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This book is a good place to start so you can understand the science. The Art and Science of Low Carbohydrate Living: An Expert Guide to Making the Life-Saving Benefits of Carbohydrate Restriction Sustainable and Enjoyable https://www.amazon.com/dp/B005CVV2AE/ref=cm_sw_r_cp_apa_Bus7ybP5P45SW Just like WLS understanding the science behind it makes it easier to understand, follow and make the right choices. /r/keto on reddit is a great place to start. I am just going to warn you. Keto is a commitment just like WLS. It isn't a diet it is a lifestyle and a way of eating. If you stop eating keto and go back to carbs the weight will pile on. Keto is not some fad diet you can follow for a little while drop weight and go back to eating trash. If you can't commit to it for life, there is no reason to even start. Keto replaces carbs with fat to keep you satisfied and once you are keto adapted your body runs on fat.

@tiffany44641 I have been a low carber, keto person off and on for about 16 years. I would lose weight but plateau and I didn't understand stalls so I would quit. I also had a portion control issue. People in the keto community feel like you can eat without portion control as long as it is high fat. Being sleeved helped me control my portions. In the beginning when I was healing I just followed a normal low carb diet. Around 6 months when I was healed, I switched to keto. Personally I feel like if I didn't switch to Keto I would not have lost this much weight. I would have topped out at about 100 pounds lost and bounced around like most WLS people. Just as importantly eating keto has allowed me to maintain my looks. I have lost 182 pounds and I look very young and healthy. I do not look sickly. My face looks amazing. Keto is great for women because the fat is great for your skin. If you look in keto groups the women that keto almost glow. I am a strong advocate for Keto. If you can portion control you can lose a lot of weight on keto. If you can't portion control wls is a great option to help you with that. The sleeve has helped me with portion control and made making the right food choices easy.

That user has leveraged Keto to lose a bunch of weight. Though I believe they were sleeved first. Nonetheless, a great person to reference for Keto success.

Most of my pre-op diet has been a modified keto diet. Difference is, not nearly as much fat.

Just curious has anyone in here tried to lose the weight on the keto diet first? And lost a lot and didn't have the surgery ?

You can make your own pizza crust out of so many things these days that are low carb, like cauliflower/broccoli, almond meal, canned chicken (I found this one super interesting!) Look for Keto recipes on Pinterest. You'll be amazed by the things people come up with to replace those "bad" carbs.

I used to make lists for my nutritionist and email them before our meetings so I didn't forget anything. That helped me to get the most out of my visits. Your nut can be a great source of information. I went every month or two for the first year. Protein is very important of course and definitely learn and stick to the rules they give you. Start reading labels and reading nutrition information from reputable websites. There is a lot to learn and fine tuning your diet is going to take some time. Low carb high protein is just one step in the right direction. In the beginning weight loss is much easier. Once you can eat more the weight loss slows, you have to look at your diet in more detail. You are eventually going to want foods you ate before. Know that there are many low carb alternatives out there. I made low carb bagels this morning that weren't half bad. I am now transitioning to a Keto diet which is high in fat, moderate in protein and low carb. I don't suggest this for a while. But at one year out, I find the higher fat (healthy fats) help me with the cravings while still facilitating weigh loss. I agree with the previous posts, and would strongly recommend you stop sugar and processed carbohydrates. I have found so many improvements since removing them from my diet in addition to weight loss. I have found that most people on this site understand the struggle, are very helpful and full of great information. Wishing you the best and looking forward to your 1 year post op post sharing your success :-)

Intuitive eating for food addicts is like saying heroin in moderation. In my keto groups people say eat until you are satisfied, and I have to speak up and remind people that some people are never satisfied because they are food addicts and they just need to portion control. If WLS could be successful at eating intuitive, they would not be WLS patients in the first place. Everyone isn't a food addict, I don't really think I was, I am just very carb sensitive and a glutton. I like to indulge and pamper myself. Post-op I switch how I do that pampering and treating myself.

I ate a couple slices after 6 or 8 weeks, didn't like how I felt physically or mentally. I no longer crave it sense doing keto for a month, but my family had it thall s past week and I had a small thin crust piece. Wasn't a big deal either way. If you have strong cravings for foods, your body is likely going through withdrawals for carbs and salt. Keto saved me from those and made following the plan easy, as I don't have the mental battles that I did during pre and post opp

Just started Keto 2 weeks ago and I really like it so far. I am still learning. It has helped me with hunger for sure. Although years of the "low fat" mentality make me feel like eating so much fat is not good health wise, so I am working on getting past that inaccuracy. I am a little surprised that I haven't gained and went down two pounds the first week after stalling for a few weeks. Doing smoothies, chicken and veggies soup, veggies and grass fed beef or chicken. Also doing almond crust Pizza. I am going to make a keto casserole this weekend. Sent from my SM-N920V using BariatricPal mobile app

I eat Keto so I might fat fast for a 1-3 days but mainly, if you keep doing the same thing, you will lose eventually. Your body has to take breaks, you can't really make it lose if it doesn't want to unless you have been eating off plan.

@Delta_35 I keep telling myself I am going to stop posting here because for me the site is basically useless. I want to stay involved in WLS community I think remembering where you came from and helping others is a good support method to stay on track. Yet, I'm not even 2 years out, I don't really consider myself a Vet. I have questions and issues I could use help with but there are virtually no successful Vets to ask. Even fewer that started with a BMI as high as mine (61). My issues and the problems I have are unique to being that large and losing so much. I have no community here I can talk to. It is basically just like being in the real world, alone with a unique experience. I like answering questions because most responses are from people less than 6 months out that have a really skewed view what post-op life is like so it is the blind leading the blind. Still with no real active community for WLS Vets, might as well just chill with my Keto friends. This isn't just a reflection of this board, this is a major long term issue with WLS patients in general, long term, they just aren't active in the WLS community. Everything is just for newbs and I also think this is why so many people fail long term, there is no long term support, just immediate post-op and that is what all information is geared for. Also, Bella is always trying to take someone to task for what they say but as soon as someone gets on her case, she wants to play victim. She is one of the most passive aggressive internet characters I have encountered in a long time.

Thanks guys! I'll look into this Keto diet and, although I recognise it's a poor habit, I think I'll use them as a crutch in the first week of the 2 week protein shake pre-op diet. Will have to ensure I drink a lot of water!

Neither dieting nor surgery works well if you are doing it because someone else is pushing you into it - it takes a personal commitment that this is what you need to succeed in life. Overall, for those of us heavy enough to be considering WLS, dieting has about a 5% success rate long term, and it doesn't matter what style of dieting is done. Low carb is the popular diet these days but is no better than the low fat diets it supplanted. After all, doing what's popular is what got most of us fat in the first place. This is a good video that presents some of the factors that can push a decision towards WLS or trying dieting again. He also has some other presentations on how the WLS works metabolically that makes it more successful than just simple dieting (something you may want to share with your parents to help them understand and gain their support), and some on things to expect from WLS and how to use it to best advantage. I don't agree with everything this doc presents, but over the years of working at this, I am closer to his perspective than the average or common WLS process. We often see people coming into these forums after giving dieting "one last try", and we often have to do some kind of diet/exercise program for insurance approval; which often does work to the degree that surgery comes along before any regain can occur. The way I approached it when my wife and I started getting serious about WLS some fourteen years ago was to look long term and work to adjust my living patterns toward what was needed for long term healthy living rather than jsut simple weight loss - I would take whatever loss that I could accomplish, and if I could be one of those lucky 5%, so much the better, but I was more focused on the lifestyle changes. I went with a very strict "no fad diet" regimen - no low carb, low fat, keto, Atkins, South Beach, Pritikin or any other "book" diet. Rather I minimized the junk foods and processed/packaged foods while moving towards more fruits and veg, whole grains in place of the refined and processed white grains, all to the extent that I could do sustainably. It wasn't perfect by anybody's book (and still isn't), but it was what I could do long term. It was a somewhat evolutionary process as I sneaked more veg into things that I ate I lost about 50lb over six months or so, which was about 1/3 of what I needed to do, At the time, we were still working to get my wife on the table through serial insurance denials, so I just went into a sustaining mode - working to lose more if I could and continuing to push the diet in the right direction. I never really lost more but I did maintain that loss for several years until insurance started covering the sleeve which seemed a better fit for my needs. The discipline that I established early certainly helped going through the surgery and weight loss process, and most particularly into the maintenance world - many who adopt some of the more extreme or radical diets in conjunction with their WLS struggle with regain or yoyo dieting later on in maintenance as they never established the dietary habits needed to sustain their loss in the long term.

Keto diet - removed all my food cravings. Mostly carb driven for me

Hi everyone! I had sleeve surgery in May 2013. Initially I lost about 140lbs, but then about a year and half post op I got pregnant. I gained some weight during and after pregnancy, and then lost some weight as well, and now I'm having a complication of some esophageal issues where I'm not able to swallow correctly. I have an appointment with a really great surgeon at an exceptional hospital in the Chicago area. I will have my first visit with them in April. I was hospitalized in January for Fluid build up and severe infection of my right lung. This was caused by aspirating food and fluid due to my esophageal problem. They did an esophogram and upper GI while I was in the hospital, and the gastroenterologist who was treating me in the hospital informed me that my sleeve had stretched, my stomach was nearly the size of a normal stomach. Additionally, the lower part of my esophagus where it connects to the stomach is dilated, as if my lower esophagus has been acting as a food pouch for quite some time. I was really shocked by this, as I had no issues post op from my sleeve and only stopped losing weight when I became pregnant, which I figured was to be expected. But since I had my baby in May 2015, I have struggled to lose anything. I was doing a keto diet at the end of last year and that was working, until I got sick in January. Now that my esophageal issues have been diagnosed, I have trouble eating anything solid. My weight has maintained since I was admitted in January but I haven't had any significant loss since then. Long story short, my primary focus is to get my esophagus issues figured out and fixed, but they referred me to two different docs - one that specializes in swallowing disorders, and the other is a GI/bariatric surgeon to address my stretched pouch. Since I'll likely need surgery to fix my esophagus, it would make sense to do any revision to my sleeve at the same time. I feel like I have 2 options (maybe 3) to discuss with regard to fixing the sleeve. Either re-sleeve, DS, or revise to gastric bypass. I should note that my highest weight was around 460, so even when I was at my lowest weight before getting pregnant, I was still at 306ish. I'm currently around 340-345 putting my BMI around 48. When I first started thinking of going the surgical route for WLS, something about the gastric bypass didn't appeal to me. So now I am struggling with if I should re-sleeve or go for the DS. I'm thinking since I still have so much to lose, the DS might be a better choice, but I honestly don't know enough about it to make a decision. I've read the limited info I could find about DS, I realize it's not a particularly popular surgical choice, but I want to hear from people who've had it, possibly people who had it after having a sleeve. I'd love to hear your stories and thoughts on the DS!

I was the doing keto before surgery. I'm now on liquid diet and obviously can't eat food but I did like the Keto diet before and would like to continue doing once I'm in regular food. Good luck to you all. No matter what, remember that making the decision of having surgery was the best decision ever!

Exercise is just walking. I do weights and yoga every now and then I eat keto. More fat than protein, very few carbs. Usually I just have steak or a pork chop. And I have a big salad in thevery afternoon. I keep it very simple and very clean. I also drink coffee with heavy cream or half and half most of the day.

I have lost 180 pounds. No one asks if I had surgery. Last summer I was walking 5 to 10 miles a day my friends are on fitbit with me, they saw that. I eat literally all day. I eat every 2 hours but I don't eat carbs. People see that too. Steaks, pork chops and other proteins. I will sit and pick all the croutons out a salad, people see that. If you actually living an active lifestyle and eating healthy no one questions what you are doing. In spite of what people think, the weight doesn't just drop off in a month. I lost 10 to 12 pounds most months, a steady decline but nothing insane. Most women lose at that pace after WLS. 98% of the population thinks diet, exercise and will power is enough to lose weight, if they see you actually practicing these they don't even consider surgery. WLS is still a pretty rare thing and an outside idea to most people. 90% of the people saying tell, are always men. Spend one week as a woman dealing with other women and get back to me on people being supportive. Also I don't know why new people think we don't eat a lot of food. Most WLS patients that are successful eat often. People are not seeing that you are eating 4 ounces at a time. They are seeing that you eat every 2 to 3 hours which is insane to most people. Also the amount of time you only eat very little is like 3 months max. Get real. Besides forums, IRL, I avoid giving people any weight loss or fitness advice. This isn't my life. I don't want to be the weight loss go to person. First of all most people aren't serious and it is a waste of time. All you have to do is say I eat Keto or I don't eat carbs and they lose interest. I have lost weight before low carbing and so have other people. Most people don't want to give up carbs to lose weight. They just want to eat whatever in moderation. I give back to the universe by posting on forums. Although honestly it is pretty pointless because the pre-ops and people less than 6 months from surgery think they know everything.

A lot of people lose and look younger. I'm not 45 plus, I am 40 ish and look 28. I regularly am approached by men age 26 or 28 who assume I'm their age. If you don't want to look old, don't go the bare minimum on protein of 60, shoot for 100 plus. Get you calories up ASAP. Take your vitamins and drink lots of fluids (I run off coffee, not water). Also I notice the ladies that Keto like me, eating high fat low carb seem to age a lot better.

Cooking is the biggest challenge for me. I'm a single mom with 2 middle schoolers, so not being able to just use a pizza crust from the store is a pain sometimes. Making dough (almond flour) is messier and takes longer- but it does taste better, so there's that. I'm moving away from substituting carb - heavy items with carb - free items and trying to just plan meals that don't center around carbs at all. The restrictions of the diet itself are fine for me. After a few days, I didn't crave sugars or breads. The fact that keto focuses so much on fats is great, because that rich mouthfeel replaces the sweets and carbs.

I lost 30 lbs on keto in 2 months. I am still pre-surgery, I definitely plan to stay keto after I get my sleeve done on the 19th.

I'm two years out today. I've stalled out for the last year with 30 pounds to go. I've been playing around with Paleo for awhile but decided to go keto a week ago. Too soon to tell if it will kick start my weight loss again but I do notice that I do not eat as much. I was in a bad habit of eating slider foods. I didn't really gain because I work out all the time but I wasn't losing either.

My sister has been on a keto diet for about a month and has broken out into a pretty bad rash. (No WL surgery). Anyone ever dealt with this? Any tips on losing the rash but sticking with the diet?

I'm not really sure that is a pretty unique situation and honestly most people here don't strive to maintain ketosis or even know what it means. You could ask some of the keto groups on Facebook or try /r/keto on reddit. Also I would try a 3 day fat fast, Google it. Or an egg fast and see if that jump starts things.