lunadreams

Thank you for this. It is so helpful! I've never been a crash dieter, and I'm worried if I can sustain being as strict as I should be! I hear such conflicting advice, between "slow and steady" and "take advantage of the 'honeymoon' time as much as you can, because it's never going to be this easy again to lose weight." I'm trying to find a bariatric therapist, but having a hard time finding someone who accepts my insurance who seems good. It's kind of weird to start thinking of myself as having disordered eating, because, for the past couple of years, I've been eating about 1600-1700 calories a day while exercising almost every day, and still not losing weight. I don't binge or restrict excessively. But I realize that, for sure, even though I'm not consuming a ton of calories, I definitely graze/snack more than I should (which I know is a pitfall for after weight loss surgery) and sometimes do eat when I'm upset or bored. And I know that a lot of social activities have centered around eating, and I've always loved to cook and bake and share food (thankfully, I do not enjoy eating much sugar!), and I know not being able to do those things in the same way will feel like deprivation and I'll need to adjust to it. So, definitely issues to work on... Unfortunately, I can't do much weight-bearing exercise, as per my neurologist, so I'm planning to get a bike, but temporarily am using one at my local gym. Good tip about supportive and unsupportive people. Did you tell many people? My husband and kids are super supportive, and I plan to tell some friends, but I have a weird relationship with my mom, who was always very body-shaming, and has her own issues around weight, and the thought of talking to her about it makes me cringe, but it also seems like it will be hard to hide it.

Thank you. Do you track as intensively now as you did in the beginning, or just periodically to make sure you're not straying too much? Yeah, my surgeon was very upfront that most people do regain a small percentage of lost weight after a couple of years. It's good to be aware of that so it isn't shocking, but also a little disheartening.

Thank you so much for all the details of what it’s really been like!

Update: I decided to go with the sleeve, after a consultation with my neurologist. She had said that the risks for neuropathy are higher with bypass, and since I already have it and don't want to do anything that could exacerbate it, I just feel more comfortable with the sleeve. Thanks to everyone for the advice.

Hi, I'm trying to decide between sleeve and bypass, and I know the vitamin requirements are more stringent with bypass. Are the vitamins you need to take after bypass all available in chewable/liquid/small tablets, or do you have to take capsules or large tablets? I can't swallow capsules and struggle with larger tablets. Also, how common are vitamin deficiencies after bypass? If I've had B & D vitamin deficiencies before (I had a B12 deficiency when I was vegetarian that did not improve with supplements...had to start eating fish and eggs to correct it, and have to take at least 10,000 IU of Vitamin D daily to have normal levels), am I more likely to develop vitamin deficiencies if I get bypass? I'm afraid of the malabsorption if I may not respond as well to supplements...

Thanks, I know D deficiencies are common, but just worried that I had B12 deficiencies before as a vegetarian that did not respond to supplements...they only normalized after I started eating eggs and fish. Just wondering if I may be more inclined toward deficiencies and may run into a problem if I don't absorb supplements well...

My endocrinologist told me that people with lower BMIs may be covered, but only if there is a serious medical issue.

Thanks, everyone, for the thoughtful advice! 😊 It seems difficult to get a consensus amongst my doctors (and myself). It seems like they feel either would be appropriate, and that switching to bypass would be a toss-up between a somewhat increased chance of resolving diabetes and losing a little more weight versus an increased risk of long-term complications and vitamin deficiencies (which I've struggled with in the past). I don't think any of my doctors feel there's a really clear answer, and that's what's making this decision really difficult. 😳

What do you do for the first couple of weeks after surgery if you have a medication that is supposed to be taken with food?

Thanks so much...good to be aware of those issues, will definitely discuss. One is an anti-inflammatory that is less corrosive than the NSAIDs that gave me an ulcer, but I’m supposed to take it for another couple of months. I may just have to delay my surgery until I’m done with it.

I’d definitely be open to an LGBTQIA+ forum, here or elsewhere.

What is the rationale for not drinking water before eating? Isn't water digested quickly on an empty stomach? Also does this mean you can't even have a small sip or two with meals? Is that permanent?

I have to go for an endoscopy before surgery, and have my first visit with the GI doc on Monday.. When I was talking with my surgeon today and expressing concern about nausea on the liquid diet, and I shared with her that I tend to get really nauseated in the morning before I eat and at night if I don't have a little something before I lie down, she said it sounded like "classic gastritis" (as well as some GERD). I wish I'd asked her...does having gastritis and/or GERD rule you out for sleeve, or can it be treated/managed? I really don't want the lap-band, which is the other surgery she suggested for me, and I was hoping to avoid the bypass, as well, because of malabsorption issues.

I'm doing my surgery at one hospital, which requires bloodwork, endoscopy, psych assessment, nutritionist visits, and six months of visits. Because it's not super-convenient for me to get to, I decided to do my endoscopy with a doctor that is in the hospital's network, but closer to where I live. She was really surprised that I didn't need a sleep study, pulmonologist clearance, stress test, and cardiology clearance (and, oddly, repeatedly asked ME why all of this wasn't required, even though I am definitely not the one deciding on what the program's requirements are or knowing what their rationale is?). I imagine, they'll do whatever clearance they need at the pre-op testing once the surgery date is set, like I've had done for other surgeries. But I'm curious if others have had to do sleep studies, go see a pulmonologist, and a cardiologist, prior to the hospital's regular pre-op testing? She did tell me, after questioning why I was having the surgery because my BMI is borderine (I have other health issues) that I would have to have the endoscopy at the hospital (a different one from where I'm having the surgery) instead of as an outpatient because I'm "pre-bariatric," though someone else I know who saw a different doctor with similar BMI within the same network who was not "pre-bariatric" was able to get it done in the their outpatient center. She told me it was a liability issue. Have others found the same?

I just met with the one at my program last week and was also really disappointed. She mostly just asked questions for the insurance and went over the pre-op and post-op diet. She seemed very rote and not at all interested in why I was there or what support I may need.

Hi, I have PCOS (as well as Type II diabetes and hypertension), with a BMI of just over 35. The surgeon recommended the sleeve for me. I hear some say bypass is better for PCOS, but I don't really want to do that, because of the risks. My fear, though, is not losing weight with the sleeve because of my PCOS, or hunger coming back to the extent that I end up going through all of this, only to gain back whatever weight I lose. Also, I've heard that most people end up losing 50% of excess weight. Does that mean initially, or after the honeymoon period when many people gain some back?

I spoke to the surgeon again today. She entered a ton of info into some kind of calculator, and I said I will probably end up around 160 (just an estimate, of course). She said, because of my PCOS, it may go more slowly. I hope I can lose more, but I would be happy with that, if I could maintain it.

The soonest appointment the surgeon I consulted with had was about two months out.

I'm taking Ozempic for my diabetes. I will speak with my endocrinologist before my surgery, but I'm curious to know if those of you who were taking Ozempic before surgery for diabetes (not for weight loss) continued the Ozempic through/after surgery, or if medications were stopped, or if the injection was replaced by something else? I'm on Ozempic because Metformin caused major hair loss for me, and I don't want to take it.

Thank you...that's good to keep in mind.

Hopefully, it'll be slow and steady for you. I understand that worry, though...

Interesting! I met with the nutritionist yesterday, and she seemed kind of clueless when I asked about plant-based protein shakes. I'm not totally dairy-free, but I limit it because it messes up my sinuses. Curious to know what plant-based protein drinks and/or powders you like? I'm a little wary of plant-based powders, because they can be gritty...