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None here but left the bariatric pal facebook group as it was full of toxic people who loved to enable each other eating like crap and call anyone who said differently the "food police" while inevitably they would post a few months later whining about stalls or regain. People were cheering people on eating cake at a few weeks post op because "it's a soft food". There were posts like that constantly. Maybe it's changed since I left but that's not a great support group for making better food choices.

Bariatric vitamins are loaded with lots of nutrients, so you do need to coat your stomach prior to taking them. I personally can’t stomach mine whether I have food or not. I tried to take my multivitamin with iron and I threw it back up. I actually can’t stomach food or water currently so hopefully this will pass. I hope things have gotten easier for you.

I haven’t been able to find any info on this but I am curious where soft protein bars (Built bars in particular because of the macros) fit in a Bariatric diet? Would these be able to be added in for the soft foods phase, or are they considered an after on the “regular” diet? These have a soft consistency, no chunks, and 5G of sugar or less so I’d like to add them in. Just not sure where.

Well I think that when people reach out for help from regain, they're looking for advice from others that experienced regain and what worked for them. Obviously not every approach works for every person but MANY here have found great success conquering their regain. For me, when I had regain and saw my bariatric team, they told me all the things that I knew they would say- do a post opt diet, go back to protein shakes, portion control, etc. A health issue required me to achieve nutritional ketosis and that's actually what helped me lose all of my regain and more. I conquered the health issue and lost my regain and have maintained over 5 yrs.

Had to quote this ^^^ because my cell bio studying butt REALLY appreciated the shoutout to the metabolic processes!! Long: Just to add. Quite a few peoples nutritionists, surgeons and PA’s programs are VLCDs. Atleast for the first 6 months. Mine doesn’t have me going over 1100 til June. I have a biology degree with a chem minor, so I truly get nutrition stuff. However... If it’s recommended by the team, who am I to say no, you’re wrong, I need to be eating more... To a surgeon who’s been doing bariatric surgeries since they were invented, and a nutritionist with a masters in dietetics from Vanderbilt... I get where you’re coming from, I really do. And I think you’re coming from a very sincere and concerned place. But from a purely scientific standpoint we are all different. And we cannot be treated as a one size fits all. There are people with diabetes, cancer, chronic pain, mental illness, etc. who go through these surgeries and lifestyle changes. All of those pts need to be mapped out differently based on THEM and their past medical history and their familial history. Our metabolic rates, our sugars, body fat, all the stuff that people want a “baseline” for, really don’t have a true baseline. Because it’s not one size fits all. It’s never a one size fits all. What might help you lose weight might make me gain it. What is too much body fat on you might be too little on me. If it’s going lower on Cals and carbs to lose or jumpstart, I don’t see that as such a negative thing like you’re portraying. You don’t have to restrict to something absurd like 500 cals, but dropping your daily calories by a few hundred for a short period of time is proven to be a huge factor in re-jumpstarting your weight loss. There’s a distinct difference between starving yourself and not eating a lot. I was a dx disordered eater when I was a teenager. I know what not eating is. And (I’m gonna use me as an example but I know there are plenty more, but want to only speak for myself) the 750-900 calories I’m getting a day is a heck of a lot more helpful and nourishing than a single low fat string cheese wrapped in a piece of ham and one blue Gatorade per day for 2.5 years. And I am eating 750+ calories of sustainable, clean, organic veggies and lean meats/seafoods with no additives or anything fake—very sustainable over time. Was being anorexic healthy? Absolutely not. Not advocating for that but rather in the opposite direction. You need to eat, but the devil is in the details with each pt and not in the broad “calorie range” scope. I see a very big difference in starving yourself and not eating much because of that previous experience. Just my .02$... Like I said, I really enjoyed the post, I just have a hard time even thinking about telling my doctors and team they’re wrong with giving me the diet they have me on, when this is the plan that’s been laid out for me, and many others as well. And they’re professionals. I mean, I paid almost $28K for this surgery (thanks no insurance and 4 days in the hospital), I’ve got to be able to trust that what my team is doing is to help and not harm me. And that they wouldn’t put me on a plan that will ruin my metabolism and make me unable to lose properly and gain back ridiculously. And that’s where these posts get harmful. Because they can have people doubting the road they’re on. I know for a fact it freaked me out good and well. We are all on the same, but separate journeys. I have to remind myself of that daily. You’re a good person Creekimp and very very knowledgeable. I honestly learn something new every time you post. I hope you dont take this as hostility but rather as an open dialogue as you are a vet; and I’m 2 mos post op with a medical profession and bio degree so I only know what I know from that. I promise I’m not being contentious but I know online tone and inflection aren’t always picked up and seen!! Also, how do you force yourself to eat that much in a day. I eat 6 “meals” a day and have to literally force myself to eat to almost misery each time to meet my goals. Do I need to add more fat or something to increase the caloric value of my food?!

First off, let me say that you should always listen to your doctor and nutritionist...rather than crazy people on the internet, myself included. But here's my rant today. And for what it's worth....this is just MY feelings on this nonsense. I'm no expert. Ya'll need to eat. Not overeat. But also NOT UNDER-EAT. Eat healthy food you enjoy. I know how it happens. Your weight loss gets sluggish and stuck and you think OMG, this isn't working, I'm Failing at this! You start to panic. And what does a lifelong self-destructive dieter DO when they start to panic? They go exteme. They go...ok, my doctor said it was ok to eat this much.....so I'm gonna try to eat HALF of that to speed up my weight loss! I'm going to work harder than anyone! I'm going to eat less! I'm going to force this weight off of my body...because this is my last chance and I'm freaking out and I can't fail at this, so I NEED to do better and cut back! Only, here's the thing. You don't need to cut back. You need to stay the course, nourish your healing body, have good energy to boost your metabolism and lose weight sensibly. Why do people do VLCDs? (very low calorie diets....1000 or less calories a day)....they do them because they show results in a hurry. And there is nothing people like better than a lower number on the scale...regardless of how they're achieving it. Or how harmfully they are achieving it. When you eat less than 1000 calories a day, did you know you lose more muscle than fat...even if you are eating tons of protien grams? When you lose muscle, you slow your metabolism, endanger your organs that have muscle (heart anyone?), and decrease your bone density. None of this is a good idea. And when you're eating starvation level calories, your body tries like hell to keep you from dying....by, you guessed it, slowing your metabolism even further. And the carb thing...can we talk about that a minute? You DO want to avoid carbs that are metabolized to sugar really fast, like sugary foods and refined white flour items because they can cause your pancrease to over-react and send too much insulin and you'll end up with rebound hunger....but other carbs, particularly ones that have good fiber content to slow the sugar can also have good protien content...and they don't do the rebound hunger thing. They give you great available energy. Why do we lose so much weight so rapidly when we do keto? We don't really....but the first five pounds is so quick and shocking that it MUST work! (except you're not losing fat, you're losing the water that your liver stores extra glucose in.....and you've stripped your liver of its emergency reserve of energy. And yeah...you can make the sugar you need from other things through gluconeogenesis....but it takes amino acids that your body is typically harvesting from your muscles.) Don't do that thing where you lose the five pounds eating keto....then eat a few carbs and go OMG, look at the weight I've gained!....and go keto again and lose the same five pounds of water. It's an illusion. (Not saying keto people can't lose weight...they do lose weight fast...but they also have about five pounds in lost water from glucose storage, no emergency stores, and their bodies may be consuming their muscles) Food for thought (literally!) Guess what organ runs exclusively on sugar? Pure glucose. Your brain. Your brain burns over 300 calories of glucose every day. At just 2% of our body weight....our brains burn about 20% of the calories we use each day! The CPU needs fuel. Lots of people lose weight rapidly with Very Low Calorie Diets after bariatric surgery. They have these amazing results that other people notice and are in awe of. They lose to goal eating very little and feel very accomplished about their self discipline and their amazing fast results. And then guess what happens? At goal...they are still people who have never learned how to eat sustainably for life. All they know is starvation and self deprivation. And starvation doesn't work long term. Please learn to eat sustainable amounts of calories. Do it early so you don't fudge your metabolism into starvation level calorie requirements. One of the best ways to have a robust metabolism...is to do exercise every day. It doesn't have to be the gym or something you find tedious. Do things you enjoy....but keep moving. It's hard to build your robust metabolism.....when you're too tired to do anything but go to work and go to bed...because you're starving yourself. Please eat. Don't overeat. But eat. Learn to eat right, not starve. Starving is not the cure and in many cases sets the stage for significant regain. Do it right, even it it's slower than other people. Do it sustainably. Learn to coexist with food, not avoid it. (easier said than done) Don't get discouraged by small losses. Just keep losing to goal with small sensible tweeks. You don't have to suffer extremes to have success. Learning to control your diet moderately...is the best skill to have when facing a lifetime of sustaining a significant weight loss. This end my rant. Totally ok if you think I'm nuts/wrong/whatever. Take what you like and leave the rest. Peace and best wishes to everyone on this crazy road.

Most of the veteran posts, lets face it.... are "Help, I've regained!" And the response I see over and over and over and over is... "Go back to basics...starve yourself at 1000 calories a day (or less)...start drinking protien shakes....do keto...blah blah blah" I don't mean to criticize heartfelt advice...and I know some of ya'll are genuinely trying to help. But why in the world would you tell someone to do the same thing over again....that didn't work the first time? It seems nuts to me. My two cents: see a bariatric therapist. Stop the self punishment. Stop the self sabotage. Stop the self harming extremes. Get down to the real reasons you're addicted to food, what you're medicating with it...and work on fixing those issues. If you do....making slow reasonable changes to your diet that have slow but steady results....will work. You don't have to starve. You don't have to do very low calorie diets that hurt your metabolism, your bone density, and your muscle mass. You don't have to be so freaking EXTREME. Breathe. Make reasonable changes you can live with for a lifetime. No crash diets. They don't work. You know this. How many years experience do you have KNOWING that this approach doesn't work? Stop running from the real issues.

What works for me, is this.......if I go up five pounds, I need to see the bariatric therapist. It's the deal I've made with myself, and it works. I very very seldom go up five pounds, but each time I do... I schedule an appointment, have a good talk about the triggers I'm dealing with....and get things straightened out before it gets worse. I cannot say enough positive things about using the bariatric therapist as another good tool. Best wishes to all.

Oh I see! With that additional information, things are very much broken. My best advice would be to seek a therapist, preferably one that has experience treating bariatric patients or people with eating disorders. This state of affairs is unsustainable and won't end well.

So yesterday I was given a tentative surgery date of May 19th. That's the day unless insurance drags it's feet or Covid changes things. So in preparation I have been going over my nutrition packet again and see that they say the first 3 months AFTER surgery ALL vitamins/minerals/etc. need to be chewable. So under the "Sleeve Gastrectomy" they have the following things listed that need to be taken and their recommendations/suggestions: Multivitamin - 2 tablets Bariatric Advantage Chewable Essential Multivitamin Bariatric Advantage Multi Chewy Bite Centrum Chewable Flintstones Complete Chewable OR Mutlivitamin - 4 tablets Bariatric Fusion Complete Chewable Multivitamin Now, further into the booklet it speaks about taking ONLY Vitamin B12 and B1 for each of the following stages: clear liquids (1 day), full liquids (14 days), and puree (7 days). On the soft foods (14 days) stage in then says to START the Multivitamin listed on page 6 & 7 (which I listed above). So on one hand it says take a chewable multivitamin right after surgery for three months and but then it says to basically NOT start it until 14-ish days out. So which is it? I also notice that it says under the soft foods stage, where you start taking the multivitamin, that it DOES NOT also list the vitamin B12 and B1. So, does that mean I only need those for the first two weeks/those stages as listed above and that's it? And finally............. 1. Of those vitamins listed above, which would you recommend I choose or do you recommend another kind? 2. Since it says the chewables have to be taken for 3 months, which vitamins did you then switch to AFTER the chewable stage? 3. I am anemic, should I automatically keep taking my iron pill (by crushing it or trying to find a chewable) or no since it's not listed? 4. Is there such a thing as a chewable B12 and B1? I never had to look for such things. Should I go ahead and buy these vitamins now or should I wait until my pre-operative class and/or my final surgeon visit to get clarification? Just trying to get all my stuff bought and gathered beforehand and not have to wait until last minute. Thanks so much!!!

I'm an introvert with few friends but in my smallish 15-person department at work, three people have had bariatric surgeries within the last two years so I get a lot of support/guidance there. My one close personal friend is also very supportive, as are my three adult children. My two siblings, both of whom are bigger than me, are the voices of doom and gloom and tell me I'm making a big mistake. I think it's just because they aren't brave enough to do something about their own situations.

That being said it's obvious that I'm still learning how to get familiar with this awesome little bariatric world! Most people (family and friends) I socialize with out here in the real world don't really understand this whole bariatric lifestyle! So I'm excited to be part of a virtual community who totally gets ME and YOU and You Too Girl! We are totally all in this together... I felt like the topic I wanted to bring up was a personal one and needed to be discussed by us women! So, here I am officially 7th months post gastric sleeve and have noticed for the past 4 months that a couple weeks before and during my period I get super hungry and quite often through the day i find it easier to eat on a regular schedule and snack between meals with no reminders. During this time I feel that I can consume more without getting as full as I usually do.I don't feel like this is a mental thing It's a real feeling...a body feeling thing...I cannot possibly understand why my pouch is not as restrictive during this time of the month? It's very strange...Has anybody else experienced this? Please do share!

For my visit, I talked on the phone to a nurse and after met virtually with the physician's assistant and dietitian. I can post about my dietitian's visit later if anyone is interested. First, I spoke with the nurse over the phone for about 15 minutes. She asked the following questions: What type of surgery or intervention are you interested in? What is your current weight? What is your blood pressure? Tell me about any prior surgeries? Next, I met with the physicians assistant (PA-C), for about 50 minutes. She asked the following questions: What is your weight history? How long have you struggled with weight? What do you think is the cause of weight gain? What are your lifestyle habits? Have you taken weight loss medication? Did the weight loss medication work for you? How much weight have you gained in the last year? What is motivating you to lose weight? What type of exercise are you doing? What's your living situation like? Do you eat out? Who does the cooking in the household? Do you eat three meals a day? Do you snack? What are you snacking on? Do you struggle with emotional eating? Have you been diagnosed with a kidney stone? Do you have an irregular heart rhythm? Have you had an EKG? Any bleeding disorders or blood clots? Have you been diagnosed with an eating disorder? Have you met with a therapist? Do you have heartburn? Do you have a stomach ulcer? Do you use your CPAP? Multiple family planning questions. Next, we discussed my medical history. She gave a general overview of: Obesity Metabolic processes Emotional health Coping skills Lifestyle changes Weight loss medications Expectations The differences in surgery, benefits, and risks associated with the sleeve and RNY were discussed. She made a surgical recommendation. There is a 2-form of contraception requirement. I was given an outline of tasks to complete. Those were: scheduling a blood draw and contacting my sleep center to request my CPAP usage download. A scheduler will call to schedule a psychological assessment, physical therapy, and an appointment with the nurse clinician who'll act as my contact throughout the process. It was also encouraged that I attend the support group for bariatric and weight management patients. Lastly, I was given the clinic's late policy and the reminder that if I gain 10 pounds before surgery, I will be re-evaluated to be sure I'm a good surgical candidate. I had the blood draw and eight tubes were taken. I was tested for vitamin deficiencies including B1, B6, D. Also, calcium, iron, prediabetes, cholesterol, creatinine for kidney function, parathyroid hormone, and others. Hope this helps anyone curious about the first visit.

From here: https://www.ecommunity.com/services/community-bariatric-and-medical-weight-loss-services/faq/after-surgery " What happens to the lower part of the stomach that is bypassed? The stomach is left in place with intact blood supply. In some cases it may shrink a bit and its lining (the mucosa) may atrophy, but for the most part it remains unchanged. The lower stomach still contributes to the function of the intestines even though it does not receive or process food—it makes intrinsic factor, which is necessary to absorb vitamin B12, and contributes to hormone balance and motility of the intestines in ways that are not entirely known. "

Yes, it sounds like you have psyched yourself out of eating...bordering on an eating disorder. Forget about volume and eat a healthy diet that includes protein, some veggies, some complex carbs. If you can find a therapist or bariatric team to give you guidance, please do. Are you at goal, close to goal? If so, it is even more important to focus on being healthy and rebuilding your energy and zest for life. PLEASE take care of yourself!!

Ok, i take it back. I incorrectly assumed you were living a way of life that was satisfying and “working”. Aside from continuing to ask for guidance from your team (who I realize is not being very helpful for you!). Can you align yourself with an alternate Bariatric team? Also, I’d like to suggest some therapy if you are willing and able...

they do make chewable calcium citrate, but I've never found any in stores - I've always ordered it online. Bariatric Advantage is one brand of chewable calcium citrate, but there are probably others. BariatricPal Store sells Bariatric Advantage chewables - but you can find it on other sites as well. Calcium citrate tablets you can find at places like Walgreens and CVS

It is very interesting how different bariatric programs differ in terms of some of the diet recommendations. For me, I am supposed to abstain from meat until 3-6 months from surgery date! At any rate, best of luck and let's keep each other updated since you are my surgery twin 🙂

These questions may help - some are targatted for surgeons, but there are questions in there that are relevant to your dietician https://njbariatricsurgeons.com/10-questions-to-ask-your-bariatric-surgeon/ Some of these may be relevant to you: https://medlineplus.gov/ency/patientinstructions/000259.htm

Hello, everyone! I had the Loop Duodenal Switch surgery 14 months ago on January 23, 2020. At my heaviest I was 389 pounds, but was 321 on the day of my surgery. I am currently 191 pounds and only 11 pounds away from my personal goal weight. When I was first looking into this surgery (which was the suggested surgery of my surgeon) I was wondering just how many vitamins I was going to have to take every day and just how much this was going to cost me. So I decided that since I just ordered a year's supply of vitamins I may as well share that for those of you who are looking into the surgery and want to know those things. And what exactly a years supply of vitamins looks like lol (though do keep in mind that every person is different. I take less iron then the norm because my iron is naturally high. I take less calcium for the same reason. And not every one will have just a Vitamin A deficiency. Some have B, or D, or K, or all the above) So, for me, personally, I take 2 bariatric multivitamins WITHOUT iron, 1 bariatric multivitamin WITH iron, and 2 Calcium Citrate every day. I also take 5,000IU of Vitamin A every OTHER day. How much does that cost? Well, you will definitely have to shop around and try different vitamins before you find some that you either like or can tolerate. Some people struggle finding vitamins because certain ones make them sick. I never had this problem. However, generally after a month... or three (depending on your surgeon) they tell you that you can go to non-chewable vitamins. I can't. I have something called EoE (Eosinophilic Esophagitis) which is an autoimmune disorder that I was diagnosed with in 2016 that causes narrowing of the esophagus and makes it impossible for me to swallow pills. Thus, chewables are my only option. It's more expensive that way, but nothing I can do about that so telling you how much everything is isn't going to help as you likely won't have a problem with the far cheaper non-chewable option. If you DO have that problem however and NEED chewable vitamins full time like myself, then I spent $565.23 on a years supply of vitamins. That's about $1.55 a day or $10.87 a week or $47.10 a month (it's not as bad as it seems at first glance when put that way, right?). I wanted to make this thread because anyone who has this surgery will have their surgeon's office reminding you repeatedly, so that you understand, that vitamins are something you HAVE to take with this surgery! You cannot just suddenly decide it's too expensive and then land yourself in the hospital or even DIE because you don't want to fork over the money to keep you healthy. If you know the price ahead of time then you can either set money aside such as my own habit of setting $50 aside a month so that I can just order 6 months or a years supply at a time once I have enough to do so (I just wiped out my vitamin savings with this recent order though lol). I wanted to make this thread because when I was going through the process I really would have like to SEE what a years supply of vitamins looks like! Also, if you have any questions about the Loop Duodenal Switch/SIPS/SADI-S and my own experiences with it, feel free to ask! Well, here's what a my own years supply of vitamins looks like:

I had appt at surgeon’s office today. I asked the PA about not feeling the restriction and she said as I increase the density of foods I should feel it more. ( I.e. will feel full earlier with steak than yogurt). She said if I was stopping before I get that feeling and feel I have eaten enough that is fine. The Nut felt 3 oz of chicken at one time is too much for where I am post op even though I feel no restriction, and I should back it down to 2 oz so I can add veggies etc now. I have been progressed to regular bariatric diet after this.

Most surgeons recommend using chewable vitamins for the first several weeks after surgery. I used Barimelts for the first 6 weeks and then I switched to BariatricPal Multivitamin One. I tried the chewables and did not like the taste, but now I take the capsules so that's not an issue. I also tried a sample pack from Bariatric Fusion, but I preferred the taste of Barimelts. Next time I order multivitamins, I am going to start the annual BariatricPal MultivitaminOne subscription because it's a great price. Some people take regular (non-bariatric) drugstore vitamins, but if you do that, you have to take a double dose, so you don't really save any money.

They'll give you a lists of things you'll need to do before they'll approve and schedule you. Each doctor is different, but most will want a history of weight loss effort, a medically supervised diet with visits to dietician and some weight loss, clearance from a bariatric therapist, medical tests...some want support group attendence, fitness classes, etc. Just very much depends on your surgeon's group policies. They will likely discuss benefits and drawbacks of each different surgery. They'll measure you and weigh you and give you a list of things to schedule.

Yes. Seeing the bariatric therapist helped. Best wishes.

Bariatric Advantage does not taste bad they just cost too damn much