Hello All

Amy, Yeah I will get throug this I am sure with the help of my OH family I think talking to my phyc regarding this does more for me since I know how to eat but it is just getting the mind to do it.. Thanks hun Debra P

Debra: Hello!~ So glad to have you back w/ us. Isolation is one factor we can control to assist our success! I sent you an email about back-on-track, but I will post a article on regain here as well. This is the time that when we were preop/newbies those older postops cautioned us about. Many of us heard but felt (as I did) we would not be the ones to struggle, regain or get off track. The honeymoon is so powerful that it really skews reality for a while. Then whammo zappo something happens at 6, 12, 24, 36 months for most. It is a challenge and an opportuinty to give up or reinforce our efforts. I agree working on the emotional stuff is imperative at this point when the tool is working 10% and the malabsorbtion of calories is a distant memory and the ability to eat more quantity/variety can happen. Our lives get in the wayof living healthfully if we allow also now. I believe you can recommit and get back where you want to be with daily consistent awareness and effort. It took me a while and still takes time to accept that HARSH reality that WLS wasn't magic as I hoped and it was a wayto get thinner and healthier, to have REALISTIC goals also is important, because having a wt loss goal that is not attainable can set us up at times to sabotage further (heck it takes so much effort to stay where we are and we dont get wher we want many give up!) Maybe the 135# is not realistic, At almost 2 yrs out I am really thinking your current wt is what will take much effort to stay at for the next 10 yrs....But prove me and statistics wrong.I am not trying to not encourage only be realistic in what I see/have seen and with my own experience of what is typical.....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.... How do you avoid emotional eating? How do you cope? What have you developed during the honeymoon to find balance in your life? How do you handle celebrations, holidays, stress (*they come all the time! each and every year!) ~~~~~~~~~~ You can do it!! Sit down and write out your goals, write out how you plan on accomplishing them (one step at a time)...each change you will make, what is your time frame (realistically), write out who/what will your support be and who/what are your barriers to success...how will you fight and overcome these??? Good luck!!!! DO YOU NEED TO GET BACK-ON-TRACK? You dreamed this would be the last time you would need to lose weight. Weight loss surgery was the answer to your weight loss failures of the past. You were doing so well. Weight seemed to fly off so to speak in the beginning, almost effortless. No matter what you did you couldn't possibly take in enough to not lose weight. For many this was the first time in your life you didn't experience physical hunger. You felt full on so little. You were limited in the variety of foods you could have. Sugar, fats or large portions made you sick. If you didn't chew well enough, or slow down to eat or if you drank with our food you got sick. Dumping syndrome, although not an intentional part of weight loss surgery works as a strong behavior modifier. Who wants to experience nausea, vomiting, sweating, chest pain, palpitations, diarrhea, fatigue, and lethargy and have to lie down for one cookie? But over time your motivation wore off. Fast forward a year or two, you heard the window slam shut, the golden period tarnish and well quite frankly the honeymoon is over. This is normal & expected but you still are surprised & horrified! Denial works for a while but after the ' 10-20 pound bounce back weight' hits you decide you can no longer live in denial. Your clothes don't fit and you are scared to death. Many think their pouches have stretched. In reality it could possibly be a mechanical problem, but most likely it is the honeymoon period ending. You are then faced with the questions, "Did I use my time wisely?" & "Did I make the lifestyle changes needed to be successful long-term"? If you answered yes to both of these questions then congratulations & do not read any further. But if you can't answer yes to these questions and you find yourself OFF-TRACK, keep reading! You remember hearing about it months ago, bariatric professionals educate regarding its existence & significance; it has many names, 'Window of opportunity', 'Golden period' & 'Honeymoon phase'. Did you really believe, understand and utilize it? Or did you think that weight loss surgery was magic and you were invincible? The first 12-24 months after weight loss surgery is a time of change, growth and rebirth for many. It is the beginning of a wonderful journey. It affords us to experience life unchained by Morbid Obesity and all its limits & complications. You have heard this mantra before a thousand times, weight loss surgery is only a tool and they operate on your stomach not your brain! What you sometimes forget is it isn't the end of your food issues. You are not alone! Do not allow yourself to be alone! It is in isolation that you continue to struggle and stay off-track. 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. And yes this means you now have to work harder than the tool! Remember it isn't the surgery alone that makes us lose weight it is the lifelong lifestyle & behavioral changes you make that enable us to lose weight and keep it off. It is the tool that gives us the opportunity to make these changes. It levels the playing field for weight loss and maintenance with those who are not Morbidly Obese! In this delicate time many things happen: dumping may decrease or stop, you are able to eat a larger variety of foods, you can eat larger quantities of food, you get over the newness of surgery and may let some habits slide, the malabsorbtion may decrease as the body tries to normalize! Basically life happens. 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! Getting and staying on-track and making is the global goal. Now break down the lifestyle habits you need to stay healthy and on-track. 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! Life will always be busy but you need to place health as a top priority and taking care of yourself has to be more important than anything else. Below are some ideas to help you refocus and get back on track. Remember everyone's needs are individual so use the following as a guide in how to break down habits. It is meant to help you feel not so overwhelmed. If you held on to some basic fundamental pouch rules you are ahead of the game. How many are you already doing? You may not be as off-track as you thought! Look at the positive and build on that! Follow-up: Ø Resolve to recommit to your lifelong aftercare program. When was the last time you went to see your bariatric surgeon, clinical nutritionist, dietician, primary care provider? When was the last time you had a complete set of labwork? Life-long follow-up is necessary for your health and can be a motivating factor for your long-term success! Do not feel ashamed of regain, empower yourself and surround yourself with professionals who can assist you on your journey! Fluid: Ø Resolve to drink 64 ounces daily, this will keep you full longer and keeps a small amount if tension on the pouch. Make sure most fluid is non-carbonated, non-caffeinated, non-alcoholic & non-calorie. In other words don't drink your calories! Many times when you think you are hungry you are simply thirsty! Fluid load before meals, by drinking a cup or two of water before you eat you can curb that hunger. Ø Do not drink with meals and wait 1-2 hours after meals to start drinking, or you will just make yourself hungry again sooner! You can eat a lot of food by sipping with meals and washing the food down because the pouch has no pyloric valve controlling the flow of food, it is now a leaky drain and after a little time you have more room in the sink to fill so you can all eat a while after you eat. Vitamins: Ø Resolve to take a multivitamin, calcium citrate, B12 sublingually or parentally as directed by your labwork. And of course any other supplements you may need such as iron, magnesium, thiamine, zinc, Vitamin A, D, E. Meals: Ø Resolve to journal your food either online or in a notebook. You can't possibly know what you are eating or need to change until you visually see it! This also helps you be aware & accountable to yourself. Some free sites for this are: http://www.fitday.com/ http://www.onlinefitnesslog.com/ http://www.dietagenda.com/ http://www.nutrawatch.com/ http://www.sparkpeople.com/ Ø Resolve to eat ONLY 3-4 small meals a day over 10-20 minutes no longer, and NO grazing. Just because you may only eat a few bites here and there, over the course of a day you can eat thousands of calories mindlessly NEVER getting full! Portions are important! Measure, don't guess that handful of peanuts you think is ¼ cup may really be a ½ a cup! Ø Eat protein first! Composition of meals should approximate: 50% protein leaving 25% of meal for veggies/fruit and 25% high fiber, multi-grain carbohydrates. Avoid sugar and refined carbohydrates such as candy, cookies, cake, crackers, bread. These refined carbohydrates are a 'waste of space' and you can easily consume many calories with little nutritional value, and they'll make you hungry sooner! It doesn't have to be 100% of the time but should be the way you eat more like 90% of the time! Many people seem to be carbohydrate sensitive while others are calorie sensitive. Finding the balance that works for you is imperative. "Diet plans" work because people are mindful, accountable and usually eat less. It is still about calories in and out for most of us. Exercise: Ø If you are not exercising start by resolving 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 daily (or more)! It helps you cope with stress, so you don't turn to food, it will help the weight loss and also give you energy! You will feel better about yourself and be less apt to go for the food. Support: Ø Resolve to either get involved in a local support group monthly. Weekly would be better but at least once a month. There are also many online support groups that can help also. Or get into therapy to deal with your food issues and look at why you are sabotaging your happiness. Most of us have food issues and we all need to face them eventually. The surgery is a great help but the brain is slow to change. It is hard work but looking at the issues and wanting to deal with them is the first step! Be proud of yourself for that and you can do it. What purpose is food serving for you? Do you need to hold on to old unhealthy habits of numbing your emotions with food or can you develop new, healthier habits to deal with stress? Today is a great time to start, not to change everything but to change one thing. Stop the excuses! If you wait you may have another 20 pounds to work on. Holidays and parties are always going to happen, you can always find an excuse to wait or a reason why you can't. Its difficult but search within yourself and find a reason why you can and do it. Remember why you started this journey and what you told yourself not so long ago! The power of positive thinking is yours! Think progress not perfection! You are worth it! Feel free to join me on: http://health.groups.yahoo.com/group/OSSG_Off_track/ Take Care, Jamie Ellis RN MS NPP Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!" PS I added this too! My motto knowledge is power!!!!!!!!! HUGE HUGS! Stopping That Rebound In Weight Ask U.S. adults if they're trying to lose weight, and three out of four say "yes," polls show. Weight loss is a major industry, from support programs to diet books to special foods. Yet more than 60 percent of Americans are overweight, and the numbers are getting higher. With all this dieting, why are so many people still unsuccessful at controlling their weight? One reason is that although many people manage to lose weight, they usually don't keep it off. Even in medically supervised weight-loss programs, people often regain, says Eva Obarzanek, a nutritionist for the U.S. government's National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and project officer of a new study on maintaining weight loss. "In a period after weight loss, usually about six months, the weight starts going back up," she says. Even in the best medically supervised programs, nearly two-thirds of participants are back where they started within three years and 80 to 90 percent within five years, says Gary Foster, Ph.D., clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania. For people who lose weight on their own, the relapse rate may be even higher. Why Weight Bounces Back Why is it so difficult to avoid putting those pounds back on? Biology, environment and the pressures of everyday life all play a role. a.. Biology - The body's metabolism, programmed for survival in times of food shortage, works against dieters. "Your metabolism slows down because it's trying to conserve energy," Obarzanek says. "So you get hungry, your body doesn't expend as many calories as before doing the same things, and you have to reduce calories even more." b.. Environment - "It's tougher to lose weight and keep weight off now than it was 20 years ago because there are so many incentives to eat more and move less," Foster says. "The cheapest foods are often the unhealthiest." Activity is reduced by labor-saving devices, sit-down entertainment such as television, and the growing number of people in desk jobs. c.. Life pressures - "Weight control takes a lot of work, hard work," Foster says. "If life gets in the way - a spouse gets ill, your child is going through behavioral problems - the disposable energy that you have for any project, including weight control, gets diverted." So you go back to old habits, and you regain weight. You Can Succeed Is it possible to lose weight and keep it off for a long time? Plenty of highly motivated people have succeeded. Now, research is starting to provide a clearer picture of how they do it. Some of the most detailed information comes from a national long-term study. The National Weight Control Registry contains information on 3,000 people who have lost 30 to 100 pounds (average, 60 pounds) and then kept their weight stable for at least one year (average, five years). They lost weight using many different diets or programs, says James Hill, Ph.D., co-director of the study along with Rena Wing, Ph.D., of Brown University. But those who keep it off have several things in common, he says. Exercise People in the weight-control registry, on average, burn up about 2,700 calories a week in physical activity, says Hill, director of the Center for Human Nutrition at the University of Colorado Health Sciences Center in Denver. That's equal to about one hour of moderately intense activity every day - for example, five miles of walking. "I think this is the most important [factor]," Hill says. It's not clear if people who lose smaller amounts of weight need to exercise this much. Still, a large body of research agrees that exercise is essential in counteracting the body's tendency to regain weight. "Without exercise, the other efforts are simply temporary," says Harold Solomon, M.D., director of the Weight Loss and Lifestyle Enhancement program at Beth Israel Deaconess Medical Center in Boston. "There are very few people who can lose weight and keep it off without changing the amount of energy they expend." Guidelines from the National Heart, Lung, and Blood Institute, part of the NIH, make the following recommendations about exercise to prevent weight gain: a.. Consult your doctor and start slowly to avoid injury. b.. If you have been inactive, start with 10 to 30 minutes of moderately intense activity, such as walking, three days a week. Build up to 30 to 45 minutes on most or all days of the week c.. Reduce sedentary activities such as watching television. Build more activity into your day by parking farther from your destination, taking the stairs instead of the elevator, gardening, walking a dog, etc. d.. Schedule your physical activity a week in advance, budget the time to do it, and use a diary to record the amount of time you spend exercising. Record the type of activity as well as the intensity. Self-Monitoring People in the weight-control registry are highly disciplined about this, Hill says. "They weigh themselves a lot and they record what they eat on a regular basis." Foster says his own experience with patients also shows that self-monitoring is important because it allows you to notice weight fluctuations early and to take action. "This doesn't mean you get crazy about every pound you go up or down," he says, "but it does mean that this is a chronic problem and when you gain weight what are you going to do about it? The way you reverse small weight gains is to have a specific plan." Sustainable, Healthy Diet Although people in the registry originally lost weight using a variety of diets, the vast majority kept the weight off by following a low-fat, high-carbohydrate diet, Hill says. Although new research indicates that low-carbohydrate regimes such as the Atkins diet can produce significant weight loss, very few people in the weight-control registry were following Atkins long-term, Hill says. Another important rule is to control portion size, Obarzanek says. And, she says, "I still believe that reducing dietary fat is the most efficient way of reducing calories." Dr. Solomon, a clinical assistant professor of medicine at Harvard Medical School, says his own patients who are successful at long-term weight control make rules for themselves about eating. Then, he says, they make those rules second nature. For example, he says, someone who eats a salad every day, but longs for a cheeseburger, at some point will give up and eat the burger. In contrast, people who permanently lose weight often say they don't do anything special to keep it off because they have made a permanent change in how they think about food, he says. "They have sort of drummed the cheeseburger out of their minds," he says. "They have a new reality." Breakfast This is another important element for people in the National Weight Control Registry. "They eat breakfast, so they're spreading out their calories over the day," Hill says. This pattern is important to reduce hunger and bingeing, Dr. Solomon says. "You have to eat breakfast. You have to spread your calories out and eat at least three or four times a day." The Role Of Support It's difficult to keep weight off, but research indicates that it helps to have some outside support. "We know that frequent contact with a health provider or some other entity that's looking after them - that would include a support group - is helpful," Obarzanek says. "We find in our clinic sessions that people who attend the most sessions lose the most weight." "Unfortunately, we don't know cause and effect. If you force people to go to sessions, would you get the same effect? Maybe people who are successful are proud, so they show up." The new NIH study on keeping weight off will explore whether certain ways of providing support are helpful. After participants lose weight, they will be randomly assigned to one of three groups. Members of the "self-directed" group will meet once with a health counselor and will receive educational materials, but no other support. A second group will receive monthly telephone calls from a counselor and occasional visits. The third group will use an Internet-based program that includes weekly e-mails with messages related to their progress and automated phone reminders to use the system. The form of support you need may depend on your personality, Foster says. "My sense is that in an attempt to find out what works we generalize too much. Some people are solo dieters and some like buddies. The most consistent data show that consistent contact with a professional improves the long-term outcome." But ultimately what matters is individual vigilance, he says. "Maintenance is a very active process. If you go with the tide, you will gain weight."

Jamie, Hun thank you so much for ALL your support, you have always been an inspiration to me and I love the way you help others here. I will take the time tonight and read through this post and get all my info in place! Thanks again, luv ya! Debra P