Weight Loss

Created by MyFitnessPal - Free Calorie Counter

Wednesday, July 16, 2008

School's out for summer....

Sort of. Today was the big CV exam for pharmacology. So glad to have that out of the way for a couple of months. We had our last classes for Principles of Anesthesia and our computer class, so now we are 5 days a week clinicals for the rest of the summer. I have 2 weeks off in August to relax and not think about school. Woot!

This afternoon I am heading out to a baseball game. A classmate had tickets to see the local minor league team play, so I'm going with another classmate. Should be fun!

Weight is down a little bit, hovering there. I didn't run last night ( my normal running day) because I was studying so much and worried about not having enough time. I got up early this morning (which was sleeping in really, since I normally get up at 4:30 now, but only had to get up at 7 today) and ran about 2.5 miles, because I didn't have that much time, but did want to get in a little bit of a run before it got too warm. It was pretty good. I try to avoid running in more than 80 degrees heat (27 deg C) if I can. When it's over 90, I bag it altogether, and usually wait until evening when it cools down a little. It's a challenge these days, when I want to be in bed early because I have to get up early, but it's still 92 degrees at 8:30.

Thank you, everyone, for the nice comments on my last post. I know trolls and negative anonymous commenters are a part of a blogger's reality, but it sucks. Why are people so hateful? If you're gonna be that way, at least grow a pair and sign your name. Oh yeah, and if you're gonna be anonymously hateful, get your facts straight. That is all.

One commenter wanted to ask about loose skin after being banded. I find it kind of oddly amusing, because you are the same weight as me now, and less than 1 inch shorter than me. So, I consider myself a success at this weight even if I don't lose another pound, but someone else wants to get banded at this weight/BMI. Ah well... I have loose skin, without a doubt. But my BMI was 42 when I started. With your BMI at around 30 right now, I kind of doubt you'll have much loose skin to worry about. That depends on a lot of things, of course, like your age, your skin's elasticity, and your body composition, how you carry your weight etc. There isn't much you can do about loose skin; either you have a lot of elasticity and it will rebound, or you don't and it won't. You do get a little more of it with rapid weight loss, but that is less with banding than with the faster-loss surgeries. But I would hesitate about pursuing lap band surgery at that weight. Assuming you can find someone who is willing to band you (my surgeon doesn't for a BMI less than 35, even self pay), I don't know that it would be worth it. Bariatric surgery is considered successful when the patient loses 60% of her excess weight. You really only have about 30 lbs of excess weight (you want to lose 40, but that gets you to about a BMI of 23, which is beyond your excess weight), so if the surgery worked for you as it does for people who are morbidly obese, you may only lose 20 lbs or less. Would it be worth it to have surgery for that? Also, for the morbidly obese, the weight loss really works because it enables the person to eat far fewer calories than they are currently eating. When we get closer to goal, our bodies don't burn as many calories, so our calorie restriction no longer causes such a big deficit of calories, and the weight loss slows down dramatically. At your size, your basal metabolic rate isn't as high as it would be at a BMI of 40 or 45. The calorie restriction caused by a lap band at an optimal restriction level might not be significantly more than it would be if you went on a mildly restrictive diet. I guess what I'm saying is I'm not sure it will work for someone with so little weight to lose. The person to ask, of course, is a band surgeon. You usually can't make an appointment with one without going to a seminar first, and you'll get some funny looks from the other participants since your weight looks more like an "after" than a "before" to most of us. I have heard of people your size being banded pretty easily in Mexico, though.

Believe me, I understand the panic and frustration of feeling helpless to control gaining weight. And I also understand that diets are almost impossible to make work, especially long term. I get why anyone would love to take advantage of the appetite suppression and satisfaction with small meals. But with any surgery the risks must be outweighed by the benefits, and most band surgeons say that the risks of surgery are too great for someone who is not morbidly obese. (And I know that BMI doesn't even come close to telling the whole story. But it is a good ballpark to work with.) I am your weight now, and I am losing just a pound or two a month right now. I'm at a good restriction level, I eat according to the rules, I exercise a lot. But my body isn't using a lot of calories now, so even though I'm not taking in that many calories, it just doesn't create enough deficit to lose weight like I did before. Starting out at that point, I don't know if you'd do better or not. But I think there is a "lightweights" forum on LBT, or something for lower BMI bandsters. They would be able to give you an idea of how successful you can expect to be. Personally, I wouldn't have surgery at that point. But that's my choice.

Perhaps some of the other bandster readers would "weigh in" on this topic?


Blair said...

Thanks Gwen for taking the time to thoughtfully and thorougly respond to my previous post. I appreciate your advice and opinion.

Here's a bit more about myself. I hope it provides insight as to why I've chosen lap band as my last resort. I have gained a significant amount of weight in the past few years. I went from 135 lbs to about 175 in about 2 years. This pattern of rapid weight gain has happened to me frequently over the past 10 years, in 2 year cycles. In order for me to lose the weight in the past, I have had to go through DRASTIC measures including extreme caloric restriction (e.g. 700-800 calories a day) and running 5 miles a day, 4-5 times a week. This has taken a huge toll on my body. And exercising at the current weight has exacerbated the destruction I've done to my back and knees as a result of all that running. Because of my desire to lose weight, I have been working out (albeit in much pain) for the past 7 months. However, despite KILLING myself at the gym, I've lost at most 3 lbs (and gained them right back plus more when I've stopped). It is so frustrating when you aren't seeing the fruits of your labor.

I recently had tests done and the doctor confirmed that I have unusual hormone levels (much like a P-Cos sufferer without actually being one). Because of this factor, it is very difficult for me to lose weight despite all the exercise and relatively "normal" eating habits (e.g. I eat about 1800 calories a day, 3 meals a day, NEVER eat fastfood, do not like sweets at all, no soda, no late-night eating, no emotional eating, etc.). As a result of this imbalance, I carry all of my weight in my stomach and upper body area-- which is quite unhealthy for my heart, breathing, and sleep-apnea issues. My triglyceride levels are also very, very high.

I realize that I don't presently have a BMI of 35. But at the rate that I am gaining, I will get there and beyond. I am also likely to develop Type II diabetes as my most recent blood-work has shown (high glucose levels and a genetic predisposition for it). I would rather not have to wait a few more years before I get to that point. It's why I've chosen to be proactive and "preemptively strike."

Again, caloric restriction has worked quite well for me in the past, and in that sense, I feel that the band is good for someone with symptoms such as mine. Because I have only had success with caloric restriction AND exercise, I feel that the band facilitates both of these objectives. It limits my appetite and calorie intake and as the weight drops, it helps me get back to the gym without having to endure painful workouts because of the excess weight. You might be wondering why I don't just see a nutritionist to work out an eating plan. I have met with a nutritionist in the past, but it hasn't solved the problem of the irritability and all-around terribleness I feel when I eat less than 1000 calories a day. And despite meeting with nutritionists, I have managed to gain the weight right back in incremental periods of time.

I also think I'm a good candidate for the band, b/c I'm not someone who'd cheat with it. I, for the most part, already have relatively good eating habits. The one thing I have struggled with is carbohydrates (e.g. breads/pastas)-- which is incredibly bad for someone with hormonal imbalances (since it is a contributing factor to truncular obesity). The band is a good deterrent for eating an unnecessary amount of these foods.

I realize that the band is a very drastic procedure. I've been considering this surgery for quite some time now and my recent diagnosis and bloodwork pushed me to make that final decision. Because calorie restriction has worked for me in the past, I am confident that the band will aid me in this endeavor. In the past, while limiting my calories, I've been irritable and a complete terror. I know that even with the band, I will experience hunger but I believe that that hunger will be considerably alleviated than the hunger I'd feel without the band. I also don't suffer currently from emotional eating so I'd have no problem differentiating real hunger from head hunger while banded.

Now back to my original post.... because I carry so much of my weight in my upper body (e.g. stomach, shoulders, upper arms, chin, neck, etc.) I am worried what will happen to me if I lose the excess 40+ lbs... I'm in my mid-twenties and in previous years, my skin has "bounced" back. But my stomach is currently HUGE (I look like I could be 7 months pregnant) and this is the area I am mainly concerned with... However, I'd still rather be at a healthy weight with excess skin than stay at my current weight without excess skin.

Any advice now that you've heard my spiel =) Thanks again.

Gwen said...

Blair, I understand the idea of the "preemptive strike" and wanting to nip an obesity problem in the bud. I hope it works for you. Do you have a surgeon who will do your surgery?

You are less likely to have loose skin problems than people who have more weight to lose. It's impossible to predict how you will do, though. Like I said, I have loose skin, but not as bad as most people. I will probably have a tummy tuck one day, but it's not urgent. But I'm about 10 years older than you, so yours is likely to do even better.

Good luck to you.