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Okay, so you bulk up before your weigh in with food, fluid, heavy clothing or shoes, or weighing down your pockets. I would worry that you go the second time without this additional bulk & you weigh a lot less & they think wow you’ve lost a lot of weight great. But the third time your weight has slowed a lot to what would be appropriate for your real weight. Plus the more you weigh the more they may want you to lose before surgery. Be careful, besides taking off my shoes I’ve been asked to remove a heavier skirt before my weigh in so they’d get a more accurate result. (Didn’t wear it on purpose just because I liked it.) My friend was told she was a couple of kilos short of meeting the BMI requirement. I remember who saying oh well a couple of weeks until Christmas & I always put on weight then so I’ll make another appointment for January. She did & she met the requirement. You have Thanksgiving soon so it may be a moot point.

I am surprised at the BMI of 39, most insurance will cover it with a BMI of 35 and two comorbidities after that it seems like once a person hits 40 BMI you only need one, and sometimes no comorbidities, and a BMI of 50 or more will usually get covered on BMI alone. None of this exempts you from any other insurance requirements though. If you are self-pay you should not have to worry about this at all only what the clinic wants you to do. As for heavier clothing, putting rocks in your pockets, and filling up on fluid before a first-time weigh-in, I did not do it, BUT I know others have. It could be a good idea if your insurance is going to require you to lose a percentage of your body weight before surgery approval. At that point, you'll be wearing the lightest breeziest outfit you have with no shoes.

Have you recently weighed in a little higher, like at your doctor's office for a physical? That may be good enough. When I was still in the nonsurgical program at my hospital, I weighed in at a BMI of just over 40. At that point, my doctor suggested I look into surgery. I was pretty shaken by hitting that number and I immediately made some changes, so 2 weeks later when I came back for my first appointment on the surgical side, I was around 39.8. They said it was fine, that they go by the highest weight for qualifying. And yes, I wore my heaviest shoes that time, just in case! I know that usually they will deduct a couple pounds for clothing, but they didn't for that highest weight, I think just to be safe. I do have a comorbidity, though, so I would qualify anyway. You might try a few days of salty foods before your next appointment, too.

Well said, @NickelChip. I agree that we need radical change from our policy makers at the highest levels, and some real nutritional education. Part of my journey is that I have finally gotten very angry about the marketing/indoctrination and policy lobbying that the for-profit "food" industries have been allowed to get away with, at the expense of our health in the USA. I'm old enough to recall that the first food pyramid from the USDA said to eat 6-11 servings of bread, rice, cereal, or pasta every day. As a young person, I thought I was practicing healthy eating when I would have two servings of cereal for breakfast, then two sandwiches for lunch, and three servings of rice for supper. 9 servings was totally within the guidelines, so why was I gaining weight??? Thank you for sharing the article, @GreenTealael. I felt like I was reading about myself! Body size, obesity, health and their places in society and the science of medicine seem to get more complicated every day. I found the short history lesson on BMI quite fascinating.

I am very close to the 40 BMI like just a few lbs shy of it. I know I can get approved with a BMI of 39 with 1 or more co morbidities but it would seem easier is the BMI was 1 point higher lol. Anyhow my initial appointment is next month. Have any of you wore heavy clothing or padded a few areas with some extra weight? I can always gave weight without trying but now that I am wanting to lol its not happening.

WOW - Do people even think before they speak? I guess she meant it as a compliment. My mom, who had a weight obsession, asked me after my surgery why I mutilated myself. She had know Idea how much I struggled with my weight. Probably didn't realize that my weight struggles were after watching and hearing her and her mother commenting about it all the time. I think the German roots and farm family background weight loss was probably considered a sign that you were being properly fed!

It's sad that others can't be happy for another's success. Especially coming from one's own family member. That catty competitive BS always bugged me and still does. I used to work in an all-women's health club and OMG... the things I heard other's saying about one another made me sick. I learned early on not to let other's opinions effect or define me. Negative comments are certainly harder to take coming from a loved one but even so..parent or not, they are mentally flawed just like the rest of us. Makes it easier to pass it off or forgive them thinking that way, I guess. I remember my Mom saying to me one day while I cared for her after she suffered a stroke... 'What happened to you?" Referring to my weight gain. I was always the fit beautiful one in the family. It hurt me momentarily. She was sharp as a tack up until the end, but the filter was gone. I could have said I quit taking care of myself after I started taking care of you. But I never would have said that to her in a million years. I don't think I even realized that till much later. As for good compliments. Most have been you look great...amazing, congrats etc. A recent one was on my curls. Is that natural or...? I smiled and said yes...along with a bit of hair product. Beautiful, she said. I'll admit it was nice to hear. Especially after feeling invisible for so long. Downside is men are starting to take notice of me again. I never missed it since a lot of that felt like sexual harassment to me. But nothing really negatives as of yet. Knock on wood. I'm sure I'll be ready for them though if I do. LOL Kinda true...

I was more aiming at the fact that most patients having WLS don't reach a normal weight. I don't know, however, how many people get out of the obese BMI into an overweight BMI. With the drugs it's the same. What you said is definitely something that's worth considering though. I don't know if we're cured or not after having WLS. With drugs that answer is IMO easier to answer: you have to take it for life just like e. g. antihypertensive drugs. These drugs don't cure high bloods pressure. When patients stop taking them, blood pressure is high again.

You will do fine. Being anxious is normal. I had the sleeve on 10/27 and had no issues at all. I was never even tired. At times I question whether I even had the surgery (which I have heard from others) because I have had no pain, nada. I was tired and dizzy the first day after surgery, but that is normal. I am losing weight (and following my doctor's recommendations exactly), and I have no hunger (except some head hunger--which I counteract by trying to focus on what is really going on--smells of food being one). Remembering your why is a very good way to deal with head hunger or any other obstacle you might experience. So many people say this, but it really is the choices you make on a daily basis. As to wiping your butt, they want you up and walking ASAP to get rid of the gas--if you can walk, you can wipe your butt. Good luck!!

I'm on Day 8 of 14 for my liquid pre-op diet, and honestly for me, it hasn't been all that bad! I didn't get "keto flu" or any of that, possibly because I've done keto diets before and knew to keep up with electrolytes. The only crummy part is when I can SMELL tasty things. I'm fine if I can see them, I'm fine sitting next to people chowing down, I'm fine watching YouTube cooking shows even, but if I walk past someone's office and smell something delicious, THEN I really miss food 😅 I'm starting to make myself anxious by reading about post-op infections (it feels like the only people I've read about getting them on my program's Facebook group are those who have the same surgeon as me...), "How will my cats EVER forgive me for not being able to sleep with me the night before surgery?!", "WHAT IF I CAN'T WIPE MY BUTT AFTER SURGERY AND MY HUSBAND HAS TO DO IT?!", etc. etc. etc. 😂 I think the big key is to always remember your "why" - Personally, I'm not just doing this to lose weight. I'm doing this because I have a family history of a number of different cancers whose risk is greatly increased with obesity (and I had a precancerous colon polyp removed earlier this year...I'm not even 40 yet). My "why" is that I want to be here a lot longer and be healthy and be able to enjoy that time doing fun, active things and not overheating and sweating my arse off while I'm at it. Today's my last day working in-office prior to surgery next Wednesday, and I'm really thankful for that. All my good savory liquids are at home! I hope everyone is doing fantastic and healing well, or having an easy time with their pre-op regimens! 💜

I went on a trip this week..and I knew I'd be doing a lot of walking so I took my most comfortable furry sketcher clogs. They've always been comfortable for long days, well since I've lost weight they're now lose and as a result they flopped around and I have two huge blisters on the balls of each foot! So good problem with bad results...but still good!

And you would have. I realized this past week while going thru years of stuff that I'm finally cleaning out, how long I actually struggled with dieting and weight loss. I found journals and food diaries and counting calorie lists, diet books and recipes etc. It made me sad. I could have avoided a lot of that if I had decided to get the surgery sooner. But I'm a firm believer that everything happens for a reason and am happy with where I am now, I can honestly say, and I've said it before...my only regret is not getting the WLS sooner.

Don't worry, it will resume. It's your body panicking because of such a drastic change in a short amount of time. The week 3 stall can last for 3 weeks itself, or sometimes more. During that time, your body can still be burning fat, but its retaining fluid to keep around because it thinks you're in a starvation situation and wants to preserve space to replenish the fat cells. It won't let go of that excess fluid and old cells until it knows you're safe, which it eventually will, and it will establish a new baseline weight as long as you stick to it. You got this!

My weight loss has stalled since November 5th. I know this is normal since loads of other people have mentioned experiencing a week 3 stall, but it is still disheartening to lose nothing for 11 days when I know I'm following the diet, focusing on protein, drinking fluids and keeping my portion sizes appropriately small. I hope this plateau breaks soon because it is demoralizing.

Yes, weight all your food together to make 3oz.

Remission is a great way of looking at it. Without diligence in the form of lifestyle changes including good nutrition and proper exercise, the weight comes back. I should mention, when I was taking Saxenda and Wegovy, my insurance plus coupons covered all but between $25-50 of the monthly costs. At that price point I would consider taking it in the future if WLS wasn't enough to maintain my goal weight, but with 100 lbs to lose, meds won't get me there, whereas surgery hopefully will.

Odds are you will be fine!! There can be awful complications with any weight loss surgery (or any surgery at all for that matter) but those are in the minority of cases, and even then, most of them are caught in time and correctable. Pretty much all of us have a "WTF did I just do to myself!?" moment. I had the DS and 3 days post op it hit me that I had irrevocably altered my stomach and intestines permanently, for life, no going back. I knew that pre-op and thought a lot about it before deciding to do it, but post op it hit me in a whole new way... And then I reminded myself that I altered my body because the way it was was in fact KILLING ME. Drastic times call for drastic measures and all that. Once I remembered that I calmed down... Remember your why. Orient yourself to your goal. And stay off of Tiktok for a while!! 😂

One just has to look at how much weight people really lose on these drugs. Many people will most likely just be "less obese" but not "no longer obese", even if one could afford taking the drug for life. Those drug won't "end obesity" - just as WLS never did.

I’ve had the gastric sleeve January of 2015, gained a good amount of my weight back. Decided to take another approach and do it RIGHT this time around. 2 week pre op was tough but possible.. Now I’m post op 11/9/23 I had the switch. Thanks god everything went well! Just here with some pain and anxious to start my next phase :puréed 🤮

Hi @texasmade88 Welcome!! Congratulations on the 22lb weight loss!! is that after your surgery? Currently, I have been stalled and I am trying not to get stressed out (although there is a small thought of omg what if I did this surgery and nothing changes for me). I won't be a month out until November 27th so I am just telling myself to chill. How are you feeling about the upcoming holidays with food and stuff? I am actually glad I will not be able to eat Thanksgiving dinner this year, it takes a lot of pressure off of me to hang out with the family.

Fascinating article. Despite having taken several of them myself over the past few years, (including Saxenda and Wegovy), I'm very hesitant to embrace a world where weight loss drugs are the first line of defense against obesity. I say this knowing that at least some of my issue comes down to poor nutrition choices, made far too easy by an environment swimming in garbage foods and a culture that values quick convenience over everything else. When I commit to good nutrition, my weight decreases. I don't get skinny, or even "not obese" but I do lose weight. When the snacks and junk food make their way back in the house and I have stressful weeks with work where I'm at my desk for 12 or more hours and fast food feels like my only option because I'm too tired to cook, I gain weight. In about the past 60 years, we've gone from 13% obesity to 40%, with a 10x rise in severe obesity. This isn't just a weird thing that happened in a vacuum. There are pretty obvious reasons for this, some that could possibly be solved with significant changes to our food policies and investment in real nutrition instead of lining the pockets of pharmaceutical companies and massive food corporations. Much of our so-called food today has been designed to be addictive, by the same folks who brought us cigarettes, no less. That should give people pause the next time they're in the grocery store looking at all those shiny boxes and bags. On the other hand, in the days when only 1% of the US population was morbidly obese...that was my family. And some of my family lived really long lives, into their 90s. Except the ones who didn't and died young. And you don't know which you'll be until it's too late. Up until my 40s, I was one of those people who had healthy bloodwork despite being 90+ lbs over my "ideal weight." I didn't worry about my weight because I was healthy. But that changed rapidly with middle age as my weight went even higher. Now I take blood pressure meds and am prediabetic. My feet and joints ache and I worry what that means as I age. I wish I had done more to keep my weight lower when I was younger and developed better habits early on. I can't believe how ignorant I was of nutrition facts when I was in my teens and 20s. One thing I know is I can't afford $12k or more a year for the rest of my life to take these "miracle drugs." I'm not sure who really can or should. I'm grateful for surgery being an option, but it's not for everyone, and neither are the drugs. As a society, I would like to see more acceptance of humans in all sizes, and more focus on real health and nutrition instead of fads and gimmicks that make a few people really rich.

I'm going the self pay route with Blossom Bariatrics, but was given similar timelines when I spoke with folks with Dr Shillingford and the Nicholson Clinics, but generally scheduling could be done 3 weeks out with 2 weeks of pre-op diet for a Sleeve procedure. From first call to the surgery is generally 1 month, but sounds like it could be less in some cases. RNY, DS, and revisions required considerably more time to plan for. Far fewer hoops to have to jump through going this route, though. I'm only going this route because my insurance declines anything related to bariatric surgery. My previous employer's insurance would only cover a lap band, and it required a year of meetings. If I missed one, or gained any weight between sessions, I had to start over, which is ridiculous. Also they didn't cover any counseling, which I definitely recommend signing up for! It's just as much mental as it is physical! I'd rather not have the equivalent of a car payment hanging over my head, but my health has been declining significantly the last few years and I need a change. My job isn't forgiving with PTO either, and it was all I could do to take the 3 days off for the week of Thanksgiving to get mine done next Monday. It's a small business, so FMLA isn't an option, so I have to go back to work the next Monday.

Pre-op weight target and surgery still in front of me I had to lose a certain weight before I could continue to the "next step". Okay then as long as the mulitvitamin has it, then I dont need the extra? just calcium citrate and iron?

I was allowed carbs on my diet plan but my office goes by calories instead of size of meal. I think at 4 weeks it was around 400 to 600 calories but by 8 weeks they wanted us to be around 800. I would see how many calories you are actually taking in and just keep following your plan. Every time I hit a stall I gain 3 pounds and my last stall I actually gained 5 lbs. My stalls are usually 3 weeks long but once it was 2 months. When I think I'm in a stall then I only weigh myself once a week at most because stalls can be rough mentally. The mental part of this weight loss was the hardest part for me. Good luck and take care!