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Thanks for the reply - I'm in North Central Ga - near Athens. Great area! I'm a total KETO failure, but I think that a lot of that has to do with me being a vegetarian for 28 years. It's hard to be veggie keto when every model of the program is telling you to eat bacon, and pork rinds for treats. I still can't help but be worried. I am going to call tomorrow and see if there is any news or the like regarding my case. I honestly thought six months would drag by slowly, but It's almost February already - March will be here soon! Fingers crossed for the approval news!

I think negativity about high protein intake is related to the negativity about the keto diet. I was told to aim for 60 grams during my weight loss. When I reached maintenance I adjusted to the 0.8 per kg of my weight. But my dietician said it should be 1g per kg but because I was a woman in her mid 50s I should be getting 1.2g but that seems too much. I aim for 50g a day but I don’t beat myself up if I only get in 40g on the odd day. It’s a bonus day when I get in 60g. I think you should just follow your plan & the recommendations from your dietician & surgeon.

There are some pretty awesome keto/low carb bloggers out there with sugar free sweets that rival the real thing. While you still have the metabolic advantage going of your honeymoon period, I'd sure check them out though, and see if you can find "healthy-er-ish" alternatives. Cuz God, that would be terrifying to gain all your weight back, just because you can't not eat sweets after dinner! I keep reading at some point, our appetite does come back, and that our ability to eat more increases with time too...I'm pretty terrified I will change my anatomy, be able to lose it all, then because I won't stay diligent enough, will gain some or all of it back! So I'm working like a one-armed-paperhanger to try to build new, healthy habits. Two of those things involve breaking up permanently with sugar and also breaking up with crunchy, carby, salty snacks. ((hugs)) And glad it's working for you right now!!

Greetings! This is probably a very silly question, but would it be appropriate to practice a Keto diet once past the 2 or 3 month post surgery? My nut and advice from the surgery center recommend limiting carbs, and of course, getting at least 60 grams of protein each day. If that is the case, wouldn’t the Keto diet be the natural path forward? Any thoughts, opinions, research, etc. are appreciated!

I won't have surgery until July 2nd, but this is my plan after I'm healed. I followed a lot of people who have had weight loss surgery and they follow keto. It seems to help. Just maybe don't go crazy on the high fats it could make you sick.

They one thing I have loved for protien is cottage cheese and dont forget a glass of milk. I have found a really great protien powder that I love that is called keto protien, it tastes really good and has no sugar in it. I think it is like 25 grams per scoop.

Yes, indeed surgery is the key factor. One of the things that I have recognized over the years of being in this game is how little dietary style influences ones weight loss after surgery. Back in the good ol' days 20-30 years ago WLS patients were often advised to just "eat like you always have, just less...." and that generally worked quite well - for the year or so, give or take, that they were losing. Maintaining that loss was not so successful with that approach, obviously, as they never changed what got them into trouble in the first place, and they often regained just as they did when doing diets in the past, though usually somewhat more slowly owing to the restriction that they had. Back when low fat diets were "in", people did just as well with their WLS as they do today with low carb and keto diets being the big thing. The important thing is developing good long term eating habits that one can maintain forever, and none of the popular fad diets do that for most people, and they tend to regain when they get tired of the diet.

Well I finally got the psychology approval which took the longest to come back for some reason and found out everything was submitted to insurance on 02/20/19.. omg I can’t believe how much I’ve been stressing over this.. It seems like thoughts of this take over most of my day.. I’m trying my best to be positive and I am so looking forward to this new journey in life. I’ve even eaten all my fairwell foods cause I know after this I’m done! I’m working on a mental change now as I know this is a must in order to be successful. I can even tell the difference going from Keto to crap. I’m excited to get back on track! I wonder how long this approval will take. I’ve seen so many different ranges. I’m sure hoping it’s quick and even more hopeful for a yes! I’ll take a slow yes over a quick no! I know most of everyone has been through this before and I appreciate all the feedback I’ve received from you guys! I can’t wait to join the cool kids club lol! Many blessings & continued success to all! And If your like me waiting I guess we just gotta keep hanging till we get to the other side!

@Joann454 I started researching this today after your post and I found this article with links to other literature http://www.ketotic.org/2014/12/the-effect-of-ketogenic-diets-on.html?m=1 It may be that lower T3 while on. Keto diet is a good thing. I am still researching, but I wanted to share this with you.

I eat high Protein (80 to 100) and low carb. I'm banded and find high high fat goes right through. I suggest you gradually increase your fat as you transition to full keto. Sent from my SM-G900V using the BariatricPal App

I don't think keto is any more a fad diet than is the diet recommended to post surgical bariatric patients. They both have specific purposes and are (or were) very effective for their original purposes. The keto diet was originally developed a long time ago as a specific treatment for severe epilepsy. At the time, before antiepileptic drugs, it worked very well in controlling symptoms. The problem is that it became popular for weight loss and it's probably not the healthiest way to eat long term. That said, I think the same thing is true for the post-surgical bariatric diet. It's a diet developed for a specific purpose and it works well for that, but it's not really a healthy way to eat for the general population. The reason we eat a protein forward diet is for a few reasons: Protein helps preserve as much muscle as possible while eating a low calorie or very low calorie diet. This helps keep your metabolism as high as possible so you burn more calories at rest. A carb forward diet (or even a more balanced diet), would cause your body to burn less fat at any given time because carbs are easily burned for energy, whereas protein is not. Protein (actually the amino acids in protein), are essential to your bodies proper functioning, whereas consumption of fat or carbs is not nearly as important. Protein is even more important when healing, thus it's critical post-surgery. The reason the medical community focuses on protein for bariatric surgery patients is due to the above. It's not because protein is actually "healthier". It's just because we are so restricted in what we can eat, thus tradeoffs must be made. I think most doctors would agree that once a bariatric surgery patient can eat more, they should not eat more protein, but instead should work to add healthy fats and carbs ASAP in the form of more whole foods. The general consensus in the medical community is that the healthiest diet is one that starts with lots of fruits and vegetables, has very little processed food, and a lot less meat than what most American or Western Europeans eat.

Have a look at Dr Matthew Weiner’s Pound of Cure book & his you tube videos. He’s a bariatric surgeon who supports a low animal protein diet. It may not be anything all that new but may make you more comfortable about how to manage your weight loss post surgery. A good dietician should help you devise a way of eating that is best for you, your health requirements & your eating preferences. The biggest ficus post surgery is your prirein intake (& fluids) but I’ve never heard anyone say they were restricted to getting their protein only from animal sources. Plenty of plant based protein shakes & powders, yoghurts, milk, etc. as you know you can eat to meet the goals you’ll be given. Initially after the surgery you will be on a staged return to eating diet. This is support your healing tummy & not put undue stress on your digestive system. There are some foods we’re not advised to eat during this period. But again a good dietician should be able to advise you of alternatives. Mind you many have refried beans on their list of recommended foods during the staged return to eating stages. While I was on keto for my pre surgery diet, I was not encouraged to follow it long term by my dietician: good for kickstarting a diet but not long term she advised. I had my own doubts about it so I was glad. Many of us use the weight loss stage to devise a way of eating that best suits our needs & preferences & don’t follow any specific ‘diet’. I mean if there was a diet that worked for everyone none of us would have been obese & needed surgery. Personally I’m a low fat, low carb (2 serves of whole/multigrain carbs a day), low sugar & high protein (absorption issue). Many vegetarians successfully have surgery so your eating preferences should not be a deterrent to you either once you find a supportive surgeon & dietician.

Even if you were gaining muscle weight, you would notice a change in the way your clothes fit. When my nutritionist told me to eat carbs pre-op, my Keto mind screamed no. I did it though and lost weight. But I highly limited them. If you are not tracking on an app like Bariastic. you can easily consume way more carbs or calories than what you need. Some people can drink their calories for the day before ever eating any food. I would limit those carbs and be mindful of how much you are eating in a day. I know before surgery, I told everyone I didn't eat that much till I started tracking my food intake and was shocked to find out I was overeating. Also..not sure what surgery you had but my doc told me of a sleeve patient/friend of hers that did everything right and lost only 30 pounds within the first year. She ended up putting her on Ozempic to help. So there are some people who simply don't respond as well to the surgery based on age, meds etc. But before going that route, I would examine the food intake amounts first. Good luck!!!

I am also a 2014 vet. I too had some regain. Here's the story for me...about 18 months after my op I left a long term career position, took a night, started grad school, switched to a leadership job, lost a parent unexpectedly, graduated grad school, went back for PhD, and more. When I had surgery, one of the main issues was a health problem that was considered reversible. In 2017 after some regain, my GI doc gave me some sobering news that it was returning. I had a serious 'come to Jesus' talk with myself. I went online looking for solutions. I sought my team. I went to some support group meetings (even online). I met with my nut. I met with a surgeon. After being given the option of a RNY revision, I realized that I KNEW WHAT TO DO, AND I HAD THE TOOL...I went full on Keto and never looked back. I am now at my lowest ever. I lost all the regain and then some. I realized through the process that FOR ME, I must always identify as a bariatric patient. I will NEVER be able to eat 'everything in small amounts'. I will always struggle. Surgery saved my life, yes, but it didn't fix my weight permanently- it did part of it but the major work was up to me. I would suggest seeking out support from your surgical team, support group, nut, psych, etc. ANYONE who is part of a bariatric practice. And start from scratch. Dense protein. Water. Shakes if necessary. Skip the 'reset' and all those things. Obviously regain comes from EATING so you have to relearn how to eat as a bariatric patient. It is absolutely possible but there are many of us here on the same timeline as you who have already been through this and are willing to help!

Seems to be lots of variations of pre surgery diets. I was on a keto diet for 2.5weeks before with no minimum weight loss required. One friend was on 2 weeks all shakes no specified weight loss required Another was on 2 meals shakes & one meal high protein, no carbs over 4weeks with a minimum weight loss requirement. I found the diet helped get you in the new mindset in regard to eating. Good luck with your surgery.

I gained 20 lbs after hitting my lowest point (138). I really needed to gain the first 10 lbs of it - I'd gotten too thin. But I've been struggling to lose the last 10 because I DIDN'T need or want that part of it (have managed to lose like 3 of it -- since March! It's tough...) anyway, I still track my food intake, but I've been doing that since my surgery in 2015 (actually, even BEFORE surgery). I've made a serious effort to stay within my maintenance calorie range, which for me is 1500-1700 per day - and I'm trying to stay at the low end of that (1500). I also really increased my exercise. My primary exercise these days is biking, which I usually do for 60-90 minutes a day, five or six days a week. It's working, but it's S-L-O-W. I know if I lowered my calories even more, to like 1200, the weight would come off faster - but I'm evidently not ready or willing to do that yet or I'd already be doing it. BUT....I'm sure it would work. at this point I just count calories - and I've been doing that since I was about a year out from surgery. I can eat anything as long as it fits into my daily calorie limit. I know that doesn't work for everyone, though. I know several people who are trying to lose regain doing Keto, or Weight Watchers, or Intermittent Fasting. And many just go back to what they were doing the first year post-surgery (not all the way back to protein shakes and purees, but back to protein first, then non-starchy vegetables - and then maybe an occasional serving of fruit or whole-grain carb) it basically comes down to what works for you and what you think you'll be able to sustain long term. Losing regain is hard and it's slow, but it's do-able

After reading a thread in another forum here, I thought I'd check in and see HOW everyone eats 2+ years post op!! I am 4.5 years post op and currently doing nutritional ketosis but seriously thinking about switching to a more 'bariatric' style eating with higher protein, lower fat and a few more starchy things (like some beans or a bit of squash) every now and again... I have also FINALLY embraced the need to move and get active so have started doing some muscle building. But, in the meantime i'm curious- how are YOU eating these days? Regular diet? Keto? Paleo? Bariatric/low carb? Diabetic diet? Cal controlled? Give your 2 cents!!

I've been a vegetarian for 18 years and a part-time vegan for about 2 years. I highly recommend Dr Garth Davis' new book called Protein-aholic. He's also on FB and actually responded to a question I asked. He's a bariatric surgeon who recommends vegan. I will still do dairy for a while, but once I can eat real food I will phase it out slowly. I've noticed a lot of people on here are keto, basically Atkins. It's expensive, and not easy to maintain long term. I've read numerous peer-reviewed studies and meta-studies that say we're eating way too much protein. I'm nowhere near any kind of expertise on diet and nutrition, but I know how I feel when I eat mostly plant-based vs. a heavy animal protein diet. And I flat out refuse to believe that fruits are bad for us. Juice is debatable. But I will never cut out whole fruit and starchy veggies like potatoes. Just my 2 cents.

I only told two people (in case of emergency) Everyone else appeared too judgemental to me so I decided not telling them was best Other than that when people ask I tell them I eat a lot less and low carb/keto

alright so i did what alot of the other people in this thread did. i saw Dr weiner videos as well and am still researching because I can still go bypass if I change my mind from sleeve. i also took the nutrition packet and began logging my food and have begun interacting with the dietician following her instructions showing food log. we go over that in telehealth apmt. I cut out the foods already that the surgeon said to (carbonated beverages lol). i also had an apmt with nurse pract from the program and for weight they can pull it from your health records from your gp. though for my second apmt I just weighed and I am down 12lbs from the diet. i was told it usually takes 3-4 months to get into the surgery room. i was told I would be required to attend support group at least once so I went to that already, and I plan to go to the next one too as they have little food topics. I am already on their end game diet through the dietician, but I am not in hardcore mode. right now I do not have to count carbs in most veg, and I have been subbing with some keto premade snacks. It's a good time to start the diet if you haven't so you know what you r getting yourself into but also a good time to experiment with foods because no pouch size yet. its kinda like easing into diet slowly. also make sure to look at check list and complete those. mine had things like support group at least once, sleep study etc and I completed what I could and scheduled with gp already to get the others. (Im waiting on gp apmt for egd but also waiting for behavioral health referral to call me with apmt as I was approved to see them for assessment)

No , they never gave a number. Rny: low fat and very little carb. Just a lot people on maintenance found doing keto/ Paleo helpful in maintenance. Some wish they would of done this earlier. Sent from my Nexus 5 using BariatricPal mobile app

You do know this is exactly the Keto eating plan. High fat, moderate protein, low carb. The REAL fats help curb hunger and your body has found the right formula if those for you!

Oh man! I am sooo sorry. I was lucky and didn't get any during my low carb/keto run but I feel we never truly know what will set one off. My very first flare to a diagnosis was with my legs going numb and they have never fully recovered so I get that completely. I just keep thinking about when I had my son and the hormone shock afterwards put me through hell with my attacks. Hopefully with our surgeries being so close we can check in with one another. #Igotyourback Sent from my SM-N960U using BariatricPal mobile app

I used to be a low carb keto blogger (fluffychixcook.com) and so I was aware of all the new products on the market both for low carb keto and sugar free/grain free ingredients and food products. These came on the market a few years back and I liked that they used erythritol as a sweetener and were dark chocolate for extra polyphenol action and also had inulin in them as fiber for more pre-biotic support of your gut. I liked their taste as well, and if you do "net carbs", then one serving is only 2g of net carbs because you can subtract fiber and erythritol (sugar alcohol) carbs. Oh, and you can now buy them in many grocery stores with the other chocolate chips.

Hey all - So like many of you, I am still trying to figure out what normal means, six months post surgery. First off, I am so happy I did the VSG - no complaints, I feel great, surgeon was fantastic, their office is responsive and follows up and I am down from an all-time high of 305, 261 on Surgery Day, and 195 Today. Hoping to get to 185. That's where my difficulty is: In the past 10 weeks, I have lost maybe 5 pounds. I find my weight fluctuates daily +/- 5 pounds, so I only track the lows as benchmarks. (IDK: water retention, lack of BM, salt...). My low was 194, today 196, the other day 200 (which is a number I hate!). I think I am spoiled by the rapidity of weight loss early on and feeling a little discouraged now that things are slower. More than that though, my fear is that my portion size is starting to feel almost normal person normal... not my pre VSG by any stretch, but not terribly restricted. I also am getting hungry again... and craving things like sweets again. After a filling dinner at 6, by 9 I think about dessert - and sometimes succumb. Thus far, I havent done anything too terrible, but the idea of making a batch of chocolate chip cookies has been on my mind for weeks. I feel like I could fall off the wagon at any time. And now that I can eat almost normal amounts again, its not like the little cheats along the way that didnt matter due to space restrictions - I COULD DO DAMAGE! (BTW- still dont understand the "2nd stomach" when it comes to dessert. If I think about having another piece of grilled chicken, I know I am full, but a bowl of iced cream, suddenly I am starving!) With slow weight loss, which I understand is normal as I am getting close to goal weight, and growing portions (8-10 oz at a time), cravings for sweets, and inter-meal hunger, I am terrified that I am a few months from seeing an uptick on the scale. Ten pounds from the finish line - which I might hit, but for how long? So, for my version of the "is this normal" questions: 1. 5 lbs in 10 weeks? 2. 8-10 oz portions 6 months out? 3. How long till 8-10oz becomes, 12, 14... 4. Is this in my control (am I stretching), or is this healing and normal? 5. Why am I hungry - is it psychological bad habits or physical healing and ok? 6. I have no problem getting enough protein, but are carbs still the enemy, or calories, or fat? 7. Macros, Keto, Calorie counting - academically I understand them all. I cant reconcile the conflicting info. Even my Doc and my nutritionist seems to differ (though they obfuscate to be respectful of one another). Anyone in a similar phase of this process with insight on this part? And tips: 1. Least harmful desserts that have worked for you? Mathing things our has been getting me a little crazy. I have gotten back to espresso/lattes lately, which I find to be a filling snack, but even with skim milk: 100 calories x 2/day x 7 days per week = 1400 calories = almost half a pound a week. Same with the 100 calorie dessert. Thus, if the I'm doing the math right: I am basically eating a neutral calorie amount at this point - evidenced by lack of meaningful weight loss. Avg 1/2 a pound a week for the past 10 = 1750 calorie deficit per week = 250 calorie deficit per day. Does that mean I am a skim milk latte and an apple a way from not losing weight. Then any excess is gain!?!? I think all I have left in my arsenal is more exercise, which frankly, doesnt seem that probable. If I liked the treadmill, I would be on this forum now would I? Welcome thoughts & feedback! Thanks all!