Hey there. I previously wrote about my decision to have gastric sleeve surgery to take charge of my health, and avoid some major health complications I was heading for.

It's been a little over a month since I had the surgery, and I wanted to give an update.

After I got over just the initial recovery (you know, soreness, getting over anesthesia, etc), the real work began. For the first 16 days, my diet was very restricted, with specific requirements for both liquid intake and protein intake. The deal there is 1) Fluids are required to live, and 2) So is protein. Nearly anything else the body can synthesize (e.g. glucose), and vitamin supplements will round out nutritional requirements. But there's no replacement for amino acids and good ole quality H2O.

This was (and frankly still is) a challenge. As part of the surgery, they removed over 50% of my stomach. I don't know the exact percentage for me personally, as it varies depending on initial stomach size, but what's left is about 8 fluid ounces of volume. That's not much. And when I am supposed to ingest 80 ounces of fluid and about 100 grams of protein per day, it's hard to physically fit that much in.

This is complicated by the fact that I have no sense of hunger anymore. Prior to the surgery, I felt hungry nearly all the time. Often when I wasn't, in a biological sense, hungry. They explained to me that the cells of the stomach release a hormone called Ghrelin, which signals to the brain that the body needs food. Since I no longer have the majority of my stomach, and therefore the majority of the cells that produce that hormone, I don't feel hungry. This means I have to remember, or remind myself, to eat. This is such a foreign concept, I'm still struggling to come to terms with it, a month in.

So this was all expected, though. I knew there would be challenges, and that this was not going to just be an easy button. Now that I'm at a point where I can eat pretty much anything, I've come up against a new challenge. I'm having to face just how unhealthy my relationship with food was. I mean, I knew, at least to some degree, that it wasn't healthy. You don't end up weighing over 400 pounds without some sort of unhealthiness going on. But I've realized the degree to which I used food for everything from celebration to emotional support when things weren't great. It was a source of comfort and happiness and entertainment and who knows what else. It also wasn't just the flavor–I still enjoy things with a lot of flavors, or familiar, comfortable flavors.

In facing this new information, I've had to start coping with a real sense of loss and actual grief for the loss. I cannot eat a lot of the things I like. I cannot eat a whole meal with friends. I cannot really have a drink with a meal. So many things that were such a big part of what I used to do. Of course I can still go out and have dinner with folks, but I'm done in just a few bites. I can't share an appetizer and then have a main course. I can't share a dessert. And even as I type this, I have an overwhelming feeling of "So what?" and yet, I can't help but grieve for the loss of these things.

I'm hopeful that at some point, I will settle in better to this new reality, and I'll find comfort in the few small bites, in the company of friends. I have to keep reminding myself that I'm only a month into this, and part of what I'm discovering is just how significant this change is for me, personally, as I go through this journey. And maybe I'll find new, healthier comfort mechanisms that aren't just large quantities of food.

That said, the weight loss is undeniable. In total, since the end of March, I'm down 62 pounds. People are noticing the weight loss, and while I don't feel particularly different, I can feel it in my clothes, which are becoming almost hilariously ill-fitting. I'm having to dig old clothes out of the back of the closet to find things that had become too small. That feels good.

I'm hoping that the changes will become apparent to me, and I'll start to feel different, better than before. So far, nothing yet, but I'm holding onto the few things that I can see, and am going to continue on the path. I mean, it's not like I have a alternative. It's a life-long physical change that I can't undo. So I guess I'll have to figure it out.

March 27 Starting Weight: 425
July 6 Weight: 363
March 27 Pants size: 56
July 6 Pants size: 52