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insurance generally doesn't require you to jump through a bunch of hoops (as long as you qualify, which you said you do) other than many policies require a diet supervised by a physician or dietitian (often for six months) - although not all have this requirement. Your bariatric clinic, on the other hand, will likely have you go through several medical clearances, though - blood tests, sleep study, EKG, etc. Some also require you to go through classes. You may first need a referral to a bariatric surgeon from your PCP - so I would start there. Once you're an official patient at a bariatric clinic, the process will begin..

Congratulations to you. I can't give perspective as a parent, just as a child. I know that my mother has made plenty of changes in her life that were not bariatric surgery but affected me a lot. At the time (when I was a teenager/in college) I was upset about some of them. But I got older and some time passed and I realized that she had to do those things for her. It might take a little while for them to get on board but they love you and they will get there. You just have to stay the course and do what is right for you.

Yes. I am ashamed. I ate a cup of nonfat yogurt with 1/8 cup of brown sugar and cocoa. Boy was it good but it wasn’t worth it. I felt much better physically the rest of the day after that, but I got on the scale tonight and I weigh 5 pounds more than I did this morning. So now I have lost a net 7 pounds instead of 12 in 6 days. I’m not going to kick myself over it. For now I guess I’ve got to continue the keto journey even if i do not feel well most of the time. Because I’ve passed out once and almost again yesterday, I am going to call the general doctor tomorrow to schedule an appointment before surgery. Because I don’t think things are right with my body. The bariatric clinic says it is not the diet but I am not convinced of that. It may be that some people just cannot do well on a plan that has only 10 grams of carbs per day and 700 calories. I mean, I am 65 years old.

You may want to get a second opinion from another bariatric surgeon. I very much trust my surgeon, but before I underwent surgery I got a second opinion from another practice to confirm I was doing the best surgery for my situation.

Your team may give you a list of shakes they prefer, but generally I think 5grams of sugar or less and 200 cals or less per shake. This criteria seemed to be the common thread in all of the shakes recommended to me by my team. Protein isolates appears to have better bioavailability than concentrates. (Someone please correct me if I’m wrong) Besides that it will depend on your personal preference for flavor and tolerance. They range from shakes, and shots to waters and soups. So there really is somethings for everyone. Testing a few at a time instead of buying a huge supply can definitely help until you find your go to brand/type. This site’s store has a ton of options. Vitamins (Bariatric) are also preference based but I personally favor one a day types.

re: shakes, everyone's tastes are so different that you're bound to get 100 different answers here. If you can find individual packets online or in specialty stores (like Vitamin Shoppe), I'd pick up some of those - that way you're not stuck with some $30+ tub of protein powder that you hate. here are the vitamin recommendations from the American Society for Metabolic and Bariatric Surgery. You might have to scroll down a ways to see them - and be sure to check the recommendations for your particular surgery (although some clinics have both sleevers and bypassers on the same vitamin regimen). For pharmacy or grocery store vitamins, you usually need to take two multivitamins a day to meet requirements. There are some bariatric-specific multivitamins out there where you only have to take one per day - but either will work as long as it meets the requirements (I take Centrum or the generic equivalent): https://asmbs.org/app/uploads/2017/06/ASMBS-Nutritional-Guidelines-2016-Update.pdf

I had emergency gallbladder surgery about a month ago. I found out I had a BMI of over 50, & a fatty liver. My gallbladder surgeon highly recommends gastric sleeve surgery. He does bariatric surgeries as well as general. Yay me... I have begun my journey; I had my 1st dietitian appointment, done my upper GI scope, have a cardiologist appointment this week & a follow up to the upper GI this week. I am waiting to find out about the sleep study and have 2-3 more appointments with the dietitian before surgery... Was wondering what the best pre & post Op protein shakes are best as well as liquid & chewable vitamins are recommended..... Sent from my LM-Q730 using BariatricPal mobile app

Many people do not tolerate higher levels of Iron in Bariatric vits. Certain types of zinc can also make you nauseous. I personally take zinc piccolinate and use desiccated liver caps for iron and other vitamins along with a B complex pill. It’s annoying to have to take so many pills, but vitamin intolerances are common.

I am in Ontario and almost 6 months post op RNY. When working through the OHIP process for bariatric surgery there are a lot of resources provided including documentation on all the do's and don'ts etc. I believe that all of these surgeries covered by OHIP are funnelled through the Ontario Bariatric Centres of Excellence. This way they were able to achieve some level (using that loosely) of standardization. I would be very surprised if the clinic/surgeon you are going through doesn't have some sort of similar options to offer you. Sometimes advocating on your own behalf isn't easy but I personally think the surgery is the easy part. The rest is what's hard. I would like to send you a pm but I have never done that in here. I will give it a try.

This 4-ingredient* protein mug cake is amazing! (*This recipe is awesome as written, but see below for my recommended modifications.) Cocoa powder, protein powder, pumpkin puree, and sweetener of choice. It sounds weird, but you don't taste the pumpkin once it's cooked. You can even make it vegan if you use vegan protein powder. https://masonfit.com/one-minute-protein-brownie/ There are a lot of low-carb mug cake recipes out there, but this is the best one I've seen because it's so easy, low in calories, and doesn't require any weird, expensive, hard-to-find ingredients (unless you count protein powder, but I'm guessing most bariatric patients have a tub or four of protein powder in the house). It's amazingly cake-like for something that contains no flour. I normally eat it directly out of the bowl/mug, but I wanted to get a picture that shows the texture (unfortunately, I'm a terrible photographer, so you might just have to trust me). . I find it a bit dry (which could be because I use whey protein isolate instead of the recommended whey/casein), so I always top it with sugar-free syrup or melted sugar-free Jello (plus a dusting of powdered Swerve), flavored Greek yogurt, or -- my favorite -- raspberry or strawberry puree (sometimes I mix about half a tablespoon of raspberry puree into the batter, which adds a little moisture). . Although this recipe is great without any modifications, I couldn't help myself from tweaking it. I like to add a pinch of salt and a splash of vanilla. I also like to substitute half of the pumpkin puree with liquid egg substitute (like Eggbeaters), which provides even more protein. But that makes it more than 4 ingredients, so if you want to keep it simple, you can stick with the original recipe. 1 tbsp dark cocoa powder 1/2 scoop vanilla protein powder (or any flavor you like) Optional - calorie-free sweetener to taste (about 1 tbsp sugar equivalent) Optional - pinch of salt 2 tbsp pumpkin puree 2 tbsp liquid egg substitute (Eggbeaters or equivalent) Optional - 1/2 tsp of vanilla extract Mix dry ingredients in a mug or small bowl. Stir in wet ingredients to make a smooth batter. Microwave for 1 to 1.5 minutes (it might take some trial and error depending on your microwave; 1 minute 20 seconds is perfect for me). . Seriously, this is SO GOOD! If you try it, let me know how it goes!

I posted about this on the sleeve forum before. I developed GERD after my sleeve and was able to control it with one PPI a day until the end of 2020 where it's increased to two PPIs, 1 H2 and tums all day. Had issues with vomiting, nausea, stomach and chest pain. Difficulty swallowing. Sore throat since December. Had an endoscopy 3/3. Lax LES causing GERD, gastritis and a nodule in the antrum of the stomach that appears to be benign but will be removed in an endoscopic ultrasound in June as a precaution as it has a small risk of turning cancerous later on. Gastroenterologist referred me to my bariatric surgeon believing revision is needed. My surgeon wasn't sure on revision because I have lost all my excess weight with no regain. I have only been in maintenance for 4 months though. He sent me for a barium swallow. Had the barium swallow and the radiologist found esophogeal dysmotility and a hernia that the endoscopy had missed. Radiologist said I will either need a nissen fundoplication or revision to bypass along with hernia repair When I called my surgeon's office to schedule a follow up the nurse said something about maybe a hernia repair would be enough which left me feeling confused. I told her I want do whatever has the best chance of not having more complications or needing more surgery in the future. I had my galbladder out June 2020 after sleeve June 2019 and really just want to be healthy with no more surgery. My follow up is on Tuesday. I am not sure what my surgeon is going to recommend. From posts here it seems nissen isn't the best option for sleeve patients. Would hernia repair be enough or is revision to bypass the best option? I just don't want to be getting hernia repair and then still have reflux be a problem due to my esophagus and end up needing a revision later on.

Yes, I am having the same problem. I passed out yesterday trying to stand up. Thankfully I landed on the couch. I checked with my daughter, an RN; she says it is hypoglycemia. She brought a glucose monitor for the next time it happens. Your blood glucose must stay above 70. What she did yesterday is cook me some yellow squash. That worked for around 20 minutes. After that, I just went to bed for the day. I have a call into the Bariatric Clinic; they told me to go to the ER. I didn't do that because it costs me $350 each time. I feel certain it is hypoglycemia since it goes away after I take in a few carbs.

I take the bariatric advantage chewable multivitamin with iron and their calcium citrate chews both twice a day and use cocoa butter and collagen peptides daily to help minimize excess skin.

I had bypass revision on Jan 11,21 which included a common chanel resection as well as making the original pouch smaller. I have lost 62 lbs and am doing amazingly well post op. No vomiting, nausea, or heartburn, I still have 3 weeks left of taking a daily prilosec but then I will be just on my bariatric vitamin and calcium chew. I was able to stop taking my only prescription medication for high blood pressure. I go to the gym about 4 times a week and my back pain has decreased significantly. My comfortable goal is to loose 40 more pounds but would love to loose 45 just to make sure. Sent from my SM-G965U using BariatricPal mobile app

My surgeon's office also recommended Bariatric Fusion chewables or liquid vitamins for the first couple of months. They did advise against patches, which is unfortunate, as it seems like such a great idea for post-op patients.

My surgeon's office recommends Bariatric Fusion chewables. I started taking one per day while I'm in pre-op phase, but post op it's 4 per day to get the required vitamins. Multiple pills, but at least it's just one vitamin bottle on the shelf.

Good Luck all with your pre-op diet and surgeries! You all will do great! For me, the 1st couple of days home after surgery were a bit rough, but by the third day, the brain fog was gone and once I figured out how much I was able to sip at once, it was much better. My surgeon said that the more I drank, the easier it would get...he was right! I also got some Proti Diet 15g Protein Soup - Chicken. My clinic sells them for $10/box of seven. Had them in the hospital and they actually soothed my new tummy. And are really good. They have been a life saver for me with getting my protein in each day. You can get them various places online, including Bariatric Pal Shop.

I am seven weeks out and those doubts and fears still creep in that I will be one of the non success stories (I’ll lose it but gain it back). I am thinking about seeing a bariatric therapist to help with this and issues with eating when board. A lot of people seem to really get a lot out of having a bariatric therapist.

patches seem to work for some but not for others. I've never tried them because I'm afraid I'd be one of the people they don't work for. you have to take two of most multivitamins to meet requirements. I think there are a few bariatric-specific multivitamins where you only have to take one per day, though - but anything from a grocery store or drug store (like Centrum) you have to take two per day.

My surgery is feeling very real now, having just booked a taxi to get myself to the hospital on Sunday morning (April 25th). The hospital is a 1hr drive away which isn't great (largely because of the added taxi expense) but there was a 12 month wait at my nearest hospital whereas its only been 1 month since my initial phone call to this one (I'm in the UK, paying privately). I've lost 24lbs in a bit over 3 weeks of pre op diet and got a 50lb total loss from my highest weight a year ago today as I did keto for 11 months before the pre op. I've come a long way over the last year, and regularly cook, shop for and have in the house lots of foods that previously I couldn't have resisted (I'm taking about you, pizza, ice cream and biscuits) without finding it a problem. I've also happily gone through the drive through with my (slim) husband and felt perfectly content with my protein water. There was a question earlier about doubts following a successful pre op diet. For me, having lost a lot of weight in the past and losing quickly on my pre op, I'm happy to have surgery. Research shows that for many reasons including hunger hormones, metabolism and fat cell activity weight loss surgery makes it significantly easier not just to lose weight but to maintain that loss. The way I see it from my research and experience is that losing weight through diet leaves you slim but in a body that physiologically is doing everything it can to get you back to being fat. Surgery leaves you slim in a body that has in a sense been reset to being slim and is not trying to get fat again. Do it by diet and you'll be left fighting your body as well as your mind to maintain. Do it by surgery and you don't have to fight your body, just keep control of your mind. That's much more achievable. Preparation wise I've got lots of protein water and shakes ready that I know I like plus chewable bariatric vitamins. I'm feeling very settled on the liquid diet which I'm glad about as I think it'll make the post surgery transition easuer. I've treated myself to a new pair of headphones with alexa built in to make my hospital time and recovery a bit more convenient. I bought a giant cosy dressing gown for a bit of comfort. And I've sorted all my outdoor sports gear /books /maps etc which have ended up in the loft after a blissful period having lost 140lbs about 12 years ago that didn't last very long before it all came back. I've read a whole load about bariatric surgery and nutrition and have lots of self improvement books lined up to read or listen to to help me keep working on me, not just my weight and relationship with food. I'm so excited about my new life and feel very determined and prepared. Loads of waffle there... Can you tell I'm excited?! Sent from my VOG-L09 using Tapatalk

@Jaelzion is correct. The ultimate decision to proceed or not is up to you. And feeling unsure or questioning your decision is not uncommon. Sure, people do struggle in those first couple of weeks. They just had surgery & are recovering & healing. Plus their digestive system has been altered which is a shock to the body. The initial diet, which is to support the healing & recovery, is pretty restrictive. The new digestive system can be pretty delicate to begin & it may be difficult to find foods it will tolerate. This can be very confusing & although people may be aware it occurs the reality can still be a shock. But it does all improve & it becomes easier. Yes, some people have complications. All surgeries have the risk of complications. Bariatric surgery risks are pretty low. Much lower than surgeries you may need if your excess weight impacts your health: cardiac, joint replacement, kidney or liver problems, etc. Same with issues that may arise in the years post surgery. You’ll likely read about them, on forums like this one, because people want to share their experiences &/or are seeking support & advice. In reality they are minority & it is very sad to read about their complications. As with all things, you should be aware of the possibilities. Personally, I haven’t had any problems. Sure, my orthostatic hypotension (drops in blood pressure) occurs more frequently but it was a pre existing condition. As was the mild gerd I had before surgery. I still have it. It manifests differently now but it’s easy to manage. Every day, I’m glad I decided to have the surgery. Good luck making your decision what ever you decide.

I am on pre-op now but my doctor only provided a list of suggested protein shakes and Premier was one of them. What I would do is ask your doctor (bypass the nurse - no pun intended haha ) and tell them that you had already purchased XYZ and your budget is not permitting (or struggling with) the purchase of Bariatric Advantage. And ask the doctor if that is a deal breaker for your surgery. At the very least, perhaps they can discount the cost to something less than $90. The good news is that you'll be drinking these even after surgery so maybe buy their product for pre-op and save the Premier shakes for post-op.

Did your doctor's office suggest/push their brand or a brand that they carry or did you find and do your own? I'm asking because I had my final pre op meeting the other day and the nurse was pushing the Bariatric Advantage that the office carries. I asked if I could just use the Premier Shakes since they have that listed as an acceptable shake and I already have a few cases handy and she said no, those are only for AFTER surgery. Not really explaining why or what the different was between them and why they couldn't be used pre surgery but could after. Anyway, what did you buy/use for your pre op? The paper she gave me to order the Bariatric Advantage lists 6 flavors and it says to pick two and the price is $90. I'm assuming that price is the total amount for BOTH. I guess compared to Premier it's cheaper to get that anyway. But looking at the nutrients they're not too far off from one another. So, what did you all use? I have to have 4 high protein shakes a day and 4 servings of non starchy veggies. NO MEAT! Thanks for your input.

Thanks for taking the time to reply!! "Hiding food from others" just means hiding my eating habits from others, like sneaking food to eat by myself so no one sees my portions and criticizes. I think that's a normal behavior for someone who's ashamed of their eating. I have seen a bariatric psychologist and started CBT to identify the thoughts behind the behaviors. I can see how cross addiction could be a problem, because the coping mechanism of food is taken away after surgery. I think in my mind I just want the answers to be "ok you're a perfect candidate let's go to surgery tomorrow!" and in reality there are some things I need to work on first.

I have bipolar disorder and some history of eating issues but only for brief periods of time (maybe 15 incidences of vomiting and a few months of restrictive eating). I can't think of anyone who hasn't yo-yo dieted: I have once lost 50 lbs and another time lost 100, but gained it back. I'm not sure what you mean by "hiding extra food from others". I have no history of addiction, but I know that can be a concern for WLS because cross addition especially alcoholism is a problem after WLS. For me, the weight center (also a major academic medical center) is requiring that my psychiatrist speak to their psychologist and clear me for surgery. Did you see the bariatric psychologist?