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I have just hit maintenance but my long term plan is to allow a 5lb gain without freaking out (because of water weight and other factors) and then if I exceed that to go right back to basics - protein first, veg and fruit second, carbs a very last third - until I'm back to my previous weight. I have no idea yet whether or not this will help me maintain but I just thought I should share. Best of luck to you x

Was your surgery 2 and a half years ago (your profile says that)? If so you might actually already be at your final new set weight. I think it's possible to get lower than that for some people but it seems to require a huge effort and then sustaining that - in a way you are fighting against what your body has decided is good for it. I do understand that it is frustrating not to reach your goal weight (I would have been really sad, I know, but my body decided it was happy with losing that amount and I know I was one of the lucky ones). Would it be possible to accept that you've made an amazing change for the good and relax into your new weight? I totally understand that might not be who you are, and I know people with much greater wisdom to share will be along soon. Best of luck.

I'm so excited for us all! I had to look up what Barret's Esophagus is, and that sounds like it would be really uncomfortable. I am sorry you have had to deal with that, and here's to hoping for relief and weight loss for you!

You nailed it about the “mind hunger.” I didn’t have it as much with the original bypass, probably because those no-no foods felt uncomfortable and/or I dumped, always out the back way. It took almost 2 years to be able to eat the bad stuff. After what turns out to be Part 1 of my revision surgery, it took a lot less, plus I don’t dump. I spoke with my surgeon to say that I wasn’t sure the Argon zapping was working, and she told me that the revision process takes several surgeries and that I should have been contacted by their obesity management team and scheduled for the next procedure. They’re working on scheduling that for August, and I’m in contact with the team. She also suggested calorie counting, as well as some of those online weight management sites like Noom. It’s as much about how you think of food and realizing why you overeat. I was getting therapy, but it was once a month, and I don’t think it really helped.

I too didn’t lose any weight until now- post op day 11. And I was also told it’s due to the fluids they pumped me full of in the hospital. I lost 33 lbs pre surgery and now in the last 2 days I’ve lost 5

It’s okay. Everyone slips at some point. As long as you don’t keep doing it you’ll be okay. Look at it as a learning opportunity. We all have to work out why, how much, often often or when we’ll eat certain foods. Why did you keep eating the pizza? Craving, emotions (happy, sad, angry, frustrated.), boredom, habit, diet fatigue, testing your limits, etc.? What can you do the next time you’re in this situation or mental place? Portion out a slice & put the rest in the fridge, only have it when you can share with a friend so they eat most of it, mange when you choose to have it so as not to compromise your weight loss, make a more nutritionally beneficial low cal version (cauliflower base, etc.)

Did you have this procedure? https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/argon-plasma-coagulation-for-weight-loss If so, pretty interesting! Please add more information because someone might be very interested and not know it’s even a possibility. Congratulations on doing well.

My office is really relaxed, maybe too relaxed I wish I had more support from them. I never had to go to any weight loss seminar. My nutrition classes consisted of me texting any questions I have to the nurse and she doesn't get back to me unless I remind her a day later. Haven't been offered any nutrition or counseling services aside from that. They emailed me a list of foods that I can eat right now but no portion sizes. I'm learning how to eat by reading gastric bypass books and on youtube. All I have to do is blood tests a couple days before and did my ekg test and heart xray already. I'm seeking therapy and joining the gym on my own. Mine is pretty much just the dr performing the surgery it seems and the rest is up to me. I'm so thankful for this group and hope that they offer more support after. Never had to do any in person weigh ins or lose a specific amount of weight they just said don't gain weight. I wonder if the lack of requirements for me is a good thing or a bad thing. No nicotine test but I'm not a smoker. I believe my liquid diet is 1 or two days before the surgery

Also wanted to add my surgeons office provides both counseling and nutrition services for life, free of charge. They also required us to complete monthly online classes and 4 in person weigh in classes during the optifast liquid diet. During that time we had to lose 5% of our excess weight or not be approved for surgery. I had to get an EEG cardio clearance including an echo, and a nicotine test, so lots and lots of hoops. Now that surgery is over, I have a phone appointment before I can advance to full liquids abd an in person class before solids, along with a two week, four week, six month and 13 month follow up appointments. If your office doesn't offer this, I would suggest scheduling follow ups on your own.

STB so pleased to see you're out the other end of this! Did they get rid of all your polyps? Do you think this will be your last procedure? 💪 Wishing you a smooth smooth road for the rest of your weight loss journey xx

1. Basics: Female, 54, 5'1 2. Total Weight lost in the 6 months BEFORE surgery (if any) 0 3. Weight on DAY OF SURGERY. 230.3 4. Weight at 1 MONTH POST surgery 206.7 5. Weight at 3 MONTHs POST surgery 184.1 6. Weight at 6 MONTHs POST surgery not there yet 7. Weight at 12 MONTHs POST surgery not there yet

Thanks for everyones replies. I thought I might add that my sleeve was for the removal of a tumour. So my goal wasn't to lose weight and I was given no aftercare advice on food intake or liquids etc. My goal has always been to gain weight as I was already underweight when I had the sleeve. Quick update. I got the results of my ct scan today. It shows my stomach is dilated and distended? Maybe not emptying properly so they'd like to get me in for a barium. Could I have stretched it? Does anyone have any info on this please? Still having the pain on and off. It seems to come in flares lasting days and then easing off. Weirdly seems to flare up if I take paracetamol or cocodamol so I've been avoiding those. Will check back in as soon as I have any other news. Hope everyone is keeping well.

Not only follow-up, pre-surgery education about what to expect in terms of weight loss, and that there is a series of surgeries to be done before the revision is complete.

It sounds like something is out of balance to be that lethargic at six months - most tend toward the energizer bunny side of things with a big chunk of weight off. Have you had labs done recently (six months would be a typical time for most programs)? Low iron or B12 are common bypass problems, which is why they usually recommend extra, but the recommendations tend to be an average and may not be enough for everyone (while being too much for others.) I would certainly check in with the surgeon or RD on this.

It’s great that there’s a cohort of us! I’m not on any sort of pre-diet yet really, but it will be starting soon. I’m happy about this, even though weight loss is only part of the reason I’m doing it. They’re addressing my Barrett’s Esophagus too, which will be a relief. How are you all feeling?

Hello all. I am excited be on this weight loss journey. I had my VGS on July 6, 2023, so I am a less than a week post-op. I started this journey at 267 lbs- consult day. The day of surgery I was 230 lbs. My surgery went well, I spent one night in the hospital. My incisions are still sore but manageable, I feel great. Today, I weighed in at 226 lbs. I live in Florida. It is so great to have a place to share my experience and get advice. I hope I can be helpful in some way and my words can inspire someone.

Just responding to my own post to have everything in one place. General Down almost 60lbs after surgery on May 18th. No complications. I followed the rules exactly on the diet, but continued to push the exercise because that's my personality. In fact, I would say I've become a little obsessive with the exercise, walking/running/biking everyday. I have also experienced a lot of ups and downs since the surgery. Food The first week after surgery I was fine with the limited clear liquids, however, near the end of the first week I was sick and tired of the clear liquids. The second week was the same. First part of the week was good because of new liquids, but near the end of the second week I was sick of the limitations. Basically I was excited every time I got new foods, and was sick of it by the end. This was not so much because I was having cravings for fatty or sugary foods, I just needed variety. Now I'm opened up to try whatever I want, except carbonation. I'm still not trying bread, but have had really small tastes of pasta (really small) or eaten really small keto tortillas without issue. I'm still keeping a daily log of all food eaten and hitting my macros on most days. I'm really focusing on my protein (100+ grams a day; I've really been aiming for 130+ grams, but it's tough) intake as I don't want to lose any more muscle. I do notice that I get the hiccups when I'm full. Sometimes my nose runs when I'm full as well. I did get the "slimes" once. I was trying to eat a breakfast taco on the keto tortilla and I guess it was too dry. I only got half down (the tortillas are only about 3.5 inches across; really small) and it felt like it was stuck. So what do you do when food is stuck, DRINK! That was a mistake. Got the slimes and eventually threw up. That's the only time that has happened. Fortunately, it was like 5 weeks after surgery, but I was worried I had done something to my stomach. Went out to eat with the family a week ago and tried ghost pepper wings (which I'm normally fine with). I also put ghost pepper hot sauce on my refried beans, without issue. The spicy wings did not go well. It was much spicier than normal and I ended up drinking water and almost threw up. Prior, I had eaten 3 wingstop wings with blue cheese and was fine (mango habanero). We went out to dinner again last night and I had a few bites of salad, about 2 ounces of chicken breast with BBQ sauce and a few bites of sweet potato and was stuffed. I used to get a 16 ounce ribeye with mushrooms and onions, mashed potatoes, veggies and a couple of tall beers. I did not feel like I was missing out, which feels kind of weird. My kids got a dessert and I wasn't interested in it. Sugar free popsicles taste really good and are almost too sweet now. I was really worried about eating out (what I was going to eat; how it was going to go, etc). I feel more comfortable now for when we go out with friends. Bonus, I have saved a TON of money on food and alcohol. Like a crazy amount. I did have a glass of bourbon on the rocks last week. Drank it slow and it went down just fine. Zero issues. I'm not going to start drinking though, and will just stick to an occasional drink. Exercise I started walking very soon after surgery, 10K steps a day, and pushed it too far too early. I dialed it back for the first two weeks, but then picked it back up. Now I either walk for 15K+ steps a day or ride the bike for an hour. Every day. I get a more intense workout on the bike plus it's better on my joints. Walking seems to hurt my hips and back, but I'm powering through. I'm going to a physical therapist on Thursday to try to figure that out. As I said above, I'm definitely obsessive about my exercise. Sometimes to the point where I wear myself out and am exhausted for the rest of the day. Some of that is a mix of the intense exercise and limited calorie intake. I've also told myself that I was not going to obsess about the scale and I was only going to weigh once a week, because the weekly/monthly trend is the only thing that matters (my weight fluctuates up and down daily, but trends down weekly/monthly). However, I find it really difficult to avoid weighing myself multiple times a day. I'm obsessed with the scale as well. Mood Overall, I'm OK. Weight loss is really good. Hit a couple of short stalls. No complications, but my mood is really up and down, which is not normal for me. So much so, that I have scheduled an appt with a therapist next week (first time in my life). The doldrums are real, especially after VSG, so take care of yourselves, physically and mentally. Meds I'm completely off my BP meds and it's currently averaging 120/80. I have GERD with a history of Barrett's Esophagus, and I'm currently taking 40mg omeprazole daily. I was really worried about it getting worse after surgery, but I have had zero issues. I have a follow up appt with my VSG doc next week and I'm going to see if I can test 20mg. I would love to get off all meds. I tried the barimelts at the suggestion of my doctor, and they were OK the first couple of days. Then they totally grossed me out. I mean, like I was about to vomit and dreaded taking them every day. I only made it about a week before I gave up. I'm back on regular vitamins for now and tolerating them just fine. I'm going to ask the doc about that next week as well. Misc Because of the connective tissue disorder, my shoulders are really messed up. My right one especially. I'm glad it's not affecting my exercising. I just saw an orthopedic and she described my shoulder as "gnarly". Reverse shoulder replacement is in my future, but in the meantime, I'll have it scoped for labrum and rotator cuff repair, plus Bankart repair with the remplissage procedure. I am looking forward to relief from the chronic pain, but not the recovery. I hear it is brutal. TLDR Wished I would've had the surgery sooner. Plan for some ups and downs. Follow the plan. Take care of yourself. Don't be afraid to ask for help.

Stalls are super frustrating! I am currently in that 3-4 week stall myself but I came across an interesting article regarding WHY it happens. Basically, your body is trying to figure out its new normal. During the low calorie liquid and puréed stage during the first 4-5 weeks, your body has gone from burning things like carbs for energy to burning fat. But during this process you had to burn through your glycogen stores as well. (Glycogen also holds a lot of water which is why we can get dehydrated even though we are drinking a lot of fluids). Our bodies are trying to find our new normal in what to burn for energy and our fluid levels are equalizing which can keep the number on the scale the same or even climb. I have a scale that gives me my water, fat and muscle composition and during this time, I am losing fat, gaining water and muscle and the scale hasn’t changed in 13 days and knowing that my body is adjusting really helped me relax. My blood pressure also dropped enough to stop my blood pressure meds!!! Be kind to yourself, give yourself good foods, drink as much water as you are able and get your movement in. As others have said here, this is a marathon, not a quick fix. Hugs to all!

I had the Argon-zapping revision surgery in June 2022. I started losing weight, to the extent that people noticed. I lost 40 pounds from my pre-surgery weight. My 16th-century dresses fit better. I noticed that I would get stuck at a certain weight. I also got constipated. Getting unconstipated helped with the weight loss. At 40 pounds lost, I got stuck for a long time. I got frustrated. At one point, I got an appetite for pastries, and I went on a tear. I gained 20 pounds. I thought that perhaps the revision wasn’t working. I have lost 13 of those pounds (being poor-ish helps). I just had a telehealth visit with my surgeon. She said that I am at a better place than expected! She gave me more information about revision surgery. One procedure isn’t enough, and I should have been scheduled for the second procedure and been followed by their obesity surgery team. I will be scheduled for the next surgery in August. If you’re frustrated about weight loss after revision surgery, speak with your surgeon, and ask if there are further surgeries that are part of your plan. One surgery isn’t the end-all of your plan!

RickM, thank you for your reply. I'm slowly realizing it's a completely different journey than when I had my sleeve 14 years ago. I'm going to try to stay away from the scale for a while (I was using it every 3 days because when I was sleeved, I was really losing weight fast). After my sleeve, I lost 15 lbs first week, 9 lbs second week, and it just melted off. Over the summer, I'd lost 78 lbs altogether. So this is a really big change. But I'm sticking to my plan, my vitamins, and working on upping my water intake. Since May 11, I've lost 43 lbs, so in retrospect, it's really not so bad. 😊

Behind paywall, here is verbiage: Ozempic is under review by European drug-safety regulators after they received reports of suicidal thoughts linked to the popular weight-loss drug and another medicine in the class. The European Medicines Agency said Monday it is evaluating the safety risk for patients who take the drugs, manufactured by Novo Nordisk, after learning that three people who took the medicines reported thoughts of self harm or suicide. Suicidal behavior isn’t listed as a side effect for Ozempic—and a related drug called Saxenda that is also subject to the review—in the European Union, the EMA said. Novo Nordisk said the company’s studies of Ozempic and Saxenda, as well as its continuing monitoring of their use, haven’t shown a link to suicidal thinking or thoughts of self harm. “Novo Nordisk remains confident in the benefit risk profile of the products and remains committed to ensuring patient safety,” a Novo Nordisk spokeswoman said. Depositary shares in Denmark-based Novo Nordisk were flat in trading on the New York Stock Exchange midday Monday. Ozempic, Saxenda and other drugs targeting a gut and brain hormone called glucagon-like peptide-1, or GLP-1, have exploded in popularity after studies found they can help people lose significant weight. Companies initially developed the class to treat people with diabetes. Ozempic, which is approved for diabetes treatment, has a sister drug named Wegovy that is cleared for chronic weight management in people who are obese. The U.S. Food and Drug Administration said it doesn’t comment on external research or individual reports, but may evaluate them. It said clinical trials for Wegovy didn’t support an increased risk of suicidal thoughts or behavior. Prescribing information for Wegovy, however, includes a warning and precaution for these risks because it has been reported in clinical trials for other weight-management drugs, the FDA said. The EMA said it would consider whether to expand its inquiry to other GLP-1 drugs. The agency said it began its review after the Icelandic Medicines Agency reported suicidal thoughts by one user of Ozempic and similar thoughts by a user of an older drug in the class called Saxenda. A third case reported by the Icelandic agency involved thoughts of self-injury by a user of Saxenda. Write to Melanie Evans at melanie.evans@wsj.com

The good news is that this seems to be fairly normal - our weight loss when we start a major effort, surgical or not, tends to be front loaded - lots of initial loss, mostly water weight, and then slows down. Plus you are just getting in.to the "three week stall" window where weight loss typically slows or stops for a bit while the body absorbs what has happened to it, and then resumes (though usually at a slower rate.) The not so good news is that as a revision, weightloss is typically slower and less than with the original surgery. My simple minded thought on this is that originally, our stomachs will hold 32-64 oz, but now after your original WLS and whatever stretch and adaptation it goes through over the years, it might hold 4-6 oz, yet you have adapted to that (learned how to eat around your sleeve/pouch) and still regained. So things will be slower. And, the biggest loss tends to be around surgery time when we are stuck with the highly restrictive pre- and post-op dieting. Additionally, the RNY is metabolically similar to your original VSG, so it doesn't provide a big change over what you had - so it is much slower going the second time around. (The DS, duodenal switch, is stronger metabolically than either of the others, so does work somewhat better on regain, but few surgeons offer it, or mention it.) Those who I have seen who have done really well with revision weight loss are those who take the "I'm not going to let that happen again" attitude and really knuckle under and get, and stay with, the program.

Let me introduce you all to the many ways I’ve eaten eggs this past week. 😂 I was feeling a little heavy so wanted switch up my diet back to keto (which has worked for me in the past) and decided on a slightly modified egg fast to get back into things. Lost 7lbs of water weight in 4 days. Eggs with avocado (my modified one a day veggie choice) and feta, hard boiled eggs with mayo and hot sauce (not pictured), snickerdoodle cream cheese egg crepes, scrambled eggs with cheese, hard boiled eggs and chipotle mayo, a pizza chaffle moth marinara (my modified one a day veggie choice), garlic bread? ( this recipe needs work but the flavor was good), the recipe called it a crustless quiche (with mayo added), mini lemon cheesecakes (these were SO good!), and then cloud eggs with homemade hollandaise (these were just ok). Annnd what I ate for breakfast this morning was these reverse scotch eggs.

Thank you. I do understand the reasons and how necessary the pre-diet is. Not doing it is not a question, I do understand the need to get the liver as small as possible. My concern was I’ve been doing the pre-diet in sort of a “Light” version, trying to figure out ahead of time (with my nutritionist’s encouragement) the flavors I like and the mechanics (like what blender works best, powder vs premix, etc etc). I want to know what I like, get the shopping out of the way and be ready to roll when the time comes. I was surprised to see the scale dropping, thought to myself Wow, I can lose weight just drinking one protein shake a day? Might want to rethink this whole thing- and then I started taking my glucose readings. What I’m worried about is it’ll be 2 more months minimum before the surgery, mandated by insurance prerequisites, and my diabetes has taken a turn for the worse. Up to this point, it’s been borderline but OF COURSE now my numbers have started spiking and I’ve started losing weight. My insurance has a BMI of 40, or of 35 with health issues. I’ve bounced around between 37 and 42 over the past few years, have the health issues (diabetes, heart, high blood pressure). I’m seeing the endocrinologist this week to probably be started on medication and I hope that gets things under control quickly. My worry is the weight I’m losing has been unexpected. I know from family members that weight loss was one of the first signs of diabetes. They regained the weight eventually, but it was rather dramatic, and muscle, not fat so there wasn’t even a silver lining there. So. That’s my worry- if this weight I’ve lost (and will possibly keep losing for a little while until medication and diet modification stops this) added to the weight loss from the 2 week liquid diet could slam the brakes on the bypass surgery at the last minute.

The pre op diet is also known as a liver shrinking diet. It’s in place to reduce the size of your liver to make it easier fir your surgeon to see where they’re operating. This is it’s real purpose. Of course losing some weight pre surgery also benefits your health & recovery, can help with breaking some habits & getting you in the right mind set for what’s to come. I’ve never heard of any one on this forum having been denied surgery because of pre surgical weight loss but that’s not to say it hasn’t happened. Check with your insurance company to be sure. All the best.