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Could I add, there is nothing wrong with having bariatric surgery for cosmetic reasons. Most of us have multiple reasons for doing the surgery because we are complex creatures.

What now? Now that’s the big question. Weight-wise, I’m going to find stabilization and probably put on the 5-10 bounce-back pounds. That’s fine. I’m still seeing a bariatric therapist, and I know to reach out – to friends, family, therapist, work – at signs of trouble. I know I take on too much work, and that’s a problematic pattern I’m still working on. I know I need to find and keep finding ways to truly love myself, because that’s the key to saying no, doing things for me, prioritizing myself. I am excited for where I am, and apprehensive about the next year. This journey has been magical through-and-through, but the compliments will stop, and this will be normal life again. What then? I’ll keep finding out, and I’ll live by the mottos I taught myself to believe when getting my mind in the right place: I have a right to be here. And I can forgive myself for anything. Even regain. Even falling into binge eating. Even losing my job. Even ending up single and lonely. I can forgive myself for anything, and that means I’m not scared of anything. Heck, for me it hopefully means I can face anything and deal with it before it becomes a problem. That’s the most important thing for Year 2. Love to all of you, thanks to each and every one of you for sharing your life with people like me, and keep being awesome!

What I wish they had told me prior to surgery I honestly had no idea how much pain I would be in right after waking up. And due to COVID-19, I wasn’t allowed anyone in the hospital to help me tell the nurses to seriously give me more morphine. I had about half an hour when I seriously wanted to kill myself due to being inflated from surgery and nowhere near covered by pain meds. Yep. It won’t feel like it, but you should get up as soon as you can. I mean that seriously. It lowered my pain from 10 to high 8 immediately. I’ve done rough contact sports, I’ve had my knee cap dislocated, torn my ACL, had a ruptured appendix, broken more bones than I care to count. And nothing compared to this. Other people have barely any pain. And you know what? I do it all again in a heartbeat. The results are that great. Otherwise, I felt pretty well-informed. I called the bariatric team when 1400 cals clearly weren’t enough, and once they heard my loss at that point, they were like ‘yeah you should’ve been on 1800 a month ago, then’. So reach out, they’re there for you. I had some stalls but expected them, talked to my close people about it, and reminded myself not to stress about it. I had a month or so of low blood sugar, but it fixed itself. I get constipated from iron supplements, so I’m actually managing without now that I can eat more (my iron increased from surgery to month 9, which is pretty neat).

My diet and calories – stages + what does a typical day look like after a year? My post-op plan was pretty standard: 1 week of fluids 1 week of puréed 1 week of soft solids and then gradually into solids. It was easy, but I had reached out for help prior to surgery and had family take care of me. I could’ve done it on my own, but I do recommend letting all pride go and simply take as much time off work as you can, ask for all and any help you can from the people around you. You have no idea how willing people are to help. That first month is so crucial to get off to a great start – it’s a long journey – and we deserve it. I had alcohol less than a month after surgery (for NYE) and it was fine. It was OK’ed with my surgeon’s team. I understand this is different for different cultures, but alcohol is a major part of life where I live, and I am done doing unsustainable things. So I had to practice flexible control right off the bat. It works well for me. For me, tracking calories and protein has been crucial I was on: 1400 cals/day for 6 months, then 1800 cals a day for 3 months and then the bariatric team asked me to stop losing and find my balance. Since then, I’ve lost 7-8 lbs as I’m finding my equilibrium. I stopped tracking on weekends, and I still track on weekdays. It’s good to keep that sense of what 2000-2200 calories look like, but it’s also a more long-term sustainable solution for me to not sit at a restaurant and think about whether I go 50 over or under on a Friday. This gets into the mental game, and I’ll cover that below. A typical day now looks like this: Breakfast Protein Oatmeal (around 200 cals) Lunch Meat + mixed salad + a little dressing at work. Small plate. Early afternoon A protein snack, like Quest Protein Chips. Late afternoon Usually some fruit, a slice of protein bread with low-fat cheese. Dinner I’ve grown fond of Thai curries with chicken + cauliflower rice. I truly have no desire for, say, burgers and pizza – it’s too heavy for my system. I repeat: it’s not that I can’t have it, I just don’t really want to. New times indeed. Evening snack(s) I tend to leave 400-600 calories for after dinner (which is easier on 2200 calories, mind you). I unfortunately work a bunch, and this has been the problem in the past – working and snacking all night long. I spend those calories on a smoothie with protein and fruit, and usually a bariatric-friendly treat like sugar-free chocolate, popsicles, or something like that. This keeps the habit of stuffing myself with empty calories somewhat at bay, while also not setting me up for failure by pretending I can go from 7pm to bedtime at 1am without eating. I can’t, so I don’t.

My journey to weight loss surgery We all have our journeys, and I love to talk about mine. I’m not ashamed in the slightest over having a hard-to-work-with metabolism in a world that isn’t made for us. It messed me up, but here I am taking back my life. I’ll keep it fairly brief here, though: I was a chubby kid, had some years in a normal weight range, dieted all the time, yo-yo weight, started working a stressful job and eventually fell into a full-on eating disorder (BED). After receiving treatment for this, I was ready for bariatric surgery, and studied my options intensively. I initially ruled out the sleeve due to the regain rates + GERD. I then wanted RNY because of its ‘tested and verified’ legacy but landed on the MGB for the superior possibility for weight loss, higher chance of keeping the weight off, and for how easy it is to revise or reverse if the need arises later. I have not regretted my choice for a second ever since.

The surgery: what is it, how does it work, what does science say about weight loss and complications with MGB? What is it? There’s nothing ‘mini’ about the MGB. The name was given by Dr. Rutledge who invented it in 1997 to describe its simpler configuration compared to Roux-en-Y gastric bypass. Basically, the stomach is divided and a long, narrow pouch is created (a little like the sleeve), but the rest of the stomach is left in place (like with RNY). A loop of the small intestine is then connected to the pouch, and that’s it. There’s one connection point – one anastomosis – and unlike the sleeve, the food travels directly down into the intestine, as the pyloric valve is bypassed. The bypass is anywhere from 150cm – 350cm (3 to 9 feet), though recently most surgeons do 150cm to avoid malnutrition later on. Here’s a diagram: How does it work? As with all bariatric surgery, there are things we know and things we don’t know. We obviously feel full faster due to the smaller stomach, but because it’s ‘open’ in the bottom to the intestine, and this anastomosis is not especially narrow, we can usually eat pretty large amounts fairly soon after surgery. My personal experience is that I’ve only felt I ‘had no more room’ a few times, and always with minced meat, weirdly enough. The big trick is that you feel satisfied very quickly, because the food lands undigested pretty far down the intestine. It’s like the feeling after a huge Christmas dinner. Technically, I could eat more, but I feel stuffed (and satisfied). So I don’t. We have at least 3-4x the malabsorption of RNY, so there’s some calories being flushed right out. Personally, I can see when I eat a higher-fat meal that some of it goes through undigested (sorry for theTMI). How much do you lose? Unlike what people think, there are tons of studies out there documenting that weight loss is generally greater after MGB than after sleeve and RNY. Not a single study out there shows less weight loss with MGB when comparing MGB and RNY. Excess Weight Loss (EWL) ranges from mid-60s % EWL to the 80s after one year (a few studies show even higher WL, but those are generally from cohorts of fairly low-BMI study populations). All-in-all, weight loss is excellent and looks like it’s long-term durable in the studies. Especially when compared to the sleeve. Complications? For some reason, there’s a ‘feeling’ among American bariatric surgeons that MGB carries a higher risk of stomach cancer. This is not true, and it has been studied. A few patients experience bile reflux, but this is a lesser concern with the Spanish ‘anti-reflux stitch’ most MGB surgeons now use. Mine did as well, and while I suffered heavily from GERD prior to surgery, this is no longer a problem. Long-term, malnutrition is an issue, so take your vitamins. Think of vitamins as being generally a good idea for sleevers, mandatory in the beginning for RNY’ers and then see how your labs develop as the years pass, to very important for MGB, also long-term, and life-or-death for our duodenal switch friends. This reflects the malabsorption – none in sleeve, a little in RNY, a moderate-to-significant amount in MGB, and a lot in DS.

I had my surgery in Mexico. It was literally the best health care experience I've ever had. I researched the hell out of it and chose an excellent doctor and hospital. The doctor was trained and certified in the US, and had excellent success rates. If it's a quality hospital and up-to-date surgeon, they use the same medical practices as they do in the US. But because labor is so much cheaper there, the nurses hover over you and take such good care of you. I did have one issue when I had an allergic reaction to a medication and we had trouble explaining what was going on to the nurse, but then they went and got one of the doctors that spoke better english. I'm absolutely sure that your friend has your best interests at heart. But she may not be well informed about this subject. Lots of people think bariatric surgery is a bad idea no matter who you are and where you do it. My mom was definitely worried when I told her I wanted to do it. But she talked to my sister-in-law, who is an endocrinologist, and told her "oh yeah, bariatric surgery works, it will add 10 years to her life." And surgery in Mexico sure sounds shady. But there's crappy surgeons in the US too. No matter where you are getting surgery, you should research the hell out of it and choose someone who you trust. My mom was nervous about it, but she also went with me and helped me communicate. I was very happy to have her along since you often feel pretty bad right afterwards. There's nothing wrong with re-evaluating your plan and making sure you're comfortable with your choices. But there's basically a 100% chance that someone who loves and cares about you will think its the wrong decision. That doesn't mean you shouldn't do it. In the end, it's your choice, not theirs. You're the one who is living in your body, you're the one who knows best what you need, and you're the one who looked into this and got the information and made the decision. That's how it should be.

Oh yes, I was ravenous until I got on semi-solid food like eggs and cottage cheese. Personally, I attributed that to getting more protein. I really did not like the taste of protein shakes, and even though I was choking them down, I don't think I was getting as much protein as my body needed. But also, solid food makes you feel more "full" than fluids, no matter what their nutritional content. Studies of gastric emptying show that fluids leave your stomach much faster than solids, even if they have the same calories. (Water goes through your stomach even quicker than liquid food.) Once you start eating solid food, the fact that your stomach is smaller will really start fully working. Bariatric surgery doesn't just work because you can't eat as much. It also changes your hormones. Ghrelin is called the "hunger hormone" and your stomach makes it when it is empty. You make less of it after bariatric surgery because you have a smaller stomach. But you also make less of it when your stomach spends more time feeling full.

Just don't take your Calcium citrate with your daily vitamins. If you are prescribed 1500 mg Calcium citrate, it should be taken 500 mg at a time. I take m daily vitamins (Bariatric Pal One-a-Day) in the morning, and my Calcium citrate at lunch, mid-afternoon, and at supper. I have my vitamins & supplements in a basket on my vanity so I see them when I brush my teeth and get ready for the day, so morning works for me. However, I think you could reverse the order with no harm.

Inspiring! I do aquatic cardio workouts 5 hours a week now pre-surgery. As soon as I'm cleared post-surgery for weight lifting, I'm going to get a personal trainer at the YMCA and begin strength training. My bariatric clinic includes sessions with a personal trainer, but the affiliated gym is 75 miles away so the local YMCA is where I'll go. I think that shrinking my excess skin is probably hopeless, but I'm going to do as much as I can before considering plastic surgery.

Amy, why not just bite the bullet and learn how to cook? For the sake of your own health and that of your also overweight husband... Many recipes are very simple. My brother insisted he couldn't cook until he was retired and how he's producing beautifully plated simple gourmet meals. It can be done! Here is one more cookbook which may be less daunting than the others I suggested (not that those recipes were terribly difficult either): The Easy 5-Ingredient Bariatric Cookbook, "100 post surgery recipes for lifelong health", by Megan Wolf. Most of the recipes can be made in 15-20 minutes. Both you and your husband can eat the same meals; you don't have to fix separate things for him. It wouldn't hurt to engage him in the cooking process, too!

200 oz of fluids is insane. That can't be good for you. Most bariatric clinics ask you to drink 48-64 oz per day, which includes your shakes and bullion. Did they tell you to drink that much? If not, take tiny sips to swirl around your mouth for your cotton mouth, rather than gulping down more water. Are you simply not pooping or do you feel like there is feces that you are utable to pass? You don't have much fiber in your diet while on the liquid diet so you may not need to poop as often. Miralax, Senocot, Milk of Magnesia, and Colase are other products that help with constipation. Have you consulted with your clinic about this?

That's a very good point, I never thought about a stall! It could well be that indeed. I will see my loss next week and if it isn't anything brilliant I will inform my bariatric team that I successfully did the 2 week period but didn't have a big loss. I suspect the actual pre-surgery one will be more liquids than solid meals, so that might have more of a success. I have downloaded a UK-based calorie counter to make my life a bit easier so I can track things better too. Fingers crossed! Honestly thank you so much, I find it hard to lose weight because of my PCOS so I should give myself more credit than I do. Congrats on your 36 pounds! I hope you hit that target weight! X

Hi @xKirstenx , I was loosing weight with “normal” food, not shakes before the pre-op diet. I lost 73lb, 33 kg. I lost nothing during the pre-op diet! So, don’t beat yourself up about the shake stage. Talk with your dietitian. We found the shakes had too much carb for me. That’s just me. I agree with gabbykittyvsg about protein. My usual real food, before and after surgery consists of 60-90 grams of protein per day. I suggest checking in with your bariatric center to review your personal nutrition plan because each person has a different protein/carb/fat goal based upon your gender, height, and build. And congratulations on your big loosing successes!

Hi there! I hope some of you could enlighten me. I am potentially having surgery next year, and my bariatric nurse recommended I do the Liver Shrinkage DIet for 2 weeks to add favour to my referral to the surgeons. I am 9 days in and I have only lost 0.6kg (just over 1 pound). Prior to this, I was eating "normally"-carbs, and treats when appropriate as part of a normal lifestyle and I was losing around 2-3pounds a week (just under 1kg). I feel really deflated and feel like I won't hit my weight loss for the surgery referral, and that this diet is just not working. I've read other forums, and people have said they're losing 21 pounds in 2 weeks! I really don't understand why I'm losing LESS than I do on a normal diet. Typical intake: -Breakfast: 2 pieces of fruit or meal replacement shake -Lunch: Soup with a side of poached egg or a piece of fruit. -Dinner: Salad (Lettuce, cucumber, onion and spring onions. Small amount of added vinegar and light salad cream) with some protein of choice eg chicken, ham, beef etc. -Drinks: Water, diet Pepsi (one a day) and 1-2 cups of tea with sweetener and milk. All of these are done to the portion recommendations, and free foods and allowances. Please note I am using Orlistat every day and have been for the past half a year. Hope someone can relieve some imposter syndrome! TIA x

I’m on the same boat Rachel. I had the sleeve in 2013. Dropped 100 pounds but have gained 65 back. I want to look into a revision. My job has open enrollment and there’s a plan that covers bariatric surgery.

I've been video-conferencing weekly with a highly recommended counselor who specializes in eating disorders @$115/hour. However, while she is both a dietitian and a counselor she usually works with bulimics, anorexics, or bingers. I don't have those problems. The first few sessions were frustrating because she kept up her usual spiel directed to those forms of disordered eating. I gave her a list of reference books before our first session, but it was obvious she had not read any of them. I had to educate her on food addiction, bariatric surgery, and my experience with my own wonky metabolism. I sought a counselor because I've gone off the rails a few times while pre-op when confronted with some really delectable food in front of me that I could not resist--namely coffee cake, strudel, pizza, Irish soda bread. As soon as I ate them my sugar/flour addiction was triggered and it took weeks to get over withdrawal again and to get back on track with my pre-op food plan. I don't want to do that after surgery so I was looking for tips and tricks for avoidance of temptation. Well, I'm not getting that type of advice. However, I am getting nutritional/dietetic information that I have not gotten from my clinic's nutritionists. I'll keep talking to her for the next two weeks because my RNY-RNY revision is just 17 days away. I'll wait and see post-surgery. The honeymoon period won't be difficult to me. The problem will arise once I'm eating "real food" again. Good luck finding a compatible counselor at a reasonable session cost.

Hey guys! I have looked into bariatric therapy and so far the only place I’ve found in my city does not take insurance and cost over $250 a session! Gulp! I’ve adjust my search to exclude the words “bariatric” and include “disordered eating, behavioral therapy”, to hopefully find one that does take insurance. I’m really curious for those that have (and/or continue to) use therapy, what are some main take away? General advice? I’m not suggestions this thread/forum could replace therapy, being that it’s very subjective, but maybe if you could share some basic lessons you’ve learned at therapy or homework they’ve assigned?

I loathe taking my vitamins. I’m a month out. I’ve found if I eat a couple spoon fulls of sugar free pudding right after i swallow, it helps weigh it down. After I have the pills in my mouth and the water, i lean my head back dramatically and tap on my throat to center the pills…. I’m sure I look REAL crazy. I also stand there a while convincing myself not to to throw up and I sorta pat my belly to get burps out, hahahaha. This is everyday, every time. I couldn’t stomach the bariatric advantage chew or calcium chews. So now I’m taking a centrum womens and a target brand calcium that I can swallow. I have an iron I’m to take every other day. A sublingual b-12 once a week. And a high dose thiamin every day, because I was deficient.

Hi! I had my surgery on the 26th of November. I'm so happy to find you guys! I'm from Argentina, and bariatric surgery is pretty new here. I'd love any advice you have ♥️

I found my nutritionist’s pre-op notes and read the following unflavored powders: 1) Designer Whey Isolate (contains 1g added sugar…deal breaker?) 2) Optimum Nutrition Gold Standard (1g added sugar) 3) Inspire Bariatric: 24g scoop, 92 calories, 20g protein, at $2.10 per serving (expensive) 4) Syntrax Nectar Unflavored Whey Protein Isolate: Calculated to compare to others, 22g scoop, 20g protein, at $1.02 per serving (reasonable) Has anyone tried Syntrax Nectar Unflavored? Taste, smell, texture? Thanks!

I'm 5'6.5" According to the CDC, as my NP stated yesterday, I'm not underweight until my BMI falls under 18 or 19. But According to bariatric standards, I'm on the low weight side and my ideal weight should be 63kg and I'm 60.something kg.so, they said some people don't lose weight, some a little, some a lot and some they have to intervene to stop it. This, I'm now terrified of. I know where I've been, I don't want that and I know what it took to get me where I am now and it was hard. Good luck with your surgery. When are you scheduled?

I don't have access to a therapist any longer. Nor a dietician..I saw the dietician once, during month 1 pre surgery and the therapist like 3x pre surgery. It's like it's been a DIY on your own type situation. At one point, around 8 months pist surgery, my team was like "you're eating too much" or "you're not losing enough" and now I'm losing too much but yet they say in the same breath "it's not your fault, it just happens ". I'm waiting for my plastic surgeon to contact me back with details on how much was removed so I can report that back to my team as they want to see how it correlates with the weightloss. Also, the abdominal tightness pist abdominoplasty and having to wear a binder for 24/7 for 2 months due to swelling makes you feel like you can barely eat..even when you take it off to eat...they say this feeling will go away in a few months. But it makes you feel like you did coming out of bariatric surgery...no room to eat 2 oz. So, we shall see what happens. I can only do what I can do and hope for the best. Right?

There are lots of recipes online for the pureed stage if you use google search. There are also many bariatric cookbooks available that cover all stages from home-made protein shakes, soft, pureed, and "normal" food. Here are some of the cookbooks I've accumulated.

I got my lapband in 2012 and got down to 206 from a high of 293. When I complained about my horrendous reflux the doctor took the fluid out of the band. The reflux eased up but I put on 50 pounds very quickly. I am in the process of qualifying for revision surgery. Federal BCBS requires the whole program again to qualify for the revision to bypass. In my case the revision is totally considered bariatric surgery.