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Before you consider reducing your use of shakes, I suggest keeping a journal of all of the food you eat (even if only a small taste) and the quantities, so you can calculate exactly how much Protein you are eating. If you truly are getting 75-95g of protein or more, then you can probably reduce your use of protein shakes as @@Veronica_mm said if you are able to maintain your 50g of protein a day with other foods. I would also caution you that very soon now, when you reach the solid foods stage, you are going to have to stop the "nibbling". Grazing (as @@James Marusek can tell you from a recent study he was talking about) is a major cause of weight gain, and that goes especially for WLS patients. When you are on liquids and purees, eating small portions constantly is fine, and even necessary to get in your minimum protein because the pouch is so small, but when you are getting into real foods, you should be moving towards discrete meals with nothing but Water or water substitutes (Powerade Zero, Crystal light, etc.) in between. Also, it's important to know what you are grazing on. Are you grazing on yogurt, cottage cheese, tuna or other high-protien foods? Ok. Are you grazing on whole fruit and veggies? Not as good, but still probably ok. Are you grazing on canned fruit, crackers, nuts or other foods with lots of carbs or fat? Probably not good. Finally, if your grazing is due to real hunger, not just "head hunger", then you might want to try adding a bit more protein to your normal meals. Protein should keep your hunger down longer. However, if you are not really hungry, but just satisfying a craving, then you may want to think up of some things to get your mind off of it, or possibly see a therapist to work on that. If not dealt with, the head hunger can really derail your success.

@@sweetnell I hope you are not offended by a newbie giving you advice. I am not a veteran, being only two weeks after surgery, but I have some ideas. These are some of the things I was taught will be lifelong habits I need to maintain. Are you drinking at least 64 oz. of fluids (preferably water) per day? Are you eating three meals, with half the meal being Protein, one-quarter fruit and veggies, and one-quarter other carbs? Are you watching your portion sizes (for instance, generally 3 oz. of protein at each meal)? If you are eating the recommended amount of protein, you should not be experiencing physical hunger. Could you be experiencing "head hunger"? If so, you will need to deal with that somehow, maybe through therapy or some other mechanism. They tell us that the #1 cause of weight gain after surgery is grazing. You need to figure out a way to stop that. Maybe talking to a NUT would help.

It's killer. I know that my Pepsi addiction was a big part of my weight gain, but finding a go-to drink is proving impossible. I am fine with changing my eating habits, so drinks can't be my downfall! Suggestions please!

It's not that I care what anyone thinks. People who know me would be shocked I didn't say anything I an open book. My weight gains and losses have been an emotional struggle not just physical. I really want to do this with our anyone in my head other than me. If that makes sense. My boys are 15&19 they know and are excited for me. My boyfriend is as well. It's not that I want to do it alone it's that I need to do this for me. I finally need to make something just about me.

I was a slow loser too. I am soon to be 64 and have orthopedic issues that limit my activity, so I am not going to lose as quickly as someone who is able to take up an aggressive exercise program. One of my blood pressure meds causes weight gain. All of our bodies and abilities are so very different, so just relax and stick with your program. Also when I was stuck on a stall that lasted for several month I gave up dairy and the scale started moving again. Hang in there and be patient.

Carol Brower, I totally get what you're saying, your opinions and feeling are very valid. Im not a therapist, and we can't "fix" you either, but may we can help you a bit. Yes, im older, happily married, together many years, but it's totally normal to want to be desired by men, to have them want to talk, flirt, engage, converse, whatever. I like it ! No lie ! And yes, before my weight gain I was slim and attractive too. After marriage and a child, the weight came on, and the men stopped engaging etc. Now im slim again, and think I look better now than before, and yes, the men want to talk, flirt, engage, converse, whatever. Human nature . It's cute, but even if I was single, I would be selective. Why? Because I'm worth it !! So are you !! And a key to a stable relationship is to have a stable relationship with yourself first . The men will follow, because that's human nature. But it's up to you how you want/allow those men to treat you. Totally. Up. To. You. I wish you well.

Well I guess it's an over simplification but in terms of body image and how I relate to men sex and desirability is a big deal for me. I wasn't always fat. I used to be a fox. And it's been torment for me to not be one anymore, if anyone can understand or relate to that. I'm very confident in my mind and intellect but I have absolutely no self esteem when it comes to body issues. This was a problem even when I was attractive. I stopped having sex 11 years ago, before I gained weight, mostly because I was repeatedly used for sex and got fed up. I think part of my weight gain was a defense mechanism -- I didn't want to be leered at anymore. But once it stopped, I realized I needed that sort of attention and not getting it made me depressed and it spiraled out of control. i've been in and out of therapy since age 10. No shrink has been able to "fix" me.

I'm 2 years out and initially lost over 110 lbs. I more than passed the expectation of my surgery team. Over the past six months I have gained back more than 15 lbs. My surgeon is okay with my weight gain because I'm still within my expected range, but I am not. He also said that they do expect some weight gain about 2 years out as your body adjusts to its new size. What I also learned from my team is that you need far less calories post surgery than a normal person. Because you have essentially flushed your system out, your heart, lungs, muscles need much less energy just to work normally. They compareded it to a car needing less fuel after a tune up. So translate fuel or energy to calories. Much less calories are now needed and that as time goes on and my body continues to adjust, I may continue to drop in the amount of calories I can tolerate. So it appears that I need to limit my daily caloric intake to approx. 1500 calories to simply not gain. Even though I'm active, running, walk, kayak, ski etc on a regular basis. Doesn't seem to matter. In fact it was suggested that I might not be able to tolerate 1500, that as time goes on I may need to reduce my caloric intake even more. I still find I need 5 smaller meals a day. Do the math, that means 250-300 calories a meal. I know I've been eating more than that. So I struggling with accepting that if I want to keep the weight off, I need to live on a highly restricted calorie diet, which basically severely limits my intake of sugar, alcohol, carbohydrates, meat and fats. I lost the weight on low fat cottage cheese, greek yogurt, salads with vinegar or yogurt dressing, fish, Beans and low-fat cheese as my primary nurishment. I am realizing that I need to follow that diet for life and it is challenging, particularly when it comes to social events and dining out. I am praying for fortitude and solice to accept this as a permanent lifestyle change and would greatly appreciate hearing your stories and knowing that I am not alone.

I thought the guidelines were pretty much the same for Cigna in general minus the fact that employer could opt out, this is the one they kept reading to me when I asked for the their policy https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf I searched through the whole thing and I didn't see anything on weight gain or loss during the 90 day nutrition, when I called several times I asked the representative as well (although they can't be 100% trusted with exact details) but she said I should try not to gain but she didn't see anything in it that stated I had to lose. I actually already had my weigh in on Saturday and I did gain 3 lbs from my last weight from water weight for certain reasons, so I guess we'll see what they say as she was supposed to be resubmitting tomorrow or the day after.

Don't do it! The number one driver of weight gain is juice and sugared drinks. You need to find something that works for you. Try Water with fruit infused in it if you don't like crystal lite. Used lemons, limes, cucumbers, raspberries, strawberries and leave your water sit in the refrigerator with the fruit. It will not be sweet but it should quench your thirst. Honestly I cannot do any of those non sweetener drinks either so I had to get very used to drinking water. It is all I drink and is the most important thing in your diet besides Protein. I would hate to see you sabotage yourself. Try doing things to get your mind off of it. I crave chocolate a lot and have to entertain myself or convince myself that I would rather have nuts or Jerky. If I do that often enough my brain believes it and I can move past it. Good luck to you!

apologies for re-posting this, but I think I posted it in the wrong forum initially Hi everyone, first time poster here! I am scheduled for a gastric sleeve on 10/19. I am currently 184 lbs, 5'4, bmi 31. After I first met with the surgeon and scheduled the surgery I was very sure this was the right thing to do. I have battled my weight for almost 10 years (I'm 30) and have tried every diet and drug under the sun with no success. My only success has ever come from a combination of medically supervised protein-sparing diet combined with phentermine. But even that 30 lb loss came back on pretty quickly. Now I'm starting to question this choice. It just seems so completely elective -- I'm healthy and young, I even completed a triathlon this weekend! But the choice goes beyond vanity, I struggle with significant depression that I never dealt with prior to the weight gain, I feel constantly exhausted (possibly from sleep apnea) and just generally feel that I'm living my life in someone else's body under a cloud of failure. I'd love to hear from others who had the surgery at a low BMI - are you happy with your choice? I'd especially love to hear from anyone who went on to have healthy pregnancies afterwards, the concern about pregnancy at my current weight has led me to hold off on having kids! Any other thoughts would be much appreciated, I do think this is the right choice for me but I struggle with feeling selfish to put my loved ones through the stress of worrying about the outcome when I'm not facing an immediate health crisis. And God forbid something happened, I wouldn't blame them for hating me for putting them through that.

Hello all and Happy Surgiversary. I have made it down to 189 without gaining weight. That is good but I have been stalling ..that would be because I have not been as Not that I have lied but have not told everything. to make an appointment with the psychologist as food has been the culprit of weight gain when making healthy choices. I will keep you all informed of this outcome.

Hi everyone, I had the sleeve gastrectomy surgery performed back in 2009. Unfortunately, I have gained my weight back. Admittedly, I did not adhere to the diet and exercise plan and once I started gaining, I was embarrassed and stopped going to the doctor. Add a divorce into the mix and I gained even more weight. I take complete responsibility for the weight gain, and I am now considering the DS as an option, since my original surgeon had mentioned that this could be the 2nd step of my sleeve surgery back in 2009. I meet with the office next week and am very nervous. I was hoping someone could tell me some of your high Protein food secrets, as I am trying to start the 90 plus grams of protein and 75 or fewer carb diet now. I am allergic to tree nuts, so the only nuts I can eat are peanuts and I don't like tuna fish or salmon, but like mild fish. Thank you for reading my post! Have a great day! Christy

I didn't do the food funeral thing and I don't regret it at all. I figured I had eaten my share of food in my life (and the share of several other people) and I didn't want to have to re-lose any weight I gained by doing so. For me, a yummy meal brings thirty minutes or so of "joy" and weight gain brings days/weeks/months of misery trying to re-lose it.

September 21st Current Stats: Nationality: Canadian Age: 26 Height: 5'3 Weight: 195 lbs BMI: 30+ Surgery: Gastric Sleeve Date: Jan 5th, 2016 Reasons why I am being sleeved 1. Digestive issues: IBS like symptoms 2. Fertility: TTC 5 years 3. Intolerances: Wheat, Dairy: Hard to avoid, so I figure if stomach is smaller I would eat smaller amounts so it may cause less havoc on my system. Reasons for my weight gain: I always been small all through school age, ate like a bird. Once high school hit a total different story. I don't over eat, I just eat the wrong foods, mainly fast foods and restaurants. I do not like a whole lot of fruits and veggies, I am obsessed with pasta; especially mac n cheese. And I am not active, And my thyroid is low. Now balanced with meds. When TTC I was put on a lot of meds because I been through 4 IVFs in 2 years. That also caused weight gain. It started to increase over the past 5 years. I was in the 150's 5 years ago, now in the 190's. It may not seem much but it shows. Especially since I am short. My mother was really overweight my whole life, Got the sleeve last year and lost 110 lbs . My sister is also doing the sleeve with me in Jan. When its my turn I hope you will follow along with my journey, and hope to inspire others to take charge of their health. I do not have the attitude that this is "The Easy Way Out" because its not! It is just as much as struggle as anything else. This surgery is a tool to assist, we still got to put in the work of eating healthy, eating the right amount, and exercising. I will continue this blog in January

I did a little research. This can be caused by pressure on the lateral femoral cutaneous nerve, and can result from tight clothing, weight gain or injury. I wonder if it might have something to do with having your abdomen filled up with CO2 during surgery. This could create pressure on the nerve that causes the condition. It could also be the swollen/distended sleeve that is pushing on the nerve. I'm going to ask my surgeon during my follow up next week to get his opinion as well.

Hi my date is the 29th for surgery. Kinda nervous same time just want it done n over with... Reasons why im doing it is that i have chronic back pain that 4 of my doctors have told me that the surgery will improve the pain.. Not to mention the polyneuropathy i have and the crazy pain that is caused by it. That has been my downfall with weight gain i hurt to much to move... So im crossing fingers that my 310 weight will drop along with pain levels. Huggs to everyone that already went and those that are prepping!!

Ok so it's been a while since I last blogged but a lot has been going on. I'm from Iceland. An island way up north. So I just came back from travelling to Spain, a Mediterranean country and let me tell you, things there are different from what I'm used to. I've been to Spain 3 times before and never thought that much about food. I just ate what ever and loved it. But having the lap band is more difficult. The town I was staying at didn't have that many restaurants but when I went to them, they carried BREAD BREAD BREAD. They loved serving bread or huge dishes! I love tabas mmmm but it's served on bread, thick slices of bread. I can only eat thin slices. So when out eating, I ended up eating fries, omelette and lasange. But only found one restaurant carrying lasagne. But I tried cooking at home as well, so I wouldn't starve and didn't really want omelette or fries for every meal. The temperature! Gosh it was HOT. That mean that my polar body was swollen ever day with extra fluid and that also meant that my stomach opening was a lot smaller. I had to make a lot of trips to the bathroom spit out food that got stuck in the opening. The Productive burping was terrible! No matter what I ate. My worst case was a tomato!! Hello!! A tomato, a very well chewed tomato! I just had terrible time with it. That's why I was afraid to eat what ever was on the menu. But fries, I know they are deep fried and not that healthy, but I could chew them into baby food! What does a hot woman need in a hot weather??? ice cream. mmmm love some good ice cream. And I had a lot of it. It was a guilty pleasure. But it was so good in the hot weather. Alcohol. I was very very careful with that. I wanted a cold beer very badly but I stuck to cocktails with no carbonated liquids in it and yes that was just fine. And never got drunk or tipsy or what ever. Did not want to add hangover and throwing up to the PB!! I even at once point thought that it would be best to finish the trip off by eating only chocolate and ice cream because that went down very well haha. Also the company I was with. They were so nice and understanding but I was giving myself hard time for making them wait for me while I ate really really really slowly. We could never eat anywhere in hurry, ever. I came with a solution though, I sometimes grabbed a banana because that's easy to eat on a go. Now at home, I'm still swollen from the travel but I couldn't wait stepping on the scale and no weight gain!! to my surprise! I'll see how it went after my body has adjusted after the travel. I have to tell you though that for the first time in my life, I had lots of left overs at the restaurants I ate at. I felt like apologizing for it to the waiters, for not finishing my food. I've always finished everything at a restaurant but I was very careful, even though the portions were big, that I would only eat until I was satisfied (not full) and I'm proud of that. Overall, I did enjoy my trip very much and Spain is a fantastic country. And I've always enjoyed the food there before the lap band. But this was a difficult trip food wise and not that healthy I'm glad it didn't set me back tough. I'm happy to be home and on Monday hopefully my body has recovered and that I will not have any extra fluid.

I have seen this issue brought up here. Seems many of us are colder at a lower calorie intake and or lower weight. Enjoy summer! Fall is approaching, and I have heating pads in several spots at my house and an electric blanket just for the foot of my bed!! (My feet seem to be the coldest part of me.... )I have resorted to running a hair dryer into my boots to heat things up! Best of luck! Sad to say that even a small weight gain made me warmer Sigh

You will be alright. Although for future reference, remember to stop after you initially make a bad choice. That thinking of "I might as well eat all that I want, since I've already blown it" will get you into trouble. One bad food choice shouldn't have too much of an effect on your weight loss. It is the continuation of bad choices after the initial one that will lead to weight gain. Think about it, when you run a red light, do you decide to go ahead and run red lights for the rest of the day? No, that would be silly. It is the same for food choices. If you make a small slip up, own up to it and move on with your bariatric diet.

From https://asmbs.org/patients/life-after-bariatric-surgery Q: Which medications should I avoid after weight loss surgery? A: Your surgeon or bariatric physician can offer guidance on this topic. One clear class of medications to avoid after Roux-en-Y gastric bypass is the “Non-steroidal anti-inflammatory drugs” (NSAIDs), which can cause ulcers or stomach irritation in anyone but are especially linked to a kind of ulcer called “marginal ulcer” after gastric bypass. Marginal ulcers can bleed or perforate. Usually they are not fatal, but they can cause a lot of months or years of misery, and are a common cause of re-operation, and even (rarely) reversal of gastric bypass. Some surgeons advise limiting the use of NSAIDs after sleeve gastrectomy and adjustable gastric banding as well. Corticosteroids (such as prednisone) can also cause ulcers and poor healing but may be necessary in some situations. Some long-acting, extended-release, or enteric coated medications may not be absorbed as well after bariatric surgery, so it is important that you work with your surgeon and primary care physician to monitor how well your medications are working. Your doctor may choose an immediate-release medication in some cases if the concern is high enough. Finally, some prescription medications can be associated with weight gain, so you and your doctor can weigh the risk of weight gain versus the benefit of that medication. There may be alternative medications in some cases with less weight gain as a side effect.

Signs and symptom hypothyroidism may include: Fatigue Increased sensitivity to cold Constipation Dry skin Unexplained weight gain Puffy face Hoarseness Muscle weakness Elevated blood cholesterol level Muscle aches, tenderness and stiffness Pain, stiffness or swelling in your joints Heavier than normal or irregular menstrual periods Thinning hair Slowed heart rate Depression Impaired memory It could account for some of your recent weight gain. It appears to be testable and treatable. http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/definition/con-20021179

Has anyone had issues with weight gain during the 90 day nutrition and getting denied? My weight has been crazy with going back and forth and I have my final visit weigh in tomorrow and know I'm 3-4lbs higher than my previous weight. Of course I had thought my previous weigh in was my final one so I didn't follow my eating plan as closely as I should have since birthday and all going on.

My candid advice? Keep them. I know that sounds like a deadweight loss and a lost opportunity to be charitable, but I honestly think that getting rid of them is a jinx. I never gave anything away, but when I lost weight without surgery a few years ago, I stored them away in a place I would really never go to for any reason (my gross attic). Alas, I needed most of them back within about a year and needed to wear them until surgery. My solution this time? Keep them around, and have them there to think of how much you never want to wear them again. Weight gain after surgery is real and happens for many people, but I think it is far more within our control than maintaining non-surgical weight loss.

Hi this doesn't have to do with your weight gain but I am waiting for my approval. I am having my band removed as well and they are doing the sleeve. How are you feeling, compared to the band?