Huge Regain. Seeking Help.

Hi, everyone.  

New poster with a huge regain problem.  I am seeking your help.  

I had VSG in 2010 and lost about 170 pounds within 15 months.  I regained about 15 pounds from the lowest point and maintained for the next year.  I ran 8 half marathons and several smaller races in 2011-13.  I can recall a trip I took in which I allowed myself to eat half a bagel….an old trigger food.  This was near my lowest point in weight.  That seemed to open the door to eating many other foods that were not in my diet while losing.  Weight slowly crept on and my exercise became much less intense and frequent. I never really felt uncomfortable or out of control or recognized I had some head issues.   It seemed like each year, I would put on 20.  I had a huge job change, a move and just quite frankly reverted into old patterns.  

My food choices have been simple carbs and I find that I tend to graze.  Definitely have not followed rules.  

A couple months ago, I have found some behavioral and emotional supports.  I feel good about myself and in the desire to regain control over my health.  Yet, I find myself at my lowest point today.  I stepped on the scale and was horrified to see how much I have gained.  Shamed, actually.  

My question is what now?  What should my approach be at this point?  

I have not honestly had a lot of dense protein, so I am not sure if I still feel a restriction.  But I was thinking of taking the route of the 5 day pouch test just to get on liquids and then progress to see how the restriction holds and to also break myself of larger portions.  But then, how do you suggest I eat?  Do I follow the original rules verses total calories?  I am perplexed how to attack this on a nutritional front given I am 5 years out and I do want to maintain an active lifestyle.  I guess I don’t want to give up one form of disordered eating for another.  While losing, I maintained more carbs in my diet that the rules stated mostly to fuel my body for running.  

So to anyone that has regained or those that have been masters at maintaining, I would love your thoughts.  

I have beat myself up plenty, so save the shame based approach….but anyone with some positive suggestions moving forward would be much appreciated.  

Thanks in advance!

Go back to your weight loss phase. 

2-3 ounces of dense protein followed by veggies

3 meals day if you did 3 meals and a snack do that. 

Dont drink your calories. With the exception of a protein shake at breakfast. 

Youll be miserable for a few days but the weight will fall off

Kudos to you for coming here and seeking advice. This journey is hard and its wnderful you reached out instead of flogging yourself forever internally. We can be really good at that and get lost in the shame.  Although I don't have the years under my belt that you do, let me through in my 2¢. (BTW, all my advice is with care and concern and no shaming, that **** doesn't do anyone any good, ever).

First off, you don't have a pouch so a pouch test is not what you need. Your sleeve needs are more basic, I think. Feed it dense protein first: eggs, cheese, chicken fish, beef, etc. Weigh, measure and track. This is critical. Start back at basics with 3-4 oz dense protein per meal and cut your carbs back to veggies and berries. Get refined carbs out of your reach again. 64 oz water at least per day and don't drink for 30 mins after eating.

Get all those trigger foods out of the house: bread, bagels, rice, pasta, cake,cookies, junk food, juice, pop, etc. Just remove them so you are not tempted. You need to break the carb addiction and having it all nearby is just too difficult. If your family wants junk food make them buy and consume it out if the house so its not around.

Start using My Fitness Pal, be completely honest and track everything. You'll have to white knuckle it for a while but in  order to get back on track you need to go back to simple eating. Eat protein first, always. Try to chew each bite for 20 seconds. After finishing your 3-4 oz protein then eat 1-2 oz veggies and or berries. Eat Greek yogurt for snacks with some berries or PB2.

Get your daily protein grams up to 90-100g per day or more. Lower your net carbs to under 80 per day so your eating much more protein than carbs. Drink one protein shake a day if that helps. Syntrax Nectar has some nice "juice-like" proteins that aren't too thick and creamy (roadside lemonade, lemon iced tea).

This is not trading one disordered eating for another, its sleeve basics and you've got to give the sleeve what it needs to work for you. Thgats why you got it. You can add more carbs in later but truthfully you gotta drastically cut them back now in type and quantify if you want to lose some of the regain. 

I Applaud you for coming here, there's lots of support to be had and its really the ultimate first step, you can do this!!! Again, this is all with care, no shaming or preaching. You did this before so you know you've got the chops to do it again.

Thanks Miss Nexxie..I have found it difficult these last few weeks to lose any weight...I just keep going up and down, but this is a reminder of what I should be doing and not what I am doing! Hopefully with your advice I will get back on track and stay there...the one thing I don't know is how many grams of Carbs are we allowed...I am almost 13 months post op VSG

I think it's not a matter of carbs "allowed". My dietician was always pushing me to high carbs and it took a long time to get her to realize they are a trigger for me and I can't just eat a slice of whole grain bread and leave it at that. Possibly, you may have similar tendencies. I get most of my carbs from veggies, berries, yogurt and oat bran (just to keep things moving ☺). I stay far away from pasta, rice, bread, cookies, etc, except for rare occasions because I love them like no other.

Where some professionals say 150 g or less daily carbs is not enough, I stuck below 80g per day until I hit goal. Not as low carb as other here but it worked for me. I'm also consuming much higher calories than most advocate but its mostly protein and it works for me. Maybe use 80g or less carbs as your initial daily target. Focus more on protein, it will fill you up.

Hugs.. You know what is not working. Too many carbs that may fuel overeating. 

Are you really back to be really active? Running, exercising?  If so, then more carbs in days that you do that may be justified.  But, based on my experience, once I start eating, or justify eating more carbs on some days, the flood gate opens and .... I just keep eating...  I learned that I can't have a cake and eat it too. 

5 day pouch test - 1. You don't have a pouch. 2. Even if you do, most people be live that this "test" is a really useless...

But, for some, if they follow "the rules" , it may help some people get "a reset". Learn what portions are. Stop grazing, and learn that it is OK to feel hungry.  

Giving up white carbs should be a priority for anyone who is trying to get on track. Also finding trigger foods... Even so called "good carbs" , if I can't Stop at one serving.. then I can't have that food around me.. (some fruits do that to me- I.e cherries) 

Identifying the triggers, physical and mental and work with them. 

I had RNY, and I still have a great restriction... If I eat dense proteins.  Drinking lots of water in between meals really helps with hunger. Avoiding eating my trigger foods or having that around me, is my way to deal with them. If trigger foods are in the house- for my partner to eat - they are not in a plain sight, they are only in qty he would eat, and after he is done - they are wrapped, packaged, put away ...etc...out of sight, out of mind....

Proper planning... Having enough good quality, veriaty of food in the house, so I don't get bored with it. 

Contingency when going out - I always have snacks in my purse. ALWAYS with me. Some in the car. At work. There it's never an excuse that I had no choice... 

While eating out - I still can choose proteins and veggies. At friends and family - well... Bringing my own food, or having some protein bars with me allows me to say "thanks, but "No", thanks" when the only choices offered are carb loaded dish like pizza, pasta, and desserts... (it happened) 

Plan meals in advance. 

My approach is rather low carbs, no grains (they are my triggers), limited fruits. Concetrating on proteins, good fats, and non starchy veggies... Nuts, event though, they are high calories, are a great snack for me. 

Good luck in taking charge...

Back to basics IMHO

-no drinking 30 minutes post eating

- dense protein first

- green leafy veggies/fruit low on the glycemic index

- exercise

- hit your protein and water targets

-weigh and log everything

- follow what works best for you with carbs (many go under 40, I do best at 100-150 type thing)

- get to support group or therapy or a combinationD

Your restriction is there. You just don't feel it when you are slider food/carb heavy... been there and done that so I totally get it. It is worthwhile to spend 4 days or so detoxing from carbs to nip the cravings/hunger in the bud and to kick your restirction in full force. My best days still are the ones where I have a protein shake for breakfast. Good luck!

Thank you...Thank you....Thank you!!!

I greatly appreciate the kind and thoughtful responses.  You have given me that pep talk to get back on track.  

I have spent the past couple days on a detox of sorts and plan to get back to basics.  Kitchen and pantry are pull of protein and more importantly void of junk!  I think I will give my body a week more to adjust before adding back exercise just so I can adjust to lower calories and fewer carbs.  I do wear a fit bit and will make daily goals for walking.  

Thanks again for the guidance and support.  I plan to stick around!!

I'll skip the numbers, but at 5 1/2 years out, I'm 2 pants sizes up from my smallest.  My son's being sleeved this Thursday  the 6th, and I've ordered enough protein that my plan is to go through the entire process again with him, beginning with clear liquids on Wednesday.  Don't know if I'll be able to stay super-strict during the liquid phase (that's much easier when you've got tons of swelling in there!) but I'm gonna try!  I'd suggest you start back at the beginning and maybe move through your post-op food phases a few days to a week at a time....we've still got our sleeves, we DO have restriction with dense proteins, and we can do this!

You have already taken the hardest step by saying enough is enough and now I want to get back on track.  Here are some steps I hope will help you. They helped me...  Also, be sure and join the Back On Track Together group link in my signature area.  

Planning/Preparing

Remember when we were preparing for surgery?  How many meetings, classes and such did we attend?  We were told the more prepared we were the better our chances were for success.  And they were right. Go through the house, car and work place and get rid of trigger foods.  Stock up on foods that will keep you on track. I removed every carb/sugar temptation and replaced it with lots of protein, veggies and fruits.  

Journaling

Get back to journaling.  This will help you identify when you feel like eating, stress factors and any triggers in your life.  Once you identify these factors, this will help you put tools in place to keep you from eating.  It became clear I was not taking time for me anymore. I worked my day job and then spent the rest of my time caring for my husband.  It was easy to reach for fast, prepackaged food.  Since I purged my home I have to eat clean as there are no other options LOL

Use a tool to track you're eating and exercise like Getting Started with Health Tracker

Once I started to track ever bite and drink it became clear why I had gained.

Goals/Rewards

Make a list of goals for yourself.  Make them realistic and small.  Some of mine were move more, purge all junk from my home, eat more protein.

Food

In general, a long term post-weight loss surgery eating plan includes foods that are high in protein, and low in fat, fiber, calories, and sugar. Important vitamins and minerals are provided as supplements. (if you had a different surgery adjust this to your food plan)

Water

Water is our Best Friend. I have to say I never went back to pop or any bad drinks, however I was drinking tea like crazy. What is wrong with drinking tea?  I was either using sugar or 3 equals and 3 sweet n lows per 32 ounce glass.  So I was either pushing to be diabetic or get cancer.  I found once I started carrying a bottle of water around 24/7 (yes had one at my bedside) I lost the cravings for the sugar and I KNOW those artificial sweeteners are not good for me. Look I am old and if you add up all the artificial sweeteners I have consumed I am sure I am at the rat in the lab getting cancer threshold

MOVE!

I can't say enough about how key this was for me. The reason I kept my weight off for almost 10 years was no matter what I kept moving.  If I could not go to the gym I would walk. I loved Zumba, bootcamp workouts, lift weights. When I stopped, the weight came on.  So for me I am starting slow to avoid injury by walking and using some of the workouts on my Demand TV.  Find something you love to do and it won't feel like a pain in the *** to do daily.

Support

If it's an option "run" don't walk to a support group.

Keep me posted on how you are doing