YOU MUST BE MILITANT to be above average
Hi guys -
I hope you find this posting helpful and informative. It's meant to be helpful and informative, rather than coddling or nurturing. This post is in response to a recent post by Frisco, where he fretted about the future success of VSG patients. Through his observations (which are coincident with my own), he sees more and more newer patients that have been provided with less tools and/or dietary requirements. Frisco called on us to look into ourselves as a community; if you reacted negatively to his call-to-arms, then may I boldly suggest that it is a possibility that you were emotionally threatened by calling attention to the elephant in the room.
This post is about you, the individual, and how you can be successful. This post summarizes how you can achieve your goal: by maintaining a militant diet plan - forever. Let's beat the dead horse - this is all about a change in your lifestyle, not a temporary revision or reduction in diet.
When you look at the people on this forum that hit 100% excess weight loss (EWL), you'll note that they eat much, much better than they used to - not just less. They have committed to leaving behind certain types and classes of food - are you that willing?
Let's look at some data. I'm a career scientist, and I love me some data. Let's see how well VSG works for the average patient a few years out (I extracted most of this information from the American Society for Metabolic and Bariatric Surgery's metadata analysis published on October 28th, 2011):
You'll note in the beginning, the average patient loses 70-75% EWL in the first year - terrific! A cause for celebration! And then as we get further out ... oh oh. Instead of heading up to 100%, it actually goes down.... to the 50-60% range. So first, if you're to lose 200 pounds, you're going to end up still needing to lose 80 or so pounds when you're 'done'. And second, yes, sadly, the average person does gain back weight that he/she lost after surgery. (Did your surgeon disclose these things to you?) Yikes. There's a lot to say about this:
We can remind ourselves that no surgery is perfect. We can also remind ourselves that these are realistic expectations - if you find yourself years out of surgery and still need to lose 50 pounds, you're not necessarily a "failure". This is also why surgeons, good ones, will push you hard to lose the most weight as soon as possible. These guys are no fools; they know that the average person will not stay on their diet plan for years. Human are astonishingly bad at doing so (after all, the success rate of losing weight with diet and exercise alone and keeping that weight off for two or more years is less than 5 percent). So, while you are on the diet plan, they want you to maximize your chance of success, so they say "lose it fast!"
I can see some of you fidgeting. You're opening your mouth to say "ok, but..."
Yes. Those are averages. Some, sadly, will have surgery and not even lose half the weight they are supposed to. But others, you point out, are at 90% or 100% EWL and have been for years! What is their secret?! Here's the shocker: it's diet and exercise and a pledge to live differently.
Like every American, I want to be above average! I want to hit the 100% mark. I don't want to lose a bunch of my fat, I want to lose nearly all of it! So, I 'stalk' these individuals that are really successful. I watch them. I ask my surgeon and nutritionist about people who are most successful, and I reach out to my support groups and interrogate them as well. What's a common difference between someone that hits 60% versus another individual hitting 100%?
They make a lifestyle commitment. They permanently change what they eat and reflect upon the quality of their food. They do not simply reduce portion sizes and they do not return to the foods that so helped to make them fat in the first place. I certainly don't intend to, nor do I want to, single anyone out. But some of you clearly are still maintaining your love affair with food. Either you're actively engaged in your love affair now, currently, or like a lover overseas, you await his/her return when you "lose all your weight". Stop kidding yourself.
Diet and exercise and lifestyle change is your first weapon. The sleeve is your second weapon, in that order. The sleeve is not the main gun, it's your backup. The sleeve is your buddy for those occasional situations in which you may be weak or stressed or broken down. If you use your sleeve as the main tool, expecting it, and not you, to do most of the work then I sincerely predict that you will be hitting average or less-than-average EWL. If you have an emotional reaction to that sentence, then good: I have achieved my intention and made you look at something in yourself that you've been refusing to look at. Like Frisco's post, this is a call-to-arms. I don't know about you all, but if I wake up in 5 years and I'm at back down to 50% EWL I'm going to be sorely pissed at myself. I don't want that situation to happen to me, and I don't want it to happen to you either.
If you maintain that you're setting up the correct mental philosophy by having mushie carbs during your mushie stage, I humbly suggest you are setting yourself up for failure. I see you, mashed potatoes with butter. This also goes for eating solid food you know you shouldn't be eating, but saying "lolz, it's alright, it's got some protein in it!". Yes, I'm looking at you, pizza. Yes, I'm coming out of the closest and I'm going to say it: Pizza is bad food during weight loss. There. I'm looking at you, fatty meats and full-fat cheeses. Oh sure, perhaps in maintenance these might be ok in moderation... but if you're already at 100% EWL, then this message isn't for you, anyway.
I'll continue with my rant! The holidays are a horrible time for us! Food aplenty shoved in our faces, in our homes, in our workplace, where we shop, it's inescapable! That is why we must remain vigilant, and stick to our diet plans all the more. So we get higher and higher up that curve to 100& EWL. If you say "lolz, it's the holidays!", you're setting yourself up for failure. If you say "you've got to live a little, eat some!", you're setting yourself up for failure. That sentiment ruined how many diets for me? Com'mon, we're all obese or recently were obese, we know how slippery of a slope it is. "You've got to treat yourself sometimes!" Sure thing, but not with food, certainly not while still losing weight. Oh sure, you have to stay sane and all, and not be withering in frustration, but that slope is suuuuuuure slippery for me, and I bet it is for most of you all too.
I've done my best to kill my old self. I took a big kitchen knife and stabbed my old self to pieces (figuratively, of course, no calling law enforcement on me). I still like food a whole bunch, but I don't try to find validation, or reassurance, or contentment, or love from food anymore. It's simply fuel, sometimes tasty fuel. I make sure I get validation and reassurance and love from living creatures now. The new me is much healthier for this, for stopping the use of food as an emotional crutch, to fill an hole where other things belong.
What can we do to be really successful?
- Stick to your diet plans - forever if you can, but at least as long as you can tolerate, and then some.
- Exercise. Do it.
- Follow Frisco's advice and UNDEREAT YOUR SLEEVE. Never use restriction to tell you when to stop eating. This is a horrible idea.
- If you know you've got mental issues about eating, see a therapist! There's no shame in this. Do what you gotta do to be successful. You see other doctors for other issues, so see a therapist if you know you'd benefit from one.
- Know that VSG isn't about just eating smaller portions; it's also about eating the right food. - If you cannot mostly or totally control what you put in your mouth, this may not have been the optimal surgical choice for you.
- Learn from your mistakes, and others' mistakes, but don't repeat them.
- Educate yourself. Know basic nutrition (protein good, carbs bad, fats are good or bad depending on the most recent publication)
- If you have questions, worries, concerns, then ask!
- Don't sit home alone, even if you think you're successful. Go to support groups - they definitely help keep you in check.
If you're like me and you're not going to be happy losing only 50%, 60%, or 70% EWL, then stack the cards in your favor! Make the commitment to change the way you live for the rest of your life!
Happy Holidays to you all... I hope you elect to find my philosophy supportive and encouraging rather than a prediction of failure on your part. In many ways, we carve out our future successes, victories, and fates. I'm going to do my best to take control of my success. I may fail, but I'm sure going to try, very hard and intently.
Try along with me. We'll do it together.
I hope you find this posting helpful and informative. It's meant to be helpful and informative, rather than coddling or nurturing. This post is in response to a recent post by Frisco, where he fretted about the future success of VSG patients. Through his observations (which are coincident with my own), he sees more and more newer patients that have been provided with less tools and/or dietary requirements. Frisco called on us to look into ourselves as a community; if you reacted negatively to his call-to-arms, then may I boldly suggest that it is a possibility that you were emotionally threatened by calling attention to the elephant in the room.
This post is about you, the individual, and how you can be successful. This post summarizes how you can achieve your goal: by maintaining a militant diet plan - forever. Let's beat the dead horse - this is all about a change in your lifestyle, not a temporary revision or reduction in diet.
When you look at the people on this forum that hit 100% excess weight loss (EWL), you'll note that they eat much, much better than they used to - not just less. They have committed to leaving behind certain types and classes of food - are you that willing?
Let's look at some data. I'm a career scientist, and I love me some data. Let's see how well VSG works for the average patient a few years out (I extracted most of this information from the American Society for Metabolic and Bariatric Surgery's metadata analysis published on October 28th, 2011):
You'll note in the beginning, the average patient loses 70-75% EWL in the first year - terrific! A cause for celebration! And then as we get further out ... oh oh. Instead of heading up to 100%, it actually goes down.... to the 50-60% range. So first, if you're to lose 200 pounds, you're going to end up still needing to lose 80 or so pounds when you're 'done'. And second, yes, sadly, the average person does gain back weight that he/she lost after surgery. (Did your surgeon disclose these things to you?) Yikes. There's a lot to say about this:
We can remind ourselves that no surgery is perfect. We can also remind ourselves that these are realistic expectations - if you find yourself years out of surgery and still need to lose 50 pounds, you're not necessarily a "failure". This is also why surgeons, good ones, will push you hard to lose the most weight as soon as possible. These guys are no fools; they know that the average person will not stay on their diet plan for years. Human are astonishingly bad at doing so (after all, the success rate of losing weight with diet and exercise alone and keeping that weight off for two or more years is less than 5 percent). So, while you are on the diet plan, they want you to maximize your chance of success, so they say "lose it fast!"
I can see some of you fidgeting. You're opening your mouth to say "ok, but..."
Yes. Those are averages. Some, sadly, will have surgery and not even lose half the weight they are supposed to. But others, you point out, are at 90% or 100% EWL and have been for years! What is their secret?! Here's the shocker: it's diet and exercise and a pledge to live differently.
Like every American, I want to be above average! I want to hit the 100% mark. I don't want to lose a bunch of my fat, I want to lose nearly all of it! So, I 'stalk' these individuals that are really successful. I watch them. I ask my surgeon and nutritionist about people who are most successful, and I reach out to my support groups and interrogate them as well. What's a common difference between someone that hits 60% versus another individual hitting 100%?
They make a lifestyle commitment. They permanently change what they eat and reflect upon the quality of their food. They do not simply reduce portion sizes and they do not return to the foods that so helped to make them fat in the first place. I certainly don't intend to, nor do I want to, single anyone out. But some of you clearly are still maintaining your love affair with food. Either you're actively engaged in your love affair now, currently, or like a lover overseas, you await his/her return when you "lose all your weight". Stop kidding yourself.
Diet and exercise and lifestyle change is your first weapon. The sleeve is your second weapon, in that order. The sleeve is not the main gun, it's your backup. The sleeve is your buddy for those occasional situations in which you may be weak or stressed or broken down. If you use your sleeve as the main tool, expecting it, and not you, to do most of the work then I sincerely predict that you will be hitting average or less-than-average EWL. If you have an emotional reaction to that sentence, then good: I have achieved my intention and made you look at something in yourself that you've been refusing to look at. Like Frisco's post, this is a call-to-arms. I don't know about you all, but if I wake up in 5 years and I'm at back down to 50% EWL I'm going to be sorely pissed at myself. I don't want that situation to happen to me, and I don't want it to happen to you either.
If you maintain that you're setting up the correct mental philosophy by having mushie carbs during your mushie stage, I humbly suggest you are setting yourself up for failure. I see you, mashed potatoes with butter. This also goes for eating solid food you know you shouldn't be eating, but saying "lolz, it's alright, it's got some protein in it!". Yes, I'm looking at you, pizza. Yes, I'm coming out of the closest and I'm going to say it: Pizza is bad food during weight loss. There. I'm looking at you, fatty meats and full-fat cheeses. Oh sure, perhaps in maintenance these might be ok in moderation... but if you're already at 100% EWL, then this message isn't for you, anyway.
I'll continue with my rant! The holidays are a horrible time for us! Food aplenty shoved in our faces, in our homes, in our workplace, where we shop, it's inescapable! That is why we must remain vigilant, and stick to our diet plans all the more. So we get higher and higher up that curve to 100& EWL. If you say "lolz, it's the holidays!", you're setting yourself up for failure. If you say "you've got to live a little, eat some!", you're setting yourself up for failure. That sentiment ruined how many diets for me? Com'mon, we're all obese or recently were obese, we know how slippery of a slope it is. "You've got to treat yourself sometimes!" Sure thing, but not with food, certainly not while still losing weight. Oh sure, you have to stay sane and all, and not be withering in frustration, but that slope is suuuuuuure slippery for me, and I bet it is for most of you all too.
I've done my best to kill my old self. I took a big kitchen knife and stabbed my old self to pieces (figuratively, of course, no calling law enforcement on me). I still like food a whole bunch, but I don't try to find validation, or reassurance, or contentment, or love from food anymore. It's simply fuel, sometimes tasty fuel. I make sure I get validation and reassurance and love from living creatures now. The new me is much healthier for this, for stopping the use of food as an emotional crutch, to fill an hole where other things belong.
What can we do to be really successful?
- Stick to your diet plans - forever if you can, but at least as long as you can tolerate, and then some.
- Exercise. Do it.
- Follow Frisco's advice and UNDEREAT YOUR SLEEVE. Never use restriction to tell you when to stop eating. This is a horrible idea.
- If you know you've got mental issues about eating, see a therapist! There's no shame in this. Do what you gotta do to be successful. You see other doctors for other issues, so see a therapist if you know you'd benefit from one.
- Know that VSG isn't about just eating smaller portions; it's also about eating the right food. - If you cannot mostly or totally control what you put in your mouth, this may not have been the optimal surgical choice for you.
- Learn from your mistakes, and others' mistakes, but don't repeat them.
- Educate yourself. Know basic nutrition (protein good, carbs bad, fats are good or bad depending on the most recent publication)
- If you have questions, worries, concerns, then ask!
- Don't sit home alone, even if you think you're successful. Go to support groups - they definitely help keep you in check.
If you're like me and you're not going to be happy losing only 50%, 60%, or 70% EWL, then stack the cards in your favor! Make the commitment to change the way you live for the rest of your life!
Happy Holidays to you all... I hope you elect to find my philosophy supportive and encouraging rather than a prediction of failure on your part. In many ways, we carve out our future successes, victories, and fates. I'm going to do my best to take control of my success. I may fail, but I'm sure going to try, very hard and intently.
Try along with me. We'll do it together.
Heaviest weight: 310 pounds (Male, 5'10")
Ruggie and Frisco I have to say, thank you, thank you, thank you. We all need to take a minute or two and read your post's. It looks like you have done your homework and are doing great. You are 100% right, the VSG is only a tool, not a fix all. If we expect to get to that 100% loss, we must stick to our new lifestyle of eating. 
HW:280 SW:270 OLD GW:190 NEW GW: 180 CW: 174
Oh, well, I can tell you what I do, but I'm not Mr. Expert - I'm still losing, and the vets here at mantainance can probably give you better guidance.
My surgeon likes to have females at 60-80g / day, and males at 80-100g /day, definitely the higher range if exercising. I'm a bit of a lazy ******* so I rely upon my protein shakes. They're easy to deal with at work and home.
I have 3 Syntrax Nectar shakes a day. Each shake is 23g protein, 2g carb, no fat, 100 calories. So, that's 69 g protein for only 6 carbs and 300 calories. At lunch, I'll eat 4 oz of low-fat cottage cheese (80 cal, 14g protein) and two ounces of some meat or prepared meat (usually 60-100 calories, 14ish g protein). So that puts me a tad under 100 g protein at about 500 calories. And I snack. Yes, I preach at you all, but I have my own failings still. I'll do something that has at least moderate amounts of protein or healthy fats - a few nuts (I mean a few!) , a few olives, beef jerkies (yum), or pork rinds (not that tasty, but satisfies a crunch desire with no carbs and decent protein).
If I have a lot of physical food, say, my normal work lunch plus I go out at night for dinner, then I'll have two protein shakes instead of three.
Also, I drink wine on the weekends, quite a bit, which I know I shouldn't do because (1) I don't need empty calories (2) it slows metabolism down. It's definitely my one vice. I'm trying to dump it still. At least if I'm going to have wine that night, I get my butt doing cardio during the daytime to partially make up for it. I record wine calories as well.
Oh, for me too: no sodas, sweet drinks (Crystal Light, etc), no carbonation, no caffeine, no liquid calories (except that wine), no bites of cookies, pastries, baked goods (even during the holidays). I do the basics like eating protein first and a couple veggies to end a meal. I don't BS myself and pat myself on that back that I "only ate one piece of pizza" with my sleeve. That's not a real victory. And I celebrate my real victories (without food) like crossing the 200 lb threshold, etc. I don't do anything like "I'm not going to have any now, but I can't wait to have this when I'm done losing weight" - like returning to soda. I'm sure there might be exceptions, but I plan to never return to soda again, regular or diet.
Hope this helps.
My surgeon likes to have females at 60-80g / day, and males at 80-100g /day, definitely the higher range if exercising. I'm a bit of a lazy ******* so I rely upon my protein shakes. They're easy to deal with at work and home.
I have 3 Syntrax Nectar shakes a day. Each shake is 23g protein, 2g carb, no fat, 100 calories. So, that's 69 g protein for only 6 carbs and 300 calories. At lunch, I'll eat 4 oz of low-fat cottage cheese (80 cal, 14g protein) and two ounces of some meat or prepared meat (usually 60-100 calories, 14ish g protein). So that puts me a tad under 100 g protein at about 500 calories. And I snack. Yes, I preach at you all, but I have my own failings still. I'll do something that has at least moderate amounts of protein or healthy fats - a few nuts (I mean a few!) , a few olives, beef jerkies (yum), or pork rinds (not that tasty, but satisfies a crunch desire with no carbs and decent protein).
If I have a lot of physical food, say, my normal work lunch plus I go out at night for dinner, then I'll have two protein shakes instead of three.
Also, I drink wine on the weekends, quite a bit, which I know I shouldn't do because (1) I don't need empty calories (2) it slows metabolism down. It's definitely my one vice. I'm trying to dump it still. At least if I'm going to have wine that night, I get my butt doing cardio during the daytime to partially make up for it. I record wine calories as well.
Oh, for me too: no sodas, sweet drinks (Crystal Light, etc), no carbonation, no caffeine, no liquid calories (except that wine), no bites of cookies, pastries, baked goods (even during the holidays). I do the basics like eating protein first and a couple veggies to end a meal. I don't BS myself and pat myself on that back that I "only ate one piece of pizza" with my sleeve. That's not a real victory. And I celebrate my real victories (without food) like crossing the 200 lb threshold, etc. I don't do anything like "I'm not going to have any now, but I can't wait to have this when I'm done losing weight" - like returning to soda. I'm sure there might be exceptions, but I plan to never return to soda again, regular or diet.
Hope this helps.
Heaviest weight: 310 pounds (Male, 5'10")
1) I do not advocate that others should follow my particular, individual diet plan. I'm only relaying what works for me. I do advocate that people use means to achieve their protein intake, and limit their carbs.
2) Nothing is going to be realistic if you take the attitude that it's not. Anything that is achievable is realistic is you decide it's going to be. I decided that I wasn't going to care about the experience of eating so much anymore, and so I do not. It's about what you'll willing to gain for the price you'd have to pay. There were times in my life when I would not have made this trade off - I was happy to shove solid food in my face all day long. My life is different now. More than just wanting it logically, on a spiritual and emotional level I want to be healthy and active, and that now overrides my eating desire when before it did not.
3) Having 3 protein shakes and a solid day (and a snack) each day works for me. I think you're right - people still in love with food are going to find this concept deplorable. I intend to continue this diet until I hit my goal (hopefully within three months). I have no issues with this at all; I love it. Shakes make it so easy to get my 100 g / day of protein. I drink them in my car, my office, at support groups, etc. If I spend three hours shopping, you better believe I consumed a protein shake during that time.
4) When I hit goal, I will decrease my protein shake amounts and increase the amount of solid food. This is an okay trade-off - solid food is convenient, (too) plentiful, and the added calories from carbs and fat should help me maintain weight.
5) I don't expect to ever (for a loooooooong time) stop drinking protein shakes. I'm transitioning to a new phase of cardiovascular exercise and muscle building - those activities require me to keep my protein intake at high levels. In fact, if I want to get serious about packing muscle off (and I'm not sure I do), I'd need much more than 100 g / day of protein. That's why bodybuilders use protein shakes too.
Do low-fat/non-fat and low-carb/no-carb protein shakes taste good? No, and I don't care.
2) Nothing is going to be realistic if you take the attitude that it's not. Anything that is achievable is realistic is you decide it's going to be. I decided that I wasn't going to care about the experience of eating so much anymore, and so I do not. It's about what you'll willing to gain for the price you'd have to pay. There were times in my life when I would not have made this trade off - I was happy to shove solid food in my face all day long. My life is different now. More than just wanting it logically, on a spiritual and emotional level I want to be healthy and active, and that now overrides my eating desire when before it did not.
3) Having 3 protein shakes and a solid day (and a snack) each day works for me. I think you're right - people still in love with food are going to find this concept deplorable. I intend to continue this diet until I hit my goal (hopefully within three months). I have no issues with this at all; I love it. Shakes make it so easy to get my 100 g / day of protein. I drink them in my car, my office, at support groups, etc. If I spend three hours shopping, you better believe I consumed a protein shake during that time.
4) When I hit goal, I will decrease my protein shake amounts and increase the amount of solid food. This is an okay trade-off - solid food is convenient, (too) plentiful, and the added calories from carbs and fat should help me maintain weight.
5) I don't expect to ever (for a loooooooong time) stop drinking protein shakes. I'm transitioning to a new phase of cardiovascular exercise and muscle building - those activities require me to keep my protein intake at high levels. In fact, if I want to get serious about packing muscle off (and I'm not sure I do), I'd need much more than 100 g / day of protein. That's why bodybuilders use protein shakes too.
Do low-fat/non-fat and low-carb/no-carb protein shakes taste good? No, and I don't care.
Heaviest weight: 310 pounds (Male, 5'10")
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