catwoman7

that's totally your call. A lot of people seem to end up in the "overweight" or "class I obese" range (with "class I obese" being...not very obese), but about 10-15% of us make it down to the normal range. I can tell you that the last 20-30 lbs are a bear to lose, but people do it. Also, keep in mind that even though we lose bone and muscle along with fat, we still end up with more bone and muscle than someone who's never been obese. So you're likely to look 10 or more lbs lighter than someone of the exact same weight who's never been obese. the other thing to keep in mind - I think you and I are around the same age. I lot of physicians nowadays like to see their older adult patients in the 23-27 BMI range, since that little extra cushion is good to have if you're sick or injured. People in that range tend to recover more quickly. I'm currently about 8 lbs overweight, after being in the normal range for a few years (the gain is mostly thanks to COVID). It plays with my head and I want to lose it, but my physician is totally happy with my weight. I do admit I look better than I did than when I was at my lowest weight two years after surgery (I thought I looked great, but looking at pictures now, no - I looked pretty awful), but yes - that "normal BMI" thing is really important to a lot of people. I think I'd be happiest if I was there again, but at the higher end so I don't look so gaunt. I'm trying - although admittedly, I think it's mostly a "mental thing" for me.

stall. Just stick to your program and stay off the scale for a few days. It'll soon break and you'll be on your way again.

liveaboard15 is correct. Most of us experience the "three week stall". Also, those weight fluctuations are just fluctuating water levels. With as little as you're probably eating, there's no way that's a true gain. It's just fluid levels.

I bought two coccyx pillows when this started happening to me - one for my office chair, and one for my car. I still use them almost eight years later (or at least in the car. I'm now retired). In general my butt doesn't hurt as much as it did (maybe I just figured out how to sit to avoid the pain?), but long-ish trips in the car will still do it to me, so I still use the pillow. Coccyx pillows look like this. The "U" part goes in the back.

you'll see your biggest loses during the first month - or for some, the first two months. Then it slows down quite a lot. I don't know your starting BMI, but i started at well over 300 lbs. I had a decent drop the first month, but then months 2-6 I lost 8-12 lbs a month. Months 7-12, I lost about 5 lbs a month, give or take. After the year mark, there were some months I only lost 2. BUT...as long as I stuck with the program, i kept losing. if you started off at a lower BMI than I did, then it's likely your monthly losses might be lower, too, because starting BMI is one of the factors that affects your rate of weight loss. But just stick with it - in the end, it's how compliant you are with your program that determines how successful you ultimately are, not how fast or slow the weight came off. If you stick to your program, the weight WILL come off.

oh - forgot to mention: for those who do end up getting GERD, often it can be controlled medically (i.e., by PPI's or another type of antacid). It seems to be people with the more severe cases who opt for revision. I honestly don't know what percentage of people get it severely enough that revision is recommended.

do whatever you can to get fluids. It may take a few days to be able to get up to the recommended amount, but keep trying. Dehydration can land you back in the hospital if you're not careful. re; not hungry - that's extremely common and one of the advantages of the surgery. Hunger does return for most people sometime during the first year - and when it does, things get a lot more challenging. So take FULL advantage of that. Definitely eat what your clinic recommends because your body needs the nutrients, but beyond that, take advantage of not being hungry. It'll never be easier in your life than it will right now to lose weight. It was a little weird for me to get used to at first, but never being hungry and not giving a flip about food made it super easy to stick to the eating plan (my hunger came back at about five months out)

very true - although the structure of the sleeve itself can also cause GERD in some people. I've read about this and can't remember exactly what the deal is, but it has something to do with the size and shape of the new stomach causing high pressure in the stomach, which can cause the acid to back up into the esophagus. It's not the majority of people - I seem to remember reading that about 30% will have reflux issues. But that means 70% won't. Some people are willing to take that risk. I wasn't because I already had GERD even before I had surgery.

most insurance companies will cover it, but it's usually not part of their "core" coverage. In order to offer it, employers need to buy a rider for it. So although her company uses Cigna, they probably decided not to have their policy include the optional bariatric surgery rider.

oh good - then the rates have improved even since I had my surgery almost eight years ago!

yes - plastic surgery will get rid of it. I hated they way my neck looked, too, so I had a face/neck lift. The turkey neck is no longer there!

you're actually correct! I was a research librarian for several years at a major university. Scholarly articles like that are generally written by PhD-level researchers and their target audience is other researchers. Before the internet age, that's how researchers who were working in the same field knew what their fellow researchers were doing on other campuses or in other agencies. It's basically how they kept up with what was going on in their field. So even though students read these articles, they aren't the intended or primary audience for them - it's basically the way researchers communicate with each other so they all know what's going on in the field.

I wouldn't have been allowed to have that. The only soups I could have were plain broth. But your plan might be different. Mine was one of the stricter ones (compared to those of some people here on BP...)

I don't know if there's anyone active on here at the moment who has (but you never know!), but i just googled him. He seems to have pretty good reviews...

I'm currently taking a graduate-level nutrition course on obesity and weight loss, and this article is pretty typical of the stuff we have for readings - i.e. written in highly specialized language that you'd practically have to have a chemistry degree to understand! Fortunately, I'm not taking the course for credit, because I sure wouldn't want to be tested on these articles! at any rate, I do know that with sleeve, the fundus part of the stomach is removed, and that's the part where most of the ghrelin is produced, so hunger levels go way down (because the ghrelin level is what lets the brain know that your body needs food. If the level is low, your brain knows that you need to eat, and you feel hungry. If the ghrelin level is high, then nope - not hungry - don't need to eat). Ghrelin is produced in other parts of the stomach as well, but a majority is made in the fundus, so levels automatically go way down - and stay low - once that part of the stomach is removed. the fundus isn't removed in RNY (in fact, none of the stomach is removed - it's just sectioned off), but I don't know how just having the major center of ghrelin production in the part of stomach that is no longer used affects ghrelin levels in your blood. I don't think researchers necessarily know that, either. Maybe it does, maybe it doesn't. Although most RNY patients lose their hunger as well. But they think it could also be due to the actions of some of the other hunger-related hormones, like leptin and GLP-1. They do know that RNY causes leptin levels to increase (and leptin is a hormone that causes a feeling of satiety. I can't remember what exactly GLP-1 does, but it has a role in hunger and satiety, too). At any rate, there have been research studies on RNY patients who are a year out, and their ghrelin levels are very low compared to "normal" people. So suffice this to say, ghrelin levels are abnormally low in RNY patients, too - but not for the same reasons that they are in sleeve patients. It could be that the major ghrelin-producing area is now in the remnant section of the stomach - or it could be that changes in some of the other hunger-related hormones could cause changes in the ghrelin level. (Or maybe it's due to a little of both...)

pretty normal fear - I'm guessing most of us had similar thoughts before going under the knife. However, the mortality rate on RNY is 0.3%. Those are actually excellent odds - lots of common surgeries - like hip replacement surgeries, for example - are less safe than RNY. Years ago weight loss surgeries were pretty risky, but they're just not anymore. Techniques have changed, and they're so common it's almost become a routine surgery. Anyway, at those odds, you have a 99.7% chance of sailing through just fine - and you will. your chances of a premature death by staying obese are actually much greater than dying from the surgery.

do they have to be in person? Unjury (the protein company) offers weekly virtual support groups and they do send receipts to you if you attend. They have one group for people pre-op to one year post-op, and another group for people over a year out (although people sometimes attend the "wrong" group - the leaders don't really care...). You can check to see if your insurance company or surgeon (whoever is requiring support group attendance) will accept that. I would imagine some do since they send people who attend a receipt afterward. Here's the info: https://unjury.com/resources/weight-loss-surgery-unjury-cares/

P.S. I don't think gaining all your weight back is that common, but it DOES happen if people aren't careful. A majority of us do have that 10-20 lb rebound in year 2 or 3, though. And I've known a few people who've gained 40, 50, or 60 lbs (due to old habits). It's easy to do if you don't watch it.

you're one of the lucky minority whose hunger never came back. For most of us, it comes back sometime during the first year. I was hoping I would have been one of the people whose hunger never came back, but no - unfortunately not. It was so much easier those first few months when I was never hungry and didn't give a flip about food!

you can gain weight with any and all types of weight loss surgeries if you let old bad habits creep back in. Weight loss surgeries are just a tool, and you have to keep up with your part of it for it to work. And they work extremely well as long as you follow the rules. a rebound weight gain of 10-20 lbs during year 2 or 3 is VERY common. That's more your body settling in to a weight it's comfortable at. If you're diligent, you'll stabilize there - or you may even lose some or all of the rebound if you work at it. But when old habits start up again, you can definitely gain weight again - sometimes a lot of it. And sometimes all of it. what WLS mainly does is control how much you can eat AT ONE SITTING. This is an example I've used a lot: Before I had surgery, when my husband and I ordered a pizza (always a large...), we'd each eat half of it. I can't do that anymore. I can eat 1-2 pieces. It's physically painful for me if I try to eat more than that. But it would be very easy to eat 1-2 pieces at 5:00 pm, and another 1-2 pieces at 8:00 pm, and yet another 1-2 pieces before bed. So....half a large pizza. THAT is the kind of stuff you have to watch out for - that, and mindless snacking (planned snacks are fine - but mindless snacking has consequences...). so to respond to your question about whether or not maintaining after two years is difficult, yes, it is. I constantly watch what I eat. If I notice the number on the scale starting to head north - esp if it gets above my "oh crap" number (the number I do NOT want to ever go over again), it's all hands on deck until it's back under control. So yes. Obesity is a very complex, chronic condition, and we do have to keep working at it to keep the weight from coming back. But the surgery DOES make that easier. There is no way I could have ever lost over 200 lbs and maintained that loss for several years (well, mostly - I did have a rebound) without this surgery.

yea pasta tends to sit in my stomach like a brick - and I can feel the effects for a long time afterward. I can handle a little of it - like 1/2 cup (100-ish ml) - but more than that and I'm miserable.

yes - it is. They have a Keto version, too, but the protein level in that one isn't as high.

I lost over 200 lbs but I had bypass. But I just wanted to say that it took almost two years for me to lose all that. My weight loss REALLY slowed down after I hit the year mark (near the end, it was like 2 lbs a month!), but it all came off. I was stalling a lot more frequently that second year, too. So many times I thought "well, this is it...", and then I'd drop a couple more pounds. Just stick with it! Your body might not be done losing yet.

that rapid weight loss seems to affect people's inner thermostats. Sometimes it's temporary, sometimes it's not. Mine was temporary - I think it just lasted a few months. But I know some people who are years out who are still freezing all the time.

Nope. It's expensive and the recovery can be painful, but it was worth every penny and all the pain.