Confused.

Well, it would be nice if it were the LAST issue, but that's not very likely. I have rheumatoid disease as well as chronic migraines, and will be on and off some pretty nasty meds for the rest of my life. I also apparently have a body that delights in having all of the "not common, but known" side effects to medications just to mess with the medical establishment.

What we determined is that the medication for my rheumatoid disease was causing a drug-induced thyroid issue that was causing ridiculous levels of fatigue as well as ramping up my migraines to unacceptable levels. Which meant we started anti-seizure medicine trying to stop the migraines, and hoping we could stop them before we hit the dosage level that caused me issues last time I took that medication. And I was already on a type of anti-depressant that was supposed to be helping with the fatigue. It wasn't until I got chatty with the sono tech that was doing the ultrasound on my thyroid gland and then went home to hit the university medical library for my own research that I discovered this uncommon but documented side effect to my rheumatoid med.

I'm now off of it for a month, and the fatigue has resolved, as well as the migraines are down to a manageable level. My rheumatologist is hoping for remission in the rheumatoid disease, but judging from the aches starting up in my hands I'm thinking that's unlikely (bloodwork will indicate what's going on when I see her next week). While remission is possible, it doesn't generally last more than a year or two with rheumatoid disease from what I can find out. And while I'd be grateful for even that kind of remission, it's not healthy to count on it. :)

I'm incredibly lucky that I pushed and pushed until I got to the right specialist for a very early diagnosis. Most auto-immune patients go 7,8,9, or more years to get a diagnosis, I got mine within a year of the worst symptoms starting up. So I have managed to avoid any joint damage so far. I choose to look at how lucky I am, and manage the situation I've been given the best I can.

I think you should test the "too rich" theory from a male identified person's experience, I will do the female identified... for science. We must cover all angles.

For science I will make that sacrifice....err...yes sacrifice is what I'm going with.

I'm willing to help with this study in any way that I can. It is for science after all!!

There is no scientific evidence (as far as I'm aware) that connects the amount you eat during the weight-loss phase to the amount you eat during maintenance.

Nutritionists' training varies wildly, and many NUTs are unfamiliar of the medical reality for bariatric patients.

Most people on OH who are successful eat 600 - 800 cal while losing, and 1,000 - 1,200 during maintenance.

My bariatric team uses Registered Dietitians, not nutritionists. The plan they have developed (its a major university medical center and certified as a bariatric center of excellence) is based upon the research they have accumulated with their thousands of patients of the years. While it may not be a peer-reviewed, published study, when they tell me that this is what has worked in their practice over X years, I believe it. My RD, MD and Nurse Practitioner all work together to prepare the voluminous materials we were given with the information on diet, exercise, pre-op and post op life.

Again, may not be peer-reviewed and in a journal, but their research within their own practice, if done by traditional "scientific" methods, is scientific.

Your practice is probably happy with 65 percent excess weight lost, as almost all are. And that's what happens to the vast majority of postops who start eating more, too soon.

I have seen those who eat more early out stall with 50 pounds left to lose. They get discouraged being that far from goal, get impatient, and say screw it. Then they do what they always did in the past -- eat crap, and gain weight. I've seen it far, far too many times to sit by while someone is advised to eat more until they are just about finished losing.

If these people are telling you starvation mode is a real thing, I wouldn't believe anything else they are saying. It's just flat out wrong.

KNITTER- You are blessed, to have such a complete team. Many practices do not provide that--or anything NEAR that

Sadly, many nutritionists take their non-bariatric training and implement it into bariatric programs. And then they tell us that most WLS patients only lose 65% of their excess weight. I wonder why they don't delve into that percentage more to see why it is and what they can do to improve those statistics.

And on that note, I am thankful every day for OH and the Vets who so kindly share their advice and expertise.