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I'm almost 2 years op post VGS. I had lost a total of 80lbs but in the last few months I have managed to gain 30lbs. I've gotten back into my old habits and I feel like a complete loser. I don't know where to go from here. I want to reach out to my doctor to help me get back on track but again I feel like I've failed and I'm embarassed. Does anyone have any advice on how to get back on track? Any help is appreciated.

Hello, all I just submitted all of my required documents for surgery. I have a BMI over 40 with no comorbidities. Insurance list they need this documentation: a description of the proposed procedure(s)  documentation of failure of weight loss by medical management  unequivocal clearance for bariatric surgery by a mental health provider  a nutritional evaluation by a physician, physician assistant, nurse practitioner or registered dietician I did all but I am a little confused, because many people are stating they have to do a diet for 6 months etc. Is "documentation of failure of weight loss by medical management". Does this mean they need a diet or just a letter from a PCP, because my doctor sent letter to PCP that stated, "the patient has made multiple weightless attempts and has been unsuccessful". PCP signed it and that was sent over to the insurance company with all other documentation. Just nervous and wanting to be reinsured I don't need a diet program to be approved.

Welcome! You have some very good questions, and the fact that you are thinking about these things is great. Weight loss surgery isn't for everyone, and I think it's really important to make the decision with your eyes wide open and be prepared for the good, the bad, and the ugly. This forum is a great place to read about other people's experiences with WLS so you can know what to expect. Pay particular attention to catwoman7's posts -- she is a great example of a WLS success story, who lost all of her excess weight and has kept it off long-term (and she is a true bariatric guru with lots of excellent advice and insight). Just about all of us have had many failed weight loss attempts in the past. Most insurance companies require evidence of failed weight loss attempts before they'll pay for surgery, because surgery is a pretty drastic solution and few people would want to go through it if they could lose and maintain weight loss without surgery. But many of us who have failed so many times before have been successful with WLS. It is true that some people gain back some or all of the weight (or don't lose as much weight as they need to) after WLS because, as you've figured out, WLS isn't magic. It still takes a lot of work and commitment and (as much as I hate the term) lifestyle changes. I get the impression that in the early years of WLS, the emphasis was on the restriction (and, to some extent, malabsorption) of surgery -- the physical limitations that made it impossible to overeat and/or that made the patient ill from eating too much fat or sugar. Patients mainly relied on eating smaller quantities to lose weight. This works in the short term, but the restriction loosens up over time (so you can eventually eat more in one sitting), and if you continue eating high-calorie foods and/or get in the habit of eating around your surgery by eating smaller portions more frequently, you can easily increase your calorie consumption back to the point of regaining weight. For me (and many others), WLS made the initial weight loss much easier than dieting alone because I had no hunger for several months after surgery, but I do get hungry now and it's a challenge to stick to my plan. I think that these days, most WLS clinics have a more comprehensive approach and provide more guidance on dietary changes. After WLS, you pretty much reboot your eating patterns, almost like a baby. You go back to consuming only liquids, then pureed and mushy foods, and tiny bites of soft foods before you get back to eating like an adult. I think this process is the turning point for your long-term path after WLS. You can either take advantage of this opportunity to get into good habits of eating nutritious food, or you can get back into your old eating habits once you are physically able to eat normal foods again (which can ultimately lead to regain). As far as how WLS affects mental health, that is very dependent on the individual and not necessarily predictable. I think it's safe to say that most people's mental health benefits greatly from weight loss because living with obesity is incredibly difficult, but of course there are instances of unexpected negative results. If you have a history of mental health issues, that's something to discuss with your provider as part of your decision (and most insurance companies and clinics require a psychological consultation to make sure you are mentally/emotionally prepared for surgery). I did my surgery completely alone. I'm 2.5 years post-op and haven't told any family, friends, or coworkers about my surgery. I live alone and had no help after my surgery. I was fortunate to have a pretty easy recovery, so I had no problems taking care of myself (although I later developed bradycardia due to the rapid weight loss and had to get a pacemaker). In a way, I think living alone makes the post-op life easier because I have complete control over the food purchasing and preparation in my house. I simply don't buy foods that don't fit in my plan, so it is easy to avoid temptation. I encourage you to continue to research WLS and read about other people's experiences as you make your decision. Good luck!

More than likely when you progress to solids that your restriction will kick into gear and you will be in no doubt that things have changed, The surgery that you have had will also be reducing the amount of grehlin (hunger hormone) and will restrict your urge to eat. It is good that things have gone well so far. Always check back in with the surgeon if you are having issues.

Therapy & ‘doing the head work’ is a very important part of not just the weight loss but maintaining. You need to ne mentally & emotionally ready for this surgery. Many of the benefits of the surgery are temporary or become weaker. If you haven’t done the head work, it is extremely easy to return to your old habits & regain your weight. The desire to eat can become so strong again it is possible to eat around your surgery. Remember the surgery changes your body not your head. The surgery affords us the time to change our relationship with food. Well it did for me. For years I skipped meals to control my intake & all it did was screw up my metabolism & I was still fat. I’ve stuck to diets & lost weight many, many times but I always regained the weight. While I was losing I looked at how, why, when & what I ate & realised what I did didn’t work for me. I needed a new way. I worked out a way of eating, not a diet, that worked for me. I haven’t been this size since I was about 12years old & have never maintained a weight loss like this ever. I have a different attitude about food & eating. It’s been sustainable, It doesn’t rely on my will power to control my eating. It doesn’t limit me or hinder me in enjoying my life as I want. Sure there are certain foods I avoid or eat very rarely because I’m careful about what I eat & it’s been my choice to do so. I feel better for it & I don’t feel like I’m missing out on anything. I still love food, enjoy what I eat & regular dine out. You’ll work out a way of eating to complement your lifestyle & meet your needs too in time. Join that art class now. Don’t wait until you move again to look for a class. Great way to meet people with similar interests.

Also a sleeve and also ended up taking 2 whole weeks off. And even after that I was really really tired at the end of a working day (sedentary job) so honestly it took me 3 weeks to get back to my baseline. I echo what the others have said about arranging some flexibility in advance if you can at all. Best of luck with your surgery. It's absolutely life changing. You will love it after you get over the initial pain and stuff.

With that being said, if every Dr has their own protocol, is their a generic post op diet/vitamin regimen, I can look up? I have read about surgeons wanting you to lose the fat around your liver? I guess it depends on BMI, anyone know any good websites to check out for that? Sent from my SM-G988U using BariatricPal mobile app

Thank you so much for the reply. I have been in therapy for a year and I luckily have a great relationship with my therapist. It really helps to hear a story like yours. I think my fear is normal. I have failed so many times before. My health is bad. I’m 5’2” and 235 lbs and I can feel the heart attack coming. I can’t live like this anymore. I’m not really living. I’m submitting the forms for Dr.Alvarez at Endobariatric. I moved from Florida to Asheville and then to Morganton. I am planning to sell my house and go back towards Asheville. I miss it there. A bit more vibrant and much better social opportunities.

I've been watching a Dr. on you tube who explains it perfectly....his name is John Pilcher. He has a few videos, you should watch the one where he talks about the 3 week stall. As long as you're following your program you're fine:)

It is never too early to start exercising more or establishing a good vitamin regime. A gradual reduction of carbs will also be beneficial. Focus on eating slower, chewing thoroughly, eliminating sodas/carbonated drinks and increasing water consumption. Often insurance companies and/or sugeons will have hoops you will have to jump through, such as...nutrition classes, participation in diet plans, counseling sessions, endoscopy, EKG/ECG. Although on rare occasions the process may be swift, in general it will often take 6 months to a year from the first appointment to surgery. Congrats on taking charge of your life!