SomeBigGuy

I was on Ozempic, Trulicity, and Mounjaro at different times between 2021 and 2023 (depending on which one insurance would cover for that month), and it helped with my Type 2 diabetes symptoms, and I lost 30lbs as a bonus. However, I feel like I hit a wall around that 30lb mark and couldn't get past it. I was stuck around 320-325lb for a year before going forward with Gastric Sleeve surgery last November. I feel like it helped significantly for my diabetes, and more for weight loss than other things I have tried, but it definitely wasn't a miracle drug for the weight loss aspect of it. It didn't really help my cravings, but then again, nothing has helped that for me. If you take it, be sure your doctor monitors your thyroid levels periodically. My mother has a history of Thyroid issues, and Mounjaro caused some significant issues for her, so she had to stop taking it.

I am counting from my highest ever weight on my tracker on this site (352), but my surgery team and primary care doctor count from my pre-op start weight (321). There's a 2 year and 30lb gap for me, but I'm counting that for me since it was work to break old habits during that period, which helped me set the pace to be more successful post surgery. As far as sticking to a plan, as others have mentioned, they do use average numbers. Everyone will fluctuate a little above or below at each stage. Also the weight loss progression will look more like stairs/steps rather than a straight line. You can expect a period of weight loss, followed by multiple plateaus. That's just your body freaking out over an unusual weight loss event, and recalibrating things to make sure you're not starving to death. Since it can't know you're doing it intentionally, it will retain fat and fluids as it panics, then release them once it realizes you are safe. Just stay the course, and don't get caught up on seeing a steady loss, otherwise you'll end up worrying over nothing (like I tend to do haha).

Congrats on the surgery and taking a huge step forward in improving your health! Also, welcome to the post-op malaise phase of the process, haha! I was there a few months ago, and I think its a rite of passage to be like "What have I done?!!" somewhere in the first 6 weeks. It does get better gradually, but the first month is the roughest. You will be able to eat "normal" foods again soon. I think I was able to eat most things again around the 3 month mark (mostly excluding carbonated drinks and alcohol). Just take your time and listen to your body. Some things will fight back, and if they do, just wait 3-5 days before trying again. I had a lot of trouble with green veggies initially, but was able to handle them around week 6. Also remember the weight loss pattern will resemble stairs and not a straight line. You'll have periods of weight loss, followed by a couple/few weeks of stalling and slight regain. This is just your body recalibrating itself after a large loss to ensure its safe to continue letting go of fat reserves, because it mistakenly thinks you're in a survival event and doesn't want you to starve to death. Just remember this is part of the process, and its not a failure. This really got me down initially and compounded that regret feeling, but after a long stall I'm making progress again. Also, Cipro is very likely the culprit in making you feel sick. it's a very strong antibiotic, and good at its job, but the side effects can be harsh. I've developed some partial hearing loss because of it after years of taking it for recurring Diverticulitis. Ask your doctor if there is another antibiotic that can do the job, but with fewer side effects. Good luck, and I wish you luck on your journey!

I have a question for folks that may have experienced this. I'm not convinced it is 100% related to my surgery since I had some of these symtpoms, albeit milder, prior to my surgery. I felt like the dizziness and general weakness went away the first 4 weeks following surgery, and I was able to walk 2 miles easily without stoppoing, and 4-5 miles a day with minimal rest. I was really looking forward to going back to the gym once I was cleared to lift weights. However, I caught Covid, and was mostly stuck in bed for 2 weeks over Christmas and New Years, around the time I was working in solid foods again. Since then I'm barely able to walk 1 mile without stopping, and even then I need to rest for over an hour to feel right again. It's gotten progressively worse, especially in the last two weeks, to the point that I don't feel comfortable driving when the vertigo and extreme fatigue hits. It's to the point that I'm falling off my treadmill if I go more than a half mile. It went from being somewhat disruptive previously to debilitating now. Luckily I work from home, but even that is starting to get disrupted. Over the past year I was evaluated for heart issues, had 3 MRI's, a CT scan, echocardiogram/ultrasound, had my carotid checked, been to two opthamologists and tried two different pairs of glasses, checked out by a Neurologist and Neurosurgeon, evaluated by an ENT, went to a hearing and balance specialist (no Menieres disease, inner ear crystals, etc), normal BP (between 110 and 130 systolic, and 70-85 diastolic), Blood Sugar has returned to my pre-diabetic levels (92-98 fasting, and no higher than 130 when checked 2 hours after eating). Pulse Oximeter is showing O2 staying between 95-98. CPAP was re-titrated to treat sleep apnea following the weight loss. Blood labs showed Total Cholesterol and LDLs somewhat high, but decreasing steadily since my surgery in November, High levels of Iron and Calcium though, but everything else plus thyroid were normal. Heart rate has dropped from pre-surgery rate averaging around 80-90 bpm down to 40-55, but my PCP wasn't able to determine why. My father and grandfather (currently 92) both have a normal heart rate between 45-55 for their whole lives, so maybe that one is hereditary. Thanks for reading and any advice is appreciated!

@brandycsiz - I think its pretty common. I've deifinitely gone off track, mostly due to other health issues and stress outside of the surgery itself. I was able to walk several miles without stopping in December, then after getting Covid (and I'm assuming long-Covid now), if I go more than 3 miles in a day or try lifting weights in the gym, I get physically ill for 2-3 days afterwards. I keep walking 1-2 miles in the evenings after work, but the lack of progress and regain of weight is very discouraging. I tended to stress eat before, and to be honest, the surgery was a success because at least it limits the amount I tend to binge on when having a bad time. I still have those cravings, but at least now I can drink 8-12oz of water and delay eating. I'm probably on track with my diet 3-4 days per week, but have been overdoing it or eating too many calorie/carb-dense foods when I have an off day or when I see family, who aren't the most supportive. My mom likes to drop off Little Debbie cakes and other snacks on my porch twice a week as she's driving by, and it's straining our relationship because I throw them away immediately, and she sees that as me being ungrateful and disrespectful. I am 6lbs heavier than I was around 8 weeks post-op, so its really getting me down. After covid, I developed some issues with my heart rate. It drops down in the upper 20's to low 30s in my sleep and my blood pressure drops too low, but if it get it past 100bpm, my blood pressure spikes, and I get dizzy and almost faint. I'm trying to get in to see specialists, but I can't get in with a specialist for 5+ months just for initial consult. I have to drive 3+ hours to another area to try to get in sooner, but I burned all my leave time for the year with Covid in January, so I can't take the days off to travel.

Thanks again @Arabesque and @ChunkCat for your advice earlier. I haven't been checking in as much, dealing with continuing health issues. Healthcare providers are difficult to get scheduled with in my area, so I'm just now getting to follow up with them. I've been waiting to get scheduled with a Neurologist since August, but no luck. I've had to burn my days off with work due to Covid at the beginning of the year, so I'm not able to get in with a specialist since the closest one available is about a 4 hour drive from here. There's also no immunologists with availability in 2024 within 4-5 hours from here either, so I'll be waiting on that for a while. I am getting in with a cardiologist to see what is going on. My heart rate is dipping down to 28-29 bpm in my sleep, and I wake up feeling exhausted. I'm on a CPAP and also getting another sleep study scheduled in April to see if adjusting that will help. I'm still just walking about 1-2 miles a day. I walked 4 miles a couple weeks ago, and was hardly able to get out of bed for 3 days. I've never been that drained from that relatively small amount of exercise before. Luckily I was able to work from home and had my laptop in bed with me, but it was a struggle with the 12 hour shifts. I am getting frustrated since I've gained weight back, and I'm 10 lb heavier than I was at New Years, but my primary care thinks whatever issues I'm having is killing my metabolism. I'm starting back on my pre-op diet this week to try to lose a little more. If anyone has any suggestions, please let me know, I am open to them. Thanks!

My understanding was that the "Net Carb" count was more for Keto / Atkins carb counting to be a guide for staying in Ketosis. Then it became a way for marketing to say its lower carb to sell more stuff. Both my primary care doctor and my surgeon told me to measure total carbs and disregard net carbs if I'm not doing either of those diets.

Congrats on all of y'all's progress! Looks like everyone is doing great!

Congrats! Sounds like you are making some good progress if you've gone through that many clothes! I can relate to both of you. I feel like I haven't made the progress I should be, but Long Covid has hurt my exercise efforts and constant brain fog is frustrating. I also hit a 6 week long stall that really brought me down. Thankfully that finally broke the last two weeks for me, but I still dont' have my strength back. A 2 mile walk pretty much drains me still, even though I was doing 4-5 miles at a time 4 weeks post-op before Covid. EDIT: Based on continuing conversation in this thread, I just wanted to say I realize I have made good progress, but was trying to emphasize that I still have a mental block that, for some reason, prevents me from appreciating it. I've lost more weight than I was ever able to on my own, but at the same time feel physically weaker than any other point in my life despite trying to exercise. Also my start weight of 352 was from my highest ever weight in 2021, and not my pre-op diet weight of 321. Not trying to be dishonest, just trying to remind myself how bad off I was 2-3 years ago.

Congratulations on the surgery and improving your health! Sounds like you are doing well! Just a heads up, you're approaching the dreaded Week 3 Stall, as its known, but don't get discouraged. Everyone hits a wall for about 2-4 weeks around that point, but that's just your body recalibrating itself to deal with the rapid weight loss. It will retain water and try to hold on to fat because its panicking from sudden change. Keep the same diet and stay the course, and it will release that fat once it realizes its safe. Expect the same temporary plateau around the Month #3 and Month #6 marks as well. Our body has to readjust periodically. Weight loss will resemble stair steps, with a brief regain of a kg or two before resuming loss, instead of a straight downward line. Just remember it's normal when that happens! You're doing great!

Agreed! We all have a baseline weight from parts of our body that just have to be there (bones, organs, skin, etc). On top of that is muscle (good weight) and fat (we need a little of this, but excess fat is what we're fighting here). That's why tracking percentage weight loss is more important as we get closer to our goals. An example I was given, just using big/easy round numbers, is pretend your start weight is 300 and your goal is 200. That means you would have 100 pounds of excess weight to lose, and the 200 is your base weight your body needs to survive (again, just using easy numbers here, not an actual guide) So if starting at 300, and you lose 50 out of the 100 excess lbs, that's a 50% loss. After that, you're starting at 250lb over the 200lb goal. To lose 50% of that (25lb), you would have to put in the equivalent amount of effort that helped you lose the previous weight, because its 50% of excess. This is why it feels like we have diminishing returns on our work. 25lb total loss at this stage feels like its not much, but its still a 50% excess weight loss! That's why weight loss slows as we get near the goal. Our metabolism readjusts because if we kept losing at that original weight, it would put our body into shock since it can't adjust that quickly. Just expect it to slow down and taper off, but track that percentage rather than actual pounds. One more thing, as you put on more muscle, that will likely keep you from hitting the exact goal if it is too low. Muscle weights in excess of 1.5x as much as fat per volume. If you go to the gym now when you previously didn't, you will gain more muscle weight, which is a good thing. The more muscle, the higher your baseline metabolism, which burns the excess fat off quicker and keeps it off. The scale doesn't tell you everything. You're doing great, keep up the good work!

This varies greatly by state, as each states' laws govern what is essential vs cosmetic medical procedures. For example, my work insurance is based in Tennessee, and all bariatric procedures are 100% cosmetic, so no coverage at all! To further complicate things, individual companies within these states can have varying coverage depending on how much business they get from your employer. Even if a company like Blue Cross or Aetna cover it for employees of one company, they won't for others. You will really need to look into the offerings you have available, and call them directly. You may have to get assertive with them to get a straight answer. I had one make me go through programs and jump through hoops to prepare for it, only to tell me they wouldn't cover anything when I went to schedule surgery. One even told me they would not cover any future medical procedures if I have it done anyway! I'm with another company and insurance plan now which didn't cover it either, but they didn't blacklist me for having a self-pay procedure. Good luck, hopefully you're more successful than I was with the insurance company.

I have the best luck with the Fairlife 30g shakes and their 26g and 42g "core" shakes. They dont' have that chemical taste that most other shakes have, and taste closer to a Nesquick. They do have monk fruit and sucralose in them, but I've been able to tolerate them. I am sensitive to a lot of sugar alcohols (sorbitol and xylitol in particular) which trigger a bad insulin response for me, but I haven't had that experience with the Fairlife brand. Premier protein isn't bad, but I think Fairlife tastes a lot better. They can be hard to find, but I've had the best luck checking at Sams Club (or Costco / BJ's Wholesale if they're in your area). They sell out fast, so I check in the morning and place a pick up order for after work.

I'm 3 months out from Gastric Sleeve surgery and have the same issue. I had constant hunger before and that never really left. The difference is now my stomach has a governor in place and will fight me if I give in. The 3rd week stall was discouraging but it passed and I lost 15 more pounds before hitting another stall now. I'm trying to change up my diet some and try some new foods, in case I'm deficient in some sort of nutrient and my body is craving it. I did eat some Korean food, sort of a low carb bibimbap type thing, and it seemed to get rid of my head-hunger and my stall broke when I was eating it more frequently, but that lasted about 3 weeks before returning. For some reason I'm really craving beef right now, but my iron levels are actually too high. I find myself constantly wanting to graze while working at my desk, I'm guessing more out of a stress relieving habit rather than true hunger, but it feels real. When I get that urge to graze after a meal, I'm making myself drink a 16oz bottle of water and chew some very flavorful gum to distract from it. It's not a cure, but instead of constant cravings, it seems to buy me 2-3 hours. Good luck, and congrats on your surgery and your progress! Definitely share with us if you find a way to curb the head-hunger feelings.

The first month or so, I was taking Miralax to help, but what worked more for me was taking a couple tablespoons of olive oil twice a day. It took about 8-12 hours for it to start working, but after the second "dose" it really worked, so plan your day accordingly.

I had a similar situation with Tennessee, but unfortunately none were available. I had to save for a while, but the clinic I went to offered a discount if you financed through CareCredit with them, so that may be an option. Also with self-pay, there's fewer hoops to jump through leading up to scheduling a surgery. That being said, i would recommend lining up some counseling along the way if you do go the self-pay route. Good luck! Hoping someone has some better news than I do.

Thanks! I did get evaluated for Orthostatic Hypotension and POTS with my primary care doctor doing the tilt table test and with the balance specialist, but both tests were negative. I used to have the Orthostatic hypotension previously but it was caused by my blood pressure medicine. Since I've been off of it, that particular dizziness has gone away. Now its more of a persistent feeling of motion, almost like its someone jiggling my glasses. It's just frustrating because I keep trying walking to exercise, but I'm stuck to using the treadmill or sidewalk and not going too far from the car. I'd prefer walking in the woods on trails, but I don't want to get stranded where my wife couldn't help me back. The brain fog is no joke. I had a lot of trouble with it before the surgery, had a one month or so break, then after covid, it came back even worse. Regarding other viruses and vertigo, I'll check back with my doctor when I go back next week to see if they can prescribe anything for that. Hoping you're doing well and feeling better yourself! Thank you again for replying!

Just curious, are you on a mainly vegetarian or vegan diet, because its common for copper levels to increase with a lack of meat. Foods that commonly have more copper include shellfish, beef liver, whole-grain products, nuts & seeds, avocados, chickpeas, tofu, potatoes, mushrooms. So if you eat a lot of these, this may be the cause. I'm not a doctor or nutritionist, just some random guy on the internet, but from what I can find on the matter, it sounds like it can be caused by eating a diet mostly consisting of those things I mentioned, but also from a deficiency in other minerals like Zinc and B & C vitamins, as well as other metals needed in a diet, which copper will take the place of in their absence. It may be worth looking into a multivitamin that's lower in copper but has other metals in safe levels. It can also be environmental, so check to see if there's anything you're around frequently that could expose you to copper, such as copper plumbing for your water, copper cookware, jewelry, and IUDs. I have a similar issue with Nickel, and have to be careful which metals I handle, since its common for steel to have nickel in its alloys.

If its not diabetes/glucose related, it could be an allergy or intolerance to certain foods. If your body mistakes it for something attacking it, it will cause inflammation in various places, and can put you in a mildly sedated state while it thinks its fighting for survival. You may want to track what you eat for a week or so, and jot down which meals made you feel more sleepy than others. Look for patterns, and check for common food intolerances online to see if there's any overlap. For some people, it could be stuff like sugar, wheat, red meat, nuts, flours, soy, gluten, food dyes/coloring, shellfish, other seafood eggs, dairy, or corn. You may also want to look into elimination diets where you cut a category of food out of your diet for a couple weeks, to see if it goes away, and slowly add them back in (1 item per week) to see if the symptoms return. Good luck in figuring it out!

I've noticed shipping is usually outrageous for these, I'm guessing because its heavy liquid weight. If you have a BJ's Wholesale nearby, they should have it too, but check online. Walmart and some grocery stores will sometimes sell individual bottles, but wholesale stores would be cheaper. My local Sam's Club has a 12pk for $21 ($1.75 each), but Kroger sells them individually for around $3.50 per bottle. When I was on the liquid stage, another thing I had to do to keep away some of the cravings was chew up a bite of something and spit it out, just to get the flavor and distract from the shakes. Others have mentioned this too and it seemed to help them somewhat. Also if you're dealing with constipation, try a tablespoon or so of olive oil 2-3x a day to get things back to normal again. It usually takes about 8 hours after the first one to kick in. It is somewhat higher calorie, but it can become an emergency if things back up too much, so it is a little more drastic than over the counter laxatives.

Congrats on the surgery! I was sleeping in the recliner for 3 weeks, and was 5 weeks out before I was comfortable lying completely flat. I'm at 10 weeks now, but I'm still using some pillows to prop myself up in the bed, I guess I got used to being propped up, but I am able to sleep flat without discomfort.

Congrats on the surgery, and your first steps towards a healthier you! It looks like I'm a day late, but echoing what others are saying, the first day is the roughest, by far, but it eases up quickly throughout the week. Walk and do arm exercises (lifting over your head, rotating, just any movement while walking), and this will help dissipate the gas pressure you're probably experiencing right now. Try to do a little every hour, even if its just walking down the hallway and back a couple times. If your doctor allows it, take Gas-X to also help with the gas pressure. It kept feeling like it was getting stuck in my left should/chest area, and was really uncomfortable. That was my biggest complaint about the process the first couple weeks, but the walking and gas-x would buy me a couple hours of relief. Also, for the protein shakes during your liquid phase, get the Fairlife brand 30g or 42g shakes if you can find them. They taste more like chocolate milk and don't have that chemical taste that a lot of other protein shakes have (Premier protein and muscle milk). Check Sams Club and Costco for those.

Congrats on the surgery! Expect the first month to be a roller coaster of emotions, hunger, anger, and a day or two of regret. That's a rite of passage for us, where I think everyone second guesses their decision. By week 5, I finally started getting a better handle on things and I'm still very happy with my decision. 10 weeks out and I'm in better shape than I've been in decades! As others have said, you feel hungry because you are hungry. Your body is used to the previous amount of eating, and panics when it realizes you're not eating what you used to. Since you were a candidate for surgery, then your body has enough fat cell reserves to live off of that for a few weeks, which is why they have you focus only on water the first two weeks, while working in more protein to prevent you from burning muscle. However, our bodies don't understand that logic and kicks into survival mode. It only understands "food" or "no food". The first six months is critical to the process because that's when we have the best opportunity to retrain our mind and bodies to adapt. In a sense it is traumatic to our bodies, and it will fight until it understands that this new normal is safe, because that's its job, to keep you alive! Once you're back to solid foods, that's when recognizing head hunger becomes more important. Around that time (somewhere around weeks 4-6), you'll have worked up to eating enough calories to be sustaining metabolism, while still running enough of a deficit to burn fat. At that point, your body will try to tell you "hey, we're close to the old normal again, go ahead and eat more!". As my therapist reminds me, remember to listen specifically to your stomach, and not your mouth. Practice eating enough to where your stomach feels full, and not pressured from too much, but at the same time, study your habits to see if you're eating to stay busy, to deflect stress (I'm guilty of this), or just because your body thinks you should keep your stomach topped off. During that period, if you feel like your stomach is craving more, double check what nutrients you are getting. If you're deficient in vitamins or minerals, you will develop insatiable cravings, but your body can't tell you exactly what its missing. It just yells "I'm Hungry!". Check with your doctor on which supplements to add or remove, and also branch out with different styles of food as long as they fit your calories/macros. I felt like I was starving for most of last week, then I got some Korean food (sort of a bibimbap inspired kale and cabbage salad with beef) on Friday, and the cravings stopped. I'm still trying to figure out what itch that scratched, but obviously I was missing something in that! Also, be very careful with sugar, starches, breads, rice, etc. That can send you into a craving spiral that lasts 2-3 days. Some sugar alcohols like Sorbitol and Xylitol also trigger that for me, while Monk Fruit, Stevia, and Splenda don't. Everyone is different, but pay attention to those ingredients, because that can make the hunger feel worse!

I agree with the others stating the importance of having a therapist or coach to walk through this with you. Dieticians and nutritionists are very helpful with making a tailored diet plan for your needs, but don't always address the issues in our head, since that's not in their job description. See if you can get your insurance to cover sessions in therapy or counseling, if nothing else, just to have someone to vent to that is obligated to not judge you . If insurance pushes back, check with local therapists that offer "coaching" sessions at a lower rate. I had to do that until my insurance rolled over at the first of the year. I'm only 10 weeks post op, but I'm dealing with constant head hunger and cravings. I'm learning now that I used the act of eating, and not the feeling of fullness, as a way to deflect stress. At least now, if I overdo it, my stomach will rebel, which is its own problem, because I don't want to put stress on the staples. My therapist is helping me practice ways to listen to my stomach, and not listen to my mouth, if that makes any sense. When those two are fighting, the stress and feelings of being a failure appear to me. I have to remind myself that despite hitting a stall and dealing with the cravings, I'm already much healthier for having decided to have surgery!

Typically the growling noise is just fluids moving through the small intestine, and not an actual hunger cue, just as@Arabesque said. You will still feel hungry early on post-op because your body is used to a lot more calories than you're able to give it for now, but that encourages more fat burning. Your body will adjust to its new normal in several weeks though. It will calm down some, but it may be more noisy going forward because you have that direct funnel to the small intestine where fluids like to make noise.