rjan

My hair loss slowed down and then mostly stopped towards the end of my first year, but didn't start coming back in until during the 2nd year. It had mostly come back in at around 18 months. Hair follicles always go through a cycle of growth, followed by a period of dormancy of 3-4 months. This whole cycle is 5-7 years. It's just that usually, your different follicles are at different points in their cycle, so you usually have some growing long while others are dormant and others are newly growing. Surgery pushes them lots of them into dormancy at the same time. They almost always come back.

People who go on a serious pre-op diet often don't have the big whoosh of weight loss in the first few months that others do because your body has already cleared out a lot of the water weight, stored carbohydrates, and sick muscle cells that makes up a big chunk of that whoosh. Once you get to a more steady state of weight loss, most (more than half) of what you are loosing will be fat. Yes, it's a journey and yes, the surgery is a only tool that helps you have success in the long term. You won't lose weight much faster than you would with a traditional diet. But imagine you lose "only" 10 lbs a month for the next year and a half - that's 180 lbs lost, which will put you at your goal weight of 210. Without the surgery, you'd likely fall off the wagon after 3 months, 6 months because you'd be starving. Instead, you'll actually be able to stick to that diet. How many diets did you start in your life where the start of that diet was more than 18 months ago? Imagine if one of those had actually worked. You'd already be at your goal weight now. But you're not, because it was too hard to stick to it. Bariatric surgery is a tool to help you stick with it. Bariatric surgery isn't a quick fix, and it doesn't mean you don't have to work pretty much just as hard as you would with a regular diet. It just makes it so all that work actually "works."

It's now been nearly 3 years since my surgery (34 months), and a year and a half since this post, so I thought I'd post an update. Mostly, I'm still gloriously happy with my results! I still have my protein powder latte most mornings, and eat 2 eggs about every other day. I still aim for 6000 steps a day and get them about 2/3 days. I did indeed lose and then regain. When I made this post at the 18 month mark, I was 140 lbs (down from 208 before surgery). I hit my low point of 136 lbs at 23 months. I'm currently 142 lbs. (Though a few lbs might be holiday/too-cold-to-walk weight - 139-141 lbs has been my usual for the 6-8 months.) But curiously, I also went down a pants size in the past year as I was slowly regaining - from size 6 to size 4. So I expect that a few pounds of the regain could be muscle lost during the rapid weight loss phase right after surgery. One of my friends told me I look better now than I did a year and a half ago. I'm not sure that I can tell any difference from looking at my photos though. May 2021, 14 months post, 142 lbs Feb 2022, 23 months post, 136 lbs. Face does look a little thinner. Dec 2022, 33 months post, 142 lbs. A tad less cheeky compared to the previous one at this weight, but mostly my skin looks better.

As regards raw veggies, my particular surgeon didn't include information about them anywhere on their food plan. The plan had me back on "normal foods" at 6-8 weeks, with long term restrictions on certain things like coffee, soda. So I wasn't sure when I was supposed to add them back. I was really craving raw veggies starting at 3-4 weeks out because I have always enjoyed them. I ended up trying salad type veggies at ~2 months post-op, and then added things like carrots, cucumbers over the next month with no problems. My post on this topic from the time is linked below. If you're just about to leave the soft food stage, it's probably too soon for raw veggies. But I think this may well be a good time to try some real meat and see how it sits with you - just cook it well, cut it up small, and start with a really small portion. Cooked veggies are also a good thing to add this stage. This was when I started to feel like I was really able to eat like a human being again.

I did not have that problem after my surgery, but I also wasn't on hormonal birth control at the time. There are other posts on here talking about this symptom. Breakthrough bleeding (a small amount of bleeding between periods) is one of the most common side effects of hormonal birth control. I did have that as a symptom when I was on hormonal birth control. In addition, bariatric surgery usually causes your hormone levels (including lady hormones) to fluctuate, often for quite a while after surgery. This is because hormones like estrogen are fat soluble and get stored in your fat, so as you lose weight, those stored hormones are released into your bloodstream. If it's a lot of bleeding - ask your doctor immediately. If it's just spotting, then it's unlikely to be a significant issue and you could probably wait until your next appointment to mention it to your doctor.

I did mine at Hospital Angeles in Tijuana with Dr. Corvalá. I believe I paid $6500 two years ago, which included pick up and drop off in San Diego. One of the best healthcare experiences I have ever had. Labor is cheap there, so they have all sorts of people hovering over you. For instance, they whisked me off for an X-ray after surgery and I was back only 15 minutes later. There was a 2 day stay after surgery. And they provided me with a big bag of toiletries when I arrive instead of nickel and diming me for every aspirin. This was my first surgery ever, so it was nice to feel taken care of. I'd just especially suggest taking a support person with you to aid with communication, both inside and outside the hospital. The only issue I had was communicating that I was having an allergic reaction to a particular drug to a nurse with limited English (though she just went and got a doctor.) Not a big deal, but nice to have someone to know to rely on because you won't be feeling well right after. https://www.angeleshealth.com/ https://lopezcorvala.com/

On the weight loss slowing, everyone here has already said that's totally normal. But since I'm a total nerd and tracked my weight loss, I can tell you exactly how mine slowed down. I've lost a total of 70 lbs over 23 months. Month 1: 3.5 lbs a week, reached -22 lbs Months 2-4: ~1.5-2 lbs a week, reached -41 lbs Months 5-12: 0.5-1 lbs a week, reached -63 lbs and passed my original goal weight at 11 months out Months 13-20: 0.2 lbs a week, currently at -70 lbs, 12 under my original goal Does this mean that you pretty much never dieted before you got surgery? Or are you comparing now to the first 6 months after surgery, where you didn't care about food much simply because you weren't hungry? After reading these boards for a few years, it seems that the people who have long term success do have to pay some attention to their diet to maintain their weight loss. But that takes a lot of different forms according to the specific issues and goals of different people. You won't necessarily have to pay as much attention to it in the long term as you do right now. Right now you're learning what works for you; later it will become habit. Especially if what you said above means that you never dieted much before - in this case you would be learning about what works for you for the first time. But for everyone, after bariatric surgery, you have to learn what your "new normal" is. Personally, my long term goal has been to maintain without having to calorie count. Before surgery, I was pre-diabetic and low carb was the only thing that ever helped me lose weight. After surgery, carbs are still an issue for me, though much, much less of an issue than before. Rather than limiting/counting carbs every day, I've found that having a 4-5 day period of low-carb every 3-4 weeks keeps my carb cravings in check. I still start my day with a protein powder latte and make sure that I have protein with every meal. Veggies help keep me full. If I feel hungry, I eat a snack, but I usually start with a piece of cheese or a few frozen meatballs (I love these things) before I have anything more junky. I eat sweets some days, but not all. I use things like sugar free ice cream or low sugar yogurt for a bit of a treat on other days.

There's truth in the gherlin explanation, but it's also oversimplified so maybe gives people the wrong impression. There's multiple hormones that affect hunger. Leptin is another hormone that makes you hungry - it is made by your fat cells as they lose energy. Leptin is proportional to the number of fat cells you have, not the volume of fat. Fat cells multiply as you gain weight, but they don't die just because you lose weight - they just get smaller. A normal weight person that used to be fat will be making more leptin than a normal weight person who was never fat because the person who used to be fat has more fat cells. Leptin is part of the reason why people have a "set point," or a weight that their body likes to be at that is maintained by the body by changing your hunger and metabolism. Insulin also increases your hunger in the long term. You make insulin after you eat, while you are feeling full. But if you are constantly making a lot of it, your muscle cells get resistant to insulin and have trouble getting food even if there's plenty of food in your blood already. They will feel hungry and tell you to eat more. This is why sugar is kind of addictive to people who tend towards insulin resistance. If your body isn't getting enough protein, that will make you feel hungry too, even if you are eating enough calories. Also, there's two sets of neutrons involved in hunger - your brain is one set, but your gut also has its own neural network, and scientist understand much less about how this "gut brain" works. One of my friends is a scientist in nutrition and physiology, and a member of obesity research societies. He's the one who told me about this "gut brain" stuff. Scientists in the field don't entirely understand why WLS works. One puzzle is that they've observed that insulin resistance improves right after surgery - within a day or two people will be off their diabetes meds. They know insulin resistance improves when you lose weight and when you exercise, but they don't know why there's this fast change after WLS. Another puzzle is that they've found that a few years out, WLS patients have a higher metabolism that is closer to a person that was never fat, whereas people who lost weight through diet/exercise have a much lower metabolism than a never fat person. WLS somehow resets your "set point," but they don't know how exactly. Scientists have tried to develop drugs that change these hormones like gherlin and/or leptin. "WLS in a bottle" would be much easier than actual surgery. But none of these approaches have worked yet. That's another indication that they don't fully understand how WLS works. But it seems likely that resetting your set point is a process that occurs as you lose weight. It's not just a change that occurs instantaneously when the surgery is done. It's not just that your smaller stomach makes you feel less hungry and you can't eat as much, so you lose weight. It's that the process - losing weight while spending a lot of that time not feeling hungry because your stomach feels really full - changes what your neural networks consider to be your set point, and that in turn makes you feel less hungry without your hunger increasing and metabolism dropping in the long term. If this is how it works, that would explain why the people who stick to the diet more strictly in the beginning have more success in the long term. For instance, if you eat sugar early on, that sugar is going to increase your insulin and insulin resistance and make you feel more hungry over the next week. Even though you may be eating exactly as many calories and have exactly the same stomach size as a person who is more strict about what they eat, that process won't work as well, and your set point won't get as low.

I had my surgery in Mexico. It was literally the best health care experience I've ever had. I researched the hell out of it and chose an excellent doctor and hospital. The doctor was trained and certified in the US, and had excellent success rates. If it's a quality hospital and up-to-date surgeon, they use the same medical practices as they do in the US. But because labor is so much cheaper there, the nurses hover over you and take such good care of you. I did have one issue when I had an allergic reaction to a medication and we had trouble explaining what was going on to the nurse, but then they went and got one of the doctors that spoke better english. I'm absolutely sure that your friend has your best interests at heart. But she may not be well informed about this subject. Lots of people think bariatric surgery is a bad idea no matter who you are and where you do it. My mom was definitely worried when I told her I wanted to do it. But she talked to my sister-in-law, who is an endocrinologist, and told her "oh yeah, bariatric surgery works, it will add 10 years to her life." And surgery in Mexico sure sounds shady. But there's crappy surgeons in the US too. No matter where you are getting surgery, you should research the hell out of it and choose someone who you trust. My mom was nervous about it, but she also went with me and helped me communicate. I was very happy to have her along since you often feel pretty bad right afterwards. There's nothing wrong with re-evaluating your plan and making sure you're comfortable with your choices. But there's basically a 100% chance that someone who loves and cares about you will think its the wrong decision. That doesn't mean you shouldn't do it. In the end, it's your choice, not theirs. You're the one who is living in your body, you're the one who knows best what you need, and you're the one who looked into this and got the information and made the decision. That's how it should be.

Oh yes, I was ravenous until I got on semi-solid food like eggs and cottage cheese. Personally, I attributed that to getting more protein. I really did not like the taste of protein shakes, and even though I was choking them down, I don't think I was getting as much protein as my body needed. But also, solid food makes you feel more "full" than fluids, no matter what their nutritional content. Studies of gastric emptying show that fluids leave your stomach much faster than solids, even if they have the same calories. (Water goes through your stomach even quicker than liquid food.) Once you start eating solid food, the fact that your stomach is smaller will really start fully working. Bariatric surgery doesn't just work because you can't eat as much. It also changes your hormones. Ghrelin is called the "hunger hormone" and your stomach makes it when it is empty. You make less of it after bariatric surgery because you have a smaller stomach. But you also make less of it when your stomach spends more time feeling full.

I don't know what your health problem is - maybe you do have a nutrition issue, or maybe it's chronic fatigue or fibromyalgia like I've struggled with, or maybe it's some other completely different health problem. None of us here know, including you. But it sounds like what your main problem is right now is that you're feeling so depressed and hopeless and lonely that it's going to be difficult to spend the time and effort to keep tracking down the mystery. I know you've already put a lot of time and effort into your health mystery, and you haven't figured it out yet. It's totally normal to be depressed in this situation! It's normal to be depressed when you're sick. It's even worse when no one around you even believes that you are sick and you feel so alone. Here is a link to a forum about chronic fatigue and fibromyalgia. Even if this isn't what you have, there will be lots of people there who understand being sick and not knowing what's wrong with you, and no one even believing that there is something wrong with you. https://www.healthrising.org/forums/ I hope it will help you feel less alone, and maybe a little bit less depressed and hopeless so that you can find the energy and hope you will need to keep trying out different ideas about what is wrong with you.

Why are you so sure that your symptoms are related to the surgery, since you say they started 6 months later? It certainly could be a vitamin issue. But there's also other possibilities. I mean your symptoms sound exactly like the problems I had for 5 years in my 20's, and then for about 2 years now. I was diagnosed with chronic fatigue syndrome back in my 20s. I wish I could tell you what to do about it, because I'm not sure myself. You could certainly seek out a doctor who is familiar with chronic fatigue syndrome. Right now is actually a good time to be looking because a lot of people are suffering with long covid, and some people think that long covid IS chronic fatigue. This doesn't mean that we've always had covid, but the idea is that chronic fatigue has always been a bad post-viral reaction (but can be caused by a variety of viruses.) However, I can very much sympathize with you. It's terrible because hardly anyone takes you seriously - not most doctors even. I'd need all my fingers and toes to count the number of people who told me I was "just depressed." But I've certainly been depressed before - and I know this ain't it. Here's an article I found really helpful. It's about medical professionals with long covid talking about how hard it is for them to navigate the health care system, even though they know it really well, and getting dismissed by their colleagues as "all in your head" or whatever. https://www.theatlantic.com/health/archive/2021/11/health-care-workers-long-covid-are-being-dismissed/620801/

This is such an interesting observation. I have never regretted it since the day after the surgery. I learned about it in Jan. 2020 and had my surgery in March 2020. For me, it was the fact that my metabolic symptoms were getting worse, and I was nearly the age when my dad got diabetes, and he seems pretty miserable now. Maybe you are right. The people who think about it longer may still be less sure about their decision, even after they've made it. Nevertheless, I do want to tell the OP and the other posters who are feeling regrets - for me, the painful/uncomfortable physical effects and some of the negative emotions (like feeling left out and feeling like a failure that you had to do this) were still very strong over the first ~9 months - but they are much better now. I don't feel pain when I swallow even water too fast; I rarely feel faint and need to lie down after meals. Also - at first you have rapidly changing hormone levels from fat-soluble hormones being released as you lose weight, and this WILL affect your emotions. In a year or too, you will likely start to feel better physically - much better than you do now, but also better than your old body did to at a year or two out. I'm 1.5 years out, and generally very happy with my decision, but I am still getting used to my own body and my new life. I still sometimes feel partly like an alien in a new world. That is a rough process. It takes time. Emotionally, it's normal to mourn when you undergo a major life change. The old you IS dead. There is no going back. Change is always hard, and that causes anxiety because you don't know yet how it will turn out. And while you hope that the future you will be healthier than the old you, of course you're also having trouble envisioning how happy that future will be. Certainly some of the pleasures the old you enjoyed have been lessened. Of course you'd rather be fat and happy, than slim and miserable! I would too. Let yourself mourn that. Sadness is a real, natural, normal feeling. Feel it. But don't forget to put some effort into the new you also. Right now you're taking a LOT less pleasure in food. But don't let yourself just wallow in depression forever. (Unless you can't help it - then seek outside help.) Think about having some new experiences and finding new pleasures. Or, perhaps think about if maybe there's something really painful in your life that you've been using food to avoid - perhaps there is a better way to solve that problem. Then, later, when most likely some of that pleasure in food returns, you'll be in a better place. I actually take much more pleasure in food now because I don't feel guilty and out of control around it, and the new changes in behavior have finally become habit. I can just focus on actually enjoying the flavor of food, not to mention the satisfying journey between anticipation and completion, hunger and fullness. I was always so hungry before - I never felt 'full' - I always just felt 'uncomfortable'. Also, there will be people who actually do feel worse in the long term. If that happens to you, seek out a therapist, or a particularly good friend, whatever you need to be able to talk about it. Feel free to send me a message if you need to talk. I may not regret this particular decision, but have certainly been other changes in my life that were irreversibly negative.

I was starving after surgery also. Moving towards real food helped - particularly the step from full liquids to purees. This is where I started to be able to eat some normal protein containing foods, like eggs and cottage cheese. (I really, really hated protein drinks until I discovered my protein powder latte.) After 1-1.5 months, when the amount I could eat also increased somewhat as the swelling went down, I went from starving to really full. Now I'm 18 months out and I still feel much reduced hunger. Personally, I think when people feel starving right after surgery, it is often because they aren't getting enough protein and their body has started to eat its muscles. I was reading a study the other day that says out of all the muscle mass you'll lose in the year after bariatric surgery (about 10-15 lbs on average), you lose half of that muscle mass in your first two months. That's almost certainly because people aren't getting enough protein at the very beginning because of the liquid diet/small amounts you can eat. Sure, it may be head hunger. But either way, I'd try increasing your protein first. Any time you feel hungry, start with whatever you can tolerate/is currently on your diet plan that contains protein.

Yeah, my weight loss has basically been like yours; really stable at about a lb a month for about a year now. It seems like it's a good idea to make changes slowly and mostly try to make good eating habits we got used to right after surgery into a lifestyle. For me, I sought out bariatric surgery because I was pre-diabetic and had gotten to the point where I was absolutely starving all the time. It made it so hard to stick to a healthy diet over the long term. Taking that ravenous hunger away made it so much easier to make a permanent adjustment to my diet over a long enough time period where it really became habit. But I also was able to add in a bit more carbs daily and eat sugar once or twice a week, and still keep up this slow but steady pace. I enjoy food so much more now that I feel in control!