X-Post from VSG Main-Maintenance and Regain

There is a current thread going on posted by doggz that has brought up some great Maintenance/Regain dialog. 

http://www.obesityhelp.com/forums/VSG/4522491/maintenance-question-comment/

Here was my post on it.....I re read it today and thought.... "Not Bad"....not the usual crap I post !!!
I also realized it is missing some things....but generally I believe it.

I thought we could define and pursue this further over here !

frisco


Post Date: 4/16/12 3:52 am 

 Regain can happen for any number of reasons or any combination of them.....

I don't want to give the impression that I got this thing figured out and in the bag.....I think we all need to study and conclude what maintenance strategy is going to work best.......Any plan is gonna be a moving target, so you have to be prepared to adjust.

Some things I have noticed/learned why some have regained or having a hard time maintaining.

- Solid lifestyle changes and proper habits were not established in the WL period.
- Lack of maintenance guidelines/aftercare/education from their bariatric program and or surgeon.
- The mindset that maintenance is so different than WL.....for most it's about 80% of the WL plan.
- Commitment and Compliance lessens.
- Some people don't understand that you still need to be eating fixed amounts of food.
- Capacity can increase as time goes on.
- Maintenance is where Sleeve Size and how you took care of it really pays off.
- 100 calories per day over your balance point is approx. 10lbs. a year weight gain.

Some of my strategy was not to go hardcore on exercise. Not to discourage anyone from exercise, but understand that exercise and food intake needs to be matched. The big trap is that it is always hard to cut back on food intake when your activity is reduced and exercise can stimulate hunger.
I'm trying to be consistent on a maintainable activity level with a consistent food intake.
*Again.....I'm not discouraging anyone from Athlete Level Training.... I'm actually jealous that I can't do it as part of my lifestyle changes.

I've also taken an interest in the Culinary Arts with an emphasis in Small Plate/Low Carb food preparation.

I'm sure I'm missing a bunch of issues......I think the point should be that WL is just the first step in long term weight control and you/we need to establish good habits from the get go and continue your/our education on long term maintenance.

frisco

I agree with most of what you say, Frisco. I do exercise most days and find that exercise decreases my appetite.  In fact, when I am fighting the urge to eat (not hunger - head hunger), if I take a walk, do my hula hoop or exercise ball, it distracts my mind from wanting food.  Since exercise has made me so much stronger and has built strength in my knees, I will continue to do so.  It also allows me a few extra calories when I decide to indulge.  But you are right.  I do worry about that if I should have to go without exercising for a period of time.  I don't want to make eating those extra calories a habit that will bite me in the butt if something happens that I can't exercise.  I also don't do all "lean" and sugar free now.  When I use mayo, salad dressing, etc. I use full strength.  Since I don't eat so much, I want to get the best flavor I can.  I guess my exercise has helped so that those extra calories don't hurt me.  I used FF and SF all the years I was MO and it didn't seem to help. lol  I do cook healthier and rarely fry anything.  But other than that, I eat what I want, just in smaller portions. 

I certainly don't do athletic level exercise!  But I am "training" for a 5K walk.  I have found this to be so inspirational to me - someone who couldn't walk 5 blocks 2 years ago.  It makes me feel so good and proud to be able to do it.  I feel like a new woman!

Thanks for your post.  It is right on target - even the exercise thing, but it isn't going to stop me from doing it.  lol

Thanks for posting this over here.. I had typed a long response and deleted it, I do that a lot.. 

Something I very very strongly agree with you on is the exercise deal. Some folks are born with a very active gene, some aren't.. the trick is not to lie to yourself about it! I was not an athlete trapped in a fat suit. I know if I dislike something I won't keep it up.

Somewhere, don't recall the thread right now I made mention of having to make life-long SUSTAINABLE changes.. for me, I could work out like crazy (hate it).. and eventually get back to loving it.. maybe, like I did when I was younger.. but I know me well enough that formal exercise for me is not sustainable long term over the years. It wasn't sustainable at the level then either when I actually was hooked on the gym.. and the one thing that got moved to the side when life hit the fan was the gym-time.

I like to be active, I like my occasional long hilly state park hikes.. I like my city park hikes.. walking to me is great exercise, as is dancing, stretching and flexibility work, something I like to do.. I even like to lift once in a while because that to me is actually fun... but I don't like the feeling that I have to do that to eat this. If I do an activity, it's because I like it.. not to make me lose weight, or to allow me to eat more.. I'd personally rather eat less and know what my body needs at a basic level, than have to add activity to it in order to keep up with my intake and not gain.. make sense in my rambling way?

I keep trying to drop the big hint that this isn't something that's done and over with at goal.. I see a lot of folks who seem to be making concessions like this is a temporary diet that's got an end. They'll endure the shakes and the treadmills for now, and then they go on with their happy lives thin forever... I could be wrong about how I'm interpreting it.. but I think in a lot of cases, I'm not. 

Some may not realize that a smaller body takes less calories to maintain, especially without exercise. I think a lot of people slack the reins on the carbs and quality of food. This makes a huge difference because the quality of foods that we eat effect our hormones, mainly insulin, and the hormones direct your body on what to do with calories.

The body is way more complex than calories in/out. Just an observation but I see many vets saying that they have more treats, talking about "maintenance" foods like adding in rice, etc. It's my view that the same food quality needs to be kept up in maintenance.

I literally see people at goal weight eating donuts, going back to ordering fast food at McDonalds, and I wonder to myself how long it will be before they start gaining weight back.

I know that I expound on this subject way too much, but I just don't get the draw of those foods anymore. In my mind those foods are firmly and irrevocably associated to going right back to being morbidly obese and all of the hell that entails.

I don't see myself ever thinking that those foods are right for me, or that there won't be consequences to eating them. Even if I didn't gain weight, which I surely would, they aren't good for my health either.

I saw a woman who was diabetic normalize her blood sugars and get to goal weight, only to go back to eating lots of sugar again! That remission of her diabetes will surely be gone if she continues, and she had a lot of body damage from her uncontrolled diabetes.

I get those foods are so yummy and addictive and tempting, but I don't understand why some people don't see the clear link between eating those foods, or having a healthy thin life. In my mind the two are mutually exclusive.

I wish sometimes I could share the peace of no longer being drawn to those foods because I'm so connected to the cost associated with them.  The guilt, the indigestion, the shame, the weight gain, etc. This is not to say I'm perfect or I wouldn't fall off the wagon, but for 7 years now I have maintained a very clear head about where these foods fall realistically for me in my priorities of life, health and happiness.

 I love all of your recipes because they really are so healthy and basic and great on portions. If I wasn't a lazy cook I'd definitely make them. I like to cook only once a day, not tons of meals, but I think you are so doing well keeping up with your quantity as well as the quality!

Bravo! I think you are a great role model.

I think some of this behavior you see comes back to sustainability and practicing moderation.. example: for me, relegating foods to rare indulgences is my reality, and I'm happy  and satisfied with that. It wouldn't be sustainable to say I will never ever have a slice of pizza again, that would just not work in my reality.. and I cannot tell someone else otherwise. So, for me the two things: health and indulgent foods are not mutually exclusive. They can co-exist under conscious moderation.

But, on that note, if I knew for me that that one slice of pizza would cause me to fall right back into an out of control state, no.. I would have to abstain for my mental and physical health. I thankfully don't face that battle. Different realities for each of us, as we all have our own issues with food and eating behaviors. I don't associate any food with guilt or shame.. food to me is varying degrees of healthy or not so much (and tasty and not so much, as at it's core it is still something enjoyable!) It's not an addictive thing for me, nor am I a big emotional eater.. I realize this is not everyone elses reality either.

Back to the example: No, pizza is not a healthy enough food choice for it to be a regular thing in my daily diet, but neither is a glass of wine.. if you look at it in a biological way.. but in my case, conscious moderation is going to have to be the key because I will still have an occasional indulgence in foods that are enjoyable to me. One slice didn't make me fat, making a poor decision in quality and quantity for the majority of my meals over the years did.

Hey there and thanks for sharing! I totally want to say that I get that not everyone is a food addict or needs strict abstinence.  HOWEVER, I know lots of vets and people who are at goal, and I see a lot of slippery slope behavior.. the more they allow junk back into their diet, the more they crave it, and the harder it is to rein it in.

This leads to cravings and weight gain, and I believe that most overweight people have this problem to a degree. Just like you said, you can do it rarely and be OK.  Some people like me can't do it at all, and then there are others who can totally eat intuitively or not have any weight consequences from eating the way they do, FOR NOW.  I think it's just a matter of knowing where you fall in the continuum.

I remain skeptical that the "lucky" folks will be able to do it forever.  I have seen a few that try but are slowly gaining.  So that's where my stance on this comes from.  Also for me it's not so much about habits, but truly a mindset or paradigm shift in how I think about food and how I view its importance for me in my life. 

 But then I HAD to change my mindset because of my food addiction issues.  However once I did I found a lot of peace in that acceptance.

Hugs..

Probably the thing that frustrates me the most is when people don't realize and embrace your first point.  Building good habits during the first 6 months is vital.  It's when the weight loss is easiest and good habits are quickly reinforced by the great movement down in the scale.  When folks fail to establish these good habits in this time frame, they justify it by saying "but I'm eating cookies and still losing!"  Wow, so misguided and it ****** me off every single time.

I didn't have 85% of my stomach cut out so I could go back to doing the same things that got me fat.  Now, I'm not perfect, and I'm going to have treats and other things on occassion, but I'm fully embracing that this is a lifestyle change and not a get-to-goal diet.

I fear for the foiks who don't embrace the lifestyle change piece, because eventually many of them will gain weight back.  Some will gain a lot and others will gain a little... and a small portion will get lucky and not gain any.  But the combo of these folks is why the longer term stats are 60-75% EWL. 

OK, end rant.  On a happy note, check out my Vegas post with pics on the main board!  Whoot!  (yes, a shameless self promotion)

Everything that I could say, has been said. I just keep on, keeping on. My new motto. I have embraced exercise, including weight lifting and love how I feel and how strong I am becoming. Some days I don't really feel like it, but the majority of the time, I go to the gym or take a walk. I have never regretted going to the gym, but I have regretted not going. This is my life and I accept it. The alternative is not acceptable.

As far as sweets, they have really lost their attraction to me. I have had bites of things, but I have never wanted to eat an entire slice of something. I stay aware from them, because I know that they are trigger foods for me. Plus, I think of how awful I would feel after eating them, and it just isn't worth it. I don't want to go down the road of diabetes, sleep apnea, etc. So, I just avoid it.

WLS has truly been a gift and second chance at a healthy and active lifestyle. I do not want to screw this up. So, I track my food, measure my portions, exercise, attend support groups, continue to educate myself, since knowledge is power, and daily weighing. I'm sure that there are more things that I do, but this is enough for now. I hope that I am doing enough to maintain the weight loss for the long term. It is really scary to think about regain.

I read the boards and just shake my head at times. Many, many people just do not "get it." To be successful, means embracing a new lifestyle and behaviors. Some will, others won't.


gail

I have nothing new to add, you people are all freaking brilliant and motivated and awesome.  I love that I can wake up in the morning and read a thread like this.   So amazing to have you guys in my life.  Group hug everyone.

Great topic Frisco, thanks for starting it on this group.

One thing you have illustrated is that anyone who was a non-cook before wls should LEARN TO COOK.

Its part of taking responsibility for what you eat and gives an understanding on what goes into healthy food and not healthy food and increases the ability to make better choices. It also liberates you from eating only in restaurants (which have ridiculous portions) or pre prepared things or being dependent on someone else for healthy food preparation.

I have known people who gained a lot of weight because they were dependent on take out and restaurants. I have always been a cook/foodie and the same skills that enable me to cook a gut busting thanksgiving dinner also enable me to cook an attractive healthy one.

Frisco, I understand you were a non cook before wls but you have taken to it like a fish to water and become quite the expert. Bet you agree that you are eating better and nicer food having learned to prepare your own.

Hubby is a non-cook so if I go out of town for a couple of days I leave a batch of barriatric friendly chilli. More days and he eats barriatric choice meals but I really wish he would learn to cook a fresh fish fillet or chicken soup.   Something to address in your upcoming food blog Frisco.

The other thought is mental preparation for maintenance just like mental readiness for wls is important. You gotta accept that life in the food department is gonna be different from here on out and accept that truth rather than continually thinking "if only I could have a few brownies ...". At the same time, its one day at a time. The best thing i still do is food journal everyday and i will probably do it forever. Just don't trust myself to try to eat intuitively and the main reason is that I am afraid I won't get enough protein if I don't track.

Diane