Alli

atxnana2

email me off list I would gladly send you my powerpoint presentation I did a while back on getting back on track! *I will add the article I wrote below on it as well! [email protected]

I realize WLS is not going to get most to 'our goals' because that is not what it is meant to do, even though we wi**** were not true. Regain is also a factor when either we have a broken tool or do not use the tool by developing lifelong consistent healthy habits with food, exercise and emotional managment.

I always recommend folks go to their surgeon and bariatric program to seek assist to see if it is mechanical and or behaviorall and what if anything can help them at least lose regained wt.

WLS is meant to give 50% excess at 5 yrs+ that is no way the same as bein gthin, it is healthier but not thin, many remain overwieght but at least not as obese as prior. It is a hard thing to realize, accept and be comfotable with for sure.

You mention you can not seem to get back to basics, I am assuming then perhaps you are not engaged in the above helathy consistent lifestyle with food, exercise and emotional regulation?

Alli if one had a malabsorbtive procedure like RNY bypass of BPD/DS is contraindicated. Your avitar says VBG did you have a verticle banded gastroplasty? THis is not malabsorbtive and known to have high complication and failure rate longterm according to literature, even in fully dedicated/compliant people.....

Here is info I share on Alli, by the way small wt losses are recorded only with this woth the s/e or money? Not for me!

~I would caution consideration of Alli (Xenical/Orlistat) as well due to its fatsoluable malabsortion effects on ADEK we already have this issue! Orlistat decreases the absorption of certain fat-soluble vitamins - for example,vitamins A, D and E. If you're taking Alli, you need to take a daily vitaminsupplement (at a time different from when you take Alli) to prevent potentialnutrient deficiencies. Besides the efficacy of the prescription strength was small that I worry the risk vs benefit of OTC form (smaller dose) would not be prudent!

Original Article: http://www.mayoclinic.com/health/alli/WT00030  
Alli weight-loss pill: Does it work?
Donald Hensrud, M.D.
(snipped section on) Efficacy

Q: How much weight do patients lose with XENICAL treatment?
A: In clinical trials involving 1064 patients, 69% on XENICAL plus diet lost 3%
or more of initial body weight within 3 months, with a mean loss of 13 lbs.18 In
clinical trials, the overall mean weight loss from randomization to the end of 1
year in the intent-to-treat population was 13.4 lbs in patients treated with
XENICAL plus diet versus 5.8 lbs in placebo-treated patients.

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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:
?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:
?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.

?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:
?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:
?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/

?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!

?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:
?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:
?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/

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Finding The Goal Again
Thoughts from Kaye - October 9, 2005
by Kaye Bailey

As the LivingAfterWLS community grows I learn more and more that weight loss surgery is not easy. In fact, many of us struggle to lose weight and keep it off. This causes me to question, what is wrong with us that we fight this would-be miracle of modern medicine? Are we weak failures destined to be fat no matter what extreme measures we take to not be obese? Why is it so hard day after day?

These are harsh self-loathing questions.
Not long ago I received a letter from Anita, a generous person and LivingAfterWLS community member. Last week was her 1-year WLS anniversary. She wrote, "I have really done some soul searching and reading since I emailed you. In reality I lost all sight of what I should be doing with my diet and exercise."

Her sentence "I really lost all sight of what I should be doing " spoke to my heart. Could the absence of long-term accountability be one reason we lose sight of the goal and struggle after WLS? We know the slogans, "WLS is only a tool" and "WLS is for life" but those statements are vague lacking accountability and action. What if we accounted to ourselves and committed to paper an action plan for improvement? Imagine a tangible tool to account, applaud and assess our present state and plot our direction with WLS? Could that be the key to greater success long term with WLS?

WLS patients are notoriously prudent to follow the pre-op directions. After surgery we religiously attend our first year follow-up appointments and support groups. After the first year we tend to slack off, we start feeling normal. Support groups seem repetitious and focus on pre-ops or newbies. Perhaps a backslide keeps us home; we are embarrassed to have stalled at losing or have regained a few pounds. Distance from my center has been an easy excuse for me, and now I don't call because staff turnover means I have to talk to strangers. By losing touch with my WLS center I have surrendered any accountability for how I use "The Tool."

Today, because I needed community support as much as anyone, we have the LivingAfterWLS Community: A no-nonsense resource for living after weight loss surgery. As an exclusive tool available only to subscribers I present the first ever "LivingAfterWLS Quarterly Personal Self-Assessment" worksheet. Having read hundreds of emails I narrowed down some questions we can ask in a sincere effort to assess our present state and make an action plan for the next three months. This worksheet should be used as a private tool with the intent to pursue better living with WLS. It is a solemn personal contract; a contract of honor and self-respect. Anyone brave enough to have WLS deserves to treat him or herself well and engage in appropriate long-term behaviors to make the most of life after WLS.

Download the LivingAfterWLS Self-Assessment Worksheet
http://www.livingafterwls.com/PDF%20Files/2006%20Self%20Asse ssment.pdf

The "Quarterly Personal Self-Assessment" tool is a two-page worksheet. Yesterday I spent quiet time in self-assessment. It was much harder to answer the questions than I thought it would be. I spoke to my husband about this. As expected his wisdom was insightful. He said, "You know, Hindsight 20/20 is an expression for a reason. It is easy to look back and see what we have done right or wrong. You and the (LAWLS) community members look back all the time and beat-up yourselves. But what you are asking with this worksheet is to look hard at yourself in the present and make a plan for improvement. Of course filling it out is hard, but it is necessary. Living without accountability is harder."
I completed my worksheet and signed the solemn contract with myself. It felt great to account to myself and promise specific actions of improvement to make my WLS work better for me. I like seeing on paper the actions for which I am now accountable. I am looking forward to reviewing this contract over the next few months. I deserve to honor these commitments and succeed long-term with WLS.

You deserve to make commitments to yourself for better living with WLS.
Download the LivingAfterWLS Self-Assessment Worksheet
Please accept this invitation to join me in the Quarterly Personal Self-Assessment. Print the worksheet, take some quiet time to evaluate where you are and where you are going. Put your WLS goal back in sight. Pre-ops, Newbies and Old-timers can all use this tool. You don't have to share it with anyone or you can share it with the world. If it works for you let me know. If it's missing something let me know.

I will include gentle accountability reminders on the website and in the newsletters. Let's work together and see how well we can make this tool work for living better after WLS.

Please accept my thanks and best wishes to Anita and the entire LivingAfterWLS community. I am inspired daily by you.
Yours in the battle,
Kaye

http://www.livingafterwls.com/Library/Self_Assessment.html#f eatured
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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!