SpartanMaker

They probably didn't give you any calorie values because they don't want you worrying about that yet. As long as you're not eating more than the recommended amounts, you'll be fine. As to macros, the absolute minimum recommended protein amount would be 60 grams, but really, shooting for 100+ would be better. It can be hard for some folks to hit that higher value early on, so as long as you're getting a minimum of 60, you should be okay for now. Just try to work up to 100+ as time goes on. Eventually, ~1 gram per pound of bodyweight would be a better target for protein, but I'd be surprised if you're able to get there at 2 months post-op. I wouldn't worry too much about carbs and fats at this point other than to say you do need a bare minimum of fats to make sure you get your essential fatty acids. In short, eat the recommended portion sizes, aspirationally shoot for 100 grams of good quality protein per day, at least 30 grams of (good), fats per day, and the rest can be carbs. Your carbs should ideally be from whole food sources like veggies, grains and fruits.

Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.

Honestly Herbalife as a company has pretty a bad reputation, so I personally would steer clear. I'm also not a fan of soy protein (which I believe is what they use), so that to me is another red flag. A third red flag for me is the sheer number of ingredients in their protein powder. I'd rather have a cleaner product personally. At the end of the day, it's going to be better for you to use this and meet your protein goal vs. avoid it and not hit your protein goal. For me, I'd look elsewhere.

Why are you against RYGB? If that's the best surgery for you, it seems like the logical choice?

Sorry to hear your team is not being helpful. I'm not too sure anyone here would be comfortable telling you what to eat instead of what your surgeon said to eat. If someone here did that, I'm frankly not sure I'd be willing to follow that advice since they're not the one doing your surgery. It sucks, but you're going to have to be your own advocate and talk to them again to make them understand your issues. I'm sure they hear from patients all the time that say they don't like vegetables, so they may just be thinking you're one of those. In this instance, the're probably just thinking they want you to "man up" and do what your supposed to, even if you don't like it. In this instance, it sounds like your issues go beyond that, so you're going to have to make sure they know this. Even to the point that you may have to delay your surgery, or find another surgeon. Best of luck.

Honestly these are questions best answered by your surgical team and dietitian. The presurgical diets vary widely from surgical team to surgical team, so they're in the best position to advise you on when to start it and what to eat. While as you said, it may not hurt to start early, it also may not really do much either. Keep in mind that the main goal of a liver reduction diet for most patients is to reduce stores of glycogen and water in your liver. 2 weeks is plenty of time to accomplish that. For larger patients, or patients with a fatty liver, they sometimes have to have an extended pre-surgical diet of 4 weeks plus to try to also reduce the excess fat that has been deposited there. This is really a patient by patient thing based on the surgeon's preferences. I for example, had a 21 day liquid only pre-surgical diet.

I slept on my back in a recliner for the first week or two. If you don't have a recliner, i don't know that I'd go out and buy one just for this, but I found it really helpful during the early recovery period. I don't really know, but I'd think it would be a bit longer for sleeve patients to recover to the point that stomach sleeping was comfortable again? Your profile doesn't seem to have that info, so I'm not sure which surgery you're planning to have.

I had no problem with normal sized capsules and tablets, but like @catwoman7, I started with and still use chewable calcium supplements. I don't really recommend chewable vitamins personally, as the ones with iron just taste really bad.

Good points. I do think post-menopausal women are still almost 4 times more likely to suffer from osteopena or osteoporosis, but I'm not surprised at all to see the rate going up for men. We as a species are just more sedentary and this is one of many diseases that unfortunately are exacerbated by our inactivity. Us older folks were also lied to for a long time about the "dangers" of activities like running, being told it would "wear out our joints". It seems the reverse is now being shown, which shouldn't be surprising if we consider Seyle's "General Adaptation Syndrome" model that first proposed the idea that our bodies respond positively to eustress. We are now finding that "impact" sports actually improve joint health and even can reverse bone loss. Food for thought.

I want to challenge your ideas a bit here. This concept that there is some underlying mechanism at work that controls our weight and that we don't have any say in the matter is based on something called set-point theory. In short, the theory is that some as yet undetermined mechanism (likely in our brain), wants us to be a certain weight and thus actively regulates both calories in and calories burned to keep us around the same weight. Anecdotally, most people can attest to the fact that there seems to be a specific weight where they naturally settle when they aren't actively trying to gain or lose weight, so the theory makes intuitive sense. That said, there are some big problems with this theory: Why have we not been able to find the actual mechanism for this set-point if it really does exist? How are some people able to change their set-point? How do we explain that overweight and obesity are significantly more prevalent in some parts of the world vs. others? In those parts of the world where overweight and obesity are more prevalent, how do we account for the fact that these issues were much less prevalent until very recently? (For example, the rate of overweight and obesity in the USA has tripled since about 1980.) To explain this, more modern interpretations have suggested a more nuanced approach. We know that historically, food scarcity was the norm. It's logical to assume our bodies are well adapted to dealing with this as a result. Unlike set-point theory, we do have a solid understanding of the physical processes involved in regulating metabolism during scarcity. This means our bodies know how to handle a lack of food pretty well by down-regulating metabolism. (There are several ways it does that, but I'm going so skip discussing those specific mechanisms for now) What our bodies are less good at is up-regulating metabolism in an environment of where there is an extreme availability of highly palatable foods like we have today. We often think of our bodies like a car that's always running. This is somewhat problematic, but let's go with the analogy for now. Just like a car idling will burn some fuel, our bodies burn some calories just keeping us alive. If there's a shortage of food/petrol, (either because I can't afford it, or because there's a true shortage), I can curtail my movment/driving to conserve how much I use. Likewise, if food/fuel is cheap and readily available, I can move/drive a lot and even fill my fuel tank (fat stores), whenever I want. Unlike a car that has a limited fuel tank that can only hold a specific amount of fuel, humans have a theoretically unlimited ability to store excess fuel in the form of fat. TL;DR: It's not so much that our bodies decide what weight to be. It's more that we were never designed to deal with cheap, easy access to super tasty food. At the end of the day, what determines whether or not you have more fat stores than you might want is whether or not you eat more calories than you burn in a day. The entire point of this overly long post is that there's no mechanism working against you that's keeping you from reaching your goal. Our bodies were designed to store excess calories to keep from starving to death when food was scarce. We rarely experience scarcity anymore, but our bodies don't know that. They still will do everything they can to hold onto those stored calories "just in case". There are ways to get beyond this, but that will have to wait for another post.

I think the thing many people get wrong when trying to transition between weight loss and weight maintenance is using an all-or-nothing mentality. By that I mean they expect to be either in "diet" mode, or "maintenance" mode, but that's not really how things work. To me, that would be like sprinting on a treadmill and thinking I can just stop running. Um, no. That would have really unpleasant consequences. You're not going to simply wake up one day and immediately go back to eating "normally". Instead, think of this more like a baby learning to walk. You're going to have some false starts. You're going to fall down a lot. In fact, you're probably going to fail more than you succeed. This is completely normal and is how you learn. Over time, you'll hopefully learn what works for you and what level of caloric intake is right. The point is, there are no "tricks" here. If you feel like you've lost too much, then just try different things to up your calories. Alternately, if you're heavier than you want, try different strategies to lower your calories, since there is no perfect solution for everyone. There's only what works for you. You didn't ask, but there are a couple of points I want to make here as well: There is no perfect number of calories for you to maintain. Let me say that again so you don't forget: there is no perfect number of calories for you! Our bodies are wonderfully adaptive and can maintain a healthy weight across a wide spectrum of calorie intake. It does this by up and down regulating your metabolism in response to intake. There is no ticking clock here whereby you have to lose the weight by a certain date after surgery or you won't lose anymore. It just does not work that way. I don't care if it takes you 9 months or 9 years to get to your ideal weight, you can get there and you can maintain at that weight. Best of luck.

Maybe a new pair if running shoes? 😉 Always works for me! 😁

So sorry you're struggling @Arabesque! I know how frustrating it is when you go from thinking you're got weight maintenance down, to finding that no matter what you try, you can't get things under control. You may not be looking for advice here, but as a guy it's in my nature to try to "fix" the issue. Please forgive me if I'm off base. I may be misremembering, but I think at one point you mentioned you don't really workout. While I'd never recommend exercise as a way to lose weight, we know from a significant amount of data that it is really beneficial in helping those that have lost weight to maintain that weight loss. You may not be in love with the idea, but it might be time to consider a change? Aside from the benefits for maintaining weight loss, we also know that cardiovascular endurance is actually a better predictor of overall health and longevity than any other single factor including obesity and smoking! This means the single best thing any of us can do for long term health is improve our cardiovascular health. In addition, we also know that regular strength training is important for several reasons, but in your case I want to point out three of them: Regular strength training improves muscle mass, which is probably the single biggest way any of us can actually improve our long-term metabolism. Overall strength is highly predictive of minimizing fall risk as we age. Since falls in older people can be catastrophic, it's something all older people need to keep in mind. There is a significant link between strength training and bone health. As I'm assuming you already know, osteoporosis is a particular problem for post-menopausal women. I wasn't very familiar with the Australian recommendations for physical activity, but unsurprisingly it's almost identical to the US recommendations: https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years Best of luck. I hope you get this figured out.

There is no magic bullet here. In terms of protein density, you're just not going to beat whey or soy protein isolate. If you don't like them as shakes, you might try mixing with less water or milk into protein pudding? It may take some experimentation to find one you like the taste of that way. I've never tried them, but bariatric pal does sell some that are prepackaged and designed specifically for making pudding. If you want to go the whole food route, eggs and chicken breast probably come in next in terms of protein density.

So this idea that you can stretch your pouch somehow and make it permanently bigger is mostly myth. First, right after surgery your stomach is swollen. Over time, the swelling goes down, thus you can accommodate more food. This is normal and to be expected. Second, your stomach is designed to stretch. This too is normal. Think of it like a balloon. With nothing in it, it's small. Fill it up and it gets bigger. Let out what you put in it and it goes back to its original shape. Third, while you can't really make your stomach any bigger, you can train it over time to handle more food. If anything, this is what's happening to people that think they "stretched out" their stomach after surgery. It's not really any bigger, but you have trained it to not "complain" as much when it is over full. There's certainly a limit here though to how much you can stuff in and I promise it's always going to be less than it was pre-surgery. I would caution you to be careful about frequent eating. If you're eating multiple times a day just to put something in your stomach, it is possible to outeat your smaller stomach. It's best at first to eat on a regular schedule because as you alluded to, it's hard to understand both hunger and fullness queues.

Just based on what you've written, this really wouldn't be either Reactive Hypoglycemia or Dumping Syndrome since both of those would be reactions to what you've eaten, not external stimuli. There is a chance that an already low blood sugar level prior to your shower or exercise is pushed even further down due to rising body temperature. This isn't a common reaction, but it's not completely unheard of either. If you don't have a blood glucose monitor, it may be a good idea to invest in one. Were I you, I'd track my blood sugar before eating, after eating, before exercise or a shower, and then at the point where your blood sugar feels like it's crashed. It would also be advisable to note exactly what you ate and the time of ingestion. This should help you uncover what's going on. I suspect it may have more to do what what you've eaten vs. temperature, but you really won't know without some data. Best of luck.

A very high protein diet can do that. I'm a bit surprised your doctor's office didn't cover this with you. It's primarily due to a significant reduction of fiber in your diet. i strongly recommend starting some fiber supplementation and in addition, consider the following: You may need to take a regular dose of a stool softener such as magnesium hydroxide or polyethylene glycol If needed, consider a stimulant such as senna or bisacodyl Acutely, If you're still having severe issues getting things moving, a saline enema may be needed. Otherwise, regular does of the above should be sufficient It can take a while to get all the above dialed in. Keep in mind, you're likely to need some or all of the above until well after surgery since your fiber intake will be really low until you're eating regular foods again.

So the reality is that we can't cheat physics. I want you to remember this both now and after your surgery. While I can't make an super accurate assessment of your total kcal expenditure per day right now, I'd guess it's probably in the range of 3000 to 4000 kcal per day based on your current weight. I'd also guess that your total intake right now is around 800-1000 kcal. This means you are absolutely burning massive amounts of fat currently. So I know you're thinking if that's true, then why isn't it reflected on the scale? The short answer is scales lie. They only show total weight, but as you alluded to above, our bodies are made up of lots of "stuff" other than fat, so scale weight can vary widely just based on how hydrated you are, how much glycogen you're storing, and the weight of your stool. In short, trust the process. You'll be fine.

So I'm a little more than 2 years out and for probably the last 6-8 weeks, I've gotten to where I just don't really enjoy eating most things. I'd say 90% of what I'm eating, I eat because I know I need to eat, not because I particularly enjoy it. Most things just taste off somehow to me, including things I used to really enjoy. I'm wondering if any other folks had anything similar happen? I will preface this by saying there's a possibility this is medication related, as I think I made a change to my meds about that same time. I'm investigating that separately.

I do think there's an element of "meh" going on with me as well. I'm not entirely sure if that's all due to things tasting a bit off, feeling tired (I've been really upping my workouts lately), or if I'm just losing some of the joy from eating. I'm sort of in the opposite boat in terms of food prep. I do almost all the food planning and shopping, as well as 90%+ of the cooking around my house. This is mostly because I'm retired and my wife is still working. When we were both still working, it was closer to 50/50. I do think if I didn't feel obliged to make food for her, I probably wouldn't bother for myself.

It's not, I promise! I could go into a lot of detail about why, but to make things short, I'd almost guarantee it's simply fluid retention. You recently had a long break from working out due to your surgery and now that you've started back working out, it's totally normal for your body to store a bit of extra fluid. Add in the implant weight and I think you're doing just fine.

I agree with @DaisyChainOz. There's probably a lot going into his feelings and communication is really important. As a man, I do also understand that some men (me included), just are not good at talking about our feelings. It's partly that we've been conditioned over a lifetime that feelings make us weak and thus we are "lesser" because of it. Also, we've just never learned how to express our feelings, nor to really understand them at all. It's not that we don't have feelings, we just don't really understand them in a way that can be expressed. I tell you all this so you can be patient with your husband. It may take some time for him to share what he's really feeling. The best thing to do is just be supportive and make sure he understands it's okay to share what he's thinking instead of what he's feeling. "Feeling" can be a trigger word for some men. One thing that may (or may not), help the discussion is understanding the risks involved. Again. I don't know what's going on in his head, but if he is fearful of change, or the risks of you having surgery, it's important to help him understand that by far, the riskier thing is NOT having the surgery. I don't know your age or current weight, but I'm assuming you are pretty heavy and likely older just based on the need for a hip replacement and the fact that your orthopedic surgeon won't do the surgery at your current weight. If you are in what's termed "Class III obesity" (in other words, you have a BMI over 40), that alone shortens your life expectancy by 10 to 14 YEARS. I think it's important for both of you to understand this. If he truly loves you, then he should want you to stick around longer.

I'd try to get your insurance company to pay for both. Gastric bypass is sometimes performed for reasons other than weight loss. Most commonly that would be for severe GERD and/or issues with gastric emptying. This happens even in patients that are not overweight and never had a previous sleeve procedure. My point is that I'd be willing to bet those procedures are covered by your insurance company since it's being done for strictly medical reasons. (Technically so is weight loss surgery, but insurance companies are stupid.) In your case it seems pretty obvious there's also medical need, so your insurance should pay for it. They'll probably deny it at first, so be prepared to fight them.

Forgot to add that the constipation was probably worse than any surgical pain. If your surgical team hasn't already communicated a plan to you for dealing with the constipation, talk to them ASAP. It's not nearly as bad if you stay ahead of it, but God forbid you wait until it's really bad!

I also had no nausea. I think the pain I had was mild compared to many other surgeries I've had. Probably the worst thing was the surgical gas pain. This is not pain in your intestines like some people think. It's from the CO2 or Nitrogen that they inject into your abdomen during the surgery. This will slowly be absorbed, but in the meantime, it puts pressure on your diaphragm and this irritates the phrenic nerve. This can cause referred pain into your shoulder that can be pretty painful. They'll tell you this, but the best thing to do is move!