Three months post op.

I had my surgery (RNY) on Oct. 3. 2005 and, I have lost 75 lbs. I have hit a plateau and would like to get on with losing again. What can I do. Please help.

Here is a plateau buster that I have come across. Congrats on your weight loss so far. Carol ***~~~PLATEAU BUSTER~~~~*** #1 - Do this for 10 days to break a plateau #2 - Drink 2 quarts of water a day #3 - You must have 45 grams of protein supplement and all your vitamins/minerals supplements each day (some suggest at least 60 and up to 80 gr) #4 - You may consume up to 3 oz of the following high protein foods, 5x a day beef pork chicken turkey lamb fish eggs low fat cheese cottage cheese plain yogurt or artificially sweetened (?) peanut butter beans/legumes You may also have: sugar free popsicles tea or coffee sugar free soda sugar free jello broths/bullion (sp?) crystal light drinks #5 - If it's not on the list, you can't have it for 10 days!!!! #6 - Keep a food diary and try to get up to 30 mins of exercise daily

Thanks Carol for the information. I will give it a try.

dean.WARNING I can be long winded!)....*and not responsible for typos..I tend to make a few w/ the long acrylic nails... First hello, welcome to YOUR JOURNEY after WT LOSS SURGERY! I can so relate to your struggles. I have been there, done that and heard this from so so so many other WLSers that I KNOW it is common. What your experiencing may be a plateau. They happen, NO MATTER WHAT WE DO to try and influence our wt and loss our body is the ULTIMATE MASTER in control of what happens. If you can grasp that along the way I beleive it will allow you some comfort and less stress. With that said I KNOW it is easier said than done..Old negative tapes of diets past ring close, "OH I will fail this too", "I will be the only one WLS doesn't work for" etc. I encourage people to reflect on WHYyou had WLS the reasons, sure wt loss is one or a bonus but are there other things you wanted? Health, happiness etc. Reframing this as NOT A RACE but a journey, a process, an adventure filled with twists and turns it may help ease the worry or fear or frustration....I propose it is MUCH MUCH more important to focus on the LIFESTYLE you are forming because that is what will allow you to MAINTAIN the loss you achieve for a long time. Focus on the healthy choices, portion sizes, energy, exercise, etc that your working on! These tools are the successes, teh wt loss is a BONUS (imho)...I lost all my wt in first 7mo about, a friend who was about my ht/wt/surgery 1mo after me lost hers (same amount as msyelf) in 2 yrs! See our journeys were quite different, she did have 10 yrs on me (and how that 10 yrs affected her metabolism etc was amazing !) but we ended in the same place so to speak! I tended to enjoy my ride more than she did...but we BOTH learned healthy habits, we both have kept wt down w/in 10# or so...THAT IS THE TRUE GOAL I think! (Getting that darn HUNKAMETAL aka the scale out of the house may help...I think we have been scale obsessed (many of us) for so many yrs why let it control us now? IF this journey is truly about health and developing healthy habits and a lifestyle..teh hunkametal is ONE SMALL (and many times inaccurate) guage of what is up w/ us..let success be how u feel, how you act, what your doing with your life!!!) so take photos monthly, take measurements monthly etc other guages ok! Wt loss is so individual.... (*I write about it so often on the yahoo groups I belong to that I saved this).... WT LOSS DIFFERENCES There are so many factors to consider, heights, starting weights, men vs. women, individual metabolisms, age, and most importantly if you have any other medical conditions or are on medications!!! Remember the heavier people are the more they will lose (but the farther away one will be from an ideal bodywt..) and the lighter one is the closer to an ideal bodywt you will get, but the less they will loose overall! EXAMPLE: After RNY surgery research states most people can/will loose 50-78% of their excess bodywt...lets say both of these "hypothetical" people lose 75% of their excess bodyweight.... 1.A 400lb person at 5'6'' (a bmi of 64) who has 250# of excess wt (ideal is 150#) will lose 187.5# and weigh 212.5# and have a BMI of 34.5, 1 1/2-2 years after surgery. 2.A 300# person of 5'6'' (a bmi of 48) who has 150# of excess bodywt. (ideal also 150#) will loose 112.5# and weigh 187.5# and have a bmi of 30, 1 1/2-2 years after surgery. This is an example just to show that you cannot compare your wt. loss to anyone else's! Listen to your doctor; mine said a 2-7# loss a week. Some weeks I lost 5 others none! ***Plateaus are also individual, some people get them every other week, others once a month and some never! Go figure...we are each individuals and our bodies are stubborn and are going to do what they want! LOL....As long as you are following your recommendations for food, vits, fluid, and exercise everything will take care of itself! Stay positive and don't get overly focused on the scale and numbers! Get the scale out of the house and weigh once a week somewhere or only when you go to the MD...Do not give the scale all that power! Listen to your body, how you feel, your energy level, how your breathe, how your clothes fit...Measure yourself, many times we lose inches and not pounds! Exercise also adds muscle and this weighs more than fat, so initially you may see no loss or a small gain, muscle in the long run will help you burn more energy and be healthier...So hang in and don't worry! The loss will come; it is just different for everyone! Check out http://www.clos.net/calc-wt-loss.htm For wt loss predictions... ~~~~~~~~~~~~ From a great group I am on GBIC http://health.groups.yahoo.com/group/GastricBypass-InfoCentral/ The owner posted this on plateaus..although I hesitate to post because GENERALLY NO MATTER WHAT U DO it is simply the time that makes the difference..it may be u changed something and the wt started but it may be a coincidence more than the change! (Or in other words it took the obsessionoff the scale, gave you something else to worry/focus on and voila time passed!) ~~~~~~~~~~~~~~ 1. Look at what you're eating... are you eating lots of breads, rolls,, buns, baked goods? Starches? Carbs? Switch some Carbs for Protein foods, are you getting your protein supplement in daily? .. Baked goods & excessive carbs will stop weight loss in it's tracks... I try to stay under 30 grams of carbs a day 2. Watch those starches..they turn to sugar... i.e. Corn, potatoes.. 3. Are you getting in 64 oz of WATER or better a day.. 4. Don't drink directly after eating a meal wait at least an hour. 5. Switch up exercise routines.. Walk one day, jog (if you're able) one day.. light hands weights for arms and use on ankles for leg lifts. Ride a bike, step aerobics, when you walk swing those arms and hips (fast walk). Increase the length of time you exercise .. Walk a little further than you normally do... Key is working on different parts of the body... Variety in types of exercise is great.. 6. Reward the body give it what it craves (NOT HIGH CALORIE OR SUGAR SNACKS) example: I don't eat potatoes as a rule or corn (starch) But if I'm stuck bouncing a few pounds back and forth I'll add a baked potato on one meal then increase the exercise ( boom ) works every time for me.. Giving the body that fuel it needs will kick start weigh loss again. It's like treating it for a job well done then it can resume the weigh loss pattern again. 7. Use a program like www.fitday.com Record EVERYTHING you eat.. You might be surprised..are u eating too much? Too little? 8. If you're drinking a lot of juices look at the sugar content ..learn to read labels. 9. Watch your sodium use a salt substitute 10. Plan three meals a day try to stay at set times.. snacks should be low calorie with some protein content if you can.. Plateau's we will all have from time to time it's inevitable these ten tips just might help though.. If I have been on a plateau I sure didn't know about it my monthly weight dropped consistently .. I'm not hung up on weighing daily that's a no no.... No more than once a week I prefer every other week.. once a month might be even be better at your doctor's office.. Victoria Bowen ~~~~~~~~~~~~~~~~~~~~~~ Plateau Panic (*charts removed because photos are attachments and wont be seen) - by Ken Miller, reprinted from Winter, 2004 issue of WLS Lifestyles Magazine. AAAHHHHH . . . HELP . . . I'm doing everything right, and I'm not losing any weight! I'm sure I'm the ONE person who has had WLS that is failing . . . it was working . . . and now it's stopped . . . and my [spouse, mother, father, assorted relatives, co-workers, Aunt Bertha, etc.] are going to say, "I told you it wouldn't work. You've spent all that [time, money, etc.] and you're a failure at it just like you've been with all those other diets . . . you just don't have the will power to push yourself away from the table." . . I know, you've read about plateaus, you knew it was coming, and you thought you were mentally prepared for it; but now that it's here . . . you can't help wondering if you're "normal" or not. Our sole focus at Bariatric Support Centers International is helping patients understand how to use their surgical weight-loss tool most effectively. In the course of a normal day we answer hundreds of different questions that all seem to boil down to one basic question: people want to know, "Am I normal?" Of course, we tell them there is no such thing as "normal" when it comes to comparing all of the effects that weight loss surgery has on each individual, but there are some common themes and some well known solutions to common problems. Today, let's focus our discussion on weight-loss plateaus. It's called a plateau because, when you look at a graphical representation of a person's weight, the data line looks like mountains and valleys and, you guessed it, plateaus. A weight-loss plateau shows up on your weight-loss progress chart as a flat horizontal line. It looks identical to a weight-gain plateau; we'll talk more about the relationship between the two later. A couple of years ago we developed an online software module that allows our members to easily plot their weight-loss progress so they can visually see their progress and use their chart to help them stay on-track, or at least warn them early if they are getting off-track. The charts look like this one that shows Colleen Cook's weight-loss progress back in 1995-96 as she lost 125 pounds in the twelve months after her gastric bypass surgery. As you can see at the upper left corner of the chart, Colleen's starting weight was 250 pounds on December 26, 1995, the date of her surgery. She set a weight-loss goal of 125 pounds that she wanted to reach within one year, so the chart shows her goal date, December 25, 1996, and her goal weight, 125 pounds, at the lower right corner of the chart. The blue line running between the two corners of the chart indicates the weight that Colleen would need to weigh on any particular day during that year if she were to reach her goal by losing all of the weight at a perfectly uniform rate during that year. The red line shows the actual path she took as she lost weight. Obviously, she didn't lose the weight uniformly. Early on she lost weight very quickly, and near the end, as she got closer to her goal, her rate of weight loss slowed way down. Colleen's chart shows some very common traits that are seen in almost everyone's journey. It shows plateaus . . . when she lost weight very slowly, or not at all, and it shows her continuing weight-loss after she broke through each plateau. Chuck Walker weighed 300 pounds when he had gastric bypass surgery on June 13, 2003 and his goal is to lose 115 lbs by July 4, 2004, a period of just over 12 months. One of the common truths we know about weight-loss patterns after surgery is that men generally lose weight faster than women do. As you can see from Chuck's chart, his pattern of weight loss has been much more rapid than he expected, and it is missing most of the plateaus that show up in everyone's weight loss pattern. Chuck thinks he's on a plateau if he doesn't lose at least 2 pounds each week! The most unusual thing about Chuck's pattern is that his rate of weight loss has been very fast right up until he was four pounds from his goal. Now, let's look at Jo Ellen Steube's chart: Jo's chart shows her weighing 290 pounds on her surgery date, July 7, 2002; and her goal was to weigh 165 pounds on Dec 22, 2003, a time period of 18 months. As you can see from her chart, she didn't make it to her goal weight by her goal date. Jo is not happy about her lack of progress toward her goal, but she's taking steps to be accountable and accepts responsibility for where she is; and she recognizes the changes she will have to make to her habits if she's going to reach her goal. When I asked her for permission to publish her chart, she gladly agreed, and then said, "I am still on the plateau, sadly not going down anymore than 198. I am trying to keep focused on what I am doing. I would be lying if I said I have done everything by the book, I have not, and I believe that is why I have not lost anymore. I am trying to re-group and get things back in order; they did not do surgery on the brain." . . . Just one more chart, then we'll tie this all together. Lisette Kaufman weighed 304 pounds on her surgery date, November 5, 2002, and her goal was to weigh 170 pounds by May 4, 2004, a time period of 18 months. As you can see, Lisette has not only achieved her original weight loss goal, but she now weighs 145 pounds: that's 25 pounds LESS than her goal and she's 7 months ahead of her goal date! All of these people had the same surgical procedure from surgeons in the same practice: open roux-en-y gastric bypass. As you can see, there are some big differences in their weight-loss journeys but there are also some important similarities too. Every one of them lost weight quickly while they were in the "honeymoon" phase, every one of them experienced a slowdown in their rate of weight-loss as they got closer to their goal weight, and every one of them experienced plateaus along the way. Everyone experiences plateaus. Not even Chuck could avoid a plateau. There are many in the bariatric field who've observed that when most people are losing weight, their plateaus occur at the same weights that they had plateaus as they were gaining weight. For example, if you weighed 255 pounds for quite a while as your weight was climbing to top out at more than 300 pounds, you are likely to encounter a plateau as you're losing weight when you reach 255 pounds. It seems as though the body remembers those plateaus that you had on the way up, and it considers them to be potential set-points where it should stop losing weight on the way down. This is a key factor to consider as you work to achieve your ultimate weight-loss goal because it's easy to become discouraged when your body hits one of these set-points and decides to hold that weight for as long as it can. Over the years, many of us have developed the habit of eating when we are depressed or discouraged. Combine that old, bad habit with your body wanting to hold at a weight that it "remembers" and you have a perfect setup that has caught some people and held them at that weight (or more) forever. If you seriously want to achieve that final weight-loss goal, and then be able to control your weight +/- 5 pounds of that weight, it is very important that you know how to blast through a plateau when it comes. So, what does it take to conquer a plateau? First, you must not panic and become anxious or discouraged. Knowledge of what to expect and what to do when it comes is the best defense against panic and depression. And patience is the key character trait you need to use to get through it. If you want to get through it more quickly, or even eliminate some plateaus along the way, follow these tips. The three main techniques to use to blast through a plateau are: 1. Eliminate all refined carbohydrates from your eating plan. Eat only protein and the most complex carbohydrates. That's protein and vegetables. No breads, pasta, potatoes, rice, tortillas, chips, etc. At BSCI, we recommend that your weight-loss food plan consist of 70% protein and 30% vegetables. That's three bites of protein and one bite of vegetables. If it's not a protein or a vegetable - don't eat it! 2. Increase your fluid intake. By fluid, I mean water. You should already be drinking at least 64 ounces of water every day. During your plateau (or if you want to help avoid or shorten plateaus) drink twice that much each day. Sip, Sip, Sip, all day long, except when you are eating a meal and during the 30 minutes before and the 30 minutes after your meal. 3. Increase your exercise. If you are walking a mile each day, walk two miles each day until your plateau breaks. If you are doing three days of cardio each week, increase it to five or six days each week during your plateau. If you have not been exercising, START NOW. Exercise builds muscle mass and additional muscle mass will burn more calories each day just to keep the additional muscle mass alive. You'll not only burn more calories through the work that you do while you are actually exercising, but you'll also burn more calories throughout the rest of the day also. Remember, increasing your muscle mass will temporarily increase your weight. Many people who don't understand this concept begin an exercise program, then notice that their weight actually goes UP a pound or two when they start exercising, so they immediately panic and stop exercising. Those who don't panic, but who keep exercising will not only see the small weight gain, but they will also get to see the big weight drop that comes a couple of weeks later as the exercise begins to pay off. And then, they also get the continued weight-loss that comes from having more muscle mass and more energy throughout the day. For most people, these three techniques are enough to break through a plateau within two or three weeks. If you've done these things and you're still on a plateau, then add step 4 also: 4. Measure the volume of the foods you eat. The exact amount you should eat will depend on the type of WLS procedure that you have had. Go back and look carefully at your surgeon's food volume guidelines. If you were initially instructed to eat 2 ounces per meal, and you are less than 6 months post-op, then measure your meals and eat only two ounces of dense, nutrient-rich protein and vegetables at each meal. If you are six to twelve months post-op, you can usually eat 4-6 ounces per meal. If you feel hungry between meals, eat a 1 ounce high protein snack, no more than twice each day (one between each meal). Consult your surgeon for specific guidelines as to the volume of food you should be eating at each meal throughout your weight-loss phase, then, measure the volume of each meal and don't eat any more than the recommended amount. DO NOT SKIP meals and attempt to "diet" your way through a plateau. Eliminating meals will only prolong your plateau since your body will go into starvation mode and attempt to hold on to, and store, every calorie it can. This will result in decreased energy, which results in less physical activity, which results in fewer calories being burned, which results in a longer plateau, or in many cases, the end of your weight-loss. This is the principle behind these techniques: Break a plateau by giving your body everything it needs to be assured that its potential supply of food and water is limitless, while at the same time, giving it additional work to do, and it will respond by increasing your muscle mass and stepping up its fuel burning systems. If your body knows that plenty of food and water is available, it won't insist on saving every bit of energy you take in, but will freely use its energy stores (fat) to meet the increased workload you are asking it to do today. Lastly, if your plateau continues, then move on to step 5: 5. You must scientifically compare your calories-in vs calories-out balance. Have your Resting Metabolic Rate (RMR) scientifically tested so you know exactly how many calories your body uses just to keep itself alive. You can find a support center, physician's office, or health club that has a MedGem? or BodyGem? RMR testing machine by logging on to the healthetech.com website and entering your zipcode to find a machine near you. Then, get a copy of a good calorie tracking software such as BalanceLog? (healthetech.com) or Desktop Diet Diaryâ (calorieking.com) and use it to track everything you eat, all of your exercise, and balance those factors against your Resting Metabolic Rate. If you do this, you will be able to identify exactly where the calories are coming from that are keeping you from breaking through the plateau and exactly what you need to do to ensure that you will start losing weight again. If you didn't ever have a plateau . . . THEN you'd be a weird duck and you'd have something to worry about. But not you, you're normal. Remember, the most important thing you need to break through a plateau is patience. If you've adopted a good eating plan and are exercising, you will break through your plateau, if you just stick with your program and don't panic or allow yourself to slip into depression and start grazing or bingeing. If you want to accelerate the breakthrough, use these techniques to make it happen faster. Also, here's another point to remember: if you are like most people, as you get closer to your final weight-loss goal you'll encounter more plateaus, and they will take longer to break through because your body knows it could stop losing weight at any time, and you'd survive just fine at the plateau where it is suggesting you stop. The deceleration in your rate of weight loss is a very normal and natural occurrence. Think of it this way: when your body weighed 300 pounds, it took twice as much energy to move it across the room or up the stairs as it takes when you weigh 150 pounds. You also had an extra 150 pounds of human cells to keep alive, and that took a lot of energy too. Now that you're slimmer and trimmer, your body isn't burning all those extra calories, and you're still taking in at least as many calories (usually many more) as you did during those first few months when you were in the "honeymoon" phase of your weight loss. More calories in and fewer calories burned each day means your rate of weight-loss must slow down. That's the way it is for everyone. It's no reason to panic. It's normal. And plateaus along the way are normal. You're normal. Now, if you didn't ever have a plateau . . . THEN you'd be a weird duck and you'd have something to worry about. But not you, you're normal. Please comment on this article, share your personal experiences - struggles and triumphs - with plateaus. Share your thoughts or read others' here: Plateau Panic. Ken Miller is the President of Bariatric Support Centers International, an independent provider of WLS support and education programs through classrooms, workbooks, and online services. See www.bariatricsupportcenter.com or email him at [email protected] ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Another good article on plateaus: Weight Loss Plateaus: 6 ways to break through Rawinia Gregory and Boris Kazakov Hit a weight-loss plateau? When you first start to lose weight you're on a roll-losing-roll; nothing can stop you. Week after week, pound after pound drops off, and the more you lose, the more motivated you get. You're in weight loss heaven! "Whoever said this was hard?" you ask yourself. "It's as easy as (eating) pie!" But then one day when you step on the scale, eagerly anticipating your next pound-punching record, something is very wrong. The numbers haven't budged! And it's not because your scale is broken. No, the inevitable has happened - you've hit a weight loss plateau. The plateau stage in a weight loss journey can be tough - but you shouldn't give up. Dietitian Boris Kazakov has these six simple tips to help you break through. 1. Stop calorie amnesia! Record everything you eat and drink If you've hit a weight loss plateau, now's a good time to take a close look at the way you've been eating lately. Maybe you just need to get back to basics: Use a food diary every day. Be honest in your diary and record everything that you eat and drink. Don't leave out that small handful of M&Ms or that piece of cheese you picked at while making dinner - every morsel counts. Are you getting too many calories? Consuming too many calories can make you gain weight or plateau. Your food diary can help you spot overindulgences, such as those two "innocent" lattes that could be adding over 350 calories to your daily intake. Are you getting enough calories? While overeating is not good for weight loss, neither is eating too little. Eating too few calories every day can trigger your body to start storing everything you do eat. It's a natural defense mechanism designed to stop you from starving in times of low food availability. Boris recommends that you make sure you're eating at least 1200 calories per day if you're female, or 1500 calories per day for males. Are you consuming a lot of salt? High sodium levels can cause you to retain fluids and feel bloated. As well as making you feel uncomfortable, fluid retention can also show up on the scales. Use your food diary to identify foods high in salt that you eat regularly, and avoid adding extra salt to your food. Measure and weigh. If you've been sizing up portions by eye, start measuring and weighing your foods accurately. It's easy to underestimate how much you're really consuming. 2. Boost your metabolism A sluggish metabolism can mean slow weight loss. Speeding up your metabolism is one way to burn those waist-expanding calories faster. Although genetics plays a part in determining your metabolism, you can give yours a kick-start by changing the way you eat. If you're usually a "three meals a day" kind of person, try Boris' recommendation of eating four to five small meals and/or snacks per day instead. "Eating regularly keeps your metabolism fired up and helps to stabilize your blood sugar throughout the day," says Boris. Keeping your blood sugar levels stable also means that you're less likely to suffer those diet-wrecking sugar cravings! 3. Protein packs a punch If hunger pangs are constantly gnawing at your insides, it can be very hard to stick to your planned healthy meals. And if you're not making good food choices, a plateau can be hard to overcome. Letting yourself get hungry is like dangling a piece of raw meat in front of a grizzly - downright dangerous! Hunger can make your willpower and resolve disappear faster than you can stuff three chocolate-iced doughnuts into your mouth, making a plateau difficult to beat. Boris suggests combating hunger by including a larger serving of protein in your meals, such as lean meat, skinless chicken, fish, legumes or tofu. Protein works wonders to fill you up - and keeps you feeling full for longer. By making sure that each of your meals contains some protein, you just might find that you really don't need that doughnut after all. 4. How's your exercise routine? Mix it up! Boring? If you do the same exercise day in, day out, it's easy to get bored - disinterest in exercise can easily cause your weight to plateau. On the other hand, mixing up your exercise activities can really get your weight moving again. Changing your exercise routine can be as simple as trying something new. How about working out with the help of a personal trainer for a month, or swapping one of your usual walking sessions for a yoga class? You can also boost your exercise by picking up your pace, exercising longer, or by doing more exercise sessions each week. The idea is to surprise your body by varying your routine regularly. Trying new things will also give you something to look forward to, and help you break through your plateau. 5. Hydrate your body Water is very important for keeping your body healthy. It also plays a role in weight loss. If you often feel bloated and retain fluids, as well as feel uncomfortable, you'll know that it can also register on the scales. Luckily there's a simple solution - drink more water! It may seem strange, but drinking lots of water actually helps to flush water from your body and stops you from retaining fluids. Water is also a great "hunger buster". Often feelings of thirst can be mistaken for hunger pangs. Next time you're feeling hungry, try drinking a large glass of water. If you're still hungry in ten minutes then go ahead and eat. However, you might find that you were really just thirsty after all. Now that's an easy way to save yourself hundreds of unneeded calories! Drinking a glass of water before eating has also been found to reduce the amount of calories consumed during a meal. So up your water intake to Boris' recommendation of at least 6 or more 8 oz glasses of water, or other fluids, per day, and you'll be kicking that weight plateau in no time. 6. Measure up Even when the scale is stuck on the same number for weeks, it doesn't always mean that you're not getting anywhere. When you hit a scale-weight plateau it's a good time to take your body measurements and use them to track your progress as well. Body measurements are good indicators of how your body shape is changing which, after all, is where most of us would like to see a difference. So instead of obsessing over the scale, think about how you feel. Do your clothes fit better? Are you feeling healthier or more energetic? Are you finding everyday tasks easier to manage? Considering the big picture can help you stay positive and remind you that a plateau on the scale doesn't necessarily mean a plateau overall. Losing weight is about being healthier and feeling good about yourself, so don't give up on your goals if the scales get stuck for a while. Stay focused, keep positive, and try some of our tips to give yourself the kick-start you need to get your weight loss moving again. Good luck! http://www.calorieking.com/library/article.php?path=13%2C14&art_id=886&printable=yes&noviews=yes Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"