how do i answer?

9 years post op my tool is still working if I use it correctly.

When I chose dense proteins and a few bites of low carbs veggies - I get fill and stay full.

When I follow low carb, moderate proteins and fat diet - I don't get that hungry. And if I do - a good quality meal is all I need.

But...if I start eating carbs, I can eat and eat and ....eat some more. And I want to eat more. Not only most carbs are slider foods, but they somehow they make my pouch insensitive to qty of food. Sugar is addictive. Carbs turn into sugar - they are addictive.

When I get hungry now before it is my meal time - I look at what I want to eat. If I crave carbs, but really don't want meat or eggs... That is an indication to me that I am not hungry, but that I deal with head hunger. If I am hungry - I will eat meat or other proteins. If I have head hunger - I may just drink some tea or coffee and wait for real hunger or time when I eat.

Here's a good article he should read:

https://www.nytimes.com/2016/12/27/health/bariatric-surgery. html

Wish I could chime in and give you helpful information. I wrestle with this same monkey every day, but the reality is...as a morbidly obese 54 year old post menopausal woman with craptastic comorbidities, I'm at the point that I have little choice. I simply MUST roll the dice and hope it doesn't come up craps. You know? I MUST do something different, otherwise it's just WLGHD (weight loss ground hog day), ad nauseum til the day I die. I can only white knuckle diet for so long without caving to my hunger cues, hormones, and a lifetime of bad habits.

Dr. Matthew Weiner, has some good videos on YouTube. I just don't actually agree with his "plant first" philosophy of nutrition.

Me too! We're in the same boat...

I am 5'4" and I gained up to the 250 range back in 2004 from a combination of moving to a sedentary job, traveling (with lots of restaurant food) and depression. In 2005 I was able to get down to 210 (Curvs and Southbeach Diet) and then in 2010 I was able to get to 170lbs (MyFitnessPal plus swimming and running) Over the next six years, while living a far more active life and making very good healthy choices in the food department, I slowly gained back up to the 205 range, which is when I decided to pursue WLS.

My answer to friends and family who ask this question ("Wait, you're only eating 800 calories a day? Why bother with the surgery?") is that A. 800* calories a day is pretty comfortable post surgery. The only desires I have are fueled by head-hunger not ACTUAL hunger. B. There is a known metabolic shift that takes place with WLS that seems to help "re-set" the body's weight range to a lower number. and C. WLS, specifically the bi-pass type, has a far better record for reduced regain than dieting alone.

I was eating between 1500 and 1700 calories, protein dense, carbs from fresh fruit, veggies, and minimal whole grains and cereals as I regained my weight. By the books, that should have been a good maintenance diet for someone with an active lifestyle. The surgeon and physician nutritionist both thought that 1500-1700 calories would be a realistic post RNY weight loss, maintenance diet. I now know that is highly unlikely but if I can maintain at 900-1100 calories a day that would be awesome (and is somewhat possible as long as keep my carbs to the minimum). The bottom line is that I won't know my maintenance level till I get there and then it is what it is.

None the less, the combination of restriction of the pouch and malabsorption will provide an edge over diet alone. I need every edge I can get!!!

*800 calories a day at 4mo out is higher than most of the veterans here on OH recommend. It's about 400 calories a day less than my NUT recommends. I'm losing very slowly, but I'm still on track to be to my goal weight in the first year. I'm working out and beating up my body as I learn knew activities and believe that the added calories help my body repair the damage and build additional muscle and bone. It's a gamble but as long as I'm on track, even if that track is frustrating and slow, I'll keep at it.

I think it's a fair question.

What's going to help in the future? Lots and lots of work at figuring out what caused you to get to the point where you needed surgery in the first place and addressing that/those issues. Our stomachs didn't cause us to become obese after all.

For me, surgery gave me the "space" I needed to sort my brain out. Could I have done that without surgery? Who knows. I DIDN'T do that without surgery, so it doesn't matter.

Your getting good advice here for sure. I'll just add one point to help open your eyes. My aunt had a minor weight problem, certainly nothing like I have, but she struggled with 40 pounds extra her whole life (sadly breast cancer took her two years ago). She also said she never ate much and was convinced of it, saying she didn't understand how she couldn't ever lose the weight.

One day we had to be together all day on a volunteer project, including that I slept over the night before so we could get an early start. So I was up and with her from the moment she got out of bed until about 8pm that night. She didn't know it but I kept track of everything she ate - everything! We hadn't been apart except for bathroom breaks from 6am until after dinner. We took a break from our project at dinner time and we talked about weight loss again (I was in one of my 5 big weight loss swings before I had WLS). She once again said - you were with me all day, you can attest to the fact that I barely ate anything. I asked her how many calories she estimated she ate for the day. She said 900 to 1,000. I told her I kept track through the dinner we had just eaten and I estimated that she actually ate closer to 2,400 calories (she was probably 5'4" and 160 pounds). When I reviewed what she ate - at first she started saying you aren't supposed to count the little nits and nats as they just get burned up and don't count. But by the time I went through everything she realized that she snacks all day long and I mean all day long. Grape here, crust of a sandwich there, cookie as she made the kids lunches, we were cooking so she tasted everything we made..... It all added up. As mentioned best thing to do right now is track every morsel to find the problem. Because if it is grazing - it is easy to graze post surgery and you need to nip that habit in the bud. Good luck.

At 3.5 years out, I certainly don't eat perfectly. But my stomach simply can't hold a medium pizza or a pound of noodles. So if I do eat pizza, it's less than 2 slices of thin crust. If I do eat pasta, it's a few bites, not 5 servings. Having a small pouch makes eating reasonable portions EASIER. Not easy. It still requires a ton of work, and every single time I open the fridge or the pantry, it's an opportunity to make a bad choice or a good choice. Will I have a hard boiled egg or popcorn? Will I have chicken breast or chips? Will I have cheese or crackers? For me, RNY gave me a chance to work diligently and follow the rules (high protein, low carb, no alcohol) for a year to get to my goal, and the hard part is now, being in maintenance. I could have never lost 190 lbs by just "eating less". Invest in a food scale and track what you eat after surgery and remain vigilant! It's a hell of a lot easier with a small pouch, but not easy in the least. With effort and dedication you can do it!

I am a newbie so I probably don't carry as much weight around here (no pun intended), but I have two answers.

I am 7 days post op. My RNY was 7/27/17. My husband asked me the same question last week. I asked him, "how many times in our 18 years together have you watched me die****ched me lose, watched me struggle, and watched me regain?" He acknowledged that I'd done this pretty much constantly for our entire two decades together. Then I find him that this surgery was a tool that would help me maintain my loss, and it would put my sleep apnea and GERD into remission. It also, more than likely, would divert me from the genetic road to heart disease and diabetes I was on. My husband thought about my father, nodded and accepted it.

Other angle: I swear two hours ago I was down the search bar rabbit hole. I found a lot of threads talking about hunger and hormones, and in those threads I found this link:

http://www.reuters.com/article/us-obesity-surgery-bacteria-i dUSBRE92Q0ZQ20130327

We are different. I was astonished, when I woke up from surgery, by how that driving desperate hunger was gone. By how things taste different. By how I don't get that rush of pleasure when I taste something, like part of my body is encouraging me to keep going. (Now granted, I'm on clears right now and it's really hard to derive pleasure from that.) Bodies are fundamentally the same--we all have the same joints and muscles and organs. But just as the difference of micrometers' length in a tendon or ligament means the difference between a Weekend Warroir and an Olympian, so do our other microscopic differences separate us.

Wow! This is awesome! I can't wait to pass it along to my surgeon.

I'm almost certain I will start a new business as "the poo fairy!" I will accept donation bacteria and make a capsule out of it like probiotics and dispense them to fluffy chix like me! :D Good times!