming up as the foremost authority on the subject. Thanks for the heads up though. I know I'm in ketosis most of the time now, and my blood sugars are holding pretty steady which is a good sign that for the most part I've got my insulin under control. Still had a massive low two nights ago when I ate something that in hindsight I shouldn't have.....when will I learn!!!!!!

      Cheers, Heather

    2. Rob_VSG


      Bikman also mentioned that some folks that eat low carb could experience rebound hypoglycemia after suddenly eating eating a lot of carbs.  Does that sound like your experience?

    3. Aussie Bear

      Aussie Bear

      I wish that was all it was. Unfortunately it doesn't take many carbs to set up a very high spike and spiral down, even when I take an acarbose tablet before eating. One dietician I saw after first being diagnosed with reactive hypoglycemia said it was my fault for being low carb for so long before my surgery.

  20. Pre-op my HbA1c was around 6.2 and I was told I was pre-diabetic. Three months post OP my HbA1c was 5.5 and considered in the "normal" reference range. My surgeon didn't check my HbA1c at my 6 month follow up. My 12 month follow up is coming up in February, I'll make sure he checks it then. Doctors here don't typically measure Insulin level either. I have home meters to monitor Glucose and Ketone levels. My fasting glucose seems to sit on the high end, typically 90-105 mg/dl (or 5-5.8 mmol/L) and my blood ketones usually range from 0.5-2 mmol/L. I would suspect that if you have good ketone levels (a better energy source than glucose) then fairly low glucose levels wouldn't be too much of a worry, but, without checking insulin at the same time it feels like we only have half of the picture. If you are concerned about hypoglycemia you might want to use a home meter if you are not are not currently doing so. My understanding is that a FBG above 50 mg/dl or 2.78 mmol/L is adequate to keep you out of a hypoglycemic state. Cheers!
  21. I am happy to share on this subject. Let me qualify first that I am just sharing my experiences and how it has been working for me and this may or may not be right for other individuals. Also, I'm an engineer and not a doctor. Since VSG, generally, does not cause nutrient malabsorption I wasn't too concerned about proper nutrition as my post-op recovery was pretty easy as far as the amounts of food I was able to consume was fairly substantial and I keep up with my vitamin supplements. I did focus on protein and drinking lots of water like the doctor told me. Aussie Bear is spot on! I too did much research, even before my surgery date, however in my case I didn't manage to come across the concerns about trying IF in the first 6 months post-op but have since found similar information that Aussie Bear discussed. I just saw a Dr. V video on youtube about why its best to focus on nutrition and getting your head straight during the honeymoon period post-op. In my case, my thought was trying IF while in the honeymoon period was a good idea because it would give me the confidence I would need to be able to implement it when my weight loss slows in the future. In my case, this worked out fine, but then I'm 58 years old, live alone and don't have many psychological challenges around food other than I really like to eat tasty food!. I even tried 3 24hr fasts in the first 6 months and when I went in for my 6 month surgery follow up, my nutritionist was aghast when I told her and she admonished me and warned that would slow my metabolism. After that the doctor measured my Resting Metabolic Rate and it was HIGHER than pre-op! Also my blood work looked great. After 8 months post-op, my weight loss did slow considerably so I slowly started extending my over night fast into the morning by skipping breakfast and found 12 hours eating and 12 hours fasting really easy to do. At 11 months post-op now my target is 8 hours eating and 16 hours fasting. Some days I hit that target some days I only get 12-14 hours fasting and others I can go as long as 18 hours fasted. This gives me plenty of flexibility to attend work lunches if needed. I should add, I too am following close to what would be considered "ketogenic diet" macros however I'm not super strict so I would call it keto-ish or keto-esque, and like Aussie Bear, approached my diet from the "low glycemic" point of view. So if I eat fruit, it is low on the glycemic index like organic wild blueberries or cherries. If I eat red meat it's usually grass fed beef, or poultry will be free range chicken, fish will be wild caught salmon and vegetables typically organically grown. Refined carbs or sugars are close to zero. Using Keto+IF has seriously reduced my head hunger and I feel very in control and satisfied. The reduced eating time window means less time planning and preparing healthy meals as well as less time thinking about food. My plan is to reach my goal of being a "normal" BMI then just fine tune my eating vs. fasting times to switch to maintenance. During this honeymoon period I have worked hard to find healthy alternatives to satisfy my every craving and over time my tastes and cravings have actually changed towards those healthy alternatives so I rarely feel like I am denying myself food that I want. Denial is rarely a long term strategy for success. I feel much better using IF and I don't believe the human body is well suited for long periods of eating and short periods of fasting. See Dr. Jason Fung's videos on Insulin and fasting, they are very informative. Being diagnosed years back as pre-type 2 diabetic, which means becoming insulin resistant, I am very focused on controlling insulin. Editing this post with an additional addendum: My weight loss post op has been done almost entirely on just diet and NO intense exercising. I can usually get in a 20 or 30 minute walk 3 or 4 times a week but other than that my lifestyle is rather sedentary. I am doing it that way because of my personality and I know if I force myself to exercise as part of losing weight that most likely at some point in the future I will likely lose interest in that activity so my full focus is on proper nutrition and eating strategy and turning that into my "new normal". Some folks on these forums are different though and have physical activities they truly enjoy and are able to enjoy even more after losing weight and that is really awesome. I still expect that at some point in the future I will find a physical activity I enjoy that keeps me motivated, but until then, I'm on track with my current approach.
  22. Hey, your date is coming up soon. I had lots of anticipation and a little bit of nervous. Everything still went way better than I anticipated, I suspect it will for you too! Most of us look back and try to remember why it was we were nervous. Best of luck and happy holidays, I'm confident you will be happy with your decision. Rob
  23. I would like to add some info to this thread. Prior to my VSG surgery I was researching keto diets, then when I looked at my surgeons post-op diet plan, it appeared it would cause ketosis and I asked him to confirm this and he said "yes" even know he didn't seem a proponent of the keto diet (but I'm stubborn). So as an experiment I purchased a blood glucose/ketone meter off of Amazon to track data after the surgery. Two days post-op my body was starting to make ketones (yep no carbs, just bone broth and water). My thought was if the post-op diet would put me into ketosis, I would see if I can keep that going from the very beginning. The worst part of starting a ketogenic diet is carb withdrawal (keto flu), and that would happen post-op so I decided I only want to experience that once. By day 5 or 6 post-op my body was making so many ketones it went off the ketone meter scale and just read "High", so that was scary, but wasn't a problem because my glucose was plenty low. During that keto flu phase, it seemed my body was making ketones but my organs (including my brain) had not started using them for fuel right away, as if they were waiting around for some carbs. After a couple weeks I felt as if I was becoming "Keto-adapted" which means I was able to use the ketones as a source of fuel for energy. At 4 weeks post-op I had mental clarity and function that exceeded what it was prior to the surgery (hint: ketone fuel crosses the blood/brain barrier more easily than glucose) and that motivated me to keep it up. Since I track blood ketones, I don't worry about being strict, if I sneak in a few carbs here and there I just check my ketone level the next day as long it is in range (for me like 0.8-2.8) I don't sweat it. Plus occasionally moving in and out of ketosis from time to time isn't really a problem as long as one doesn't go on a multi-day carbohydrate binge. The weight I'm dropping is substantial and my blood tests are good, so my surgeon doesn't ask me what I'm eating. My regular doctor has taken me off the blood pressure meds (my last prescription) and all of the auto-immune issues I had are about gone (yes ketones are anti-inflammatory). I am in month 9 post-op and am now trying a daily 8 hour eating window and 16 hour fasting window. Being keto-adapted seems to train the body to smoothly transition to metabolizing stored fat when fasting so no noticeable loss of energy when I fast. I tend to feel an increase in energy near the end of the fast at which point I'm eating food to calm down. My 2 cents worth. Rob
  24. This strategy works well for me too, I don't think of it as not eating, just delaying the activity. Also, I found this video from Dr. V the weight loss surgeon helped me rethink how I view hunger: Rob
  25. You will crave tomorrow what you eat today. Especially carbs! Keep up the good fight. Rob