There are several of us here that are a year or more post op. Some have reached their goal. Some are still working their way. Feel free to post away with specifics and I'm sure someone will respond.
Cindy
1 year post op
-127

Hi Stimpy!

I think it would be fair to say that much of my activity in this group the past 3-4 months has been focused on this very topic.

One of the things I began to notice early on in my participation here was the number of people who struggle with maintaining their weight loss over the long term 1,2, 5 years down the road. I began to realize that I was not immune from the very same forces that my peers here - people much further along in the journey than I was - experienced. Forces that seek to sabotage our hard work as we move forward. I'm just 7 months out - and I'm greatly appreciating the participation here by those much further along who are recognizing and working to find ways to deal with these long term issues

Put in the simplest terms possible, we know that long term success of weight loss surgery depends upon the very same things that any non-surgical weight management program does - a permanent, sustainable change to the way we live - the basic components of that change include balanced, healthy nutrituion in proper amounts and daily exercise. In short, we must "follow the whole program", today, tomorrow and for the rest of our lives.

As weight loss surgery patients, we all know this (or at least we should). But that makes the task sound so much simpler and easy than it actually is. I have said many times here that the devil is between the knowing and the doing.

Why is this so?

That question has many answers, but at its root lie the factors that contributed to our obesity in the first place. Yes, we are obese, but WHY are we obese? Saying "because we eat too much" doesn't really give us any useful information. Far too often, obesity is dismissed as 'laziness', 'stupidity' or 'lack of moral character'. Worse, we often come to believe these things about ourselves - and that just reinforces the cycle of obesity.

For a few lucky people, the answer really is just as simple "follow the whole program", now and foverever. If this approach works for someone, then there is probably no need that person to dig deeper. Go with what works.

But in those instance where long term weight is more problematic, it's useful to remember that obesity never exists in a vacuum. We tend to call obesity a 'disease' but there are times when it may be more useful to view obesity as merely a symptom of something else - often several something elses. For the weight loss surgery patient, these conributing factors rarely go away when the weight does. They often just sit on the sidelines for a bit and then rise up trying to sabotage all our hard work.

In such cases, significant time and effort - and professional assistance - may be required to try to identify what your individual 'contributing factors' are. And treating those issues may be critical to achieving the goal we all share here - long term weight management.

For example, in my own case, I have discovered - after my weight loss surgery - that I have lived for 52 years with undiagnosed ADHD. The more I learned, the clearer it was that undiagnosed and untreated ADHD was major contributing factor in my own obesity. It is now beginning to be recognized by professionals that undiagnosed and untreated ADHD is much more prevalent among obese people than in the general population - perhaps as high as 25-30%, particularly in women.

Diagnosis and treatment of my ADHD has been an overwhelmingly positive experience and has significant positive implications for my ability to manage my weight and achieve long term success with my weight loss surgery.

If you are interested, I have written extensively about my own experience here:

http://tinyurl.com/gbs-adhd

Some info on rates of ADHD among obese people is posted here:

http://tinyurl.com/gbs-adhd-02

There are several other people here who also share an interest in the general topic of long term weight maintenance. Bari, for example, has posted extensively on the many issues involved here. Bari is pre-surgery but looking at these issues with all the seriousnes sit deserves. There are many people here 1,2, 5 or more years out who are sharing what works for them as well.

Thanks Jerry: Yes, interesting. God, food is for me like a hard-core heroin addict. If I don't have at LEAST 2,300 calories a day, I feel crappy. Almost like I am going to lose my mind. I am 54, was diagnosed with bi-polar, 15 years ago. Whatever that means. My first husband always said I had ADHD, like he would tell me to do something, and I would always get sidetracked with something else. Is that what ADHD is? I thought it was the ability not to concentrate and follow through. And I always thought ADHD people were thin because they were always "hyper". My feelings are "simple" , I am hungry, if I don't eat enough calories, I don't feel good, lethargic, pissy, catty, mean, hateful, agitated. If I eat enough calories I am o.k. I have taken every anti-depressent known to man, and not one of them makes a difference with my appetite. Now, if I had the old fashion diet pills of the early 80's, and I exercised, I could maintain my weight, but it would still be hard. It is unreal. Maybe if I went into psychotherapy and hypnosis it would help. I will go to your link and read about ADHD. I mean I can follow through with tasks, I can read a book. I read directions and can follow them. But yeah, sometimes my mind has like 10 things going on that I am trying to focus on and complete. Anyways thanks for your reply. I wish there was a spiritual group or twelve step support group for people trying to maintain their weight. Thxs - Stimpy

Stimpy,

First, I cannot diagnose ADHD in anyone else - this can only be done by a professional, one who is both knowledgable and CURRENT in the field. What I can tell you in a nutshell is this:

- ADHD in adults has only been recognized for 15 years
- ADHD is complex, no single trait conclusively proves ADHD
- ADHD is expressed differently from person to person
- No one has all the traits
- 85% of adults with ADHD are undiagnosed and untreated
- ADHD and bipolar are often mistaken for each other by professionals
- Many professionals are not current, especially with respect to ADHD in adults
- ADHD goes undiagnosed most often when the person has the "primarily inattentive" type, which is characterized primarily by distraction rather than hyperactivity.
- More women than men have the "inattentive type"
- ADHD begins in childhood, although with "inattentive type", it may not be recognized.
- Treatment for ADHD is HIGHLY effective for most people
- Contrary to popular belief, the drugs used to treat ADHD are both safe and effective over the long term
- The best treatment for ADHD is a combination of meds + education + exercise + good diet + working WITH your ADHD rather than against it (i.e multi-modal)
- Surprisingly perhaps, there is HUGE upside to ADHD If you learn how to work with it, you can leverage certain aspects (like hyperfocus) to your advantage.

If you suspect that you have ADHD, you should first locate a professional known to be knowleable and CURRENT in the field of ADHD in adults - this step is critically important. It is an unfortunate fact that many professionals are not so well informed. Finding the right professional is essential. You are looking for someone who is currently managing ADHD treatment for several adults using a multimodal approach (i.e. meds + other stuff as above). Avoid anyone who does not fit this description.

Seek a professional evaluation from this person. Should it be determined by that you have ADHD, know this: It has the potential to be one of the most significant and incredibly positive experiences in your life.

It took me 5-6 months to go from 1st suggestion of ADHD to learning more to seeking evaluation and treatment. I was rather resistent to notion at at first. I had MANY MANY misconceptions about what ADHD is and is not. Turns out most people do.

But the 'coincidences' keep piling up and the more I learned, the more I began to see the connections in my life. How the ADHD was connected not just to my obesity and my eventual decision to have weight loss surgery, but to so very much more.

Wow, 2,300 calories a day is pretty hardcore... I'm 14 months out now, and wish I knew exactly what to tell ya about coping with that, except to say its gotta be something you have to work on mentally. Because for me, I get maybe 900-1100 calories a day at this point. I honestly couldn't get in 2,300 even if I tried.

And just so you know, I suffer from major depression, anxiety disorder, and panic attacks. I've had to stop my antidepressants because I was experiencing absorbsion issues that I couldn't overcome. So although I'm unmedicated, I've found other ways to cope. I do have bad days, but more good days now.

I suggest nutritional and mental counsiling. As I can only give little tips and tricks about eating right, but it sounds like you need much more support as you may be describing an eating disorder here.

I really do wish you the best and hope you find the help you need.

Thanks Callie, but yeah, me too, at 1400 months out I could easily get by on 1,000 calories, but now at 3 years out it is just not cutting it. I have to figure something out. I have to get radical.