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Old 04-10-2006, 07:11 PM   #1
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Default WLS from a Fitness Expert's Point of View

I did a Google search on WLS today, and found the following article written by fitness expert Phil Kaplan. It looks like he did a lot of research on the subject, talking to several bariatric surgeons and many WLS patients.

I have only posted a few highlights from the article, to comply with the copyright laws. I urge everyone who's interested in this subject to follow the link at the bottom to read the article in its entirity. It seems to be a very balanced and informative article.

Quote:
Bariatric Surgery

Fitness Expert Phil Kaplan discusses some of the considerations that should be weighed when considering a gastric bypass or any weight reduction surgery.

Singer and talk show host Carnie Wilson has pretty much become the poster person for bariatric surgery and now surgeons are advertising their services and why not? As obesity skyrockets, surgery that promises to bring an obese individual back to a manageable weight has great appeal. The ads, unfortunately, seem to sway people into finding the potential outcomes as positive, when there are serious risks that should carefully be weighed out.

The two most common Bariatric procedures are banded gastroplasty and the bypass. I'll explain the basics of each. Keep in mind, I am not a medical doctor, and this information is the result only of a foundational knowledge of anatomy combined with extensive interviews with medical professionals and bariatric patients.

Before I explain the procedures, you should know that every bariatric patient I spoke to told me the residual pain was far more severe than they expected, even with lengthy pre-surgery consults with doctors.

<snip>

It's important to note that this surgery is drastic and is only a consideration for the morbidly obese, people who have over 100 pounds to lose. It should not be viewed as a shortcut for someone struggling to lose 25 or 30 pounds (although I fear that as its popularity grows, unethical doctors will be compelled to tap further into the potential for accumulating great wealth creating "pouches"). Since the surgery should only target as candidates people with 100 pounds plus of excess weight, most who are approved for surgery will likely have risk factors going in. Obesity, as you know, contributes to likelihood of hypertension, diabetes, and pulmonary problems, all issues that can greatly affect the risk associated with any surgery.

Interestingly, while many candidates for bariatric surgical procedures have joint issues, arthritis, circulatory and respiratory problems, the stomach and the small intestine are often working quite well. It's sort of ironic that the surgery on a patient with many maladies can cripple two fully functional organs, the stomach and the small intestine. Since most of absorption normally occurs in the small intestine, the risks of malnutrition or nutrient deficiency are very real.

Complications from bariatric surgery can include:

o - Spilling of gastric juices and digests into the abdomen

o - Peritonitis (a potentially fatal abdominal infection)

o - Malnutrition

o - Nutrient Deficiencies

o - Nausea and Vomiting

o - Dehydration

o - Blood clots

In severe cases, the following long term complications may emerge:

Dumping Syndrome, where stomach contents move too quickly through the small intestine. This can result in violent vomiting and diarrhea, chronic nausea, weakenss, sweating, and an inability to eat sweets without unpleasant or serious consequences.

Gallstones are formed when cholesterol and other matter form clumps in the gallbladder. It appears that the more significant the weight loss, the greater the likelihood of gallstones. Statistically it appears that more than 1/3 of bariatric surgery patients develop gallstones.

Weakening of bone and/or Metabolic Bone Disease can be the result of decreased absorption of calcium.

Anemia may result from malabsorption of vitamin B12 and iron, particularly in menstruating women.

Childbearing is not recommended for women who have undergone bariatric surgery and many develop residual hair loss and skin problems.

<snip>

I should also mention that in speaking to more than a dozen bariatric surgeons from different parts of the United States, every one told me that their surgical patients had all been through 10-20 years of dieting. By now you should understand, consistent bouts with calorie deprivation guarantee a slower metabolism, greater propensity for fat storage, and a far greater challenge in shedding fat in the future. If these patients were taught to eat supportively and to exercise in a harmony with their healthful nutrition regimen, I strongly believe many could move past the desperation that leads them to face the surgical risks in the hope of being 'rescued."

While I promised I would keep the identities of the bariatric patients I spoke to confidential, I don't believe I'd be violating any confidence if I shared the following:

While several said life was better after the post surgery weight loss, not one of them felt they could live the normal life they'd hoped for. They all felt they had to constantly watch what they put in their mouth. They all feared regaining the weight. Many were confused by all the nutritional supplements they were encouraged to take, some found it difficult to get down the oversized pills, and many frequently found themselves with abdominal pain, low energy, and bouts of nausea.

Even some of the patients who were satisfied with the result and expressed that they were happier since the surgery had suffered undesirable effects such as hair loss, bad breath, gum and dental issues, and violent vomiting if they took in more food than was recommended.

<more>

http://www.philkaplan.com/thefitnesstruth/bariatric.htm
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Old 04-10-2006, 08:53 PM   #2
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Hmmm. Nothing new or suprising there. In fact, it pretty much supports what we've been saying. Don't do it "willy nilly", try reasonable measures first, and know that it's a life changing event.

The only part I disagree with is this:

Quote:
If these patients were taught to eat supportively and to exercise in a harmony with their healthful nutrition regimen, I strongly believe many could move past the desperation that leads them to face the surgical risks in the hope of being 'rescued."
This guys a fitness expert. Of course he thinks that exercise and eating well will help people lose weight. They all say that and yet... what's the actual success rate for person who, indeed, has over 100 pounds to lose? I still encourage people to try, because the vast majority of people benefit from exercise and dietary changes. But expecting to lose 100 pounds that way is hopeful thinking. I hope it works for folks, but in my experience -- as a patiet and as a member of the size acceptance community -- I just haven't seen it, unfortunately.
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Old 04-10-2006, 09:29 PM   #3
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Originally Posted by Wayne_Zitkus
I did a Google search on WLS today, and found the following article written by fitness expert Phil Kaplan. It looks like he did a lot of research on the subject, talking to several bariatric surgeons and many WLS patients.
The article is more of a middle of the road perspective of the issues with WLS. (I've seen dozens similar to it over the years.) Once someone has started looking for WLS info in earnest, they've usually already decided to have it. They are just looking for information that validates their decision (and people who will support them emotionally after their surgery.) This article probably won't do that so they will ignore it.

Most pre-ops just don't appreciate the implications of what the article is really talking about. Someone who is physically and emotionally miserable is usually desperate for a "cure" like WLS. They probably won't fully understand the implications of metabolic bone disease when they are told they can prevent problems by taking a calcium supplement to prevent osteoporosis.

I'm increasingly frustrated about the loss of bone in post-ops. This past weekend I had dinner with another couple of friends who are RNY post-ops. The wife of this couple admits to losing two inches of height in the four years since her surgery. Even so, with her recent regain, she'd go in for another surgery to increase the malabsorption. And this is with her admitting she's got ongoing GI problems significant enough to keep seeking medical attention for what sounds like a variant of intestinal stasis (extremely poor motility, taking over ten to twelve days for elimination).

Her husband regrets ever having the surgery, although I don't know if he's lost any height. I'd estimate he never got below a BMI of 55 (from a BMI of about 65 to 70).
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Old 04-11-2006, 06:37 AM   #4
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I think that the article was pretty close to accurate, at least in that it summarized many of my experiences.

It is difficult for me to be impartial, because I consider myself a success story. I was once 296 pounds, in very poor health, and unable to live the life that I wanted to. I lived in a constant state of denial. Anything that hurt me, I dealt with it by attempting to stuff myself numb. Hence, the issue(s) never were appropriately dealt with. I can say with certainty that strenuous exercise was impossible for me. There were some that could have helped, such as water aerobics, but I was far too uncomfortable with myself to try it. I wanted so badly to get pregnant and have a child, but I was infertile. My doctors were very strongly against fertility drugs, because given my body mass, the amount that I needed could cause some serious & difficult side effects.

My weight today hovers between 150-155. Not only do I exercise, I truly enjoy it. I am addicted to Yoga, I love bike riding & roller skating & taking long, brisk walks & even jogging. I did get pregnant, but I miscarried. It is not uncommon, and my ob/gyn is confident that effects of my WLS did not cause my miscarriage. I was very bitter and angry about it, because I feel that I had WLS so that I could have a child. For a long time, that was the extremely narrow focus for my entire life. I didn't think a whole lot other impacts that losing weight would have on my life - some positive, some not.

I am grateful that my body is strong and flexible. I do not take for granted that it will always be this way. I know that I could develop problems down the road, some of which could specifically be traced to WLS. I do what I can to ensure that I am complying with program directives, and I hope for the best.

My weight fluctuates by as much as 10 pounds. I do constantly live in fear that I will lose control and gain it all back, which is why I am a little harder on myself than I probably need to be. I felt absolutely wonderful at 200 lbs, and I looked great. At 150, I am not small, but I do not have the protective layer of fat that keeps my face smooth & wrinkle free .... and the spare tire of skin around my tummy is very noticeable, since everything else on my body is comparatively small. But I won't let myself regain that weight, because I fear that I'll never stop, once I let down my guard. I don't like that aspect of my life, but feel that it is an acceptable trade-off.

The bottom line for me is that I feel free. There are so many things that I wish I could have done differently, and I wish that I could have sustained my pregnancy, but the reality is that I didn't, it didn't, and I can't go back in time. I can only move forward.

My position here is that WLS is not an easy fix, shouldn't be a snappy answer to a complicated problem, and should only be the option of last resort. And if it is done correctly, and the person having it done is emotionally prepared for ALL possibilities (inasmuch as we can ever anticipate the future), it can be a positive life-altering experience.

My weight loss is only one part of who I am now, and it is in fact a very tiny part of me. I am more confident, far less likely to take shit from anyone, happier with myself, and when problems arise, I face them dead on. I will always have this: When my life was spinning out of control 2 years ago, I took action. For me, it was a wise choice.

I may not always feel this way, but I do now. I can't live in the land of "what if". I could develop problems later .... just as I could have dropped dead of a massive heart attack before I ever saw 40, had I continued to compulsively eat my way around my problems.
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Old 04-11-2006, 06:43 AM   #5
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Default Gallstones...

...are a common side-effect of any severe caloric restriction. AAMOF, many bariatric surgeons recommend that ones gall bladder be removed prior to WLS. My last diet was that infamous 400kcal liquid fast (and, no, I didn't jump on the Oprah bandwagon, as I did this diet before she made it famous), and I developed gallstones as a direct result of being on that regimen for 4 months. (Side note: I hated that diet so much that I told everyone that I wouldn't recommend it to my worst enemy. Nonetheless, my friends and family ALL went on the fast, solely because they liked the way that I looked at 180 pounds [I'd exercised a lot while on the fast, and I looked better at 180 than I had previously at 160]. To my mind, this only goes to show the lemming-like effect that superficial results will have on the decision-making abilities of the general population. I mean, here I was dissing the thing, and yet everyone jumped on the bandwagon. Imagine how it is for WLS, with all of its celebrity shills! But for me, it was the nail in the coffin for any and all dieting. Period. I stopped dieting after that, and I never looked back.)
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Old 04-11-2006, 07:26 AM   #6
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I believe there were a lot of excellent points in the above article. There are a couple I don't necessarily agree with. One being the exercise; lets face it; at over 300lbs and walking with a cane I didn't really have many options for "exercise" Water aerobics were not recommended because of the fear of infection in my leg that I'd been fighting on and off for 2 years prior to my surgery.

The second is bone loss...I am 40+ years old and I just had a bone scan that reflected that I am doing most excellent. So much in fact that in a recent accident I broke NO bones.

Whenever I read these articles why is it that you read "everyone I spoke with said....." I find it hard to believe that they didn't interview one person that was happy and healthy with their surgery.

Just for the record...I read all of these type of articles prior to my surgery; I wasn't looking for validation for what I wanted. I wanted to make sure I knew ALL the possible risks. After thinking about it for over a year I then decided to have the surgery when the other option was amputation.
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Old 04-11-2006, 08:47 AM   #7
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One other thing I wanted to add to the excellent posts here is that not all bypass surgeries are created equal.

I think an enormous factor, one discounted, is how much intestine is bypassed. Some doctors and patients choose a more distal bypass, where more intestine is bypassed, whieh leads to a greater, quicker weight loss; this, however, for obvious reasons leads to worse problems with malabsorption. (Ya can't just malabsorb the bad stuff; sadly, the good stuff also ends up not getting where it needs to go as well). It's not necessary, however, to do a distal bypass, even in a very large person. My doc wanted to do a distal on me, because of my size, but I insisted (nurses make HORRIBLE patients!) that he do a proximal. He warned me that it would mean slower weight loss -- and I said that was okay with me. So in a very real way I traded being a size 2 (or 4 or 6 or who knows) for having bones, teeth, nerves and muscles.

This is one of the reasons that, if my weight loss ends here, I'm happy. I do fear regaining, but that's no different than the very real fear that I experienced watching my weight skyrocket despite my attempts at portion control and exercise. Losing mobility from weight gain (or for any reason, including my auotimmune disease) is very frightening; I don't think that's a bad thing, or a side effect of the surgery. It's reality, and if it helps keep me on the straight and narrow where my diet is concerned, then I see it as a good thing.
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Old 04-11-2006, 08:56 AM   #8
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My personal trainer is very much against WLS, he knows people who got it and he also researched it. H said one of the key problems is that (as he put it) it merely puts a bandage on the real problem, which is compulsive overeating for most of those who get WLS. He said at the very LEAST those contemplating it should be required to have in depth psychiatric counseling to insure they don't end up doing things such as "eating around the surgery". But he does understand WHY someone would feel so desperate as to have WLS; he himself was once around 400 lbs.

I think Carnie Wilson hit that nail on the head when she used the slogan "I'm STILL hungry!"
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Old 04-11-2006, 08:59 AM   #9
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Quote:
Originally Posted by Miss Vickie
Losing mobility from weight gain (or for any reason, including my auotimmune disease) is very frightening; I don't think that's a bad thing, or a side effect of the surgery. It's reality, and if it helps keep me on the straight and narrow where my diet is concerned, then I see it as a good thing.

Vickie, I just wanted to respond to this one comment you made. How you feel about your illness keeping you on the "straight and narrow" regarding diet/exercise is exactly how I feel about my IBS: it keeps me eating right/working out for my health. In that sense, illness can be a good thing.
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Old 04-11-2006, 09:02 AM   #10
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Quote:
Originally Posted by Miss Vickie
Hmmm. Nothing new or suprising there. In fact, it pretty much supports what we've been saying. Don't do it "willy nilly", try reasonable measures first, and know that it's a life changing event.

The only part I disagree with is this:



This guys a fitness expert. Of course he thinks that exercise and eating well will help people lose weight. They all say that and yet... what's the actual success rate for person who, indeed, has over 100 pounds to lose? I still encourage people to try, because the vast majority of people benefit from exercise and dietary changes. But expecting to lose 100 pounds that way is hopeful thinking. I hope it works for folks, but in my experience -- as a patiet and as a member of the size acceptance community -- I just haven't seen it, unfortunately.
You haven't?
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Old 04-11-2006, 09:06 AM   #11
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Quote:
Originally Posted by FitChick
Vickie, I just wanted to respond to this one comment you made. How you feel about your illness keeping you on the "straight and narrow" regarding diet/exercise is exactly how I feel about my IBS: it keeps me eating right/working out for my health. In that sense, illness can be a good thing.
Same here, actually. I have to carefully monitor how much sugar I take in at once, most particularly when mixed with lactose. I can get extremely ill if I eat more than a few bites of ice cream, and when I have my daily lattes, I have to request sugar free flavoring. I don't dump in the traditional sense of the word, but if I overload on sugar, I do feel awful -- enough so that I avoid overdoing it. I do not consider this a bad thing. I'm grateful that I seem to have a built in moderator. It's not as if I cannot indulge in sweet treats (and damn, but I can put away the carbs, especially chips), but I have to limit my portion sizes or I pay big time.
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Old 04-11-2006, 11:11 AM   #12
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It works like that for me with IBS, too. On the IBS support forum, I sometimes joke that I envision my IBS like a Nazi officer with a whip....getting ready to crack that whip the *second* I eat a little too much fat...as in, "Ve haf VAYS of punishing you for that food!"
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Old 04-11-2006, 12:26 PM   #13
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Quote:
Originally Posted by FitChick
You haven't?
Not without other GI problems such as yours that have their own malabsorption issues. No, I haven't. If there are lots of supersize women who have managed to lose weight and keep it off, I'd love it if they'd talk to me.
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Old 04-11-2006, 01:31 PM   #14
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I have to agree; I was racking my brains trying to think of one person who I know that has lost weight without having some other issue that enabled them to do so. Of all my friends I can't think of one...wow; that is truly suprising
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Old 04-11-2006, 02:13 PM   #15
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I just think that, given the mobility problems many of us have at higher weights that it's very difficult. Not impossible, but very difficult, particularly if there's hormonal issues at play that make our bodies even MORE desirous of holding onto weight. I know it happens -- I know at least one person who's done marvelously -- but the vast majority of us seem to be unable to lose a significant amount of weight without some sort of surgical or pharmaceutical intervention. This makes me think that it really ISN'T just "eat right and exercise" or "exercise some willpower" but a much more complicated issue than we are led to believe.

OTOH, the health benefits can be reaped without a huge weight loss, which is prety encouraging, I think.
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Old 04-11-2006, 02:35 PM   #16
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Actually, I have come across a number of others online and off who did lose a lot of weight just by eating less food/lower fat food, and exercising. One woman particularly interested me because she went on to become a racing cyclist, and she had been even bigger than me at one time.

Here is her site about it:

http://hometown.aol.com/mjsplanforli.../personal.html

There are others, but I remember her the best because of the cycling connection.

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Old 04-11-2006, 03:08 PM   #17
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Quote:
Originally Posted by Miss Vickie
I know it happens -- I know at least one person who's done marvelously -- but the vast majority of us seem to be unable to lose a significant amount of weight without some sort of surgical or pharmaceutical intervention.
Y ou know me too Vickie I was 100 lbs bigger 5 years ago.

And I think there are thousands of people out there who lose large amounts of weight every year using diet and exercise. Do they keep it off? About as much as WLS patients do. My best friend in NJ lost over 200 lbs 2 years ago and it hasn't come back yet.

It can be done it just takes time.
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Old 04-11-2006, 03:24 PM   #18
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I think that anything can be done, given proper motivation and willpower. It's very, very difficult for super-size people to lose a significant amount of weight, IMO, and based on personal experience. I spent many years on the yo-yo diet cycle: Getting fed up with my decreasing mobility & self-loathing, and going on whatever punishing fad diet was popular at the time. I had absolutely no problem losing 40-60 pounds. The issue for me was regaining all of that, and then some, the second I grew tired of depriving myself. A reality for many of us is that we're human, and it's very, very difficult to follow a strict diet plan that doesn't include all the foods we are used to, in the quantities that we wish for. That kind of restraint takes incredible willpower. It was too much for me. I had an enormous appetite, and a rampaging (undiagnosed) eating disorder, and depriving myself was unsustainable over the long term.

I do not personally know of any very large person who lost a very significant amount of weight. I have a family friend who did lose a little over 100 lbs, but he is still a bit over 500 lbs, and at the higher end of the scale, it is not unheard of to lose what is an enormous amount to the rest of us - just with some moderate lifestyle changes. The problem remains, for those of us who desire it, how to keep it off?

I am not pretending to have all of the answers here -- I readily acknowledge that I still battle with making appropriate food choices. The difference is, at my current weight, I can and do exercise without pain or extreme fatigue holding me back. My surgically altered stomach makes it impossible for me to binge eat. May 3 is my 2nd year post-op. I doubt that I will ever be able to eat anything approaching what I once could. And finally -- it is much, much easier for me to lose 5 pounds than it is to lose 150. I do monitor myself, and my exercise routine is now an enjoyable and built-in part of my life.

I wish that I had what it took to do this on my own. I didn't. I took a calculated risk and utilized a tool to aid me in weight loss, and it paid off (for me). I absolutely would not have succeeded on a traditional diet & exercise plan.
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Old 04-11-2006, 03:36 PM   #19
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I hope this makes sense, but...I think if I'd been TRYING to LOSE WEIGHT (and not just trying to treat my IBS), it might not have happened. That sounds like a weird thing to say, but for me at least, a lot of it is in the mind.

I never had a desire to lose weight, but if I had, I think it would THEN have been very hard for me because that's how it does seem to be for the ppl I know who WANT to lose. Am I making any sense here?

I guess what I mean is, my former weight never gave me any issues, either physically or emotionally, so there was never a DESIRE to lose it. But my IBS, now THAT was a royal pain in the *ss (pun intended). For THAT, YES, I would eat right and exercise. But not to lose weight when the weight wasn't complicating my life. For me, anyway, and maybe some others, the DESIRE needs to take precedence over ALL else. For me, it was the absolute desire to end my IBS attacks. That came to matter to me more than ANYTHING, even more than some of the foods I used to like.
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Old 04-11-2006, 03:53 PM   #20
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Originally Posted by Sandie_Zitkus
Y ou know me too Vickie I was 100 lbs bigger 5 years ago.

And I think there are thousands of people out there who lose large amounts of weight every year using diet and exercise. Do they keep it off? About as much as WLS patients do. My best friend in NJ lost over 200 lbs 2 years ago and it hasn't come back yet.

It can be done it just takes time.
You know, I didn't know that, Sandie. Do you mind my asking how you lost and and, even tougher, kept it off?? As you say, it's the keeping it off that's the problem. I'm less concerned with some magical goal weight than I am keeping off what I've lost so far, which is why I'm taking advantage of my easier movement now to get my ass to the gym. I hate it, but I know that if I don't exercise, I probably have a good chance of regaining the hundred plus pounds that I've lost.

I, for one, was never able to lose weight, let alone keep it off. The only time I was successful was with Jenny Craig, and I got SO sick from the food that I had to stop, and of course it came back on. Hell, I was bulimic in college and didn't lose weight. (How weird is THAT??) The best I ever got was maintaining, and that worked great until I got sick and couldn't move much. Then the weight came on, very quickly, as did the co-morbids.
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Old 04-11-2006, 04:34 PM   #21
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The only thing I can tell you Vickie is I completely changed my diet. No refined sugars EVER (they work like speed on me) NO CARBS - even the smallest amounts of carbs make me hold fluids and I regain.) Low fat protein and lots of veggies (cooked - raw is too hard for me to degest). Every once in a while I will have white rice - it very soothing and cleansing. This is a diet suggested to me by a very knowledgable kind and caring accupuncturist I went to.

Now don't get me wrong - it's tough - and I have regained when I veer from this eating plan. But I know my body wants to be fat - so I will probably always be fat - but I can be healthier. I do not exhaust myself exercising - I am kind to my body. I walk (as much as I can) for the joy of it - I do chairdancing because it's fun. I use free weights 5 and 10 pounds when I remember.

Vickie I would suggest finding a way of exercising that you love not hate. It makes a difference.


Quote:
Originally Posted by Miss Vickie
You know, I didn't know that, Sandie. Do you mind my asking how you lost and and, even tougher, kept it off?? As you say, it's the keeping it off that's the problem. I'm less concerned with some magical goal weight than I am keeping off what I've lost so far, which is why I'm taking advantage of my easier movement now to get my ass to the gym. I hate it, but I know that if I don't exercise, I probably have a good chance of regaining the hundred plus pounds that I've lost.

I, for one, was never able to lose weight, let alone keep it off. The only time I was successful was with Jenny Craig, and I got SO sick from the food that I had to stop, and of course it came back on. Hell, I was bulimic in college and didn't lose weight. (How weird is THAT??) The best I ever got was maintaining, and that worked great until I got sick and couldn't move much. Then the weight came on, very quickly, as did the co-morbids.
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Old 04-11-2006, 04:51 PM   #22
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Originally Posted by Sandie_Zitkus
The only thing I can tell you Vickie is I completely changed my diet. No refined sugars EVER (they work like speed on me) NO CARBS - even the smallest amounts of carbs make me hold fluids and I regain.) Low fat protein and lots of veggies (cooked - raw is too hard for me to degest). Every once in a while I will have white rice - it very soothing and cleansing. This is a diet suggested to me by a very knowledgable kind and caring accupuncturist I went to.
Wow, that must be very difficult to follow. I can't imagine, although I suppose if you feel a lot better without them that's usually good incentive.

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Vickie I would suggest finding a way of exercising that you love not hate. It makes a difference.
Well, once I get my butt there, I more or less like it. I enjoy lifting weights, particularly seeing myself getting stronger, able to do more, etc. And the cardio is good, again once I get started. But it's the getting there that's the problem. I always seem to come up with about twenty different excuses not to go, but once I get there, I tend to enjoy pushing myself and end up doing much more than I anticipated. Right now I'm training for a triathlon, so that's been a real motivator for me as well. I've never done any kind of organized athletic event (other than track team in high school), and it's very scary, but it's geared for women of all fitness levels so I don't think it should be too bad. My goal is just to finish it. I have no illusions about doing it quickly. I just want to do it.

I'm just not one of those people for whom exercise is enjoyable, other than horseback riding, which I hope to start this spring.
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Old 04-11-2006, 10:16 PM   #23
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Vickie....I love horseback riding....let's you and I make a date and go. Are you still having surgery on Friday? Where and what time?
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Old 04-12-2006, 03:07 AM   #24
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I simply did what the "Eating for IBS" book I got at Waldenbooks said to do. I did not cut carbs at all, only fat and portion sizes. This is because high fat foods and too much food in one sitting often brings on IBS-D attacks. I do eat complex carbs a lot more, but only because I think they are healthier, has nothing to do with my IBS. I also have broken up my three meals a day into 5 or 6 smaller ones, spaced evenly apart (you need to do this for IBS-D to avoid overloading the sensitive GI system all at once.)

One good thing about IBS: sugar is not a trigger food, so I can have all I want of it. Though I don't pig out on it because too much of that is no good healthwise. Sugar was not really what made me fat anyway, it was fried foods. I used to LOVE them, but they didn't love me since they helped trigger my IBS attacks.

And Sandie is RIGHT: find a form of exercise you truly enjoy. Otherwise you'll give it up in no time. I started out with bellydancing, ended up with cycling (or actually, returned to it since I'd been a runner and cyclist in my youth.)

I don't recall following any plan, I just ate anything I wanted as long as it was lower in fat and was a normal sized portion. I also drank and continue to drink water almost exclusively, and lots of it. Its very cleansing! I crave diet pepsi every now and then but try to avoid it due to the phosphoric acid in it.

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Old 04-12-2006, 01:48 PM   #25
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Originally Posted by TraciJo67
I do not personally know of any very large person who lost a very significant amount of weight. I have a family friend who did lose a little over 100 lbs, but he is still a bit over 500 lbs, and at the higher end of the scale, it is not unheard of to lose what is an enormous amount to the rest of us - just with some moderate lifestyle changes. The problem remains, for those of us who desire it, how to keep it off?
Well, that's the Million Dollar Question, isn't it? Right now I'm about 340 and I've lost around 110 lbs, and I keep yo-yo'ing about 6-7 lbs back and forth. Fact is, it gets harder as you go along, because my body still wants that weight back, and I have these vivid food fantasies and temptations and it's hard as hell. For me it is *all* about willpower, because if I eat the wrong things I will gain, and even eating right, it's very difficult to lose without exercising, and I just don't seem to have the time, the energy, nor the will, to do it lately, though I really need to and will have to buckle down again and do it. Given my inflammitory/pain stuff, I think it will be easier as the weather warms up.

But yeah, at times it's excruciatingly difficult, but losing weight is the only way to maintain and improve my mobility, so for me it's worth it, as difficult as it is. I still consider getting the Lap Band from time to time, though I don't know if I ever will.
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