I just had my four year check up with my weight loss surgeon and the nutritionist at USC.
Still working on balancing my supplements to deal with a downward trend in my iron, as well as caclium and vitamin D absorption. Am making some adjustments and will re-check these labs in three months.
The nutritionist had some good advice for me. At four years out, maintaining my weight loss depends on me. I knew this already. I have gained 5 lb since my three year check up. I knew I was up, but actually thought it was more. I tend to bounce around a 10 lb range. Not something I am happy about, but I know if I was not watching it and mindful of it, it could be a great deal higher, and instead of bouncing I could just be going higher.
We talked about stress eating. Talked about knowing when you have had enough versus overeating (she says if you are not hungry after 3-4 hours, but can go five hours until your next meal, you ate too much at the previous meal). I found that interesting, and will watch from that view. We talked about going too long to eat, blood sugar crashes, etc. Talked about planning. Talked about balancing, i.e. if you eat something higher in fat or calories, balance out the rest of the day by making lower fat/calorie choices (of course). The basics include protein, then fruits and vegetables, then plain carbs. I knew this already, but it is always good to have a refresher. She also wants me to up my cardio, to shoot for 45 minutes per day, rather than a shorter time with interval training. I will switch over to this, although I may just die of boredom! Whatever works.