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Must meet one of the following three criteria: 1. Must have a minimum body mass index (BMI) of > 30 with a diagnosis of Diabetes Mellitus. 2. Must have a BMI of > 35-39 and must have at least one of the following conditions: a. Degenerative joint disease of major weight bearing joint(s). The member must be a candidate for joint replacement surgery if weight loss is achieved. b. Other rare chronic conditions (for example, pseudo tumor cerebri) in which there is medical evidence that bariatric surgery is medically necessary and that the benefits of bariatric surgery outweigh the risk of surgical mortality. 3. Must have a minimum BMI of > 40 Here is their wording. I’m obviously number 3 I’m just worried it’s a case by case basis and they won’t approve me.

I went with the Spire group in the UK. My package lasted 2 years so I had all the help I needed. I paid about £12,000 as well. I had excellent care. I know of people who have gone to Turkey for the surgery and have no after care. I have heard on here that others have had aftercare. If you are going that route its a question you may need to ask. As this surgery affects us all differently its impossible to help others when specifics are needed. Only a bariatric dietician can help. Turkey is advertising the surgery for £2000, I don't know if I would risk it though.

I’m just beginning my second week of my pre op learning and it’s been a fun, interesting week (for me anyway!) I started eating a little better, getting more protein in to my daily diet and logging everything. Good news is that I’m 9lbs down in the first week so I will take that win thank you very much. I’ve also been practicing mindful eating too. My approach to eating was to hoover food up as quickly as possible but, after reading about WLS and what I need to concentrate on post-surgery, I have made sure that every meal has taken 20 mins to eat, that I eat off a plate, put my cutlery down between bites, don’t put more food in my mouth when I already have some food in there etc. Being a sceptical kind of person, I wasn’t really sold on the benefits of this but I gave it a whirl, just to see. I will definitely hold my hand up and admit that my scepticism was misplaced. My head and stomach now recognise that I have actually eaten something and it’s registered with them. I now have a feeling of fullness that I didn’t have before, which really is an eye opener. I know it probably sounds strange but I honestly cannot remember having this? Disordered eating has been such a part of my life for a very long time. I’ve also been giving different sources of protein a try, not for post-op as I’ve really taken on board people’s findings of tastes etc changing after surgery, but for the liver reduction diet and to give myself some variety now as I move towards that. I have tried protein water (a bit sweet but doable) protein yoghurts and protein puddings. Hubby recommended some PHD whey protein but I haven’t tried that yet. The bag isn’t yet open and all I can smell is overpowering vanilla 🤢 I will try it at some point this week, just to see if it tastes better than it smells! I’ve also ordered some 0%-everything flavour drops to try in Greek yoghurt etc, just waiting for those to arrive. My Bariatric plates arrived this week, plus measuring cups and spoons. I’ve been consistently taking my multivitamin, vitamin D and folic acid (because of pre-existing meds) have taken the dreaded ‘before’ photos (and managed not to cry) and generally had a positive week. I know my surgery may be a long way off but things are moving in the right direction and I’m happy about that. Onwards and downwards!

Well, bariatric surgeon did not find anything wrong with my pouch (inside my pouch, no scar tissue causing problems, no hernia/bleeding inside pouch, etc.). Ironically unlike the 3 incisions that I had during my gastric bypass surgery, I have FIVE incisions. I guess he REALLY looked around. I look like I got attacked by a knife-wielding assailant with very precise aim..lol. I have my follow up with the surgeon tomorrow to talk about the procedure (he only saw my husband after the procedure as he had back to back surgeries lined up) as I have not officially spoken with him. I am trying to remember to ask him about their stance/experience on semiglutide/similar meds for their patients.

Congratulations! I'm almost 4 months post-op from gastric bypass and my advice is to watch every video from Dr. Matthew Weiner (Pound of Cure Weight Loss) and Dr. John Pilcher on YouTube. These were by far the best resources I found, and I go back and watch many of them (especially Dr. Weiner's, and also his new podcast) all the time even now. Especially the ones on how to build lifelong behaviors to keep the weight off. One thing I did early on, right after my first bariatric appointment where I weighed in at my highest weight ever (yikes!) was order Dr. Weiner's books. There's The Pound of Cure, which gives a detailed, step by step way to make healthy changes to your diet, plus a second book explaining how bariatric surgery really works and then his bariatric cookbook (I also really like Bariatric Meal Prep Made Easy by Kristin Willard). I made several of the changes recommended by the Pound of Cure (I didn't start with the 2-week diet, just started implementing changes I thought I could manage) and over time I lost about 12 pounds, plus just felt healthier and more in control of what I was eating. One other piece of advice: don't over-buy protein supplements. So many people on this board will tell you this, and I did not heed the advice. Now my cupboard is full of protein supplements I stopped liking after surgery and will never use. I've barely needed supplements after the first month or so, honestly. I feel guilty at how much money I spent on them, but I will likely end up throwing them all away (most are opened so can't be donated). If you want to stock up on anything, an unflavored protein powder is much more likely to be useful to you in the long run than the flavored shakes. But if you're buying flavored ones, consider trying a soup flavored one because the sweet ones get old really fast, even pre-surgery. Oh, and take "before" photos! I know taking photos can be so uncomfortable, but you will want them. Choose something very form fitting to start. I went with a pair of exercise leggings and a tank top that was so tight it was like skin. I took photos about a week after my first appointment, so around my highest weight, and then on the day before surgery and at each month-marker thereafter. So far, I've worn the same clothing each time, although I may need to change that as it becomes too baggy to show the progress clearly. Take your measurements the same day you take your photos. You may struggle to see (or refuse to believe) the changes in yourself, but the photos and measurements don't lie. Even if it's painful to see the photos now, you will be so grateful to have them later. I was in shock and wanted to cry when I truly looked at my highest weight photos, but I'm so glad I took them.

Hi 👋 I’m just starting my journey too! My appointments are over the next couple of months but no indication of when I could expect surgery. It could be up to a year apparently but I’m hoping that everything is straightforward with the appointments and tests so there’s no delays (and therefore my surgery is sooner 🤞) Where are you based? I’m UK 😊 I’ve been reading everything I can, downloading bariatric recipe books, ordered a couple of bariatric plates (advised by dietitian for portion control) plus measuring cups and spoons to make weighing a bit simpler. I’ve started to eat a more protein-based diet and I’m learning to slow down my eating (20 mins) so I’m not overwhelmed when I have to start the liver control diet and then surgery! Good luck with your journey, hope everything goes smoothly for you.

I think that's why I feel exhausted at times, working out and not fueling enough. Maybe I need more. But, I'm trying to follow the dieticians directions as close as I can. She has more experience at this than I do. I haven't ate food to fuel my body since I was a kid. My fear is, if I eat too much I'll resort back to bad habits. I'm sure that is most everyone's fear after bariatric surgery. 

So relieved to report I finally dropped to a new "lowest weight" after my 2-week stall. Weighed in at 198.6 this morning, a drop of 0.6 since yesterday. I really hope that might continue a few days at least before I hit the next rough patch. The cravings for sweets and carbs are real! I'm fortunate that I do feel a lot of restriction, or at least I do if I am eating the right kinds of foods. I can only manage about 2-3 oz (60-85g) of heavier proteins, which include salmon, poultry, beef, and pork. I also get full at around 4 oz (100g) veggies. Sadly, if I do eat bread or crackers, they seem to go down easy. Same with ice cream or candy. I had really hoped that wouldn't be the case. It makes it that much more important for me not to keep those types of things in the house. I'm struggling with what to eat, especially for breakfast. Nothing sounds good. I'm tired of plain yogurt and cottage cheese. I'm tired of protein shakes and smoothies. I was enjoying smoked salmon with cucumbers on rye crisp bread until last week when it made me violently ill. I've become repulsed by eggs. Plus, I don't usually get hungry until later in the morning. Today, I decided to wait, and I finally started to feel some real hunger at 10:00am. So, I'm having a leftover big Italian meatball from dinner a few nights ago. Lunch and dinner options aren't much easier. Cooking is a hassle when you can eat so little, and my kids don't like the kinds of things I can eat. But I worry it sets me up for grazing when I don't have a plan. I'd really like to do some meal prep and have a list of maybe 10 go-to meals that are bariatric approved and easy to make any time of day. I'd like to spend a few hours roasting a sheet pan of veggies and cooking some chicken to store in the fridge for the week and incorporate into meals. I need to clean out the fridge and pantry. I just don't seem to have the motivation to do any of it. It's like all my energy has run dry, although my bloodwork came back good so it's not an issue of something being off. Just my attitude, I guess! I'm feeling stressed and a little overwhelmed, and it shows in my environment because my house is getting cluttered and I have a pile of laundry that is quickly going to consume me. What I wouldn't give for a housekeeper to keep the place tidy and my own cook to make healthy meals and deliver them to me at appropriate times during the day.

@BlondePatriotInCDA and @SleeveToBypass2023 This discussion has inspired me to talk to the bariatric surgeon I switched to here in Fort Worth when I see him on a post-op follow up appt on 6/10/24 as I want to discuss how his practice is managing this new set of 'tools' with their bariatric surgery patients. I wish he'd been my original bariatric surgeon. Due to abdominal pain I've been chasing for 2 yrs (right side) I ended up referred to him. TOMORROW, he is performing an investigative laparoscopic procedure to 'scope' the inside of my pouch and see if some of the occasional 'old blood' I have in my er..stools and the pain that hits out of nowhere that feels like my intestines are knotting up, is related to any issue inside the pouch or with scar tissue. I've already done an upper & lower GI in May, gall bladder has been gone for 2 yrs, had a CT-scan, etc. Wish me luck tomorrow. I'm looking at it as very nice and expensive nap with hopefully useful information obtained. I'm also curious what he has to say about my pouch now that it has been 5 years. Is he gonna say 'wow, you sure managed to stretch that sucker!'...lol

I don't plan on being on them for a lifetime, I just need the head hunger to stop and help with the constant hunger...I've been good at fighting it..but I can foresee starting to cheat if I don't get some help. I've tried the alternatives to side track my brain...doesn't work. $250 is way better..hopefully my doctor who's had bariatric surgery will prescribe something to help!

OMG! I'm so thrilled for you!! I remember this!! You are looking so great in your pics!! AWESOME JOB!! I noticed your highest weight was 421. My highest was 400. When I joined here, I only entered 390 as that was the weight I was at when I started trying to lose some more 'on my own' as I was going through the insurance process (SO LONG) to get approved for bariatric surgery. 5 years later and I'm wondering if I should have changed my weight to the highest I ever was or if that is confusing to anyone. Again, I'm just so very happy for you!

Yeah, I worry that people, including 'us bariatric surgery patients' who haven't done the mental/headspace work (and I don't mean this in reference to the 2 people you know that have done the weight loss injections) that most of us try to look or are 'made to look at' at when preparing for gastric bypass will have to stay on them 'forever'. Of course, doing a sleeve or gastric bypass is a very permanent 'anatomical' decision that can, if we are not vigilant also not be successful in the long term for people who feel the surgery is the 'only fix' needed. Since all of my health issues are already under control after my gastric bypass - I NEVER had high blood pressure despite weighing almost 400 lbs and I was not a diabetic but I could tell the toll that being that heavy was taking on my body (my knees, sleep apnea, DVT's/PE's, etc.) I was leery of doing anything that would require 'forever' outside of the bypass surgery. I'm looking for a new therapist right now that specializes not only in anxiety and depression but in working with bariatric patients/weight loss as I know I can I have to be constantly vigilant with my headspace or NOTHING will work. I also am not willing to take the shots for the rest of my life for myself. For other people weighing risks versus benefits I can see this being a highly individualized and personal decision especially if weight loss surgery is not an option for them no matter the reason (leery of it, insurance won't pay, BMI not high enough, etc.). Everyone's journey is their own. The only thing I advocate is for everyone to be as informed as possible and to do their research and make the best decision for themselves. I need to do more research about long term implications of these drugs, but I haven't found much data out there (too new to have that much historical data yet). I'm within 10 lbs of when I told the clinic I'm going to that I would be tapering off and ending the weekly shots. Will try to remember to post more when I've been off the shots for more than a couple of months to talk about struggles or successes I have.

It took about 2 to 4 weeks worth of injections for the true total benefits to settle in and when it did, it was so FREEING. I still absolutely am delighted I had gastric bypass. I also could not afford to pay $1000 a month. I found a local 'wellness' clinic here in Fort Worth where I pay roughly $300 a MONTH for weekly injections. I skipped their package of B12 and Semiglutide as I'm already on an inhalable B-12 supplement. Definitely shop around. I do worry about it causing long term complications (unsure what those are at this point outside of blurbs I've read) but I'm also not wanting this to be something I end up needing to do every week past this 6 to 9 month window. They have other clients that after they got where they wanted, they tapered off completely or come in for monthly or bi monthly injections only. I'd like to taper completely. I have gone a month with no injections after i started and while I had a slight hunger increase, the food chatter was so dang muted. I actually ended up reducing my dosage as I got to a point where I was not eating enough which is ALSO NOT my goal. My protein intake plummeted simply because I was not taking in enough calories. Luckily the place I work with is conservative with dosing and they have multiple patients that had bariatric surgery years ago and they are always ready to discuss 'what is the least amount of semiglutide that you need to be sudcessful'.

Agreed catwoman7 - that was my BIGGEST concern. I was trying to remember how high into the 180's I hit and I found my paperwork. I had gone up to 187 (17 lbs over my weight I had been holding stable on and mentally remembering the 'brief period' at 167, I felt I had gained 20 lbs but it was really more like 17 from my 'stable weight). Prior gains I had ALWAYS kept within a manageable 5 to 10 lb window. We have an adult daughter with multiple mental health issues that moved back in with us over a year ago and the combined stress between her needs and my job was seriously impacting every aspect of my life. I'm also seeking a new therapist that also specializes in clients who are considering or have had bariatric surgery who can help me with multiple issues as I never want to return to food again as a 'medication' for stress and heartache.

Congrats on the loss, Warren! Tomorrow is my scheduled 'peek'. Luckily the doctor doing this is a bariatric surgeon that specializes in revisions. Things at work and home are so stressful that I'm ALMOST looking forward to anesthesia simply for the temporary 'rest'...lol.... If there is nothing wrong 'there', then I'm going to have a long talk with my new 'GI' doctor. I hope this doesn't sound bad but after chasing this pain for almost 2 years, I really want them to find 'something' and hopefully minor, but I'm running out of options and I'm still completely salty on my primary doctor's response.

thanks all. Dr changed my meds.. hoping I can sleep through the night.. adhd meds are too strong and Which prenatal vitamins do you take? is that along with bariatric vitamins? anyone also took a nutritional Labs .. thinking of buying a home test kit

Dang it! Back up to 200 today. I could see the digital scale contemplating telling me 199.8, but it decided nope. I've had days with tons of exercise. Days with no exercise. Days with over 1000 calories. Days with barely 500 calories because what I ate made me sick. None of it does anything to move the weight. I get on the scale daily because I like to see the graph as a visual. But I'd like it better if the number went down. On the bright side, my blood work all looks pretty good. A bit low in Vitamin A, zinc, and prealbumin, but so far no one has said I should change anything. @LisaCaryl I love the NSV with the jeans! What a nice surprise, even if you did get stuck wearing them to your group. I have one more week of school runs and after school activities before my kids are out for the summer. At that point, I am going to make a weekly meal plan and try out some new recipes from the bariatric cookbooks that are gathering dust because I've been too busy. I've also found a workout video to try with my pilates bar resistance band set, so that's going to happen this week, at least once.

Congratulations on your success for starters! I would not say you are weird, the excess skin is a badge of honor and proof of your hard work. That being said I completely 100% understand feeling self conscious of it. I am not a fan of the stomach folds and flappy arms on myself either. However, once you meet the right person, they will look past that to the person that you are. Yes it will take effort and bravery on your part to put yourself out there, but you've been on this journey I'm sure to live your best healthier life to the fullest which includes companionship. Maybe also seek out some therapy or a bariatric support group that can help with your anxiety. You are not alone in your feelings. I know plastic surgery here in the US is quite expensive, but I definitely will be looking into it when i'm closer to goal. If that is something that is attainable for you, may be something you can work towards. But in the meantime try not to hold yourself back from enjoying this new lease on life.

You are looking great, well done. Not a man but feeling the same way and have a lot of self doubt about starting to date (my friends are trying to push me to it) because the excess skin is all fine when it is hidden under the clothes but God forbid anyone was to see me naked, it is bad enough when the good looking doctors have to take a peak! I realise that a lot of my fear is in my own head and of my own making but not helped by social media etc.. At the moment I am trying to focus on the mental side of things and practice a bit of self love (no not masturbation 😂) by reading books on finding happiness and learning to dampen my own negativity. I never thought it would be something I would read and try to act on but I am trying my best to put positivity out into the word and hope it comes back. I am learning to have a smiling face instead of resting bit*h face, it is hard work 😂 Not sure if or when I will ever put myself out there but the positivity is good to give and get. Anyway, I just wanted to say you are not alone plus everyone (not just bariatric patients) is weird in their own way and we just have to try and embrace it and find that other person (persons) who get us.

Sometimes you have to ring some bells like HELLO, i need some aftercare and followup. Congrats you finally got your appt. and your A1C going down! I'm not sure about B12. Some labs calculate it differently as the high end of the normal range for mine is 1245. I'm sure if it's an issue it will be or should be addressed by your team. The Vitamin D for sure should be. I know for me it was getting to the higher side of normal and my dietician had me drop down from bariatric vitamin to a regular multi and cut back on my calcium chews which also contain lots of Vitamin D. Woohoo on the weightloss. And the hair loss will eventually slow down. Mine lasted from about month 3-6 at it's worst and has slowed considerably and now I'm only just slightly annoyed at all the short hairs from regrowth.

So I finally reached out my bariatric team and they said my post op appts "slipped through the cracks", So instead of having a 3 and 6 month appt I am have one next week (at 5months ish) that will combine my 3 and 6 month post op appt. ANYWAYS to my point! I got my blood work and everything is normal range! my A1C even went down from 5.6 to 5.3 which is pretty groovy! Also my iron is normal for the first time in my life! However my B12 is 1116 which from what I read optimal results are >500 for bariatric patients? So does that mean I am doubly good? My Vitamin D is at 119 and toxic levels are over 100. So my assumption is I could probably cut back on those vitamins lol. I feel great! I am down to 185 as of last week. Hair is still shedding but tis life. Thanks for coming to my ted talk!

Like the others said before me, I think it is highly unlikely that you have stretched your stomach. Weight will fluctuate (annoying I know) as your body copes with the changes. Please try not to stress yourself out unnecessarily. I think try to find a resource of a dietician, maybe even one online if that is quicker than a local one. Did your care team, at the time, give you any reading material for post-op foods etc? I didn't get much advice for long-term from my team so I spent a lot of time online and found some good online reading material at 'Bariatric Meal Prep', 'My Bariatric Dietitian' and a few other sites/blogs.

Great advice from everyone and I would second finding yourself a nutritionalist/dietician sooner rather than later. And maybe a therapist who has experience with bariatric surgery & disordered eating. Do you track your food? I’m not a tracker (didn’t have to) but I do random checks on portions sizes, nutrient content & protein to ensure I’m on the right path or haven’t got complacent. It might be idea to start tracking if you don’t even for a few weeks just to see where you may be missing some key nutrients, to ensure a balanced intake, etc. can’t hurt anyway. Check out some the you tube videos by Drs Matthew Weiner and/or John Pilcher. Dr Weiner has some great books too which may be helpful. These may offer some support while you’re trying to find a new surgeon & doctor.

First, don't panic! And don't compare your progress to others, if you can help it. I agree with everything Nickel said -- including the book rec. Kristin Willard's Bariatric Meal Prep is a great resource, and I also really like "The High-Protein Bariatric Cookbook" by Stacey Gulbin and "Fresh Start Bariatric Cookbook" by Sarah Kent. I think a good Bariatric book might help cover some of the information you've been missing from your 'care-team'. Is it possible that you've been focusing extra/too much on calories and not enough on what makes up those calories? My team told me that calories can be important (especially later on) but the first several months it was definitely more about making sure you're getting enough nutrients. 60-80 g protein per day minimum -- my team told me for me personally, she'd actually recommend 70-90g -- and definitely 3 meals a day (+ 1-2 protein-geared snacks). If you have to make them smaller at first since you're used to eating two meals, that should be ok. Maybe while you get back into a regular routine, make one of your meals a protein shake or protein bar? It was suggested to me that both my day (and each meal) should be 50-60% protein, and the rest of my plate should be mostly non-starchy veg -- with any starchy veg or complex carb coming in at 10-15% (20% max). The types of carbohydrates can be really important too. A whole grain/whole wheat item or a starchy but nutritious veg is going to put you in a much better place than a processed corn taco or white tortilla. Are you taking any supplements? Also, maybe check out local nutritionists and see if any of them have experience with bariatric patients.