SpartanMaker

+1 on this. There are lots of benefits to strength training, but the most germaine here is the fact that it will increase your metabolism.

I feel like you may have a misunderstanding here? (Unfortunately a very common one!) From the sound of it, you're expecting restriction to be the thing that keeps you from gaining weight, but that's rarely true for most post-surgical patients. A cursory glance at these forums should be proof enough of that. Look at all the posts from people asking for help because they gained a bunch of weight back and don't know what to do now. Some recommendations: Consider finding a therapist that specializes in eating disorders and work with them to reset your relationship with food. As long as you have a desire to be "full" and keep pushing the envelope, regain is going to be a real possibility. Talk to a nutritionist to get a handle on proper amounts and types of food that will work for you to maintain your weight. Track your calories and macros. If you don't know how much you're really eating, it's hard to know how much is enough, and how much is too much. Find a way to have your Resting or Basal Metabolic Rate tested (Google it). This will tell you how many calories you're actually burning per day. Use this, along with your food log to make sure you're not eating more than your burning.

In addition to the great advice above, I'd recommend creating a diary or log to help you track this. There are lots of different potential causes, so the more you can document, the more likely you can find the cause. Some things to document: Start by making note of the following: Any specific symptoms. "Shaky" can mean different things to different people, so you want to be more descriptive. Are you having any other symptoms that either occur at the same time or shortly before or after? The time it starts and the time it stops. Whether this comes on suddenly, or if it's more gradual. Other daily things such as the when you eat, when you drink, when you get up, when you go to bed, etc. what specifically you were doing when it started. What if anything you did to make it stop and how effective it was. After a while, you may start to see some patterns emerge such as Whether or not this happens only once a day, or multiple times a day. Maybe it happens at roughly the same time every day or maybe it's more random? If it's more random, are you noticing any other patterns? Maybe you are more likely to be in a particular room or participating in a specific activity when this occurs? maybe it's correlated with meals? (Up to 30-60 minutes before or after.) Perhaps it happens after eating something specific? I think you get the idea here. The more details you put into your log, the more likely you are to find help. Once you have this info, I think it will really help your medical team find possible causes. Also if you have access to a blood pressure monitor and a blood sugar test kit, checking those things multiple times a day, but especially when this issue occurs, would be a really good idea. If you do have access to those, add the readings to your log. I hope you figure it out. I know from experience that having no idea what's going on with your body is super annoying.

Regarding medications, I take 30 different medications or supplements per day and really don't have any issues taking them at this point. I obviously don't do them all at once, but it's not like I take them one at a time either. Right now, it's roughly five to seven at a time, spread throughout the day. I was pretty challenging the first few weeks to get everything in because at that point, I was having to take maybe one or two at a time. I'd say I did that for 3-4 weeks, and slowly started upping the amount I take at once. I'm hopeful I'll eventually get to just twice a day (because some of my meds are BID), but that may be a bit longer still.

I tend to just say "eating less and moving more". It's factually correct and avoids any judgements or follow-up questions I might get if I went into more detail regarding surgery or my specific diet & exercise routine.

Ah, but that's an entirely different issue. I 100% agree that many of these plans are not always easy to follow, but someone's ability to follow what they were told is independent of my recommendation to stick to the plan. Full disclosure, like @ms.sss, I have been paving my own way, rather than blindly following the generic plan I was given. I have a strong scientific background and understand human nutrition better than most, so I feel comfortable deviating from what I was given. I understand the why behind the recommendations and understand how to bend the recommendations without breaking them. There are a lot of people that have WLS and just don't have that sort of background or knowledge. As a result, I think it would be irresponsible of me to tell them anything other than "follow your plan", or at least "talk to your team". Also, don't even get me started on what I think about some nutritionists and the advice they sometimes give that has absolutely no scientific basis other than what they were told in undergraduate school 30 years ago. At least those nutritionists have a working relationship with their patient that I just don't have. Plus, to people here, I'm just some rando on the interwebs and as a general rule, forums, as good as this one is, are not the right place to be getting medical advice.

Full disclosure: I still eat fast as well, but like you know my limits. This has worked for me and though I'd love to slow down, I'm just too old of a dog to learn this new trick.

Fair point. I mostly put it that way to keep from going down the rabbit hole regarding whether it's okay to deviate from the plan you were given. Especially since advice given here on this forum (or elsewhere online), may well be even less beneficial than the admittedly sometimes marginal plans many of us received. I look at it like this: Can you eat off your particular team's plan and still be successful? Absolutely. Can you also be successful if you follow their recommendations closely? Certainly. Unfortunately what is also true is that if you don't know what your doing, or not monitoring closely, you can also get into trouble eating off plan. Thus my real point is stick to the plan your were given and your odds of success are good. Deviate from that plan and you may or may not be successful depending on your own personal experience and knowledge regarding nutrition and your ability to keep from falling into old bad habits. Simply put, following the plan you were given is the safe choice.

I certainly understand why you'd say that, however I do worry that you and others are beating yourselves up over this concept of "willpower", when self control/willpower isn't actually what separates those that are successful at weight loss and those that aren't successful. I mean, I get it. We've been told this over and over again, but there is a growing body of research that shows it's not self control that's actually at work here. In reality, your ability to resist that tempting food is no different than successful dieters, or even people that have never had a weight issue at all. What those folks do differently is reframe the problem. For example, instead of thinking resisting a particular food comes down to "being strong", they might mentally tell themselves that it actually tastes bad, or maybe they visualize the lousy feeling they tell themselves they'll feel after eating it. Over time, these sorts of approaches help them develop new habits that replace the old unhealthy ones. It's not an instant process, but it is something that anyone can do. For those that need the help, this is something a qualified therapist can assist with. I mention all this, because beating yourself up for being "weak" is counter productive and just makes the problem worse. Obese people are not weak or lacking in self control. Some of us just lack good strategies for replacing bad habits with good ones.

There's a lot to unpack here. Let's start with why we're told to eat slowly: First of all, recognize that you had a bunch of nerves cut. There are multiple ways your digestive system signals your brain that your are full, but these nerves are the immediate feedback mechanism. Unfortunately, that immediate feedback mechanism is basically broken for a while after surgery. The other signals that you should stop eating are mostly hormonal, but these take a lot longer to activate. (20 minutes is often thrown around, but this is dependent on lots of factors like what and how much you ate.) Bottom line, if you eat faster, it's easy to eat enough to make yourself really sick before you ever get the signal to stop. Obviously this is problematic partly because your stomach is smaller and will fill up faster than it used to, but you also need to remember that early on after surgery, your stomach is also really swollen and inflamed. An inflamed stomach can't stretch like it's supposed to, so there's not a lot of difference between empty and over-full. Taken together, the eat slow recommendation is primarily to keep you from making yourself sick. A secondary consideration is that your team wants you to learn "mindful eating" where you're much more aware of everything that you consume. Being mindful of your consumption is correlated with better outcomes for bariatric patients. Hopefully that answers your original question. I want to touch on something else that's a bit of a personal pet peeve: you mentioned, and I hear a lot of others worrying about "stretching their new stomach". There's more myth than fact here and this idea really needs to die out. The truth is that stomachs are designed to work like a balloon. They stretch out as needed, but when empty, they return back to their original size. Can you make it stretch it out to the point it allows you to eat more over time? Yes, and that's exactly what should happen! This is one of the reasons every bariatric plan I've ever seen allows you to slowly increase how much you eat the further away you get from surgery. You need this to happen so that as you get to maintenance, you'll be able to eat enough calories to maintain your new healthy weight. What you're not going to do is somehow "ruin" your new smaller stomach just because you overate once or twice. It would take overeating a lot over time for excessive stretching to happen. I think what sometimes happens is the inflammation starts going down and people find that they can eat more than expected. Remember, the stomach stretches as needed (up to a point), so they start to panic. That does not mean there's a problem. It actually means that things are progressing like they should. If this is you, just stick to plan and you'll be fine.

It about has to be something you're eating. I don't think this is necessarily related to your weight loss surgery, but it's possible I suppose. If you haven't talked to your surgical team, I'd recommend at least asking about it. That said, I'd be looking first at a food insensitivity. There are lots of things people can have issues with, but some of the more common ones are dairy, histamines and gluten. You can try an "elimination diet" to see if what you're eating is causing the problem. Google it if you're not familiar with the idea. Something else to consider is adding probiotics to your daily regimen. When your gut bacteria are out of kilter, it can cause a lot of gut issues including bad gas. Good luck.

The truth is that you are many times more likely to die of complications related to obesity, than you are from anything related to the surgery. In addition, WLS surgery actually has a much lower complication rate than a lot of other common surgeries like knee surgery. While nothing's guaranteed, as long as you follow your surgeon's instructions like quitting smoking (if you smoke), following your pre-op diet (assuming you have one), following your discharge and post-op instructions, it's really unlikely you'll have any issues whatsoever. The complication rate is a lot higher for older patients (70+), smokers, and those with severe pre-op conditions like undiagnosed heart disease.

I also take a LOT of meds and supplements. I'm probably at about 30 per day. I had no issues whatsoever taking everything once I got home from the hospital, but I did have to space things out a bit. Early on, it was quite a chore just keeping up with everything. The biggest issue was that I was told not to take more than 1 capsule at a time since they can stick together and then potentially not pass through the stoma. More than one tablet at a time was fine, but capsules I needed to be careful with. Now that I'm further out from surgery, I don't really worry about that anymore. I currently take quite a few tablets and capsules together and have no issues.

I have no issues whatsoever taking pills. I'm 4 months in now and I can take a big pile at a time just fine. Hopefully it will be the same for you.

That's awesome news! I too have been dealing with something sort of similar, so I totally understand. Back in november, I noticed a mass in my neck. We did some biopsies, but they were inconclusive. I'm sitting here right now after just getting home from having the mass surgically removed. I unfortunately won't know for sure if the tumor was malignant or not until sometime next week. It's really tough dealing with all the emotions, but probably hardest for me has just been the thought that I worked so hard and went through so much (e.g. WLS), to try to get healthy, only to discover it may all have been for nothing. Could really use all your thoughts and prayers as I fight through this and hopefully fully recover.

Fairlife is my go to. I especially like the Salted Caramel and if you shop at Costco, they carry them. I find the Fairlife drinks just plain taste better than most other brands I've tried. I also learned something cool, at least for me. If you like Lattes or cappuccinos, Fairlife will froth just like milk. (Premier Protein won't.) I froth half of one of Fairlife drinks and add that to my coffee of choice a few times a day.

I had surgery at 58. Looking of global demographic data, it would appear that the average age for weight loss surgery in most Western countries is between 45 and 50. Asian and Middle-eastern countries tend to have a younger demographic.

I bought a couple and personally didn't find them useful at all. Early on post-surgery, they were suggesting things that didn't match my plan, so I couldn't make any of the recipes. An example I remember is something called "Ricotta Bake". This is supposed to be a puree stage food, but it was not allowed on my plan until later in soft food stage. By then, I didn't have to restrict myself to just the ingredients in Ricotta Bake, so I never ended up making this. There were lot's of other examples, but this is one I specifically remember. I'd also say that 75 or 80% of these recipes are readily available on the web for free, so once again, probably no need for a cookbook. I'm 4 months in now and we just make "normal" recipes. I simply eat less of whatever we make.

Yes, crazy good to wear those smaller sizes! I've been losing so fast that I've actually dropped through some clothes I bought after surgery. I still struggle to see it myself sometimes, but going from a tight 44 to a lose 38 waist in pants makes it pretty obvious. I've had a few major stalls as well, but am officially down over 100 pounds now. I'm obviously really happy about that, but also a bit shocked at how fast it's come off. @Hope4NewMe don't count on maintaining a 10 pound loss per month. For the math geeks, most of the time weight loss follows a pattern called exponential decay. It looks something like this: The important takeaway is that the closer you get to goal, the slower the loss.

I think there are a few questions you need to answer first: Why are you struggling to lose that last 100 pounds? What are you expecting medication to do for you that you can't do on your own? Can you afford it? Most of the newer GLP1 agonist weight loss medications (e.g. Ozempic, Saxsenda, Rybelsus and others), are not covered by insurance. If you are self pay, they may cost $1,200 to $1,500 a month or more. Keep in mind (as some have pointed out above), most people that lose weight with these meds gain the weight back when they stop. If price is not a consideration for you, can you even find the medication? Some of these medications are in critically short supply right now.

I concur with @summerset. I'm not really following what you mean by "more than recommended" or why you find it worrying? If you're eating more than your team said you should, stop doing that. Problem solved. Keep in mind that early on after surgery your stomach is inflamed and multiple nerves have been cut. In short, it's unlikely that you'd be able to feel all the appropriate signals to tell you when you're full. This is why most team's have recommendations on specific foods and volumes you should be eating at every stage. These are not only for the safety of your healing stomach, but also to keep you from eating so much you make yourself sick. They are NOT hard "limits" of exactly how much your stomach can hold. Please tell me if I'm wrong, but my suspicion is you were expecting surgical restriction to keep you from overeating and you're testing the limits. Because you are able to eat more than what your team suggested you eat, you are worried that this means you're going to fail later. This is an important point, so I'm going to bold it: Success or failure post-surgery probably has more to do with your ability to follow your team's recommendations than it does with you being restricted by a smaller stomach. Once you get past the initial stages, it's can be as easy to overeat as it was before surgery. If you are headed down this path, I highly recommend working with a therapist that specializes in disordered eating because surgery alone may not be enough.

it's not that unusual to see similar results. You are likely just retaining fluid post-surgery (very common), which could mask any fat loss. Give yourself time and try not to stress. The weight loss will come.

Here's my two cents: Obesity is a medical condition and bariatric surgery has proven to be the most successful long-term treatment option. I'm surprised that even among those of us that have had WLS, we sometimes still act like it was needed due to a lack of willpower or some sort of moral failure. We really have to get over that and acknowledge obesity as a disease state that sometimes requires surgical treatment. To me, it follows that many children also suffer from obesity and that it would be morally wrong to withhold effective treatments options. I wouldn't withhold cancer treatments from a child, so why would it be okay to withhold WLS from children if we know that it can effectively treat their disease state? Regarding all the comments about can a child understand the need or what's required long-term, that really feels like a red herring. Just like we all had to show that we were ready for surgery by jumping through various hoops like psych evals, nutrition visits, & documentation of past diet failures, I would expect the same to be true for children. Those children or parents that aren't ready would be disqualified, just like some people can't or won't complete all the requirements as adults.

There are lots of diet plans, both pre and post WLS so it's hard to say exactly what you should do. Personal preferences also play into this a lot. I'd recommend talking to your team as they will have the best info regarding their plan and what they want you to do. As far as protein drink recommendations, I prefer the Fairlife Nutrition Plan pre-made shakes to most others. On the exercise front, sounds like you have a decent plan already, but I'd add a couple of things: Squats are great, but don't neglect your upper body or core. If you can, add in some planks, side planks, pushups and pullups. All of these can be modified to where you're at physically. For example, if you can't do a regular pushup, start with wall pushups. Progress to an elevated surface such as a bench, then move on to a pushup on your knees, etc. Make sure you keep in mind that you want to keep progressing in both the strength and cardio work. So maybe instead of walking just a mile and quitting, try to extend that a few minutes this week, then do a few more minutes next week, etc. Work up to 45 minutes to an hour a day. Instead of just increasing time, you can also vary your pace with walking "intervals". This would be maybe 30 seconds of all-out walking as fast as you can, followed by 2-3 minutes of a more normal pace to recover. Over time, make the all-out push last longer and/or shorten the recovery period.

Reposting something I posted elsewhere: 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.