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"Animal studies have convincingly proven that artificial sweeteners cause body weight gain. A sweet taste induces an insulin response, which causes blood sugar to be stored in tissues, but because blood sugar does not increase with artificial sweeteners, there is hypoglycemia and increased food intake." "One reference showed, in patients with Type II diabetes, that the reduction of plasma glucose and insulin levels during exercise was similar after a sucrose meal compared to an aspartame-sweetened meal.[49] These results were obtained even though the aspartame meal contained 22% less calories and 10% less carbohydrates." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198517/ "Taste and reward signaling in the brain is immensely complex. Research is only beginning to understand how altered brain activity with prolonged use of artificial sweeteners may impact our health long-term." https://blogs.scientificamerican.com/mind-guest-blog/tricking-taste-buds-but-not-the-brain-artificial-sweeteners-change-braine28099s-pleasure-response-to-sweet/ There is a ton of research on sweeteners, brain chemistry and satiety. The point is foods should be as natural as possible and sugar isn't a devil. Years of yo-yo dieting is the real problem and crap genetics.

Good afternoon love! Just wanted to reply to your comment and share a bit of my journey with u. I had a revision in December from a VBG(first weight loss surgery approved) in 2004 to a gastric bypass do to esophogus issues, heartburn and major weight gain. I lost 46lbs after revision. The vitamins I see you posted are great but expensive. I have blood check up every 3 months have been amazing and i take a Bariatric vitamin from amazon. 16.77 month. My health is fabulous. Look into amzon for vitamins love. It will really save you money and they work just as well. Please take your daily calcuim after revision and you will be just fine. Good luck and God Bless you

Hey Sara - my insurance covers this but I feel your pain with the infertility. I am still paying off my IVF. My husband and I struggled for a long time but we were blessed with children so keep working on it. I now have four crazy kids and a heap of credit card bills but I wouldn't change it for the world. As for the friend thing - I couldn't speak to my best friend for two weeks after she announced she was pregnant. I wanted so much to be happy for her but she told me on a day that I found out I wasn't. anyway, enough about me. keep you chin up and look into what Mrs Fuller said. Stress is a big factor in weight gain AND infertility so try and reduce yours. Best of luck to you. I'll keep you in my prayers

Hi! I am 3 years out from my lap-band surgery. About 7 months ago, I started having a bit of discomfort under my left breast when I would bend over to pick something up. When I would be sitting down, I would lean back to avoid this feeling. I had my surgery in California, but have subsequently moved to PA and am followed by a surgeon in Pittsburgh. Over the phone twice (it is a 2-hour drive), they told me that it did not sound like anything band-related, perhaps, just some inflammation. It went completely away after a couple of months. Four months ago, I went to the ER with severe abdominal pain. After x-rays and a CT scan with contrast, they diagnosed me with constipation. Okay. I took some meds and did get rid of my constipation (!), BUT since then have had chronic diarrhea (sometimes just water). In the interim, as part of the workup to determine the cause of my diarrhea, weight loss, extreme fatigue, I had a colonoscopy and EGD. Last week, the EGD showed that my band has eroded into my stomach. Now, I obviously have been in contact with my surgeon in the city, and am scheduled for an upper GI series and interview, etc. next week. On the phone, however, they tell me that none of my symptoms have to do with my band. My PCP here says that he doesn't see how it could be anything but my band. I have even found an undissolved pill in my stool. Interestingly, one of the symptoms of erosion is supposed to be weight gain because of loss of restriction, but I have lost 25 pounds in these past few months and have very little appetite and still have lots of restriction. On films, my band is pretty far into my stomach; it is not a minor erosion. I come here wondering if anyone else has experienced these types of symptoms with erosion. Because if this hypermotility is not band-associated, I'm wondering what my next step will be. Oh, in case you're wondering, I have lost 75 pounds. :confused: Thanks, Kelli

I experience similar issues. I will eat a healthy 300-350 cal breakfast about 8:30 and by 11 I feel hungry, by 11:30...very hungry. I was at 5.5 but had to get an unfill b/c my healthy protein (meats) were getting stuck and began eating the slider foods which caused me some weight gain. I am probably going to make an appt to discuss this and see what they say. Really confused. I am thinking maybe I am eating too fast at times, but it is always the chicken and turkey that gets stuck.!@#$%. Anyone else????

Janet... I had a 6 pound weight gain after surgery. Don't fret. It took me almost 6 days to see a drop on the scale at home. If your bowels are not moving, that can have an impact. Also all those fluids in the hospital really did a number on me. As soon as I was able to drink more water and get in some proper nutrition, things really improved. I was 314 day of surgery. Two days post op on hospital scale I was 320!!! Today, I am 307. Take heart, it will get better. I am living proof. I thought what the heck...only I can go for WLS and GAIN weight!!!! Hang in there. You will do fine and sorry about the bruising. I still hurt too and bending over really gives me pain. We are going to make it. I know we will. Cyber hug to you.

Here is an academic overview of the various bariatric procedures with a bit of excess 'science stuff' thrown in. No opinion. No bias. Published 2012 by the UK Royal College of Physicians. If anyone requires further clarification to the sources contained (hopefully its been copied successfully), please see the reference list at the end. This will provide you (licensing permitting) with a link to those original source documents so you can do your own further research/analysis. Any questions or queries, please do not hesitate to ask. Revs x Overview of bariatric surgery for the physician Keng Ngee Hng, Specialty registrar in gastroenterology1⇓ and Yeng S Ang, Consultant gastroenterologist and honorary lecturer2 + Author Affiliations 1Salford Royal NHS Foundation Trust 2Faculty of Medicine, University of Manchester, Oxford Road, Manchester Address for correspondence: Dr KN Hng, 4 Fern Close, Shevington, Wigan WN6 8BL. Email:keng_ngee@hotmail.com Abstract The worldwide pandemic of obesity carries alarming health and socioeconomic implications. Bariatric surgery is currently the only effective treatment for severe obesity. It is safe, with mortality comparable to that of cholecystectomy, and effective in producing substantial and sustainable weight loss, along with high rates of resolution of associated comorbidities, including type 2 diabetes. For this reason, indications for bariatric surgery are being widened. In addition to volume restriction and malabsorption, bariatric surgery brings about neurohormonal changes that affect satiety and glucose homeostasis. Increased understanding of these mechanisms will help realise therapeutic benefits by pharmacological means. Bariatric surgery improves long-term mortality but can cause long-term nutritional deficiencies. The safety of pregnancy after bariatric surgery is still being elucidated. Introduction Obesity is a worldwide pandemic,1–4 with the number of obese children and adolescents increasing alarmingly.5 This has serious health and socioeconomic implications due to the attendant increase in related comorbidities.1,2,4,6 Obesity causes type 2 diabetes, hypertension, dyslipidaemia, cardiovascular disease, obstructive sleep apnoea, obesity hypoventilation syndrome, cancer, steatohepatitis, gastro-oesophageal reflux, gallstones, pseudotumour cerebri, osteoarthritis, infertility and urinary incontinence.1–6 Severe obesity reduces life expectancy by 5–20 years.1 Diet, exercise and drug treatments for severe obesity have been disappointing.1–3,5–12 At the present time, bariatric surgery is the only treatment that reliably produces substantial and sustainable weight loss.1–7,9,13 It is indicated in people with BMI >40 kg/m2 or with BMI >35 kg/m2 in the presence of significant comorbidity.3,5,7,14 Bariatric surgery is cost effective,3,6,15 achieving weight loss, as well as improvement or resolution of associated comorbidities.1,2,5,6,9,15,16 In the past decade, the development of centres of excellence,5,6laparoscopic techniques,2,5,6 improved safety profiles2,6,9 and better documentation of clinical effectiveness2,6,15 have fuelled an increase in the number of procedures performed. Types of surgery Bariatric surgical procedures are traditionally classified as restrictive, malabsorptive or combined according to their mechanism of action. The procedures most commonly performed are laparoscopic adjustable gastric banding and roux-en-y gastric bypass.3,13 Sleeve gastrectomy is increasingly performed.2,6,7 Biliopancreatic diversion and biliopancreatic diversion with duodenal switch are much more complex and performed infrequently.2,5,17,22 Other historical procedures are no longer in common use. In addition to restriction and malabsorption, recent evidence suggests that neurohormonal changes are an important effect of bariatric surgery.2,6,7,17,18 Bariatric surgery is only part of the management of severe obesity. Careful patient selection and preparation are extremely important, as are long-term compliance with diet, nutritional supplementation and follow up.2,5,6,19 Laparoscopic adjustable gastric banding2 A purely restrictive procedure, laparoscopic adjustable gastric banding (LABG) is the least invasive procedure, is completely reversible and has the lowest mortality.19 A silicone inflatable band is placed around the stomach cardia immediately below the gastrooesophageal junction (Fig 1). This is connected to a subcutaneous port that is used for band adjustment.5,6 The band compresses the cardia to generate a sense of satiety and reduced appetite, which is thought to be mediated via vagal afferents.2 Roux-en-Y gastric bypass (RYGB) is a combined procedure that is also performed laparoscopically. A 20–30-ml gastric pouch connected to the jejunum forms the Roux limb (Fig 2). The disconnected duodenal limb is anastomosed 75–150 cm along the Roux limb, forming a Y configuration. The distal stomach, duodenum and part of the proximal jejunum are thus bypassed.5–7,20 Despite the traditional classification of the this procedure, malabsorption is not significant with the standard RYGB surgery.7 In an extended gastric bypass, the Roux limb is lengthened to increase the malabsorptive component.6,20 In sleeve gastrectomy, 60–80% of the stomach is removed along the greater curvature to leave a restricting ‘sleeve’ of stomach along the lesser curve (Fig 3).5,20,21 Originally the first step of the biliopancreatic diversion with duodenal switch (see below), sleeve gastrectomy has evolved into a staging procedure for super obese or high-risk patients.2,5–7,20 It is also increasingly used as a standalone procedure.2,6,7 Biliopancreatic diversion (BPD) and biliopancreatic diversion with duodenal switch (BPD/DS) are malabsorptive operations that result in bypass of most of the small intestine. With BPD/DS, a sleeve gastrectomy is performed, leaving the pylorus intact. The duodenum is then disconnected and the stomach anastomosed to the distal small bowel (the ‘duodenal switch’), creating a short alimentary limb. The long biliopancreatic limb is then anastomosed to the ileum 75–100 cm proximal to the ileocaecal valve, so digestion and absorption occurs only in the short common channel.5,6,20 With BPD, a partial gastrectomy leaves a 400 ml gastric pouch and the common channel is shortened to just 50 cm.5 Safety profile and complications Bariatric surgery is safe.2,5,6,9,22–24 High-volume centres of excellence deliver bariatric surgery with inhospital mortality of 0.14% and 90-day mortality of 0.35%, which is comparable to that for cholecystectomy.6 Acute complications, including haemorrhage, obstruction, anastomotic leak, wound infection, cardiac arrhythmias, pulmonary emboli, respiratory failure and rhabdomyolysis, occur in 5–10% of patients.5,6,9,10,25 Long-term complications include internal hernias, anastomotic stenoses, marginal ulceration, fistulae, diarrhoea, dumping syndrome, gallstones, emotional disorders and nutritional deficiencies.5,6,13,15,20,25–27 Patients with LAGB can experience port problems, stomal obstruction, band slippage/erosion, pouch dilation, gastro-oesophageal reflux and oesophageal dilation.5,13,19,25 Malnutrition is a concern with BPD with or without DS.1,17 Long-term risks for sleeve gastrectomy are unknown.5 The Longitudinal Assessment of Bariatric Surgery22 reported overall 30-day mortality of 0.3% for 4,610 patients having LAGB or RYGB for the first time, with 4.3% of patients having a major adverse outcome within 30 days. This was most frequent among patients having open RYGB (7.8%). A meta-analysis involving 85,048 patients reported a total 30-day mortality of 0.28% and a two-year mortality of a further 0.35%.24 The most complex malabsorptive procedures had the highest perioperative mortality at 1.11%. Mortality for gastric banding is between one in 2,000 and one in 5,700.2 Effects on weight, comorbidities and long-term mortality After RYGB, patients lose 60–70% of their excess weight over two years, and this is largely durable.1,2,6,9,15,16,28 Weight loss is dependent on long-term compliance with dietary recommendations.2,5,6 Sugary, energy-dense foods and drinks can ‘bypass the bypass’. After gastric banding, patients lose about 50% (range 39%–59%) of their excess weight at a slower rate, often continuing into the fifth year.1,2,5,6,9,19 Regular band adjustment is necessary.16 The Swedish Obese Subjects (SOS) study reported a reoperation or conversion rate of 31% for gastric banding and 17% for gastric bypass among patients followed for ≥10 years, excluding operations for postoperative complications.16 However, at the centre in Melbourne, only about 10% of patients after LAGB need some revisional procedure, including band replacement, in the following 10 years.2 Biliopancreatic diversion with or without DS produces excess weight loss of 70.1%9sleeve gastrectomy produces initial excess weight loss of 55%, but this may not be durable.2 Bariatric surgery also produces significant improvement in obesity-related comorbidities, with the most remarkable effect being resolution of type 2 diabetes (T2DM). A meta-analysis encompassing 22,094 patients reported complete remission of T2DM in 76.8% of patients,9 and a registry from the UK with data on 8,710 patients reported resolution of T2DM in 85.5% of patients.29 Major improvement often occurs within days after RYGB, before significant weight loss is achieved.5–7,17,18 After LAGB, improvement in T2DM occurs more slowly as a result of weight loss.2,7,19 Combined or malabsorptive procedures produce greater improvement than purely restrictive procedures.1,2,5,9,18 Diabetes less than three years in duration, no insulin requirement, milder obesity with BMI <40 kg/m2 and weight loss ≥10% predict complete resolution of T2DM.18,19 Bariatric surgery is now advocated by some for the treatment of T2DM in patients with BMI <35 kg/m2.4,7,30,31 Bariatic surgery effectively treats all other associated comorbidities: from steatohepatitis and pseudotumour cerebri to urinary incontinence.1–3,5,6,15 Meta-analysis showed that hyperlipidaemia improved in ≥70% of patients, hypertension resolved in 61.7% (and resolved or improved in 78.5%) and obstructive sleep apnoea resolved in 83.6%.9 At five years, the risk of cardiovascular disease had decreased by 72%.3 The incidence of cancer also reduced markedly,6,15,16 as did the risk of developing new comorbid conditions.15 Long-term efficacy is well documented.5,6,28 At follow up after 10 years, the Swedish Obese Subjects (SOS) study showed a 29% reduction in adjusted all-cause mortality, primarily because of decreases in cancer and myocardial infarction.16A retrospective cohort study of 7,925 patients after RYGB reported a 40% reduction in all-cause mortality during mean follow up of 7.1 years.23 Specific mortality decreased by 56% for coronary artery disease, by 92% for diabetes and by 60% for cancer. A large observational study, in which the vast majority of patients had undergone RYGB, reported an 89% risk reduction in five-year mortality.15 Energy homeostasis and hormonal changes Weight loss after bariatric surgery is not explained by volume restriction and malabsorption alone.17 Indeed malabsorption is estimated to account for only 5% of the weight loss following standard RYGB.17 Bariatric surgery causes significant changes in the neurohormonal profile, which contributes to sustained weight loss through changes in appetite, satiety, food preferences and eating patterns and explains the remarkable effect on T2DM.2,5–7,17,18 The hypothalamus32 Hormonal signals provide information about energy status to the hypothalamus. Adipokines are secreted by adipose tissue and enterokines by the gut. Incretins are enterokines that stimulate release of insulin after food intake.18 Two hypothalamic circuits influence food intake, and both contribute to acquisition and storage of nutrient energy. The homeostatic circuit increases appetite and locomotion in response to energy shortage. The hedonic circuit is engaged at stable weight plateaus in association with increases in body fat. It heightens finickiness to taste of food. Obese animals overeat palatable food but undereat bland foods and lose weight. In our current obesogenic environment, the hedonic circuit facilitates the seeking of energy-dense foods uncoupled from energy status. Enterokines Ghrelin,33 which is mostly synthesised in the stomach, is a potent appetite stimulator involved in hunger and meal initiation. Circulating levels are inversely proportional to BMI and respond to changes in body weight. Ghrelin enhances gut motility and speeds gastric emptying.17 It promotes lipid accumulation and weight gain, favouring glucose utilisation. It also inhibits insulin secretion and impairs glucose tolerance.18 Levels of ghrelin reported after bariatric surgery have been variable, which may be due to differences in surgical techniques and research methods.7,18Overall, the trend is for a decrease in ghrelin levels after RYGB and an increase after gastric banding.7,17 Sleeve gastrectomy, which removes most of the ghrelin-producing stomach, reduces levels of ghrelin. Peptide YY (PYY)34 is secreted postprandially by L cells in the pancreas, small intestine and colon. It suppresses appetite and promotes satiety via signalling actions in the brain. It also delays gastric emptying (the ileal brake) and enhances insulin sensitivity.7 Secretion of PYY generally corresponds to the energy ingested, although it may vary depending on the macronutrient content.17Interestingly, levels also correlate positively with exercise intensity, with resulting decreases in food intake. Glucagon-like peptide 1 (GLP-1) is co-secreted postprandially with PYY in the distal intestine.17 A powerful incretin, GLP-1 potentiates glucose-stimulated insulin secretion, enhances β-cell growth and survival, inhibits glucagon release and enhances all steps of insulin biosynthesis.7,17 It also slows gastric emptying to produce greater gastric distension and helps regulate appetite and body weight.7,17 Obese individuals have lower levels of PYY and GLP-1, and levels are decreased further in patients with diabetes.5,17,18 Two hypotheses exist to explain the hormonal and metabolic effects of the RYGB: the hindgut hypothesis the foregut exclusion theory. The hindgut hypothesis postulates that after RYGB and malabsorptive procedures, rapid nutrient delivery to the distal gut L cells and their increased exposure to incompletely digested nutrients lead to an early and exaggerated PYY and GLP-1 response, contributing to early satiety, reduced meal size and early resolution of T2DM.7,17,18 Ileal transposition studies provide strong evidence for this. Interposition of an ileal segment into the proximal gut in rodents produced exaggerated PYY, GLP-1 and enteroglucagon responses, reduced food intake, weight loss, improved insulin sensitivity and overall improved glucose homeostasis.7 The foregut exclusion theory proposes that exclusion of the duodenum and proximal jejunum after RYGB is the mechanism that mediates the effects of bariatric surgery.7,18 However, duodenal–jejunal bypass experiments in rats supporting this theory are compounded by the accompanying pyloric disruption that results in accelerated gastric emptying and rapid nutrient delivery to the hindgut.7 The endoluminal duodenal–jejunal sleeve also accelerates gastric emptying by abolishing duodenal osmoreceptor control of pyloric contraction.7 This 60 cm-long sleeve prevents nutrient contact with the duodenum and proximal jejunum, while biliary and pancreatic secretions flow outside the sleeve, delaying digestion.35 A possible mediator of the foregut exclusion theory is the gastric inhibitory polypeptide or glucose-dependent insulinotropic polypeptide (GIP), which is secreted by K cells in the duodenum in response to nutrient absorption.18,39,40 In addition to its incretin action, GIP promotes lipogenesis,41 with GIP receptor knockout mice protected against diet-induced obesity and insulin resistance,39 while antagonism of the GIP receptor improves glucose tolerance and insulin sensitivity and partially corrects pancreatic islet hypertrophy and β-cell hyperplasia.40 Levels of GIP are suppressed after malabsorptive procedures.18,41 Adipokines Adiponectin17,36,37 is synthesised primarily in adipose tissue, with levels inversely correlated with BMI. It is an important insulin sensitiser, and hypoadiponectinaemia causes insulin resistance and T2DM. Adiponectin also possesses antiatherogenic, anti-inflammatory and cardioprotective properties and may act centrally to modulate food intake and energy expenditure. Weight loss following bariatic surgery increases levels of adiponectin. Leptin38,32 is secreted by adipose tissue and regulates body weight via its action on the hypothalamus. It increases nocturnally to stimulate lipolysis but also increases postprandially to induce anorexia. In addition, leptin plays an important role in glucose homeostasis. Levels of leptin are proportional to body fat, with starvation or energy shortage activating the homeostatic mechanism in the hypothalamus to restore energy balance. However, leptin resistance develops in obesity. Weight loss from bariatic surgery reduces leptin levels.17 Many other enterokines and adipokines exist, some of which may also play a part in producing and sustaining weight loss or diabetes remission after bariatric surgery.17,18 Understanding the mechanisms of action of bariatric surgery will help realise therapeutic benefits by pharmacological means.6,7,19 Nutritional deficiencies Nutritional deficiency is common after bariatric surgery and the risk increases from LAGB through SG and RYGB to BPD with or without DS.20,26,31 The problem is heightened by the fact that micronutrient deficiencies are already highly prevalent in obese patients before surgery.21 After surgery, patients are at particular risk of deficiencies in Vitamins B1, B12, C, A and D and folic acid, as well as Iron, Calcium and Protein.20,26 Lifelong prophylactic supplementation is often necessary, and regular monitoring is essential.26 Investigation of clinical syndromes resulting from malnutrition can be challenging. Anaemia20,27 After bariatric surgery, patients are prone to iron deficiency because of intestinal bypass, pouch hypoacidity and intolerance of red meat. Obesity creates a state of chronic inflammation that can contribute to anaemia. Anaemia can also be caused by deficiencies in folate, Vitamin B12, vitamin E (haemolytic anaemia), copper (anaemia and neutropenia), Vitamin A and zinc. In refractory anaemia, gastrointestinal blood loss must be considered. Bleeding in the excluded stomach, duodenum or biliopancreatic limb is problematic as the usual endoscopic access route is no longer available. Neurological problems6,20 Neurological symptoms can result from deficiencies in thiamine, vitamin B12, niacin, vitamin E and copper or from hypocalcaemia secondary to Vitamin D deficiency. Clinical syndromes includes Wernicke's encephalopathy, peripheral neuropathy, dry beriberi, neuropsychiatric beriberi, pellagra, ataxia, spasticity, myelopathy, muscle weakness, posterior column signs and ptosis. Oedema6,20 Patients with oedema may have underlying heart failure, which can also be due to wet beriberi (thiamine deficiency) or selenium deficiency. Hypoalbuminaemia may be caused by liver cirrhosis secondary to steatohepatitis; severe protein/calorie malnutrition; kwashiorkor; and diarrhoea secondary to bacterial overgrowth, malabsorption of bile salts and niacin deficiency. Eye, skin and hair problems20 Vitamin A deficiency causes difficulties with nocturnal vision and reduced visual acuity. Vitamin E deficiency can cause retinopathy. Thiamine deficiency can present with blurred or double vision. Dry skin, pruritus and rash can be caused by deficiencies in vitamin A, niacin, riboflavin, zinc and essential fatty acids. Hair changes can be due to zinc deficiency or protein malnutrition. Pregnancy after bariatric surgery About half of patients undergoing bariatric surgery are women of childbearing age,8 which introduces specific concerns. Obesity is strongly associated with infertility8 and increases the risk of obstetric complications.8 Yet the effects of rapid weight loss and potential malnutrition in pregnant patients are of concern. Bariatric surgery improves fertility42,43 and reduces the incidence of obesity-related complications such as gestational hypertension, gestational diabetes, pre-eclampsia and foetal macrosomia when compared with obese controls. The effect on premature delivery, miscarriage, intrauterine growth retardation, low birth weight and neural tube defects and the need for caesarean section are unclear.8,43 Maternal surgical weight loss reduces the prevalence of obesity and cardiometabolic risk factors in offspring until the adolescent years.42 Pregnancy seems to have little effect on the surgically induced weight loss.8 Patients are generally advised to delay pregnancy until after the period of maximal weight loss (12–18 months).8 Extra vigilance in preconception, antenatal and obstetric care is required. Conclusion In summary, bariatric surgery is a safe and effective treatment for severe obesity and its associated comorbidities. It is particularly effective in the treatment of T2DM. Neurohormonal changes that affect appetite, satiety, glucose homeostasis and long-term energy balance contribute to its long-term efficacy. Two hypotheses exist to explain how hormonal changes produce these effects, and both may contribute. Patient adherence to postsurgical aspects of management is very important. Pregnancy after bariatric surgery brings additional considerations. Finally, the indications for bariatric surgery are being widened. Acknowledgements Dr Keng Ngee Hng is a specialty registrar in gastroenterology and has previously submitted part of this work for her Master of Science in gastroenterology (Salford University). Dr Yeng S Ang is the educational supervisor for Dr Hng and has refined the ideas, concepts and layout of the previous work. Recent updates are also included within this paper. © 2012 Royal College of Physicians

I know! I am excited to get this weight off! The start of my weight gain was fertility drugs! 45 pounds, 3 sets of drugs, and a surgery later I got pregnant. Lost weight in beginning of pregnancy and only had 3 positive pound weight gain. Over the years I had surgery for my gallbladder, appendix, stat csection, and 7 laparoscopic procedures for endometriosis. The final surgery my hysterectomy really added the weight! I just gave up! So tired of trying every diet and failing!! I exercise but I have so much belly fat from the hormones being imbalanced and scar tissue! Hoping to get this weight off and start running again! I am ready for my old self to come back!

My husband and I enjoy eating out quite often, hence the weight gain. Now I’ve learned to deconstruct meals to take in protein first, then non starches, starches, then fruit. Wish food establishments wouldn’t charge for a full meal when you’ve taken out a good portion of the no-no foods.

That’s correct, sleeve surgery removes around 75-80% of your tummy but gastric bypass creates a much smaller tummy from your tummy & attaches it to your rerouted intestines. Your remaining tummy is still there after bypass but no food can enter it. Further conversations with your surgeon may be needed to help you understand the differences in the surgeries, how they impact your body & which may be best for your needs. It may help ease some of your nerves too. (Nerves before surgery are very common - fear of the unknown, uncertainty, etc.) With both surgeries your ability to consume large portions is reduced. Initially after either surgery when you start consuming purées you will only be able to eat 1/4 - 1/3 cup of food. This slowly increases. (By 6 months I could eat about a cup of food & now I eat about the recommended serving size or a little less.) And it is possible for you to eventually eat around your smaller tummy which of course results in weight gain & something to be aware of. Changing your eating habits, your relationship with food, understanding the nutritional benefits of food, etc. are vital aspects of losing your weight & maintaining the loss. This is the work you have to do & has nothing to do with the surgery. Many find the temporary changes to our sense taste & sometimes smell after surgery is an opportunity to try different & healthier foods. I have some food sensitivities so I recognise you may as well but are they legitimate food sensitivities or just you don’t like to eat certain foods (taste, texture, etc.)? A dietician can help with this as well. Often working with a therapist is very helpful to work through your relationship ship with find & what is behind your eating habits., as well as your hunger (distinguishing between head hunger & real hunger). Focus on eating your protein first at every meal. Then eat your vegetables. Finally if you are able eat any carbs. This will be the same advice you will be given after surgery & when your able to eat solid foods. There were many meals I only ate my protein & couldn’t or didn’t want to eat anything else. ( I still have days like this almost 4 years out.) Start tracking your food (portion sizes, calories, protein & other macros). There are some great apps you can use. You can be successful with either surgery but after the honeymoon stage when things like your appetite returns, most of your success depends upon you. You have to be ready for the surgery & the changes it brings & the changes you have to make. Surgery was the best thing I ever did. All the best whatever you decide to do.

I just want to thank NGM for starting this thread, being a S-L-O-W loser can be very frustrating. It took me ten days post up just to lose my weight gain from surgery. The irony of going through the surgery and my weight being up was heartbreaking. But now the scale is starting to move and I know I've done the right thing for myself. This a life changing decision and its not so important to get there first but to get there and stay there. God bless you all and it is nice to know that I'm not alone and sharing my struggle with all of you.

Mine fit my thumb now!! I'm going to wait til I get to goal to get them resized. I had to resize them because of my weight gain, so I will probably have to get the stones reset instead!!! KInda cool thought, a new band for a new me!!!! ~cheri

I didn't manage the insomnia very well. I honestly think the insomnia contributed to my continuing weight gain through my 50s and 60s. There's all kinds of research that links insomnia and weight gain. Here's what I'm doing these days that's helping a lot: * Post-WLS I'm drinking less coffee than I did before -- no more than a cup a day. That is helping. * I'm exercising a lot more than I did 100 pounds ago -- and that physically "wears me out" and lets me rest better at night. * About 50% of the nights I take either a Melatonin or half an Ambien. It helps. Sometimes. * Since WLS I go to bed when my husband goes to bed, in other words -- at the same time every night. Following that sleep schedule rule really does help. * I manage my reflux a lot better since WLS -- meaning that I actually take my H2 blocker antacid (Ranitadine) every day and on time. * Since losing 100 pounds, I don't have stress incontinence and don't have to get up during the night to pee anymore. Not a single time. * Finally, I'm just a lot less stressed at 100 pounds less than I used to weigh than I used to be. I fall asleep easier and generally sleep better throughout the night. However, one thing I have NOT conquered that still messes with my sleep is to deal with the damned cat who always wants out when I'm sleeping soundly; I then have trouble getting back to sleep. I think the cat and I are going to have a serious discussion. I think he's going to have to spend the whole night outside from now on. Thanks for making me focus on this a little better. The cat won't appreciate it, but I do.

I'm not sure how to explain this but am going to torture you all by trying to muddle through. I recently heard a speech or whatever you call it on Sexual abuse and harrasement. Now...I have never thought of myself as being a victim of this, but this person obviously has triggered something. I can't stop thinking about what she said and this one moment in my life keeps poppingin my head when I do. When I was 16 my moms boss at the time grabbed at me and tried to kiss me....he said something about if I wasn't careful that I would end up as fat as my mom. His teenage son came in and kinda kept anything from happening. I remember telling my Mom, but she didn't believe me and said something to the effect I must have been mistaken. Now here is the interesting part...or the part that has started making me thinking I'm mental. Looking back through pictures and videos of myself, I wasn't heavy at that time. I won't say I didn't have a weight promblem, because I did...I was dieting almost constantly...and in the typical teenage fashion doing it in not so healthy ways. But sometime around that time is when I slowly started gaining weight. I mean it wasn't sudden, but looking at my pictures you would think thats when my weight promblem started, because thats when my attempts to control seem to have started failing. Now I have lost weight over the years...and to be honest I haven't thought about that incident in my life for years and years. But since hearing the speech its been tumbling around and around. I have a pysch evaul in August, and I really don't want to delay the surgery at this point....but think I might benifit from some type of body image counsiling as I loose the weight. Anyone else want to psycho anaylize me in the mean time . And if I talk about this now with the psych will it jeapordize my approval? I have never before thought that my weight promblem was all that emotional, since my weight gain was slow except for the weight gained and not lost during my pregnancies. Melissa

Hi Christy, I am not familiar with the med you have been taking so long. What exactly is it for? Have youseen a Neurosurgeon about your tumor, and if so, what does he/she say about whether or not surgery would be a definite plan for the future? Have you ever had any surgeries on it yet? Sorry, I don't recall alot of these things from your earlier post. I was starting the process for lap band surgery two years ago and then all came to a screeching halt because I first found out that my insurance has an exclusion through my employer for any kind of weight loss surgery, and second, my second tumor was found. I decided to get that surgery done and already knew that I would also be having the radiation treatment too later on. I am not sure if this surgery will help your weight gain, but for the most part, I believe it will because even though you are on meds that probably caused the weight gain by overeating or not processing fat like it should, the band should keep you in control over that. So, you are having surgery on Monday also? Cool! I will be thinking about you too hun. You take care and don't stress over the other. Concentrate on the surgery and how well it will help you in the long run. Take care, Judy

I take valproic acid ( depakote) for bipolar and they gave it to me in a liquid suspension and it is more stable than the pill was and they had to cut my daily dose on half!! That was a good thing as depakote causes weight gain! So just check with your doctor as there may be a liquid form of the medication you take.

Hello, I am just wondering if anyone who has a pituitary tumor has had the surgery and if so, did it still work? I currently have an adenoma and the hormones are so bad. I think it has been a major cause of my massive weight gain. I'm scheduled for lapband on Monday!!!!!! Thanks!!!

Hey Dimples58, Soooooooo.....drinking after wls is truly different for every person. I was also advised by my medical crew that I would not be able to tolerate much alcohol, BUT this was not true for me. I can drink a sailor under the table. Lol! This is not good though because it's a lot of calories and causes weight gain. My first attempt was a shot of whiskey about 6 months post op and I felt nothing. The only time I feel it quickly is if I don't eat first.

When I was stuck on a plateau, I went back on the liquid diet. The Protein powder that I used has 120 calories in it. I drank 3-4 of those per day and I started losing again. I am still not a fast loser. I have lost 10lbs since August. I see some weight gain coming this week. Thurs. is my birthday. Going out to dinner with friends thurs fri and sat nights. I am sure there will also be some birthday cake involved too. If I gain 5 lbs in one weekend, it will probably take me a month to lose it. :mad: I will do Protein shakes for Breakfast and lunch those days so I can save my calories for dinner and make sure I do a lot of cardio on those days too. I will try to avoid it, but it seems to happen anyway if I go out to eat.

SouthBeach Diet Tips and Guides The SouthBeach Diet is different from the Atkins diet in that it is not a low carbohydrate diet. Regardless of which phase you are currently in, you should follow these recommendations: Drink a minimum of 8 glasses of water, decaffeinated beverages such as club soda, tea, coffee, or decaffeinated sugar-free soda every day Limit your intake of caffeine-containing beverages to 1 cup each day Take one multivitamin and mineral supplement daily Take 500 mg of calcium for both men and women under the age of 50, and 1,000 mg for women over the age of 50, each day Eating can be both pleasurable and healthy as long as you eat the proper foods. All the meals in the SouthBeach Diet consist of healthy combinations of carbohydrates, proteins, and fats. Dishes can be made by anyone and the ingredients can be found in most grocery stores. These foods will satisfy your hunger without depriving your system of the low-quality starches and sugars that caused problems with your blood chemistry in the first place. The SouthBeach Diet does not involve counting calories, fat grams, or portion sizes. This plan was designed to be simplistic and will help you understand the principles of metabolism and put it to work for your own body. A major key to success with the South Beach Diet is the Glycemic index (GI), which ranks carbohydrate foods based on the effect on blood sugar levels. When you start adding foods back into your diet in Phase 2, keep your focus on low-GI foods such as apples, berries, grapefruit, high-fiber cereal, and whole grain breads. Preparing For The Rest Of Your Life Mindset Change for South Beach Diet You have learned what the South Beach Diet is, how it works, and what to eat. Now, you need to get prepared to change the way you eat, for life. Start by accepting that the first couple of weeks will be a big change but one you will not regret. The first morning of this diet, you will eat a breakfast that may consist of a two-egg omelet with two slices of Canadian bacon, cooked in either spray canola or olive oil. In your old life, you may have toasted bread or a bagel and had fresh fruit or fruit juice to go along with your omelet. However, with the South Beach Diet, the bread will have to wait. Most people have been conditioned their entire life to add bread to meals. You have toast with breakfast, sandwiches on bread for lunch, dinner rolls with dinner, and cake, cookies, or pie for dessert. However, during Phase 1, you will have to forget about the bread. It may take a few days to leave old habits behind but keep in mind that it is during this time that your body’s inability to process sugars and starches is being reversed. After trying numerous diets, most leave you feeling hungry, is one of the most difficult aspects of any diet. A common denominator seen with overweight people is that most of them skip eating breakfast. When this happens, blood sugar drops, which then increases the desire for bad carbohydrates to escalate until lunch when the entire meal is blown. Planning for South Beach Diet Planning will help you stay away from snacking or substituting things that are not healthy and could cause weight gain. Remember that once you start into Phase 2, carbohydrates will start being introduced back into your diet along with fruits. You also need to remember to eat your mid-morning and mid-afternoon snacks, even if you do not feel like it. Some of the greatest low-fats foods to incorporate into your planning include cheese and yogurt to replace the fats since they have no bad carbohydrates. In addition, the sugar is found in the lactose, milk sugar, is one of the things you can have with the South Beach Diet. The South Beach Diet is a lifetime change, lifetime commitment, and a lifetime of health and vitality! How Does The South Beach Diet Work? As mentioned, the South Beach Diet is unique, successful, easy, and works in a three-phase process. Unlike many other so-called diets, with the South Beach Diet, simply substitutes your bad carbohydrates and fats for good ones. After trying this, you will be amazed by how well and quickly it works. South Beach Diet Phase 1 South Beach Diet Phase 1 lasts for two weeks. During this first phase, you will eat normal meals of chicken, beef, turkey, fish, and shellfish, lots of vegetables, eggs, cheese, nuts, and garden salads using 100% olive oil for your salad dressing. Each day for 14 days, you will eat three, well-balanced meals. While eating until your hunger is satisfied may go against most diets, with the South Beach Diet, it is part of the plan. Trying to lose weight and become healthy by depriving the body of food makes no sense. In addition to the three meals each day, you will also eat a snack between breakfast and lunch, and then again between lunch and dinner. Even if you do not feel like eating these snacks, for the South Beach Diet to work, you need to, and after dinner, you will even have dessert. Additionally, during this phase, you can drink all the coffee and tea you want and be sure to drink lots of water. You may be thinking that this is a lot of food - it is! With most diets, you deprive your body, eating only small portions of foods that are unappealing. The change you will make during this phase is that you will cut out all bread, rice, potatoes, pasta, baked goods, fruit, candy, cake, cookies, ice cream, or sugar. Keep in mind that these eliminated foods will be added back into your diet, starting in Phase 2. In addition to taking these foods out of your diet temporarily, you will also need to avoid beer, or any kind of alcohol. Once you start Phase 2, reasonable amounts of wine can be added back in. Instead of feeling overwhelmed about the foods that will be taken out of your diet during the first two weeks, stop and think about this for a minute. To achieve a life of health and lose unwanted weight, two weeks is a small investment to make. After all, you are worth it! The first two or three days will be somewhat challenging, but breaking any bad habit starts out a little bumpy. Once you pass this small hurdle, the rest of the time will go by quicker than you think. When you see the results that these changes bring, you will be glad you did not give up!

I really think you should wait to have any plastic surgery done until you are closer to goal. I am now down to 150 lbs at 5'5" from 294, and am very close to my 140-145 goal. I can tell you that my body has made changes I never thought would happen. My breast shrank with the last 15 lbs and actually look better than they did two months ago...so I believe that if I had already had something done, I would have to have it redone at some point. I just know that my sister-in-law had breast lift, implants and TT done all at once when she got down to 200 lbs and needs the TT done again after a 30 lb weight gain and loss. Any kind of weight fluctuation will effect the TT. Her breast didn't seem to change a lot when she put the weight on and then lost it again. I only want to go through that sugery one time!!!

SouthBeach Diet Tips and Guides The SouthBeach Diet is different from the Atkins diet in that it is not a low carbohydrate diet. Regardless of which phase you are currently in, you should follow these recommendations: Drink a minimum of 8 glasses of Water, decaffeinated beverages such as club soda, tea, coffee, or decaffeinated sugar-free soda every day Limit your intake of caffeine-containing beverages to 1 cup each day Take one Multivitamin and mineral supplement daily Take 500 mg of Calcium for both men and women under the age of 50, and 1,000 mg for women over the age of 50, each day Eating can be both pleasurable and healthy as long as you eat the proper foods. All the meals in the SouthBeach Diet consist of healthy combinations of carbohydrates, Proteins, and fats. Dishes can be made by anyone and the ingredients can be found in most grocery stores. These foods will satisfy your hunger without depriving your system of the low-quality starches and sugars that caused problems with your blood chemistry in the first place. The SouthBeach Diet does not involve counting calories, fat grams, or portion sizes. This plan was designed to be simplistic and will help you understand the principles of metabolism and put it to work for your own body. A major key to success with the South Beach Diet is the Glycemic index (GI), which ranks carbohydrate foods based on the effect on blood sugar levels. When you start adding foods back into your diet in Phase 2, keep your focus on low-GI foods such as apples, berries, grapefruit, high-Fiber Cereal, and whole grain breads. Preparing For The Rest Of Your Life Mindset Change for South Beach Diet You have learned what the South Beach Diet is, how it works, and what to eat. Now, you need to get prepared to change the way you eat, for life. Start by accepting that the first couple of weeks will be a big change but one you will not regret. The first morning of this diet, you will eat a breakfast that may consist of a two-egg omelet with two slices of Canadian bacon, cooked in either spray canola or olive oil. In your old life, you may have toasted bread or a bagel and had fresh fruit or fruit juice to go along with your omelet. However, with the South Beach Diet, the bread will have to wait. Most people have been conditioned their entire life to add bread to meals. You have toast with breakfast, sandwiches on bread for lunch, dinner rolls with dinner, and cake, Cookies, or pie for dessert. However, during Phase 1, you will have to forget about the bread. It may take a few days to leave old habits behind but keep in mind that it is during this time that your body’s inability to process sugars and starches is being reversed. After trying numerous diets, most leave you feeling hungry, is one of the most difficult aspects of any diet. A common denominator seen with overweight people is that most of them skip eating breakfast. When this happens, blood sugar drops, which then increases the desire for bad carbohydrates to escalate until lunch when the entire meal is blown. Planning for South Beach Diet Planning will help you stay away from snacking or substituting things that are not healthy and could cause weight gain. Remember that once you start into Phase 2, carbohydrates will start being introduced back into your diet along with fruits. You also need to remember to eat your mid-morning and mid-afternoon Snacks, even if you do not feel like it. Some of the greatest low-fats foods to incorporate into your planning include cheese and yogurt to replace the fats since they have no bad carbohydrates. In addition, the sugar is found in the lactose, milk sugar, is one of the things you can have with the South Beach Diet. The South Beach Diet is a lifetime change, lifetime commitment, and a lifetime of health and vitality! How Does The South Beach Diet Work? As mentioned, the South Beach Diet is unique, successful, easy, and works in a three-phase process. Unlike many other so-called diets, with the South Beach Diet, simply substitutes your bad carbohydrates and fats for good ones. After trying this, you will be amazed by how well and quickly it works. South Beach Diet Phase 1 South Beach Diet Phase 1 lasts for two weeks. During this first phase, you will eat normal meals of chicken, beef, turkey, fish, and shellfish, lots of vegetables, eggs, cheese, nuts, and garden salads using 100% olive oil for your salad dressing. Each day for 14 days, you will eat three, well-balanced meals. While eating until your hunger is satisfied may go against most diets, with the South Beach Diet, it is part of the plan. Trying to lose weight and become healthy by depriving the body of food makes no sense. In addition to the three meals each day, you will also eat a snack between breakfast and lunch, and then again between lunch and dinner. Even if you do not feel like eating these snacks, for the South Beach Diet to work, you need to, and after dinner, you will even have dessert. Additionally, during this phase, you can drink all the coffee and tea you want and be sure to drink lots of water. You may be thinking that this is a lot of food - it is! With most diets, you deprive your body, eating only small portions of foods that are unappealing. The change you will make during this phase is that you will cut out all bread, rice, potatoes, Pasta, baked goods, fruit, candy, cake, cookies, ice cream, or sugar. Keep in mind that these eliminated foods will be added back into your diet, starting in Phase 2. In addition to taking these foods out of your diet temporarily, you will also need to avoid beer, or any kind of alcohol. Once you start Phase 2, reasonable amounts of wine can be added back in. Instead of feeling overwhelmed about the foods that will be taken out of your diet during the first two weeks, stop and think about this for a minute. To achieve a life of health and lose unwanted weight, two weeks is a small investment to make. After all, you are worth it! The first two or three days will be somewhat challenging, but breaking any bad habit starts out a little bumpy. Once you pass this small hurdle, the rest of the time will go by quicker than you think. When you see the results that these changes bring, you will be glad you did not give up! 30 Things You Need to Know About The South BeacH The South Beach Diet -- despite sometimes being referred to as one -- is in fact not a low-carb diet plan. The South Beach Diet is based on eating the right carbohydrates (i.e. "good carbs") and fats. Eventually, you will be satisfied without eating the carbs you normally do, as your body adjusts to the good carbs you are eating. It is completely acceptable and recommended on The South Beach Diet to eat until you are fully satisfied. The first two weeks of The South Beach Diet are called Phase 1. Phase 1 is the strictest part of The South Beach Diet and provides the fewest allowable foods as compared to the other two Phases. The purpose of Phase 1 of The South Beach Diet is to adjust the way your body reacts to sugar and starches. You will lose the most weight during Phase 1 (up to 14 pounds), especially belly fat. During Phase 1 you will not be eating bread, rice, potatoes or pasta. The first few days of Phase 1 are the most difficult part of this diet. Baked goods, sweets, and fruits are completely off-limits during Phase 1 as well. Alcohol of any kind is not allowed during Phase 1. During these two weeks you'll be eating high-fiber foods such as vegetables and salads, as well as fish, meat, chicken, eggs, non-fat yogurt, low-fat cheese, and nuts. The South Beach Diet allows you six meals a day: three main meals, two snacks, and one dessert. You'll find a variety of recipes in the book, such as Marinated Flank Steak, but you don't have to cook to follow the plan. The science behind this diet is the Glycemic Index, which measures how a food impacts your blood sugar. Since salads and vegetables are naturally low on the Glycemic Index, you can consume virtually unlimited amounts of them on this plan. After Phase 1, those powerful cravings for candy, baked goods and "bad carbs" like white bread will be a thing of the past. Eventually, you can eat anything you want and still be considered on the program. If you feel hungry during Phase 1, increase the amounts of allowable foods you are eating.<SCRIPT>zSB(3,3)</SCRIPT> Eliminating "bad carbs" from your diet is a way for this diet to give your bloodstream a fresh start, free of those insulin-spiking starches and sweets. You can quell your sweet tooth: Sugar-free Gelatin such as pre-packaged sugar-free Jello cups are an easy and recommended dessert during Phase 1. Dr. Agatston provides recipes for a number of Phase 1 desserts that use reduced-fat ricotta cheese. Obese individuals may choose to stay on Phase 1 for longer than two weeks. Most people should advance to Phase 2 after two weeks to prevent getting burned out. Phase 2 is much more liberal than Phase 1. You will return previously "forbidden" foods such as whole grain breads, fruits, and sweet potatoes back into your diet (albeit a little bit at a time) during Phase 2. Weight loss will slow down significantly during Phase 2. Phase 3 is the maintenance Phase of The South Beach Diet. You can add any foods you wish unless you find that you are gaining weight. You can start over in Phase 1 again if you see you are gaining weight during Phase 3. You can start over in Phase 1 again if you see you are gaining weight during Phase 3.

I had the same concerns myself a few years back, as it is genetics on both sides of the family to be overweight. I am the obese one of the family on my side, and yet, I was always the athletic one, go figure. On my husband's side, he has one sister who is obese, as well as many great aunts and uncles and his mother. The rest of his family has a weight problem, but it's minimal. On my side, half are overweight, the rest are thin, and I am, as I mentioned above, the only obese one in the family. I've learned with my kids, to limit junk food intake, and teach them about healthy eating habits. Tell them why a glass of orange juice is better for them (potassium for the heart, vitamin C for colds) than Hi C, or a side of salad instead of chips with their sandwich for lunch. I find that if they understand the importance of nutrition, and not weight gain/loss, it is less intimidating to them. If you constantly get after them for having a freeze pop on a hot day, you will only make them feel guilty for having it, then they will sneak food, to make themselves feel better. Let them have that treat- it's ok, so long as they get enough exercise and eat properly most of the time! Isn't that what we should concentrate on, instead of scaring them into eating their way into an eating disorder? I cannot emphasize enough, physical exercise. I see way too many kids, obese, heavy, and skinny, playing too many video and computer games. Kick their butts outside, give them a ball, and tell them to PLAY. For that matter, join them- you'll both benefit from the exercise and fun.

LOL Salsa...I was sitting here thinking the exact same thing about Frangi and Stein Mart!!! I'll be back on the exercise thread tomorrow. Nursing a back pull . But...no weight gain!!:biggrin2:

One if my closest friends and I talked about this very thing. She and I actually train and dance together. She does not have a history of obesity or weight gain. She said, "I really didn't know what to say that was my business." Because I hadn't started the conversation. We all come from different places.