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I had this issue really bad at my heaviest. I was on medication for it. A couple years ago I carried my eldest to bed - I'd just laid her down and boom - if I'd have been pregnant I swear my Water had broke. Pee just ran down between my legs and onto the floor. I ran to the bathroom freaking out. I didn't know what was wrong with me. My doctor tried to narrow it down. Blamed a lot of it on my thyroid condition (hypo). That seems to be the "blame catcher". Anytime something is going on weird with my period, blatter, or body it is my thyroid. That's what they tell me anyway. It seems that my 275+ frame was putting excess pressure on my bladder and causing it to spasm. I was eventually weened off of the medication. As I've lost weight I've noticed the - run like hell and unbutton your pants as you go urge has become less frequent.

Why haven't you made any plans for Christmas with your kids? Why don't you have a celebration with them before the actual day and do something really fun. I mean since you waited this long to make your own plans your husband beat you to the punch line. The only plan you've made is to not let your kids go out of state with your ex. Start acting proactively instead of reactively. Thats my 2 cents.

Hi all- I just received an apology from Persistance, saying she did not mean to come across to hard on our WonderMom here. When responding to her, I realized, I too had handled it wrong. While she was harsh in the way she said things, she too is honestly looking out for Wonders safety. She deals personally with abusive relationships, and has seen the worst happen. NONE of us want that for Wonder, we all have different ways of voiceing that, and advising her. Some of us wish we could just go pull her out of the house, and fix it all for her!!! We can't. Dammit! Anyway--please know wonder, that we all just want the best for you, we worry about you. Many of us have been where you are, and know it can go from bad to worse very quickly, and we just want you to be proactive rather than reactive to things he says and does. Keep in contact with your attorney, and with us---even when we say things you don't like it is done, hoping to help you. I really do not believe anyone is trying to be unsupportive, we all just show it in different ways. Tough love is afterall still love---just wrapped up differently. Hang in there Wonder---we're all here! Kat

Hi. I had Graves Disease & now I'm hypo, so I shared your concern. You will def lose weight. I'm about a month out & so far have lost about 24 lbs. I think that's pretty good! My hypo dose of med is 225 mg and I have to crush my pills before I take them & that's not as bad as I thought it would be. Talk to your dr about your concerns. It really might make you feel better. Anyway, good luck & see you on the "losers bench"!

That approach works for me; it is pro-active instead of being merely reactive. I was proactive, too. I weighed in at 195 and I paid to have the band installed; this has been a largely positive experience. I was able to overcome the gluttony which kept me married to my plate. And to take the time away from this in order to do some research as to what would make for healthy little snacks for someone who despised cooking. lol

I had reactive hypoglycemia pre op. I pretty much new I'd be sick as a dog if I had any sort of carbs at breakfast or lunch. I always got sick between 2:30 pm and 4pm and would have to eat something or I would pass out. Since surgery two weeks ago I have not had any symptoms of hypoglycemia at all.

"Gold standard" is a marketing term used in selling a procedure (cynically, it has been said that it applies to the surgeons themselves, as that is where they make the most "gold") and as such is basically meaningless. Here in the States, there are four mainstream procedures that are routinely performed, and approved by the ASMBS and the US insurance industry - lap bands, RNY, VSG and DS. The bands are falling out of favor owing to their high longterm complication rate and low effectiveness, but there is still a lot of marketing push for them by their manufacturers. The RNY has been around for forty years or so, based upon procedures that had been first developed 100 years before to treat gastric cancer and other gastric maladies (Billroth II). It was an improvement over the existing malabsorptive procedures such as the JIB (jejuno ileal bypass) but it still had the longstanding tradeoffs of its basic configuration - bile reflux, marginal ulcers (aka, the "NSAID problem"), dumping syndrome and moderate nutritional deficiencies. Bile reflux has largely been eliminated in the RNY WLS procedure via tailored limb lengths, but the others remain as common side effects and are largely controlled by diet or medication restrictions and supplements. It is overall a very good and mature procedure that works well with tolerable side effects, but it is far from perfect, which is why there is been an ongoing effort in the industry to find a replacement (this is how progress is made.) The duodenal switch (DS) was developed in the mid to late 1980's, which combined a moderate level of malabsorption with a moderate level of restriction (compared to the RNY which is more highly restrictive and minimally malabsorptive) that takes care of the RNY's problems with bile reflux, dumping/reactive hypoglycemia and marginal ulcers. In exchange, it is more technically challenging for the surgeon (which is why most don't offer it) and is a little more fussy on its' supplement regimen. On the plus side, it is more effective in treating diabetes, somewhat more effective on overall average weight loss, and much better at resisting regain. It should certainly be on the radar for anyone in the high BMI ranges and/or with a history of yoyo dieting. The main thing that has held the DS back from being more popular is its complexity, which often doesn't fit in with either surgeon's skill sets or business models (can't do as many procedures in a day.) The VSG came out of the DS as it is the first phase when the DS is done in two steps. Typically the VSG stomach is made smaller, about half the size, than the DS sleeve. It overall yields similar weight loss and regain characteristics to the RNY but without the dumping/reactive hypoglycemia or marginal ulcer predispositions and is also quicker and easier for the surgeon to perform, which is why it has been gaining popularity. The primary downside is the predisposition toward acid reflux owing to the stomach volume being reduced much more than the acid producing potential, to which the body doesn't always adapt. Nothing is perfect, and they all have a place for different circumstances. Getting beyond marketing fluff, hey are all the "gold standard" when used appropriately. The next new thing that is working its way through the industry is the SIPS/SADI (sometimes called the "loop" or simplified DS) that shows some good promise of having effectiveness somewhere between the RNY and the DS, with surgical complexity on the order of the RNY (it is being promoted as being "almost as good as the DS" while being more "accessible" - simpler so more surgeons can do it. It is still usually considered by most insurance to be investigational, and has yet to gain approval by the ASMBS, but there's a good chance that it may become that RNY replacement that the industry has been looking for.

We had a free health screening at work so I figured id see what my numbers were looking like almost 4 months post op. My cholesterol was down from a little over 200 a year ago to 109 now which is great and my blood pressure was perfect but my glucose levels were low. It was only 57 which seemed to concern the person taking it. I ate a banana about an hour before. Anyone know if this is a normal glucose level for an RNY patient? Or could it be reactive hypoglycemia from the banana?

Being dizzy, lightheadedness, fainting can also be caused by low blood sugar. There is a condition that occurs in Gastric Bypass patients called Reactive Hypoglycemia. One man in our bariatric surgery support group developed that condition. After fainting one time, he figured out the cause and then learned how to control the condition. Here are a few links. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

@RJ'S/beginning First, you belong here on BP. You are a wonderful host, and you bring a different perspective. All that you have been through makes you uniquely qualified to discuss the painful complications you've had that others would benefit from hearing. If I were going through something like that, I would come to sites like this and look for someone like you, because I would want to know that there is hope. You offer that people. Second, you are a success, and no one can take that away from you, and most certainly not with words. One thing I've learned about the medical community, is that they tend to be single minded in approach, and their single mind is focused around their specialty. If you had back pain and you went to a surgeon, he'd want to operate. If you went to a pain specialist, he'd want to inject you. If you went to a psychiatrist, he'd want to treat you with imagery. If you went to a GP, he'd try to manage it with pain meds. If you went to a sports medicine, he'd try to treat you with physical therapy. All of that's a little simplistic, but you get the picture. I wonder if you aren't focusing too much on his words? Just because he is calling you a survivor, it doesn't take away the fact that you are also successful, does it? It's just semantics, and in truth, he's right. You've survived A LOT, and are still dealing with that outcome. And I think surviving all that you have speaks to your wonderful spirit! I think you should be proud that you survived AND succeeded! He's just simply looking at it from his perspective, and that is treating the reactive hypoglycemia. I do hope he can figure out how to make that happen soon, so you can feel better an move on with the wonderful life you have successfully created for yourself!

Update I I Ok so the Doc says I have severe obstructive sleep apnea with low oxygen and failure to up oxygen levels after an apnea event, plus hypo ventilation. So I am waiting to be fitted with a fashionable CPAP machine as we speak. Lovely. The only thing I can do is turn around my attitude, so I am happy that we have discovered the problem, that the office is working my insurance issue and that I may experience what I have read can be life changing sleep after receiving this machine. And guess what? I get to install it myself :-D

I seemed to have developed hypo thyroidisym after surgery. My PCP didn't put me on anything yet. I just reached gaol and she wants to recheck it in a month.

I have hypo thyroid and i am 2 months out. I have lost 45 pounds so far. My doc is a debbie downer as he thinks that is slow, but ai m half way to goal so I am concidering it a win

Well, I'm glad we all can help answer questions. Ik that the hypo controls it, but now I c that ghelin can affect the hypo as well. Thx

I relied so heavily on this forum and others in the months leading up to my procedure that I promised myself I would provide a 12 month update, FAQ and experience summary for others planning the same thing for the same reasons. I recently posted this to Reddit and bariatricpal rounds out the plan. My story is positive – overwhelmingly positive – but I think most importantly my story is not emotional. I don’t have a psychological problem with food. I was never tormented or made to suffer for my weight (beyond finding flights uncomfortable and shirts being too short). I made this choice on statistical grounds – it would extend my life on average and go a long way to improving my diabetes. I wanted to provide a vanilla story to remind everyone this pretty survivable and the majority of people have non-descript and unexciting recoveries. My lift is pretty much the same - I just eat a lot less, dont shoot insulin and hopefully will live longer. Forums tend to have an over representation of negative outcomes - that makes perfect sense and it's absolutely fine for people to use them to get some reassurance and communicate with people in the same situation. For everyone else - just remember you're less likely to jump on a forum and tell your story if nothing went wrong or it wasn't any different from other people and as a result it can seem like a higher proportion of people are suffering than maybe is the case. I was a lower-BMI diabetic, not quite type 1 or type 2, but insulin dependent nonetheless. My BMI was 31, my surgeryweight was 126kg (277lbs) and I’m 196cm tall (6’5). I was diagnosed at 100kg (220lbs) but assumed type 1 as I wasn’t visually overweight. However in the 5 years since diagnosis I’ve continued to produce some insulin suggesting I’m not a pure type 1 or 2 - but closer to type 2. I gained 26kg in a year after diagnosis once i started on insulin. I’m broad shouldered/chesty with skinny legs - like an apple jammed on some chopsticks. Maybe like the fat Mr Incredible. My intention for having the bypass was not solely weight loss – I suspected that my diabetes was closer to type 2. I suspected the improvements people see immediately in diabetes management post bypass may apply to me. It was a gamble that paid off, My decision making process was quite straight forward – I had a young daughter at the time (now have a son too) and had lost my father to a heart attack when I was 7. He was fit and not diabetic but had a heart condition. I new statistically I was due for a similar fate carrying excess weight plus diabetes onboard. This was the best way to knock out one of those (the weight side) and hopefully improve the diabetes. I went from 126kg to 83kg (180lb), my BMI is low end of healthy. My biggest positive is my immediate cessation of insulin shots and a current HBA1c of 5.8 with oral meds only. It took about 6 months to get to my goal weight of 90kg. I'm still slowly losing and need to stop. Lead-up and Prep I was not obese to look at visually. The majority of healthcare professionals I spoke to did not think surgery, let alone Gastric Bypass, was necessary. In the end – my PCP, endo and surgeon all agreed that, while not essential, bypass was a prudent decision with potentially long-term benefits. The surgeon did not want me to bother with a gastric sleeve – if the endgame was diabetes improvement then the gold standard was a bypass. In Australia you need to be over 35 BMI or over 30 with a comorbidity to be eligible. I had slightly elevated Blood Pressure - that plus the diabetes made me eligible. I paid $2000 out of pocket, my private health insurance paid the rest. No psych required, I had a few meetings with a nutritionist and everything was greenlit. From first enquiry to surgery was four months. The fee I paid includes lifetime consults with the surgeon. I did not need a pre-op diet as i was not that overweight and my liver was not a concern. Surgery My procedure was in June 2018. My anaesthetic recovery was rough, but otherwise the process was fine. The most discomfort was immediately in the 12 hours following – in part due to surgical site pain but mostly because the bed could not accommodate my height so I was forever crossing my legs or scrunching them up, only to have a nurse slap them and wake me up for fear of DVT. Nurses kept promising to find a bed extender - eventually I lashed out in a post-anaesthetic haze at a nurse who slapped my feet - she took the end off the bed with a flourish. My feet shot out, I cried in relief, apologised profusely and slept for eight hours. Day two was stiff and sore but i was mobile, able to shower and sipping fine. I went home the morning of day three. I had PHENOMENAL life ruining headaches from day two. I went home with some serious opiates because I lived 90 minuts from my surgeon and couldn’t drive to get a script if they hit again. On day four my dietician cleared me for coffee and it immediately wiped out the headache – turns out I’d been in caffeine withdrawal. So I really recommend you taper that off in advance if you have a problem with coffee like i do. If you're diabetic then buy a freestyle libre glucose monitor for the procedure if you dont have a CGM. They want hourly blood glucoses, instead of being woken and pin pricked every hour I could just show them how to use the scanner and they'd take it while i slept. I had some minor aches 6 weeks out and one of the surgery sites oozed a little clear fluid. It subsided immediately. I was home for two weeks. I could have gone back at one week. I'm an accountant though and my starting weight was comparatively low so i was mobile quick. I completely understand if you're starting form a heavier weight then you should plan to take the full time. Food/Eating The normal progression of foods was fine and unremarkable from what is described on most forms. I graduated to solids a little earlier than I should have. I cheated like mad and was feeling fine, it was only when I snuck a tiny piece of casserole beef and vomited violently did I start to behave myself. I was vomiting once or twice a week from eating too much or too fast. Savoury ricotta bake, hearty soups and coconut water were my saviors. The vomiting subsided, 18 months out I vomit maybe once every two or three months and only when I do something stupid. My problem before surgery was eating very fast and taking large bites – that has been hard to deal with post surgery. In fact I tend to still eat large bites and then sit unable to eat for extended periods. I was very sensitive to sugar post-op and frequently had dumping. That subsided in a month with changes in eating, changes in my appetite and better food/liquid rules. I currently only get dumping in the morning, and only if I eat something sugary. I do get nauseous easily in the morning too – it’s something I’m working with my nutritionist on to find out why. Otherwise I can eat whatever I want within reason. I don’t drink soda, but had quit it before my procedure. Milky protein makes me nauseous too (any type of creamy protein really) so I use a water protein additive from costpricesupplements. This helps me hit 2L fluids daily. I can eat about a cup and a half food. Liquidy foods – stews, soups, casseroles – I can eat a lot more than that. Tougher foods like steak or dry chicken much less. I gulp liquids. I had a sensitive stomach before the surgery and took Metamucil religiously to keep my gut regular. I have not had any issues post op with flatulence but have had looser bowels. Metamucil still helps – but no worse or in any way less manageable than pre-op. Diabetes I went off insulin immediately after my surgery. It wasn’t a cure – I’m still diabetic – but metformin and trajenta keep me in an aggressively managed hba1c. I have a so-so diet – I eat too much sugary junk food and carbs. I could go without diabetic meds I believe but my diet would be depressing so ive truck a compromise. On this basis alone this was the best decision I could have made for my physical wellbeing. My blood pressure is fine, my cholesterol is non-existent and I'm able to even job a moderate distance without discomfort. Random observations • I’m cold. So cold. It’s 35 degree outside where I am (90’s Fahrenheit) but as soon as I go into any office I need a sweater. I really became dependant on sweaters, long johns and socks this last winter. Im not cooler in summer – just as hot and bothered as before. Maybe a better way to describe it is that I feel the temperature more in general, like I lost my insulation. • I am too skinny. Clothes don’t fit that great – most men this tall have a bit more chest/gut on them. Australia has limited/no tall clothing ranges domestically so I’m importing loads of stuff from the UK/USA. i still think i look fat when i look in the mirror. • My bum is bony and I need cushions to sit comfortably. I also had a cyst on a butt cheek I didn’t know about – now im so bony there I’ll need to get it removed so I can sit on kitchen chairs comfortably again. • I gained about 1.5” of penis length. It was a welcome addition. I needed to learn how to be more gentle and patient using it. With a young family and little sleep it's yet to be fully road tested – but I’ll be ready when we start to sleep again. • I have a little loose skin. nothing dramatic. mostly around the gut and love handles. • I am very sensitive to meds and drugs. I'm not much of a drinker but i like weed edibles - what would give me a mild buzz before gets me quite high now. I sober up quicker now too. I take xanax on flights to help sleep - i take a quarter of the dose now. • I drink red wine socially and now cannot really get drunk. I sober up quite fast but get a mild buzz pretty quickly too. • Dumping sucks but it should not be a discouraging factor. Its not life ruining – anyone who’s had a hypo as a diabetic it’s a bit like that with some gastro thrown in. It resolves pretty fast (30ish minutes for me) and is a self-reinforcing feedback loop for shitty food behaviours. For this reason alone I consider the bypass as the better choice for me. • I’ve lost a fair bit of muscle tone and will need to somehow up my protein and start some weight training to recover it. This needs to be balanced with not losing for further weight. • I have to remind myself to eat. Not just because of low appetite, but because once my pouch shrinks for a day then eating again can be uncomfortable and time consuming. As long as I eat fairly frequently my pouch is all good and I can eat quite a lot pretty fast – forget about it for 2 or 4 hours and I’ll need to take some time to eat a bit and get my appetite back. • I was hungry for 33 years and bordered on a pathological inability to waste food. I ate my meal and anything my wife or kid didn’t eat. I’d eat a meal out, go home and have a sandwich. We ate at bars and pubs because the servings were larger. I would eat until I was very uncomfortable if the portion was large enough. Now I still can’t bring myself to leave food – so I have this silly aversion to ordering anything more than something off the appetisers list. I don’t like asking for to-go containers (it’s an Australian thing – it’s really stupid because we pay so much for food out we should keep every bloody morsel) but have started to now order what I actually want instead of what I think I can finish. It’s funny – I went from ordering what I thought would be the biggest portion so I didn’t feel hungry (instead of what I thought looked good) to ordering what I thought I could finish and not waste. Regrets? None to speak of specifically. In a very minor way travel is less fun. I looooove travelling to southeast asia and the USA and love eating all the different things. My appetite is so low now, and eating can be so inconvenient, that I don’t get to eat anywhere near as much variety when I travel. I was recently in SE Asia and looking forward to a huge array of currys. I ate only two in five days as I had no appetite at all. I just need to travel differently now - actually plan to stop for meals instead of just charging all over a city and snacking on the way. I wish id been more sensitive to my wife's emotional processing of the scenario. She's gone from having the tall, chubby guy that was the physical build she was attracted to, to having a skinny beanpole. This was while she was having our second kid and all the very natural weight gain associated. She's not overweight and is, objectively i reckon, absolutely gorgeous but definitely feels marginalised by the process and is quick to colour me as vain or obsessed with my image now I am buying new clothes. I think i could have been more mindful of what I said or did. She was overwhelmingly supportive though and agrees this was worthwhile. Closing thoughts If you are considering this process and maybe you're on the margins of eligibility my experience would say go for it. my hope here was to give a vanilla experience to the mix, unique only in my taking the more permanent bypass on despite my lower starting weight. Sent from my SM-A705YN using BariatricPal mobile app

It happened to me tonight and I thought i was very planful. Since having RNY 2 years ago I get episodes of reactive hypoglycemia. Today I had my normal Breakfast which was a Protein shake and knowing I would be going to my granddaughter's volleyball game decided to eat my lunch later than normal. I ended up having lunch at 2:30pm - I had a lunch that had great protein and veggies but also had more than normal carbs as it was a ground beef pasty. Then about 2 hours later I had a handful of almonds. I knew her game started at 6:30 and would like run until 8:30 but honestly thought i would be fine until then. Well, while on the way to the game I started to have the very low sugar crash and when it hits me, it hits me fast and it gets pretty scary. I start shaking, Sweating and getting very confused. I have learned the early signs (which come usually about 5 minutes before i end up in big trouble). Like an idiot, I did not bring anything with me. No glucose, no meter nothing.....So I looked at hubby who thankfully was driving and said you need to find either a walgreens or a gas station and find it fast. Well, we were in hicksville, USA and so the only thing we could find nearby was a gas station. I knew I needed some sugar but not alot and then i needed something with protein which would keep it from coming right back in an hour. So, I grabbed some dark chocolate and a protein bar. I ate 4 small squares of chocolate and then followed up with about 1/3 of the protein bar. Within 10 minutes I was fine and was able to hold off for a very late dinner at Stir Crazy where I had delicious chicken breast and veggie stir fry from Their fresh market bar. I really really need to be more careful with this! And going forward, a ground beef pasty clearly had more carbs than i even realized or it would not have happened to me. UGH!

I have hypo. If its under .3 then it's hyper. 4.9 is hypo. I havnt said anything to surgery yet bc I just found out today and I havnt even had my consultations yet but I know someone told me that they wanted your thyroid under control before surgery

No, the band will not prevent the symptoms of hypo/hyperglycemia. I was hypoglycemic for decades. Now I'm hyperglycemic. In both cases, I had to eat something every 3 hours to keep my blood sugar stable. Still do. .

From my research, reactive hypoglycemia is pretty common about 18-24 months after WLS. I have it and noticed it mainly at night when I would have a carb snack with my evening meds. I have to have a small amount of protein with every snack and meal.

No, no eliminating anything from my diet - I am not eating anything new that I didn't eat pre-op, and I'm not eating anything I don't have permission to eat. My surgeon mentioned it may be a systemic reaction, something I ingested at the hospital. Maybe the thrush prevention mouth wash thing I had to take, who knows. I stopped the heavy duty painkillers about 4 days out. Have you considered shingles? It comes out with stress in the body and is only mildly reactive to steroids.

Here is a link to an article on reactive hypoglycemia post–gastric bypass. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass The three most important things after surgery are fluids, Vitamins and Protein. Since you said that "when I drink Protein I throw instantly", have you tried MILK. 32 ounces of 1% milk fortified with 1 cup of powdered milk will give you 56 grams of protein. You cannot drink this all at once but spreading this out throughout the day will help you meet your daily protein requirement.

I have been struggling with hypothyroidism for the past 6 years....still trying to get levels evened out! My Endocrineologist was very supportive and my Bariatric doctor said I would have NO PROBLEM with hypo and the band. I can still take my meds (they are small enough), but you do have to take caution when eating anything with Calcium within 3 hours of taking your meds....that makes Protein shakes something that I have in the afternoon or evening! It has been a great experience so far! Good luck!

I'm also Hypo-thyroid... I'm glad I found this post. I realized that I am not alone. Few people really understand the challenges and frustrations we face.

My weight loss is so slow. I can't help but get discouraged. I am excerising, eating the recommended foods and drinking my water. I was banded 03/30/2011, my pre-op weight was 215 pds. I had a fill 04/30/2011 (not sure how much fill). My current weight is 205 pds. I am petite, so I need to lose about 90-100 pds. I know I did not gain it overnight, but hoped for more progress by now.

@@Wayward Traveler Hey! Thanks for the reply, I have ventured to the gym twice. The first day was just 40 minutes on the treadmill, I found medium incline and a moderate walking pace was my best bet. I definitely feel like running is a little far off, I get the feeling that the jarring motion would make the balloon... uncomfortable? I can't say I feel it specifically in my stomach, but I'm aware of the weight of it and it can move a bit. For instance, if I'm in bed and I roll onto my right side to turn off a lamp or grab my phone I can feel the balloon sort of bear down on the remainder of my stomach. It's not painful by any means, but certainly peculiar and unpleasant. I think if I were to run any great distance/duration I might get the same sensation in an up/down kind of way (I'm trying to avoid saying the balloon would 'bounce' because I feel it's pretty secure in situ, but it would definitely maybe push as I move up and down). So running, short term, maybe for a warm up or something I think would be fine, but not as a complete form of exercise. At least not for me after only one week. Today I tried my hand at the cross trainer, basically fine, though I did get a little... er, fullness (?) around the diaphragm (not heartburn, but like something was sitting low in my chest?) when I started to get a bit too high intensity, I think it was the twisting through the torso that caused that. I calmed it down by shifting my hands from the long moving grips to the short, stationary ones for a minutes or so, so that I twisted a little less. So, anyway, I was pretty happy with the outcome. Now, Krav Maga! Oh my goodness I love it! I started it last year and I have zero regrets. Not only is it a great workout, but its a useful skill to have under your belt. The practice I go to is for people 18 and above and it's pretty serious about what it does, but that works for me because no one is there to waste time. For my first class I rocked up feeling like I'd be this loser 30 YO woman, far too overweight and surrounded by hotheaded dudebros tripping on testosterone. I persevered only because I had watched a doco years ago about Krav Maga and had promised myself I'd investigate when I moved to an area that had a class. Anyway, so I was expecting some sort of quasi UFC thing: not at all what happened. People there came from so many different backgrounds and fitness levels. Young women, older women, fit guys, unfit guys... you get the point, all different and all there just to learn. The class is essentially at whatever difficultly level you require, if you're a beginner there's a grade for that and other students to work with, I progress when I am ready. Some people pick it up quickly and some don't and that's fine. You stay at your level until you are confident to move on. It also isn't really a 'martial art' as much as it is a system of self protection. You won't see people competing for belts (or at all, though there is a grading system) because in Krav Maga the best fight is the one you see coming and can avoid altogether (or with a swift knee to the groin). The warm up is typical of any fitness class, jogging in a circle, a few push ups (on your knees if you need to), sit ups, stretches. Then usually it's about learning new techniques then consolidating them with a partner and protective pads. The part that I found most challenging when I began (and still struggle with) is the confrontational nature of it. I'm not sure why (because it seems obvious in hindsight) but I was shocked in my first class to realise actual people would be attacking me (in a controlled and force-appropriate way, no one was trying to beat me or anything). I think the first thing we drilled what getting out of a front-on chokehold so there I was with a stranger trying to choke me. I learned very quickly that I freeze and panic in aggressive situations, but now that months have passed and I'm slowly teaching myself to have more reactive and useful responses to stress (not just in terms of physical violence, but in very useful situations like unexpected traffic panics, dropping things etc). So the thing that I hated about the class at first is actually the cause for one of the things I love about the class: I haven't just gotten fitter, I've become more situationally aware and better at handling pressure. As for backs and knees, my class is about working with what you've got, so if you're older or have injuries you learn to compensate and work with what you can do. Plus I'm sure you'd be able to opt out of any drills that cause pain. I'm sure all classes and teachers vary a bit. My class is affiliated with Krav Maga Global, and I know they are everywhere but it can't hurt to get in touch with the people near you and see if you can get in on an info session or beginners class. In my experience if you actually like what you're doing it won't feel so much like having to work out. For me, Krav Maga gives me those few nights a week that I can look forward to and work on myself, that fact that there's an element of fitness is just a bonus. I am so vey keen to get back to class and I'm aiming for the first week of June. @@flamingfeather_fly The balloon is a Fluid filled orb placed in the stomach to inhibit appetite and limit space. I have an Orbera but if you'd like to know more I'd suggest looking at Google.