BigSue

I wonder if this bothers people because it hits a little too close to home. I used to hate when people said, "It's not a diet -- it's a lifestyle change!" (usually when referring to... a diet, e.g., keto). But now, I get it, as much as I hate to admit. I actually use that now to shut people up when they get too nosy about my weight loss (I have kept my surgery private and not told any friends, family, or coworkers). When they demand to know my secret to weight loss, I say I made a lot of lifestyle changes, and that's not what they want to hear. I see a lot of people on this forum who seem to expect the surgery to work like magic -- to make weight loss easy, instant, and permanent. Reminding people that surgery is a tool, not something that works on its own, might be a reality that's hard to face.

Try protein hot cocoa. I found it much easier to drink warm beverages in my early post-op days than cold. The Bariatric Pal hot cocoa mix is delicious but you can get other brands of protein hot cocoa on Amazon.

My surgery was 2.5 years ago, so it's sort of a distant memory at this point... I don't mean to scare anyone -- I actually hope it will be reassuring to know that (at least for me) waking up from surgery was the worst part. I remember being in the bed in the waiting area before surgery with an IV, and then nothing until I woke up. A lot of people remember being in the operating room, having to move themselves from the bed to the table, but I don't remember any of that. I woke up in a lot of pain and for some reason, I had it in my head that something went wrong and they didn't complete the bypass. When I was able to speak, I asked, "What happened?" I guess the nurses thought I was disoriented and explained that I was in the hospital and I just had gastric bypass surgery. I felt intense regret, wondering why I did this to myself. I could barely move, but I remember looking around and seeing the monitor showing my vitals. I had a blood pressure cuff on my arm that periodically ran, and it was a lot higher than normal, but nobody seemed concerned. I didn't really feel the incisions, but I had a lot of pain that I assumed was gas pain, based on what I had read before surgery, and I knew that I was supposed to walk to help with the gas pain. I kept asking to get up and walk, and the nurses told me I had to wait until they took me to my recovery room. I stayed in the hospital for one long, rough night. I was trying to walk as much as possible, up and down the halls. I made the mistake of walking at dinner time, and the non-bariatric patients had actual food, and the smell nauseated me. I got a meal tray with a protein shake, water, apple juice, coffee, and fruit cocktail (it was supposed to be sugar-free Jello, but apparently they were out and decided that fruit cocktail was the next best thing, LOL... The bariatric nurse was very upset that they had given me something that I shouldn't eat, but of course I knew better and did not eat it). Between walking, I tried to sip as much as possible, and it was very difficult. Fortunately, I had IV fluids, so plenty of hydration (and I had to pee very frequently). After the first few hours, I had very little pain and did not need to take any pain medication. I did have discomfort in my stomach, like cramping/spasms, so they gave me anti-spasm and anti-nausea medication. I had leg compression machines on my legs while I slept. The nurses came in to check on me periodically. My surgeon came in once. Once the anesthesia wore off and I was fully awake, I was eager to get out of the hospital and go home, and I felt like I had to wait forever. In hindsight, I'm glad they kept me for longer than I wanted because while I was there, I was getting hydrated with IV fluids, which was good because it was so hard to drink fluids those first few days. Once I got home, the first few days were not pleasant, but I had very little pain and recovered quickly. So if you feel completely miserable when you wake up, just know that you will get through it and things will likely improve very quickly.

I've looked at some bariatric cookbooks and I do not think they are worthwhile. There are tons of free recipes available on the internet. After the first couple of months, you don't really need bariatric-specific recipes (but don't sleep on the ricotta bake -- it is delicious and I made it regularly during my pureed and soft food stages). I have found a lot of wonderful recipes on Pinterest. I've had the best luck searching for "skinny" and "WW" (Weight Watchers). "Healthy," "low-carb," and "keto" also have some good results; you just have to make sure they meet your requirements ("keto" recipes in particular can be a mixed bag, because some of them are very high in fat, which can cause dumping for bariatric patients).

The first few months post-op are the hardest because you’re still healing from surgery and adjusting to a lot of changes, but you’re not yet getting the benefits of the weight loss. It’s very normal at this stage to have feelings of regret and wonder if the surgery was a mistake. As time goes by, though, it gets easier in many ways. You’ll be able to re-introduce more foods into your diet as well as get used to the changes that will become your new “normal.” And in the meantime, you’ll lose a lot of weight and get to experience life as a non-obese person. This rough part of your journey will be a blip in your memory, and if you’re like most of us, eventually your only regret will be that you didn’t do this sooner.

I don't like the term, "slider food." It bugs me because it almost makes it sound like a good thing to defeat the surgery by intentionally eating foods that are easy to overeat, and the thought of the food "sliding" down sounds kind of gross as well.

My dermatologist recommended Nutrafol. I'm a little skeptical because his office sells it, but he didn't push me to buy it from them (he gave me a pamphlet and said it's available on Amazon if I'd rather buy it online). I decided not to try it at this point because it's really expensive and I'm not sure it's worth it. My dermatologist also recommended Rogaine (he said to use the men's formula because it's stronger than the women's formula) but said that if you stop using it, you'll lose any regrowth that you got from using it. It is less expensive than Nutrafol, too. I did try Vegamour for several months and as far as I can tell, it didn't make any difference. I've been taking biotin faithfully every day since surgery, and I doubt it helps, but I figure it doesn't hurt, and it's cheap, so I keep taking it. But honestly, I think the only improvement has just been from waiting for it to grow back. I had a different surgery 15 months after my gastric bypass and experienced another round of telogen effluvium, but it's been improving for the last few months even thought I gave up on growth products.

Yes! This is the video I was referring to. Thanks for posting it -- I hadn't been able to find it again on YouTube (it's not in my YouTube history because I watched it embedded on this forum). This is great info.

I'm sure this isn't the response you were hoping to get, but remember that you are about to get major surgery. Your surgeon -- whom you are trusting to cut you open and surgically rearrange your digestive system -- has given you explicit instructions for your pre-op diet, and now you are asking strangers on the internet for permission to circumvent your surgeon's instructions. Is it worth taking that chance?

I agree with those who recommend you find another PCP. I would be concerned about this doctor's fixation on your BMI. First of all, as a bariatric patient, you might not need to have a BMI within the "normal" range. I saw a video on YouTube a while back (someone linked to it on this forum) by a bariatric surgeon talking about the best weight for bariatric patients and he suggested that a "normal" BMI may actually be too low. So the first problem with this doctor is that his advice for you to lose weight might not even be correct. The other thing that bothers me here is that I have a dear friend who went to her PCP complaining of malaise, and the doctor dismissed her symptoms and told her she would probably feel better if she dropped 10 pounds (and this is someone I have always envied because she has always been in great shape;). Turns out she had cancer. I would be wary about a doctor who jumps straight to losing weight as the cure for everything. Something I appreciate about my PCP is that she never commented on my weight. She suggested I change my diet and be more active to lower my blood pressure and blood glucose, which are obviously associated with weight loss, but she recommended actual actions and not just, "lose weight." Likewise, she didn't praise me for losing weight, only for improving my health. I wish more doctors would take that approach instead of just using BMI as an all-purpose measure of health.

You’ve lost 62 pounds in 6 months and you’re dissatisfied with that? I think that looking at other bariatric patients can skew our perspectives on weight loss. If you are expecting the same rate of weight loss as the patients on My 600 Pound Life, for example, that is not realistic because you don’t have nearly as much weight to lose. Your expectations for weight loss may not be realistic. At your height of 5’6”, your goal weight of 140 pounds puts you at a BMI of 22.6. The average gastric bypass patient loses 50-70% of excess weight, which means that the average gastric bypass patient doesn’t quite get to a BMI below 25 (which would be 155 pounds for a 5’6” person). With a starting weight of 270 pounds, your excess weight was 115 pounds. If you lose 70% of that, it’s 81 pounds of weight loss and a final weight of 189 pounds. A loss of 62 pounds in 6 months puts you on track to achieve that in a year (but remember that there are a lot of factors that can affect rate of weight loss, and you may lose faster or slower than others). Keep in mind that this is an average and not indicative of any individual patient. It is certainly possible to lose more than that. Some gastric bypass patients do lose all their excess weight and end up with a BMI below 25. You might be able to get to 140 pounds, but it is probably going to take a lot of work. The surgery is just a tool, not magic. If you were expecting to shed all your excess weight in 6 months without trying, then maybe you did waste your time and money, but if you are willing to put in the effort and use the WLS to your advantage, then you can achieve more weight loss than you ever have before.

My B12 is always high because I take a B12 supplement, and the doctor is not concerned about it. Don’t be too worried about your labs being outside of “normal” values because those values are generic, and as a bariatric patient, your results might be different from what the lab considers “normal” and still be fine. Your surgeon is an expert on bariatric patients and can review the results to see if there’s any reason for concern. I have also noticed that different laboratories have slightly different “normal” ranges for some things, so even then, if your results are slightly outside of what one place considers normal, they could be within the normal range of another place.

This is one of those things that you can’t fully comprehend until you experience it. Before my surgery, I read about people struggling to get enough fluids, but I thought it would be simple if I just remembered to keep sipping. Ha! It is much harder than it looks. I think most surgeons’ expectations for fluid intake are unrealistic for the first few days after surgery. I found it easier to drink warm fluids than cold, and protein hot cocoa was a necessity for protein intake in the beginning. Protein soups are also helpful.

The first few months post-op are the hardest because you’re still healing from surgery and adjusting to a lot of changes, but you’re not yet getting the benefits of the weight loss. It’s very normal at this stage to have feelings of regret and wonder if the surgery was a mistake. As time goes by, though, it gets easier in many ways. You’ll be able to re-introduce more foods into your diet as well as get used to the changes that will become your new “normal.” And in the meantime, you’ll lose a lot of weight and get to experience life as a non-obese person. This rough part of your journey will be a blip in your memory, and if you’re like most of us, eventually your only regret will be that you didn’t do this sooner. I’m 2.5 years out from gastric bypass and I can eat pretty much normally. I still avoid foods that are high in sugar or fat, and bread, pasta, and rice, but I tolerate most foods and I eat pretty normal-sized portions. In fact, it scares me sometimes to see how much volume I can eat, and I have to be pretty careful to eat low-calorie foods. Sometimes I kind of miss the early post-op days when I could only eat a few bites at a time and was never hungry. Although it’s not fun, take advantage of this time because it will never be easier to lose weight than it is right now.

Can you physically remove the temptations? I know it’s not always easy if you live with other people who don’t follow your food requirements, but if you can, keep the demon’s food out of the house. Get rid of anything you have that you don’t want to be tempted to eat. Donate it to a food bank. Anything you can’t donate (e.g., perishable food like baked goods), it will usually disappear pretty quickly if you leave it in the break room at work. Grocery pickup/delivery is a game-changer (I’m a big fan of Walmart Plus, but a lot of stores offer this type of service). I can count on one hand the number of times I’ve set foot in a grocery store in the past year. I have a saved list of my standard weekly grocery items (mainly fresh and frozen produce, meat, and fish), and anything else I need, I just add to my cart ad hoc throughout the week. I never have to look at the demon’s foods. I don’t have to walk through the bakery aisle and smell the cakes and donuts, I don’t have to walk through the cookie aisle and see the new Oreo flavors. I don’t have to resist temptation every time I go in the pantry because I have nothing that I shouldn’t be eating, I do have healthy(ish) treats that I eat every day so I don’t feel deprived. (Yes, I eat a lot of artificially sweetened foods. Maybe not the “healthiest” choices on earth, but the perfect is the enemy of the good.)

Oh wow, I feel your pain! My parents came to visit me, after I had lost 200 pounds, and my mom saw me mixing the essential amino acid supplement that I take daily (as recommended by my PCP). She looked at the label and said, “You know that has CALORIES?!” Five. It has five calories in a scoop. And thanks, mom, I lost 200 pounds without your help but I still need you to micromanage my calories. I guess some moms just can’t help themselves. Most of the time — and I think this is true in your case and mine — they have good intentions but no idea how harmful they can be. My mom put me on the path of yo-yo dieting from my pre-teen years. I’m sure she just wanted me to be healthy and never anticipated that the yo-yo dieting would contribute to long-term weight gain. So I feel free to ignore her comments.

I don’t have any answers about treatments for loose neck skin, but I will say that your weight/size is the first thing most people notice. No matter how wobbly your neck is, in all likelihood, people will see that you’ve lost weight and think you look fantastic.

Torrid is a plus-size store, so their size 0 is equivalent to a large in non-plus sizing. It was weird for me to size out of plus-size stores. For my entire adult life, I was limited to a handful of stores that made clothes in my size, and now that I can find clothes in my size almost anywhere, the options are overwhelming and I have no idea where to shop!

Please call your surgeon's office. Most of them have an answering service where they can direct you to someone on call after hours. You do not need to wait until your surgeon returns from maternity leave. I bet your surgeon made arrangements for someone else to see her patients while she is on maternity leave. This is urgent and another doctor can help you.

Please call your surgeon’s office. If you can’t keep water down, you will quickly get dehydrated and that can be very serious. Eating solid food too soon may or may not be the cause, but don’t let that stop you from getting medical attention.

You can ask your clinic for advice, but it's probably going to be up to you to figure out, mainly because you have to work it around your schedule. It can seem complicated at first, but you get used to it. I take a multivitamin with iron plus an additional iron supplement, calcium 3x/day, B12, biotin, and D3. Calcium and iron are supposed to be at least 2 hours apart, and I also take a prescription thyroid medication that's supposed to be 4 hours apart from calcium and iron. I use a free app called Medisafe to track my medications and remind me. It's really useful because you can track what time you took everything, and it also tracks how many of each you have left and reminds you to refill. You can set reminders at whatever time you want. I set reminders as follows, but I usually stay ahead of schedule. 6:00 am - Thyroid prescription 10:30 am - Multivitamin with iron, B12, Biotin, D3 1:00 pm - 1st calcium 3:30 pm - iron 6:00 pm - 2nd calcium 8:30 pm - 3rd calcium I also recommend getting a pill organizer with 3 or 4 compartments for each day, where each day has its own removable box (the one I have looks like this one: https://smile.amazon.com/Organizer-Compartments-Moisture-Proof-Medication-Supplements/dp/B07Q9JSHMP). I distribute my pills in that once per week, and then I can just grab the box for the day.

When I first re-introduced solid food after surgery, I was really diligent about eating slowly. I used a tiny fork/spoon and a timer on my phone to time 30 seconds to chew each bite and then 60 seconds before taking the next bite. It probably took 20-30 minutes to eat a very small meal. I’m 2 years post-op now and I am not nearly as careful about eating slowly (I no longer use a timer), but I’ve gotten into the habit of chewing well and taking time between bites. I use normal utensils and take full-sized bites of most things. Salad and most other veggies go down quickly and easily, but I still have to make sure to chew dense foods like meat well. I used to have frequent problems of a bite of meat feeling stuck on the way down, but that rarely happens anymore (maybe once every few months). I feel like I eat at a pretty normal pace now, maybe a little slower than average, but I usually eat alone, and when I do eat with other people, I notice that I take much longer to eat than everyone else, which was not the case before surgery. I like to eat meals that require some assembly (e.g., tacos on low carb tortillas) or have multiple items (e.g., chili and salad) that I can switch between. I find that helps to naturally slow me down. I also do other things while eating, like watching TV or reading, which some say is bad because you should focus on your meal, but I would go crazy if I tried to eat slowly with nothing to do between bites! It still typically takes me 15-30 minutes to eat a meal, but I am eating much larger portions now than right after surgery.

Congrats on getting your surgery date! If you’re anything like me, it feels like the process drags on forever until you get to a few weeks before surgery and then it feels like it snuck up on you soooo quickly.

Here's what I take: Bariatric multivitamin with 45 mg iron B12 sublingual, 1000 micrograms Biotin, 10,000 micrograms D3, 5000 IU Iron bisglycinate, 36 mg Calcium citrate, 500 mg, 3x/day I take the multivitamin, B12, biotin, and D3 together. Calcium and iron are supposed to be at least 2 hours apart, and I also take thyroid medication that is supposed to be 4 hours apart from calcium and iron, so I take the thyroid medication first thing in the morning, multi/B12/biotin/D3 4 hours later, 1st calcium 2 hours later, iron bisglycinate 2 hours later, 2nd calcium 2 hours later, 3rd calcium 2 hours later. I use an app called Medisafe to track and remind me. It was a lot at first, but I'm used to it now and I have a routine. You may need to take chewable vitamins for a short period of time after your surgery (I was told to take chewables for the first 6 weeks, but you should follow your surgeon's instructions). I think the chewables taste terrible, so I switched to a capsule after the first 6 weeks. The BariatricPal One multivitamin is the best deal I've found if you get the annual subscription (but definitely buy a smaller quantity to try before you commit to buying a year's worth). I get the one with 45 mg of iron, but your iron needs may vary. Another thing to keep in mind about iron is that the most common forms (ferrous fumarate or sulfate) cause nausea for some people, especially when taken on an empty stomach, and can also cause constipation. There's another type of iron (iron bisglycinate) that doesn't cause nausea or constipation, but that's not what most multivitamins have, so you'd have to take it separately. I had low iron even before surgery, so I actually take both. I also highly recommend the BariatricPal calcium chews because they are delicious. They taste like candy and I actually look forward to taking them. French Vanilla Caramel and Belgian Chocolate Caramel are my favorites. You can often get them on sale for 20-25% off (I actually just restocked last week when they had 25% off all BariatricPal brand products). Make sure you get calcium citrate, not calcium carbonate. Most drug store calcium supplements are calcium carbonate, which is not absorbed well by bariatric surgery patients. I buy the other ones from Amazon. B12 (NatureMade) is cherry flavored, and biotin and D3 (Natrol) are strawberry. It doesn't feel like such a chore to take all these pills when they taste good.

I use MyFitnessPal and I just don’t use the “complete diary” function. It really isn’t necessary to close out the day. I’ve been using MyFitnessPal for 2.5 years, so I’m kind of attached to it, but a lot of people prefer other apps such as Baritastic, Lose It, or Cronometer, so you might want to give those a try if you don’t like MyFitnessPal.