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Differences in size never cease to amaze me. I am almost exactly the same weight as you but 3 inches taller and I am a US size 8-10. No idea how that happens. OP I am a firm believer in the concept of a new set weight after bariatric surgery. I would have been happy 15 or 20 pounds heavier than where I settled. That was my goal actually. After I got into that ballpark I didn't try to lose any more, but it just happened. And then, eating very much the same stuff, my loss then stopped. And I've maintained thereabouts for a year or more with very little effort. If you can keep eating healthy and nutritious foods then could you just see where that gets you to? There are lots of healthy people with a BMI of 25+ and lots with a BMI of 19-. You'll find yourself somewhere in the middle eventually I suspect.

The last time I was talking about having a stall after nearly 3 weeks. My weight all the sudden dropped. But, I can also tell that I'm losing inches. Even when the weight doesn't move. My energy is all over the place the past week or so, I feel like I could do a triathlon, sometimes I feel like I just did a triathlon without doing anything. I assure you it's normal. I'm seeing this first hand, also this is what I get told by the doctor, dietician, nurse and exercise specialist. Two of them have had gastric bypass. The other two have been in the bariatric field for several years. The Dietician told me my stomach is like a new baby, since I'm only 3 months post op. There's several more months ( or longer) for our body to get it figured out. Right now it's brand new. I know how tough it is to see the scale not move, but I also know this is still early in the process. I'm trying to look at it like I have a brand new 3 months old stomach and there's going to be growing pains. Try not to be hard on yourself, it's a process and it takes time. That's what I keep trying to tell myself. I know it's cheesy and a line from a movie. But, like Rocky Balboa, if you get knocked down the only thing you can do is get up and keep moving forward.

I'm surprised they didn't give you a sleep study. The Bariatric clinic where I'm going requires it before moving on through the process for bariatric surgery. If you're not having any sleep issues now, you probably didn't need it. Glad to hear you're hitting the Fluid and Protein goals. Good luck on your journey.

if you're having your surgery in the US, the bariatric clinic usually includes post-op care, at least for the first year. My clinic provided it for the first five or so years - after that, patients who didn't have any issues (which is most of us) were referred to their regular PCP for their yearly exams/bloodwork. if you're having your surgery abroad, It depends on your US doctor if he/she will do follow ups. Check with them before your surgery. If it's an emergency, I can't imagine a hospital turning you away. Although that said, emergencies are pretty rare.

Thanks all. I am still losing weight each week so it wouldn't be for any time soon, I was just wondering about it for an extra energy boost at a later date when I am sure I might reach a plateau. I had seen it really heavily plugged on a bariatric blog so was wondering about it.

WOW. No offense, but I'm glad I'm not in the UK. There's absolutely no way I could do 4 weeks. 2 weeks pushed me to my very limits. By the time I couldn't do it anymore and was ready to just give up, it was the day before surgery! I give you all the credit in the world. Just hearing 4 weeks would have absolutely put me off from the surgery. The fact that you're doing it is extremely admirable and impressive. We'll all definitely be here to support you and cheer you on. If you can do 4 weeks of this, you can definitely stick to the bariatric diet after.

I had my one year check up with my bariatric surgeon yesterday, labs were all perfect, I was told I'm 20 percentage points down in my BMI and the surgeon said I'm exactly what the program hopes for in outcomes...etc. Etc... My questions to the doctor were the following: 1. When do I quit aching / feeling pain in my hips, shoulders and elbows I've heard so much about after losing weight?! He asked if I had this pain beforehand, I told him no its all since surgery. 2. I also asked about occasional pain that feels like gallbladder pain now (its been removed) asking if it could be a stone in my biliary tract? He said not likely its probably just "phantom pain." All fine and good but there's nothing phantom about it - it hurts like my old gallbladder attacks! 3. Lastly, I wanted to know when I get the magical much talked about energy after losing weight? He said everyone is different, and "you do seem to have an odd bunch of symptoms that should go away after surgery - not start up"! He went on to say that I might not meet my goal, saying it might be "unrealistic" yet I asked at my first meeting with him when he asked about my goal if it was unreasonable to which he said no! If I'm doing "exceptionally well" on the program then why is it now possibly "unreasonable"? He said I've got maybe 6 months more in which the surgery will continue to help me lose weight, but since its slowing down...I probably won't hit the goal (40 lbs to go). He knew the average weight lost in the 18 months following surgery, why say my goal was reasonable then? Sorry, I'm finding myself annoyed and discouraged now. So, my questions are: anyone else around a year out that is or has experienced the above issues? If so, do you still deal with it? If not, when did it go away (any of the above)? Did you after being told your goal is unreasonable and probably won't hit it, continue to lose and hit your goal or did you adjust your goal?

Hi, @AnyaC! I'm Andrea. I haven't been scheduled yet, but given the requirements of my insurance, I think I'll be having surgery in August or September. So if we're not exactly September surgery buddies, we're probably going to be close. Right now, I've had my surgeon consult, a zillion blood tests, and my first dietician visit. I have several other required pre-op appointments scheduled, including an endoscopy (tube down the throat to look at my esophagus and entrance of my stomach). Not looking forward to that, but it's my surgeon's standard and he's done about a million bariatric surgeries, so I guess he knows what he's doing. I've just gone from drinking tons of carbonated beverages to 2 cans a day. Thought it would be really hard since I get my caffeine from diet Coke (don't like coffee) but it's been easy so far. I'm reading everything I can get my hands on, trying to learn all I can. I'm about a month into my new exercise routine. I work from home so I got a treadmill and I walk during meetings. I'm doing 20 minutes, 3 times each workday, so it's a mile and a half currently. Monday I will go to 25 minutes. I want to be in the best shape I can for surgery! So what do you have to do pre-op? How are you feeling about it all?

@BlueParis The liquid diet isn't so bad. I guess it's a good thing I'm not actually hungry. I bought a bunch of smooth soups to add my protein powder to so I wouldn't need to do shakes, and picked up some favorite yogurt flavors. For the vitamin issue, are you able to buy Celebrate or Bariatric Fusion brands of vitamins in France? If so, they both make multivitamins that are iron free, and then a soft-chew iron supplement. I would suggest getting your multivitamin in first thing and then taking the soft chew iron in very little nibbles throughout the day. Celebrate's cherry flavor is pretty good, and the texture is like a chewy candy (like Starburst, if you are familiar with that candy). It's probably the 45mg of iron hitting all at once that's causing the issue, so if you took the very tiniest of bites 6 or even 12 times per day, you could get the iron in by the end of the day without the shock to your stomach.

Thank you all so much. I was so taken aback by this entire conversation. She even had the gall and AUDACITY to ask me if I wanted to try phentermine!!! PHENTERMINE!!! I told her that not only would I never ever take that, I would be finding a new doctor. For her to KNOW about the cardiac issues I had after my hernia surgery in December and then suggest a medication with known cardiac implications....I can't fathom what was going through her mind. She said to me that if I felt better at maybe 170 instead of 155 or 160, she could maybe see if that would be ok. I said "Ok with WHO?? It's MY body, and I'm ok with it as it is now". She said I've come so far and made so much progress that it seems like such a shame to not get myself to a healthier and more normal weight and bmi. I explained AGAIN that I lost 238 pounds from my highest weight, which is what I weighed when I first came to her. I reminded her that SHE REFERRED ME TO THE BARIATRIC SURGEON. I reminded her that I've lost 205 pounds since my first surgery. I've done enough. I've gotten off all of my meds that I wanted to, started the career I wanted, became active and started doing all the things I wanted to. I have my life and health back. There is NOTHING else I need or want to accomplish, besides plastics in a few years. She didn't use to be like this. She was an amazing doctor. But for some reason, she's jumped on the BMI bandwagon and decided that it's the only way to judge if someone is healthy. I can't get behind that, and I can't tolerate this from her anymore. Definitely looking for a new doctor.

That definitely doesn't sound normal. I would definitely consult your bariatric team or PCP.

Hey Warren, I'm presuming because they would only look at fixing the opening if they did feel it was contributing to the pain and other issues I'm having 'downstream'. This would not be a true revision in the sense of reducing the size of the pouch. My insurance company also only pays for 1 bariatric surgery in your 'lifetime'. They would only pass for the revision of opening if it were medically necessitated, and they would not consider 'failure to lose weight' or a 'weight regain' as medically necessary. My GI wanted me to talk to the bariatric surgeon who specializes in revisions. The surgeon does not think what is happening to me is 'dumping due to widened opening'. He said it doesn't sound like dumping to him and if that happened to everyone whose opening widened, everyone would be having "dumping" issues after a couple of years. He did point out that both the upper and lower GI I had done do not look at the inside of the pouch so if there is a hernia that is causing the on again/off again pain and on rare occasions bleeding (looks like coffee grounds), then the GI doctor would not know as they never 'scope' the pouch for a routine upper/lower GI. He also indicated that depending on the scope size a GI doctor uses, it doesn't go through every single space that we have (due to us having been um "modified"?) so it would take a doctor who uses an extra long scope. That last part I must confess I do not understand at all. He does have me scheduled right now for a laparoscopic investigatory procedure to take a look inside my pouch and see if there is scar tissue or a hernia that needs to be addressed. He also gave me prescription acid reflux meds and said if i got better after 'taking' them, I could cancel the procedure in 2 weeks. What he fails to understand and I've tried telling his office, I can go a month with no pain. Then I go back to back days in extreme pain. Have not been able to tie it to specific food, time of day I'm eating, etc. My right side starts with a stabby/cramping pain (closest I can compare if it feels like the pain I used to get when I ovulated or that 'stitch in your side' type feeling. It often goes downhill from there. I have tried to get it figured out now for 2 years but taking ANY medicine and 'not having an episode in the next 2 weeks' does NOT give me a definitive answer as I do not have this pain all the time, it is just enough to be frustrating and has lasted LONG enough to be concerning. The 'coffee ground' type bleeding that I have observed is one and off for the past 3 months (maybe it started a while ago but now I know what to 'look for'. I don't like going under anesthesia but I'm probably going to keep that procedure scheduled as I have no guarantee that ANY medicine given for the next 2 weeks has 'fixed' any issue. I wonder if anyone else has ever had their opening revised but not their pouch out of curiosity.

I have yet to get a date. I was trying for the Duodenal switch. Insurance denied, it was expected since that was the only bariatric surgery they don't cover, but it was worth a try. Resubmitted for Rouen-Y gastric bypass. Should hear back in a week or so. Hopefully I can get a surgery date in February.

Here's to a smooth surgery and recovery!! There are some soft food recipes on the Baritastic app (if you use it). Check with your nutritionist as well. My nutritionist gave me some recipes compiled by my bariatric program- I didn't use any. I must admit that I was not adventurous with food in the first few phases. I stuck to the basics - shakes, yogurt, soup, etc. During the pureed stages, I added tuna and other soft fish.

It took about 2 to 4 weeks worth of injections for the true total benefits to settle in and when it did, it was so FREEING. I still absolutely am delighted I had gastric bypass. I also could not afford to pay $1000 a month. I found a local 'wellness' clinic here in Fort Worth where I pay roughly $300 a MONTH for weekly injections. I skipped their package of B12 and Semiglutide as I'm already on an inhalable B-12 supplement. Definitely shop around. I do worry about it causing long term complications (unsure what those are at this point outside of blurbs I've read) but I'm also not wanting this to be something I end up needing to do every week past this 6 to 9 month window. They have other clients that after they got where they wanted, they tapered off completely or come in for monthly or bi monthly injections only. I'd like to taper completely. I have gone a month with no injections after i started and while I had a slight hunger increase, the food chatter was so dang muted. I actually ended up reducing my dosage as I got to a point where I was not eating enough which is ALSO NOT my goal. My protein intake plummeted simply because I was not taking in enough calories. Luckily the place I work with is conservative with dosing and they have multiple patients that had bariatric surgery years ago and they are always ready to discuss 'what is the least amount of semiglutide that you need to be sudcessful'.

I only wore the Pneumatic compression leg device the first day in the hospital until I left. Do you have a known circulation issue the doctors are/were trying to circumvent with having you wear it so long? Unless your bariatric team or GP specifically tells you you need to utilize the device I don't feel you need too wear them again.

I have yet to see a nutritionist or dietician that truly understands the optimal diet for a SADI or DS patient. Most of the time we just get a modified version of what they give Bypass and Sleeve patients. But as you say, you aren't absorbing as much as they are, therefore to give you their requirements would leave you malnourished. 15 grams of fat is absurd by all medical standards. Most medical studies show we need 60 grams of fat for proper hormone function and even if you ate 60 grams of fat, with an altered digestive tract, you aren't absorbing that much, so you need to eat a little more than that. Even the ASMBS recommends 60 grams of fat by 1 year out!! Your dietician is not following best practices. Most SADI/DS patients I know follow the vets that have been living with this surgery for 10+ years and maintaining their weight loss. We figure they know more about optimal diet than a surgeon who has never lived with this surgery, or a dietician that has never even researched best diet for bariatric patients of various surgeries. Most patients I know are eating 100-120 grams of protein, less than 50 grams of carbs, and over 60 grams of fat, usually around 100 grams of fat for SADI and 150 grams for DS. You can increase your carbs once you have reached your goal weight, they tend to slow/stop weight loss, so in active weight loss it is important to keep them low so you stay in ketosis. A calorie range makes dieticians feel better, but it makes no sense for a SADI or DS patient because we malabsorb so much fat we can't even begin to properly calculate our calories. You could eat 1200 calories, but that wouldn't be what your body is absorbing. I'm sorry this is so complicated. In the end you have to decide what you feel best at. I don't feel good following guidelines like your dietician gave you and when I go over 50 grams of carbs I stop losing weight. So...yeah. I'm going to follow what allows my brain and hormones to function, what makes my skin, hair, and eyes feel best, what gives me the most energy, and what allows me to lose weight steadily. I'm the one that has to live in this body. It is sad these surgeries are so uncommon there are no good studies about optimal nutrition for them. But there is no way I'd go below ASMBS guidelines, they are the closest thing bariatric surgeons have to a standardizing body. Your dietician should be able to give you ASMBS guidelines for your surgery.

I’m really excited about the progress being made in pharmacology to manage obesity! This medication works well but is still generally considered a lifetime or long term treatment. Some can manage to keep the additional weight lost off with intensive lifestyle changes. However its so new there is much data on this for our population. Check out Dr. Weiner, he covers the topic extensively on his podcast and has additional info on his website. https://youtu.be/eu6Zt0LTg14?si=_rPWlf8DlrhGh3u6 https://www.poundofcureweightloss.com/glp1-medications/ Please connect with a Bariatric/weight management team that supports this. Unless you are T2D, you’ll likely be prescribed Zepbound. Make sure to check your insurance coverage and download the coupons. https://zepbound.lilly.com/coverage-savings

Ok I'm the QUEEN of stalls lol So here's what I can say. Take from it what you will. Cold hands and feet: I have that, and for me, it's due to weight loss AND low iron. I'm anemic, so I take a bariatric vitamin w/ iron and an additional iron supplement w/ vit c and it keeps my iron levels at the lowest part of normal. When it dips down, my hands and feet are like literal ice cubes. Breaking a long stall: So I tend to gain 3-5 pounds when a stall hits and then lose the same 1-3 pounds over and over until it breaks (and I lose like 6 or 7 pounds all at once). My stalls can last anywhere from several weeks to 3 months. It SUX. When I have a stall, I change up my work out routine to confuse my body. If you do the same things in the same order every day, your body gets used to it and gets complacent and the work out becomes less affective. So I add new things, take things out, add or take away reps, etc. I pay extra close attention to what I eat and when. On work out days, my fluids, protein, calories, and carbs MUST be higher because if not, my body thinks it's starving and holds on to everything. I prioritize fluids, protein, and low carb above all else, but I still make sure that I'm at a calorie deficit while getting in enough to prevent my body from thinking its starving. I also only weigh myself once per week and pay special attention to NSVs, because even when the scale isn't doing what you want, your body still is. Fat gets redistributed, you slim down, that's when you see you drop sizes in clothes, rings, etc... When I work out, I keep my calories at around 1300 - 1400 depending on what work outs I do. I drink an electrolyte drink (Propel or gatorade zero) and an additional 64oz of fluids at LEAST. I keep my protein at 80-90g, my carbs at 40-50g, and healthy fats at 40-50g. When I'm not working out, I keep my calories at around 1000 - 1150, my fluids at around 64oz, my protein between 60-70g, my carbs between 20-30g, and my healthy fats between 20-30g. We need less when we aren't working out. We need more when we are. Just keep at a deficit while still providing more when working out. And make sure you change up the work outs. Right now, your body is really confused. You have to be patient with it, but at the same time, show it who's boss and shake things up to get it going again. You still have time to get where you want to be. Make sure you're not grazing through the day, be mindful what you're eating, when, and how often. Go back to your bariatric diet basics if you need to. You got this.

I'm prescribed MM for diabetic neuropathy pain, and got both tinctures and edibles and they do quell the pain and burning enough to allow me to have a restful sleep. Taking the same amount with both, the edibles are way less effective, so...I'm thinking I can no longer process them correctly due to my bariatric surgery? Does anyone have any experience with this or know that this is a fact? Thanks.

Does every doctor interpret this treatment process differently? I've been reading so many different timelines that everyone is being given, and I'm confused as to whether there is actually a "norm" and then doctors deviate accordingly, or if each doctor/medical group sets their ideal SOP? For instance, my surgeon required 2 full weeks of liquid only diet for pre-op and at least one night in the hospital after surgery. My first in-person check-in was at one week. I have video/phone appointments until my next in-person at 6 months. Pureed/soft foods don't start until week 3. Solid foods will start week 7. Red meat/shrimp at 6 months. I have Kaiser in the DMV, so the food part is proscribed by the bariatric department, but even the overnight requirement was different with other people having surgery the same day as me. A nurse said my surgeon makes it a standard while others are out in hours. Obviously, it looks like my doctor is moving out of an abundance of caution, which I appreciate, but is anyone not in the Kaiser system getting the same guidance?

I'm not sure a PCP would have too detailed an understanding of complications from any bariatric surgery, even a more common one. At least I wouldn't rely on that. Although I have a feeling if she has a patient who gets a certain procedure, she might be more likely to read up on it. Is your surgeon attached to a weight loss center of some kind? Mine is, and I'm expected to go for a follow up at the center yearly, basically forever, so I'll always be in close contact for questions. Honestly, I think you need to choose your surgery based on which one will work best for you, which could very well be the SADI. A long term complication is going to be rare, but also you'll know to bring it up if something happens. You don't have to rely on your doctor to think of it, and any doctor will know how to find out more of needed, even if they don't really know much about it now.

I'm so sorry you are feeling this way but I can empathize with the anxiety. I suffer from both anxiety & panic disorder. It was pretty well controlled until about 2 weeks before surgery & it slowly progressed. The week after my surgery my anxiety was in a full blown upheaval! I have a question for you, I was on medication for depression & anxiety before surgery & was warned that psych meds specifically can be absorbed less after gastric bypass surgery. They say a lot of these medications are absorbed in the small intestine. The psychiatrist that did my evaluation said if you don't feel quite right after surgery to NOT just write it off as not feeling good because you just had surgery. He said don't panic, just be mindful that if the feelings don't go away your medication doses may need to be adjusted. This is exactly what happened to me. My feelings & mood continued to escalate until I just didn't feel like myself at all. I reached out to my provider & she switched my medication. Thankfully, I can already tell a difference but these medications take a while to fully kick in which is so hard when, mentally, you really just want to feel like yourself again. All of that being said, after surgery it is not uncommon to feel anxious & even depressed due to all of the medications, especially pain meds & anesthesia meds. Feeling overwhelmed or even depressed after bariatric surgery is not uncommon either but I think some, maybe a lot of us, just assume we're going to be in a better head space after surgery because we'll be losing weight & finally be on the path we've been longing for for so long & thus, when we feel anxious or depressed it completely catches us off guard. Personally, I think we should be required to do a certain amount of counseling before we have this surgery with someone who specializes in bariatric counseling. Not just a few appointments to fill out questionnaires & be approved for it. This surgery is SO huge & life altering in so many ways. Just my opinion. I hope you are feeling much better real soon!❤️🙏❤️

Thank you for the response @learn2cook it’s a little scary even though it seems to be really common. I don’t want a revision and hoping I can just get a hernia repair. But such is life. The doctor said I also had some curves to my sleeve so a revision maybe in my future. But he wasn’t a Bariatric doctor but a gastro. Thank you

I take a lot of vitamins, more than that list. My advice is to buy these containers, enough for a month, and dose out all your vitamins for the month. https://www.amazon.com/gp/product/B08QR78YP3/ I spend about $200 every other month. You could do it a bit cheaper depending on the brands you buy (for instance, Citracal Petites are more cost effective than the bariatric calcium chews and both are calcium citrate) and which ones you take. I take a lot because I had some deficiencies pre-op. But they all fit in those cases! I just grab my little container for the day and carry it around with me. I set alarms to remind me to take them. I put my meds in with the vitamins. The way I look at it, my junk food budget is now my vitamin budget, and I feel a lot better taking those vitamins than I ever did eating junk food! LOL