Question:
Should I listen to my PCP or Trainer and Dietician?
Hi there, Amos Family!, Not sure if any recall, I had some issues with both my Dietician as well as my Personal trainer. My dietician doesn't have the first clue about WLS, while I was in the hospital, she gave me regular jello instead of sugar free and my Trainer believes in the more carb lifestyle. I follow a majority of what my dietician tells me ( after I run it past my Doctor) and I only follow my Trainer's advice on exercise issues. <p> Okay here's the new dilema, I stll have another 40 lbs to lose. I was on a plateau for a while, didn't bother me too much because I figured I could try to gain some muscle back and firm up. When I saw my Dr. he said that he didn't want me to concentrate so much on the muscle aspect and to try to still get down in weight. He said once I am much, much closer to goal, ( about 10 pounds) then I can fully concentrate on firming up. But I don't know who I should listen to.... the doctor that knows a great deal about WLS or a dietician that admits, she is 'learning as she goes along' and a Trainer that seems almost anti WLS? Summary..... Doc wants me to continue losing. Trainer wants me to stop and focus on muscles and weight training and Dietician says to focus on my daily nutritional requirements. What would you do, Amos Family? Thanks, Vi Open RNY 9/23/02 down 144 lbs. — Vi F. (posted on June 22, 2004)
June 22, 2004
I will assume your PCP is the one who recommended you for WLS. You should
listen to your doctor (PCP) or speak to the surgeon who did your surgery.
Your dietician should also be onboard with you as far as what your daily
requirements are for WLS as opposed to someone who has not had WLS. I
highly recommend looking for a dietician who is qualified with WLS
patients. I beleive you can find a list on the website. If not, call the
surgeon who did your operation and see who he woudl recommend. I am
suprised at how many people actually have the same question and concerns
that you do. I am very fortunate in the fact that my dietician works in
conjunction with the surgeon who did my WLS. As far as the trainer goes, I
agree with your PCP, lose the weight then concentrate on firming up.
Good Luck to you!
Sherry S
— sac287
June 22, 2004
Well exercise uses calories that help you loose weight:) I would add lots
of exercise while being diet compliant to maximize weight loss and muscle
tone. One doesnt exclude the other:) BTW you dietician and trainer both
need some educating on post op life. I would ask your surgeon for some
educational materials for these folks. If they are going to make money off
of you they should at least be educated to a bariatric patients needs. I
was close to goal but never expected to reach it. I had plateaued out. Then
I got invoplved in gutting a friends fire damaged home. I lost weight fast
while building muscle mass. Its in my long winded profile. Thats the sort
of thing you need to do.
— bob-haller
June 22, 2004
Hi again, Amos Family! My Surgeon moved his practice to NY, so I can't get
in touch with him. But yes, my PCP is the one who recommended the WLS and
he has published numerous papers on the subject and is a huge advocate for
it. My Trainer doesn't want me to do any sort of cardio exercises at all,
she wants me to solely do weight training and that's it. And the dietician
is the only one that works out of the hospital where I had surgery,
unfortunately they only have 2 and the other one doesn't work at all with
WLS patients, this one is willing to.
Bob, that is a great idea of getting them some materials to read, maybe
even suggesting to go to a support group for it.
Vi
— Vi F.
June 22, 2004
Continuing aerboic exercise is definitely important for many reasons so do
walking on your own. However, I am a huge believer in weight training. I
went back to WT at 9 weeks PO. I could not do too much for walking at that
point due to pain and cramping in my overloaded joints, so anything was
better than nothing. I did keep trying to slowly increase my walking but
it took a long time to come around. I believe the WT has a ton to do with
how quickly I lost the weight and associated fat and achieving some toning,
as minimal as it was on my overstretched 43 yr old body. WT will build
muscle, that you always carry with you. Muscle turns your body into an
efficient fuel burning machine, ultimately helping your lose more weight.
WT and aerobic exercise are not mutually exclusive. They should both be
done in my opinion. My WLS and team is finally realizing how much WT plays
into this losing and maintaining process. To the point that they are
intending to push it much harder and clearly incorporate it into the
program. When I went through almost 17 months ago I was told to not worry
about WT and focus on aerobic exercise only. Fortunately I knew what was
best for my body and did what I could of both. I had been doing WT for the
9 years previous to have WLS. While I still gained weight, because the
aerobic exercise wasn't there and the food choices sucked, I still went
into WLS with way more muscle mass than most. I was never so thankful as
to have the strong legs that I did as it allowed me to lift myself totally
with my legs so my arms could old the traumatized belly.
<p>You may never lose that last 40 lbs because your body just isn't
meant to reach that number. Some docs and patients set unrealistic goals
driving people crazy. It's a new healthy life that is most important and
it doesn't take fitting in a height/weight chart as "normal" to
meet that criteria. Working on WT will help tighten things and set you up
for long term maintenance through good habits. However, do not let your
trainer go overboard as you need a program you are comfortable with and can
handle for the rest of your life.
— zoedogcbr
June 22, 2004
You know life should be a balance, work versus relaxing, good food choices,
a little bit of junk, exercise of all types:) Exercise is the only way to
raise our base metabolism rate that burns calories. So do some lifting, I
kinda did that working at the grocery store, moving skids of pop and stuff.
But get out a walk walk walk! BTW the number on the scale isnt as important
as being healthy! Your PCP probably wants you get get firmly to goal
bacause long term theres a regain risk. But we MOs have strong big leg
muscles and lower body strength from carring around all that tonage. Big
HEAVY leg bones too. This all adds weight we just cant loose and keeps some
from ever getting to goal. Just DONT use this as a excuse to eat junk or
high calorie liquids! I am sure some surgeon could get some educational
materials to your trainer and dietician. They need serious info. Their lack
of knowledge could hurt other post ops:(
— bob-haller
June 23, 2004
I can see how you are confused! Here's my opinion. I would find a dietician
and trainer who is familiar with WLS patients and WLS friendly. Also,
you've lost a huge amount of weight - how much of that 40 lbs you have left
to lose is excess skin that only surgery can fix, not exercise? You may be
closer to goal than you think.
— Yolanda J.
June 23, 2004
Seems to me that your Doctor is the one that knows most about WLS that is
who i would listen to...Good luck
— Gina Q.
June 23, 2004
Original Poster.... I sneak in walking before my Trainer shows up. I don't
know if it's me, but I have always thought of exercise as INCLUDING cardio,
to not include it, I almost feel as if I'm cheating. I know I'm not but
that's just how it seems to me. I have an exercise bike and cardioglide
here at home that I also use, for days I am not up to going to the Club.
<p>
Honestly, I don't think my Doc's goal are too unrealistic. He doesn't want
me to be thin or what I should weigh with my height. The number he picked
out is right in the middle of being in the 'overweight' range. His goal
and what would put me in the 'normal' range are a good 15 lbs apart. For
me personally, if I could lose another 25 lbs, I'd be VERY happy with that.
I haven't been in the 150's since Primary school. I am happy this weight
now in the 170's, my blood pressure has never been so good (I had to have
surgery a month ago and I had to stay a little longer in recovery because
my pressure was so low! That has NEVER happened to me) And most of the
co-morbs I had are gone ( or at least not showing their ugly faces) I would
not think of myself as a failure if I didn't get out of the 170's, I guess
it would just be nice to sort of see what I was like at 12 now at 34!
<p>
Oh my Bob! You hit the nail on the head again. I do have HUGE legs!! I
still see them as being as big as they were preWLS, I know they aren't
because I take measurements on a monthly basis, but they just seem that
way. And even before I began gaining weight as a kid, I had pretty
muscular legs. I want to swim but refuse to because of my legs, I designed
a special swimsuit that I am making specifically to NOT show my legs. Does
anyone know how much weight our legs can actually have on them? I
appreciate all the opinions thusfar and look forward to hopefully hearing
more.
Thanks, Vi
— Vi F.
June 23, 2004
In answer to your last question about how much our legs weigh, I would bet
that my lower half weighs at least 125 lbs of my 195 lb body, with 80-90
lbs of that between the thighs and knees. The legs bones are huge. I
don't mean the legs themselves, although they are huge also, but my knee
bones are huge and solid. I will never have normal sized knees without
knee replacements. Consequently I will never have totally normal sized
legs, even after the skin removal, as I do not want my knees to stand out.
I want enough skin and fat left so that my legs have a balanced shape and
that will mean they remain larger. My calves are slightly larger also, but
not out of proportion to my knees. If you looked at my ankles then my legs
could become normal sized and look right, but head north from there and
things change quickly. I just had 4 liters of fat lipo'd out of my upper
legs, as part of another PS. This was done in preparation for the skin
removal in Nov. It's not always done but since we had the opportunity to
do it, because of the other procedure, we took advantage of it. Once all
the swelling goes down my legs will actually look way worse than before the
lipo but in the long run this will produce the best results, which is what
I was most concerned about.
<p>My legs will always be larger but I am very thankful that they
managed to hold up all the years I beat the crap out of them with the
excess weight. The least I can do is accept them now. At 43 I cannot
expect a 20 yr old body that was never overweight. At least not without a
total bionic replacement of joints etc. LOL It is easy to suddenly get a
lot more critical about our bodies after having some PS as the undone stuff
really stands out, but it is necessary to also be realistic. My fiance
says my legs just make me look like a power lifter. I can handle that, at
least for now. I will be interested to see what the end result is after
the skin removal and the recovery period. Not looking forward to the pain
but am curious about what they will look like.
— zoedogcbr
June 23, 2004
As far as a swimsuit, wear it and with pride. I know people look and stare
at my legs but I just focus on how good the rest of me looks in that
swimsuit now. I will not hide under clothes just to apease other people's
opinions. If someone were to ask me or make a comment I would tell them
what had happened and if it was a sarcastic comment by comeback would be
that it's better than the alternative. I have huge bat wings and turkey
neck wrinkled skin when hanging down. My fiancee's 3 yr old son keeps
asking about them. Rather than get mad at him I took the opportunity to
explain that I used to be very overweight and that by losing the weight I
have lots of extra skin. My hope is that this information/image sticks
with him and he remembers it at times in his life that he approaches being
overweight, if it happens. He also made a comment that my legs were fat
and I told him that was true and explained the situation. We also told him
that while it was true that people would be hurt if he said that to them.
So it's been a learning opportunity for him. Good thing I am okay with the
situation, otherwise it sure could ruin my day.
— zoedogcbr
June 23, 2004
Here is what my surgoen told me. He said to concentrate on the aerobic
exercise more than weight training at this point because as large as I was
I already have more muscle mass than normal people. My body needed it to
carry all the extra weight around. I think a balance of the 2 is a good
idea.
— catleth
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