Question:
4 Years post-op and gaining weight after pregnancy

I had my surgery in May 2003 and lost 100lbs. Even then I didn't get all the way to my goal. Since then, my weight loss has stopped. I just had a baby 9 months ago and gained 25lbs and still haven't lost any of that. Because me nor the baby was gaining any weight through the pregnancy I was advised to eat often and high caloric foods. Now my eating habits are terrible. Since the surgery is so far out will my body still respond the way it did right after surgery? I feel I have really lost touch with taking care of myself and doing what I have to do since surgery. Any advise or help please?    — jmikelsmom (posted on July 25, 2007)

July 25, 2007
First your OH Profile is not filled out to understand your plight. I can understand adding food but nutrition foods and extra proteins. But NOT eatting whatever you felt like and deffinently NOT High Caloric foods. You need to get back to the Basics as though you just Received your Weightloss Surgery!! Start with this Plateau Buster plan - WLS Plateau Buster Do This For 10 Days To Break A Plateau # 1 - Drink at least 64 oz. of water a day, as close to 128 oz. if possible. # 2 - You must have 45 grams of protein supplement and all your vitamin & mineral supplements each day. # 3 - You may consume up to 3 oz. of the following high-protein foods, 5 times a day: a.. beef, b.. pork, c.. chicken, d.. turkey, e.. lamb, f.. fish, g.. eggs, h.. low-fat cheese, i.. cottage cheese, j.. plain yogurt (or artificially sweetened), k.. peanut butter, l.. beans/legumes. # 4 - You may also have: a.. sugar-free popsicles (avoid juice popsicles), b.. tea or coffee, c.. sugar-free Jello, d.. broths & bouillons, e.. Crystal Lite drinks (Walmart's Brand is the same but cheaper). # 5 - IF IT IS NOT ON THE LIST YOU MAY NOT HAVE IT! # 6 - Keep a food diary and try to get 30 minutes of exercise daily. And walk at least 30 minutes each day to start increasing another 15 minutes each week. Swimming is also great, but continuous for an hour non-stop such as an Water Aerobis Class. Here is alsi the Pouch Rules for Dummies Plan - RULES OF THE POUCH 1. The patient must time meals five (5) hours apart or the patient will get too hungry in between. 2. The patient needs to eat finely cut meat and raw or slightly cooked veggies with each meal. 3. The patient must eat the entire meal in 5-15 minutes. A 30-45 minute meal will cause failure. 4. No liquids for 1.5 to 2 hours after each meal. 5. After 1.5 to 2 hours, begin sipping water and over the next three hours slowly increase water intake. 6. Three hours after last meal, begin drinking copious amounts of water and other calorie-free fluids. 7. Fifteen minutes before the next meal, drink as much as possible as quickly as possible. This is called "water loading." 8. You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness. THREE PRINCIPLES FOR GAINING AND MAINTAINING SATIETY 1. Fill pouch full quickly at each meal. 2. Stay full by slowing the emptying of the pouch. (Eat solids. No liquids 15 minutes before and none until 1.5 hours after a meal). 3. Protein, protein, protein. Three meals a day. No high calorie liquids. THE IDEAL MEAL FOR WEIGHT LOSS The ideal meal is one that is made up of the following: 1/3 of your meal to be low fat protein, 1/3 of your meal low starch vegetables and 1/3 of your meal solid fruits. This type of meal will stay in your pouch a long time and is good for your health. FLUID LOADING Fluid loading is drinking water/liquids as quickly as possible to fill the pouch, which provides the feeling of fullness for about 15 to 25 minutes. The patient needs to drink about 80% of his/her maximum amount of liquid in 15 to 30 seconds. Then just take swallows until fullness is reached. The patient will quickly learn his/her maximum tolerance, which is usually between 8-12 ounces. Fluid loading works because the roux limb of the intestine fills up, contracting and backing up any future food to come into the pouch. The pouch is very sensitive to this and the feeling of fullness will last much longer than the reality of how long the pouch was actually full. EXERCISE In addition to exercise helping to increase the weight loss, it is important for the patient to understand that exercise is a natural antidepressant and will help them from falling into a depression cycle. In addition, exercise revs up their metabolic rate during a time when their metabolism, after the shock of surgery, tends to want to slow down. Original article written by: Mason. EE, Personal Communication, 1980. Barber. W, Diet al, Brain Stem Response To Phasic Gastric Distention. Am J. Physical 1983: 245(2): G242-8 Flanagan, L. Measurement of Functional Pouch Volume Following the Gastric Bypass Procedure. Ob Surg 1996; 6:38-43. "Dummies" version rewritten by Sally Perez.
   — Michael Eak

July 25, 2007
Ok.... I am not going to slam you!! It is HARD being pregnant after WLS. I did it last year, and I am pregnant again this year (babies will be 12 months apart). I did originally get to my goal, and after the first baby I lost all but 6-10 pounds (but I got pregnant again right away, and yes started gaining again!). I only gained a total of 36 pounds the first pregnancy--and I ate whatever I wanted--I bet Hershey's was having a shortage, LOL. I had to eat more often and high calorie foods also or I would not have been able to feed my baby!! You do what you have to do. But I am planning on getting all this weight back off after I deliver. I am going to try to do the protein first or maybe even the liquid diet. I have heard that those steps can jump start the weight loss again! Don't listen to people (especially a man) who trys to tell you what you should or should not have eaten--let them try being pregnant and STARVING to death!!
   — GAYLE CARMACK-LYONS

July 26, 2007
Hi Kari, and thanks for writing. I looked at your profile hoping to find out how old you are, and didn't see that:( Profiles are so important when you look for advice, there are so many variables. Congratulations on 100 pounds lost! That is awesome. Having babies after wls has got to be a big head job if you ask me. I was well past having babies when I had surgery (Praise God!), so you have my respect for being young and tackling this job of weight loss after surgery as well. It can be done Kari, and it is very possible for you to lose weight. Obesity is a head issue with a body consequence, and in your note above you give several signs of decline. You talk about high calorie foods, you walk about your eating habits in genergal being poor, and more important you talk about having lost touch with caring for yourself. I see these things as important head issues you need to address. What we put in our mouths is our choice. We fall victim to our own lust when we give in to things we know better than to do. I have to find a distraction in order to keep me away from the wrong choices, and even at 3 years out it is a battle. That lust increases when our bellys are growing with a wonderful child that we want to be healthy, and yet we "feel" fat, so what the heck, I may as well give up and eat what I want and pay for it later? Sound familiar? The lust doesn't change because we had surgery. You have to deal with your mind set. First, I would suggest that you revamp your commitment and find touch with your fight to have good health. It is a fight, and it is up to you to fight, no one will do it for you. Are you worth it? I would say yes, and I hope you do too. Eat healthy for your baby, and get your advice from a nutritionist that deals with wls and can think about your baby with you, not from a separate source. If your doctors are not thinking about the big picture of you and wls and the baby, then they are leaving you out of the plan. You must eat good things because some of that is mal absorbed and you need all the absorption you can get for your child, yet you do not need to eat high calorie foods to just put on fat. That does not make sense at all. The thing is, it is hard to go against the judgement of a doctor when they are supposed to know it all. I would recommend that perhaps you find a book or two that may support nutrition and pregnancy, and in your head you have to balance your wls stuff. Many times, with all due respect Kari, we lose ourselves because we are tired of the fight and want to lose ourselves. Stand up and fight girl, it is a battle, and it doesn't change. Protect your health and the health of your baby at all cost, but fight every day for your health. No one will do it for you, and the choice is yours, as well as the consequence. You can have success, but it will be a battle. Game face on girl, let's go! Take care, Patricia P.
   — Patricia P