ChunkCat

Welcome!! I had a friend who had bypass about the same time as you did and it was very different back then!! We have so many more resources available now. And SO many more products!! I remember how much she hated adding protein powders to her food and how stubborn she was about ignoring healthy food. She lost a ton of weight but I often wonder if she regained since she ate such junk post op. Eventually the portions catch up with you! Most advice for losing weight a while after surgery is to go back to basics, watching your portion size, cutting out simple carbs, getting most of your calories from healthy complex carbs, a little fat, and a generous portion of lean protein. Eat your protein portion first, your veggies second, and a few bites of a healthy starch/carb last, if you still have room. Get in whatever good movement you can. Drink at least 64 oz of water and for bypass patients I believe your protein per day should be close to 80 grams. You'd have to ask your doctor about your calories though. Do you still feel your restriction? I know with bypass they can do testing to see what your pouch looks like and hernia surgery is a good time to revise it if it needs a revision. I just had a hernia repair. I'm about 6 months post op from a Duodenal Switch. The healing process after hernia repair has been a lot like bariatric surgery. I can only eat liquids and some purees at the moment and I'm a week out. But I'm so glad I had the repair done!

This is totally normal---but freaks you out just the same because what if it stops, right!?! The first 3 months are normally fastest. But the closer you are to your goal weight, the slower it gets. Each surgery has a bit different loss rate, but if you stay the course, even as you slow down, you will get to goal. If you have hit 50% of your excess weight by 6 months you are doing really well according to most surgeons. I definitely didn't lose 50% in the first 3 months, most people I see lose 50% by month 5 or 6. But it also depends on how much you have to lose and your individual body's pace. Some lose it really rapidly and are at goal by month 7 or 8. Some take 18 months to hit the same goal. My body is a slow poke and likes to have 6 week stalls! So I hit my 50% mark at close to 5 months but have been stalled for a month since and actually regained 6 lbs, lost it, and then just gained 15 lbs in fluid from surgery again. My weight tracking app looks like an absolute mess. LOL Working out can seem to cause stalls and slowing down too, because you are trading fat for muscle and muscle weighs more. Plus the act of working out changes the fluid balance and such in your body, so sometimes you appear to gain some weight when you start working out in earnest, but it'll balance out over time.

This sounds miserable. I haven't had bypass so I can't comment on that, but I did just have a hiatal hernia repair due to food getting caught in my esophagus and causing choking and chest pain. Best they can tell it was probably a sliding hernia, so sometimes most food could pass but pills would get stuck, and other days nothing could pass but water at a trickle. It was a really scary feeling and I'm thankful they got me in so quickly! You say you have this pain, but are you having any of the other symptoms of dumping like diarrhea, heart palpitations, dizziness, nausea, etc...? I would consult the revision specialist to see if they have run into something like this before. Right sided pain is so non-specific. I have a ovary that hides and when I ovulate on that side it hurt like HELL. I think it was pinned by my bladder and uterus, because after my hysterectomy the pain is much better (they left my ovaries). But that would only be for a few days every few months. Not as frequent as your pain sounds. I hope you find some answers. I'm sorry you are in such pain!

You can do this Carrielee!! I started out with many of the things on your list. Now most of them are gone. I'm almost 6 months post op a Duodenal Switch. I've lost half my weight, from 320 to 240!! I feel incredible. It is so, so, SO worth it!

I can't believe it. I got on the scale this morning and it was 244.5 lbs. I've officially lost half of the weight towards my goal! I'm down 76 lbs since my highest weight and 63 lbs since surgery. And I'm not even 5 months out! I really didn't think it would happen this quickly. And weirdly enough, I feel smaller now than when I was this weight before. Weight distribution is a funny thing. Here's a pic of me pre-op at about 312 lbs, and two pics of me from today! I have so much more energy and mobility now. I'm so grateful to myself for having this surgery despite my fears and concerns. It has been SO worth it! Big thank yous to all of you guys for supporting me as I go through this, I really value this forum and everyone who posts here! ❤️

We eat out a lot since my partner works a very time intense job, we have no kids, and I'm still recovering from some serious health issues that cause a ton of fatigue. I generally aim for the same things at a restaurant that I would cook at home--healthy proteins, lighter sauces/marinades, sides that are low carb veggies instead of starches, and I always tell the waiters no chips/no bread, because if it isn't even brought to the table, we can't eat it! Hahaha! I've found that a lot of places will work with you to modify what you are ordering if you let them know you have special dietary needs. At my favorite breakfast place they make me a modified kids plate (one egg, one sausage, and fresh fruit) when I don't feel like having leftovers from a full size omelet. At my favorite pho place they replace the noodles with veggies. At Mexican places I tend to order fajitas with no tortillas, beans, or rice (my stomach does not play nice with beans or I would eat those!), or if I don't want leftovers, a side salad and steal some of my partner's protein. Steakhouses are VERY easy as long as you tell them to keep the bread. Two veggie sides and a lean steak usually means several meals at home later! Our local taco place will make you any taco in a lettuce leaf, or in a bowl instead of a tortilla. Thai places almost always will hold the rice and give me extra veggies if I ask when I order a curry. Sashimi is an easy alternative to sushi that avoids rice and I just ask for a side of avocado so I can still have the tuna and avocado combination I love so much! Smoked chicken or pork from the bbq places is great for several meals and they always have green beans or collard greens. And there's a Peruvian chicken place close by whose chicken I like much better than the supermarket and they make salads with fresh vinaigrettes instead of cream dressings. If we are traveling we tend to eat at some sort of chain restaurant that has their nutritional info online so I can hit my macros without worrying too much. The best advice I can give for eating out is to try and get ahold of the menu ahead of time so you can find a few options without feeling rushed in the moment when the waitress wants your order. And ask for a to-go container when they bring your food so you can put away all but the portion you would usually eat. Dieters tend to do this anyway, but our dietician suggested it to a woman who goes out to eat daily for business meetings so she wouldn't feel self-conscious about having so much food left on her plate in front of clients. When you put away your food before you start eating, people tend to forget you did and you can still stash away any last bits if you don't want to leave them behind after you eat. ❤️

I'm so glad you tried the muffins and liked them!! I really enjoyed mine, they kept well in the fridge and warmed up really well with a quick zap in the microwave. Regarding the nutritional needs of a SADI patient. We don't really know, honestly. The SADI is too new to have some of the longer term studies that have been done on the sleeve, bypass, and DS. But it is commonly thought by most surgeons that the dietary needs of a SADI are more than with the bypass because SADI patients are thought to malabsorb more than a bypass patient. And their needs are most likely a little less than a traditional DS. That said, I attended nutrition classes with all the different surgeries in one group, so we had to learn everybody's requirements!! Most good surgeons recommend that SADI patients follow the dietary requirements of a DS patient to be on the safe side. That means 80-120 grams of protein, less than 50 TOTAL carbs while in the active weight loss phase (the dietician said "net carbs" is not an official measurement, but if you want to follow net carbs you'd need to keep under 30 net carbs since they get counted differently, most DS patients introduce a bit more complex carbs into their diets once they reach maintenance weight) and the fat grams recommended by the ASMBS is 60 grams of fat by 1 year post op. However, SADI and DS patients malabsorb a good amount of fat, so veterans of the surgeries will tell you that you need more fat than that. I seem to feel best around 80-100 grams of fat a day, but there are veterans of the DS surgeries that eat closer to 150 grams, or whatever alleviates their constipation and eases their symptoms of low fat like dry eyes and dry skin. According to most studies, a DS patient only absorbs about 20-30% of the fat they consume, around 60% of the protein they consume, 60-80% of the complex carbs, and every single calorie of simple carbs!! That's why simple carbs are so important to restrict post surgery (besides the digestive drama), you can eat your way around any surgery with simple carbs... And this is why counting calories is pretty useless for DS and SADI patients. We don't yet know exactly what the percentage of absorptions is for SADI patients as they haven't done a breakdown study (as far as I know) but it is safe to assume SADI patients absorb a little more fat and protein than a traditional DS patient would. The best way to find your own perfect macros post surgery IMO is to aim for 80-120 grams of protein and then watch your protein labs. They will tell you if you need more protein or if you can back off a little. And for me at least, I find my skin, hair and eyes are highly sensitive to when I have too little fat in my diet.

Yay for progress!!

I'm so sorry you are struggling with this still and that you aren't able to get in with a specialist. Post viral issues are both literally and figuratively exhausting. What you experienced with the walking 4 miles and not getting out of bed for 3 days afterwards is caused "post exertional malaise" and it is common in long covid as well as things like Chronic Fatigue Syndrome. I experience it a lot. That device I linked to earlier is supposed to help you gauge where your body's threshold is regarding this and keep you right under it so that you can still be physically active without triggering that backlash. It is a really frustrating thing to experience, especially when a few months ago you could have walked that distance without issue. I experience this still every time I try to push beyond 5,000 steps a day. This is a vast improvement over what triggered it pre-op, but it is still nowhere near where I want to be. I'm going to add in some strength training components to see if strengthening the muscle function in my body will help me be able to push the threshold up a bit, but if not I'm going to find a physiologist who can help me figure it out because I hate the physical limitations that come with these viral conditions and general deconditioning.

Hahahaha!! I have been getting mad about this too! And the vast inconsistency of sizes when you are trying to buy clothes that fit online!! Why haven't these things been standardized, it is truly absurd. Fabric differences are one thing, but a 6 inch difference in bust in the same size and same fabric is wicked annoying...

Yeah, not buying it. The medical community looks for what it wants to see. I married a statistician. They constantly remind me "Correlation does not equal causation!!" The medical community wants to believe that more physical activity will miraculously solve obesity issues because it puts the cause and the remedy right back in our laps, instead of admitting that this is a disease that is very complex and no one smoking gun is the cause or the cure. We need holistic approaches. I was a very active child. So were my siblings. My brother is a normal weight, my sister is often underweight, and I ended up over 300 lbs. My parents are normal weight though they both have siblings with weight issues. I gained a ton of weight while I was still active. Puberty hit and it was like someone switched on a helium tank and I just ballooned up. I've had more doctors than I care to count tell me that if I just got more physical activity and stopped eating McDonalds all would be well, ignoring the fact that I hate McDonalds and until my autoimmune disease got severe I was quite physically active. I know a lot of thin people who are couch potatoes. I know a lot of fat people who are active. These "studies" do nothing but continue to give doctors more ammunition in the shame game that is current obesity management. My partner is Chinese, was raised on traditional Cantonese food (which is very healthy in general), in a family where everyone is effortlessly thin except their grandmother who was diabetic... Several years ago my partner was diagnosed with diabetes. They've had weight issues all their life, despite being very active for most of it. Is it genetics? Perhaps. Is it current lifestyle? It probably contributed to it. Was it due to a childhood diet based on rice? Not likely, that diet also incorporated a ton of healthy protein options and a healthy variety of vegetables, including plenty of greens. A lack of exercise was certainly not the cause of it and increasing exercise is not going to be the cure for it either...

I dose out my vitamins for a whole month at a time using these pill cases: https://www.amazon.com/gp/product/B08QR78YP3 Sometimes you can find them (or a similar brand) with a coupon for a bit more off, but honestly they are cheap enough to get 4 and still not break the bank. Start with 1 or 2 though until you know you like them. I love how colorful they are, it helps me not lose them when I carry around the day's doses. Then I set a medication reminder (iphones have this in the health section, but you can get apps for it too). I have to take vitamins and meds 4 times a day, so doing this really helps me remember to take them and to not get behind. Finding movement you enjoy is important. Gyms aren't necessary and for many of us they hold a lot of negative associations. If you love the gym then disregard this suggestion, but if you don't, you might be much more likely to do an exercise that actually feels GOOD in your body to do. Also, I carry protein snacks with me at all times. And when I get off track and forget, I stop at a store or gas station to get little packets of nuts and jerky, instead of stopping at a fast food place or eating a bunch of simple carbs. I keep reminding myself that just because I'm cleared for "all foods" does not mean that "all foods" are "right now" foods. Some things are not for us in this first 18 months, even if we can technically digest them fine. When I relax into that awareness and get myself back into ketosis, I usually feel better and stop craving simple carbs so much. Except for chocolate. I will always want chocolate. LOL

In people with an intestinal component to their surgery (like gastric bypass, SADI, and DS) sometimes GI symptoms can happen like chronic gas. You might consider exploring a FODMAP diet to see if you can find the foods that are triggering the gas. Odds are something you are eating is causing this... You could also try adding a probiotic, sometimes the gut microbiome can get off kilter. And a reduction in the simple carbs you are eating might help too if you eat a lot of carbs as opposed to a protein heavy diet. As for the burping, it sounds like for some reason you are swallowing a lot of air. You might try drinking fluids a bit differently. If you drink from a bottle or a straw a lot, you might switch to a wide mouthed cup. My dietician said a lot of water bottles and narrow shaped cups (as well as straws) can cause you to swallow a lot more air than normal, causing burping and sometimes nausea. I'm sorry food doesn't feel good right now. I feel the movement of food in my esophagus and stomach a lot, as well as when I drink. Small sips and small bites help. Small is smaller than you think. I hear it gets better as time goes on... Sometimes I can eat relatively normally, other times (like this week) my restriction is super high and I can only eat half of what I normally do, or less. There is an ebb and flow to this. So on my high restriction days I eat less and drink more protein supplements. On my low restriction days I get more veggies in and a hefty dose of meat based proteins. I figure it all averages out in the end! I agree though, a talk with your doctor is in order. You shouldn't be experiencing pain at this point. On rare occasions bypass patients can develop strictures which could cause some of the symptoms you list.

Gastric bypass for GERD developed from a sleeve surgery is considered the gold standard of treatment. However, it is not 100% effective... A number of studies, like this one https://www.nature.com/articles/s41366-022-01072-9 show that up to 30% of people still report post-operative GERD symptoms to some degree after gastric bypass. You are not experiencing the impossible, nor are you imagining it. Unfortunately these occurrences have not been well studied, so it is good you are having an endoscopy to check things out. Hopefully it will show something that can be easily corrected!! In the meantime, elevating the head of your bed when you sleep can make a big difference. You can do this by elevating the actual mattress, or sleeping with a wedge pillow. As an aside, when you developed GERD with the sleeve, did they do studies to prove GERD due to stomach acid reflux? I ask because some people with GERD actually have bile reflux, which can produce the same symptoms but has a very different treatment path. It is worth ensuring they've tested for bile reflux just to be sure they are treating the right condition.

You look amazing @ZeeGee!! And you look STRONG! @brandycsiz You are not the only one. LOL I went on vacation for 4 days for my birthday and managed to gain 6 lbs! Logically I know that I didn't gain 6 lbs of fat, it is mostly water, but it still panicked me and made me feel like my progress was stunted for the month... Part of it is my fault though. I was eating out for every meal so that means more sodium and more carbs. I wasn't hydrating well. I didn't hit my protein goals. And the bed was awful so I wasn't sleeping well. Life happens! I took yesterday to feel depressed about it and panicked over breaking my surgery. LOL Then this morning I got up, made a protein shake, and had lots of protein for lunch (baked chicken thighs and green beans). I made a tall glass of sour watermelon flavored water and am plotting dinner. Carbs are under control. I slept in today to help offset my sleep debt. And tomorrow when the weather clears up I'll be back walking... The issue is not that we get off track sometimes. The issue is that in getting off track we lose hope, start to get down on ourselves, and want to eat a whole cake. 😂 But if you know better, you can do better. So gently but firmly course correct in the ways that you can each day. Make steady improvements back towards your goal. And see these acts as self care rather than harsh discipline. In this, as is with most things in life, our journey is much more important than our destination. Journey well my friends. We can do this!! 😍

Yes! Happy to share! It's this one: https://www.wholesomeyum.com/keto-banana-muffins-recipe/ I doubled the banana flavoring emulsion (I got mine from Amazon) and I added vanilla. None of the box mixes were low carb enough for me and I used to be a chef so I have a bias towards homemade things. 😂 I can empathize with the carb cravings. When I eat carbs I crave them intensely for days afterwards. There are a lot of people who make judgments about those of us who use artificial sweeteners, and though I prefer the real thing, I simply cannot have it. My body HATES carbs, it just doesn't know what to do with them and whether it's a piece of cake or a bagel, it will bloat me and I'll want 3 times as much the next meal. It is just not worth it. And now with the surgery and my designer insides, it isn't worth the gas and such either... The only exception I seem to be able to make is a small amount of very dark chocolate. I think the reason it doesn't cause the carb cravings is because my craving for the minerals in it is stronger. LOL And even with that I can't have it two days in a row without cravings kicking in stronger... I think it is perfectly reasonable to ask those close to you to support you with limitations around what they offer you. I asked the same thing of those close to me and they were happy to do so because it gave them a tangible way to help me with my goal. We don't gain weight in isolation. Food is a social thing. We ask our social circle for support around other goals like going to school or raising our children, we should be able to ask for support with this too. It increases our chances of success!! The head game will do you in every time. Having people close to you wise to that helps tremendously in my experience... As long as they don't turn into food police. 😂

I agree with NickelChip, your PCP not knowing about the surgery is not a big deal IMO. What is most important is that YOU understand your surgery and whatever anatomy you end up with, and that you are able to communicate that to emergency responders and ER doctors in an emergency. Everyone close to me knows what surgery I've had done, knows the technical term for it, and it is in my phone's health info that emergency responders can access. A lot of SADI and DS patients carry a card illustration of their surgery in their wallets or on their phones. When I was considering the SADI and two surgeons recommended I do the DS instead I had reservations. I live in North Carolina and we have some really stellar bariatric surgeons here in Raleigh. But I plan on moving back to New Zealand in the next few years and DS surgery is really rare there, there are only 2 surgeons I know of in the country who can perform it and they are both in Auckland. My surgeon here told me as long as I planned on having the first few years locally here in Raleigh, and as long as there was one surgeon that could be consulted about my care in the area I move to, I should be fine with the DS... The same applies to the SADI. What we tend to forget is that people have surgery on their small intestines for a variety of reasons besides bariatric surgery. Cancer, Crohn's, etc... Many people have designer insides and while not every gastro doc is trained to do a DS or SADI, they have the technical skill to find a surgeon to consult with about your surgery should they need it. In terms of your PCP what she most needs to know is that it is vital to order a FULL panel of bariatric labs for you at least once a year, as well as at any point if you start having symptoms of a vitamin deficiency or protein deficiency. She'll also need to watch your iron levels. These are things a PCP can do. She also needs to be in good communication with your surgeon if she has any questions. Doctors act like they can't talk to each other, but they can. I have an autoimmune GI condition that causes ulcerations sometimes (like Crohn's) and my bariatric surgeon actually called and consulted with my GI doctor to ensure they were on the same page about the surgery and to ensure it was a safe surgical option for me. That made me feel SO well cared for! My PCP has a sister who had the sleeve done so she's familiar with the bariatric surgery options. She is well read, researches what she needs to, knows how to consult when she needs more info, and trusts me to tell her what I need when I need it. For me, that's the perfect PCP. I don't need her to understand the complexities of my surgery. I just need her to know when she's out of her depth and needs to refer out to a GI doctor, my bariatric surgeon, or the ER.

They are way more delicious than they should be. LOL Thank you for the compliment!! I've lost the same amount as you, 75.5 lbs !! Though I adjust the weight through the side thing on the right and it only does whole numbers... I can't believe you've lost that much so soon! You are hoofin' it to your goal!

Aww, you guys are good for a woman's ego!! Thank you!! ❤️

Thank you!! You guys are awesome!

Thank you!! I am incredibly happy. Getting my Vitamin D from 13 to almost 100 has done wonders for my depression. The extra energy DOES feel amazing, especially because I have Chronic Fatigue Syndrome and I never really expected the surgery to impact that favorably. The first 4 weeks were hard energy-wise. I remember how exhausting even taking a shower was until I was past a month out. Bariatric surgery is major surgery and it takes our bodies a while to heal from that. Add in our dietary restrictions as we slowly incorporate food again and it is a great recipe for fatigue. I'd say by about week 8 the nausea disappeared and I noticed I was gaining energy steadily. I could stand in the kitchen and cook. I could go for a short walk. I could shower and actually leave the house without a nap first. I had not been able to do those things in several years so it was a striking difference. Hang in there!! It is a good sign you feel about back to normal energy-wise right now! Yes, according to everything I've read, the goal is 50% by 6 months for a DS surgery, so I'm ahead of my goal. I really hope things continue on steadily. A lot of people lose a chunk early on and then taper down slower after month 3. My body doesn't like to follow general trends, so I stalled out for most of that time and then suddenly my weight loss sped up! It is quicker now than it has been since about a week post op. Isn't that funny? Everyone's body has its own rhythm. It is so, so hard to trust that, but it seems to be true the more people I see go through this surgery.

Caffeine is usually restricted for the first few months in a virgin DS/SADI surgery to help prevent dehydration. You may not have this restriction put on you since you already have your sleeve and should keep food and fluids down fine post-op since they probably won't resleeve you unless yours was done wrong. Even if they put you on caffeine restriction, it is only for a little while. There is no reason to restrict it long term, it doesn't harm the digestive system. My partner loves to dine out and we don't have kids, so I've been eating out since a month after surgery. I am careful with my choices, the first thing I ate out was grilled swordfish and sauteed green beans. It was fine. I've since eaten Thai curries (mild), pho without the noodles (they put veggies instead), sashimi, fajitas with guacamole and cheese sauce (no tortillas, rice, or beans), steak (ribeye is my favorite and digests better now than it even did pre-op), wings, traditional Chinese food (nothing fried, no rice), Peruvian chicken, the list goes on and on. I try to stick to protein/veggie options. Anything I wanted to eat at a restaurant I tried to have a version of at home first to know how it would affect me. I tolerate most things pretty well, though it seems my digestive system prefers baby spinach over iceburg or romaine lettuce, but that's not a huge sacrifice. And I can't eat beans at all, but I never really tolerated them pre-op either. Also I try not to have too many cruciferous veggies at once (broccoli, cauliflower, cabbage), as they cause bloating, but I had that problem before surgery too. (I have had IBS and an inflammatory bowel disease since I was a teenager.) That said I try to make healthy choices in general whether eating out or eating at home. DS patients don't really need to restrict fat because we malabsorb so much of it (regardless of what the dieticians tell you) and SADI patients can eat a moderate amount of fat as they malabsorb a moderate amount of fat. Too much fat in one sitting can cause diarrhea, but you'd have to really make an effort to do that, and any bariatric surgery other than the sleeve can cause that issue. Coke Zero does not have sugar alcohols in it, it has Splenda, so it is fine from that perspective. Carbonation is only an issue if it bloats your sleeve. However, it can cause you to be hungry faster, or cause gas due to the air bubbles, so it isn't the best habit to have long term. But it won't piss off your intestines. I switched to unsweetened iced tea and carry Splenda or Equal packets with me! Sugar alcohols are things like erythritol, xylitol, and malitol. Allulose can also cause gastric upset depending on how tolerant you are of it. I can usually have a little of any of those, but more than a tablespoon and I'll be in the bathroom half the night. 🤣