I'm tired of being hungry all the time because of portion control. If I wanted to feel comfortable all the time AND hit 2k calories, I'd basically have to eat salad all day, every day. That is just not realistic.
I went to my doctor last month to discuss WLS. I know my stomach has been stretched; it's obvious by how much of ANY food it takes to get me comfortable, not full.
I tried talking to her, but she just would not listen. She kept talking to me about proper diet and exercise and how it will boost my metabolism. I explained that I knew. It's not that I'm stupid. I'm fairly well educated on this matter because I've done my research; I don't exactly like this life.
I know how exercise and proper diet work, and I've been successful but I get tired of being hungry and give up and go back to eating well, but eating 'too much' because I'm always hungry. Proper diet and exercise will not make my stomach shrink.
She would not listen. I've never, up to that point at least, left my doctor (I've had her for a year, but I'm saying this as a whole- every doctor I've ever had) feeling so ignored and simply not cared about. I was crushed.
I go back in two weeks and I need advice on how to get her to listen. Am I not saying something that I should be saying to grab her attention? I'm just beside myself in frustration and now anger towards her for not listening and considering my requests for a referral for possible WLS. At this point in my life, I feel like it's my last chance at getting where I need to be.

So please.. Share with me what you can. Thanks all.

If your doctor is opposed to wls, and you're sure it's what you want, you may need to find a different doctor.

That being said, I would suggest you try a couple things first, because they're working for me like nothing else has in 40 years of dieting. I've been morbidly obese since grade school and have never lost more than 70 lbs (and I only did that on prescription diet pills). Dieting was always pure torture (even on diet pills).

Now, I'm losing weight so comfortably that it doesn't feel like work at all (though I have been deliberately losing slowly, because I am willing to sacrifice speed for comfort).

I had to rule out wls, because I have health issues that would put me at EXTREME risk, so after reasearching it, I ended up having to find a different way (and am glad I did, not only because they're working, but because I think wls wouldn't have been effective for me unless I learned the same strategies anyway).

I had reallly thought wls was my only hope, so when I was told I wasn't a good candidate for wls, I didn't think I had any alternative. I thought I'd either have to risk death or have to accept super morbid obesity.

I thought my situation was hopeless. I had tried everything (or thought I had), but it turned out I hadn't tried everything. (While I'd tried very low-carb and had always gotten ill from it, I hadn't tried moderately low-carb until my doctor suggested I tried low-carb but warned me not to go to low - so I had to experiment to find the carb and calorie level best for me - and it's changed along the way, so I have to keep experimenting).

In many ways I had to learn to to diet "backwards." That is, I had to make changes very gradually (most diets have you make extreme changes and somehow you're supposed to adapt to them). For me this was especially vital, because any sudden change in diet or exercise woulde aggravate my health issues. One day of overdoing it could land me in bed for a week.

I WAS able to shrink my stomach significantly by following a plan I read about in Prevention or Reader's Digest magazine. Instead of regular sized meals, you never eat more than 1 cup of food at a time and you space out the food as much as you're able (at first I couldn't even wait a whole hour to have some more food).

I used to think that a frozen dinner was a ridiculously tiny serving (I could have eaten four), and now they're just about perfect. Now I eat and am comfortable with much smaller portions, even when I go to buffets (which I now prefer and do well on - as long as I'm eating few carbs).

Reducing carbs also helped TREMENDOUSLY. I can't even begin to describe what a difference. I use a low-carb exchange plan and love it (when I started my calorie total was probably around 2500 calories or more - now I use about 1800). I've tweaked the plan over the course of my weight loss - experimenting with different carb and calorie levels.

Most of my life, I've been uncomfortably hungry 24/7. Even after I was stuffed from eating to the point of feeling about to hurl, I would still feel "starved," and compelled to eat and eat and eat. Low-carb radically changed my life. On very low-carb I'm never hungry - but tend to get headaches and other very unpleasant symptoms. Finding the carb level and calorie level that controls hunger without causing other issues has been a bit of a balancing act, but well worth it.


My exercise at first consisted of getting up during commercials and doing some dishes. Then I used a cheap step-counting pedometer (clipped to my shoes so I wouldn't lose it or let it go through the wash) and my daily goal was to beat the prior day's step count (even if only by a step or two).

As I could do more, I added more.

Even if you still want to pursue wls, the process often takes a year or more (Sometimes a lot more than ayear), because insurance companies make you jump through a lot of hoops - and even if you can pay for it out-of-pocket, most wls surgeons also make you jump through a lot of hoops, including months of counseling), so some of these techniques might help you lose some weight during the waiting process.

Some people thing that they'll be made ineligible for wls if they lose any weight before the surgery - but this generally isn't true. The wls surgeons actually like to see that you can commit to and succeed at weight loss (some even require it, which doesn't seem to make sense, I mean if you could lose weight without the surgery, why would you want the surgery - but the doctors aren't necessarily looking for long-term success, just the ability to stick with a plan for weeks/months).

Good luck, and I hope some of what I've said helps.

Hi Princess Squish

I'm three weeks post-op (MGB). My life has changed tremendously as a result of having WLS.

To be fair, I did every diet known to man - Atkins, South Beach, the portion control trick. I'm a former professional-level ballet dancer - I know how to diet and exercise. I could lose weight - for a time. While being completely miserable and hating myself.

Here's the problem, for me: I was *always* hungry. In order to feel comfy, I had to eat far more than was necessary. I tried eating a cup of food and no more - for many people, that works great. For me, it was torturous. So, sick with sleep apnea, severe hypertension and severe asthma that killed my exercise tolerance, I sought out WLS.

What I did was go backwards. I found my surgeon first. THEN I went to my primary doc with a letter explaining my choice.

I did not ask permission. I did not ask for a referral to a surgeon, since I already had my surgeon. I said, "I plan to have this procedure on this date. What I need from you is a letter to my surgeon in which you agree to care for my primary medical needs after surgery, and my surgeon will attend to my needs related to this surgery. Also, I need you to order the following: labs, EKG, PFT, etc. This will get me healthy and well, and I know you want me to be healthy and well - and if you don't, I will find a doctor who supports my decision." DONE.

My doctor got right on it - but if he hadn't, I would have called around and asked doctors whether they supported my right to weight loss surgery. I was willing to go up to 200 miles.

I'm not a very assertive person. To be honest, I was nervous going in to my doc. But you know what? I told the office staff and his nurse that I was having surgery, and I needed their help to make sure I got all my paperwork in order, and they were fantastic. My doctor probably would have given me the "let's diet AGAIN" song and dance had I not put it in writing and repeated it verbally. I made a special appointment specifically to explain my decision, what my surgery would do (mine involves a vertical pouch plus a six-foot bypass), and what I expected from surgery. It worked.

Try being assertive. You have a right and a choice in your medical care. You are the patient, not the doormat. You have a right to seek treatment, and a right to refuse treatment from anyone who does not feel supportive to you. Find your surgeon and your procedure first - THEN go see your doctor.

From my first surgical consult to my surgery was less than two months. I got it done, including the psych evaluation. It does not always take a year or more. Even if you are relying on insurance, it doesn't have to take a year.

Julie

Salads all day long would make me starving. I eat lots of protein, limit my carbs and am never starving.
Can you post a sample menu? usually when people say their meals are leaving them hungry, there are a lot of simple carbs, "diet" foods and very little fat or protein.

Two things (and both have already been mentioned by others,so I'm just reinforcing, really):

First, if your doctor does not support your decision, find another doctor. Your doctor works for you. If they are not performing as you need, fire them and hire someone else. Some doctors are quite simply against WLS for one reason or another (just like the rest of us, doctors are human and have their own biases). Of course, this is all assuming you are using your health insurance and it requires a referral to a bariatric surgeon. If not, then just skip your doctor completely. There are also things you can do for free without your doc. I started by doing as much research as I could online about WLS until I selected the procedure I wanted. Not all surgeons offer all procedures, so once I picked my procedure, I sought out highly-qualified surgeons in THAT procedure. I attended their free WLS seminars (often required before you can schedule a consultation anyway) and started seeing my doctor once a month for weight loss (my insurance required a documented 6 months of medically supervised dieting before they would approve WLS). I also took the time to dig into my insurance coverage to see what exactly would/would not be covered (not all insurances cover WLS, some that do only cover certain procedures, and almost all that do have pre-qualification requirements, such as the 6-month diet).

Second, have you tried a low-carb diet? By that, I mean STOP counting calories and just eat low in carbs without restricting your fat intake (fat is NOT the enemy it has been made out to be!). When I eat low in carbs, I can eat more calories and still maintain or lose weight; when I add carbs back in, I have to further restrict my calories. Unfortunately, despite what most doctors and dieticians will tell you, it's really NOT only about "calories in vs. calories out" and all calories are NOT created equal. 2000 calories worth of eggs or cheese in a day will yield far different results compared to 2000 calories worth of candy bars or bread (obviously both extreme examples, but you get the idea), and I don't just mean regarding overall health, but rather specifically regarding weight gain/loss even though both would provide 2000 calories.

After surgery, many surgeons require a pretty low-carb diet anyway. But the difference is that the appetite is so diminished by surgery, it's not the same struggle, at least not for awhile. For several months to a year, you get time to work through your head issues (WHY you eat) because your new body simply will not allow overeating without very painful consequences.

There is a learning curve with surgery. You will learn about ghrelin and what it does to appetite and cravings and why only surgery can correct your levels. You will learn about dumping syndrome and what can cause it, if you have a bypass. You will learn what your surgeon wants you to eat, which may or may not be low-carb, and what works for your new body. You will also learn that surgery hurts a lot, that you will miss some foods, and that you will not miss others.

Weight loss surgery is only a tool, but it is a valid, viable tool. It's not the easy way out, but it has changed my life already. Now, I can control what I eat.

Preop, I got SO sick of people telling me "just do it like I'm doing it, because what I am doing is working." If one more person had told me to go low-carb and control my portions I might have gotten rather rude. They acted like I hadn't tried those things many, many times. What made them think this time would work when none of the other times had?

Fact is, any altered eating pattern - low carb, small portions, nothing but salad, whatever - will work for a while. For a lucky few with enough awesomeness and willpower, it works for a long time. I was not one of those awesome, willpower-laden people. Those things always stopped working for me after awhile. And when they did, I felt like a failure. I hated myself. ****, I'm still afraid I will fail at surgery. And you know what? I just refuse to feel bad about that.

Surgery is not right for everyone. It was right for me. If you decide it's right for you, then I for one am here to support you through your process.

ETA: Jill, I just saw your post above mine. I am so not ranting at you

I have literally tried every diet out there. You name it, I've tried it- most likely anyway.
Seagirl-- I didn't say I ate salads all day. Just to clarify.
Imp- I feel like you described. Everybody has told me 'how to do it'. I've done it. I know that nothing has worked for me. I'm not going to take pills of any sort that will mess with my appetite/etc.
Kaplods-- I swear up and down, I tried the various carb monitoring type diets.
It's not that diets don't work. They do, but I take a lot of food to feel COMFORTABLE... not even full, and that's NOT healthy or normal.
Jill- With my insurance I have to go to my physician first. I HAVE, however, picked the method I want, the team of surgeons I want to go through, and I've already gone through the seminar. I have the application, but I cannot turn it in until my physician signs off and does what she needs to do. That's where I'm stuck.
I've got multiple records through my doctor of attempting weight loss, and even then the scale went up and down. I honestly don't see how I can be denied- but with insurance, ya' never know.

Here's what I had yesterday:

Breakfast: Ham and cheese egg scramble with 1 piece of lightly buttered toast
Mid Morning: Turkey sausage quesadilla
Lunch:Chicken Fresco burrito and a soft fresco steak taco
Mid Afternoon: 2 (there's 2 in one package) PB granola bars
Dinner: 5oz beef carne, 1 cup fruit and 1 cup veggies
Evening: Pomegranate and blueberry smoothie.
Later I had a Weight Watchers ice cream candy bar.


My total calories came in at 1660

Wow!!! you guys don't need me! wait. I DO have one more thing to add. One of the main reasons I had surgery was not to lose the weight. it was to give myself the best chance to KEEP IT OFF. and THIS might be an important point to raise with your doc.

over the years, i'd gained and lost somewhere north of 500 pounds, but keeping it off was nearly impossible. So, I knew that i would somehow or other be able to lose the weight, even if it meant a year on something like Medifast. BUT i knew I couldn't live with the eventual regain. My health was so poor that it probably would have killed me.

So, as you're looking at your options, studying the various surgery choices, finding the right combination of surgeon and medical doctor, think about how you're willing to live for the rest of your life. Gastric bypass is the gold standard, but some people can't manage the dumping syndrome and vomiting [from eating unwisely]. Some folks get bad gas from duodenal switch [Jilly does NOT], but great results with diabetes control. Others love their bands, but some people have slippages and other complications, and still others don't like seeing their surgeons for fills and other adjustments.

vertical gastrectomy is a possibility, but it's not commonly used [getting more common, though], and conventional wisdom has it that it's not good for REALLY massive weight loss [i'm not so sure - i've read of successful massive weight loss]. Gastric pacing is in clinical trials [we have a thread here with people from that trial].

soooo, there's a lot to think about, and a lot to discuss. No matter what you decide, take enough time to decide that it's right for you.

we posted at about the same time. So, tell me about that pomegranate and blueberry smoothie. what's in it? sounds divine!!!!!!

Then it's time to go to a different doctor. You can have your medical records transferred, so you won't lose any of your weight or dieting history.
And "ya never know" is right. If your insurance requires 6 months of supervised diet, they may require that you be seen by the doc EVERY month for 6 months. If you missed one appointment, you'd have to start over. If you went every other month for a year, that wouldn't count. You have to really dig into your insurance requirements very specifically - they can get ridiculously picky because they don't want to fork over the thousands of $$ for surgery (though some insurance companies are easier to deal with than others). Your surgeon's office should also have an insurance coordinator who may be able to assist you once you have had your consultation.
No worries - I only mentioned the low-carb dieting because she specifically complained about portion control and calorie restriction. With low-carbing, I didn't have to focus on either of those things (with the exception of portion control for things that had carbs, like some nuts that I could easily go overboard with!).

I also thought I had read something about the OP being uncertain about WLS, but I must be remembering something from another thread because I just scrolled through and don't see that here

But was this a satisfying day for you, or did you still feel hungry? I'm assuming the latter, in which case this would not be a god typical menu for you.

Of course, my first reaction would be to say ditch the toast, ditch the tortillas and taco shells (or seek out lower-carb tortillas), ditch the granola bars, ditch the smoothie, ditch the ice cream, and ditch most of the fruit (and I'm not familiar with beef carne, but if it includes any type of starchy veggies or grains, ditch those, too). Replace with things like eggs, cheeses, meats, maybe some nuts, and exchange the low-fat/low-cal ice cream treat for something like a no-sugar-added fudgesicle or other low-carb treat.

I was thinking the same thing. My diet is very heavy on meat, cheese, avocados - lots of fat and protein and still staying around 1500-1700 per day. Things like granola bars, too much fruit, ice cream - all that sugar is going to cause blood sugar crashes and make you feel hungrier.

Also, have you been checked to make sure you don't have an ulcer or heartburn that is making you feel hungry when really it is stomach acid acting up?

Also, I have often found that just sitting quietly with myself saying "you have given your body enough fuel for the day. This feeling is uncomfortable but it will not hurt me" is a good way to get past the "must keep eating" feeling. And having some tea or going for a walk too.

Lordy, was this was true for me as well. I didn't feel comfortable unless I ate huge amounts of food (when I went to a buffet, which I did about three to five times a week, I'd fill my plate until no more food could fit on it without rolling off, and even so, it would take three plates of food for me to feel full - two and a half just to feel barely satisfied).

Shrinking my stomach myself was a really hard and slow process. I just didn't have a choice because wls wasn't an option (it might be in the future, and if so, I'll have to decide whether I want or need to at that time).

I'm not anti wls, because I would have chosen it for myself if the risks weren't so high in my case. WLS may be your best option, it's just not your only option, if for some reason it becomes unavailable to you. Do your research, find another doctor if you need to, though most doctors are probably going to suggest the diet/exercise route before they recommend surgery - and they're probably going to want (and need for insurance purposes) proof of failed diet and exercise (sometimes the companies are very specific and they essentially demand WW because you have "proof" of attempted compliance in your meeting/weight book).

Sadly the wls "hoops" to jump through are insane. A lot of what I'm currently doing, I started as part of the hoop jumping process just in case my risk profile would improve, so that if it did I wouldn't have to start the hoop-jumping fresh. For example, I joined TOPS to document my attempts at weight loss (taking off pounds sensibly, it's sort of like a more budget-friendly Weight Watchers except you can follow any plan you wish, and there are contests, challenges and other incentives that can reduce the cost of membership to almost nothing).

If my risk profile improved and I could have the surgery today, my TOPS membership probably would satisfy the condition of proof of attempt (and while I've lost 105 lbs, it's taken me 7 years to do it - I would hope that's proof that I've made a good-faith effort and can stick with a wls regime, but also prove that weight loss wasn't easy or simple for me).

Ironically, what I started as preparation for wls, has given me the confidence to believe that I can do this with or without wls (I may still end up choosing wls, so I'm not going to criticise that choice).

I just wanted to share some options in case wls doesn't work out for you, or if you have to postpone it for some reason.

Hi there - I know you've "tried every diet out there" and I had felt the same way when I first tried to lose. Granted I didn't have as much to lose but I swear I was hungry all the time and felt like I had no control, which is what I told my Dr.. And she couldn't do anything about that except tell me what my ideal weight should be (thanks a lot!).

The only thing that worked (and still is working) is to eat low carb and very low sugar as Kaplods said. That means avoiding breads, tortillas, taco shells, cereals, ice cream, yogurt, shakes and the like and especially substituting sugar and fake sugar with Stevia. I also avoid milk and most fruit except for berries (lactose and fructose are also sugars). It goes without saying that I don't drink pop or fast food.

I tried it and after about 2 - 3 days....The cravings went away. They really did. I still get hungry only when my body needs to eat but I'm not hungry all the time and I can easily resist huge portions and even snacks easily.

I get almost all of my carbs from veggies and enjoy all kinds of lean proteins: beef, chicken, fish, beans, eggs, tuna, shrimp, etc. Also can eat healthy oils and full-fat salad dressings (they often have lower carb and sugar than diet). Am getting lots of compliments and people always ask what I did (like there's a magic pill they're missing) and I tell them cut out sugar and simple carbs. Another benefit is that your midsection (stomach area) will flatten over time. :-)

I try to keep sugar to 6 grams per day, carbs to about 150 (six servings of up to 25 Grams each serving.)

I'm sharing with you because this really works on hunger cravings and you sound so desperate you want to have surgery. Good luck!