22 years ago at age 47, weighing 271 lbs. at a height of 5'0",  I had an RNY gastric bypass, open surgery, with NO removal of any intestine, which means that every calorie I eat is still digested, and still counts. 

The doctor's recommendation for post-surgery eating was simple. "Eat three meals a day of whatever food you want, but make half of each meal protein; avoid fried foods and sweets; and have no carbonated beverages."

My surgery was done when the procedure was still considered experimental.  At the time, it was performed here in California by only a few doctors. To get surgery, people had to travel to San Diego, stay in the hospital 2 or 3 days, then stay at a local hotel for an additional 10 post-surgery days before being released to return back home.  Follow-up care was received once a month during the surgeon's visit to one of the nearby temporary clinics located in various cities throughout California.  About five years later,  surgeons all over California began setting up specialized practices for weight-loss surgery, and coordinated with nutritionists who made specific post-surgery diet recommendations like protein shakes etc. That happened several years before laser surgery became common.

The first year after surgery my body would tolerate very little food.  Eating more than one-quarter to one-half cup of food at a time made me feel uncomfortably stuffed like after Thanksgiving dinner.  

I frequently experienced Dumping syndrome, which is caused by food passing too quickly into the small intestine. This caused immediate symptoms of flushing, weakness, fatigue, dizziness, and an intense desire to lie down. Severe episodes include feelings of nausea, and even stomach cramps.

I experienced severe dumping symptoms after just a swallow or two of fruit juice; or one or two bites of fried-or-greasy food; or a bite or two of any sweet like cookies, cake, pie, candy. I also became lactose intolerant. Milk made me feel ill, and even the tiniest bit of ice cream, with it's combination of milk and sugar, immediately made me lie-down-with-dry-heaves-ill.

Therefore, due to my weight-loss surgery, that entire first year my food intake was somewhere between 200 to 600 calories a day, which caused my weight to drop from 271 down to 161 lbs .... without dieting. This happened while I ate however much I could, of whatever food my body would tolerate.  The reason I did not binge, cheat, or quit, even when my weight-loss was slower than I believed I deserved, was because it was physically impossible for me to do so. 

Most people think that weight loss after WLS always happens rapidly.  That immense amounts of weight fall off everyone's body every week, 5-10-15 pounds, week-after-week, like on the Biggest Loser tv show.. only maybe even faster. 

However, Real Life AFTER a Gastric Bypass Surgery, works just like Real Life BEFORE a Gastric Bypass Surgery.  Even though after a RNY surgery Everyone has a smaller stomach, and Everyone eats just a small amount, the rate of weight-loss continues to be an individual matter.  Some people's bodies simply drop weight faster than other people's bodies, and surgery doesn't change that fact. 

Below is a graph of my own individual weight-loss results. This is what happened to MY body during the 64 weeks after a RNY gastric bypass surgery.  ...

My New Year's resolution
was to lose 20 pounds by the end of 2014.

I only have 25 lbs to go.
 

 For the past 9 ½ years … every day … I have consistently logged all of my food intake into a food journal, using a computer software program. The use of this basic tool has been the foundation of my weight-loss and long term maintenance of that weight-loss.

Here's a recent post by Canadian obesity specialist, Dr. Yoni Freedhoff of WeightyMatters about the benefits of keeping a Food Diary.

"What if I told you that in just two minutes a day you can double your weight loss success? And, rest assured, those two minutes won’t be spent busting out painful sweat while a trainer yells at you, or over a hot stove cooking a gourmet vegan meal.

Instead, spend those two minutes keeping track of what you’re eating by tapping on a smartphone or scribbling in a journal. Studies have shown that the amount of weight you’re liable to lose in a weight-loss program will be double that if you undertook that same effort, but didn’t keep a food diary.

No, food diarizing isn’t exactly sexy, and no, it probably can’t be fairly described as a whole hoot of fun, but it sure is easy these days.

Back in 2004 when I started working with patients on weight management there were no smartphones and diaries were just that – paper diaries that required a person to not only jot down what they were eating, but also to spend real time flipping through other books that provided calorie listings.

Nowadays we’ve got it easy. There’s a wealth of apps that do all the heavy lifting for us and not having missed a day of food diarizing since May 7, 2011, I can tell you, two minutes a day might even be an exaggeration of the actual time and effort required in keeping one.

While food diaries don’t cause you to burn calories directly, they do play three crucial roles:

Firstly food diaries give you some sense of where you’re at. Thinking of calories as the currency of weight (or frankly whatever else you might want to track – points, carbs, etc.,) keeping a careful accounting of your spending will help you with their budgeting. It’s important here to note that it’s not about never spending your calories, but rather using your records to pick and choose which ones are truly worth it. Why waste your calories on foods you don’t adore?

Secondly food diaries become fabulous investigational tools. By tracking patterns of hunger, cravings or food intolerances, patterns can appear and then instead of focusing on trying to deal with the downstream problem of trying to will yourself away from the cookies, you can instead focus on those cookie craving’s upstream cause to nip them in the bud. Giving you an example from my life, I’ve learned that if I have a breakfast without at least 20 grams of protein I have much more difficulty with food cravings at night. By ensuring my breakfasts are well organized I don’t need to battle with my dietary demons at night.

There’s quite a lot of online information about weight-loss available. But almost nothing about long-term maintenance of that weight-loss. One could conclude that people who have successfully maintained a large weight-loss for 5 plus years simply lose interest in the process and move on to other interests.  However, this doesn’t appear to be the most likely conclusion.

 First, all available research indicates that less than 5% of all successful dieters actually maintain lost weight for two years after a large weight-loss.  If one chose to use the numbers of the National Weight Loss Registry (of which I am a member), this total number would be a fraction less than 1%.

Next, two years is not really an exceptionally long time.  When I see someone who reports success at weight-loss, I mentally say… “Yeah, come talk to me in 5 years … or 8 years.”

People losing weight tend to post frequently and make themselves highly visible.  People gaining weight tend not to report that fact.  Almost no one who has a very-large weight-loss, reports their maintenance numbers after the first few years of maintenance.  

The highly-visible, online personalities who blog about their large weight-losses, tend to disappear a year or two after their success.  I’ve followed a few of these bloggers with interest as they lost weight, thinking perhaps THIS person will be an exception… that perhaps THIS ...

Fitness is not a measure of worth.

People who choose exercise activities, meaning various types of movement or fitness, as a hobby are no more praiseworthy than people who choose anything else as a hobby.

Fitness by any definition is not an obligation.

There is also no personal obligation to have a thin, or a “normal-weight", body.

Seeking weight-loss is not the same thing as living with healthy habits, and thin or "not fat" isn’t the same thing as "Healthy".

There are healthy and unhealthy people at every size, so reaching a certain body size is neither a guarantee of health, nor a sure preventative or cure for disease. Body Size and Health are two different things and people can, and often do, pursue one without the other.

In fact, seeking "Health" is not a moral, social, or personal obligation. People can choose to prioritize and pursue health at whatever level they want. Their choice to seek health by “engaging in a healthy lifestyle” doesn’t guarantee them personal health. It also doesn’t make them better than people who don’t choose to prioritize or pursue health.

There are also different kinds of health. and all of them aren't available to everyone.  For example: Mental health and Physical health are two different things, and these two types of health don’t necessarily go together.

What does "healthy" even mean?

Healthy is simply the opposite of  diseased or dead.  Human beings are born, they live, and they die.  The human body is designed to wear out.  Even the most "healthy" bodies become "unhealthy" as they get old, and eventually every body ceases its function. Sudden or lingering, death comes to everyone, and except for death-by-accident, people of all ages become sick and then die.

While the term "healthy", refers to the general condition of a person's mind and body, usually meaning to be free from illness, injury or pain, that term is now loosely used to refer to various substances, activities, and ideas that allegedly promote that general condition.

However, despite all claims to the contrary, most things ...  including personal values ...  that are sold to us by the diet (and fitness) industry are the exact opposite of “healthy”.