Sunday, June 16, 2024

It can slow things down in that department! I find it makes me pee a lot the first few days (losing inflammation?), so if I don't drink a lot I end up with a headache and mild constipation.

I'm trying to be mindful of having enough water because I am typically bad at that. I have days when everything is a bit slow but it seems to resolve by the next day.

my big fat rosebush

I visited with my dad and gave him a Father's Day haircut! It was a nice visit. He was cognitively sharp this afternoon. He instigated conversation and we had a lovely back and forth chat. Yes, he still struggled for some words here and there, but the flow of conversation was so natural. I enjoyed the moment. I feel like I was the one who got the Father's Day gift!

I'm going to rant a little... It is a well meaning rant. Liz's comment about lightheadedness got me thinking.

Liz, the only time I get lightheaded is during a workout when I get over oxygenated during a hard core lift. I don't think it is a tirzepatide effect. I'm going to go out on a limb here and suggest another possibility - too few calories. I know women require fewer calories than men, but I read what some of you ladies eat and it seems shockingly inadequate for nutritional purposes. I did some digging yesterday on nutrition requirements for our over 50 and 60 age group. Paula is eating the absolute minimum calories for metabolism health and stability for a woman at or near 60 - 1,200 per day. My reading also taught me that caloric deprivation can lead to dizziness/light headedness in the same way that low blood sugar can. Eating an adequate amount of protein will help the metabolism manage the calorie deficit. For a woman of 60 years or more protein intake should be a minimum of 0.8 grams per 1 pound of body weight. Ideally a woman of 60 should eat 1.0 - 1.2 grams of protein per pound of body weight, if she is trying to lose fat. So that means a woman of 120 pounds should be eating between 96 and 122 grams of protein per day.

I absolutely struggle to get in 120 grams of protein per day since being on the weight loss meds. I have to supplement with Fairlife protein drinks and Quest bars to make my daily protein goals. Some days I fall short, but overall I push myself to eat the protein. More often than not, I make my goal.

My worry is that those of us who take the meds will fall into old "diet" patterns or go into post VSG surgery type of calorie deficits. (By "those of us" I also mean my friends in real life who take the meds - not just us on this board.) I think that falling into super low calorie eating is worrisome because eventually we will end up in the same boat that led us to regain. I hope that makes sense.

There isn't one of us on this board who doesn't have some type of disordered eating habits, tendencies, etc... I want us all to be hyper aware of how the semagultide and tirzepatide can trigger disordered thinking and old dieting beliefs. It happens to me at least weekly and I feel lucky that I have had close to 10 years on the couch and 4 plus years of intensive eating disorder work. I am usually able to recognize my eating disorder coming out to play and work with the disordered thinking. I also believe that is why my weight is coming off slowly, but steadily. I'm losing roughly 1% of my weight per week. I'm not losing fast at all, but this has been by far the most emotionally comfortable weight loss I have ever had.

The most common eating disorder thinking that pops up for me is this one: The little red guy on my shoulder appears and whispers, "You aren't really hungry. You don't need to eat. You'll lose weight faster if you don't. And then you can splurge on something later if you store up all those extra calories." It is so, so tempting because for the first time in my life (excluding immediately post VSG) I am not hungry all the damn time and even if I am hungry, I can postpone eating without issue. Sometimes I have to tell myself that I have to eat or I will start losing muscle. For me that is a great motivator. I work really hard to build and maintain muscle, so the idea of losing it to my eating disorder for the sake of weight loss is unappealing. I remember my aunt's neighbor and Karen Carpenter who both died from diet related muscle loss which caused heart failure. It's a helpful reminder to me to eat the protein.

Ozempic Face is a real thing. I have seen it. It is caused by rapid weight loss in which muscle is used by the body to fuel routine body function because too few calories and grams of protein are consumed. I thought one of my returning puppy buyers was sick - possibly cancer. He had the same look my mom did with terminal pancreatic cancer. No, not cancer. He was taking Ozempic for weight loss and had lost a lot of weight very quickly. Sure he was thin, thin, thin, but he did not look well. I don't want that for any of us. Let us all make sure we are eating adequately to maintain good nutrition.

A very wise friend recently said to me, "Just because we know a lot about nutrition and healthy eating, doesn't mean we still don't struggle with disordered thinking around food and our bodies."

End of rant.

What a gift of a visit with your dad!

A good reminder Peps, meant with love I know. Nutrition and muscle preservation should always take a front seat to weight loss especially at our age! What good is thin if we aren't strong and healthy enough to enjoy it?

Yes! Great reminder Peps! I need to add regular movement and resistance training to help preserve that muscle!

Truth and well said.

You of course have a completely different situation having had the whipple surgery. How do you manage your nutritional requirements?

My mom died from pancreatic cancer. Even though she was diligent about pursuing care in the early stages of her illness (unexplained weight loss, diarrhea...) blood work, CT scans and MRI missed the small pencil dot of cancer on her pancreas in November or 1996. Instead she was given anti anxiety and IBS meds to calm her system. By February 1997 the cancer had metastasized to her lung and liver. No Whipple possible at that point. So I have a little knowledge about the surgery even if it wasn't really available back then anyhow... very experimental. But no stone was left unturned, as they say.

When you go into weight loss mode, naturally you will lose much more quickly than average because of your digestive and nutritional deficits, correct? (Hell, you've lost close to 40 pounds in 8 weeks, I believe!!!) So, with the monumental redesign of your digestive system, how does your medical team suggest you get all the nutrition your body needs? My guess is that life saving whipple surgery on a bariatric surgery patient is highly uncommon and presents an even greater medical challenge!

Devon, I'm so sorry to think that your mom had to endure such an experience as she did. I'm sure your whole family suffered as well, as you loved, cared for and endured with and for her.

My IPMN was found incidentally on a scan taken for something totally unrelated. And I was also Asymptomatic and had no clue-pure dumb luck. I had the Whipple because the cyst was very large, growing and unstable. The cyst was precancerous (Grace of God). Oddly, the results of WLS (surgeon said having no fat around the pancreas to deal with turned what was supposed to be a 10 hr surgery into a less than 5 hr one). On the other hand, now, Mr Whipple and Sir Sleeve do not always play well with each other.

I did lose my pyloric valve as well as duodenum and a slice of my sleeve. Everything thing else was reshuffled and cobbled together. Makes food, eating and nutrition pretty dicey. I was encouraged to eat lots of soluble fiber, soft protein, and carbs. Before surgery- protein forward, full fat, good carbs and clean eating. After surgery, basically I ate slider food because they were easy...plenty of calories, kept me alive. I gained the 15 pounds I was under weight, but with no restriction went on and regained an additional 45#s more than I wanted.

Sorry, way more prequel than you asked for but

The reason your post was so pertinent to me is that because I've returned to protein forward and healthy carbs (dropped the slider carbs/sugars) and restriction has returned to the point of not being able to get enough calories in. So, the quick weight loss. I don't supplement with sliders #1 the calories are worthless nutritionally and #2 eating that stuff triggers my addiction to them. Same as the terrible, never ending cravings.

My "team" right now has me supplementing vitamin/minerals (malabsorption). Sometimes eating well and eating enough just plain hurts. Trying to add calories by increasing number of meals-5 or 6 a day which is tiresome, but allows the jacked up digestive system to take more in with out a civil war like reaction. All agree it's best to stay away from the triggers that lead to reactivating the cravings.

I haven't reached the 1,000 cal/day yet, but working on it. Also getting closer to my protein goal which is anything upwards of 80 +

Wow! Just wow! So much to consider I knew you had a catastrophic remodel of your gut, but didn't realize you lost the duodenum, as well. Damn! That's a major piece of your gut and nutrient absorption gone - Poof!!!

You are one strong lady! I bow before you!