Good Morning. That's what she said

At last night's support group we talked about goals and objects. I mentioned that a goal this year was to eat more balanced because my DSr friends were teasing me about drinking protein rather getting my protein from dense meat. Well, she (the dietitian) said that's not YOUR goal then. Then she asked if I felt good and my labs and protein levels are good....yep, they're excellent and I feel great. "Then that's a kind of goal that you're thinking maybe you should have but what's the benefit that YOU get with it to really make it YOUR goal?" Hmmm...If I still malabsorb around 50% of the dense protein exactly what is it's benefit over protein shakes? None, unless I need dense protein sitting in my stomach for a long time to keep me from mindless eating. 

She hit it on the head..."I think YOUR goal is to keep your restriction as long as you can and therefore you limit the size of your meals but stay healthy with your vitamin supplements and shakes. You have 2 goals-- 1. to stay as healthy as you can  2. while keeping your sleeve as small as you can for as long as possible. You have supporting objectives to drink 80 grams of protein a day, take all your vitamins every day and limit eating to good things in the size of snack portions. Just because you snack doesn't mean you aren't eating healthy things. A new objective could be to limit how often you snack and start a schedule, but don't make a goal that isn't YOURS that you really get no benefit from and you really don't want to achieve in the first place. Objectives are measurable and that's the only way you'll know if you're on the right path to achieve your goals." 

I thought that analysis and explanation was pretty good even if she is a NUT and only 12 years old. 

--gina
      

Well Gina, if I were to have been sitting next to you in that room what I would have heard was this......"Gina you are a smart woman who knows what her body needs in order to stay as healthy as possible!  I trust your judgement thus far because I've seen the results!  You do your thang girl!"

I think the other thing that's helpful in Dr Elariny's practice is his philosophy that people aren't going to be able to change their innate eating processes just because they get WLS--they usually fall back into their pattern. They need a WLS that will work with or hinder their eating processes. Thus the categorizations he has for us: "bloater"-- the one meal a day big eater and non snacker (usually men), "sweeter"--those addicted to sugar treats and even meals, and "grazers"--those that get 70% of their calories through snacking. Of course their are other considerations like BMI, physical limitations and the willingness to take supplements but he says a surgeon cannot (or shouldn't) berate a patient for failing if he gives a "sweeter" the band, for example. The band can work great for the bloater but not a sweeter or grazer.

He is so right too!  I remember having the discussion with my surgeon about what type of surgery I should have and after telling him my eating habits he said RNY.  I think any good bariatric surgeon should suggest the type of surgery that suits the patients eating "personality" which isn't necessarily the surgery the patient may want.  Great post today!

 so  what   surgery should grazers get ?  

He recommends the DS for folks who get 70% of their daily calories form snacks or higher BMI folks. The DS is one of the harder WLSs to "break", has the longest weight loss window and long term maintenance is the most successful.  

Im also one of those people who would rather drink my protein than eat meals.   Im at a healthy weight, my labs are good, and I feel good - so I will continue doing what works for me.  Cindy

I WANT IT ALL!!!
Actually, I am really enjoying eating and not having any trouble with portions and food groups, so far.  I also love my protein coffee and protein hot chocolate at night.  In the summer, love my lemon tea protein.  I'm still working on a balance that will work for me day in and day out.
In terms of goal setting, I think she is right on.

I think your NUT actually gave you some pretty insightful advice -  for all of us. 

I still do at least 1 protein shake a day.  The only meal I eat on a regular basis is dinner with the family -  other than that, I don't care if I eat.  I do have scheduled meals - yogurt for breakfast, something protein for lunch - but it's because I know I need to eat, not because I want to or because I feel hungry.  So for me, that protein shake is a necessity to reach my protein goal.