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First off I gained 5 lbs this week. Not lost. Gained. :tounge_smile: Medications - Up until last Saturday I had been talking the following medications. Benicar - Blood pressure medication Antenolol - Blood pressure medication Furosemide - Heavy diuretic (water pill) Klor-con - Potassium pill (counter balance to the furosemide) It's great that I am able to go off these medications now and that my blood pressure is doing so well. My blood pressure reads on a continual basis to be in the middle of the normal blood pressure range. With my legs over the last week I have had a minuet amount of swelling not the measurable amount that I had in the past. I also have not worn the compression socks that I have so I will wear those over the next week and see if that makes a measurable difference. What I am not sure about is going off the Furosemide. I know that some of the weight I gained this week is water weight but I just don't know how much of that is. It's something I have to work through. Exercise - I have to say this has been a decent week for exercise. Of course walking every evening after work but also I have been good also in getting out at lunch time to walk. It feels great to know that I am pushing myself harder with this but I can tell that I still need more. I am going to have to add some additional exercises to my daily program to continue my weight loss. Food - I have made some bad food choices this week. There has been a couple of times that I snacked on stuff I shouldn't have and I know that I am eating more then I should. This has to change and is changing starting today. I can tell that I need a fill and I do have a scheduled fill on the 26th. I just wish it was sooner to help me with this hunger that I have been getting. I have to be strong once again and have the will to keep working at the weight loss. I am so close to breaking that 400 lbs mark and continue on down. Overall - Overall this week is a wash to me. Off medications and doing good with walking but bad food choices resulting in a weight gain. I have to really step it up more this next week. I have had a steady weight loss since the middle of October. In the middle of October I weighed 465 lbs and today I weigh 415 lbs. So yes that is a total of 50 lbs since then and since my highest weight in January of 2008 I have lost a total of 70 lbs but I have a lot more to go and need to keep focus on what it is I am doing. I guess this is my two steps forward and one step back week. Now get moving forward and don't let this discourage me is what I have to do now.

I Have a BMI of 45. I cant believe this has happened again ( the weight gain). Behavioral & spiritual methods have worked, for a while. I'm on the presurgical diet from north Fl surgeons. Surgery is scheduled for 2weeks. I'm hopeful & nervous. I'm on the liquid protein drink/bar 4 a day plus a broiled chicken breast, or tuna without mayo. My first day today. I'm doing this for 2 weeks for the sake of a safe surgery. Thats what they tell me. Im trying to think positive, but I find myself crying a little bit. Positive Positive. I'll make it through. Can someone respond w/ inspiring words, or not. A response would be helpful to me. Thanks. :crying:

You guys I am kind of afraid. I think im going to loose weight and gain it right back. I have suffered with weight gain all my life. Skinnt one day and overweight the next. I can't wait until Tuesday!?!?!

This is supported by other threads here but so well said. Basically it says, your gut microbes control your hunger for their own good, but not necessarily yours. http://www.medscape.com/viewarticle/831069?src=wnl_edit_tpal&uac=204266DY I don't remember if I needed to join this free medical research site or not to see this file... I love this site and get lots of interesting research results from several areas of interest.. including weight gain and WL surgery....

I have done quite a bit of research on this topic, because it was the biggest worry deciding to go with the sleeve! YES! your stomach and "Relax" or "Stretch" to some degree but never to its original size. The stomach you have remaining is mostly muscle, and the strchy part is what was removed, so it will be much more difficult for it to stretch than before. I think my big worry is Slider foods, and I think that attributes to weight gain for many. But overall, I know that I have to cherish and protect my little sleeve I want it to serve me as long and as well as it can!

I can't make a decision for you, but I can shed some light on my thought process as I had the same thoughts and fears you did. I went around and around with this for more than two years. I was really scared of the small, but real possibility that something could go wrong. I have two children and a husband who is disabled with muscular dystrophy. He is completely dependent on me for all things. While he is a wonderful husband and father, he cannot drive the kids around to their activities, or get himself to their stuff. If something happened to me, it would be devastating to my family beyond just the loss of a mother. I was 272 lbs when I finally made my decision. I had no other co morbitities other than some mild sleep apnea. But the reality is, the chances of my having a heart attack, or developing diabetes and all the complications that go with it are much higher than 1%!! Then where would I be, and where would that leave them? I was only living half my life....if even that. I tried doing it on my own, but the reality has always been, I would have some success and then gain it all back plus an extra ten pounds for good measure. I finally decided enough was enough. I did my research, found a really good surgeon who has logged several hundred of the proceedure I was doing. It was time to give my trust to GOD, the surgeon and his team. I figured if it was my time, then it would be my time one way or another regardless if I went through the surgery or not. I was part of the 99.9% where everything goes right. I have read the posts of people who have had terrible complications. My heart goes out to them. I also see how that can really scare someone who is still deciding. But, now that I have done this and taken the chance, I am so happy that I did. I have undone over 15 years of weight gain in just three months. I am finally eating healthy and feeding my family healthy and enjoying it. I still have just a little under half way to go, but I now know it is doable! I have so much more energy for my family and feel like I am living life again. Yes, there is some risk, but it is a calculated and small risk to take, with huge gains on the other side.

Sounds as though this would be an expensive way to go. A bit like doing "lite n easy" or one of those other programs. I think it is important that we learn to cook nutritious, band friendly meals for ourselves. I'm not saying you are one of them but I know there are a lot of people that don't cook at all and I think in many instances this can be a contributing factor to weight gain. I like,as far as possible, to eat the same as the rest of my family. I don't want to be different. Occasionally however there is nothing wrong with using a service like this. Its also good to be able to have some healthy prepared meals in the freezer for when you don't have time to cook.

There are many examples of when self-sabotaging behavior around food continues after Weight Loss Surgery. It seems that the more people who commit to surgery without fully resolving their emotional reasons for bingeing, compulsive sugar cravings, zoned out or mindless grazing, and disordered eating in general then the more people who post-WLS will continue to struggle with emotional eating. Weight loss that stalls, plateaus or ends in a person gaining back more weight than they originally lost are all forms of yo-yo dieting. This see-saw pattern of weight loss versus weight gain can go on for years. It is never about being greedy, and never about a lack of willpower. It is, however, a repetitive cycle of behavior of the emotional eater who self-sabotages their weight loss success due to a number of key habitual, responses many of which exist below conscious awareness. There are many examples of when self-sabotaging behavior around food continues after WLS. It seems that the more people who commit to surgery without fully resolving their emotional reasons for bingeing, compulsive sugar cravings, zoned out or mindless grazing, and disordered eating in general then the more people who post-WLS will continue to struggle with emotional eating. Therapists Sally Baker and Liz Hogon specialize in resolving emotional eating. They see a growing number of clients post-WLS in their individual practices in London, England and Melbourne, Australia. Endless over thinking about food, and a whole range of compulsive behaviors can continue after surgery. Even the feelings of dissatisfaction about amount of weight lost post-WLS is just an aspect of the negative self-belief that can dominate the thought processes and feelings of someone in the grip of emotional eating. Changes can take place, and belief systems that no longer serve a person can be released and replaced with a more positive, and helpful framework. Sally and Liz have found from their work that as many of the emotional drivers, and reasons for carrying excess weight in the first place are below conscious awareness then that is where the therapy work needs to happen for change to really embed and be sustained.

Thank you- and everyone who posted here. Yes, I had back surgery also in 2004- which started my bigger weight gain. I will have my shot on Thursday and I am determined that it work

I would go back in for a slight unfill. Being too tight actually leads to weight gain because you're reduced to eating slider foods and drinking your calories so it's definitely not in your best interest. On a side note- if you're expecting "magic" or even weight loss from a fill, you're going to be very disappointed. The band is just a tool and fills don't result in weight loss. Weight loss happens when you're burning more calories than you're consuming, so even with the band, you still have to work for the weight loss. This link may help you have more realistic expectations from the band: http://drsimpson.net/fills/Lap-band-eating/lap-band-not-restriction/lap-band-and-restriction.html Best wishes.

I loved my nuvaring. No side effects. Insertion was a bit intimidating, but the pill made me very very sick. I had no weight gain, didn't have to remember to take a pill, and could make it so I didn't have a period every months. I totally recommend it.

I gained almost 20lbs during the 6 mo of insurance required weigh-ins. It wasn’t intentional but the weight gain took me from 38-40 BMI and insurance approved a sleeve.

@ - I kinds hit one monthly. I am 52 and entering the big "M" and have started skipping but I still have symptoms and some mild weight gain every month - to me as a long time dieter - it is the norm:)

I should know this, but can't remember. I had an open hernia repair last Wednesday. The day before surgery I weighed 201. Today I weighed 210. There is NO WAY I could have gained. I'm eating a lot less post surgery. Grant it, I'm not moving much, but this is depressing. This was my second open surgery since February 5 of this year. This is beginning to take a mental and physical toll on this old gal.

I have been having anxiety about gaining weight. I would be fine if I stayed where I'm at. I'm a size 8. But I even have bad dreams about gaining it all back. I think it's because all my other attempts have failed at weightloss. Is anyone else having these same dreams/ anxiety/ fears???

The thing about people that had surgeries is they dont seem to realize they still have the porcedure in place and they can again follow the rules and lose weight....maybe with a good therapist,but I believe it is possible.All that the weight gain means is that you are practicing the old habits of your before surgery days. Still,I pray I never lose control to the point of allowing myself to gain that much before I catch myself and stop myself.I am reall praying that. xxo

I am NOT telling my boss.......... HE FREAKED when I took time off for my consult and kept asking me if I had an interview.... so when I told him I needed time off for appointments (tomorrow and next MOnday) he looked at me cockeyed (thinking I had 2nd and 3rd interviews) so I broke down and told him that I was meeting with a nutritionist.. (NOT telling him about the psych) OMG... it has been nonstop talking about NUTRITION!!! and my latest weight gain..... We are in a small department with adjoining offices so our only coworkers are each other.. he is 60+ and he truly thinks of me as a daughter..... HE IS NOT SUBTLE and basically a loveable pain in the ass..... I am taking PTO days to cover my time. I have told exactly ONE person here because she is a good friend, but I'm already regretting that one too. because she is now making excuses why SHE CANT DO IT.... (I told her today... HEY its not for everyone, but it IS FOR ME, I'm not trying to talk you into it) Good luck with whatever you decide.............. (OH and I will most likely tell people freely AFTER I have lost weight.. because I am HR and I truly want people to know they have the option with our insurance)

I think all of us can understand your fear but consider the fact that at three weeks post-op, you really don't have any basis for assuming anything. A minor weight gain following the surgery is quite common and doesn't mean a thing. So - perhaps the best thing you can do is take a deep breath and really focus on trying to relax and setting your fears aside. Trust the process. Allow your body to find its own way in its own time. Consider focusing all of that energy on continuing to follow the protocol as closely to the letter as you can possibly can. Stay active - even if it's only walking short distances. Drink as much Water as you can. Get as much of your doctor's recommended Protein as you can - protein is crucial for healing and you're doing a lot of healing right now. And I know you don't want to hear it but ... stay away from the scales for at least a week and two would be even better! Instead of being a slave to the scales - consider becoming a slave to a food log. Now is the perfect time to start (if you haven't already). I've been logging for almost two years and the single biggest benefit from a long list of benefits is - peace of mind. Regardless of what the scales tell me, if I KNOW (not think, know) that I'm meeting my calorie goals and eating healthy, the rest will take care of itself. You're gonna love the new you!!

After my battle with my insurance company, I was approved. Initially I was told that because I had given birth to twins in the last year, that more than likely that was where my weight gain came from. After they recieved my medical records they saw that I was infact pounds smaller after the birth of my daughters. I had this surgery to improve my health, I have horrible cycles, high blood pressure, sleep apnea, and I'm just out of shape. I need to be in good health to take care of my daughters. It has been a struggle for me. The pre-op two weeks diet, i did in moderation, i kicked candy and sodas but i backslide on small portions of food. After surgery on the 28th, i'm scared but a burger sure sounds good. I can not wait to lose this hunger feeling. the only thing keeping me going is the fact that i went through so many doctor visits to get here to screw it all up and I dont want to make myself sick. I'm struggling! I hate the protein drinks! can't drink no more than two, bare drank one today and that was because i put it in coffee. I'm dying for some grits or potatoes. My head hurts alot. taking multi-vit. drinking some water, not really thirsty. I have gas moments and it feels so good to burp. No bowel movement yet. I have consumed a few oz. of chicken broth over the last few days. Any advice?:smile:

I'm up 2 lbs this week. I'm 10 weeks out and went up 2 lbs this week. I never believed stressed caused weight gain but I think so. I'm averaging no more than 700 cal a day between 50-70g of Proteins I do struggle with Water its just the timing things out that screws me up. My carbs. have only been over 30 a couple of times but I've been going through some crap. I just wish I would've waited to have the surgery. I did post before the surgery with second thoughts and wanting to cancel because the family wasnt very supportive. Well now I really wished I waited. I'm 21/2 months out was down 31 lbs now 29 and i'm stressing about only having 6-8 months of restriction. I stalled for 2 weeks now up 2. This is crazy I've been working out running walking cardiovascular weights everything. Anyone go through stress and still loose.

What r d problems of weight gaining post gastric sleeve...

Im 7 weeks today and have lost 30 lbs since surgery. From last Wednesday to today I have lost a total off 1.1 lbs. however from Sunday to today I have gained .7 lb. what's the deal. I'm getting between 500-600 cal., 60 grm, Protein, less than 20 gram carb, less than 10 gram sugar, and around 32 oz of Water....before you sayit. I struggle with my water. Help is this normal

I'm 2 months post-op. Lost 35lbs since surgery and 40 on my own. Two weeks ago, oh happy day, family doc took me off Metformin(diabetes). Also had my first fill that day. I have a bad habit of weighing everyday. So imagine my surprise when one day I gained a pound. Didn't panic, probably just Water weight. Well 2 days after that I was up a total of 3lbs. I am doing everything by the book. Weighing and measuring. 800 to 1,000 calories a meal. Getting all my water and Protein. Exercise 5 days a week. Cardio and weights. The only thing different is I'm of the metformin. Talked to my nurse. She said this could be the culprit and not weigh and not to worry. Well I am worried. I went so far as to have my husband hide the scale. I thought being taken off the medication was a good thing. I'll get it figured out. My question: has anyone else had this problem?

BE ENCOURAGED! I agree, your stress does not help your weight-loss. You are losing weight!!! This is not the biggest loser...we are not always gonna pull double digit losses every week. If you do great and if you don't don't let that determine the success for this journey. You have made a decision to take back your life! That is great! My dad who always had a snide remark about my weight told me after returning home from surgery that he was proud of me. I could not believe it. I believe your mom will be too. Don't stress yourself unnecessarily. Just because mom paid does not mean it is her journey. It is yours. You did it for you and no one else. Remember that this is a tool to weight-loss. It is not the magic pill. While the surgery deals with the amount of food that affects our weight we must begin to deal with the emotional and other causes that effect our weight gain. In the meanwhile BE ENCOURAGED by the new choices, achievements and all the possibilities! Remember how you felt while preparing for the surgery? Remember that excitement??! Go back to those moments and enjoy the possibilities! Dream of them! Get rid of the scale!!!!!! Get rid of the scale!!!! You are doing a great job!!!

I am 41 years old, married to a wonderful man, and the mother of two young adult children. I hope that my Lap Band story will inspire others whose lives – like mine - have been disrupted by serious weight gain... and then restored. I am the happiest person now: happy with my body, grateful for the opportunity I took to change my life, and excited about life each and every day. I went from 254 pounds to 137 and will soon reach my goal of 130. It's still unbelievable to me to have the life back that I thought I'd never have again. I wasn't always obese and drained of energy and self-confidence. Years ago, I weighed a fairly steady 145 pounds and had an hourglass figure. At 5' 6", I was slim on top and carried more weight in my hips, but I was well within the range of normal and I led an active life. I was in good shape, working out 5 or 6 times a week and I'm an OB/Gyn Medical Assistant, so that means being on my feet all day long. I was also disciplined and consistent in my eating and exercising habits and all together, that was enough to keep myself looking fit over the years. During my first pregnancy, I continued to eat well and exercise regularly. I gained a very typical 35 pounds, and lost it all in six months by simply eating well and resuming my usual workout routine. I felt good about that and just went back to living my normal life. My problems began during my second pregnancy when I suddenly developed dangerously high blood pressure and toxemia. I was given steroid injections, and had to be hospitalized twice for high blood pressure. At 28 weeks, I was put on complete bed rest and, at 33 weeks, underwent an emergency C-section. I was very fortunate to survive and to bring a healthy baby girl into the world, because I was close to having a stroke when they took her. The doctors said that either one of us could have died due to the severity of my medical condition. My metabolism was completely different after that. I had gained 80 pounds during the pregnancy and weeks of bed rest and I couldn't get the weight off after my daughter was born no matter how hard I tried. And I tried everything: Jenny Craig, NutriSystem, and many other diet and exercise plans. The fact is that I had a new body, and I didn't know how to make it do what it used to do. My weight gain was steady and terrifying, despite my best efforts, and it got to the point where I hated looking at myself in the mirror. During the years that followed, I kept trying to get into shape. I exercised, I did MediFast shakes, and I continued trying new diets but nothing worked. I would lose 40 pounds and it would come right back on, and I wasn't a junk food eater. You can imagine how frustrating it was: no matter how careful I was, no matter how hard I worked out, nothing changed. I just kept gaining weight and it was heart wrenching. I cried so much, and endured criticism from certain people who said, "Gosh, you were so slender before. Why can't you lose the weight?" They just didn't understand. I thought I'd always be like that: fat, with no energy, and deeply unhappy. On the outside, I put up a good front and people were always telling me, "You look so happy!" That's because I kept my feelings inside, but I literally felt uncomfortable in my own skin. In the meanwhile, my oldest daughter was grappling with a weight problem herself, something she likely inherited from her father's side of the family. She started going online and exploring gastric bypass surgery. I understood how she felt and thought if she wants to do something about this, it's important and I'm going to help her any way I can because I know how she feels. I attended one of Dr. Haiavy's seminars on lap band surgery not long after that to see if it might help my daughter. After the seminar, I decided to make an appointment for her to consult with him and it occurred to me that maybe I should get one myself. So, I made appointments for both of us. That was the real turning point, when I began to have hope. I found out that it wasn't me – I actually had a metabolic problem. During my consultation, it turned out that my daughter wasn't overweight enough to qualify for the procedure, which is reserved for those who are significantly overweight. During my own consultation with Dr. Haiavy, we went over my health history and pregnancies. He told me that my metabolic system had been altered by the second pregnancy, and wasn't functioning normally. He also confirmed my belief that even if I lost weight, it would come back. I was so relieved! He was putting words to my experience, and validating what I had been through. Now that I knew what the problem was, I could focus on finding a solution. I decided that I wanted to undergo the lap band surgery. I felt absolutely clear about the decision, despite the changes I would have to make in my lifestyle afterwards. Dr. Haiavy told me all about the procedure and the pros and cons, and answered my questions. He also referred me to a dietician for a consultation. Then I waited for about a month until my insurance company determined that they would approve the surgery. During the consultations, I learned what I would and wouldn't be able to eat following lap band surgery, and which Vitamins I would have to take for the rest of my life to make up for what I wouldn't be able to absorb. I learned that bariatric patients have to take chewable vitamins at much higher dosage levels than regular Multivitamins in order to get enough nutrition. I take Bariatric Advantage, which is packed with B6, B12, Calcium, zinc, vitamins E, D, A, K, and so on. I was excited the day of the surgery and it went well. Going in, being prepped, talking to Dr. Haiavy, and having the procedure done in Dr. Haiavy's surgical center...it was quick and I wasn't nervous. It only took about an hour and a few hours later I was able to go home. The recovery process was surprisingly quick and uneventful. I was definitely sore and stayed down for two days, but I only missed three days of work since I scheduled before the weekend. I was on a liquid diet – including Jell-O, broth, and a little yogurt. I was definitely tired that first week back to work, but I got through it and after that I felt fine. The eating reality after lap band surgery requires a change in lifestyle and there's no getting around it. You can only eat 3 or four ounces of food at a time, a tablespoon of this and a tablespoon of that because that's all your stomach can hold at any given time. It was strange at first. I tended to over-serve myself, proving the saying that your eyes (and brain) are bigger than your stomach! You think you can eat more, because your brain says you can, and it has to adjust to your new physical reality. I started using a baby spoon to make sure I didn't take big bites of food, and I still use one because it works. There are foods you can't have, such as rice, Pasta, bread, and French fries, but I don't mind the diet change for the most part. It's a little tougher if I'm in a restaurant. I have to be very careful and I usually order fish, mashed potatoes, and a vegetable – eating a little, and taking the rest home for a meal the next day. It sounds like a big sacrifice, but the bottom line is that I wanted to be at a normal weight more than anything and it's well worth it. It takes awhile to adapt, because you have to eat consciously and carefully. It took a few months for me to make all the adjustments, but I got used to it. Then the weight just falls off! I had my surgery in June of 2009 and lost 10 pounds the first week, then four additional pounds during the next month. It didn't seem like enough at the time, but Dr. Haiavy had told me I would need to be patient and that weight loss happens differently for each person. The band itself has to be adjusted properly and it takes awhile to figure that out. Well, he was right. I lost another 15 pounds, then another 12, and then the rest of it followed. I went from 256 pounds to 138 (my goal weight is 135) and it it's just been amazing. The interesting thing is that I used to be too thin on top and somewhat bottom-heavy, but when I lost all the weight, my body changed. My weight actually redistributed itself and now my body is more balanced – top and bottom – and it looks better than it ever did before. I'm completely proportioned now. I did so well that Dr. Haiavy invited me to come to a seminar he was having for other doctors, to share my experience, and I agreed. When his office manager saw me, she couldn't believe the change in me! She said, "You look amazing!" and that made me feel so good. The doctors had the same reaction, because I didn't look like I'd lost a lot of weight. I just looked normal, as if I'd never been fat. It was a wonderful experience for me. I exercised consistently during the months I was losing and it made a big difference. I found a cheap exercise bike I liked it because it had a feature that enabled me to move my arms while I pedaled, and I was on that bike 5 days a week, 45 minutes at a time. I also used ankle weights on my arms and circled them around to tone my upper arms, but I didn't do any weight lifting or other kinds of exercise. I just stayed with it. The transformation from Size 22 to Size 4. A funny thing happened during that time. I had no clothing that fit me, so I went to a department store and found, to my delight, that I could fit into a size 14 pair of jeans. I was thrilled! A month later, I went back and fit (snugly) into size 12. I thought, 'Well, I can't keep going in and buying jeans I only wear for a few weeks before they don't fit,' but less than a month later, I was back at the store again and it was size 10, then 8, then 6...and finally Size 4. Incredible! I never imagined I could be a Size 4 person, but I am. My life now: words can't express it. I still bike and I like to take walks in the hills around my home. Of course, I work on my feet too so I get plenty of exercise. My cholesterol levels are great and my blood pressure was 112 over 70 the last time it was checked. And I continue to wear Size 4. I'm so happy... and before I was crying on the inside all the time. My husband has been incredibly supportive all along and didn't know how unhappy I was. Now sometimes I glance at myself in the mirror and say, "Oh, my gosh! It's me!" The feeling is...well words just can't express it. I'm so happy with who I am now, and with the way that I look and the amount of energy I have. Every time I get an invitation in the mail for a social gathering, I say, "Oh, RSVP...I'm going!" My daughter was able to have the lap band procedure done two weeks before I had mine. She's also 5' 3" tall and she went from 254 pounds to 137 pounds, on her way to her weight goal of 130. We can wear jeans, little summer dresses, and shorts, and it's so much fun to shop for clothing now. Recently, I went to a wedding and recalled how awful it was for me - to be so heavy and to dread having to go to events where I had to find something nice to wear. This time, it was like a celebration, and I found the most beautiful dress. Having lap band surgery is not a cop out and it's not the easy way out. I'm often asked, "Why was the lap band surgery so successful for you?" Well, the answer is simple: I was compliant. Some people have the surgery and they're looking for a miracle, but they don't want to do the work it takes to get the best long-term results. But I knew I had to do the work. My doctor told me, "it's 40% surgery and 60% the patient." I took that to heart. You have to eat right, you have to exercise, and you have to make these changes permanent. I never miss an appointment with my doctor. I eat what I was supposed to eat and I learned quickly that you really have to do what your doctor tells you to do. I've heard people say that having the surgery is taking the easy way out. Well, I say, 'No it isn't!' It's harder, in a way, because you have to give up a lot. It was important for me to know that I had to do the work. If you're considering lap band surgery, here's what I'd like to share with you. I want to tell you the truth. It's not easy. You have to work at it. There are many foods I can no longer eat, and I'll always have to eat tiny amounts of food at any meal. You have to do what your doctor tells you to do. You have to really, really want it. You need to exercise and you have to train yourself not to cheat on your diet. But, you have choices. You can be fat or you can be slim and give up certain foods. It's not a big loss, when you look at what you can be, and you don't really miss the things you give up after awhile. You look great and you feel good about yourself and it changes your life in so many positive ways. If you put in the effort, the payoff is phenomenal. Give them a call, they really took great care of me at Surgical Arts of Inland Empire. 909-579-3111 or their website at www.surgicalartsinlandempire.com