VSG: you're doing it wrong

[JackieOnLine]

I work in healthcare and recently met a woman who had just lost 100 pounds by having a VSG. she was about 6 months out and I can't violate her privacy by describing the situation but I was treating her for something else and here is what I saw: food, all of it crap, all over her room.

pop! crackers! pie! I'm not kidding - if it was a simple carb, she had some. what the hell?

you know what: I spent years, literally, on OH posting things like "there's more than one way to do this" and "you have to find what works for you" - or responding to posters who thought eating saltines was The Evil.

however! when I had a cracker it was part of a larger plan that included WATER and PROTEIN. her plan, I figured out after some careful conversation, was to eat whatever she damn well pleased on the theory that she can "only eat a little bit" - after all, it was working so far. like magic, in fact!

I was not able to get through to her, either. and her family all ate crap and were bringing her stuff that was crap and I think, basically, she will end up regaining every pound. sadly!

I gave it a lot of thought: everything pointing towards failure so what ONE thing could I leave her with that might give her a chance. I decided tracking was it - track your intake. so, gently, I let her know what a difference it could make and how easy it could be and then I repeated that whenever I saw her. She wasn't listening but maybe enough sank in that when she starts to regain she will remember.

Seriously? I don't think she has much of a chance, but if she has any it will be because she starts tracking what she puts in her mouth. Then she has to FACE it and then she can get help. Because what she is doing now will not work, long term.

 

[Jo777]

Very true, and she will likely in about a year or so, start swinging the other way, proclaim her surgery was broken as the crackers and pop start emptying much faster.. and regain.. and you can't save her, unless she wants to put in the tiny bit of effort it takes.. and that's the rub, most are willing to do a little work, education wise, tracking.. just plain THINKING.. but not all.

The common (not so?) sense thing that ran through my head, even past all the other knowledge that was rattling in it from years of differing diets etc.. was I have such limited volume, and I still have nutritional needs to meet, for things like protein, and fatty acids and vites.. that pre-op, even when my diet was shit on occasion, I could eat enough real food to satisfy those needs in between the junk, but post-op, nope.. if I ate my fill of junk, I could't eat my meat.. so I pretty much was the good little VSGer till goal, and still 80% of the time, eat well.

Granted NOW those crackers don't fill me up like they did the first 6mo (unless they have some cheese on them), but there are days even now I have nibble-fests/graze constantly, and realize later I didn't get in enough vital stuff, LIKE WATER- because I kept my stomach so full of food that I couldn't drink when thirst hit! That's pretty damn sobering that restriction is not to be messed with..

Folks need to be smart enough for anything to work and continue to work, and there are differing levels of smarts.. most can handle the VSG, but there are some that just shouldn't have any alterations for sheer lack of willingness to fucking educate themselves above the pop and Cheetos as a meal mindset. This is not the fault of the surgeon/classes/etc.. it's just sheer unwillingness on the patient's part. I sound so callous, but I also work in health care, and see some pretty negligent stuff happening, and for most, unless they are mentally challenged, it mostly comes down to intentional ignorance/non-compliance and frank laziness. It's just not important to them, they don't want to take the time, physically, mentally or emotionally.. so they or those in their care suffer.

 

[KathyF]

My daughter is almost 3 months out from her VSG and doing well. She is following the rules and concentrating on eating her protein and avoiding sugar. However, she is rather worried about a workmate who had her VSG about a month before she did. The workmate is drinking sugar sodas and eating sweets and carby foods at the expense of eating the foods she should be eating. She is still losing weight, but you know that is going to catch up with her at some point. It seems that she did it more for her boyfriend rather than for herself and her health. I think that mindset has a lot to do with her inability to comply.

 

[JackieOnLine]

I know a friend of a friend who is in the same place. my friend is watching her eat/drink all kinds of stuff while still losing weight, but knows this will end.

I find two major theories:
I will eat - or eventually* - eat everything including sweets/treats "in moderation" OR

I will avoid all of that stuff because I can't DO moderation.

I think either could work, or either could backfire.

but what I described in the OP and what your daughter is seeing, Kathy, is clearly not a good plan.



*when: at goal? after 6 months or a year?

 

[happyteacher]

I dunno.... I was not a "model" vsg'r during my weight loss phase. My first two months I followed the Cirangle plan, but low blood sugar put a halt to that. Then I started following my bariatric team's recommendations- and that worked great for me. I ate some junk food throughout the weight loss phase for sure. Obviously I didn't lose 150 pounds eating only that though. Maybe it is possible the woman in the hospital had all that crap because people were bringing it to her, and that is not necessarily representative of where she is long term. Another thought is that I have had my share of surgeries and recoveries (cancer patient, plastic surgery) and I really struggle with eating crap during recoveries, but that is not my typical eating pattern otherwise. I really hope this woman is able to make the needed changes to improve her diet. Tracking was a huge help during weight loss for me, and I still go back to it when I start to struggle now.

 

[JackieOnLine]

Maybe it is possible the woman in the hospital had all that crap because people were bringing it to her, and that is not necessarily representative of where she is long term.

I was hoping that, but what she had to say is why I was so worried for her. she was so amazed at how small the amounts she could eat were and she seemed to have no sense that what she was eating mattered at all. she thought she had a "good" supper, for example, because she had some vegetable soup and a few bites of pie. when I asked about protein... blank stare.

 

[Lilyofthevalley]

I am curious what the "eating rules" for the VSG. I have a friend who is planning to have it and she has been told she can eat anything she wants. I told her I think most of us can eat anything we want but we will then have to deal with the consequences, good or bad. I am a DSer so I don't know much about the needs of the VSG. I thought if I know more about her specific surgery I can be of more support to her. Thanks

 

[JackieOnLine]

that is an excellent question and I hope you have given her this link so she can come here and post, too.

a lot of people do low carb - eat dense protein first and then you can eat "anything you want" in the sense that you won't have room for much else. OTOH I have read about people - like me - who reached goal eating ...less carb, but not necessarily low carb.

it's going to differ by your size, metabolism and - of course - surgeons will have different rules. I'll be back after I think about this some more.

 

[JackieOnLine]

I asked a friend who had a VSG in this country. she said

I think the "rules" are eating protein first, veggies second, fruits last. Limited carbs.

No liquid calories (soft drinks, milkshakes, etc).
Drink 64 oz of water.

Stop before you feel full......otherwise LOOK OUT!!!

you aren't suppose to drink liquids before eating (15 minutes?) or after eating (30 minutes? might be 60)

mostly, programs have you do a certain number of calories. sometimes a dumb number, like 800. I mean, it's like a diet, then, isn't it? what the hell! sometimes they say have a certain number of meals and snacks.

the big question is what to eat. early out (and this part can last a long time) you struggle to get in enough protein and you just can't fit in any more.

long term? I have seen people do low-fat, sugar free everything. I hate both those but people do it.

the eating "anything" might be in contrast to a banding, the more well known restriction only surgery. band folks can have a lot of trouble eating certain things like raw vegetables. further out, VSGers generally don't have that problem.

I might have more tomorrow. Jo will post - she does low carb.

I hope your friend comes here and posts!

 

[Jo777]

Yep- I do mostly low carb by default as I regularly/usually avoid grains and starches and sugar, in maint- under 100g a day usually, prob about 60-80ish normally from veggies, sauces, yogurt, some fruits. some days higher, but not too often, and those are usually from eating not so great choices.

Early out - after some protein, I even didn't have much room for veggies (before the swelling/stomach stiffness loosened, post 6mo or so.) That's the time, when you are so restricted, that you can have a huge hand beating back some of the bad habits.. if you are focusing on feeding your body what it needs to heal, and to lose weight and maintain health at the same time.. you don't have a lot of room to work with.. So the rules are, at least to me: hydration, protein (imo, for a VSGer- woman 60-70g a day is fine, a man- 80-90g or so..), then incorporating real foods, as tolerated.

I drank 2 protein shakes a day for about 6 mo, than 1 a day for a year.. now I use some as creamer, just for the boost plus I like it. I could have easily at 6mo out eaten more than my fill of chips, donuts, pie.. that shit doesn't fill you up after the first year, at least not enough to save you.. so yeah, the persons who think that a sleeve of Ritz that they have to nibble on because three crackers fill them up 2months post op, are going to be in for a shocker if they are still relying on that in a year or two. I can down a sleeve on the drive home.. I did it once. It was stupid, but very possible.

Further on, some opt to incorporate more starches/fruits/grains/sugar.. but, at least for a lot of us it seems, eating an excess of carbs (no matter the source, bread, grains, starches, fruit or sugar.. all get broken down to glucose in the body, save fruit- fructose actually is worse for you than glucose.. but that's a whole 'nother subject.) What 'an excess' ends up being, isn't something someone else can accurately tell you.. but for most, unless you are working out a lot.. under 150g is pretty safe, closer to 100 or under may be better for maintaining, and for me- I wanted to get it off, while the getting was good, and since it was a struggle to get in 70g protein, and a few bites of veggies- I regularly stayed sub 40g for almost a year, now about double that, but my intake has also increased.

Funny story, I totally was oblivious to the whole "primal" movement (not paleo, I do eat dairy on occasion- too much causes me issues, but always has).. I stumbled upon Mark's Daily Apple online, and realized, I pretty much eat fairly primal*. He has a great chart which by my own pre and post VSG experience seems to fit for me.. also seems to work on my normie husband.

*When not pigging out on things that cause me distress later, bread, beer, sugar, waaay too much dairy=bloat, gut swelling, gas, water retention, general ick, and mood funk in addition to plain old weight gain.. my gut-bugs have changed I think, I cannot tolerate eating crap too often or I feel terrible for a while, and it takes me some time to get over it.

 

[Lynn5707]

Hi,

This is first post here. I had VSG July 2011. I am also in healthcare. When I was first out I usually had 80-100 pro. daily and few carbs. I just didn't have room after having protein. Now, I am tracking and try to keep carbs around 100. Last year I put on about 10 pounds, which I'd like to get off. I think my reason for weight gain was I just became too comfortable. I do like that with the sleeve I can "tolerate" any food, so as far as that goes I don't have problems. But I do need to be aware of old habits and reversing them before all my weight comes back.

So for now staying around 100 carbs,veggies, fruit and occ. whole grains. I am concentrating on whole unprocessed foods as well.

Tracking is key for me!

 

[southernlady]

Hi,

This is first post here. I had VSG July 2011. I am also in healthcare. When I was first out I usually had 80-100 pro. daily and few carbs. I just didn't have room after having protein. Now, I am tracking and try to keep carbs around 100. Last year I put on about 10 pounds, which I'd like to get off. I think my reason for weight gain was I just became too comfortable. I do like that with the sleeve I can "tolerate" any food, so as far as that goes I don't have problems. But I do need to be aware of old habits and reversing them before all my weight comes back.

So for now staying around 100 carbs,veggies, fruit and occ. whole grains. I am concentrating on whole unprocessed foods as well.

Tracking is key for me!

Welcome, Lynn...glad to see you join us.

 

[JackieOnLine]

Hi Lynn! :039: I am so glad you found us.

(by the way, can I ask how you found us?)

 

[bearmom]

It makes you sad for her, and you have to wonder what advice she was given for post op from the nut. The good thing is she has a sleeve, so non-compliance may mean she doesn't lose, or even gains, but won't kill herself with lack of supplements.

I have a friend nearby that got RNY several years ago, and is not compliant, and she will complain to me assuming I'm having the same issues. She eats what she wants, is gaining, and her farts could knock a buzzard off a shit wagon. She thinks those are the worste possible outcomes, but I'm worried she is going to find out being equally non-compliant with her vitamins will be much worse.

I wish there were a way to screen before we have surgery for those that won't take it seriously.

 

[Munchkin]

*THIS* is a smart group of people. Not all people are this smart/educated about nutrition and food. If you fought the fat for your whole life you ended up learning a lot about the enemy, food. There is a whole other group of people out there, the majority, who know very little.

I will never forget a college friend telling me how disappointed she was that she wasn't losing weight on her new 'diet'. I asked what she was eating and she replied Doritos and chocolate milk. Think about this. A woman with a college education actually told me this and was expecting me to commiserate with her over her failure to lose weight. So many people have no idea that it's frightening! This is who eats all that the crap they are pumping full of HFCS and plain old sugar. They just eat what's affordable and tastes good then they are surprised when they are diagnosed with diabetes.

Fast forward 30 years and I was working in an office with about 10 people who had WLS of one kind or another. Today, I am the only one who isn't back to MO.