SpartanMaker

Sounds like a plan. I would also definitely recommend strength training. It does not have to be anything fancy, even a solid bodyweight only routine would help. You can google something like "bodyweight exercises for beginners" and use that to get started. Note that it's not unusual for beginners to see both extra water retention and even muscle growth when starting strength training, so don't be surprised if you see a jump up on the scale. This type of exercise will not only burn calories, but will also boost your overall metabolic rate, meaning you'll burn more calories, even at rest.

An endocrinologist works with pretty much any issue related to the endocrine system, meaning your thyroid, pituitary gland, hypothalamus, adrenal gland, etc. Basically most anything hormone related is something they can help treat. You can always ask you PCP for a referral, but depending on your doc and your insurance, they may be loathe to do so if you don't have anything showing up on your blood tests. If you're insurance does not require a referral to see a specialist, the you can always just make an appointment. There definitely are some hormone imbalances that can slow your metabolism such that your maintenance calories will be pretty low. Alternately, it may not be a hormone imbalance at all. It may just be what's normal for you. One additional thing for you to consider is that exercise, especially strength training, would allow you to eat more without gaining. What's your exercise routine look like right now?

I have something sort of similar going on, but maybe a little different? I can't walk a straight line to save my life! If I ever get pulled over and am asked to do a drunk test, I'd fail miserably, even though I'm stone cold sober. I'm thinking it has something to do with my center of gravity changing and my body not being able to adjust fast enough? Maybe that, combined with just being a bit light headed all the time from a drop in blood pressure? Whatever it is, I'd like to get over it soon!

Are you talking about a metallic taste? I don't have this problem, but I understand it can happen to some people. I'm not saying this is the cause, but it might be an indication that you actually are suffering from hypercalcemia, which means you have an excess of calcium in your blood. It might be worth talking to your medical team and having some test run to rule out medical issues? If it's not a metallic taste, then all bets are off, but I still think it would be worth a discussion with your doctor and maybe some blood test, just to rule out anything.

The only real way to know this would be to have your Basal or Resting Metabolic Rate analyzed. While BMR and RMR are technically slightly different, they are often used interchangeably. The tests to determine this are readily available in clinics and even some gyms. You should be able to find some options by googling something like "metabolic testing near me". Note that there are a few different types of tests used (feel free to research them), and some are a bit more accurate than others, but they are generally pretty close. Alternately, there are online calculators that you can use, and even some digital scales (those that use BIA), that can also provide either your BMR or RMR. Unfortunately, neither the scales or calculators are all that accurate. It's not uncommon for those to be off by 10 or even 20%. Obviously more than enough to have you potentially eating too much.

My team actually had me hold off on the ursodiol until the 2 week follow-up. They didn't explain why, but I suspect it's just because that's a pretty large capsule.

I hear ya. I think for some people, they have them open up the capsule and add it to yogurt or something. I didn't have to do that, so didn't worry about it.

Capsules were recommended by my team right out of the gate, so that's where I started and never had a problem. I also agree that the chewables are just plain bad.

It's hard to know ahead of time how you may feel 3-4 weeks post-op. Some people are fine or even have more energy than before, and some can get tired pretty quick due to the low caloric intake. You may just have to bow out of some activities based on your energy levels. I'd honestly be more worried about lots of eating out (if that's what your family does during this time), and your ability to follow your program.

Sorry for the novel folks, but maybe before getting to tips and tricks, let's talk a bit about what causes plateaus: First, the most common reason for any stall, including the dreaded 3-week stall is simply that you are retaining more water. There are a few reasons this happens, but around the 3-week mark it comes down to the fact that your body is adjusting to a low carb intake after converting from glycogen to ketones for energy. More water is needed to burn glycogen, so you were retaining more water pre-surgery than you are now that you're using primarily ketones for energy. At about the 3-week mark, your body eventually recognizes that the water loss is long term, so other mechanisms have started kicking in to start holding on to more water. This water loss due to the change between glycogen and ketones is the primary reason for "keto flu", and something that increases your risk of dehydration early after surgery. The other "reasons" for plateaus really don't apply as much at the 3 week mark, but will become more important later in the process. Let's cover those too though so you're prepared: As you lose more weight, your overall metabolic rate will slow down. People sometimes think fat is not metabolically active, but that's not true. Less fat means your metabolism slows down, even if you retain the same amount of muscle. As you lose weight, it takes less effort to move, so the amount of calories you burn from activity also drops quite a bit. As you progress, you'll be able to eat more and especially if you're not tracking intake closely by weighing and measuring your food, you can easily be eating a lot more than you think. This one may be TMI for some, but you may simply be retaining more stool. This is going to be hard for some people to hear, but I can tell you one thing it's not, and that's hormones. Yes, various hormonal processes negatively impact weight loss in a myriad of ways, but they don't overcome basic physics: if you eat less than you are burning, you'll lose weight. What these hormones can do if they're out of whack, is not good things like slowing your metabolism, increasing your hunger, screwing with water weight, or even fooling you into thinking you're eating less than you are. So, with all that sciency stuff out of the way, what do we actually do if we're in a stall? Well, I think it depends on when it happens and how long it lasts: If it's early (a.k.a. the 3-week stall), just keep doing what you're doing and you should be fine. I know people don't like that advice, but as I said, it's just water, so don't worry about it. Later on, especially if the stall is lasting longer than 2-3 weeks. that's when I think it's important that you look closely at what you are actually burning, as well as really tracking what you are eating. If you don't know your BMR (Basal Metabolic Rate), you should. The closer you are to goal, the harder it is to get the balance right between intake and output to make sure you're not eating too much, so fixing this starts with knowing your BMR and accurate food logging. There's a lot of anecdotal advice thrown around about "ways to break a stall", but there seems to be little scientific evidence for any of it. Most of it certainly won't hurt to try, e.g. breaking up your routine in terms of diet or exercise, but just understand that this change may or may not have had any impact. If it makes you feel better to be proactive, go for it. Longer term, there is one piece of solid advice that's backed up by lots of research: Even if you don't really like working out, do it anyway. Those WLS patients that make a regular habit of exercising for 45 minutes to an hour most days a week are significantly more likely to reach their goal and maintain the weight loss. (One caveat here: significantly changing your exercise routine can make you retain water and possibly even add muscle, so don't freak out if you see a stall or even a gain.) I'll take that exercise advice one step further and say you really should be doing some form of strength training. This is also backed up by lots of studies, but the great thing about strength training is that it makes your burn more calories even at rest (in other words, it increases your metabolic rate). There are lots of other benefits, but the metabolic benefit is the most germaine to the stall question. Those that do strength training are less likely to stall during weight loss.

I suspect this is one of the reasons many doctors (like mine), recommend a lower carb diet, at least initially after WLS. I personally have a love/hate relationship with low carb dieting. I lost a great deal of weight doing low carb ~20 years ago, but ended up gaining it all back and then some, because I found it unsustainable long-term. As a result, I'm intending to take more of a "smart-carb" approach this time. The reality is, not all carbs are the same. My plan is to limit my intake of simple carbs, especially processed foods as much as possible, while adding in complex carbs via whole foods as tolerated.

My surgeon and I agreed that at 6 months post-op, it would be a good time for me to get retested. Your results may vary, because where I started, the rate I'm losing at and the amount of weight I lost pre-op are all different than you. I suspect I'll be at most, within 20 pounds of my initial goal weight at the 6 month mark and very likely less than that.

Maybe I'm hungry or something, but I keep reading the title of this thread as FOOD shrinkage, and I think, duh, what did you think would happen when your stomach shrunk! That's all. You can all go back to talking about feet now.

I had another anecdote to share: My wife is also overweight, but she's decided WLS is not for her. That said, she's been doing a fantastic job of losing on her own. She told me yesterday that apparently the rumor going around her work is that SHE had weight loss surgery. She even had people ask her if she had surgery and some people didn't believe her when she told them no. According to her, these almost universally seem to be other overweight/obese people? It's as if they are saying that she must have some magic secret for all her weight loss and we all know that weight loss surgery is magic so that must be it...

We kind of played it by ear. My doctor suggested I ask for 6 weeks up front because that should be about the max I might want, even if we had major complications like having to do the surgery as an open procedure instead of laparoscopically. I went into things actually expecting to only need roughly 2 weeks. At my 2 week follow-up, the PA and I agreed that I'd do another 2 weeks part time just to make sure I didn't overdo things and end up hurting my recovery. One of my biggest challenges with going back to work has been getting my fluids in. I sometimes forget to drink while I'm mentally focused on a task or in meetings. Pre-op, I could just gulp some water whenever and be fine, but that no longer works! I think a lot of people can successfully go back to work sooner than i did, but I like that I had the freedom to choose what was right for me. I wasn't rushed to go back because I was worried about burning through my PTO hours, or because I'd only asked for a certain amount of time off. Here's the thing. I had virtually no pain or nausea, so those weren't even considerations. The challenge for me was (and still is), that eating so little leaves me fairly fatigued and mentally drained. Even though I work from home, it was better for me to take a little more time to make sure I was ready to actually do what I'm paid to do. That said, I'm also 58. If I was younger, I probably could have started back sooner. I know some people do successfully go back to work sooner than I did and understand some don't have the luxury to decide for themselves. In the end we all have to do what's right for us based on our own set of circumstances. TL;DR: if you have the benefit, I'd definitely use it. You should be able to work with your bariatric team to decide when going back to work is right for you. (Which sounds a lot like a commercial for disability insurance, though I promise I don't work for an insurance company!)

I didn't really have a choice. Per my companies policy, if I'm going to be out more than 3 works days due to a medical issue, I'm required to file for short term disability. Could I have tried to do it under the table? I suppose, but what if something went wrong and I wasn't able to return as scheduled? Process wise, it depends on your company and their provider, but most likely you'll start the process by contacting your HR department or the insurance carrier, or both. They then request paperwork from the surgeon and make a case decision at that point. To be released back to work, the insurance carrier also typically needs the doctor to sign-off, so there will be a little more paperwork post surgery for you and the doctor. For me personally, the thing that I have always hated about using short term disability is that 30% of my compensation is a bonus plan. The short term disability pays my salary at 100%, but my company does not use the disability pay when calculating my bonus, thus i lose a little bit of money overall. Aside from that, you pay for the insurance so you might as well use it, right?

Congrats on your success and thanks for sharing! Though I never played any sports at your level, I was very active when younger until sidelined by a serious injury. Continuing to eat like I needed to when i was burning through 5-6k calories a day had a pretty detrimental impact on my health. Glad you finally found something that worked for you!

Same here. Didn't bother and didn't need to, but for some folks it may be useful.

I got a bunch of the 1oz cups from the hospital, but stopped using them after the first few days. What I did use a little longer was Dixie cups like you use in the bathroom. These are cheap for a huge amount and supposedly hold 3 oz filled to the top. I just learned where the 2oz line was and filled things to there.

This made me think about my own decision not to share my surgery with anyone that didn't have a "need to know". Virtually everyone I work with has never actually seen me in person, only via zoom, since we almost all work remotely. I didn't tell anyone, even my boss that I was having weight loss surgery. Quarterly, my larger team (50-60 folks) gets together in person now, but I've put off traveling for these meetings for most of the year. I used my significant hearing loss as the main rationale. I do have a significant challenge hearing in crowded rooms due to my hearing loss, so it's absolutely an issue. If I'm honest with myself though, I put off going mostly because I was ashamed of my weight. I also knew that after surgery, I'd be closer to a "normal" weight and while some might notice a difference between "video" me and "in person" me, I figured it won't be nearly as noticeable for most folks. Anyway, mid-December, I'm finally planning to go to the quarterly get together. Fair or not, I know 2 things are true, and I made the choices I did based on this: Being obese carries a significant stigma that we are lazy, have no self-control, are morally bankrupt, are unattractive, etc. I've seen and felt this personally and its impact on promotions and work assignments. No one will ever admit to feeling this way or letting it impact business decisions, but it happens consciously or not. (I digress here a bit, but if you doubt this is real, look at the C-suite in any major corporation and one consistent theme is that it's exceptionally rare to see someone that's even overweight, much less obese.) Many people think that WLS is the easy way out, so don't associate weight lost this way as "redeeming ourselves" for the laziness and lack of self-control. In effect, only if you lose weight "naturally", are you proven "worthy" again. Frankly it sucks that these attitudes are so prevalent, but they are. I made the choices I did because I don't need anyone at work judging me or my motivations. As someone else said, I did this to save my life. We should be celebrating it. Instead, it's just more stigmatizing.

LOL, what you've said you've done makes you look like an amateur compared to me! I have 12 different calcium chews and 6 different bariatric vitamins. I stocked up on over 100 premixed protein drinks, several protein powders, grocery store foods, and dozens of different options of so called "bariatric" foods. There's no question that I went overboard, but maybe it's the boy scout coming out: I wanted to be prepared. I also didn't want to be a burden on my wife, and ask her to have to go shopping for me if I wasn't able to tolerate what we had in the house. I 100% agree with @ShoppGirl. If this is helping you feel in control, then I think it's healthy. Only you can decide if it's become a problem for you.

Yea, typical stupid BMI based guides. Fun (or not so fun), fact: BMI was never meant to tell anyone what they should weigh. It was developed almost 200 years ago by a Belgian mathematician (not a doctor), that was looking to define the normal curve for weight distribution across the human population. The formula is basically your weight in kilograms divided by your height in metres squared. It's an excellent tool for scientific analysis on large groups of people where "averages" matter. Using it as a guideline for what any single individual should weigh is nuts though! BMI doesn't take into account frame size, bone density, race (yes, BMI is racist), muscle mass, medical history, or anything else on an individual level that might account for a variation in weight. As an example, did you know that competitive male bodybuilders (with bodyfat percentages around 4-8%), are almost all considered "obese" or even "morbidly obese" based on BMI alone? Anyone trying to use a BMI chart to determine what they "should" weigh is well advised to proceed with caution.

The way I look at it is that the vitamins are cheap insurance. Even though I just had surgery, I've taken a multivitamin for years. Not because I was trying to make up for a diet deficiency, but because there are some really nasty diseases/conditions that can occur if you did end up having a significant deficiency of certain vitamins or minerals. Even with just lower levels of some things, you can be left feeling not so hot. So the question in my mind isn't why take a multivitamin, but rather why not?

I'm not familiar with the Bariatric Fusion brand (I use Bariatric Advantage one-a-day with Iron), but based on a comparison I did, most of the bariatric vitamin brands are fairly similar. If you're doctor recommended Bariatric Fusion, you should be fine using it. I'll go out on a limb a bit here and state that the majority of us probably take one-a-day capsules. Why capsules? Lots of us have found that the chewables don't taste very good. Why one-a-day? because why take more pills than I have to? You can probably check the Bariatric Fusion website, but most of the time, the only real difference between the one-a-day versions and the multi-day ones is that the one a day is bigger. If you have issues taking large capsules, you might want to stick with multi-day. Separate vitamin D or B12 may or may not be needed. Your multivitamins already have D and B12 in them, so unless you're one of the folks that have a hard time absorbing those from you multivitamins, I don't think a separate supplement is needed. Best to check in with your medical team on that one, but most people only use it if their labs show a deficiency. You don't want an ADEK multivitamin. Those are designed specifically for DS patients. Collagen is fine to take. It's a good source of protein, though it is missing one essential amino acid. Nonetheless, if your other protein sources are complete proteins, I don't see anything wrong with adding collagen as well.

I'm still trying to figure that out! If I overeat (or what I assume is overeating?), I don't seem to get any of the horrible symptoms I was told to expect, just maybe some additional upper abdominal pain? It's almost, but not quite like heartburn. I also notice, often a bit later, that I feel fuller lower down in my abdomen. I assume that may be me feeling the roux limb being full, but I'm not sure?