NickelChip

This is a new video Dr. Weiner (bariatric surgeon in Tucson) put out through his podcast this week. He is one of the best resources out there for reliable information on bariatric surgery and the science of weight loss. This 55-minute video is all the most up to date information to get you started with all the basic questions you might have (and if you want more in-depth information, he has hundreds of other videos that dive deeper). He talks about nutrition, exercise, surgery, and GLP-1 meds.

Same on the tweezing to get fine brows! My left side is coming in decently but my right is very bare in spots. However, after about 8 weeks, I am starting to see tiny dots, like stubble, coming in. I find I have to dye mine once a month to be able to see them since so much is turning grey/white. I'm tempted by microblading but I keep reading horror stories that make me hesitate.

That doesn't sound like enough food, or a very healthy choice, to be honest. Crispy chicken is fried. Sweet tea is nutritionally the same as soda and can provide a shocking number of empty calories. You aren't getting enough protein and if you're only eating once a day, that's probably messing up your metabolism. Just based on what my dietician has told me, I suggest three meals per day, a minimum of 60g protein per day, 64 oz water, and little to no sugar or simple carbs. You might try cottage cheese with fresh berries for breakfast, a spinach salad with 3oz grilled chicken for lunch, and 3oz baked salmon with steamed broccoli for dinner. Maybe add in a serving of raw almonds for a snack. Make sure you weigh all your portions.

This sounds like the three week stall. Totally normal! Your body burns glycogen for energy, and during extreme calorie restriction, you burn a lot of it. Glycogen is stored in the body along with water, so each gram of glycogen you burn for fuel also releases 3 grams of water, which you flush out. This is why you lose weight so quickly the first few weeks, not because you are burning all of that weight just from fat stores. After the first few weeks, you start to be able to eat some solid foods along with your protein shakes. This gives your body a chance to replenish the glycogen you burned, which is vital for survival. But it means that for every gram of glycogen you store, you also store about 3 grams of water. Your body is continuing to burn fat during this time, but you won't see it on the scale because it kind of zeroes out with the whole glycogen/water storage thing going on. After a week or two, your body will be back to normal in terms of glycogen reserves and you should start to see your weight decrease again at a moderate pace. I really wish doctors would explain this to patients before surgery because it's just basic science, and people totally freak out when they are eating nothing and not seeing the number on the scale go down. I think doctors forget that their patients have failed at about a million attempts at weight loss prior to surgery and we are naturally prone to believing we are failing again. But you're not! Also, counting calories at this stage is pointless. You're in a massive calorie deficit. It's impossible not to be unless you are doing something terribly wrong against every bit of medical advice. Focus on protein and water but don't stress over calories until you get to a point many motnhs from surgery where there may be a legitimate possibility that you are overeating.

I can speak to minoxidil for eyebrows because I had almost no eyebrows left after years of thyroid issues and I started using it a few months ago on my brows and I'm slowly getting my eyebrows back! I also have some chronic thinning hair issues on the top and a patch at the back of my head. With the surgery hair loss, it's gotten so much worse that I wear a hat all the time. I decided to go ahead and use minoxidil for that, too. I'm okay with having to use it every day forever since I know it was not great pre-surgery, anyway, so it's something I might as well address now. I'm at almost 10 months post-op and the hair loss has completely stopped and the new growth is visible. If I had been pleased with my hair thickness pre-surgery, I would have just waited it out without using anything. My guess is by summertime it will look a lot better. In the meantime, hats and big headbands are my go-to. For reference, I use a 5% foam on my brows (Rogaine brand) and a 5% liquid spray on my head (If you are in USA, the brand is Dabida and I buy it on Amazon in a 3-bottle pack for about $40). One container of foam will last at least 6 months or more since I use the tiniest bit on the brows. The spray is 60mL per bottle and I use 4 sprays daily, which is supposed to be equal to 1 mL, so a 3-pack should last about 6 months. You could use the liquid on brows but the foam is easier to manage. I put it on brows and head at night before bed. It does seem to dry my hair a bit, so I bought a really good hair masque to use weekly for deep conditioning.

One thing I've learned through experience is that it's hard to predict what will happen next. My weight loss slowed significantly in July but then I dropped a lot in August and September, but slowed again in October and even more in November. A lot of it not really because of any major changes in my behavior, either. There's a lot going on that you can't really see throughout this whole process. I notice, for example, that my body shape changes when my weight is steady. I do try to be honest with myself. Sometimes, I know for certain I have been doing everything correctly and am not losing. That's fine. Sometimes, I lose weight and I know I did so despite making some poor choices. I try to be aware of that because it will not be as easy as time goes on (it already isn't for me!). I know that if I have things in the house, I will be tempted by them, but I rarely would leave the house to go buy something I didn't already have just because it sounded good. If I buy cookies, I may end up eating four of them instead of the two I said I would eat. If I don't buy them, I will eat zero. So, after the holidays, not buying or making the stuff is my main strategy. For me, it's all about figuring out how I want to live. I want to be healthy, but I don't want to be miserable. I'm working on being more intentional with what I eat and how I exercise. My goal now that my appetite and capacity have kind of settled into a fairly predictable pattern, is to strengthen my routines around food prepping and setting regular meal times. If I can stick to that most of the time, have a solid list of things I make on a regular basis and keep in the house ready to go in an instant, and things I do NOT keep anywhere near me, I won't feel like I need to worry about the occasional indulgences. Because skipping all holiday snacks or treats, or never ordering a dessert or a special cocktail, isn't a way I want to live! But I also don't want to lose track and let myself indulge all year because I forgot to set limits.

Oh, yes. I'm just a bit ahead of you surgery-wise at nearly 10 months post-op, and I've noticed a few things as time has gone on. First, the number of pounds I'm losing in a month has slowed. Early on, I was losing 10+ lbs in a month. Two months ago, I lost 6lbs in a month. Now, I'm losing more like 2lbs in a month. Second, there's more noticeable daily fluctuation now. (I like to weigh myself every morning right when I get up, just to have a record.) In the past, I would bounce up or down a few ounces over a few days and then continue my downward progress. Now, I see half a pound or more difference, and I might bounce around for a week or two before reaching a new low weight. I'm currently about 12 lbs away from a "normal" BMI, so that has a big impact on how quickly weight changes. My smart scale also tells me I have higher than average muscle and bone (taken with a grain of salt since I know they're not completely accurate). One thing I notice now is that some of what I see on my body as "areas for improvement" are no longer simply "would look better if less fat." Now it's more like "would look better if more toned." As for staying on plan with nutrition, I'm not going to lie. This time of year is a challenge. There are sweets everywhere, and sadly, I can eat them with far too few side effects. I'm not going crazy like I would have pre-surgery, but I would say it's pretty easy to not be in much of a calorie deficit, either. Plus more eating out at restaurants, more holiday parties, etc. Nutrition is something I will tackle again in January.

So, you don't feel "full", but do you feel "hungry"? Or do you just keep eating because you can? This early on, your body is still adjusting and relearning signals. Hopefully, you don't feel physical hunger pangs (most people don't but some do). Either way, you need to portion out your foods. A bariatric meal is generally 3-4oz of meat and around 1/2 cup vegetables. Even if you CAN eat more than that, you aren't supposed to and don't need to. It's pretty early to be adding in a grain, but that can also be part of your meal at some point. The feeling of restriction is different between the sleeve and the bypass, so I can't speak to it from experience, but I've seen so many people here say the sleeve restriction doesn't truly kick in for a few months. Until then, it's your job to only eat what you're supposed to eat. It helped me to get very small plates. I ate off a saucer for the first 6 months. Half of it would be my meat and half was a non-starchy veg. I would weigh the meat (after cooking) and just fill the empty space with the veg. If you are already truly feeling hunger, fill yourself with vegetables, fruit, and healthy whole grains as opposed to protein or simple carbs. After a certain point, let's say maybe 100g in a day, you really don't need the protein, so if you're truly hungry, a salad or steamed broccoli will do a lot more to fill you up with very few calories ounce per ounce. It can also really help to set specific meal times and not allow yourself to eat in between.

You're only two weeks out, so it's absolutely fine to take things slow. It's also fine not to hit the targets that have been set for you this early on. Just do your best. I actually did okay for the first few weeks, but at one point around week 4, my stomach just didn't want certain solid foods and I started having vomiting. My doctor had me go back to liquids for another two weeks. It was no fun at the time, but it eventually went away. Your body will adjust over time and you'll go back to mostly normal. I really liked creamy tomato soup with plain protein powder mixed in during the soft phase. Also, refried beans with some melted cheese were delicious. Think of food as more of a "nice to have" thing right now, knowing you are getting what you need from your protein and vitamin supplements. It's okay just to have a bite or two, or to have the same things for a few days in a row and not get a lot of variety. The first few months you're retraining yourself with eating and your body is going to be doing all sorts of weird things until it recovers.

I'll be cooking Thanksgiving dinner! I'm not stressing about it. I don't think it will be too much of an issue as the types of foods I will be making (traditional Thanksgiving staples) are the kinds of things I like but am not crazy about. My bigger concern for overindulgence is probably the charcuterie board I'm putting out earlier in the day, along with the candy I'll have in the candy dishes. In my case, I see my family frequently and they all know about the surgery, so it will just be a normal experience in that sense. I'm looking forward to cold leftover turkey! Even though there will only be 8 of us and probably 3 people who will barely touch the turkey, I ordered the bigger one (16-24lb range) because I want leftovers for my lunches.

Wow, losing 245 lbs is just mind-blowing! Your results were impressive before, but updating it to the total amount just leaves me speechless.

I put mine as the weight on the day I went to my first surgical consult, which was also my highest recorded weight. With the diet and lifestyle changes I made as part of the program, I lost about 13 lbs in the 6 months between then and the start of my pre-op diet. I lost another 13 lbs in those 2 weeks of liquid diet before surgery. But I want credit for all the weight I lost! Interestingly, Dr. Weiner recently said on a podcast that the weight lost on a pre-op diet definitely is credited to the surgery in his opinion. The reasoning was that if you go on a liquid diet, lose 13 lbs, and then try to keep that weight off without having surgery just by eating right, you are going to regain most or all of it in a matter of weeks. The fact that we lose that weight and then keep losing more weight instead of gaining is thanks to the metabolic changes of the surgery. He also told me in a live Q&A support group a while back to use my weight from before the pre-op diet as my starting weight if I wanted to plug it into a prediction calculator. I raised the concern of being a bit behind the prediction based on one of those calculators and he asked me what my weight was before the liquid diet. When we used that number instead of my surgery day weight, it tracked much better (and is still looking very accurate at 9 months out). He said if I had always been 225 lbs (my day of surgery weight) that would be one thing, but in reality, my "true" weight was somewhere between 238 and 251 in terms of what my metabolism was trying to overcome with the surgery. I feel like that's one of those big questions a lot of us have in the beginning and nobody really gives an answer on the calculator sites.

I had to add the laughing emoji on your last comment because that bullshit button is awesome. If only we all had one on our foreheads that other people could press as needed... (although we would probably not appreciate it so much in the moment, I'm thinking). Good luck on your trip and remember to give yourself grace as you navigate a totally new life experience of being a bariatric patient in a different environment, with family, during the holidays. It's not going to go perfectly, and that's fine.

Yep, I'm 9 months post-op and may or may not just be coming out of about a 3-week stall. It's very normal and expected to start slowing down, stalling, and having small weight gains at this point. I hit a low of 170.2 toward the end of October, immediately bounced up a pound, and didn't drop below that low point until 3 days ago. Personally, I find that whenever I hit a new low after a little bit of a stall, especially if it involves a large one-day drop (I went from 170.8 to 169.0 in a day), I'll usually bounce around a little before seeing any steady declines. Most people continue losing weight until at least 12 months, and sometimes a little bit more until 18 or 24 months. But with a lot more stalls, especially the closer you get to a "normal" BMI. (I'm about 14 pounds away from not being considered overweight by the medical charts). The important thing is to develop a healthy eating and exercise routine that is sustainable no matter what the scale says. If you're doing what is reasonable and recommended, keep doing it. There's no need to change what isn't broken. On the other hand, if you know you've been straying from your good habits, focus on getting back to where you know you should be. Eating healthy foods in the correct portions on a regular schedule, moving your body throughout the week, getting the right amount of protein, taking vitamins, and drinking water are all things you will be doing for the rest of your life, even though at some point the scale will stop going down. The advice I am giving myself these days is to try to separate those good things I am doing from the number on the scale. Because for me, if I start seeing weight loss as a "reward" for "being good", it makes it harder to continue the good lifelong habits when that "reward" inevitably goes away. It also won't do you any favors in the long run if you try to introduce a bunch of things you know you will never be able to maintain just to get the scale moving faster. I might be able to drop a few pounds really fast if I went back to 500 calories per day or re-did my 2 week liquid diet, but I can't live like that forever, so it's a false victory. I think we all have to find the right balance of habits we can maintain fairly steadily for a lifetime and a healthy weight we can maintain without torturing ourselves. And remember that just because you hit the 12-month mark doesn't mean the game is over. You can always introduce improvements to your nutrition or your exercise that will result in slow and steady changes over time. You don't have to workout 5 days a week for 2 hours a day if that isn't your thing, but if you add some resistance training a few times per week or an extra walk after dinner, you will see those results down the road.

It sounds like your resources are limited for getting support in your local area, so I wanted to recommend looking into the Pound of Cure nutrition program, which is run by Dr. Weiner in Tucson, AZ (he also has a couple books and YouTube channel with bariatric educational information). It's $49 a month and allows you to attend unlimited online support groups with their dietician and peer leaders, as well as a few sessions per month that are run by Dr. Weiner. I've subscribed for a while and go to at least a few of the groups per month as my schedule permits. Many times there will just be a few people in the group and you can really get a chance to ask your questions and get some good advice. Just for example, there's a group for the first year post-op, for emotional eating and stress management, and even one for surviving the holidays and travel. They've been in this business for many years and I'm betting they could think of dozens of patients who felt exactly how you do right now but went on to be successful.

Honestly, your food pictures all look pretty healthy, so no notes there. I would watch out for any mindless snacking, just in case you have fallen back into a habit of popping a handful of nuts when you walk past your pantry (guilty!) or adding a lot of cream to your coffee. You know, the type of thing your brain may not even be registering. I had a friend who thought his coffee was fine because he didn't put sweetener in it, but he put a ton of half and half, along the lines of a full cup per day, or an extra 300 calories he forgot about! But other than that, plateaus are normal. I am approaching 9 months post-op and for the past 6 weeks, I have been bouncing up and down by about 2 lbs but never dropping lower than the lowest weight I hit in early October. From everything I've heard and read, it's part of the process and is pretty common the closer you get to a normal weight and the farther out you are from surgery. There are a few things you might try, though. First, increase your protein so you are at 80-100 grams instead of the minimum 60. Try to make that from real food and not a shake. You might also increase your non-starchy veggie intake, which will provide more fiber. Add in another 32oz of water each day. Go to bed an hour earlier if you can. It's counterintuitive, but increase your calories by 100 and cut back on your exercise a little to see what happens. Sometimes, your body starts to conserve too much energy because it fears starvation and giving it a little more while asking it to do a little less breaks that cycle. Also, the fact that you fit into clothing at 195 lbs that your family members wore at 30 lbs lighter suggests that some of your weight is not fat but "infrastructure." When we get very heavy, our body grows more bone and muscle to hold it, and bigger organs to carry out their functions on a larger scale. When we lose weight in a hurry, all that architecture remains in place for quite some time, adding to the number on the scale. You may look now like you did at 10, 20, or even 30 pounds lighter back in the days before you ever became obese. If you have some old photos of a time when you were the goal weight you have in mind now, try doing a side by side comparison. You might already look really close to where you are trying to be even if the scale says otherwise.

Just because you are allowed to eat anything does not mean you, personally, are able to do so. There are a few likely culprits to your issues with discomfort and vomiting. You may be eating too much, too fast, not chewing enough even though you think you are, or the food you are eating is too difficult for your system to handle right now. Check your portion sizes, how fast you are eating, and focus on soft foods. You may need longer between eating and drinking. Some people can handle 10-15 minutes. Some need 30 minutes. If I feel a stuck feeling even an hour after eating, I do not drink anything because it will make me sick. I had enough issues with vomiting that my doctor put me back on liquids at around 4 weeks and I did that a couple weeks just to give my body more time to heal. Even almost 9 months out from RNY, I sometimes get sick. It's usually texture/dryness related. It's gone from once a week to just once in a while, and instead of all the food coming up, it's usually just mucous now. I try to pay attention to why so I can adjust. Basically, you need to listen to your body and make changes based on what is working and not working for you because we're all different.

It is on the DS board, but it also shows up on the recent topics list, which everyone sees without knowing which board it is on, so that's why you are getting responses from people with other surgeries. Although, since the switch includes the creation of a sleeve as one half of the procedure, those answers are probably closest to what you should expect capacity-wise, with bypass experiences being maybe a little different.

So, there's a normal meal and then there's what you get in a restaurant or what we've been taught to think is a normal meal. At about 8 months out, I can eat a full serving of chicken breast. That's defined as being between 3-4 oz. And in the same sitting, I can also eat a serving of broccoli, which is about 1 cup. I don't tend to eat grains often, but if someone gave me a serving of brown rice, which is 1/2 cup cooked, along with the chicken and the broccoli, I could probably eat about half of that on a good day, but not touch it on a day when I have a smaller appetite. Personally, I would be more likely to substitute a second veg or a fruit. What I've just listed would be considered a "standard" meal by a nutrition expert. It has about 280 calories and 24 g protein, and provides balanced nutrition from several food groups, along with fiber. But most people would probably think it was way too small, and if you went to a restaurant, you would get 4x that much food, plus half a gallon of fat and sugar laden sauce on top. And probably cheese, just for good measure. Could I eat that? No. And hopefully I will never be able to. A sandwich is tricky because of bread. I find bread too filling. I was out this weekend at a sports stadium and had to order my lunch from a food truck. I chose the grilled chicken pita wrap and ate all of the insides but treated the pita like a plate that got thrown away at the end. I do the same with a soup and half sandwich combo from a restaurant, eating the sandwich filling and the soup but ditching the bread.

The answer to that question is it is different for everyone. It depends on how your metabolism responded to the surgery, how much exercise you get, your body composition (fat compared to muscle), and even what kinds of foods you eat. Some people must maintain at a lower than average caloric intake while others can eat much closer to a "normal" amount and do just fine. It's very much a trial and error process to find what works for you, and you may need to make adjustments as time goes on, too.

As others have said, absolutely not. Fruit, veg, and lean protein is essential to good health. I had protein shakes for the two weeks before surgery to shrink my liver, and for the first few weeks after as my insides healed. I would never want to rely on them beyond that. I can't even imagine how horrible and unfulfilling that would be. I've continued to have maybe one shake a day as a supplement when it's difficult to hit my protein goals. Tonight I'm having a protein hot chocolate from Premier Protein because it's chilly outside and a nice treat. But mostly I eat real, minimally processed foods. It's important to remember that supplements and vitamins and minerals are only able to provide the nutrients we know about, the ones scientists have discovered are directly responsible for diseases and disorders if you don't get them. But there are countless thousands of compounds in natural foods that we need and that are absent from shakes and supplements because they haven't been studied. The only way to get that is to eat a wide variety of real whole foods.

Taking care of your mental health doesn't have to cost money. You can talk openly with trusted friends or family about your body image issues and low self-esteem. Or you can post here in this forum where you will find hundreds of people who share a lived experience of navigating the world in larger bodies. You can heck self-help books out of the library. Or buy a notebook from the dollar store and start journaling about your thoughts. You can meditate with the help of free YouTube videos. Or listen to relevant podcasts. You can find free sources of help if it's important to you and you want to make a change. Then again, I don't know you, so I could be completely misreading the situation. You can ignore this advice if you think I'm wrong, or if you just don't think anything I've suggested is worth trying. But after reading your original post, I thought it was important to say that if you can't immediately reverse your weight gain, it doesn't mean your life can't be really good.

Chewing for 22 times or 22 seconds is fine. But then wait at least that long between swallowing and taking the next bite. That's how you make your meal last 20-30 minutes. Very small bites, lots of chewing, and pausing between bites to let your fullness signals have a chance to catch up. It's hard to explain how small your bites will need to be after surgery to remain comfortable and not make yourself sick early on. After surgery, I bought a set of cocktail forks and demitasse spoons. They are tiny, like something you would use for a doll. For the first three months, I ate with those. My bites were the size of a pea. Picture your golf ball size meal. Mentally cut it into 20 pieces. Or literally get yourself a 3 oz meatball and actually divide it into 20 pieces. Right now, you don't have any restriction, so it will feel crazy to do this, but after surgery, you can consume one piece per minute and you will most likely feel great. Faster and you risk feeling bad, at least for the first many months. I just made the mistake of eating about 1/2 cup of raw baby carrots too quickly because I was distracted by work, and I am filled with regret. And belly pain. I feel like I've gorged myself on Thanksgiving turkey and all the trimmings and gotten it stuck halfway down my throat. I now get to reflect for the next few hours about why that was a bad idea to not slow down. It's a learning process, even well after surgery.

Hooray! 199 absolutely should be celebrated!

You definitely have a serious issue, but I don't think it's your weight. Your weight isn't going to kill you, at least not at the size you are right now, but your mental health might. And it certainly is robbing you of the joy in life that you deserve to experience. That's tragic. And unfortunately, surgery or weight loss isn't a cure. Gaining weight can take a toll, both mentally and physically. I understand, because I went from 5'6" and 127 lbs at age 16 to weighing 225 lbs by age 32 and hitting 250 lbs by 49. I tried many diets. I exercised. I worked with a dietician for about 7 years and tried many medications, including Saxenda and Wegovy. I developed high blood pressure and became prediabetic. For 33 years, I gained weight, lost a bit for a while, and kept gaining more. But I also lived a fairly happy life. I got married, bought a house, had two children, started a career I enjoyed, traveled to lots of places I had always wanted to see, learned new hobbies, spent time with friends and loved ones. Was I frustrated that I had to buy clothing in the plus department? Yes. Did I sometimes look in the mirror and feel sad at how I looked? Absolutely. But that wasn't my identity and it didn't dictate what I allowed myself to do or experience. Feeling like your life is destroyed, that life is a cruel joke, and reaching a point where you do not wish to continue living is an extreme and unhealthy reaction to gaining weight. It's a huge red flag that something else is going on with your mental health. That, in my opinion, is way more pressing to take care of right now than reducing the size of your body. I had surgery because I knew it was what I needed for my health. It would clear up physical issues and help me live a longer life with more activity and less pain. I did it because I loved myself and I knew I deserved to get every ounce of joy from life that I could. But a year ago, 80 lbs heavier than now, I loved myself exactly as much as I do today. I don't love myself any more now because I'm thinner, even though I do love how I look. And I love myself now way more than I probably did when I was downright skinny in my youth. There's no magic number on the scale that makes you worth loving. You're worth that at every size, shape, and age. I'm not saying to give up on losing weight or on getting weight loss surgery. If it's important to you, you can find a way. There are some amazing and affordable self-pay surgery options available in Mexico, for example. You could start saving a little bit of money each month now if it feels worth it to you. I hope this won't happen, but if you continue to gain weight, you will eventually qualify for surgery through your health care. In the US, it's at a 35 BMI with comorbidities and at a 40 BMI based on obesity alone. I assume the standards in Canada are similar. But no matter what you do, I would encourage you to find help with your mental health and self-image. You deserve to be happy with who you are and not to have how you feel about yourself be based primarily on something as arbitrary as a number on the scale or the tag inside your jeans.