Search the Community

Was your surgery for bypass? I just got my revision done last week just wondering how the weight loss goes after. Thanks for responding. Sent from my SM-S906U using BariatricPal mobile app

Wow, now that's worth considering. I've had IBS since my teens. Thanks. I just noticed your weight loss - 180lbs in 3 months? Wow, just wow.

Thanks for the advice and congrats. Your weight loss looks phenomenal!

Wow, 30 pills! This does make me feel better. I'm still going to ask my surgeon and PCP, but I've been reading that Cox-1 specific NSAIDS liike Celebrex and Mobic are ok for regular use. I'm on Mobic (meloxicam) for osteoarthritus. I realize the need may be reduced after weight loss but age could bring it back and NSAIDS are about all there is for this. On malabsorbtion, after looking at all the surgical schematics which distort the dimensions, I thought maybe it was only a foot bypassed. It's actually up to 5 feet which I guess could make some difference. Still, that's out of 26 feet of small intestines. I think I'm going to stop worrying about dumping. It sounds like something that can be controlled and may happen with either surgery. GERD concerns me more. I was concerned about it because I have IBS and diarrhea with cramps has been a nemisis for a long time 😣

i stopped drinking in the first day of my 2 week pre-op diet. And no, i didn't have to take a blood-alcohol test at any time. Had my first drink (2-3 sips of red wine) at around 3 weeks post op. Had my 2nd (partial) drink around 2-3 months post which gave me one of the worst dumping experiences i have had to date (it was a sugary soju-sake cocktail). I had maybe 4-5 (partial) drinks during weight loss phase: vodka sodas or very dry red wine. Now im just a normal regular drinker for the most part (but i still try to stay away from overly sugary drinks). Im 4 years post op.

Hello all its been years I think since I've been on the boards. Weight loss wise I am doing well maintaining my 100lb plus weight loss from my sleeve surgery on Mexico 3 years ago. Relationship wise things have been great until recently. A little background we have been married 20plus years and have adult children. My husband was okay with my surgery and very supportive of the surgery. We work in the same industry and for the past 6 years have been working together in a predominantly male dominated field. This has never been an issue until now. My husband recently was switched from the shift we worked together and moved to another one. When he was notified he'd be moved he had them move me as well so we could continue to work together....no big deal whatever even though I was very happy where I was. So now we are on the new shift and not in the same building and it is eating him up he has become very insecure. He doesnt question what i wear or anything like that he is jusy super insecure. Since we are on a new schedule and delegated to specific buildings he can't pop up in my work area anymore and lay eyes on me,we don't have lunch at the same time,and he is attempting to get that changed. He hasn't said anything to me directly but he gives coworkers mean looks when they look at me and tries to stay stuck to me as much as he can. I'm genuinely not understanding why he is behaving that way and it's very shocking. I don't plan on leaving him I'm just concerned as to why he is doing this all of a sudden. Anyone else dealt with an issue like this where you work with your spouse and they became insecure? I think I'm gonna talk to him about it soon I just wanna vent because this is coming out of nowhere. At first I told him about things coworkers would say to me because of transparency but now if I feel it's too much I'd just go to hr if it's bad because I'm sure he would blow his fuse. Lately anything I tell him a coworker says he wants to confront them. I have convinced him not to but this puts me in a bad position and I wonder if I should continue working with him or find something else. Advice?

My ex's uncle had this. Usually it's stumbled upon accidentally during an emergent surgery situation. Which is what happened with his uncle. He had emergency appendectomy probably about 50 years ago and the surgeons were just dumbfounded when they opened his abdomen. So of course this has nothing to do with weight loss surgery, but my advice would be if you live close to a university that teaches medicine, and has a bariatric center, reach out to them. They would LOVE to get their scalpels on you, lol. Sorry, bad joke. But yeah, they love hard cases, and atypical cases. They publish papers on these cases. You're in North Carolina. How close are you to Wake Forest, they have a bariatric center https://www.wakehealth.edu/treatment/b/bariatric-surgery I wish you the best! Keep us updated!

Look into Mounjaro. It is a diabetes med that is showing early success with weight loss. It's currently in fast track FDA trial to be approved as a weight loss drug. Patients using it report appetite suppression, decrease in food thoughts and slowed gastric emptying. I think it has the potential to be revolutionary.

Hi David, I'm in Washington also. I have just started my journey, spoke with the Dr. and am making sure I have everything done, my insurance requires 4 months of medically supervised weight loss so I'm starting that in November, and I need the Endoscopy so I'm thinking I won't be ready for surgery until Feb-March 2023. Who are you seeing for your procedure? I'm going through MultiCare.

In the weeks before surgery you’re on the restrictive pre surgery diet so no alcohol for about two weeks +/- prior to your surgery. After surgery you’ll be advised to avoid alcohol too for a period of time. Alcohol is high in empty calories, dehydrates you & will slow your metabolism & weight loss. Plus there is the concern that if you have an addiction to food you will become addicted to alcohol as you can’t satisfy your food cravings.

A chose bypass due to GERD, but I also had some reservations around dumping and medications. Medication-wise, the reality is over time, a lot of the medications you take may end up going away. Especially if they are for conditions like high blood pressure or diabetes that are often reversed with weight loss. Personally, I was really worried about NSAIDS, because I have a number of physical issues that have had me on prescription NSAIDS for over 35 years now. My surgeon agreed that even with bypass, I could keep taking them as long as I continued to take a PPI to limit the risk of ulcers. I'm also hopeful that as I get closer to goal, I may be able to give them up entirely. For the rest of my meds (if you include supplements, I take over 30 different pills a day), no mention has ever been made about me needing to adjust the dosage in any way. Honestly, I think the whole "malabsorption" thing for bypass may be a bit overblown? As far as I'm aware, the only ones where you might run into a problem are extended release versions of medications. For most of those, there are non extended release alternatives. If you have specific medication concerns, my suggestion would be to talk with your bariatric team. They can best advise you if bypass would be an issue for you with that medication. As far as dumping is concerned, dumping is far from guaranteed with bypass. I have not experienced it and many others here have not either. Plus, we've had first hand reports that even some sleevers have end up with dumping syndrome. Certainly it's much more likely with bypass, but I'm not sure I'd worry about this too much. If you do end up with that issue, it can certainly help you stay on plan and may help you do better in the long run by controlling your intake of things you probably shouldn't be eating anyway.

Medical Groups Replace Outdated Consensus Statement that Overly Restricts Access to Modern-Day Weight-Loss Surgery NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery. The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it. The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world. "The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.” In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied. New Patient Selection Standards — Times Have Changed The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.” But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5. Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.” It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide. Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S. “The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.” The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.” About IFSO The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity. About ASMBS The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

If so I suspect that refocussing on protein first, veg second, fruit third and carbs last might be a good place to start. You should still be able to use your restriction to your advantage or at the very least fill up on protein and veg to kick start another loss. I really hope you can get back on top of this. 😍

Oh I like your system of rewards! Hope you enjoy every minute of your appointment and your new hair (before and after photos please)??

Well I’m guessing your maintenance diet is a little different than your weight loss phase of the diet. I’m thinking you just have to go back to the weight loss phase. I have gained too and that’s my plan. I am going back and forth as to whether I should start with a week of my liver shrink diet which was basically two shakes and a lean protein and veggie dinner.

I have seen people on here who have gained back 30 or 40 pounds and they have been able to lose it. Your restriction should still be there. You most likely have just changed WHAT you are eating throughout all of those stressors. Change it back to your post surgery plan and you should lose. It will be a little more difficult because you probably have your appetite back but you can do it. I am saying all this for myself too as i have gained some back and I’m struggling to lose. I have an appointment set with an endocrinologist because I thought something may be wrong with my hormones because I didn’t think I was eating that bad but my husband told me last night he thinks maybe I have been splurging more than I realize (don’t quit tracking folks). I’m still going to make sure but I’m thinking that I’m right there with you. I have heard of people going all the way back to their liquid diet but idk if that extreme is necessary. I was thinking of going back to my liver shrink diet. It sort of detoxed me from all the junk and mine wasn’t too bad. Actually the more I think of it it kinda looks the same as the post surgery regular diet. It was mostly lean meat and veggies (just a little more veggies) with a couple shakes as best as I can recall. I guess what it really amounts to is just getting back on plan 100% for dinner with a couple shakes a day to cut calories a bit further. I am expecting the loss to be slower this time cause I can eat more now and I have my appetite so I can’t cut calories AS much but I’m hoping it will still come off eventually. I will be rooting for you too. We can do this.

I’ve gained 15-20 due to chemo, steroids and forced menopause and have no idea how to start with the loss

Same thing with the lack of sugar cravings. If I start getting a craving for chocolate I just have part of a Fairlife chocolate shake. The other part that's been easy for me is the lightened mental load of this weight-loss process. I used to agonize over calories and carbs eaten. I would track everything and make a point to workout several times per week. I would beat myself up over slip-ups and cheats. I was always thinking about my next meal. Now I'm less stressed and making better choices in general. The weight is steadily coming off and for the first time I don't have to fight my metabolism tooth and nail.

This is a good point. Especially if you are someone that has non-alcohol related fatty liver disease (NAFLD), or especially the more severe form non-alcohol related steatohepatitis (NASH), regular drinking probably isn't in your best interest. A lot of obese people end up with NAFLD/NASH since obesity is the leading cause. Depending on the severity of your disease progression, you may have caused sufficient damage to your liver that frequent drinking on top of that could put you on a one way path to cirrosis, liver cancer, and/or liver failure. Now that said, one drink or even a few now and again isn't going to cause severe disease. Also, weight loss often can completely reverse NAFLD, so if you didn't actually damage your liver permanently, this may not be a factor. I totally get those that say alcohol is a poison and don't understand why anyone would purposely poison themselves. Objectively though, ALL of us are here because we purposely poisoned ourselves with food. I'm in no position to judge anyone that chooses to drink. (By the way, my main hobby pre-surgery was winemaking, so stopping drinking was an even bigger challenge for me. I had to give up not only nightly glass of wine, but my main hobby.) In the end, I think we're all grown-ups and everyone needs to decide for themselves what's right. Just know the risks and decide for yourself if the risks are worth it to you.

I had VSG at HospitalBC and they also do plastic surgery, specializing in post-weight loss stuff. I'm not familiar with that side of their work, I just know that many patients return for plastics. I did have a wonderful experience there for my bariatric surgery though,

On your current weight loss journey, what was the easiest change for you or was much easier than you thought ? so far for me it has been not consuming a lot of sugary stuff. I used to crave it all the time and thought I always would, but since I reduced it down and mostly cut it out I do not have constant cravings anymore. Occasionally I get a little twinge but something small and sweet but not sugary will often satisfy. what about you?

+1 i had like 4-5 partial drinks during entire weight loss phase. Now, i am what one would call a regular drinker (some may even, dare i say, call me an alcoholic). I was a drinker before surgery as well. (Though before surgery I would drink lots in a short amount of time, every few weeks, now i drink less at a time, but more often). My increased drinking frequency had a lot to do with Covid lockdowns starting in 2020 though. From a weight-loss perspective, what little i did drink during weight loss phase did not seem to affect ME in getting to goal. Nor does the amounts i drink now seem to affect my ability to maintain my current weight (note though that i simultaneously keep an eye on my total calories - alcohol or otherwise- , so there’s also that) I get tipsy quite fast post-wls (and on small amounts), but I also sober up in record speed. As others said above, if you really want to, try it out and observe how you react, and then decide if want to again. Or, don’t. Up to you…you know yourself best. Sincerely, An alcohol-drinking-DRINKER (from Canada). (i also smoke, drive above the speed limit, and am late paying my taxes this year…)

Great suggestion. Dr Weiner just made an instagram post about the GLP-1 the other day for weight loss. It’s hard to get insurance to cover it though if your not diabetic but since you are this may be a really good option for you, OP. Also his book, a pound of cure was really informative.

It's not uncommon that bariatric programs warn people not to drink alcohol post-op. Some, like your team seem to take a "never again" approach, while some say avoid it for a specific length of time, such as the first year. As I understand it, here are the biggest concerns those programs have: The biggest concern by far is that there is an increased risk of developing Alcohol Use Disorder. As @Starwarsandcupcakes mentioned, some research suggest that susceptible patients transfer disordered eating onto alcohol. Some studies have even found that the incidence is as high as 20% of bariatric surgery patients. The second concern is that alcohol affects our altered biology differently. Honestly this is worse for gastric bypass patients, but sleeve patients still have have issues with getting drunk much faster, on much less alcohol. Further, it can take a lot longer to metabolize the alcohol you do consume, meaning you'll stay drunk longer. Bottom line, it's really easy to overdo things and end up completely drunk on a lot less booze than before. There is also the concern that this is wasted calories that provide no nutritional benefit and can slow your weight loss. Obviously for those in maintenance, this doesn't really matter, but for those still losing, it might be a concern for some.

If I were you I would consider trying the nutritionist and bariatric therapist first. Those two things are often a huge part of why the surgery is successful and they very well could just be enough to get you there without surgery. I understand that you have tried everything and can’t lose and I get it that you need to do something. I was lower BMI as well (35). But, I had the sleeve a year and a half ago and I still didn’t get to my dream weight. This surgery is a great option for many people but it is still major surgery. Post surgery you cannot take NSAIDS for pain and you may struggle with constipation plus have to take vitamins all for the rest of your life. These are all things that you can live with and of course if you still can’t lose the weight they may be things you have to live with but I wish someone had told me to give it one last try with the nutritionist and therapy before I committed to all this. I may still be exactly where I am by now but at least I wouldn’t have to wonder if I could’ve done it on my own. Having said that, ask your doctors of course because you do have medical issues that I did not have and maybe losing the weight asap is really important and the surgery is definitely a faster way to lose it. Also, IF your insurance will cover you can kill two birds with one stone if you get the process started while trying to lose. For many insurance companies you have to do 6 months of physician managed weight loss attempt anyways so you can do all that while you see if the nutritionist can help and maybe even talk to a bariatric therapist to see if you have any disordered eating behaviors that they can help you with. In terms of getting the surgery if that’s what you choose you may have to wait until you get to a BMI of 30 to qualify, BUT. If you haven’t been measured in a while your height may be shorter than you think because we shrink as we age and your BMI will be higher than you think. (BMI goes up almost an entire point just because of one inch). Also, I would still call around because I believe anything under 35 you will have to be self pay so maybe with your medical issues they would consider doing it just under 30. I’m pretty sure it’s up to the doctor.