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this is the first time I've heard of a case like this, and I've been on this site for nine years. I malabsorb protein so from the get-go I've had to be sure to get at least 100 grams in every day, but it sounds like your mother's case is more extreme. I still have a protein shake every morning so I can be sure my intake ends up at least 100 grams by the end of the day, but it sounds like your mother may need even more than. that. Maybe her liver issues are a factor in this, too. I've taken OTC vitamins all along and have never had deficiencies - and that's true of many of us. Usually, OTC versions are fine (although you usually have to take two regular multis a day, rather than one (which is true of many of the bariatric-specific multis). She may have to get prescription-strength vitamins (I know they have prescription-strength vitamin D, for example - not sure about other vitamins). hmmm...not sure what to tell you. This sounds like a pretty rare condition, so I hope someone can help her!

Hi I don't know of many people with the protein problem but my daughter is in the same position as your mother her blood level for protein is almost non exciting her bariatric surgeon has told it is because she hS malabsorption but at the same time she is allergic to protein where as I hD the bypass and have fat malabsorption I am also 69yrs lost 70kg my daughter had the sleeve In Australia we have a group on Facebook for the over 50 people maybe she should look at and even join it hope this helps abit

I don’t personal buy it on bariatric pal, but might look into it. Before my surgery I bought some protein soup and protein pudding on Amazon. I picked the one that is bariatric friendly like low in carb, and low in sugar. The protein pudding I tried the variety pack first, but the 0 sugar one didn’t taste to my liking and I bought the one I like that have 2garm of sugar in it. The soup and pudding have extra 12-15 gram of protein. I only use it when my meals does not meet my protein requirements and it can give me a boost, or I use it when I am craving dessert. It does help a lot for me. But I had only used 2 time after surgery. I used it more when I was in my pre ob liquid diet.

My mom had gastric bypass a few months ago. Her doctor wanted her to have it because she was Type 2 diabetic and in danger of a lot of other health issues that would be solved by losing weight. She is 69 years old. Things were going well at first - she felt well, she was able to eat as needed, and was losing the weight. She is about 5'5" and I'm not sure about her current weight, but she's lost quite a bit and can now fit into like size large in women's (she was at a 2XL or 3XL before). But recently she has become very weak and has fallen several times (which is dangerous at her age). She went in to the doctor and they were initially convinced based on scans and blood work that she she had fatty liver that had advanced to cirrhosis, and they said it was Stage 3 cirrhosis (and that her only hope for survival would be a liver transplant). The doctor also told her that she was severely malnourished, comparing her to starving kids in other countries. He said that was the cause of her weakness, along with the liver issues. A biopsy was done on her liver and she's Stage 1 of fatty liver, which means she can turn it around with diet and exercise, and we're all very happy about that. However, she is still extremely malnourished. The doctor's solution was that she eat more protein. She has been focused on doing so ever since her surgery; now she is trying to up her intake even further. And despite trying to get as much protein as she can, her last blood work showed that her protein is at a 2, which is apparently really bad. So a couple of questions for you - Have you heard of anyone going through something similar to this? What did they do to improve their nutrition and overall health? (Because at this point the doctor is now recommending undoing the surgery so that she can absorb protein better, but I don't want my elderly mother to undergo surgery again.) How can she up her protein? She is already eating large amounts of protein at every meal and snacking on it throughout the day. She is also eating plenty of vegetables. I know you're not supposed to get your protein from drinking, but would that be helpful here? Just to make sure that she's getting enough? And how many grams of protein should she be eating a day? What kind of vitamins should she be taking, and at what dosage? She is very low on like Vitamin D and B, and assures me that she's taking OTC vitamins that her doctor recommended. I know that's not good enough if you have absorption issues and gastric bypass, and I also know that doctors' recommendations (especially those who don't focus on bariatrics) often recommend way below what is needed. (Her vitamin levels are bad enough that the doctor wrote her a prescription for vitamins to take once a week.) She told me she takes the Fusion brand Multivitamin every day (designed for bariatric patients) and a calcium/Vitamin D that is 1000iu twice a day. Looking at the label for the multivitamin, it seems low to me. Any and all advice/help/suggestions would be most welcome. Thank you!

Do you all buy any of bariatric pal foods? I’m about 3 days away from my 4 month post op. The bariatric foods hep me a lot to stick to my 60+ mg of protein a day still drink one shake a day because I get about 40mg protein in one shake. I usually drink around 4-6 pm so with my meals and snacks. I get the rest or more of protein through out. I too have sm stalls depending on if my right leg is swollen or I need to have a good bowel movement sorry TMI but I’m on pain management with chronic constipation. But I’m losing steady not as fast as first surgery but since I’m more sedentary then prior it’s expected but losing. Day of surgery was 304 now 272

This varies greatly by state, as each states' laws govern what is essential vs cosmetic medical procedures. For example, my work insurance is based in Tennessee, and all bariatric procedures are 100% cosmetic, so no coverage at all! To further complicate things, individual companies within these states can have varying coverage depending on how much business they get from your employer. Even if a company like Blue Cross or Aetna cover it for employees of one company, they won't for others. You will really need to look into the offerings you have available, and call them directly. You may have to get assertive with them to get a straight answer. I had one make me go through programs and jump through hoops to prepare for it, only to tell me they wouldn't cover anything when I went to schedule surgery. One even told me they would not cover any future medical procedures if I have it done anyway! I'm with another company and insurance plan now which didn't cover it either, but they didn't blacklist me for having a self-pay procedure. Good luck, hopefully you're more successful than I was with the insurance company.

There are things like miracle noodles, heart of palm noodles, and of course most of our "fullness" should come from veggies once we are a year out. Think high volume low carb veggies like lettuce, mixed greens, cabbage, cauliflower, broccoli, as well as colorful things like bell peppers, tomatoes, onions, green beans, etc... These paired with a little fat and a decent amount of protein should help you feel fuller longer. I think it is very well possible you could be experiencing true hunger. You are MUCH taller than the average woman (if you are not a woman I apologize for the assumption) and the dietary guidelines that surgeons and nutritionists hand out are usually useless if you fall outside their standard patient. If you are exercising enough to get your heart rate up for a consistent amount of time or doing weights/strength training, you could be burning a fair number of calories too. Both of these things would make me think you may have a higher caloric need, even though you are a sleeve patient, than the average sleever would. If your surgeon's nutritionist isn't interested in customizing your true caloric need given your frame, height, and activity level, you may need to have a few sessions with someone else who is trained in bariatrics and will actually help you work through this so you can stop feeling guilt when you eat more than your surgeon wants you to. Also, have you tried the Millie's sipping broths? You can get a sample pack of their flavors on Amazon for a pretty reasonable cost. They might help ease the hunger between meals until you find a dietician to talk to.

What’s the best insurance to have when you’re interested in having Bariatric surgery covered by insurance?

I was told by my bariatric team nurse that it's normally a two week wait, and they would call me at that point to set up my surgery date. BCBS approved me within a week. So, I was surprised when the hospital nurse called me with check in day instructions and found my surgeon had already scheduled my surgery in 10 days. So what normally would have been a 2 week wait for approval, then a 2 week pre-op diet turned into a Fastrack to surgery. My liver shrinking diet was shortened because of it which was OK with me and obviously OK by my doctor. Good luck!

Congrats on the weightloss and the pregnancy! I have not taken them personally, but they do make prenatal bariatric vitamins. Procare Health which they carry here on bariatric pal. https://store.bariatricpal.com/products/procare-health-bariatric-multivitamin-capsule-prenatal?currency=USD&variant=5189958074405&utm_medium=cpc&utm_source=google&utm_campaign=Google Shopping&stkn=24a7de865f58&gad_source=1&gclid=CjwKCAiA29auBhBxEiwAnKcSqvHF7gegDH5JR7Hxartz8Q2592gZWW3ALpKpKmUJvttRygoWVzuq3xoCR5AQAvD_BwE

Hey all, I got VSG in August 2022. I've lost over 150lbs and just found out I'm 5 weeks pregnant (first time!). I've spoken to my surgeon, nutritionist and obgyn, but no one had a solid recommendation for prenatal. My surgeon said to take 2 prenatal vitamins which will give me what I need, while my obgyn said to compare my bariatric multivitamin to prenatal and if possible, stick with what I've been using. I do have a prescription for folic acid that I take daily which is why I assume the obgyn is not entirely worried about the prenatal itself. They also discussed making sure there's not too much iron which could lead to constipation. Anyways, could you guys share what you did or what was recommended to you? I currently take bariatric choice once daily multivitamin. Would also love to know what your daily regiment was (ex: prenatal, calcium chew, etc). Thanks so much!

Bowel movements the color you describe is usually do to fat malabsorption. That wouldn't be unusual since you had the Bypass and that causes some malabsorption. It is good they are doing a HIDA scan and ultrasound, as nausea with things like peanut butter could indicate you are having issues digesting fat. Some people get that when their gallbladder starts to misbehave. I have never had bloating that distends the belly like that, so I can't relate, but I have had about 6 colonoscopies for other things so if they go that route don't worry, you'll take a nap and it'll be all over. LOL The prep is definitely worse than the test. I hope they figure out what is going on! Some people develop SIBO after bariatric surgery and that can cause a lot of bloating, so if their tests don't show anything you may want to chat with a Gastro doc about that possibility!

Just wanted to say I'm starting Day 13 of my 2 week preop liquid diet and it's not so bad at this point. I mean, I wouldn't recommend it to friends, but my energy levels are good and the hunger isn't terrible. The first few days I was tired and cold all the time, but it is winter and I live near Boston, so cold comes with the territory. 4 weeks would be hard, but you can do it! I suggest getting any source of temptation out of sight, and keep yourself busy. Also, if you're like me, you will start thinking of the most random food-related things, like a food you like or a restaurant you went to one time 10 years ago, just totally out of the blue. Avoid cooking shows. I stupidly was halfway through an episode of Great British Baking Show before I realized what I was doing! OMG, why am I watching someone cook a tart right now?!? If you're allowed it, get the chicken soup flavored shakes (I know Bariatric Fusion, Unjury, and Celebrate have versions, if those brands are available to you). That has been such a life saver as I'm really tired of everything being sweet. Sugar free jello is lovely and only 5 calories, so it should be fine for you to have. It's almost like chewing, sort of. Good luck!

For life? Not true at all. Stage two of the post op return to eating is purée. It usually is weeks 3 & 4 so two weeks only in the first month. The staged return to eating (usually a two week cycle of liquids, purée, soft then solid foods) is to protect & support your healing tummy. It takes about 8 weeks to fully heal. Some surgeons recommend chewing well before swallowing to help during this time too to ensure nothing too coarse or fibrous is swallowed that could impact your healing. It also makes you stop & think about your eating. I wasn’t told to do that. A couple of weeks on the solid food stage (probably early start of month 3) I was eating chicken thighs, steak, lamb chops, pork loin, etc. Yes we are advised to eat slowly. It takes a good 20 odd minutes for the message to get through that you’re full. If you eat quickly you’ll easily eat too much & be over full. It’s about being mindful when eating too. Putting your cutlery down between bites & really thinking about if you need the next bite yet or just want it is a good habit to get into. It’s actually a good practice for everyone not just bariatric patients. So many people just shovel in spoonful after spoonful of food in their mouths & before they know it they’ve eaten copious amounts of food & are groaning & uncomfortable because they are overfull. Something to be aware of is eating too much, too fast or food that is too coarse or fibrous can result in the foamies. Thick foamy saliva rises to protect your oesophagus & to help you bring up the excess food or food that is causing a blockage. I still have the foamies at times. I think my oesophagus is more sensitive. Char grilled meats & vegetables & sometimes fibrous vegetables can cause me grief. But I feel fine once I’ve bought up the offending thing, I feel fine. Last time I had an episode it was because I hadn’t trimmed my sugar snap peas well & there was string left dangling & it irritated me. Most people rarely experience it & not in the long term. There’s lots of misinformation & scary horror stories online many not based on any truth or vey little or posted to drive likes (the scarier the story the more clicks). Go to reputable medical sites & forums like this one. Generally a good idea to avoid social media too. Highly recommend the you tube videos of Dr Matt Weiner (A pound of Cure) & Dr John Pilcher. Straight forward, practical information, clearly explained.

Thanks so much! I am on a Vegan Shake and using some almond milk with no sugar added. I have slowed down on veggies and fruit. Apparently someone didn’t put on my chart that I suffer from IBS. Then nutritionist is calling me on Tuesday to help with a diet that’s is more manageable for me. I was told that My IBS could get better or worse. I read the Bariatric Bible they gave me and it is in there. I pray for the better scenario. They told me if I have any doubts then I shouldn't do it. It’s not that I have doubts, I’m scared of any surgery! I am nervous and I feel it would be favorable if one hear some positive. That’s why I am on here. I am hoping I hear the positive. I hate drama. I realize that it will be very difficult recovery. I don’t know how many days I will be in pain. They want me walking 20 min 3 times a day. I can do 10 minutes and I will work my way up. I think they do this liver cleanse for the purpose to make surgery easier but to show us this is your new way of life. When I look at phase 2 it’s not as much dairy, fruit and veggies they are requiring now. I am almost there I have today and tomorrow. Then clear liquids on Tuesday. My surgery Wednesday. I am giving it all to God! Thanks for all who reached out!

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.

Sleeve in 2017 to revision Gastric Bypass Aug 2023 - Update Hi All! I can't believe how fast time has gone! I will be going to my 6 mth check up tomorrow 2/20/24. Everything is a lot better! As of today I am 173lbs, I'll update my ticker it's still at 183. I am able to eat more varieties that I cook at home. Can't tolerate beef to well but I was never a big red meat person. I am still on the fence with salads/raw vegs though I can tolerate raw onions and tomatoes. I CANNOT eat take out! Purchased chinese for my son as he was going back to college... tried a little and was bringing it back up the rest of the night! If I eat out it has to be at a place that actually cooks food like salmon, veggies, no added anything. Food prepared at home is MUCH beter because you know what's in it. I am not doing too well with my multi because I purchased capsules that I open to put in my protein smoothies (Unjury Vanilla) which I don't take every day anymore. I just purchase the multi-vitamin patch from the bariatric store, I'll update you on that later My food is mostly a diet consistency of pescatarian due to the low cal/high protein and the ease of my system digesting the food. I would occassionally eat chicken as well (ground, poached breast etc), turkey hardly ever because the meat is not as soft as chicken. My veggies are fine steamed, some legumes & beans (occasional), as far as grains or potatoes etc I try to not do carbs at all or keep them at a bare minimum (jasmine or basati brown rice) with an occasional meal...I've really gotten into sweet potatoes as I didn't eat them a lot before. Swelling is gone, skin is good, and I can visually see the difference in pounds and inches loss especially from a side view lol. I still have work to do (vitamins, eat more, move more) and I am working on it. BTW!!!! I am back in the health & wellness field as I start my new position next week. I took a pause last summer. Now as I am on my health journey I'll be helping my patients with weight loss and adopting healthier lifestyles. My goal is to lose 13 more lbs and as you all know after running so long and you can see the finish line in sight....your legs get weary and that last sprint is the hardest. It is good to move from "morbidly obese", to "obese", to now "overweight"...do you guys feel the same? Let me know how you all are doing!

@newbegining2024 Hi All! I can't believe how fast time has gone! I will be going to my 6 mth check up tomorrow 2/20/24. Everything is a lot better! As of today I am 173lbs, I'll update my ticker it's still at 183. I am able to eat more varieties that I cook at home. Can't tolerate beef to well but I was never a big red meat person. I am still on the fence with salads/raw vegs though I can tolerate raw onions and tomatoes. I am not doing too well with my multi because I purchased capsules that I open to put in my smoothies which I don't take every day anymore. I just purchase the multi-vitamin pack from the bariatric store, I'll update you on that later My food is mostly a diet consistency of pescatarian due to the low cal/high protein and the ease of my system digesting the food. I would occassionally eat chicken as well (ground, poached breast etc), turkey hardly ever because the meat is not as soft as chicken. My veggies are fine steamed, some legumes & beans (occasional), as far as grains or potatoes etc I try to not do carbs at all or keep them at a bare minimum with an occasional meal...I've really gotten into sweet potatoes as I didn't eat them a lot before. Swelling is gone, skin is good, and I can visually see the difference in pounds and inches loss especially from a side view lol. I still have work to do (vitamins, eat more) and I am working on it. BTW!!!! I am back in the health & wellness field as I start my new position next week. I took a pause last summer. Now as I am on my health journey I'll be helping my patients with weight loss and adopting healthier lifestyles. My goal is to lose 13 more lbs and as you all know after running so long and you can see the finish line in sight....your legs get weary and that last sprint is the hardest. Let me know how you all are doing! (this will be posted in a new thread as well)

Hi Joe! My surgery is in 4 days. I am 5'6" and at my highest weight, I was 250 pounds, which gave me a BMI of 40.3. Since starting the nutrition program and pre-op liquid diet, I am down to 228 pounds, so a BMI of 36.8. I have high blood pressure, prediabetes, and high cholesterol. Like you, I've dieted countless times. In fact, I was enrolled in the nonsurgical program at my hospital for 7 years, starting when I was 42. I found it relatively easy to lose up to about 15% of my total body weight, around 40 lbs, by counting calories, exercising religiously, and not letting my guard down for a minute. After that, I would stall. Then the weight would creep back up. My doctor would prescribe meds (including Wegovy for a while, but it's too expensive for longterm use for me), and I'd lose 10 pounds. Then I would stall, followed by regain. Or the nutritionist would suggest a new approach, and I would lose a few pounds again, followed by regain. A little more each time. After 7 years of trying, I was back to my highest weight ever. I feel like I wasted a whole lot of time with nothing to show for it. And now I'm nearly 50. My blood pressure, blood sugar, and cholesterol all have gotten worse. My feet hurt. My joints ache. I feel older than I am, and I don't want to be old before my time. I know from reading the latest studies in weight loss science that my chance of long term success in reaching and maintaining a healthy weight without the metabolic reset of bariatric surgery is around 5%. I'm fortunate because I've seen my brother go through sleeve surgery 15 years ago. He lost a huge amount of weight (about half his body weight) and though he has regained a fair amount of that, it's nowhere near where he used to be. His appetite is now what I would call the smaller side of normal. Nobody looks at him having dinner and would guess he had surgery. So I know that the most drastic parts of this (like a liquid diet!) are phases you have to get through to get somewhere better. I feel nervous, too. I've never had surgery. I worry about complications. I'm hardly ever sick, so I sometimes think what if I'm trading decent health for problems? But realistically, problems are in my future. I've seen it in countless family members. The writing is on the wall. And the surgery is very safe. So for me, the risk is worth it. I've tried on my own long enough to know it isn't going to happen for me without this. And a BMI of 40 might not be as big as some people, but it's big enough to rob me of good health in my future. I really hope this helps at least give you some things to think about to help you make your decision. Wishing you all the best!

If you don't already have it, the Baritastic app is pretty handy. So far, I'm only tracking food (well, liquids) and my weight, but there's more fun stuff, too. The bariatric nurse at the hospital recommended it during my pre-op appointment.

The lactose in the shakes can cause people to poop badly. There is something to take to help with lactose intolerance but I dont know what it would be called in the US. This might be something to ask at your meeting. There is also another preop diet to follow for those who are lactose intolerant. But that would normally be suggested by the dietician. Not sure why it wasnt suggested for you. Again another question for the meeting. I was not allowed fruit in my preop. If you have IBS you may find that certain fruits/foods may not agree with your tummy. Its all trial and error to find out what the culprits are that are affecting you. Fruit/vegies that have a high seed/fiber content were a no no for me before my RNY. Kiwi fruit, Zucchini, stone fruit, grapes etc are a bit of a problem but after you have the bypass you may find that you have the opposite problem and these fruits/vegies will help things to move along. It is all a bit of a learning curve. If you were to go an do it on your own these are issues that you would have to face anyway with having IBS so there no point is ditching the op at this stage. It is not part of their remit to even say "well if you cant handle it you may become malnourished". This statement smacks of shaming. It is their job to educate you in navigating it all. The RNY job is to make our bodies less capable of absorbing nutrients/calories from the food. This process is called malabsorption. This is the reason that you will be taking bariatric vitamins for the rest or your life. You will require blood tests on a yearly basis for the rest of your life to check that your body is being given the correct amount nutrients and head off any long term issues. Eating well and taking care of your body is something to focus on. I have been listening to the podcasts of The Bari Chronicles. You may find the Vitamin episode helpful. https://podcasters.spotify.com/pod/show/the-bari-chronicles/episodes/Multivitamins-Nutrition-For-Weight-Loss-Surgery-e2eduqv (Also available on apple podcasts. I hope it all goes well at the meeting.

I take this one and it's fantastic. I need the iron because I've always been a bit anemic, but they also have them without iron. https://store.bariatricpal.com/products/bariatricpal-multivitamin-one-day-bariatric-capsule-45mg-iron?variant=13156335845453

I am taking B12 sublingual 1000mg once a day. Could be the diet I eat have additional B12 in it. My Bariatric team did say I can take B12 every other day and see how it turn out. Because I just have surgery done, I won’t test it , maybe after the 3 month post op I will test taking it every other day and see how the result comes out. Ever since I am young I do feel like my body absorb more nutrient than everyone else. I have no science to back it up tho. It is in my gene that my family member are in plus size, maybe that’s a factor that effect it.

Programs are so different, but you should definitely be eating, or at least attempting, more solid foods by 8 weeks. In case this helps, I've just found this YouTube channel where a bariatric dietician is working through the food stages in the post op diet. I don't think she'll get to where you are until next week, but you might want to check her out: https://www.youtube.com/@BariatricFoodCoach Also, I found this video really helpful in explaining how to approach eating right after surgery:

What are your go to foods / snacks to buy on the bariatric pal website??? Im 2 months post op I really have little to no appetite. But with head hunger Im dying to have coffee & a muffin but want to stay away from high carbs. Sick of protein shakes just need some new things to try. Living off sugar free jello, pudding & 2 pieces of air fried chicken tenderloin. Every other day Is everything on the website ok to eat after Vsg ?