There is a rebound period that hits many WLS patients at 2 years or more out from surgery. Some patients can regain 10 to 20% of the excess weight that they lost after surgery. Others can regain even more. Long term results are discussed in an article from the Harvard Medical School (article was removed from site). According to The Ohio State University Medical Center FAQ, long term studies show that patients usually regain less than 15% of their weight 5 to 10 years after RNY surgery. I don't know what the results are for other types of bariatric surgery. The good news is that many WLS patients keep all their lost weight off even after many years. The bottom line is that WLS is a tool. It is not a cure for the disease of morbid obesity. To keep the weight off for a lifetime, one must be conscientious about exercise and good eating habits.

What Are Carbs & Why We Need Them

A carbohydrate is an essential nutrient that is converted to glucose and provides energy to the body and brain. Carbs specifically:
? serve as the primary energy source for working muscle
? ensure the brain and nervous system function properly
? help the body use fat more efficiently
? are great for digestion when they are high in fiber
Dietary sources include foods made from grains (cereal, crackers, bread, pasta, tortillas, cereal), beans, fruits, vegetables, milk , cheese and foods containing any form of sugar.
Carb Categories
Carbs fall into all types of categories and it's important to have a clear understanding of each so that you know which carbs to moderate and which ones to eliminate when losing weight.
Complex Carbs need to be broken down into a more simple form before they can be absorbed so they release glucose into the bloodstream slowly. Breads, cereals, potatoes, and legumes are examples of complex carbs.
Simple Carbs are already in their simplest form and are absorbed into the bloodstream very quickly giving you an initial burst of energy. Fruit, milk, juices, cookies, and yogurt are examples of simple carbs.
High Glycemic Carbs the glycemic index is a measure of how quickly a carb raises blood sugar. A high glycemic carb raises blood sugar very quickly. This spike in blood sugar elicits the insulin response which means that your body produces high amounts of insulin to return your blood sugar to normal. It does this by converting all the glucose into fat which gets stored in your body. It also causes low blood sugar that leads to more cravings for processed sugary carbs. Examples of high g.i. carbs include potatoes, corn, carrots, gatorade, bagels, white bread, corn flakes, ice cream, bananas, raisins, table sugar.
Low Glycemic Carbs cause a small rise in blood sugar. These include; skim milk, all bran cereal, apples, peaches, black beans, plums, fructose, broccoli, spinach, and, peas. There is a common misconception that the only way to lose weight is to stick to low glycemic carbs. This is not true. You can still eat high g.i. carbs as long as you combine with protein and healthy fats. Check out the examples below to see how.
Refined (Processed) Carbs are products that have been altered to increase shelf life. Anything that's frozen, canned, or boxed, is refined. If you check the list of ingredients you will often see words like rolled, bleached, dehydrated, partially hydrogenated, etc. Foods like white bread, pasta, fruit juice, crackers, cookies, etc. have been stripped of nutrients like fiber and fall into this category.
Unrefined Carbs are obviously foods that are in their natural state. Oranges are unrefined while orange juice is refined. The less processed a food the more nutrients it provides.
How Many Carbs Per Day?
Contrary to popular belief low carb is not the only way to lose weight and it's also not for everyone. If you've tried it all and think it's the only option left for you check out Is The Atkins Diet Right for You? and get the details. For most people the best type of diet for weightloss is one that still allows you a lot of the foods you like so you don't feel deprived and start cheating. It's close to balanced but almost low carb with the following breakdown of total calories, 45% carbs, 25% protein, and 25% fat. No matter what your situation you should never take in less than 1200 calories a day and for those who workout this amount of calories could send your body into starvation mode so be sure to figure your ideal calorie intake before cutting back. Create a small calorie deficit and multiply your daily calories by 45% for your daily carb calories. Then divide that amount by 4 to determine how many grams of carbs you need per day. Here's a few calorie ranges broken down into carbs calories and grams:
? 1300 cal./day - 585 carb cal./day - 146g carbs/day
? 1400 cal./day - 630 carb cal./day - 157g carbs/day
? 1500 cal./day - 675 carb cal./day - 169g carbs/day
? 1600 cal./day - 720 carb cal./day - 180g carbs/day
Carbs to Avoid
So which carbs are goods ones and which ones are bad? While you're trying to lose weight avoid most processed foods including: pasta, white rice, fruit juice, sugar loaded fat free yogurt, most crackers, cookies, pastries, white bread, chips, pretzels, bagels, sports drinks, soft drinks, and candy. This will help you reach your goal weight at a much faster pace. Once you lose the weight you will be able to eat these foods again in moderation.
Carbs to Moderate
Many of the most popular diet plans tell you to avoid starchy carbs and high glycemic carbs but they do serve a purpose. If you're working out your body needs them for energy and they also help your body burn fat. There are 3 simple rules when it comes to starchy and high glycemic carbs:
? Limit yourself to two servings a day of each
? Eat them in the first half of your day
? Always combine with protein
Doing this allows you to eat some of the foods you like and still lose weight. For example: In the first half of your day you can have eggs and potatoes for breakfast, fruit salad and protein shake for a snack, and tuna with veggies, balsamic vinegar & olive oil in half a whole wheat pita for lunch. In the afternoon you could eat whey protein shake & 1 apple for a snack, plus a chicken breast and spinach & tomato salad for dinner.


Carbs You Can Indulge
Not many people are into eating greens and high fiber cereal (13g of more per serving) but these are the carbs the help you feel full, have the most nutrients, and really boost metabolism so indulge all you want.
Cycle Your Carbs
Another great strategy is to vary your carb grams based on your activity level. On the days you're lifting heavy and doing a lot of cardio you can allow yourself a little more carbs than on the days you don't work out at all. But don't use this as an excuse to indulge your chocolate cake fantasies. All this means is that you can eat an extra piece of fruit or an extra serving of brown rice. If you stick to these simple rules you will have no problem shedding those pounds without feeling too deprived.