Is anyone post and hasnt met their goal?
Etta:
You do not say your age, HT,medical comorbidities. But here is some info I have shared w/ my support groups.... Reaching goal is tricky whose goal, is it attainable or even realistic? WLS is not meant to get people thin or to an ideal body wt, it is meant to make them healtheir and give them an opportunity to have healthier lifestyles (food choices and exercise) and to lose 50% of their excess wt at 5, 10, 15 yrs post surgery. Some lose more, some less, regain can happen if consistency with healthy food choices, smaller portions and exercise are not adhereed to. Grazing, drining w/ eating, not exercising,emotional eating, drinking calories, alcohol intake etc can all sabotage the tool...
REALISTIC EXPECTATIONS
WHERE IT ALL STARTS!
The surgical community considers anyone a success when they have lost 50% of their excess weight. Right here we have a problem. MANY approach this surgery expecting to lose 100% of our excess weight. And if we don't, then we consider ourselves failures even though our surgeon is adding our name to their success column.The first month or two after the surgery makes matters worse. You are losing 20 pounds +/- a month and believing that this will go on forever. I know I had my calculator out and was trying to figure out how long it would be before I hit my goal (excess pounds divided by 20). But life isn't like that for most of us. We hit plateaus. We come to the end of our widow of opportunity before we reach our goal and we stop losing. Or we stop losing and regain some of our weight. Why do surgeons consider 50% as a success? It is because there is no other method that you could use that would result in that much weight loss on a permanent basis (think 5, 10, 15 years). Remember back to your old diet days? Yes, you lost weight, but regained it plus additional weight. The best you can attain with dieting is a 5% weight loss.Before surgery, have your eyes wide open. Although most people lose 70% to 80% of their excess weight, you may lose only 50%. Figure out what 50% is, and be sure to rejoice when you hit that mark. ANYTHING ELSE IS A BONUS!
WT LOSS DIFFERENCES
There are so many factors to consider, heights, starting weights, men vs. women, individual metabolisms, age, and most importantly if you have any other medical conditions or are on medications!!! Remember the heavier people are the more they will lose (but the farther away one will be from an ideal bodywt..) and the lighter one is the closer to an ideal bodywt you will get, but the less they will loose overall!
EXAMPLE: After RNY surgery research states most people can/will loose 50-78% of their excess bodywt...lets say both of these "hypothetical" people lose 75% of their excess bodyweight....
1.A 400lb person at 5'6'' (a bmi of 64) who has 250# of excess wt (ideal is 150#) will lose 187.5# and weigh 212.5# and have a BMI of 34.5, 1 1/2-2 years after surgery.
2.A 300# person of 5'6'' (a bmi of 48) who has 150# of excess bodywt. (ideal also 150#) will loose 112.5# and weigh 187.5# and have a bmi of 30, 1 1/2-2 years after surgery.
THE TRUTH ABOUT REGAIN *THAT NO ONE WANTS TO HEAR!
WLS is a tool, if you eat the wrong foods (carbs/sugar we NEVER EVER malabsorb, digestion/absorbtion of these substances happens starting in the MOUTH!), overfill pouch, graze all day, don't exercise, drink calories, eat and drink together then we can/will regain wt. IT IS still about calories and you can regain wt. WLS is the tool to help us lose wt, PSYCHOLOGY is the tool to help us maintain that loss!
WLS is a tool that should lead us to a LIFESTYLE CHANGE...
~How we see & use food. FUEL or SELF SOOTHING
~How we keep our bodies active. EXERCISE or INACTIVITY
~How we use our brain. EATING TO LIVE VS. LIVING TO EAT
WLS IS NOT MAGIC, IT IS NOT A GET OUT OF MORBID OBESITY JAIL FREE CARD...NO MATTER WHAT THE HONEYMOON HAD US FOOLED INTO BELIEVING! IT IS HARD WORK! PERIOD.
THIS IS ABOUT PERSONAL ACCOUNTABILITY!!!
JAMIE'S BACK ON TRACK TIPS
Your surgery hasn't failed; you are just not using your tool to its potential that is all. It is there still; you need to get back to basics though. Remember it isn't the surgery alone that makes us lose weight it is the lifelong lifestyle & behavioral changes we make that enable us to lose weight and keep it off. Dumping isn't guaranteed (~ 50% will dump early on only!) after surgery and may decrease the farther we get post-op....with that said:
You know the rules of the tool & what you aren't doing.
So how to get back to basics? You have to just take one step at a time; it doesn't have to be all or nothing that is old thinking! What do you feel you can conquer first?
Write down your goal for the week, then work on it, once you have one goal under your belt start on another, be patient and kind to yourself, no one said this was easy! It is hard and no one is perfect! But you can change. The negative habits didn't happen overnight so neither will positive ones! But they wont happen if you don't start somewhere! Asking for help and admitting the problem is a great first step! Get to a local support group at least monthly if available, this keeps you focused on what you are doing and accountable to yourself...Life will always be busy but you need to reprioritize health as a higher priority and taking care of yourself has to be more important than anything else!
DO NOT RETURN TO DIETS! THEY DIDN'T WORK PREOP AND WON'T POSTOP!
MY 3 FAVORITE MANTRAS:
1. IF YOUR LIFE IS TOO BUSY TO EXERCISE OR TAKE CARE OF YOURSELF THAN YOUR LIFE HAS TO CHANGE! THIS IS NOT SELFISHNESS!
2. PROGRESS NOT PERFECTION!
3. IT IS WHAT WE DO 90% OF THE TIME THAT MATTERS, THINK CONSISTENCY!
What works for me is the PHILOSOPHY of the South Beach Diet....It is a good marriage between healthy lifestyle and postop WLS needs! I must stress it is not a diet but a way of life for me! I am carb sensitive, when I eat more refined carbs I am hungry sooner and crave more carbs, it is a vicious cycle, but when I eat better carbs, getter fats, healthy lean proteins the way the pouch rules dictate I do well and maintain
SAMPLE GOALS:
1. Fluid: Resolve to drink AT LEAST 64 ounces (This will keep you full longer and tension on the pouch) of NON-carbonated-NON-calorie fluid a day. (Water, Crystal Lite, diet Kool-Aid) In other words don't drink your calories! DO NOT DRINK WITH MEALS and WAIT 1-2 HOURS AFTER MEALS TO START DRINKING....(OR YOU WILL JUST MAKE YOURSELF HUNGRY AGAIN...SOONER!).
2. Vitamins: Resolve to take 1-2 multivitamin(s) a day, calcium as citrate form ~1,500mg a day (some may need more), & ~1,000mcg B12 liquid/tablets sublingually daily (some may need intramuscular shots). Other vitamins are based on labs/dexascans: some will need extra iron/vit C (pills/shots/infusions), vitamin A, D, E, K, Zinc, Magnesium, Thiamine (B1), Folate, B6, selenium....This is a reason we need to follow up for life with our healthcare providers, deficiencies can happen not just early postop but anytime postop!
3. Protein: Resolve to get in ~65 grams a day (this will vary due to age/ht/wt/medical comorbidities) either in the food you eat or by supplementing with shakes *this is controlversial. EAT PROTEIN FIRST!!! IT fills the pouch!(less room for carbs)
4. MEALS: Resolve to eat no more than 3-5 small meals a day, NO GRAZING! Take 15-20 minutes for a meal no less/more, pay attention to the food, not a TV, radio, newspaper! Composition of meals: ~50% protein leaving 25% of meal for veggies/fruit and 25% carbs (whole/multigrain/low glycemic index/.load).
5. Exercise: Resolve to exercise 30 min 3x a week, then increase to 60 min 3x a week or 30 min 6x a wee****il you are exercising 30 min MOST DAYS OF THE WEEK (or more)! It helps you cope with stress, so you don't turn to food, it will help the wt loss and also give you energy! You will feel better about yourself and be less apt to go for the carbs. NOTHING revs the metabolism better! START SOMEWHERE! VARIETY IS KEY!
6. SUPPORT: Resolve to either get involved in a local support group monthly (weekly would be better but at least 1x a month), online support is also helpful and/or get into therapy to deal with your food issues and look at why you are sabotaging your happiness. We all have food issues/demons and we all need to face them eventually the surgery is a great help but the brain is a hard organ to change and unfortunately they didn't operate it when they shrunk our tummy! Be around those whom can support and not sabotage your success, this may mean making new friends and giving up old/unhealthy ones!
I am glad you are looking at the issues and wanting to deal with them! Be proud of yourself for that and you can do it. Now is a great time to start, holidays and parties are always going to happen, we can always find an excuse to wait or a reason why we can't, search within yourself and find a reason why you can and do it (nothing tastes as good as health and thin feel!)!
Those that have goals that are health focused and functionally focused do the best (vs. those that are scale or weight/number focused). I am such a firm believer in not allowing the scale (or hunkametal that it is) to rule or dictate ones life/thoughts/feelings any longer, I agree we want to lose wt but gaining our health and ability to function in life are far more important than any number the scale can read; otherwise if it never reads the number we think, others say, a chart suggests we fail and that is simply not true!!! Most of our lives we have set RIGID, UNREALISTIC WEIGHT LOSS GOALS for ourselves that are BOTH UNATTAINABLE and CHRONICALLY DISAPPOINTING and lead to DEVASTATION & the slippery slope of self-sabotage...Review the UNDERLYING lifestyle change such as exercise, food choices, self-awareness/monitoring, avoidance of emotional eating, adherence to living self responsibly in a CONSISTENT way that is the foundation to our long-term success. For me I keep telling myself daily that***THE GOAL SHOULD NEVER BE A NUMBER*** These choices are what makes WLS work long-term and not be another failed diet attempt (and believe me it is for MANY! So I use that fear to keep plugging along)...It is a wonderful tool to build the foundation and sadly one that has ways to be defeated/broken down as we all can discover (grazing etc). Consider writing all the 'supports' of diet/exercise/lifestyle changes, coping skills etc for non-emotional eating (i.e through individual therapy, support groups) you have worked on, now where do you need to add reinforcements? You now are seeing it can collapse and the WLS tool if not used properly/consistently can be defeated w/o the extra supporting structures...Like having only one wall of your basement in place before putting the house on top.. what happens? it can crumble w/ the weight of the house (your life/the worlds challenges), but if you have the 4 walls in place (food choices/planning/healthy and consistent choices, exercise, self awareness/monitoring, support); then the WLS tool can just reinforce that foundation and make the house stand strong for a long long time! Your tool will be back soon, but the tool to work on now may be the brain! For me it is anyways!
Take Care,
Jamie 
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
You do not say your age, HT,medical comorbidities. But here is some info I have shared w/ my support groups.... Reaching goal is tricky whose goal, is it attainable or even realistic? WLS is not meant to get people thin or to an ideal body wt, it is meant to make them healtheir and give them an opportunity to have healthier lifestyles (food choices and exercise) and to lose 50% of their excess wt at 5, 10, 15 yrs post surgery. Some lose more, some less, regain can happen if consistency with healthy food choices, smaller portions and exercise are not adhereed to. Grazing, drining w/ eating, not exercising,emotional eating, drinking calories, alcohol intake etc can all sabotage the tool...
REALISTIC EXPECTATIONS
WHERE IT ALL STARTS!
The surgical community considers anyone a success when they have lost 50% of their excess weight. Right here we have a problem. MANY approach this surgery expecting to lose 100% of our excess weight. And if we don't, then we consider ourselves failures even though our surgeon is adding our name to their success column.The first month or two after the surgery makes matters worse. You are losing 20 pounds +/- a month and believing that this will go on forever. I know I had my calculator out and was trying to figure out how long it would be before I hit my goal (excess pounds divided by 20). But life isn't like that for most of us. We hit plateaus. We come to the end of our widow of opportunity before we reach our goal and we stop losing. Or we stop losing and regain some of our weight. Why do surgeons consider 50% as a success? It is because there is no other method that you could use that would result in that much weight loss on a permanent basis (think 5, 10, 15 years). Remember back to your old diet days? Yes, you lost weight, but regained it plus additional weight. The best you can attain with dieting is a 5% weight loss.Before surgery, have your eyes wide open. Although most people lose 70% to 80% of their excess weight, you may lose only 50%. Figure out what 50% is, and be sure to rejoice when you hit that mark. ANYTHING ELSE IS A BONUS!
WT LOSS DIFFERENCES
There are so many factors to consider, heights, starting weights, men vs. women, individual metabolisms, age, and most importantly if you have any other medical conditions or are on medications!!! Remember the heavier people are the more they will lose (but the farther away one will be from an ideal bodywt..) and the lighter one is the closer to an ideal bodywt you will get, but the less they will loose overall!
EXAMPLE: After RNY surgery research states most people can/will loose 50-78% of their excess bodywt...lets say both of these "hypothetical" people lose 75% of their excess bodyweight....
1.A 400lb person at 5'6'' (a bmi of 64) who has 250# of excess wt (ideal is 150#) will lose 187.5# and weigh 212.5# and have a BMI of 34.5, 1 1/2-2 years after surgery.
2.A 300# person of 5'6'' (a bmi of 48) who has 150# of excess bodywt. (ideal also 150#) will loose 112.5# and weigh 187.5# and have a bmi of 30, 1 1/2-2 years after surgery.
THE TRUTH ABOUT REGAIN *THAT NO ONE WANTS TO HEAR!
WLS is a tool, if you eat the wrong foods (carbs/sugar we NEVER EVER malabsorb, digestion/absorbtion of these substances happens starting in the MOUTH!), overfill pouch, graze all day, don't exercise, drink calories, eat and drink together then we can/will regain wt. IT IS still about calories and you can regain wt. WLS is the tool to help us lose wt, PSYCHOLOGY is the tool to help us maintain that loss!
WLS is a tool that should lead us to a LIFESTYLE CHANGE...
~How we see & use food. FUEL or SELF SOOTHING
~How we keep our bodies active. EXERCISE or INACTIVITY
~How we use our brain. EATING TO LIVE VS. LIVING TO EAT
WLS IS NOT MAGIC, IT IS NOT A GET OUT OF MORBID OBESITY JAIL FREE CARD...NO MATTER WHAT THE HONEYMOON HAD US FOOLED INTO BELIEVING! IT IS HARD WORK! PERIOD.
THIS IS ABOUT PERSONAL ACCOUNTABILITY!!!
JAMIE'S BACK ON TRACK TIPS
Your surgery hasn't failed; you are just not using your tool to its potential that is all. It is there still; you need to get back to basics though. Remember it isn't the surgery alone that makes us lose weight it is the lifelong lifestyle & behavioral changes we make that enable us to lose weight and keep it off. Dumping isn't guaranteed (~ 50% will dump early on only!) after surgery and may decrease the farther we get post-op....with that said:
You know the rules of the tool & what you aren't doing.
So how to get back to basics? You have to just take one step at a time; it doesn't have to be all or nothing that is old thinking! What do you feel you can conquer first?
Write down your goal for the week, then work on it, once you have one goal under your belt start on another, be patient and kind to yourself, no one said this was easy! It is hard and no one is perfect! But you can change. The negative habits didn't happen overnight so neither will positive ones! But they wont happen if you don't start somewhere! Asking for help and admitting the problem is a great first step! Get to a local support group at least monthly if available, this keeps you focused on what you are doing and accountable to yourself...Life will always be busy but you need to reprioritize health as a higher priority and taking care of yourself has to be more important than anything else!
DO NOT RETURN TO DIETS! THEY DIDN'T WORK PREOP AND WON'T POSTOP!
MY 3 FAVORITE MANTRAS:
1. IF YOUR LIFE IS TOO BUSY TO EXERCISE OR TAKE CARE OF YOURSELF THAN YOUR LIFE HAS TO CHANGE! THIS IS NOT SELFISHNESS!
2. PROGRESS NOT PERFECTION!
3. IT IS WHAT WE DO 90% OF THE TIME THAT MATTERS, THINK CONSISTENCY!
What works for me is the PHILOSOPHY of the South Beach Diet....It is a good marriage between healthy lifestyle and postop WLS needs! I must stress it is not a diet but a way of life for me! I am carb sensitive, when I eat more refined carbs I am hungry sooner and crave more carbs, it is a vicious cycle, but when I eat better carbs, getter fats, healthy lean proteins the way the pouch rules dictate I do well and maintain
SAMPLE GOALS:
1. Fluid: Resolve to drink AT LEAST 64 ounces (This will keep you full longer and tension on the pouch) of NON-carbonated-NON-calorie fluid a day. (Water, Crystal Lite, diet Kool-Aid) In other words don't drink your calories! DO NOT DRINK WITH MEALS and WAIT 1-2 HOURS AFTER MEALS TO START DRINKING....(OR YOU WILL JUST MAKE YOURSELF HUNGRY AGAIN...SOONER!).
2. Vitamins: Resolve to take 1-2 multivitamin(s) a day, calcium as citrate form ~1,500mg a day (some may need more), & ~1,000mcg B12 liquid/tablets sublingually daily (some may need intramuscular shots). Other vitamins are based on labs/dexascans: some will need extra iron/vit C (pills/shots/infusions), vitamin A, D, E, K, Zinc, Magnesium, Thiamine (B1), Folate, B6, selenium....This is a reason we need to follow up for life with our healthcare providers, deficiencies can happen not just early postop but anytime postop!
3. Protein: Resolve to get in ~65 grams a day (this will vary due to age/ht/wt/medical comorbidities) either in the food you eat or by supplementing with shakes *this is controlversial. EAT PROTEIN FIRST!!! IT fills the pouch!(less room for carbs)
4. MEALS: Resolve to eat no more than 3-5 small meals a day, NO GRAZING! Take 15-20 minutes for a meal no less/more, pay attention to the food, not a TV, radio, newspaper! Composition of meals: ~50% protein leaving 25% of meal for veggies/fruit and 25% carbs (whole/multigrain/low glycemic index/.load).
5. Exercise: Resolve to exercise 30 min 3x a week, then increase to 60 min 3x a week or 30 min 6x a wee****il you are exercising 30 min MOST DAYS OF THE WEEK (or more)! It helps you cope with stress, so you don't turn to food, it will help the wt loss and also give you energy! You will feel better about yourself and be less apt to go for the carbs. NOTHING revs the metabolism better! START SOMEWHERE! VARIETY IS KEY!
6. SUPPORT: Resolve to either get involved in a local support group monthly (weekly would be better but at least 1x a month), online support is also helpful and/or get into therapy to deal with your food issues and look at why you are sabotaging your happiness. We all have food issues/demons and we all need to face them eventually the surgery is a great help but the brain is a hard organ to change and unfortunately they didn't operate it when they shrunk our tummy! Be around those whom can support and not sabotage your success, this may mean making new friends and giving up old/unhealthy ones!
I am glad you are looking at the issues and wanting to deal with them! Be proud of yourself for that and you can do it. Now is a great time to start, holidays and parties are always going to happen, we can always find an excuse to wait or a reason why we can't, search within yourself and find a reason why you can and do it (nothing tastes as good as health and thin feel!)!
Those that have goals that are health focused and functionally focused do the best (vs. those that are scale or weight/number focused). I am such a firm believer in not allowing the scale (or hunkametal that it is) to rule or dictate ones life/thoughts/feelings any longer, I agree we want to lose wt but gaining our health and ability to function in life are far more important than any number the scale can read; otherwise if it never reads the number we think, others say, a chart suggests we fail and that is simply not true!!! Most of our lives we have set RIGID, UNREALISTIC WEIGHT LOSS GOALS for ourselves that are BOTH UNATTAINABLE and CHRONICALLY DISAPPOINTING and lead to DEVASTATION & the slippery slope of self-sabotage...Review the UNDERLYING lifestyle change such as exercise, food choices, self-awareness/monitoring, avoidance of emotional eating, adherence to living self responsibly in a CONSISTENT way that is the foundation to our long-term success. For me I keep telling myself daily that***THE GOAL SHOULD NEVER BE A NUMBER*** These choices are what makes WLS work long-term and not be another failed diet attempt (and believe me it is for MANY! So I use that fear to keep plugging along)...It is a wonderful tool to build the foundation and sadly one that has ways to be defeated/broken down as we all can discover (grazing etc). Consider writing all the 'supports' of diet/exercise/lifestyle changes, coping skills etc for non-emotional eating (i.e through individual therapy, support groups) you have worked on, now where do you need to add reinforcements? You now are seeing it can collapse and the WLS tool if not used properly/consistently can be defeated w/o the extra supporting structures...Like having only one wall of your basement in place before putting the house on top.. what happens? it can crumble w/ the weight of the house (your life/the worlds challenges), but if you have the 4 walls in place (food choices/planning/healthy and consistent choices, exercise, self awareness/monitoring, support); then the WLS tool can just reinforce that foundation and make the house stand strong for a long long time! Your tool will be back soon, but the tool to work on now may be the brain! For me it is anyways!
Take Care,
Jamie
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!" 
I to am 3 years post op and have not reached my goal, am very upset over this. Acutally it will be 3 years March 8th. Have about about 25 more pounds to go and things just won't move. Thinking I might not be getting enough protien, I don't know, ready to throw in the towel. Have a great day and good luck.
Linda
Hi Etta,
I am 17 months out, and I haven't met my personal goal yet either--But, I realize that I am 61 (soon to be 62), and I am holding at between 146 and 151--I am not happy with the status quo--I would like to lose all the weight that the doctor said I should--BUT --I feel a thousand percent better than I did--I look a lot better and I am still working on losing. Maybe if you go back to basics--for a booster shot--eat a strict protein diet and cut out all the extra calories (we generally can consume more after the first year--and I don't know about you, but I can eat almost anything without getting a bad reaction now). I am thinking about joining Weigh****chers or some weight program --in order to keep me on track --and whatever you do--you MUST exercise to keep the weight from coming back.
I understand how you feel--I do hope and pray that you get to a place that will make you feel content
Marian SC
242.4/ 148/goal 129-135
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