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I have posted a new blog entitled "Foundation of Success". Please read the blog and the associated questions and then come join in on the discussion of this topic.

I look forward to your participation and input.

Hi Michelle,

I understand your concerns about not being able to make the changes you need to make to have this be successful. I had those concerns myself and to be honest, I'm still a work in progress and probably always will be. I have to say that I truly do not believe that I could or would have lost the weight without the surgery. The surgery actually 'forces' you to make some drastic changes early on and you can work with it to maximize your outcome; not just with the initial weight loss, but with the likelyhood that you will be able to maintain that weight loss. While some will say "Oh, you took the easy way out." There is nothing 'easy' about WLS, in any form and it isn't a cure all, but it does give you a 'leg up' or and 'edge'. You can expect to lose an average of 60 to 80 percent of your excess weight with RNY. Because of your BMI, you might be a candidate for DS, which might be something to consider if you are concerned about your ability to 'stay on the straight an narrow'. I don't advocate one over another, but each surgery type has it's strengths and weaknesses, it might be worth looking at RNY and DS to see if one fits your needs better.

With whatever surgery you choose, you will need to make behavioral changes and if you are like me, that might be the most frightening thing because if we were able to make behavioral changes we wouldn't be in this mess in the first place. I have found that during the first few months of the surgery, to be honest you aren't really making concious behavior changes, they are all dictated by the surgical intervention, but as you move past the early stages, then you will start making concious decsions that will impact your outcome. I have made much better decsions after surgery than I ever could or would have before. I think it's important to join a support group... virtual and in person. That's why I started this one and the one that meets in person in Raleigh (come join us... www.meetup.com/nc-wls) I started them, because I needed more support than I could get with my once a month meetings through my program. You will also need to find a way to identify and deal with your not so healthy affair with food. I find that it's almost like being in an abusive relationship; it hurts us so bad, but there are some things that comfort us and we keep going back. There are a number of ways to address these issues. I think getting counseling is a really good thing. Another thing that has been invaluable to me has been a program that I found called the 'Beck Diet Solution.' It's not a diet, it's a program to help you identify and manage behavior that keeps you fat, so that you can learn to 'think thin.' For me, I doubt that the program alone, would have been enough, but then the surgery alone wouldn't have been 'enough' either. With the combination of support, surgery and working on making behavioral changes, I have hope that I will be successful in the long term because we all know that losing the weight isn't the definition of success, it's losing the weight and keeping it off.

I wish you success in your journey.

Layla,

Congratulations!!! I look forward to watching your continuing metamorphosis.

((((Kathy)))),

I'm so sorry that you are struggling. You have made an enormous strides towards the healthier you that you strive to be. I had my surgery through Duke as well, as did my husband. He also had your surgeon, so I know that basic drill through them. First of all, you may be being hard on yourself. Secondly, realize that while the surgery will 'guarantee' that you WILL lose weight during the first year, but it will be your changes in behavior that will help you maximize the loss and maintain the loss in the long run. Sooooo.... If you aren't doing it now, consider logging everything that you put in your mouth. This helps to develop awareness and if we are honest with ourselves now, we have to admit that we had not been honest with ourselves before; we used to have ostrich syndrome and like the hear no evil monkeys we never really looked at what we were doing. So accountability and knowledge can be key here. I find that when I log my intake I make much better, measured choices. You need to be getting about 800 to 1000 calories a day and need to have about 60 grams of protien at a minimum. I like to use www.mydailyplate.com to log my intake because it has nearly everything in it and I don't have to re-invent the wheel everytime I want to log something. If you aren't moving you tail, then get yourself a pedometer and see how much you are moving; you should be shooting for a minimum of 10K steps a day. If you aren't then start working up to it. Statistics show that those who participate in support groups and exercise are much more likely to reach goal and maintain their goal weight in the long run. And remember, you are in this for the long haul.

I would also suggest that you log your intake for at least a week and then call Patrick and ask him to help you evaluate your eating to see if you can do anything differently.

You can do this and we are here. We will listen and try to help.