Time for food again! Advice needed

Whether something is a fad or not is a social characterization of the product or activity that has little or nothing to do with its technical or therapeutic merits; it is simply that many indulge in that activity because others are doing so, too. It is useful to understand this character as that can have a big influence in what we get out of it, how to benefit from it and how to mitigate its' negative effects. Gluten free is getting big in the fad world as many think that it will help them lose weight, or see a favorite celebrity touting it. This is a great thing if one suffers from Celiac or non-Celiac gluten intolerance as it means that there a lot more gluten free products on the market than there otherwise would be. Likewise, when my wife was first diagnosed as diabetic some thirty years ago, there was little available in the supermarkets at the time aimed at that problem, as everything was aimed at the low fat fad; one had to go mail order (remember that?) or if in a major market, a specialty bricks and mortar sugar free store. Today, those products are all over the place. On the negative side, it means that one needs to be attentive to the marketing directed at the fad, since everyone is counting carbs, any labeling for them will be as charitable as possible (usually without going to VW levels of fraud.) But it does mean that one needs to look out for the frankenfoods that make dubious substitutions in the name of a low carb number (just as in the days of the low fat frankenfoods.)

If I were, for instance, interested in buying shares in Tesla, it is in my interest to understand that there is a strong fad component in its ownership makeup because many people like the car, or Elon, and this influences the price that one may pay for it - quite independent of the intrinsic value of the company. This may be a positive or a negative, but shouldn't be ignored. This makes it quite a different proposition than buying, say, Con Edison which few buy simply because they are a customer and who know who the CEO is?

It's a double edged sword - which means that it needs to be treated accordingly.

You say that:

Whether something is a fad or not is a social characterization of the product or activity that has little or nothing to do with its technical or therapeutic merits

The gluten free movement certainly counts as a fad, because, as you point out, unless you have celiac or other gluten intolerance, being gluten free has no technical or therapeuti.

But the actual definition of fad is:

fad fad/ noun

1. an intense and widely shared enthusiasm for something, especially one that is short-lived and without basis in the object's qualities; a craze.

So labeling something as a fad is to brand it with BOTH broad popularity AND being without any quality or value.

The gluten free movement certainly counts as a fad, because, as you point out, unless you have celiac or other gluten intolerance, being gluten free has no technical or therapeutic value.

Low carb, especially for those morbidly obese, or formerly morbidly obese, has tremendous medical value, as Donna points out above. This is not a fad. It may have broad popularity, but also accomplishes specific medical purposes. To call it a fad is simply incorrect. But I'm sure you will be inflexible enough to continue doing so anyway.

The problem that we have here is that there are lots of hypotheses in the diet business which sound good and have plausible scientific bases, but have yet (or never do) achieve validation and acceptance with the cognizant scientific community. Part of the problem is that, as with the recent thread on the findings that associate low carb dieting with lower life expectancy, it is real tough to do sound long term research in the field, as it is hard to enforce dietary standards on test groups over long periods of time; as with this study, self reporting is a common technique. Rodent studies can better provide long term dietary enforcement, but with the obvious objection about the comparability of rodent vs. human physiology (particularly if the trials find against one's hypothesis!) Also as noted in that discussion is that sponsorship can influence results - the meat packing industry loves Atkins and keto diets as much as ADM and Kellog's like grain based diets. These are influences that have to get evaluated at the higher scientific levels as part of the validation process that tend to get ignored at the more marketing based diet promotional level.

I suspect that part of the professional resistance toward acceptance of the keto/Atkins hypotheses is that there is still that sticking point about diets overall not having a notable effect on the obesity problem - that 95+ % long term failure rate that no diet seems to be able to break. Certainly, there may be a different lucky 5ish % who can succeed with different diet schemes, which seems to bring some professional judgement and guidance into play as to which diet plan my be most appropriate for which patient. There may also be some experience at play here, as witness the low fat/cholesterol diets that had similarly detailed biochemical rationale, but ultimately failed to make the jump from a limited, specific case to the general case; it seems that our physiology and biochemistry is a lot more complex than is represented in these different hypotheses, which makes it tougher to reach general conclusions from specific treatments. In the cases where WLS is added to the mix, success rates are much higher, but there likewise doesn't seem to be much top level evidence that these different dietary styles play as significant a role as the various advocates may suggest.

As with those online BMR calculators that suggest what your BMR should be as opposed to what it actually is (which can be quite different for us current and former fatties,) so too it seems that these diet hypotheses seem to represent what they think your body should be doing vs. what top line data suggests is actually happening. Or, in other words, the model is incomplete and only represents part of the picture. That doesn't mean that it isn't useful in trying to understand what is happening (which is usually the point of making such a model,) but caution needs to be applied in stretching it beyond its' intended purpose (granted, if the purpose is to simply sell a diet and the paraphernalia that goes with it, then anything that sounds convincing is fair game; if it is to treat a particular patient's problems, then one needs to be a bit more cir****pect.)

I recognize that we are coming at this from quite disparate perspectives. I come at this from what one may characterize as a success perspective, modeling my views and actions based upon the past fifteen years or so of working with a program that put little emphasis on carbohydrate restriction, other than simple carbs and sugars, and seeing the success of those who were a few years ahead of us, and indeed we still have dinner with a good group of them most every month in our support group. Demographically, I can't see that the group is markedly different than any other group of WLS patients and prospects, (and possibly a bit heavier than average,) but certainly not a group of lightweights. By your writings, you are dealing with many who have been struggling, and demographically these days that will tend to mean that they are having problems with carbs and sugars; I suspect that a generation ago you would be dealing with many who were struggling with fat cravings, as that was the predominant dietary abuse at that time and where most of the excess calories were coming from.

As to the subject early diets of potatoes, refries, oatmeal, etc., they aren't intended as comfort food or a substitute for meats, but as a transition between liquids and more solid foods. Generally, adding protein to the mashed potatoes is recommended if those are being used, but overall it is part of a transitory scheme rather than as part of a long term staple. I haven't seen anything particularly negative about it used in those terms, though certainly abuse is possible as with anything. Looking at our online population here, I suspect that we have more of a problem with eating disorder transfers (orthorexia, anyone?) than oatmeal addiction. (My own schtick was to try to keep as maintenance oriented a diet as possible within our restrictions to limit the transition issues that seem to create the most problems for people, with or without WLS.)

I think this is the most sensible, logical and reasonable post I've ever seen on post WLS diet.

THANK you califsleevin, for taking the time to write this all out!

Most people are dying to add foods back in. My best advice is to take it slow. It's not an emergency. Add one food at a time, and see how you tolerate it. One person will do great with eggs, for example, while someone else can't eat eggs for several months. Go slow to see where you fall.

Weighing and logging food was critical to my success. I know I would have eaten more at every meal if I hadn't. And eating more would have meant slower loss, and I might never have reached my goal.

By far the most commonly used app/website is MyFitnessPal. It's free, and it syncs with a lot of other apps, devices, etc, if you want to. It's really easy to use.

I like MyFitness Pal (app). I've used it on and off for years and it's pretty easy. My nutritionist likes Baritastic as it's geared toward us. But because I am familiar with MFP, I just stayed with it.

Why not come on over to the menu thread and participate? It's more than just food recitations and it's a good place for tangents.

For food: I reco getting a rotisserie chicken or preparing chicken in a slow cooker. Ma**** up with a fork (make sure it isn't too dry) with a spoonful of beans or avocado. That used to keep me going for hours.

A few tips:

• Eat slowly and take TINY bites. As in, each bite is the size of a grain of rice. Put your fork down between bites to make yourself move slower.
  
  
• Measure your food, and start with smaller portions, about 1oz. Your stomach has been cut and you won't feel any sort of restriction for at least a few weeks, so it's easy to fill your sleeve too full.
  
  
• Make sure not to drink for 30 minutes after you eat. That will wash the food right out of your sleeve and you won't feel satisfied.
  
  
• If you want recipes, look at Eggface's blog. Her ricotta bake and egg bites are great recipes for when you've moved to soft food.

I started out using My Fitness Pal, but I've since switched to Cronometer. After I got used to the interface, I went for the paid version ($50 per year). Cronometer tracks everything- the amino acids in your protein, total carbs and net carbs, vitamins and minerals, your Basal Metobolic Rate, your macro percentages.

It takes some time to set up your targets for macros and micros (it defaults to standard recommended amounts, but I adjusted the numbers to what I need as a wls patient). And it doesn't have as many packaged foods or recipes entered into the system as MFP does, so I also spent some time doing that.

But now that I've got it all set up, I find it invaluable.

For adding foods, as others have said go slow and chew really well. I think it helps to eat in a quiet environment, as much as possible. And at the first sign of trouble when introducing a new food, stop whatever it is you're eating. For me, "trouble" has meant a sudden crazy gurgling in my sleeve. First time it happened in reaction to SF ketchup. I kept eating and within a few minutes I was hot and dizzy and felt unwell. It's happened once or twice since then with a new food, and I just stop immediately and I'm fine. Then I grab some yogurt or a protein shake instead.

Also, papaya enzymes. I take them when the gurgling happens, and when food seems to be sitting heavy in my sleeve. They're supposed to help with digestion.

You're getting lots of great advice about not just what, but how to eat.

I also want to add: Try not to eat with distractions. The one time I painfully overate was because I was multitasking and working on my computer at the same time.

Also: Do NOT feel like you need to "finish" the food that you prepared for yourself. At your stage, I'd have about 2 or 3 oz of food on a plate. After about 1.5 oz, I'd feel "done". But I had a mental impulse to not "waste" what I'd prepared and plated--it was so little food already, and I'd put work into making it! I really had the fight the urge to take more bites. It's okay to save food for later. If food waste is troubling to you, get a composter. Just do NOT eat more than your sleeve can handle, for silly reasons.

Eggs was my first more solid food choice. Eggs with a tiny bit of jalapeno hummus, I think. I ate half of one egg lol.

Myfitnesspal is the app of choice around here, and I like it. It's easy to use. Best advice is to weigh and measure your food, it's hard to overeat at a meal when your meal is portioned out for the amount you need already.