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Hi Seif_s88, Yes I can relate. I lost about 100 pounds and have gained back about 50. 10 days ago I restarted a keto diet which has worked for me in the past. Down 10 pounds so far. I find that the keto diet helps with cravings and I like the discipline. I check my urine ketones every morning, and I find that to be motivating, as well as seeing the scale move down. I remembered to get baseline measurements, so I can see progress that way too. Omgoodness- body image issues. I get that too. I am 55 and was sleeved almost 10 years ago. The ups and downs sometimes make my head spin. Some days I look in the mirror and am shocked to how time has gone by. Overall, I try to be kind to myself. When I get too much in my head about my appearance, I try to remind myself that I am more than this body. So much more.. and so are you

Not sure which diet you're on, but super low carb can result in "Keto flu". I don't have a fat restriction on my pre-op diet and found that good fats + grey Celtic sea salt really helped me. Like, coconut oil and a pinch of salt in my shake. Or just a grass-fed burger with no bun. My headaches got better when I flipped into full ketosis around day 4. Sent from my iPad using the BariatricPal App

I am also insulin resistant and I have PCOS. so I defiantly have to watch my carb intake. But I love chicken fish broccoli spinach salad with lemon. Etc. when I was younger I didn’t notice that all the bs carbs I was eating was not good for me and I was on the Fast track To obesity and addiction. I can drop my weight and I do by myself but I always always always crave sugar and fight my growling tummy. So after I had my baby I immediately got to work on the VSG surgery. Knowing my BMI would be high enough to qualify for surgery. I have the tools cause I have done it for years. But I wanted a little help. And I could never get below 200. So I am hoping to do this with the sleeve tool. But I totally understand what ur saying. I don’t eat keto but I watch all my intakes. And I make healthy choice. I do not eat pasta ( I am Italian and my family looks at me with disgust every family dinner) i never have drank soda or ate chips etc. because of pcos and I know it will pack on me. My hugest weight ever was 336! It was when I was a lot younger before I found out about pcos and insulin resistance. Then I controlled my weight at 240 for years. Got pregnant with baby 3 and decided this is my golden time weight was 275. And I qualified. I am so happy to have this tool to help me.

Sustainability is certainly a key factor in long term success in this game - and I wouldn't be so sure that keto would be any faster, and they often are slower if they do it literally as they tend to run at higher calorie levels (they just lose a bit more water weight at the outset, which they give back at the end when they figure out what they are going to do for the rest of their life,) Likewise, I never did any of those diets but rather maintained a more classical balance of fruits, veg, whole grains, etc. along with the requisite protein, consistent with my caloric budget for weight loss - the same diet that I was on before surgery and now, years post-op, calorically adjusted for maintenance. If I need to drop a bit, dropping the calories around 20% does the trick without any panicky "back to basics" or "reset" diets. Funny thing (not really) is that most of the other post ops in our support group, most of whom are 10-20 years out and maintaining a normal weight range, likewise never got into these extreme low carb diets and seem to be a lot more tolerant of the occasional indulgence or unavoidable junk ingestion than those who did these extreme diets and are always worried about slippery slopes and carb monkeys. A couple of years ago we even had an accidental pizza fest when the restaurant we usually meet at closed without warning and we had to go around the corner to a pizza joint. The doc bought a couple of pizzas, some shared while others ordered sandwiches (heaven forbid!), salads or something else. I ordered a lasagna as that is something that just isn't worth making at home anymore. Yet no one suffered irreperable harm.

I said I was doing a modified Keto diet, and I just wasn't hungry with it. I only had a few very funny happenings. Toward the end of the year, one of the students asked if I was dying as I kept getting smaller. Another thing that happened to me was my stomach was growling all of the time. During state testing when everyone was absolutely quietly working on their tests off would go my stomach for about 2 minutes. They were used to it so they tried to not laugh. When I told them I had to lose weight for health reasons they were very supportive, unusual for middle school students! Good luck!!! I'm now waiting for my insurance approval.

Some of you know I was interested in the IF topic but since I'm only 8 weeks out, it is probably not time for me to try to introduce that. As I am a super slow loser and am very metabolically challenged..I tend to opt for a keto based way of eating. Keeping carbs under 20 grams, etc. Keeping fat isolated to much less than the average 'keto WOL' and staying with the healthier fats. I've been stalled at the same weight for 10 days and I have been exercising during this time. Haven't noticed any new change in the way things fit (looking for non-scale victories, etc.)..and before that it took 2 to 3 weeks to lose 2 lbs. Was aiming for 800 calories or less with protein as highest macro followed by fat and then by carbs. When discussing IF on another thread, I posted what my dr recommended and it is based on 800 calories a day with 40% protein, 30% carbs, and 30% fat. I'm so nervous about changing my diet around, increasing carbs, etc. but at this point, I'm so frustrated with my slow losing pace and my stall, that I figure that I might as well try it. I've lost 32 lbs in 8.5 weeks which probably sounds ok to other slow losers but what bothers me is that in basically the last 3 wks of my 8.5 wk journey, I've lost roughly...2 lbs with the past 10 days at a big fat 0. I was ok with just losing 2 lbs a week..but i feel like my weight loss not only started slowing even more in the past several weeks, but it is now trickling to a standstill and I'm only 8 weeks out. I figured I'd see something like this starting maybe in month 4...definitely not month 2. I've tried to stay positive but that it is becoming harder and harder to do so...

I understand that low ebb feeling. I have lost all motivation to restart a new diet program because I know in the end it's the same things I was doing before and it just didn't work. I also tried really strict keto and exercised a ton, like ran 4K every day, biked to work, lifted super heavy weights for a woman. I also did fasting and actually enjoyed it but it just didn't stick when life got mixed up with my routine. I just can't go through it again with that fear of failure. I need something much more permanent and long-term. A tool I could fall back on when life gets too stressful. Maybe the sleeve will be like a hard stop to overeating and provide a real-time reminder that overeating does not feel good. I hope your appointment with the surgeon goes well! I also have a consultation on October 19th. I'm not sure yet if it will be me trying to convince her or her trying to convince me lol I have a lot of concerns about reflux and want to avoid any revision surgeries. Do you have a set of questions to ask the surgeon?

A list of low carb keto friendly fruits... Berries are your friend! I don't eat fruit except strawberries. I am not a huge fruit person, never have been. I'd rather eat veggies, you can eat large amounts for very few calories. i am not the sweet tooth type, but I like a strawberry now and then.

Hi everyone! I'm now almost eight weeks post op (5 July) and I've lost 15kg. I still find liquid and soft food easier to digest and find foods too rich... basically my body regects food quickly. I haven't come up with a good weight loss story yet, keto seems believable... Anyway nice to have a community xx

Totally the same! I am 5 weeks post op - I can eat so much more than others on this forum! Today, we had a shared lunch at church - I had one large sausage roll (minus the pastry casing), 3 tbsp of tuna pasta salad, 3 tbsp bulgar wheat salad, the full topping of a large slice of veggie pizza and a keto brownie. The worrying thing is... I didn't feel restriction. 😲I only stopped because I felt I should. Does anyone here think that a person's height and frame size has an effect on this?

I'm going closet shopping this weekend to hopefully find something to wear Christmas Eve to church. I'm down to 220.0 and I'm 3 weeks and 3 days post op. Starting weight 246 lbs, surgery weight 237 lbs... Total loss since surgery is also 17 lbs. I've been sticking to Keto diet and have really been craving carbs lately. I'm wondering if anyone else did or is doing keto diet post op and if so, what happens to the weight loss if you go back to a regular diet?

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.

Keto is not a LOW Protein diet. It is high protein, high fat, low carb way of life. I love it! I do however watch my fat and don't do as much as they say too. But I have no cravings for carbs at all. I make all kinds of yummy food (Pinterest Keto) that the whole family loves. Want to see an actual VSG person on Keto, get on youtube and search for "watch kitty shrink" she does nothing but Keto and looks amazing! Good luck!

you're very likely in ketosis. The metallic taste (at the back of the throat and sides of the tongue?) is a result of breaking down and using ketones, the by-product of which is acetyl-CoA and acetate.... dont worry about it it indicates your insulin and blood sugar levels are dropping.. also a good thing. It will resolve through the day then come back periodically. This goes away entirely for most people who enter ketosis and stay there after a few weeks. More info, look up "keto breath"

Hmmm. This is a forum of wls people finding their way to goal in whatever manner works for them and seeking support and sometimes answers from the same pool that they are in. Since there is no way science has mastered the perfect way to do this, the vast experiment continues. I do think there is a lot of crap on here at times with some good advice. When I read about regains, it seems to be caused by our inability to control emotional eating or age-related metabolic changes that science hasn't helped us solve yet. Keto or lower carb plans DO WORK for many obese/formerly obese that regained, it's the not continuing a plan that derails people. There are some successes with moderate plans, but not as many long term wls people use that approach. i fail to see how getting riled up about any of it is productive. I also cannot give advice to any vet that has had a regain and wants to start over - I can encourage them. Since I am sleeved less than a year and in no position to tell a vet what plan works for them, as I am still figuring myself out.

I'm sorry you have to deal with that on top of surgery as well! My periods have become irregular as I have gotten older, so you are now living my fear. With caffeine I had a headache for 3 days when I gave it up, with my keto diets in the past I never got headaches but I heard the keto flu is common and ranges in duration. Whatever it is though, I hope it passes soon. The diet is bad enough without adding pain to the mix. Oh no!! I'm so sorry! That really is horrible to get that close and have to start over. Hugs!

I also start my pre-op diet on the 5th but my 2 weeks are split. The 1st week I can have 1 meal (high protein, low carb ) per day but the second week is only liquids. I also have to keep my calories under 800 per day - yuck. You sound very much like my twin. I have 4 different kinds of premier shakes,5 yummy sounding keto shakes, several different types of broth and canned soups that I can strain, pudding, jello and I'll buy yogurt when it gets closer. I also have a clever fox journal that has spots for pictures and measurements to keep me motivated. I'm as prepared as much as I think I can be. Thinking and preparing keeps me busy and makes the time pass faster. I get more and more nervous the closer it gets, but excited too. Can't wait to have a new me

I just bought some soup mixes from Keto Chow, haven't tried them though. They're high protein and low carb and despite the name, the dry mix is low fat as well.

Sorry for the novel folks, but maybe before getting to tips and tricks, let's talk a bit about what causes plateaus: First, the most common reason for any stall, including the dreaded 3-week stall is simply that you are retaining more water. There are a few reasons this happens, but around the 3-week mark it comes down to the fact that your body is adjusting to a low carb intake after converting from glycogen to ketones for energy. More water is needed to burn glycogen, so you were retaining more water pre-surgery than you are now that you're using primarily ketones for energy. At about the 3-week mark, your body eventually recognizes that the water loss is long term, so other mechanisms have started kicking in to start holding on to more water. This water loss due to the change between glycogen and ketones is the primary reason for "keto flu", and something that increases your risk of dehydration early after surgery. The other "reasons" for plateaus really don't apply as much at the 3 week mark, but will become more important later in the process. Let's cover those too though so you're prepared: As you lose more weight, your overall metabolic rate will slow down. People sometimes think fat is not metabolically active, but that's not true. Less fat means your metabolism slows down, even if you retain the same amount of muscle. As you lose weight, it takes less effort to move, so the amount of calories you burn from activity also drops quite a bit. As you progress, you'll be able to eat more and especially if you're not tracking intake closely by weighing and measuring your food, you can easily be eating a lot more than you think. This one may be TMI for some, but you may simply be retaining more stool. This is going to be hard for some people to hear, but I can tell you one thing it's not, and that's hormones. Yes, various hormonal processes negatively impact weight loss in a myriad of ways, but they don't overcome basic physics: if you eat less than you are burning, you'll lose weight. What these hormones can do if they're out of whack, is not good things like slowing your metabolism, increasing your hunger, screwing with water weight, or even fooling you into thinking you're eating less than you are. So, with all that sciency stuff out of the way, what do we actually do if we're in a stall? Well, I think it depends on when it happens and how long it lasts: If it's early (a.k.a. the 3-week stall), just keep doing what you're doing and you should be fine. I know people don't like that advice, but as I said, it's just water, so don't worry about it. Later on, especially if the stall is lasting longer than 2-3 weeks. that's when I think it's important that you look closely at what you are actually burning, as well as really tracking what you are eating. If you don't know your BMR (Basal Metabolic Rate), you should. The closer you are to goal, the harder it is to get the balance right between intake and output to make sure you're not eating too much, so fixing this starts with knowing your BMR and accurate food logging. There's a lot of anecdotal advice thrown around about "ways to break a stall", but there seems to be little scientific evidence for any of it. Most of it certainly won't hurt to try, e.g. breaking up your routine in terms of diet or exercise, but just understand that this change may or may not have had any impact. If it makes you feel better to be proactive, go for it. Longer term, there is one piece of solid advice that's backed up by lots of research: Even if you don't really like working out, do it anyway. Those WLS patients that make a regular habit of exercising for 45 minutes to an hour most days a week are significantly more likely to reach their goal and maintain the weight loss. (One caveat here: significantly changing your exercise routine can make you retain water and possibly even add muscle, so don't freak out if you see a stall or even a gain.) I'll take that exercise advice one step further and say you really should be doing some form of strength training. This is also backed up by lots of studies, but the great thing about strength training is that it makes your burn more calories even at rest (in other words, it increases your metabolic rate). There are lots of other benefits, but the metabolic benefit is the most germaine to the stall question. Those that do strength training are less likely to stall during weight loss.

My kids and my husband and one friend know. My son told his fiancee. That's it. Too many judgmental people in my life. Everyone has been trying to talk me into doing keto, not knowing I've done the surgery. It bothers me that people are trying to push me into it. Plus I'm so emotional post op. I've lost nearly 30 lbs in a month and a half and I feel like them pushing me means I haven't lost fast enough for them. So if I tell them I've had the surgery what will they think? That I can't do anything right? No thank you. I'll keep it to myself. Sent from my LGL59BL using BariatricPal mobile app

I too thought the balloon was the answer for me...NO! lost about 30 lbs and put it right back on. I had to address my eating addiction first. I have been doing Keto for almost a year and have lost a solid 40 lbs. eating addiction is real!! Good luck, the balloon isn’t the answer and a big waste of money.

Hi all. I was sleeved 4/4/17 and have plateaued and just upset w myself. I do the protein first but maybe not enough water. I don’t know. I would like to figure out my macros and try the keto diet. mi75 or Biloxigirl any suggestions? Please and Thanks

Low carb, high fat Though I do focus more on protein so I'm not sure if it's true-keto. The big thing for me was watching carbs.

I am 52 - 5’9” and weighed 241 when I was sleeved on Nov 14. I wasn’t “huge” but people would have described me as “a bigger lady”. I was wearing size 16 to my mortification. My problem is that have arthritis (not a qualifying cormorbiduty) and my bp kept rising and my cholesterol was not helped by the keto diet I had tried for 2 full years. I’m 11 weeks out and weigh 207. This makes my BMI 30.6. I’m almost overweight and not obese! My bp is in the normal range. My clothes are too big. I was able to buy a well fitting large, rather than XL shirt. I’ve had zero complications. Wish I had done it sooner (you’ll hear this a lot). By the way, the band - man, people are constantly talking about how it slipped, etc. sounds like a nightmare.

I'm not sure the "meeting your deductible or Out of Pocket" expense is part of the actual approval process or its criteria. I started in May 2017 and had to go through the blood panels, exercise evaluation, colonoscopy, psych eval, several consults with a Nutritionist, and get a letter of recommendation from my PCP, two sleep studies for apnea and of course meeting with the surgeon several times. This actually took about six months. I did the sleep study early on because I knew I had severe apnea and needed to be on a BiPap machine for at least 30 days prior to being submitted for approval. On the 3rd and last pre op visit with the doc he told me to lose 10-15 pounds then sent me to his affiliated Nutritionist who set me up with a Keto diet. I failed that because although I was in ketosis many times, I still ate too many calories. I decided to go on the Bariatric Fusion website Liver Reduction Diet. It sucked but I ended up being OK with shakes and homemade chicken stock. I lost 13.5 pounds and at my next doc visit he submitted me to my insurance and I literally was approved within 72 hours. I am in California with Anthem Blue Cross. It's end of year and my OOP will happen to be less than $500. I know it's not what you want to hear but what I'm learning here is if you're self pay, almost anything goes. If you're insured (and their rules vary wildly) we have to be patient and abide by what they tell us to be approved. I've actually taken this time to "try" to reprogram my stubborn mindset into learning another way of thinking about food and my eating habits. This site is an amazing resource and I think the most important take away is that I need to realize my life will forever be changed the moment I come out of the recovery room and I truly need to be committed to a healthier lifestyle. I'm 53 and it's my time. Watch out [emoji8][emoji8][emoji8][emoji8]