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Start a list of questions and take them with you because the appointments seem to go so fast. My first question would be whether you have to do the 3 or 6 months of medically managed weight loss attempt (to prove to insurance you can’t do it on your own). If you do ask if you do it with them. If so, you will have lots of visits to get your questions answered by the team so that takes off a bit of the pressure to think of everything this one time. Although you may still only meet with the surgeon once so try to be prepared for that visit if you have questions for them. Have you decided on which surgery you would like to have? They will most likely have a recommendation for you. Especially if you have a medical reason to choose one over the other but some people get a choice.

My philosophy is that you don't pick a goal weight -- your goal weight picks you. That probably sounds silly, and it's sort of an exaggeration, but when you're talking about the massive weight loss one gets from weight loss surgery, it's not necessarily practical to target a specific number on the scale. I didn't really have a "goal weight" -- nor did my surgeon -- until I went to my psychological evaluation and the psychiatrist asked me. Even that, I think, was mainly about checking to make sure I had realistic expectations. The number I gave was based on the average/typical weight loss for gastric bypass patients. I think I went with 180 pounds, but I actually ended up around 140. To me, the number on the scale is pretty meaningless. And I say that as someone with an analytical mind, who loves numbers and spreadsheets and graphs. The non-scale victories are far, far more important to your quality of life. First, and foremost are the health goals -- things like getting off of medications, having a healthy blood pressure and blood glucose, etc. Then there are the physical benefits like being able to walk a mile without sweating or a few flights of stairs without getting winded, and not having constant pain in your feet and knees. And of course the social benefits of literally fitting into the world -- flying without a seatbelt extension, sitting in a booth at a restaurant, not having to worry about weight limits on furniture. Finally, being more confident and satisfied with your body/appearance, having more clothing options, and being more accepted by people and society in general (which is really sad, but true). I think if you are fixated on a specific number on the scale, you can lose sight of those important non-scale victories. I'm not saying you shouldn't track your weight (I weigh myself probably more than I should, multiple times per day) or that the scale isn't important to your progress, but you don't know what the number will be when you hit the point that you have lost enough weight to improve your life. That's especially true when you start out at a high weight, because your body will not be the same at 220 pounds (after losing 200+ pounds) as someone who has never been higher than 220 pounds, because your body will have more skin and bigger bones even with the same amount of fat and muscle.

What has your doctor recommended? If your bone loss & calcium absorption level is poor they should have you on appropriate meds, etc. to help you better manage it. A friend was put a high calcium diet (including more dairy, oily fish, tinned fish with soft bones -salmon, mackerel, beans, etc.) to support hers. She walks a fine line though as she also has a heart condition & too much calcium cause heart issues. How are your vitamin D levels? Your body needs D to help absorb calcium. Not sure if you drink alcohol but it impedes the body’s ability to absorb calcium & vitamin D. I was prescribed Creons (pancreatic enzymes) to help with my protein malabsorption issues. I believe they can help many malabsorption issues. Worth asking your doctor.

The stats are averages & based on your weight after three years. With sleeve or bypass the average weight loss at that point is around 60/65% of the weight you had to lose to put you in a healthy weight range. It reflects factors such as bounce back weight gain, lifestyle changes, complacency, health changes etc. It’s not necessarily the lowest weight you’ll reach, or even where you’ll settle. It’s just gives you a bit of an idea. Some exceed it others don’t reach it. And as @ShoppGirl said your new set point will most inform of where you settle. Personally, I chose my goal as this was the weight I always dropped to before gaining again. It also put me in a healthy weight range (if you use BMI as a guide). Most choose a weight that was where they once were or think they’d like to be. No scientific reasoning at all. I passed my goal but I’m an outlier - someone who doesn’t fit the stats. I didn’t work at losing that much it was just where my body settled. My lowest was 48.2 but settled at 49kg. A medication change & a needed dietary change & I’m at 51kg & have been there for about 9 months. (Would prefer to be 49 but … you know life.) I think setting benchmarks for along the way like you’re doing is a great idea. If you set a final goal make it a ‘it would be nice if I got to that but I accept I may not & that’s okay’ goal. Congratulations on what you’ve achieved so far.

I do every morning after morning pee in my underwear. I log in my computer . I like the fact I can see progress and if do not loose any then I try to do a bit more walking and do not over think it. I do know there will be times when I will stall and then drop again. Think long term and not short term. From 265.5 lbs two week before surgery and 250 day of surgery and today I'm at 242.8 lbs. 11 days after. I'm happy where I am and will continue to travel down my weight loss journey....

I set a goal of a weight that I achieved through diet but of course couldn’t maintain for even a short time. I surpassed it a little but then gained back to right around that weight which seems to be where my body is happy. Your body is ultimately going to decide for you what your set point is. You can exercise more and eat less to maintain a slightly lower weight but you will struggle daily to lose more than your body wants. Your are smart to set mini goals though and you should celebrate every single one of them as you go. Congratulations on your loss so far.

I have bipolar disorder and my team warned me that people with it, statistically, do not lose as much weight as those without. Well, they were right, I didn’t, and now at a year and a half out I have started gaining a bit. I completely understand where you are coming from. It just doesn’t seem fair. I try to keep reminding myself that I am still much better off than I was though. Even if I can’t fit into my skinny jeans my knees don’t hurt like they were beginning to before surgery and at the rate I was going (about ten pounds a year) I would be even heavier now with even more pain. Try not to think of it as all for nothing. Your loss you have achieved is definitely something and of you can keep the majority of it off you are still better off now than if you did not have the surgery.

I just think my second stall ended but mine are the same. I gained 1-2 lbs and then stayed there for about 2 weeks and then this week I have lost 5 lbs so far (since Monday, 1lb per day) I usually only weigh myself on Monday's but this week did mid week to see if I was out of my stall. 6 month follow up today and I am still a bit ahead of my weight loss chart the surgeon gave me. My chart says I should loose aprox. 97 lbs in 6 months and as of this morning I have lost 106 lbs in those 6 months!

You can always depend upon a couple of things post surgery. Everyone loses at their own rate & every rate is okay. The heady faster rates of loss of the first weeks don’t last. Everyone’s’ rate of loss slows & it will be even slower as you get closer to your goal or your maintenance point. Sure you may have a week when your loss is a little more or a week it’s a little less. Your weight loss is not an even straight downward line on a graph. It zigs & zags, up & down. If anything it almost curves a little as your rate of loss slows. As long as your general trend is downwards your golden. I lost almost 70lbs in 6 months but that was me. Generally men lose more quickly but there are other factors that may influence your rate of loss (age, amount to lose, genetics, health status, medications, etc.). Celebrate every pound you lose. You’ll get where you are meant to be in your time.

Does everyone have hair loss/thinning hair? Can it be avoided by making sure to continue to get enough protein?

Hi Emily. I had to have my oesophagus stretched a little at the entry to my stomach. I was also told to have 100-150mls at a time. But I still struggle with vomit and nausea. The dietician said to skip purée to soft foods but I’m struggling so staying on purée and liquids. I use a protein powder called rule 1 (r1) first thing in the morning and last thing at night. It seems to help. My surgeon is on leave till 14 th oct. And my gp said if I can’t get fluids in and under control by next week I will be hospilized. I am skeptic to eat/drink due to vomiting too. I have set an alarm every hour to drink or eat. Mostly drink smoothies and soups. I started back walking last week and this week I’m back in the gym. Like everyone else my weight loss has slowed.

You’ll likely get a wide range of answers here cuz we all started off at different weights, have different heights, different diets/exercise habits/genes (you will also read alot of variations of what i just said, ha). Not counting the first two months when i recorded my highest per-month-losses, i basically lost about 10 lbs a month until i hit goal. But i started out at 235 lbs, am 5’2”, and female. To factor out starting weights and heights, you could ask for people’s percentage weight loss month over month…but this involves math 😂😂😂

My surgery date was August 30. I know that I have loss excessive weight. I’ve lost 45 pounds already. But I when I eat or drink anything I feel like I have gas. It takes at least 40 minutes to actually burp but once I drink a little water it feels the same again. To conclude I don’t really care to eat because I hate this feeling. Can anyone identify with this???

So good that you've found this forum - everyone here is so supportive. Sounds like revision is the right thing, particularly given your GERD. And congratulations on your new arrival (maybe not so new now?)!!! My pre-op diet was 2 weeks of 800 calories a day. I could do it whatever way I wanted. What I did was three meal replacement shakes or soups (or whatever) and a small protein and veg meal in the evening. I should say I live in Ireland so it's likely to be different for you. My original surgery date was cancelled the day before I was meant to have it and not re-scheduled for 2 months so I ended up sticking to the 800 calories (give or take) all that time and losing 25lbs. I now view those as pounds I don't have to work hard to lose now, although at the time it was absolutely agonizing waiting for a date!!! I wish you all the best on your weight loss journey. I think your experience with the sleeve and the challenges you faced along the way will really help you get the best out of a bypass.

it is really individual; but honestly 1/2 lb a day sounds great!! there is an average weight loss time period. most people loose a decreasing amount per month for about 18 months. In that time there will be times of both rapid weight loss, steady weight loss and stalls where no weight is lost or it fluctuates up and down within water weight range (8 lbs is a gallon of retained fluid) stick to your program, watch what you eat and get your body moving. build muscle as much as you can.

I'm off the proton pump meds entirely, after taking them for more than 20 years. It was actually the voice doc who suggested weight loss surgery when I told him I'd like to get off the PPI meds. I don't think I have a problem in the lungs. My voice coach says I move more air than most of her clients, some of whom are experienced pros. For me, when I eat too much, I start sneezing. If overeat a little, it might be half a dozen sneezes. IF it's a lot, I might sneeze 20 or 30 times before I stop.

I also had a completely arbitrary goal of 120 lbs (it was the midpoint of healthy BMI range for my height). I called goal at 127 lbs instead because i felt I was looking too skeletor-ish. Like @Arabesque, i started to increase calories to stop weight loss, and was able to do so about 3-4 months later, but not until I lost a few more pounds and settled into 115. I was 118 even this morning, and i don’t look nearly as skeletal as i did when i was calling a 127 goal (i’m 4 years post op, btw). I basically eat whatever i want (luckily i don’t nor want too eat much anyway) and i dont feel food-deprived in any way nor exercise beyond what my lazy ass is willing to do (lol). But i am way more active than I used to be pre-wls. In a nutshell i can stay at my current weight with little to no effort given my current lifestyle. soooooo this is my long winded way of saying that weight goals are moving targets and that what u want/are satisfied with now may not be what you want/are satisfied with later. If you are satisfied with the efforts you are putting in (or not putting in) to sustain a weight, then, i say Goal Acheived.

hi! I'm brand new here. I'm having RNY 10/31, so I made it into this group by a few hours!!! LOL I'm happy to have found you all. I started my weight loss back in April, and I've lost 37 lbs. I start my liquid pre-op diet on 10/17. I am so excited and so so so ready.

I'm so upset. In the last 9 days I've gained 9 pounds!!! Nothing has changed with my diet and workouts. I take my vitamins like I'm supposed to. I never cheat on my diet, I work out 5 days a week. So I called my dietician and after we went over everything she said "remember when I told you that having pcos would cause you problems with weight loss? Well here it is. If you remember, you lost 100 pounds on keto and then the weight just started coming back no matter what you did? It looks like it's happening again." I literally started to cry, because nothing I did stopped the weight from coming back. I asked if I could do a pouch reset and maybe reverse it now and she said "you certainly can try, but you aren't gaining because of over eating or cheating on your diet. You're gaining because of a hormonal imbalance that seems to like you being fat". I don't know what to do. I had such high hopes that the surgery and weight loss would help improve the pcos, but it looks like, once again, it's out to sabotage me. I guess it's not enough that it caused me to have 10 miscarriages through the years, or need fertility meds to have my daughter, or never be able to get pregnant again after her. Now it won't let me lose weight and keep it off. I feel so defeated. All my hard work and once again, it's all for nothing.

21 lbs since surgery is awesome! I also had VSG on the 25th and I’m only down 12 since surgery. That includes a random gain after I added in semi-solid food, so I am still up from my lowest. I can tell that I have been retaining water. Not only do I see it, but I could tell with drinking and not going to the bathroom. I have been desperate for answers and what I have read is that you spend most of your first month dehydrated, even if you are getting in fluids. That a portion of the weight loss is water and that sometime during the first month your body makes an adjustment to rebalance fluid levels, causing a stall or gain and that eventually this works itself out. I went for a big jog thinking I would help myself and the next day I was not only sore, but 3+ up on the scale lol Now I’m just trying to drink as much as I can and trying to convince myself that there is no way you can gain fat weight from an average 600 calories a day!

Always remember, we all lose at our own rate. Some are slow losers while others lose more quickly. There’s no right or wrong rate of loss. Sure there are generalisations & averages but you should never use them to judge if you’re failing. It really is impossible to compare your loss in pounds or inches to anyone else. So many factors influence your loss. Body shape, skeletal frame, age, genetics, starting weight, where you carried your weight, general health, genetics, etc. As you lose more weight you’ll notice you’ll drop sizes more quickly. Sizes tend to differ by 2 inches. It takes a loss of more pounds to lose 2 inches around your body when you’re bigger than when you’re smaller. That lose ‘10lbs & drop a dress size’ only applies to people who are pretty much in a healthy body weight range to begin. Took me a good 10/15kg (30lbs) to drop a dress size & a bit when I first started losing. How much exercise you do is really personal. Yes, there are lots of benefits but, for most, exercise only contributes to about 10% of the weight you have to lose. Have 100lbs to lose, exercise will burn 10lbs. I didn’t really exercise at all & I lost all my weight & more. All I do now is some stretching, & use resistance bands. I wouldn’t burn 40 calories. Ha! But that’s me. You’ll get there but in your time.

You seem to have a really cynical outlook on all of this. I, too, am a scientist by profession, and I've always been a bit of a pessimist, but I think sometimes, it's worth giving people the benefit of the doubt. It looks like you don't think your bariatric team has your best interests at heart. I know you've been burned before, and I also know what it's like to be constantly judged as stupid, lazy, noncompliant, untrustworthy, unworthy, etc. because of my weight, so I can understand your feelings about this, but don't forget that these are people who have devoted their careers to providing weight loss surgery. I'm not saying that they all genuinely care about alleviating the plight of the obese, or that they're sympathetic toward those of us in a position of needing this surgery, but I doubt there are very many medical professionals in the bariatric surgery field who are out to punish and criticize fat patients just for fun (or out of personal dislike of fat people). If for no other reason than their own self-interest, chances are that they want patients to succeed with weight loss surgery, and they are probably doing what they believe will contribute to their patients' success. Another thing to keep in mind is that sometimes people can be right for the wrong reasons. I've run into this in my own job, where someone has told me something that didn't seem to make sense, and I (as someone like you with an inquisitive mind) have gone looking for the real story, only to find that what I was told was correct, even though the reasoning was not. In this case, your dietitian might be giving you good direction even if she doesn't actually understand what she's talking about. Just because that dietitian (or even the whole bariatric team) doesn't know or understand the reasoning behind the rules, it doesn't necessarily mean that the rules are incorrect or arbitrary. Finally, if you hang around this forum for long enough, you will see that many patients want and need a lot of hand-holding. Some people would rather be given strict but arbitrary rules than loose guidelines. People are constantly on here posting questions like, "I had surgery X days ago; can I eat Y?" And honestly, considering that, I can't blame surgeons at all for wanting to make things as black and white as possible so they don't have to spend all their time answering these incredibly specific questions, tailored to each individual patient. Most patients are not medical researchers, and many want definitive instructions from their doctors. Many people would be paralyzed with indecision if they were told, "Some studies say X and others say Y; you figure it out." Ultimately, it's up to you to decide how closely to follow your surgeon's directions, and if you do your own research and believe you have found a better way, you can make that decision. But I would venture to say that you will likely have a better experience if you have a mindset of working WITH your bariatric surgery team instead of taking an adversarial approach.

I'm 4.5 months out from my surgery and at 5'2" I've lost 65 pounds so far. I've gone down from a size 22/20 jeans to a size 14 or in some cases even size 12. To put in perspective, my older sister who had the same surgery (RNY) a few years ago, also 5'2, had lost 45 pounds at the point I'm at. This shows how different weight loss is individually. In my case a lot is probably from nutritional issues and losing weight too quickly. That's an ongoing issue my team is still trying to work out. It's hard to get enough nutrition when you are full for the day after literally one bite of something in the morning.

Re: does it really matter I mean, yes. There are other possible bad outcomes besides literally dying. If the effectiveness of bariatric surgery comes down in large part to microbiomic changes, for example, suggesting that I remove all fiber from my diet until over 6 months post surgery and introducing large amounts of artificial sweeteners into my diet could in fact work against positive changes to the gut microbiome. If my ability to lose weight pre-surgery comes down to emphasising foods that extend satiety (fiber, protein, fat), dramatically reducing my fat and fiber intake before surgery could cause me to overeat or binge eat and my weight loss to stall or reverse. If long term success comes from following one's hunger cues, teaching myself to eat according to the clock they've set, whether I'm hungry or not, in order to meet arbitrary goals could limit my weight loss long term or trigger binge eating again. They're not suggesting I take a spoonful of arsenic at bedtime, but that doesn't mean that their suggestions are neutral. They have no systematic evidence that their program creates success for the average patient or not. (The great part of this sort of program, from the practitioner perspective, is that you can almost always blame poor outcomes on non-compliance.) Some of the program requirements for the pre-surgery diet are literally impossible to follow at the same time. I can't take one or two bean-sized bites per minute, finish meals in less than 30 minutes, and eat 2200+ calories per day without a significant portion of those bites being high fat meats, full fat dairy, or, I dunno, peanut butter straight out of the jar, all of which are verboten. So regardless of what I'm doing now, I'm not compliant. It's not possible to comply fully. (The handwavy answer was "healthy fats". I have no idea how much avocado my dietitian expects me to be able to eat. I suppose technically if I ate just chicken breasts with avocado and nothing else...) I'm also not the average patient anyway (it's probably pretty clear at this point that I'm not neurotypical, for example, I understand that people with regular would either comply or lie without much difficulty either way), so even if their arbitrary program did create success for the average patient for whatever reason that means very little for whether it would work for me. The arbitrariness and the ultimatum annoy me. The fact that I'm being asked to disregard everything I know about how I personally deal with change to adopt a post-surgical style diet (low-fat, regimented, and frequent) half a year before any potential surgery date with an intact GI system, that I'm expected to throw away everything I know about what I need to lose weight, stop binge eating, and have the energy to do intense exercise frightens me. I'm terrified that I'm going to gain weight or relapse into binge eating (thus getting denied for surgery) and I feel like they're pushing me into that direction. All because Typical Tammy deals best with gradually introduced changes over a long time period and simple, unambiguous, authoritative instructions from medical professionals she sees as trustworthy experts? Nah. I mean, I'm sure there are, but this is the only one I have access to. And, ultimately, it doesn't really matter, as long as I can jump through their stupid little hoops, I can get what I need from them. It's just.... a long and irritating process of circus training. I'm not really looking for advice or anything, I understand the options and am resigned to them, this is a rant and rave.

Oh gosh I think it's human nature to compare ourselves to others in a similar boat! I do all the time, for good or bad. OP - 4.5 months after surgery I had lost 43lbs. I've gone on to lose 115 at just over 10 months so I think you're bang on target to reach goal. I wish you all the best on your journey. I have also noticed that weight loss and changes in clothing size are absolutely not linear - there are times when I have lost lots and not gone down a size like *forever*, and vice versa.