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Doctors' philosophy on this vary from a few weeks to never again depending upon their experiences. The basic issues are: Healing - alcohol is somewhat corrosive to the stomach lining so one needs to give things a chance to heal first, Typically we see a few weeks to a few months sited for this. Alcohol tolerance - rapid stomach emptying means it tends to hit faster, and with less (i.e., a "cheap drunk") so care must be taken there, Transfer addiction - we can no longer satisfy whatever addictive tendencies we have with food, so it is easy to transfer that addiction to something else, like alcohol, drugs, shopping, gambling, etc. What was a casual habit of a glass of wine with dinner occasionally can easily turn into full blown alcoholism. Liver health - starting as morbidly obese, or worse, our livers are not usually in very good shape to begin with (hence the "liver shrinking" pre-op diets that are often prescribed) and the liver is further stressed from its role in metabolizing all that fat that we are rapidly losing. It doesn't need any more stress from ingesting a known liver toxin like alcohol (not a judgemental thing, just our physiology at work). My surgeon is also a biliopancreatic (livers and pancreas) transplant surgeon, so he is in the no alcohol as long as we are losing weight camp (and ideally forever) and indeed we sign a contract to that effect - he doesn't want any of his bariatric patients coming back onto his transplant table! Those are the issues in play, and some aspects bother different surgeons to different degrees, so they have different policies. Check with what your surgeon's policy is, and decide for yourself - we are all adults here.

timmytommy, ColieCallwell, I'm surprised you wouldn't be approved if you lost too much weight durring the process. I thought insurance used your starting weight for approval. This just proves how everyone's path to surgery and requirements are different. timmytommy, what you'll need to accomplish during your six-month pre-op depends on what your insurance requires and what your doctor/ surgeon wants/needs to prove that you're physically and mentally ready for surgery. You may be required to do the following: Begin a medical weight loss program Lose weight Have psychological evaluation See a registered dietician (RD) See an exercise therapist or get on an exercise plan Attend a support group for bariatric patients Reduce soda/ alcohol Stop smoking/ using tobacco products Make dietary changes Increase protein Start a vitamin/ Supplement routine Sleep studies/ Maintain CPAP/BiPAP compliance Labs/ Tests: blood panel for CBC, thyroid function, B12, HgbA1--for prediabetes/diabetes, other vitamins EKG/ cardiac stress test EDG (esophagogastroduodenoscopy) Good luck!

My PreOp was food - high protein low carbs. I wouldn’t worry as the whole process is to shrink and soften your liver. Mention to your doctor or say nothing. A friend who did Bariatric said she didn’t stick to hers and it still happened. I had a chicken burger and french fries with a soft drink a couple of days before my surgery and my liver had shrunk and there were no complications and my dr said they didn’t need the tool to lift they could use a stitch xx hope this helps

@MotoZen, I'd read that the author of Proteinaholic was a bariatric surgeon. Does he have anything written about pre-op and post-op plant-based diets, or would you be willing to share information from your nutritionists there? I've tried asking the dietitians at my program about plant-based options and they are really not helpful. I'm not 100% plant-based, but mostly plant-based, and I don't eat meat or consume dairy. I was really curious for his recommendations...

8 months- checking in today at 192.8 lbs, for total weight lost of 146.2 lbs. I have 27.8 lbs left to go to get to goal. My weight loss is slowing down but it’s still going. I know that as I get closer to a regular body weight the weight loss is going to get slower and more difficult but I do miss the days of regular 3-5 lb drops every week. July 5 represented one year of concerted weight loss effort for me. On that day in 2020 I started a low carb low calorie diet that was supposed to last for two weeks- I needed to drop weight for my first in person weigh in at the Bariatric clinic and I was terrified I was going to be disqualified due to gaining weight during my 6 month program. I squeaked under the line, and when I got home I just decided to keep it up a little longer to help with weight loss prior to surgery. I ended up keeping it up a whole year! So I have two anniversaries in my head, July 5 and November 10, diet date and surgery date. I’ve been doing good on exercise, and I’m trying to focus better on making sure I keep my diet in check. I’ve gotten lackadaisical about tracking food and I need to work on that because I can’t rely on portion control forever. I also need to focus more on getting sleep- I know that impacts weight loss and I’m terrible about staying up late after the kids are asleep to read books. I remember some celebrity had a big awards show and said something like “I want to thank myself, for all the hard work I put in, for the sacrifices I made, etc” and everyone laughing. But you know what, I would like to thank myself. For starting a diet 12 months ago and sticking with it though the hard parts. For getting a surgery that terrified me but still jumping through all the hoops and getting it done. For drinking tomato soup for thanksgiving and giving up the candy and snack food that got me to 339 lbs. 😀 If anyone is reading this and has 150+ lbs to lose, it’s possible. It’s possible with a sleeve, or a bypass, or whatever surgery you get. Surgery doesn’t do the work for you, but it helps so much. Next month I will be in the 180s and getting closer to a normal BMI. I’m committing this month to tracking each day, exercising 3-5 times a week, and going to bed earlier. August here we come!

I have thought about all the milestones (negative) that I hit before finally turning to surgery. These were NOT tipping points for me: -needing seat belt extender on flight -struggling to tie my sneakers -Winded walking to my office or up the stairs -prediabetes diagnosis And so many years of dieting struggles The tipping point was -getting an A1C test of 6.9 and a Diabetes diagnosis. - getting prescribed diabetes, cholesterol, and blood pressure medications. -And Not being able to go on bike rides with my daughter I felt so hopeless until I finally followed my cardiologists suggestion to attend an informational session for bariatric surgery. After another 4 months of considering all the risks (real and perceived) with taking this step, I could not imagine any other way that I would be able to lose the amount of weight that I needed to get healthy again. Just over 3 months later and 54 lbs down, I am only sorry I was so resistant to the idea of surgery to help lose weight. I feel more than hopeful again. I have a long way still to go, but it feels doable now. And I already feel so much success to be able to move more comfortably and no longer need the medication prescribed just 8 months ago! And I am getting my bike tuned so I can go biking with my daughter on the nearby bike path that I have avoided riding for over 5 years!!

I currently have a BMI of 36.5 with comorbidities. I have to follow the 6 month pre-op diet as part of the bariatric program. My question is: what if I lose too much weight during this phase and fall below 35 BMI? Will this exclude me from surgery? I know I can be successful at a 6 month diet, but past experience has proven that I will gain that weight back. Any feedback is welcome!

I was referred to a long standing bariatric doctor. I found out that he does not believe in revision sugery despite the research (2019). I am now in the process of finding a new doctor with approval for the procedure. I am excited and scared as heck. I will never give up! So, here we start again! Sent from my SM-G965U using BariatricPal mobile app

Thank you so much for replying! I was especially interested in your thoughts because you have posted a lot about this subject. It's too bad not all bariatric centers provide this kind of resources. So, if I'm understanding what you're saying, it seems like you think I should try to find another therapist -- one who has experience treating WLS patients or at least disordered eating? I actually really liked the guy who did my pre-surgery psych eval and I've been thinking about going to him. It seems like it might be awkward, but I got the sense that he knew a lot about WLS and the issues relating to it. I had a session with my current therapist today and I wrote up a list of issues that I wanted to address, and I think that helped... But I don't want to keep wasting time and money with someone who is not going to be able to help me with what I need to work on.

Finding triggers is definitely the key. Tools also help as well. For me, I purchased the bowl and plate with all the measurements on them. Words cannot express how much they help keep me on track! I also heard of people doing "pouch resets" to regain their stopping points. I would suggest meeting with your bariatric nutritionist to discuss how to go about this if you feel the issue is no longer feeling full as quickly when you eat. If the issue is fighting temptation with forbidden foods, try looking up bariatric friendly substitutes or recipes. I've found that to be a God send. There's literally a healthy, bariatric-friendly version of every bad food out there! All it takes is a little research and recipe planning. If you're ever interested in swapping recipes or product ideas, let me know. Good luck to you! You've got this!

You've lost so much weight!!! That's something to be super proud of, definitely take a minute to pat yourself on the back and celebrate your accomplishment. I'm sorry you're going through this. 115 is a really low goal. Most bariatric patients don't get to such a low BMI. Maybe work on losing the 30 lbs you need to for skin surgery and set your final goal a little higher so you don't feel so disheartened? As for losing more weight right now, don't do anything drastic; just focus on the basics, like eating good food; veggies and lean protein. Try using an app like MyFitnessPal or Baritastic to track your calories. Don't beat yourself up for gaining weight during the pandemic - it happened to a LOT of people!! Wishing you the best!

Sounds like you have recurring strictures. What did your Bariatric surgeon suggest?

Sue, I wish I knew who to call in Tennessee, but I don't. I'm sorry. My group is affiliated with a research university and they do their homework. They have a few therapists that they have vetted and recommend to follow up with surgery patients. In addition to doing counseling appointments, our therapists also provide leadership for our support group meetings. It's kinda cool to see your therapist in the framework of working with several people you know going through the process. I know mine has heard a hundred bariatric surgery horror stories, success stories, has heard people just like me struggling through the process of making lifelong peace with food. If you're trying to find a therapist on your own, I'd suggest looking for someone with experience treating disordered eating, cross over addiction and food addiction. Find someone who can help you identify eating triggers associated with unmet needs. (they're usually linked). Those needs need to be addressed to ensure the habits don't backslide. Looks like the University of Tennessee has a bariatric center. It might be worth calling them and seeing if they have someone vetted who they work with....who is good....maybe you could do video visits? You are dead right that it's hard to find the RIGHT therapist for this niche. But I can't recommend it enough. Best wishes.

Jayali, I can think of three reasons why you are feeling so depressed and tired: post partum depression, carrying for an infant while holding down a job, and lack of vitamins and minerals. You need to get with the program. Take your supplements religiously and eat according to your food plan. I recommend that seek treatment for your addictions: medication and food. This may mean joining a 12-step program such as Overeaters Anonymous, AA, or NA. Avoid all sugar, artificial sweeteners, and flour. These are the things that trigger most of us. Otherwise, you will defeat your surgery and regain all that you've lost. If you've been prescribed a CPAP machine, find a mask that suits you, and use the CPAP every night. Getting enough sleep can make all the difference in the world. There are non-addictive sleeping pills that are very effective, such as Lunesta. I recommend reading Weight Loss Surgery Does Not Cure Food Addiction by Connie Stapleton and How Weight Loss Surgery Really Works, by Matthew Weiner. Please return to your obstetrician and bariatric surgeon and get help.

This got way longer than I expected, so let me start with the TL;DR: If you have gotten counseling that has helped with your WLS success, can you please give me some tips for how to find a good therapist? And what I should be discussing with that therapist? I'm looking at you, @Creekimp13 and @catwoman7 (since you've both mentioned the importance of therapy in your long-term success), but I would love to hear from anyone who has gotten this kind of counseling... I've seen so many people say that therapy is really important for long-term success with WLS. I'm almost a year out and I've been struggling lately, and I've had a hard time finding a good therapist. I searched my insurance company's website for therapists who treat eating disorders. I reached out to a practice that had a few therapists who had eating disorders listed as one of their specialties, and they sent a very curt reply saying that they don't have anyone on staff who treats eating disorders. I called another practice and explained that I'm a WLS patient looking for counseling on food and eating issues, and they assured me they could help, but the therapist they assigned to me knew nothing about WLS. I had a few sessions with him and it was useless. I had to keep explaining basics about WLS (like food restrictions, dumping syndrome, not eating and drinking at the same time, loose skin -- which he thought would go away on its own if I exercise enough and when I explained that the only way to get rid of it is plastic surgery, he suggested I ask my bariatric surgeon to do it at my next follow-up). He didn't seem to understand my issues at all. In hindsight, I probably should have walked out of the first session. When I started telling him my WLS story and mentioned that my highest weight was 341 pounds, he interrupted me: "Sue?" I stopped and said, "Yes?" He replied, with a big smile on his face, "Sue, you were FAT!" and then busted out laughing, like it was cool to make fun of how fat I used to be just because I'm not that big anymore. When I told him I wanted to get counseling to address my food and eating issues to make sure I don't gain the weight back, he replied, "You won't gain the weight back. If I had a $100 bill right now, I would bet $100 that you won't gain the weight back," and then we never discussed regain again in the next 3 sessions. I think he was under the impression that regain was an irrational fear and he did his job by reassuring me that it's not going to happen. Then I found another practice that has a whole paragraph on its web site about the support they offer for bariatric patients both before and after surgery. I called to make an appointment and said that I had bariatric surgery last year and I was interested in the post-surgery counseling they described on their web site. The receptionist told me she needed my surgeon's office notes from my most recent visit, and was oddly insistent that the notes come directly from the surgeon's office and not from me downloading them from my electronic chart and sending them. I had to sign release paperwork for the surgeon's office, and when the counseling practice got it, they called me and said they were confused because my surgeon's notes said I already had the surgery so there was no need for me to get a pre-surgery evaluation. I guess they thought I was asking for a psych eval for surgery approval and couldn't understand why I would need counseling after I already had the surgery. I cited the paragraph on their web site and they sent me to a seemingly random therapist (probably the first one with an opening) who had no experience with WLS patients. She's better than the last guy, but the sessions have been pretty generic -- basically, she asks me how my week has been, I talk about things that happen (usually relating to WLS issues), and she asks me how I feel about it or how I handled it. Doesn't feel like I'm getting anywhere -- just feels like a WLS patient Q&A. I told her this and she suggested I think about what exactly I want to discuss and tell her next week. I'll give that a try, but to be honest, I don't really know -- she's the therapist, so I was counting on her to provide that kind of guidance!

I just wanted to say thank you to all y'all. I found this site a while ago and have been lurking and reading and learning. The honest talk helped me with a lot of the anxiety I was having about surgery. The photos inspired me so much—so many of you changed your lives and kept them changed. The folks who are really into exercise reassured me that it isn't over (I love my CrossFit, and I can't wait until my weight isn't the limiting factor). And just the fact that so many people's lives improved finally got me over the "shame hump". I called for a referral, had my initial consultation last week, and am tentatively scheduled for VSG in late August. (My insurance has been frankly amazing. So few roadblocks that I kept checking to make sure they were talking about bariatric surgery.) To say I can't wait for this is an understatement. I just want y'all to know you're changing lives for me and for other lurkers who haven't clicked that "sign up" button yet. Thank you.

Has anyone tried the chocolate pb. Meal replacement from bariatric fusion? Redoing another 10days & with it being expensive .. I would rather know beforehand if it’s worth buying or not ... Thanks

Depending on which Aetna plan you have. Reach out to your Primary care to see if you need a referral. Research some bariatric surgeons in your area and see if they are in your network. My surgeon asked what surgery i was interested in what i've tried in the past what my eating habits are my medical past and if I had diagnosed with any of the co-morbilities he weighed me twice then approved me to move forward with scheduling with a dietician, endoscopy and sleep study. I have had to find a psychologist to get a psychological evaluation to determine my mental readiness. Took about 15-20 to get cleared. But check with your insurance as this was an out of pocket expense for $310.

I may not have had surgery yet, but I have listened to what my surgeon and other surgeons have said. Fluid goes right through the stomach. It doesn't stay in the stomach. But I agree with @RickM ask your GI guy to talk to your bariatric surgeon and come up with a better plan.

About how many pounds do you have to lose to comfortably go down a full pants size (not snugly fit). Asking because I personally find the mythic 10 pound estimate to be way off but maybe it's just me? Also, any other bariatric discussion boards you can recommend to visit?

I’m so sorry that you got treated that way. I can’t say as mine ( follow up) will be much better. We will see tomorrow. We have a ‘portal’ to send/receive messages to the bariatric team, but this far the ‘answers’ I get are ‘short and not REALLY answering anything I’m asking’. It seems that since the surgery they are kinda ‘done’ w me, and that may be just my emotions talking, or I’m sure that’s what they will try and say, lol. I have only lost 7 pounds, and I know I shouldn’t be ‘on the scale’, but of course I am! I see all these other ppl loosing soo much more post op. My pain is ok, I haven’t taken anything since 3 days out, but I am having a ‘stitch pain’( from what I’ve read) when I move a certain way, raise my arm. It’s on the right side. I did have a minor hernia repair while he was in tho, I had no idea I had it. As far as bandages, I was glued shut, so I never had any bandages so I’m not sure about that. I started my vitamins back today. I haven’t had any trouble getting my water in daily. The first few days it was a struggle. I have not been nauseous or thrown up at all , knock on wood,. I have followed the diet ( mostly, I had some mashed potatoes) . I have NOT ate ANYTHING sweet, I’m scared of dumping syndrome. I drink the protein shakes for most of my protein, and just started yesterday on stage 3, adding ‘mushy meat’ to my diet and smashed veggies. The ricotta bake tasted SOOOO heavenly!! How are you feeling????

Hello fellow Bariatricals, I am 3 months out and wanted to compare everyone else 3 month weight loss. I have only list 13kg which is 28 pounds. I am not worried, as I am losing and Ive always had a slow metabolism. How were you guys at 3 months post op ( please only give me weight loss from surgery day).

wow - that is pretty awful. My reaction was the same as Arabesque's - have they seen your medical records and test results? Have they talked to your surgeon? How much research have they done on the various bariatric surgeries? I think a lot of people who haven't done much research on bariatric surgeries are remembering bypasses from years ago. Those WERE risky. But they do them completely differently now. They aren't much riskier than the sleeve nowadays (and honestly, neither surgery is very risky). I'm sorry you're going through this. I only told my immediate family and a few close friends before the surgery, so fortunately, I didn't have to deal with this. This sounds mean, but maybe you should just start ignoring them == as in deleting their texts without responding. That's what I would do at this point. You shouldn't have to put up with this.

So sorry they’re not being supportive. I didn’t tell anyone in my family but my mother & one brother & his wife because I knew they wouldn’t judge & would understand & be supportive. Have you turned it back on them & asked what research they have done & where they got their information? Is it from recognised & legitimate sources? What medical people have they spoken too? Have they looked at all your medical test results & history? How many people who’ve actually had weight loss surgery have they spoken too (they’ll never be able to compete with the number of people on this forum)? Do they understand the reasons why bypass is the better option for you? Do they think you’re not intelligent enough to make a rational, informed & logical decision about your own health? Why can’t they just say they’re concerned but offer support & willingness to be there for you? Honestly, there are risks. But there are risks with all surgeries & they are pretty low for bariatric surgeries. It can be a struggle to get used to how your digestive system works post surgery but you’ll get used to its idiosyncrasies & discover how it works for you. I hope they can see your position & can be encouraging & not negative.

I went with RNY over VSG because the RNY has been around (in roughly its current format) since the 60s; there's half a century of long term follow up. The long term follow up with VSG is shorter. I always choose the devil I know Fun fact: the earliest reported example of bariatric surgery was performed on Sancho the Fat (the King of Leon) in the 10th century!