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The primary question here is,,,why? What do you hope to accomplish with it? If keto is something that you are already doing and like, and makes sense for you to keep doing it for the foreseeable future, then yes, you can do keto after surgery and it will work as well as anything. If you are hoping to adopt it because of a belief that it will improve your WLS performance, then forget it. Summerset, above, has the right idea that the WLS by itself is plenty strong enough on its own. Looking back 20-30 years, patients were often told to just "eat like you always did, just less..." and it worked! For a while. Of course, eating like what got them fat in the first place didn't prevent them from gaining weight again in the longer term. But this does illustrate one of the big powers of your WLS - that it is relatively insensitive to what style of diet is used that first six months to a year when we are losing rapidly. Low carb diets that are popular today work just as well as yesterday's low fat diets. This means that we can concentrate on learning how to eat for long term health and weight control rather than promised quickie weight loss followed by inevitable regain that we get from the various fad diets. In the non-WLS world, diets fail 95+ percent of the time when you look out beyond a year, as people either hit diet fatigue and fall back on old habits, or they may actually get down to a normalish weight, and then regain as they fall back into old habits. The same thing happens with WLS, only it usually takes longer given the lingering restriction that we have - but the weight can come back over time if we don't learn how to keep it off, and most diets don't teach that.

One reason I refuse to do a carb restricted diet....is that I know I can't do it for a lifetime....I feel like crap without carbs. If I do keto? I know myself enough to know that eventually I'll fall off that wagon. I have adjusted to healthy carbs, though, and have even learned to love them:) We all have some things that we know are our Achilles heels. I don't want to give my Achilles heel leverage in my life anymore. All the habits I'm building right now...I'm building on the basis of....this is a lifetime change. This is a diet I can love for a lifetime. This is a diet I will never feel deprived on while I'm eating it. It's hard to build your forever diet. But I'm hopeful. I'm tired of diet fatigue...where I push, push, push, until I break....because of my unrealistic expectations. I'm tired of deprivation until goal...it doesn't work. You starve yourself until hit goal and you go....Finally, I can EAT! And then you screw yourself. It's crazy. This time around I'm going slow and steady, I'm keeping my expectations sane, and letting myself enjoy every meal, every little victory, every stall. LOL:) For the first time, I really feel like I'm going to succeed for a lifetime. Because I am so done with that diet yoyo ****. f**k that. I love my forever diet. it makes me feel strong, happy, and like success....is inevitable. Even if it takes a while.

This is a question I have asked myself also. I see that studies show plant based diets are proven to be very healthy and so, I questioned basing my diet on protein. I now do plant based, low carb, but not keto low and healthy fats. I have gained about 5/6 lbs and seem to stay there as long as I don't add processed foods or sugar to my diet. My blood work #s are excellent. I am experimenting with intermittent fasting 8:16, hoping it will help me drop a few more.

I would have said Ketosis. It doesn't matter the amount of calories per day, it's WHAT foods you are consuming. Do u have Keto-sticks to test your urine?

I am 3 months out from RNY surgery and have lost about 45lbs , the weight has been slow moving this past month and I work out 7 days a week, I do a full mix of cardio , weight lifting and yoga/Pilates / barre and follow a Keto or Lazy Keto diet. Depression , anxiety, sleeplessness , restlessness and anger have been a constant no matter how much I keep my endorphins up. Is this normal? Is it normal to look in the mirror or photos and still be angry and upset with what you see? Are the mood swings 3 months out still normal? I’m disgusted and saddened by what is looking back at me and I am critiquing myself harder than before when I was 200lbs , 154lbs just doesn’t feel like the progress I was hoping g for at 3 months and I feel like no matter how hard I work out I am not seeing the muscles or definition in my body , all I see is saggy skin , bingo arms and cellulite. I just want to know am I the only that has felt or feels this way ?

My surgery is feeling very real now, having just booked a taxi to get myself to the hospital on Sunday morning (April 25th). The hospital is a 1hr drive away which isn't great (largely because of the added taxi expense) but there was a 12 month wait at my nearest hospital whereas its only been 1 month since my initial phone call to this one (I'm in the UK, paying privately). I've lost 24lbs in a bit over 3 weeks of pre op diet and got a 50lb total loss from my highest weight a year ago today as I did keto for 11 months before the pre op. I've come a long way over the last year, and regularly cook, shop for and have in the house lots of foods that previously I couldn't have resisted (I'm taking about you, pizza, ice cream and biscuits) without finding it a problem. I've also happily gone through the drive through with my (slim) husband and felt perfectly content with my protein water. There was a question earlier about doubts following a successful pre op diet. For me, having lost a lot of weight in the past and losing quickly on my pre op, I'm happy to have surgery. Research shows that for many reasons including hunger hormones, metabolism and fat cell activity weight loss surgery makes it significantly easier not just to lose weight but to maintain that loss. The way I see it from my research and experience is that losing weight through diet leaves you slim but in a body that physiologically is doing everything it can to get you back to being fat. Surgery leaves you slim in a body that has in a sense been reset to being slim and is not trying to get fat again. Do it by diet and you'll be left fighting your body as well as your mind to maintain. Do it by surgery and you don't have to fight your body, just keep control of your mind. That's much more achievable. Preparation wise I've got lots of protein water and shakes ready that I know I like plus chewable bariatric vitamins. I'm feeling very settled on the liquid diet which I'm glad about as I think it'll make the post surgery transition easuer. I've treated myself to a new pair of headphones with alexa built in to make my hospital time and recovery a bit more convenient. I bought a giant cosy dressing gown for a bit of comfort. And I've sorted all my outdoor sports gear /books /maps etc which have ended up in the loft after a blissful period having lost 140lbs about 12 years ago that didn't last very long before it all came back. I've read a whole load about bariatric surgery and nutrition and have lots of self improvement books lined up to read or listen to to help me keep working on me, not just my weight and relationship with food. I'm so excited about my new life and feel very determined and prepared. Loads of waffle there... Can you tell I'm excited?! Sent from my VOG-L09 using Tapatalk

here's an article about it. It lists both headaches and dizziness as symptoms: https://www.healthline.com/nutrition/keto-flu-symptoms#symptoms

I can't stand the shakes because I'm really not a big fan of sweets. I just moved on to the soft solids stage of my diet and the hard part for me is separating liquids from meals. I reccomend Genepro protein powder because a tiny scoop is 30g of protein. You can put it in just about anything and it's amazing! And when you advance your diet there is a keto version of pretty much everything you crave. Hang in there! Sent from my SM-G950U using BariatricPal mobile app

some of the keto stuff tastes amazing … i haven’t made actual cookies yet…. one tip: get lilys brand sugar free chocolate chips they are great !!!

I thought the Hershey ones were good too. I have made keto brownies and they weren’t bad at all. Never cookies but I will for me. Especially after seeing all those cookies and not being able to eat them. Lol

I cannot take credit for any of the following (I copied and pasted from a few sites...): Ketosis merely means that our bodies are using fat for energy. Ketones (also called ketone bodies) are molecules generated during fat metabolism, whether from the fat in the guacamole you just ate or fat you were carrying around your middle. When our bodies are breaking down fat for energy, most of the it gets converted more or less directly to ATP. (Remember high school biology? This is the "energy molecule.") But ketones are also produced as part of the process. When people eat less carbohydrate, their bodies turn to fat for energy, so it makes sense that more ketones are generated. Some of those ketones (acetoacetate and ß-hydroxybutyrate) are used for energy; the heart muscle and kidneys, for example, prefer ketones to glucose. Most cells, including the brain cells, are able to use ketones for at least part of their energy. But there is one type of ketone molecule, called acetone, that cannot be used and is excreted as waste, mostly in the urine and breath. The description of the smell varies, but it is often described as "fruity" or like the smell of apples which are "past their prime" (or even downright rotten). The good news is that keto-breath usually doesn't last forever. Most people find it dies down after a few weeks, or at the most a few months. The reason is unclear, but it seems our bodies adapt in some way. Children on a ketogenic diet for epilepsy have been shown to have less acetone in their breath as time goes on, for example. In the meantime, there are things you can do to minimize the impact of "keto-breath": Drink more water: try 8 glasses per day to see if this helps, and then you can experiment from that point. Natural breath fresheners to try include mint, parsley or other greens, cloves, cinnamon, and fennel seeds. Some people swear by breath capsules, which are usually made from parsley oil (e.g. Mint Assure) for keto-breath. Others find they do not help. sugar-free mints or gum can be tried, but watch the carbs in them. Ammonia Breath from Protein When the body metabolizes protein, ammonia is produced. When people eat high-protein meals, there tends to be increased ammonia in their breath and/or urine. In large amounts, this can smell pretty bad. It's important to remember that we don't need lots and lots of protein in our diets. Our bodies use protein to maintain and build muscles, to make enzymes, and for other structural and chemical needs. The body will convert excess protein to energy, which is where you will get the extra ammonia (this also happens during starvation or long exercise when the body begins to rely on breaking down muscles for energy if it runs out of sources of fats and/or carbohydrates). Find Out How Much Protein Your Body Needs Sometimes people load up on protein because they are afraid to eat more fat. This is one of the reasons why it is rarely a good idea to try to eat a diet that is low in both carbohydrates and fats. The solution to "ammonia breath" for people on a low-carb diet is often to increase fats in the diet, and cut back some on protein foods. Above all, don't let problems with your breath derail you from staying with a diet that is improving your health. Instead, try to figure out the cause of the bad-smelling breath and tackle it. Body Odor There are a number of chemical changes that take place in your body when you're on a low-carb diet, some of which can cause a foul body odor. Ketone bodies have an odd odor to them; they're not unlike fingernail polish remover in their smell. Once you enter ketosis, it's common for others to smell ketone bodies on your breath and in your sweat, which can give you a foul, sickly-sweet odor.

I love carbs and sugar. I still crave both just as much, immediately after the surgery. My plan is everything in moderation, one day at a time. If I cut something out of my diet completely, I usually end up giving in and over doing it. Right now Saturday is my "cheat day" which means higher calories and a treat. I am pretty much low carb the rest of the week. I don't know what this will look like long term, I'm pretty certain I will be a complete failure 3 years out. Apparently the only way to be successful at this, is to become a body builder, or marathon runner and eat a lifelong keto diet. But, I don't want to eat only chicken and cottage cheese for the rest of my life, and I sure as hell haven't noticed an increased desire to run marathons post surgery either.

According to research ive done on the keto diet suggests that having carbs increases the craving for carbs. Not medical advice.

Hey BabyNewYear, I'm also almost 4 months and doing great. What a fantastic experience I've been having all the way! Some things haven't changed: I still don't feel when I need to stop eating, so I pretty much overeat many times because my brain doesn't want to stop, so at least once a week I feel extremely sick because of course our stomachs can't handle the amount of food. As I mentioned you before I stopped losing weight after week 5, so I have decided to start a lchf/keto/banting lifestyle which is a lifestyle based on very low carbs, moderate Protein and high in fat; why this approach? I'm barely hungry when I eat fat, it allows me to fulfil my protein requirements and sugars (carbs) is what gave me the metabolic syndrome, weight gain and led me to surgery. I'm really happy with this approach and I really honestly hope that I can follow this the rest of my life. Many ask about my sugar and cholesterol levels with this diet and all of them are back to normal. I'm down 17 kg (37lbs 8oz or 2 stones 9.5lbs ) from 76 kg (167lbs 9oz or 11 stones 13.55lbs) to 59kg (130lbs 1oz or 9 stones 4 lbs) and I'm only 4 kg (8lbs 13 oz or 8.8 lbs) from my goal weight. Lately I've been losing between 0.5kg or less per week (around one pound or less). None of my clothes, underwear nor shoes fit. I've lost my ass, it's totally flat so sitting is painful because I'm sitting on my hips and training has it's ups and downs because I lost more weight from my right side of my body so my sneakers are loser on one side and I hurt my right knee quit often. I'm also trying to become stronger with weight lifting so that I can continue to lose fat. My stomach is still big compared to the rest of my body, but I can start seeing my neck, hands and hip bones. Lose skin on my ass, boobs and upper arms. hair loss, it's bad... but I've seen worst cases on instagram, so I still feel lucky about this, but there is hair absolutely EVERYWHERE! I'm taking Biotin for this. What an amazing journey!!! Looking forward to the next update! Cheers!

I have had episodes both pre and post. I find that sticking to a structured plan helps me. Currently I am loosely following a Keto plan. It eliminates many of my trigger foods. I find avoidance of certain foods and setting dietary and activity goals help me focus on the right things.

My son also has the same schedule. What you need to do is look into Keto high protein foods. My son says he's never eaten more than when he switched to Keto diet for his type 1 diabetes. He's always got jerky, cheese, almonds on hand. Most grocery stores carry protein foods and so does Amazon. I drink Ensure Max 30 g of protein and they fill me up. Protein foods fill you up, carbs spike your sugar and make you hungry in no time. Keep a small baggy of almonds around to eat or jerky with cheese. Is it easy, some days better than others. But living with obesity and food being your best friend is fun either. You can do it if you focus on what you can do and eat rather than what you can't do. Browse the keto, high protein section in your markets you may be surprised. They even have ice cream. You can do it.

If making the decisions later is difficult, make the decision earlier when your willpower is intact. Pack lunch. Leave your wallet home and just bring your license to the gym. Never grocery shop hungry. In terms of food, I'm the opposite of what is described: the longer i make healthy food selections (for me, that's keto) the easier it is to keep making the right selections. Cravings are nil and weight loss is a steady reward and so I have no desire or incentive to cave.

Stlll doing keto and IF? Did the dietician go over your daily food intake? Did they make any suggestions? Anything else that may be masking scale weight loss? Fluid retention? Been excercising a lot lately? Do you know if you are losing inches/centimetres? If you aren't already may be useful to use body measurements they can be motivating when the scales aren't going down.

Yes, Pinterest is a great source. There are also recipes on a site called SkinnyTaste that cater to dieters and weight loss including keto, paleo, weight watchers, vegetarian, etc. Thanks for sharing.

I'm weirdly excited to have someone else to talk to about this too! I had my sleeve with no complications back in 2013. At the time, I was morbidly obese and had a new dx of high blood pressure, but was otherwise healthy and had no health issues to speak of. The sleeve recovery was fine and I lost about 150lbs. Then... I got pregnant. Pregnancy was good, baby and I were healthy, my son was born and life was great. Except that I had allowed about 50lbs to creep back on. So last spring/summer, I decided to kick start my weight loss and went on a keto diet. Shortly after, I started having symptoms of achalasia, which I didn't know what it was at the time, and just attributed my indigestion and vomiting to eating too dense of protein too often with my sleeve. I wasn't seeing my bariatric doc anymore due to insurance changes and just thought I needed to be more careful about what I was eating. In January, I experienced sudden onset of chest pain on my right side, that was so intense I would've thought I was having a heart attack if it were happening on the left side of my chest. I went to the ER, was checked for a pulmonary embolism (which it wasn't) and had a CT of my chest. I had empyema and pneumonia. I was admitted, the next day I had 2 liters aspirated from my lung, and it wasn't enough. I had to have surgery (thoracotomy), and during that surgery I aspirated. I ended up being put on a ventilator, sedated until they could stabilize me and operate again. I had my second surgery which was successful, but left me in so much pain! After that, I ended up with sepsis in my blood, my kidneys failed and I needed dialysis - all while I was too drugged up to know what was happening. I was referred to a university hospital in Chicago by the GI that saw me in the hospital. I had all the testing and confirmed I had achalasia - which now that I know what it is and have read up on it, I realize that my symptoms were all pretty spot on for this condition. My new bariatric surgeon says that the sleeve will cause reflux if he does the myotomy without converting to bypass, so that's what we're doing. I totally understand what you mean that some days are better than others. There are days I can eat just about anything with no problem, if I try to eat the same things the next day, it's a disaster and I'm miserable all day. Unfortunately, the easiest thing to get down most days are CARBS. If I continue to have swallowing problems after the myotomy/bypass, I have no idea what I'll eat! I also have problems with protein shakes, water, yogurt... stuff you would *think* goes down easily, doesn't. I'm quite nervous about what comes after this and why I developed this in the first place. Knowing that it's an auto-immune disease has me worried I may develop others, as you did. I'm sorry for us both suffering from this awful condition! Losing 50lbs in 4 months is fantastic, especially given the disadvantage of eating problems. I hope for similar results - I figure if getting this condition is what prompted me to do something about the remaining weight that I never lost with my sleeve, then it's not all bad. If you have any links of resources for this condition, please share. I've done my own research, but then I see other people referencing having "atypical achalasia" or "type 2 achalasia" and I have no idea what that means!

I think I actually have a similar thread somewhere here in the vet's forum. I'm 4 years out and have similar struggles. I fell off program, went through HUGE life changes and had regain. I floated around regain land, eating and drinking everything I wanted- after all, my sleeve controlled the AMOUNT I eat, right??- and finally woke up when I got ugly medical results last fall. YOU GOT THIS. For me, I went hard core Keto the next day and got my crud together. But you KNOW what to do. Go back to post op. Relearn WHAT to eat. Focus on water, protein, moving every day, etc. Dig out your old papers from your clinic or doc and reread them. I do that occasionally. Don't waste time looking at various diet sites, groups, etc. As bariatric patients we know that protein, food amounts, water, movement all work for us (I did the same, I even went to a new surgeon to inquire about revision but he told me I didn't need it). Consider finding a brand new support group. Even if you have to drive a little ways, going to a new group is SO much easier because you don't have to face people who knew you when you were losing and were post op. For me, people in my new group never knew me post op, so they only met me last year and by getting my crud together, I've lost about 45 lbs (all my regain) and am back on track to FINALLY get to my actual goal. YOU GOT THIS girl, hang in there !!!!!!!

I wanted WINGS!!!!! Is like we are alcoholics....and there alcohol EVERYWHERE and we can't drink it. The smells are amazing when we can't eat anymore of it. Honestly, we are addicted to carbs, candy sweets...and now we made a decision COLD TURKEY to not eat it again. I will never judge anyone with addictions again. It takes a great deal of strong will to stop eating the things we loved. Then again, our stomach is so small that we couldn't eat more then 2 oz at the time.lol....I am 3 weeks post surgery. I miss the wings..but I am going to try the Keto diet...all the bread free wings I can fit in three oz belly!!

I didn't tell anyone except my husband and mom for this very reason, and I have never discussed dieting with others. People get evangelical about keto or Paleo or vegan or whatever they happen to be into. The best diet is the one that you can stick to, the one that works for your personality, tastes, lifestyle and body chemistry, and there is no one-size-fits-all.

I just google to find recipes. Here are some of the sites I like. http://www.ibreatheimhungry.com/ https://www.ruled.me/keto-recipes/ https://www.dietdoctor.com/low-carb/recipes/best-keto-recipes I also found that many of my normal recipes worked with minor substitutions. e.g Use zucchini noodles instead of pasta, choose higher fat beef, add cheese / butter.

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!