Ruthiep
New Member
This is the bariatric surgeon who has written a book called: "Successful Weight Loss with the Gastric Sleeve" ***
www.TheGastricSleeve.com
I bought it for my Kindle and read it and had various issues with it. He (the author himself) had been very helpful to me in getting it downloaded, and was extremely approachable when I emailed him with my issues. Our conversation by email follows; it might be useful for others.
me: From what I am hearing and seeing on various forums, many of my WLS buddies are having problems getting enough calories in on a daily basis to avoid their bodies going into starvation mode and weightloss stalling as a result. I know I probably don't get in as much as 800 calories a day. And yet you are constantly advocating calorie restriction, even at a early stage, when surely the body needs to heal. You say to avoid all cereals. My bariatric dietitian deliberately pushed me to have a wholegrain cereal breakfast, and another bowl of wholegrain cereal or porridge if I was hungry . It was also recommended to me to eat a small amount of nuts as a snack as these are a good source of protein, but you seem to be pushing your reader to avoid anything high calorie including nuts. I would have thought post bariatric surgery is not a time for a very low calorie intake, and for bulking out our intake with low calorie foods such as produce. This is surely for when we had normal sized stomachs and had to fill them with *something* that wouldn't add weight. indeed I have heard from many patients who deliberately eat high fat protein, in other words are basically on an Atkins type diet of little or no carbs and as much high fat food as they want. I have never been comfortable with that, but many others have said, this surgery has meant an end to dieting, they just eat small healthy meals as you say concentrating on protein all the time, but not focussing so much on low calorie foods.
What do you think?
Hi Ruthie. Thanks for touching base. I'm sorry I couldn't answer yesterday since I was traveling. Regarding your calorie intake, I totally understand your point but you also have to remember that you have a time frame to get the most out of your sleeve. That "golden year" is important. So if you don't have to lose to much, yes you can go as your dietician says without a problem and get to goal. If your BMI is higher then you will have to watch out what you eat and try to restrict calories just a bit more. I hope this makes sense?
regards,
Dr. Alvarez
me: I've been thinking about this issue whilst waiting for your response. Is it possible that you are aiming your book at the super morbidly obese (over 300lbs) Americans who cannot sensibly control their eating even after a sleeve, and are likely to be the ones to purée candy bars and cream cakes in order to get their fix of high fat high sugar foods? We Brits are definitely heading in the same direction; there are more and more morbidly obese people here every year but we're still not quite at the US level yet. Personally I started out at less than 200lbs (BMI 37.8 ) so I've never been quite that addicted to food as the 400lbs plus types might be. I now (almost 12 weeks post op) am down to 161lbs (BMI just over 30) so have lost 50% plus of my excess body weight already. I guess with the American super morbidly obese, you can't afford to give them any wiggle room or they'll go crazy eating too much of the high fat foods?
Also you say to avoid yogurts, milk, etc. Why? These foods are staples in the liquid protein stakes, and can often be tolerated when very little else can.
Ruthie
Hi Ruthie. Yes you are correct. A patient with your BMI can eat pretty much anything and your sleeve will restrict you and will get you to goal. So I wouldn't worry there.
Dr. A.
PS. There is some sort of lactose intolerance in post-sleeve patients which explosive diarrhea, etc Especially in the initial stages. So that is why I mention that.
Me: Could I ask you one question. My surgeon is always going on about the dangers of stretching the pouch by eating even one mouthful past satiety. He has put the fear of God into me on that topic. Having seen a sleeve operation on TV, the stomach left looked on the screen like a wiggly little worm; it's very hard to imagine that stretching back to full size again. I have no intention of testing this out, and I presume the sleeved stomach does stretch to some extent post op, but if someone is really REALLY naughty, what percent of the original can the sleeved stomach be stretched back to?
Ruthie
If you are really naughty the stomach will stretch about 3% in the next 5 years. Never to the size it was.
I hope this helps.
Dr. A
There you go, peeps.
_________________
Ruthie xx
www.TheGastricSleeve.com
I bought it for my Kindle and read it and had various issues with it. He (the author himself) had been very helpful to me in getting it downloaded, and was extremely approachable when I emailed him with my issues. Our conversation by email follows; it might be useful for others.
me: From what I am hearing and seeing on various forums, many of my WLS buddies are having problems getting enough calories in on a daily basis to avoid their bodies going into starvation mode and weightloss stalling as a result. I know I probably don't get in as much as 800 calories a day. And yet you are constantly advocating calorie restriction, even at a early stage, when surely the body needs to heal. You say to avoid all cereals. My bariatric dietitian deliberately pushed me to have a wholegrain cereal breakfast, and another bowl of wholegrain cereal or porridge if I was hungry . It was also recommended to me to eat a small amount of nuts as a snack as these are a good source of protein, but you seem to be pushing your reader to avoid anything high calorie including nuts. I would have thought post bariatric surgery is not a time for a very low calorie intake, and for bulking out our intake with low calorie foods such as produce. This is surely for when we had normal sized stomachs and had to fill them with *something* that wouldn't add weight. indeed I have heard from many patients who deliberately eat high fat protein, in other words are basically on an Atkins type diet of little or no carbs and as much high fat food as they want. I have never been comfortable with that, but many others have said, this surgery has meant an end to dieting, they just eat small healthy meals as you say concentrating on protein all the time, but not focussing so much on low calorie foods.
What do you think?
Hi Ruthie. Thanks for touching base. I'm sorry I couldn't answer yesterday since I was traveling. Regarding your calorie intake, I totally understand your point but you also have to remember that you have a time frame to get the most out of your sleeve. That "golden year" is important. So if you don't have to lose to much, yes you can go as your dietician says without a problem and get to goal. If your BMI is higher then you will have to watch out what you eat and try to restrict calories just a bit more. I hope this makes sense?
regards,
Dr. Alvarez
me: I've been thinking about this issue whilst waiting for your response. Is it possible that you are aiming your book at the super morbidly obese (over 300lbs) Americans who cannot sensibly control their eating even after a sleeve, and are likely to be the ones to purée candy bars and cream cakes in order to get their fix of high fat high sugar foods? We Brits are definitely heading in the same direction; there are more and more morbidly obese people here every year but we're still not quite at the US level yet. Personally I started out at less than 200lbs (BMI 37.8 ) so I've never been quite that addicted to food as the 400lbs plus types might be. I now (almost 12 weeks post op) am down to 161lbs (BMI just over 30) so have lost 50% plus of my excess body weight already. I guess with the American super morbidly obese, you can't afford to give them any wiggle room or they'll go crazy eating too much of the high fat foods?
Also you say to avoid yogurts, milk, etc. Why? These foods are staples in the liquid protein stakes, and can often be tolerated when very little else can.
Ruthie
Hi Ruthie. Yes you are correct. A patient with your BMI can eat pretty much anything and your sleeve will restrict you and will get you to goal. So I wouldn't worry there.
Dr. A.
PS. There is some sort of lactose intolerance in post-sleeve patients which explosive diarrhea, etc Especially in the initial stages. So that is why I mention that.
Me: Could I ask you one question. My surgeon is always going on about the dangers of stretching the pouch by eating even one mouthful past satiety. He has put the fear of God into me on that topic. Having seen a sleeve operation on TV, the stomach left looked on the screen like a wiggly little worm; it's very hard to imagine that stretching back to full size again. I have no intention of testing this out, and I presume the sleeved stomach does stretch to some extent post op, but if someone is really REALLY naughty, what percent of the original can the sleeved stomach be stretched back to?
Ruthie
If you are really naughty the stomach will stretch about 3% in the next 5 years. Never to the size it was.
I hope this helps.
Dr. A
There you go, peeps.
_________________
Ruthie xx
I have him as a fb friend. Thats some great advice there 
:8855: 
