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I'm nearly 10 months out now. Lost 75 lb. I'm 5'6", starting weight 240, now 165 (which is goal according to my surgeon but I'd like to lose 10 more). I feel awesome, sleep better, take the stairs without thinking about it, have more energy, and get lots of attention from men (ok that's the downside, but have to admit it feels good!). My meals are protein-focused but i don't count grams anymore. I drink around 40 oz per day and no issues, take my Vitamins, my labs look great. No blood pressure medicine the last 6 months. I didn't advance my diet nearly as quickly as the previous poster, but tolerate everything well in general. Fried foods give me nausea so i avoid them (not good for me anyway so no big deal). I avoid bread, biscuits, Cereal, tortillas, etc (except the low-carb tortillas--I will have ONE and make a Taco or mini pizza out of it, and I'm full). I don't drink alcohol because my fiance is in alcohol recovery, but it has a ton of calories so it's best avoided anyway. As a snack i will eat a handful of nuts and a cheese stick or a Greek yogurt (which contains extra Protein compared to regular yogurt and i think it has a better texture). Sometimes i will have 8 or 10 Blue Diamond Nut Thins with a little cheese dip to squash that craving for something crunchy. I love to go to Red Lobster and order the snow crab. So yummy and my tummy tolerates it very very well. For exercise i walk about 12 miles/week or more. This is a new way of eating for me, and it's for life. It's working for me, I'm used to it now and i like it. I'm very happy. Only regret is i didn't do this 10 years ago. Don't be afraid. Realize this is the first step in a journey that will bring you joy, health, and a longer life!

Carlene: You are a gorgeous wonderful mom to take on your grandchildren for your DD and in all probablity giving the children an upbringing they so richly deserve. My bro in law is an alcoholic and a bi polar now in his 70's. Has been sober pretty much of of the time with a few slips. AA helped him and today he is in his 30th year. My sister went to Alanon for support. Somehow you wonderful woman must make time for yourself. All the baby chasing etc is tiring, but nothing like a little time off for yourself will revitalize you. You need that aqa walking. Is there anyone you know that could take the children for a 1/2 hour. In our community centre, they have day care for single moms while they take the exercise program. Any around your area? Just a few thoughts.

HW 243 SW 228 12/3/13 CW 186 Total loss 57 pounds Lost 3 pounds last week even though I was on vacation at an all-inclusive resort! That is more than I usually lose per week at this stage. I ate what I wanted, but no rice, pasta or fried foods - I did have a tiny bit of bread 2 or 3 times. I completely skipped all the free alcohol, but I had 1-2 bites of desert with dinner. I took protein powder packets with me and the staff was willing to blend them for me with a little juice or milk. I had them add a little fruit and ice. I was also very careful to stay hydrated since it was about 85 degrees each day. One big change was the amount of exercise. My work is sedentary and it is a good day if my Fitbit records 3,500-4,000 steps. However, this resort is so large that they run a golf cart shuttle to help you get around. I walked everywhere instead, so I was over 10,000 steps every day and went as high as 13,000! I have not exercised hardly at all since my surgery and now I see why others weight loss is much faster than mine. I know what I need to do...

I have an event that I told a friend I'd go to a while back. Tickets are bought and I want to do something fun. I was 100% prepared to cancel when I asked my surgeon when I could have alcohol again, and I was surprised when he said it was okay. I'm planning on having a non-carbonated drink, maybe two, and that's it. I'm sure it's not going to help me, but I don't think it's going to hurt either. For me, it's worth it. The point is I discussed it with my surgeon first and am adhering to my own plan set by my surgeon and NUT. I trust him completely and if he says it's okay, then I feel comfortable drinking in moderation.

I do not drink at home after a stressful day when I am alone (that's when I ate too) It stared for me with my pain meds (refilled twice after surgery) I found I was taking them at night to relax. So I stopped quickly! I've never had a drug or alcohol problem so it surprised me at bit. I will have 1 glass of wine or cocktail if I go out to a social function only, and that's not very often. It's a good thing that you are noticing it now and are looking for a way to deal with it.

Careful with the Werther's. Lots of us are very sensitive to the sugar alcohols in them, and this can become more of a problem postop. I discovered the mini Werther's preop and was SO excited---until I discovered that 1/3 of the "serving" had more sugar alcohol than my poor gut could tolerate. Horrible cramps and diarrhea ensued---which is likely something you don't want to experience. So, take it slow with them until you determine whether your body has difficulty with sugar alcohols. Some people have no problem at all with them---but for others, they are misery.

The holiday season is here and it’s time for us all to quickly gain ten pounds. What? Why would I say that? I say that because it’s written all over the place. Over the next few weeks, you are going to see and hear references to our tendency to gain weight during this time of year in every newspaper, magazine, website, blog and television news program. And while the opportunities to eat may increase this time of year and the kinds of foods pushed on us are often not the healthiest, you don’t have to gain weight. However, if you expect to…you will. The holiday season is here and it’s time for us all to quickly gain ten pounds. What? Why would I say that? I say that because it’s written all over the place. Over the next few weeks, you are going to see and hear references to our tendency to gain weight during this time of year in every newspaper, magazine, website, blog and television news program. And while the opportunities to eat may increase this time of year and the kinds of foods pushed on us are often not the healthiest, you don’t have to gain weight. However, if you expect to…you will. What do expectations have to do with weight gain? Think of expectations as a combination of predictions and learned patterns of behavior. Outcomes that have occurred in the past, we generally expect to happen again. Take Thanksgiving for example, or what I like to call “National Binge Eating Day.” Thanksgiving is one of those few days of the year where the holiday seems to be about overeating. Of course, Thanksgiving is supposed to be about taking the opportunity to give thanks for how fortunate we are to live in this great country and to count our blessings for what we have. However, if you ask most Americans what comes to mind when they think of Thanksgiving I’ll bet turkey, stuffing, pie and football come long before giving thanks. More importantly, it’s not only food and eating that we think of but overeating and overindulging. This is so common that it’s often parodied in television commercials. Companies that manufacture antacids run ads showing people with exploding pant buttons or slumped back in the big armchair following the big meal. Thanksgiving, holiday parties and overeating seem to be synonymous. Many of us expect to overeat on Thanksgiving and at holiday parties so we inadvertently mentally gear up for this to happen. With this expectation of overeating in mind, our behavior becomes less controllable…you’re psychologically setting the stage for a binge to occur by expecting a huge meal to be served and by recalling previous Thanksgivings when you overate. Similarly, this is the season of holiday parties. Holiday parties tend to include foods that are rich, highly caloric and plentiful. And let’s not forget the alcohol. When you attend holiday parties, many of us expect these foods and drinks to be available and we are more likely to overindulge if that has been our pattern in the past. You’re certainly not a drone who is unable to make change, but it is infinitely less likely unless you take active steps to make that change. What can you do to prevent overeating at this time of year and gaining those extra pounds? Change your expectations by planning what you will do ahead of time. On the morning of Thanksgiving, think about what the likely layout will be where you are having the meal. Have you been there before? Do you know what to expect to be on the table? If so, plan ahead. Make some decisions about what you will eat and how much. Promise yourself that you will not overeat. After all, it’s just one meal and ironically many people who overeat say they’re not particularly fond of Thanksgiving food. They just get caught up in the collective binge mentality and the rest is history. If you plan ahead and carefully consider what to do instead of binging, you have a much better chance of controlling yourself and feeling good about your eating behavior afterwards. Consider that while eating may be a significant and enjoyable part of holiday parties and gatherings, OVEREATING does not need to be. Try not to give yourself permission to overindulge. Let’s face it…eating is fun and enjoyable and is a large part of holiday merriment. However, there is no fun in feeling nauseas or uncomfortable just after the meal and guilty and self-deprecating hours later. Don’t starve yourself on Thanksgiving morning or on the day of a holiday party. This is one of the most common, yet foolish strategies people employ. The calories you give up by skipping breakfast and lunch usually pale in comparison to the calorie content of the evening binge at Thanksgiving or the holiday party. Instead, eat normally during the day which may actually help keep you from binging later. You are far more likely to control yourself if you are mostly full during the day rather than starving when you walk in the door of the party. Consider making some eating compromises. Who said you have to have turkey only on Thanksgiving? Is pecan pie banned at other times of year? Consider having the foods that truly are once a year items rather than loading up on everything. And even then, you don’t need five pounds of the special foods. If you only get to eat your grandmother’s special stuffing once a year, you certainly shouldn’t pass that up. However, I promise you that eating a ton of it will not make you happier than having two nice size tablespoons of the stuff. Again, plan ahead and make decisions earlier in the day. Watch the booze. Alcohol causes our judgment to get a little fuzzy. You are going to be more successful controlling your behavior if your brain is firing on all cylinders. If you drink too much too early in the day, you’re going to have a tougher time sticking to whatever plan you created. Also, too much alcohol causes us to make other foolish decisions. There are enough unfortunate tragedies that happen this time of year. Make sure you’re not a part of one. I’m not suggesting in any way that you be a killjoy and I certainly don’t believe that it’s necessary to avoid holiday parties or gatherings where food is available. By planning ahead, changing your expectations, and making a few specific eating compromises, you can truly have your cake and eat it too. Happy Holidays!

Thank you so much, I think I am getting there by realizing that I have to ditch the alcohol which leads to snacking. I also have to exercise for at least 30 minutes a day at least 5 days a week. Thank you for the support. I hate that this thread has slowed down so much because I really need the support. This has happened to me so many times since being banded the bottom line is we have to follow the rules as you know. Sometimes we self sabotage so I totally understand the I don't know why.

Yes, I have found that there is a steep learning curve with the band. I am not where I want to be at least 60 lbs down but I am down almost 40 and if I had not been banded God knows where I'd be. I have found the band to be harder than any plan I've ever done but I have no regrets and know that if I had lost it otherwise I would have been back up in my weight. I hate the stalls and the plateaus but at least the scale is going down and I know that would not be the case with anything else. I have learned that I cannot drink any alcohol because it stalls me so in my case having those drinks on the weekend just caused me to have back to back stalls. So for the next 6 months I'm ramping up my exercise by joining the gym and watching my portions and quality of food and I'm sorely in need of a fill which I'll get on 3/9/10. I'm also going to do a 24 hr detox every Monday. I still have hopes of reaching my goal by 8/16/11...my 1 year surgiversary. We will all make our goals.

My one thing people don't know about me, I am what you get when you cross a gay alcoholic and Pollyanna. I must say it is not a bad combination!

I understand "testing the waters", but with all the warnings and rules about drinking, I would be very careful so early out. I too challenge compliance in most areas of my life, but want to lose my 100 in a timely manner without regret or accidental alcoholism or any other transfer addictions either... Even Grey goose has calories, and three of them have about 189, 2/3rds of you daily at two weeks....

That's true that no one is forcing them, but they are also not able to make a fully informed decision in their right minds. Legally, I would assume that this would open the organization up to litigation because they were taking advantage of the fact that someone might not be legally competent when they sign the consent. To me, it's the same as someone expecting a mentally retarded person to be able to fully understand the implications of what they would be signing. If a drug addict is in need of a fix, and is signing something to get money to buy more drugs, they aren't mentally competent to understand the full implications of what they are signing. This gets into a slippery slope, to me. If you start arguing about babies having rights, then you will eventually slide into an anti-abortion argument. I'm pro-choice. I think that with certain limitations (how far into the pregnancy, etc.), a woman's body is her own to control, even if she chooses to put drugs into it. If she is choosing to put illegal substances into it, arrest her and put her in jail. Otherwise, it's hers to control. That's one reason I oppose laws against pregnant women drinking alcohol or smoking cigarettes. I may not agree with their actions, but I think a woman should be able to do whatever she wants to her body.

Alanon is for family of alcoholics and alateen is for children of alcoholics. They teach family to apply the 12 steps in their own lives so they may be less affected by the alcoholic and his/ her actions. It's something you could do just for you. There are meetings everywhere and can be found in local yellow pages online. I urge you to try it. I hats to see you suffer, babe.

Yea most people think you're alcoholic or a pill popper when the enzymes are high. HW 358 SW 344 CW 273 RNY 4/11/2013

It is so hard the first few weeks. I remember watching the Food Network while at home recovering the first week post op and feeling so sad and sorry for myself like I would never get to eat again. I'm glad each week is getting a little easier and so proud that are following your plan and not using food or alcohol to deal with things. That is an emotional challenge for us all and where the saying on here that "they operate on our bellies and not our brains" comes from as we all learn to deal with our emotions. Following the post op plan/guidelines helped me a lot the first few months because it kept me focused. I kept a whiteboard to track my water and vitamins early on. Keep up the good work!

You can get particles of food in the incision. So you are not supposed to be eating anything with little pieces of anything that could get stuck. That is what I was told. I would eat ice pops so once you are cleared from drinking clear fluids I imagine you could have froyo. But...ice cream in any form is a trap. Give yourself some limits...Like I promise not to drink Alcohol until month six. I promise not to eat chips or fries until 1 year. Whatever is appropriate for you. Making sure you are in control of the driver's seat is important. The first year you won't have much control, but after a year or two you could easily lose focus since are natural instinct is to over eat.

Personally I wouldn't want to find out how alcohol was going to affect me while I was trying to enjoy a grad party. Some people get violently ill with very little booze post surgery. One month after is pretty soon to try getting drunk. The real risk is possibly spending the night in/on the toilet.

The hyprocrisy in the Catholic Church has always been a problem. Now that the Pope himself has been shown to have put the church before its' parishoners health and well being is almost unthinkable! If any of these priests had been teachers in a public school, the uproar and anger would have been played out in the news media and in our communities to the point that Americans would be calling for public lynchings. There's nothing much worse than for someone who has influence over a child, for them to sexually abuse those children. Children look to adults for guidance. They consider adults the ones who are there to teach them to do the right thing in all ways. We have a friend whose son attended a Baptist Church elementary school in Tampa, Florida. They didn't find out about their son's sexual abuse by one of the male teachers until after he was grown and had been in the Army (in a bomb disposal unit) for several years. He came home from the desert a wreck. It took many nights of drinking alcohol, hand wringing and support by his parents before he could unburden himself of the horrific things that happened to him when he was a child at the hands of that teacher. Can you imagine that scenario? Can imagine that happening to your child? They did their research and learned that the same teacher who abused their son was still a teacher at that school. How many years did that vile human being commit disgusting acts on boys who relied on him? How many other parents learned what that man did to their own sons over the years? Anyone who didn't report it and anyone who swept it under the rug is just as culpable as the pedophile himself as far as I'm concerned. John is still in therapy - too many years after his first discussion with his parents about the sexual assault against him when he was a child. The Pope and everyone involved need to be prosecuted to the fullest extent of the law. Otherwise when will it ever cease?

i just went to my first support group meeting last night (my surgery is June 11) and we went around the room and everyone got to ask a question. mine was "how soon can i have my whiskey and what kind of effects will i be looking at?" out of the 8 post-op people, 5 of them had tried alcohol. most said one or two drinks were fine, but the felt the effects WAY SOONER then they used to. the nurse there said once your stomach heals (3 months), you can have alcohol in moderation, but watch what you mix with it. my go to is a 7/7-i love them. but since we can't drink pop (which i cut out 3 months ago) i might have to mix it with some sour mix and have a whiskey sour. i don't want to get drunk, i just want to have a drink once in a while when i'm out with friends. so just remember, moderation is key!

I posted on this EXACT question 2 days ago: Now, with greater experience, and most than 1 year post-op, I feel I can elaborate a bit more. I would STRONGLY advise against drinking ANY alcohol so early after surgery!!!!! Alcohol dehydrates your body. At the moment, your everyday battle is staying hydrated and allowing your surgical site to heal. The lime in the margarita will likely irritate your stomach lining, causing great discomfort. The alcohol will get you drunk VERY fast in VERY small quantities, and you will not be in good control of your decision making regarding other foods, which could lead you to make dangerous decisions around what is safe to eat so early on. Feel free to go out with your friends, but take on the role of designated driver (if you don't want them to know WHY you're not drinking), or just tell them you are staying away from alcohol for a while because it conflicts with some meds or supplements you're taking. Of course that all assumes they don't know about your surgery. If they know, tell them the truth! Your surgeon and nutritionist have strongly advised....NO DRINKING for min. 6 months post-op. You surgeon may not have spelled that out to you (though hopefully it was discussed). The physical effects of alcohol are bad, but the psychological possibilities of developing a new dependency or addiction (alcohol vs food) are very real and serious and worse than the hangover and illness the booze might temporarily cause you. Even if the addiction part is not "in play" here, the possibility of your having less control of your decision regarding food at the concert is still very real if you've been drinking. You really can't afford to slip up and eat the wrong thing this early post-op. It could have serious repercussions and land you in the hospital with a leak or complication you could have easily avoided. You made a smart choice with this surgery. Keep up the good choices and stay away from alcohol until you're better healed and in a more normal eating/drinking routine.

When you researched and prepped for VSG what did your surgeon and NUT tell you about consuming alcohol?

I had my first alcoholic beverage 6weeks post op. WARNING, alcohol takes affect much quicker now. Pre op I could easily have 6-8shots before getting buzzed. At 6weeks 2shots & I was walking crooked. And it was a roller coaster ride. I'd be drunk 1 minute then a few minutes later feel nothing then buzzed again with nothing more to drink. It was crazy. Enjoy yourself, but even if you feel completely sober, do not drive,

Because use of tobacco and alcohol is a CHOICE and I am not going to shed a tear over those who willingly and knowingly take part in an activity that is known to cause death or disease. My priorities are perfect where they are and I am right in their order. And I think the anti-tobacco forces have done a great job against the tobacco industry. And with education. Fewer people smoke. Non-smokers rightfully demand not to be exposed to second hand smoke. Smokers are now piranhas. Not welcome where they used to be (restaurants, workplaces, etc). Thankfully. And lawsuits against the tobacco industry have been successful in many cases. Now it's time to take on the big health insurance industry. And we will win in the end. It's going to happen.

You can make your own refreezable ice pack with a gallon freezer bag. Fill it with 3 cups of water and 1 cup of rubbing alcohol and then just put it in the freezer. Make two so you can always have one ready to go while you are using the other one.

What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. 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