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Hi pals, I am a 31 yr old male, 340lbs as of today and have diabetes, high blood pressure, and severe sleep apnea. My physician brought up the topic of getting bariatric surgery and how it could be helpful for someone like me. I started doing research on various surgeries, their benefits, complications, and side effects and after much research, I have made up my mind to get a gastric sleeve done. I checked with my insurance today and learned that the surgery will not be covered under my plan, which sucks due to the high costs involved but I think the costs and risks outweigh the benefits over time. Could you pals help me get started on my journey here? I am looking to get it done sooner than later and since I will be paying out of my pocket, I am looking for some economical options stateside. Please share your experience with me, especially if you have had one done recently and the cost was a consideration in your case too. Thank you very much! Your pal

What are you drinking? Try some vegan protein powder like GARDEN OF LIFE. It has so many vitamins & nutrients in it that most other shakes don’t. I used a few different brands & was allowed to blend in fruit as long as I didn’t go over 15g of carbs. I never once deviated from the plan. It’s not worth having your surgery canceled when they find out your liver hasn’t shrank or whatever other reason. I also believe that if you cheat it will cause slower healing or complications but that’s just my opinion. The sacrifice is so worth it. Good luck! By the way my liquid diet was 28 days.

Whether the doctor believes in something or not is irrelevant. The only real question is whether WLS is medically indicated for you. And also important is whether the doctor said anything else about why she thinks you are specifically not a good candidate or if she just thinks it's not warranted for any of her patients. If you don't mind sharing, do you know your current BMI? (If you don't you can find an online calculator.) The general rule of thumb, at least for sleeve, is 1) minimum of 40 or 2) between 35 and 39 if there are other complicating medical conditions such as diabetes or severe sleep apnea. If you don't meet either of those criteria you might not have a case. But if you do and the doctor refuses to submit a referral, you could go over the doctor's head and contact the medical director where the doctor practices to report her. You can also contact your insurance company and let them know that your doctor is failing to follow proper medical protocols.

Not wanting to be a Debbie downer BUT...... I think you need to be stopped for 4-6 weeks as a minimum before surgery due to all the nasty complications like increased chance of infection, poor wound healing and higher chance of respiratory infections alongside the pressures of anaesthesia. As for your question, different surgeons test at different intervsls by different ways including urine, blood or breath. Be aware that smoking cessation products containing nicotine will give a positive result. Cold turkey is by far the best way to stop but I've heard vaping nicotine free can help in the early days. Good luck xxx

My Surgery was Fantastic!!! I will be three months on 2/20 and I am down 57.4 pounds. I love Dr. Curry and all the staff, I had no complications and I made sure I followed all the guidelines to the T. I feel AWESOME!! If you have specific questions once you get started, please don't hesitate to shoot me a message. Pict on the left was 11/4 (surgery was 11/20), pict on the right was 2 months out

I actually went below my goal weight but I had some complications due to Strictures. I lost 132 in 6 months but I did gain up to 125#'s now I weigh 124 to 129#'s. Which I will take in a New York minute. I got to my goal and haven't lost any more. I didn't have but 1 gain when I was 6 months out. I jumped on my scales and it said I was up 1#. The next day (after I was so bummed) I lost 3#'s. I think when you are told about the Honeymoon Phase being your 1st year to 1 and 1/2 is not always the bottom line. It may get harder to loose as quickly but from seeing posts on here there are many thatkeep losing longer. Good Luck on your Journey!!

I am 5 years post gastric bypass surgery, but I’ve had complications with my back. I recently had my 3rd lumbar fusion approximately 8 weeks ago. I was told by my surgeon it was very important not to gain weight as this will put pressure on my back and worsen my pain. Well I’ve found that very difficult to do. My pain is so severe after this surgery I am afraid to move. I try walking but I can only walk max 1 block due to severe nerve damage pain to both my legs. I have also been depressed because I was told I could never go back to my job (I’m a dialysis nurse) due to the repetitive strain n pressure. I’m an emotional eater. I have gained 10-15 lbs since my surgery on 12/13/17. My pain gets worse every day cus of this. I can’t stop eating n I can’t exercise. Anyone going thru anything similar to this or know if someone with the same problem that can give me some advice? I am already depressed so I don’t need Any criticism or negative comments, just need advice on any diets or exercises. Not sure how I have been able to eat so much, since my bypass I have always eaten very little n I was able to lose a total of 105 lbs

I was in exactly this situation that you were talking about. Each program is slightly different with varying requirements. I got some credit for the past accomplishments with the hospital system that I transferred into but the new program had even more requirements than the old one. I was a bit disheartened at first but I realized that the additional tests and screening were to really give me the best hope for a safe surgery. I chose to cut ties with my first program because the staff just had horrible bedside manner and wanted to get in there and out quickly. I was concerned that if I had complications after surgery, would they behave dismissively to me? I am not a whiner or complainer per se, but if they're treating me terribly insensitively now, what happens when I truly need their guidance? Why do you want to cut ties? If the reason is finding a faster route, it isn't worth it. If the reason is that you have reservations about the quality of care, then it is worth consideration.

I've been on a liquid diet once before. It takes 4 to 5 days before you feel less crappy. But, one day you will wake up with hunger gone and actually feeling energetic. To keep staying on task, tell yourself that this is ultimately to make you safer for surgery. This is the reason that you're doing it. Tell yourself that if you cheat, you risk surgery complications or even having your surgery cancelled altogether. You worked way too hard to get this far. Just look at things hour to hour. Don't look beyond the next hour. This is a time tested technique and it's what allows Navy SEALs and Army Rangers to get through some of the most physically and mentally brutal training imaginable. It's about wanting it and keeping your mind in the present.

What happens? Worst case - doc gets in there to do surgery, sees that your liver hasn't shrunk due to not following the diet, and decides then and there not to go through with the surgery. My doc had apparently done that to patients in the past. That was enough for me to stay on track. Even if the doc goes through if your liver doesn't shrink then it's going to be more difficult for them to work around. I had a fluke bleed develop (on my third day) in my spleen that was likely caused by getting bumped while they were working. My surgery went fine, doc said liver was fantastic, and I did everything to plan. So that being said I sure as hell wouldn't have wanted to do anything else to have made things more complicated for them. I'm an oddball statistic (only met on other person on here that had the same thing happen) so I'm not trying to scare you. Point is do everything you can to make sure you have a smooth and easy surgery. A lot of us had to do two weeks of a liquid diet. It isn't fun, but you have to keep in mind that it's liquids on the other side too. This is a good time to really evaluate your relationship with food. You'll get through it. It's a few days of suffering for a whole bunch of rewards on the other side.

Eh....around weeks 3-4 I'd say. Keep in mind I had some complications with my surgery and was in the hospital for almost a week. My recovery got off to a really slow start. I went back to work during week 3 and was okay, but tired. Didn't have much pain by then but not much energy. After the 4th week when I was back to actually eating some food again things seemed to speed up on getting back to normal.

I am feeling great! I've lost about 42lbs and 30 inches. I haven't had any complications with introducing foods, just a little acid reflux week 3 and 4 but it subsided. I have so much more energy. I try to get myself to the gym 3-4 days a week. I get about 60g of protein and about 48oz of water. I'm not hitting my goals with that. It is something I have struggled with right along. I take each day at a time! How are you feeling since surgery? Sent from my SM-N950U using BariatricPal mobile app

This journey is HARD. Pre-op diet and post-op diet especially are difficult, plus if (God forbid) you experience a complication, you are going to need support. My psych eval included ensuring I have plenty of support at home to help me with my recovery from surgery and help me stay on track. As much as it would be awesome to say "Piss off!" and just do what you want anyway (LOL) you have to live with this guy and let's be honest, that ain't gonna work. Your hubby is very wrong that this is the "easy" way out. As someone who's done WW, and lost and regained the weight a few times, I can tell you this is just as difficult. It's a hard decision, it takes will power and dedication, just like any other lifestyle change you make. He needs to be educated. Suggestions: Would he respond better if you wrote him a letter explaining why you feel the way you do? Sometimes if people see it in writing, it resonates better. Do you have a support group through your surgeon's office that you can take him to? Would he go to a meeting? Don't take this the wrong way, but a mediator or therapist could help, too. There is NO shame in it-- sometimes having someone in the room to push the conversation in the right direction (meaning, understanding each other on a deeper level) would be helpful. Just throwing ideas out there. I would also provide him information on how safe the surgery is. I'd be willing to bet he's afraid to see you go under the knife! Completely reasonable to be afraid, but the surgery is very safe, generally. Especially if you're young (you look it) and have few health issues. If he wants to keep you around for a long time-- prevention of health issues is best!! That's why I did it.

Hi there, Sorry to hear of your struggles. We don't have the same type of surgery but I have reactive hypoglycemia. Some of us will develop this as a complication from surgery. Sounds like you are managing it. I use a glucose meter. I usually know when my blood sugar is crashing. I can feel it coming on. I agree this takes work even years out. I have times when I'm doing well. When I'm not, I peek back in here to get back on track. Wishing you the best, Jenn

Three weeks and 20lbs down. I can start pureed food today. However, I would really like to see 25 - 30lbs come off in my first month. I might stay on liquids one more week. I have not exercised at all yet. Frankly, I have no energy because of the liquid diet. I am listening to my body and I figure week four will be when I can start my workout routine. I am seeing changes in my body and it is exciting. I started at 257lbs and I am now down to 237lbs. Overall, things have been great with no complications. No buyers remorse here. People say the first month is really hard but it hasn't been bad. Sure, day one looking at three weeks ahead of liquids seemed impossible. Yet, here I am adding a week. It takes a lot of self control and listening to your body. If you are hungry, it is probably time for a shake or some broth. At first the hunger hits and you think there is no way it will satisfy. Yet, you just keep doing it and soon your body and mind sink up and you realize, yes this does satisfy me and it is enough. I hope you are all doing well on your journey and that this helps in some way. Sent from my SM-G930V using BariatricPal mobile app

I haven't had any major complications, but there are definitely mental aspects to post-surgery life that I didn't really think about. First, you can't overeat - even if you have the worst day ever, you can't turn to food for comfort. Is that a con? Not really, but it does mean you have to find new ways to deal with your issues. Prepare yourself. Second, there are times that you are going to be pissed off that you can't eat what others are eating or as much as they are eating. I didn't expect that at all. You just have to change your way of thinking! You can't take a break from your new lifestyle. You will get sick and/or potentially cause harm to yourself if you don't follow your diet guidelines. This is 100% commitment for the rest of your life. I'm not saying you'll never eat normal foods, but you have to be committed to eating nutritious foods in the right quantities. Make sure you are ready for that before you take the plunge. I didn't have any major food issues before surgery . . . I just neglected myself for too long, which led to my weight gain. That being said, the mental aspects have still affected me from time to time. They are all manageable, but I definitely think this is more of a head game than people realize before surgery. Good luck with your decision! Even with all of the above, I do NOT regret my decision. I feel better than I have felt in years, and I'm really happy I went through with my surgery!!

The first month is pretty damned rough for a lot of us. I had complications and the first 3 weeks were, well, hell. But, I'm a year out and can say I have no regrets at all. Can I eat a small plate of food? Yes and no. You'll learn how different foods will fill you up. If I'm eating some type of slider food I can probably get 1-2 cups of food in depending on what it is. Other times it's a single cup and that's all I can manage. The next couple months are going to be a learning experience. Some things will frustrate you initially, but you will learn to work through it. Drinking will get back to normal for you. I mean I can't pound down a 44 oz diet soda like I did in the old days, but I can take a pretty decent sized gulp of water now and it doesn't bother me. It's pretty normal to have some feelings of regret, especially if you're dealing with pain and difficulty in getting anything down. Try to keep your focus on the long run. I know this phase is pretty depressing but it truly does get better. Once you get past this initial hump and then can start transitioning to regular foods you'll see things start to improve quickly with your outlook and attitude. Hang in there. This will pass.

Thank you so much! And yeah... whew. Now if you're able and willing to pay yourself, it's often much easier to get things done. It's definitely way more complicated when insurance gets involved. I just... I don't even know how my situation got so screwed up I do agree somewhat with the bolded. It makes me feel weird (not judgey, just weird) that people can hypothetically have surgery within weeks of even coming up with the idea. I'd been reading about WLS in depth for nearly 2 years when I walked into the surgeon's office the first time! So I think there's some pros & cons to the system for sure. But there's something to be said for making the decision and moving forward immediately. Leaves much less time for the emotional pity parties and food funerals

I have a few questions for those who have gone through this or are going through this. First one is, why did you choose the sleeve or bypass over the other? I was thinking originally of getting the sleeve done, as dumping syndrome scares me as does the thought of them rerouting my intestines. That being said, I do sometimes get bad heartburn, (not enough where I need to take any medication or anything, but enough to be annoying) and I'm worried about GERD afterwards, and I have heard that, while both are effective, the Bypass has slightly better results so far. So just wondering what people's thoughts were on it. I'm 28 years old, mother of a one year old and my husband is super supportive about anything. my CW is 344 at 5'8.5'' Figured I'd get some last minute advice before I talk to the surgeon and see what his thoughts were as well. I don't have any major complications, I did have an Arrhythmia two years ago but after quitting my insane job, it's gone. VERY mild sleep apnea. The Dr's office says normally our insurance requires 6months of recorded weight loss attempts but since my BMI is over 50, it will probably be like 3 months. (I'm hoping that's the latest, as we had wanted to plan on trying for baby #2 next August-ish, and I know they like you to be 18 months out beforehand, and we have a wedding that my husband will be best man of Early June.) we have our first meeting with the weight loss center's doctor (not our surgeon, but our surgeon recommended this) and dietician tomorrow.) The last question is, I'm going to my first consultation/dietician class tomorrow morning, are there any questions you would have liked to have asked early on of your first consultations? Thanks in advance!

I had my sleeve done last year at 65. I also had my gall bladder removed and a hernia repair at the same time. I had no complications and took no narcotics after it. I will admit for a few days it felt as if I did a million sit-ups but after a couple of days all was well. I was worried that the surgeon might think I was too old but no, she never said a thing. I guess I was lucky in that I had no co-morbidities except the excess weight! For those reading this, don't let your age make you second guess the surgery!

Hi @daizeoh. Here's more information than you asked for. I'm just a thorough kind of guy, The insurance company will only deny you for these reasons: You do not meet the criteria. Failure to follow the pre-op protocol. Not passing the psychiatric evaluation. Not being covered for weight loss services. CRITERIA: I'm pretty sure the standard rule of thumb for eligibility, at least for males, is a BMI of 40 or up or a combination of BMI of 35-40 with other complicating factors like severe sleep apnea. It may differ for women. PROTOCOL: Each insurance company has different pre-op protocols regarding things like pro-op dieting. Your doctor's staff will know what your insurance requires. There are reports of requirements of pre-op diets ranging from zero to six months as well as other things like endoscopies and other pre-op exams to ensure you're healthy enough to endure the surgery. The doctor's staff will all handle checking with the insurance company to find out exactly what you need. It's probably better to let them deal with the insurance company than doing it yourself since they know exactly what to ask. PSYCH EXAM: If you do not pass the psych exam you may be able to get a treatment protocol to follow that would help you get past that hurdle. The psych exam includes things like not having drug or alcohol addictions, so if you've had that recently they'd require you to be sober for six months. If they determine you have undiagnosed or untreated depression they might recommend seeing a therapist weekly until the therapist believes you have a handle on it. The psych exam also ensures that you have a good support system in place for your recovery period, so if you live alone with twelve cats but have no local friends or family, you're a poor candidate. NOT COVERED: Not all insurance policies cover weight loss services and bariatric surgery. This is something you could call and ask about yourself. If you have coverage through an employer and these services are not covered, it's because your employer decided not to include the coverage, which can be done to keep premiums lower. The most important thing is to ask questions. You'll get a lot of advice here, often confusing and conflicting. In addition, all doctors are different: most will do the surgery in a hospital and have you spend the night, some will do it outpatient and you'll be home by 4pm the same day. Some will require a pre-op liquid diet, others won't. No two people will have a similar experience, so just because one person says they have the same insurance company as you does not mean you'll have the same requirements.

So I'm going to take the next few days and mull this over, but I'm considering postponing my surgery to May. (I have authorization from the insco through June.) The point of all the hurrying was to get it done in February before everything with my husband's job imploded... now that it's in March and whatever happens with the insurance will happen regardless, it's more of a PITA than anything else because it's in the middle of my school semester. I'm feeling so amazed at how everything got so complicated, lol. I originally wanted to have surgery in December but I screwed it up when I missed an appointment and had to restart my 6-month diet. So then the plan was January, but waiting for all the testing to be completed pushed it back again. Now you guys know the story of February in painful detail so I won't repeat that... and now it's in March. So................ I just don't see the difference between March & May, practically speaking, and May is more convenient in many ways. Again, I'm going to sleep on it for a bit. I don't want to be rash. I'll discuss with my support system and make a list of pros & cons before deciding. (Is it super petty that one of the appeals of having surgery in May is that one of the pieces we're singing in the music program this semester has a high C and I'm the only one who can hit it-- and I was worried that I wouldn't get to sing it after surgery???? Lolololol okay don't answer that. *angel face*)

Check out this article: https://www.bariatricpal.com/magazine/622-types-of-bariatric-surgery-by-the-numbers-and-what-it-means/ Lap bands work for some people and I don't see the point of attacking individuals who have had great success. That said, there is a big chance of complications with the band. I live in Australia, where there were an insanely high rate of lap bands performed and now they are out of favour. Interestingly, if people are looking for a non-permanent, less invasive strategy they are getting the balloons. I think we'll see a growth in that. I wanted a lap band and my surgeon was like no. He has performed thousands of WLSs and basically won't do them anymore. Apparently, he constantly does revisions from the lap band to VGS or bypass. His view is that the lap band doesn't work long term for most people. There's no correct answer but make sure you get medical advice and are comfortable with your decision.

1. It depends. Some people seem OK to return after a few days (my surgeon mentioned they had someone who returned after 2 days!!!), others may need two weeks. This will vary according to whether you have any complications, what kind of job you have, how your body copes with the surgery (anesthesia makes me sick for days). Expect to take at least a week (I speak for sleeve, I don't know if bypass is longer). 2. I told my boss that I was having surgery and did not provide further details Legally you may not have to give any details (that is the law in Australia, speak to a medical practitioner about what information you are legally required to provide). I had my general practitioner doctor (I didn't want my boss googling my surgeon's name and seeing what they specialise in so I didn't get a note from them) prepare me a medical certificate that just said I would be unable to attend work because I was having surgery to treat a medical condition. This was the truth. 3. I just told colleagues that I had surgery. People shouldn't pry. If you don't want them knowing you had WLS, you can lie or imply it was something else. You could be vague and say it was a female problem and they will not ask anymore, there's also hernia and gallbladder removals which give you a similar recovery time. What you tell people will depend on your personality (and in terms of your boss, maybe applicable workplace laws), but I'm a private person and it's nobody's damn business! Lol. Where I am, WLS is pretty rare, I don't need people's judgement. I know this surgery is definitely not for everyone. It's not the easy way out. I'm not interested in people's uninformed opinions. I don't want anyone scrutinizing me to see what/how much I'm eating. I haven't been at my workplace long, and I don't want to be known as the person who had weight loss surgery. I don't want it defining me. That said, people are different. You may want support, you may feel comfortable talking about it. You may just want to share your amazing adventure with everyone! That's totally cool! You may not want to lie about how you lost the weight. If someone who was obese asked me how I lost the weight, I would probably be honest about my WLS. But my colleagues are all (without exception) slim, fit attractive individuals. So I don't feel bad about lying. That's part of why I did lie. I don't expect slim people to understand how I got here. The pervasive view is that obesity is an issue of laziness or lacking personal responsibility. It's so much more complicated than that, our biochemistry, hormones, gut microbiome, neurology, psychology, family history, environment etc all contribute to how we became obese. How we deal with it is complex. I'm not going to defend myself to people. Lol. Rant over. I think that it's totally up to you about what you tell people!

My brother and husband know and about 3 choice friends. I haven't even told my bestie because she freaks out every time she hears someone mention wls - someone's relative like 20 years ago had nasty complications and it's stuck in her head. It's no one's business. My boss knows I had surgery and wished me well. I told a few coworkers I had a hiatal hernia and am using the recovery period to work with my dietitian (who I started seeing last summer in the pre-op period, but they don't know that's the reason) to completely rework my eating habits so I can continue to lose weight post surgery. That's not completely a lie..... Even when I checked into the hospital - I ran into one of my husband's friends whose wife was having surgery same day. I don't know what she had, she doesn't know what I had. We just text to ask how recovery is going. My medical choices are mine and no one's business.