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As @@Dub says, it's all about moderation during drinking and remediation in the days after. I only drink sugar free drinks that are all around 100 calories. If I'm in a situation where I'm drinking for a long period of time (all day on a boat, followed by dinner with friends), I might get to 500 calories of alcohol on such a day. This might get me up to 2,000 total that day, which is more than normal, but will not break my diet. When I see it show up on the scale, I go back to my post opt diet and get back under goal in a day or two (remediation). That said, if you think you've been a food addict or may have alcoholic tendencies, I'd steer clear. Btw, unlike most of the women here, I don't find it hits me any harder than it did when I was on a low carb diet back in the day. If all you have in your stomach is Protein and veggies, you will feel the booze faster.

On the contrary if someone said that orange juice made my feet smell better I would look for any evidence that corroborated that statement either falsely or truthfully. What I would like is actual evidence on the long term effects of diet soda consumption in any quantities on the sleeve. In the absence of that my alternative is to either soak my feet in orange juice as failure to do so could result in stinky feet while doing so could result in sticky but better smelling feet. LOL indeed this line of think i.e. weighing the upside vs the downside of a behavior has led to some very strange things. Think of the all the strange detox drinks that people drink on the basis it may make the younger, healthy, anti aging etc. Large parts of the beauty industry and indeed the diet industry are predicated on the fact they can make a dubious claim back by nothing more than observational study and the suckers start lining up with their cash. It harkens back to the days of snake oil merchants just tell folks what they want to hear and they will do the believing all on their own. Forget the soda question, how about evidence that sleeves can be stretched (more easily than a normal stomach). I've looked and I can't find any. I ask my surgeon and she said no. The former paramedic who hung about the operating room selling staples isn't that credible (to me anyways). Everything I've read or heard about failure is attributed to easily digested high calorie food or beverage. Regular soda, candy, Cookies, alcohol, chips, etc. I have never heard of someone stretching their sleeve and getting fat eating an entire pizza a one sitting! Has anyone?

I could drink fine after surgery although it was about 6 months before I did. Now at 1.5 years out I can barely have a glass of wine without getting drunk. Also the hangovers are brutal. The further out I get the less I can handle alcohol. I've pretty much stopped drinking. But a sip or two is okay. Sent from my iPhone using the BariatricPal App

Today is my last day before I start my pre diet and I'm feeling Very afraid and cranky. Alcohol and food have always been my run-to's when I'm stressed. Reality is settling in Sent from my iPhone using the BariatricPal App

I made changes to my diet as soon asI knew in my heart that I was doing WLS. I cut out alcohol, coffee, soda, sweets, starches and pastas. I eat high protein, low carb and drink lots of water (basically it is all I drink) I downloaded the Fitpal app and log everything I eat. That has probably helped me more than anything else. Keeps me accountable. I do allow myself one night a month to eat out and have something on the naughty list. When I crave something I just tell myself I can have it in due time. I have been doing this since March and have lost 35 lbs so far. I will keep it up until my liquid diet phase before surgery.

@@cseidman - Congratulations on your surgery. I would caution you with the "drink anything but soda"...of course giving up soda is a great thing but please don't replace it with other high calorie beverages and/or alcohol. It would be really easy to start drinking sweetened lemonade, iced tea, fruit juices, etc. and rack up the calories. Just be careful I have a fitbit and I love it too. You will be amazed at how much good information you can get from it.

What wonderful responses you've had on this thread! I'm 21 months post-op, have lost all my excess weight (100 pounds) and now maintaining easily at 135 pounds. Currently (and I emphasize "currently" because things could change, which would mean I'd have to change what I'm doing) ... * I love food! Love the taste of it, the varieties of it, the nutrition of it, the discoveries, the freedom, and the fact that I am no longer afraid of food. Food has become a resource to me, as well as a pleasure. * Since I'm now on maintenance (eating about 1800 cals/day) about 75% of my calories come from nutritious food. The other 25% of my calories come from from good-tasting, but un-nutritious things like alcohol (one drink a day), sugar treats (e.g., 1 biscotti, 2 squares of dark chocolate), or a starchy item (e.g., small biscuit). * I eat a lot of animal and plant Protein, aim for 5 veggies and fruits a day, whole grains, and mostly healthy fats and oils (although I do have a little butter). * I eat full-fat cheese, skim milk, low-fat yogurt -- weird combo, I know, but I like it. * I minimize fast food -- have it rarely. * Only rarely do I eat white bread, white rice, white potatoes, white flour Pasta. Instead, I eat whole grain breads, brown rice, sweet potatoes, whole wheat, protein-enhanced pasta. * I make most of my eating decisions when I make grocery lists and shop for food. If trigger and unnutritious foods are not in the house, I can't eat them. That's a very good piece of advice for you. * I cook a lot more than I used to -- which reflects how rarely I eat "fast food" these days. * I plan my meals and I track all my food and drink intake in My Fitness Pal. I love it. Frankly, for me, it's the second best tool I use to maintain my weight; the first best tool, of course, is my sleeve. * I still (most days) drink a Protein Drink for Breakfast. I just like the taste, and it gives me a great start to the day of 25 grams of protein for only 170 calories. * I take my very few meds (thyroid and H2 blocker antacid) and my Vitamins and other dietary supplements daily and on time. * So far, no food is permanently off limits -- although a lot of foods are on the "only once a week" list or "once in a blue moon" list or "only at X restaurant" list. * I'm still learning a lot about nutrition, metabolism, and eating mindfully. I expect I'll never stop learning. I hope not.

I have two sisters that had the surgery one of them turned to alcohol and she never drank before Chelsea got very conceited and almost lost her husband cuz she was being promiscuous with other men Luckily everything got better for her and she's doing well now I've heard that people will replace one addiction with another I am positive that I will be a gym rat because that's what happened last time I lost a lot of weight. Sent from my SAMSUNG-SM-G930A using the BariatricPal App

@@Anna Nim I've got no good reason why WLS allows some people to keep the weight off. It's obvious why it doesn't work for a lot of people.....they don't follow the rules, they go back to old eating habits, they basically don't make the necessary lifestyle changes. But why can some people do these things? How are previously fat folks who were never successful losing (and keeping off) weight through traditional diets "magically" able to succeed with WLS? Why couldn't they log their food and eat more Protein and make better choices and not use food as an emotional crutch before surgery? I seriously don't know. For me, I think it was because surgery allowed me a second chance at finally doing things right. The strict diet and sleeve restriction in the beginning allowed me to lose more weight than any diet ever has. I became a thin person for the first time in my life. I was given a "get out of jail free" card and it was up to me whether I wanted to put in the work to stay out of jail or did I want to make the same mistakes that landed me there in the first place. I chose the former. And let me tell you, the psychological aspect far outweighs the physical aspect of surgery when it comes to long term success. But I knew that going into this so I was prepared. When life started slamming me with stress, I sought the help of a therapist rather than turning back to my old comfort buddies, food and alcohol. The statistics of how many people lost how much weight or regained X number of pounds has absolutely nothing to do with me.....or you. You can do whatever you want with your sleeve. The choices that determine success or failure are yours. But you have to commit to serious change....including giving up the carbs..... and if you aren't ready or mentally prepared to do that then no, surgery is not the answer for your weight problems.

There is a surgeon, Dr. Matthew Weiner, who has produced a very good series of videos on YouTube that provide a great deal of information about the surgery and weight loss. One of them discusses the changes that occur in our metabolic setpoint after weight loss surgery (can't remember exactly which one it was). If I remember correctly the videos all advertise his book "A Pound of Cure", but looking past that they are full of good information about the surgery, the body's reaction to it, and how to be successful with it. You can search YouTube for "Matthew Weiner" and go to his channel, where you will find all of the videos. In a nutshell, the sleeve resets our metabolic setpoint. Instead of your body striving constantly to retain fat, it now strives to lose fat to bring itself to it's new, more normal target. As long as we work with it by eating enough Protein, limiting carbs, sugar and alcohol, and provide some moderate exercise it works. This is why they say the sleeve is a tool... you need to make the behavioral changes to go along with it to allow your body to be successful. To understand why resetting the metabolic setpoint is important, look at the recent articles published about The Biggest Loser contestants. They all lost great amounts of weight through diet and exercise. Many of them have gained it back. Diet and exercise alone don't work long term because they don't change the metabolic setpoint. When your body loses weight it goes into survival response mode and does all it can to restore the lost weight. We must change the setpoint for long term weight loss success. Changing the setpoint is the equivalent of changing the thermostat in your house. This is the key metabolic benefit of VSG. Researchers believe your metabolic setpoint is controlled by the leptin-ghrelin-insulin balance in your system. VSG removes most of the stomach tissue that generates ghrelin (hunger hormone). This is why we aren't very hungry, except for head hunger, after surgery. Removing most of the ghrelin also affects the leptin (fat storage hormone) level, causing the body to want to reduce leptin levels and release fat. The change in both of these also impacts insulin levels, which reduces insulin resistance and in many cases immediately resolves type II diabetes. Endocrinologists don't know exactly why and how all of this works yet, but it does. In fact the ASMBS has reclassified the sleeve from a "restrictive" procedure to a "metabolic" procedure due to the impact it has on our metabolism. I believe those that have not been successful believed that the surgery was all they needed, and didn't change their lifestyle, food selection or habits. The sleeve should be a catalyst to change to a new, healthier behavior.

I, too, had ulcers and it didn't interfere with surgery. As a drug and alcohol counselor, I congratulate you on use being in the past. Good luck with surgery! Sent from my KFASWI using the BariatricPal App

As @@con con referenced, this topic has been covered many times over (not as much as stalls, though!). All sides have been debated at length. Do a search on here for "alcohol" and you will discover dozens of opinions, experiences, and words of advice about postop alcohol consumption.

Oh yay the alcohol topic again lmmfao. Seriously if this goes its usual way I will need several shots kidding!!!!!! Sent from my iPhone using the BariatricPal App

@@pinklantern, I am sorry you are feeling this way. It is very tough. As you noted, you’re at a tough time right now, and things will get easier. At this point, there’s no going back, so the only thing to do is figure out how you’ll make the best of what you have. If your friends won’t even do anything that doesn’t revolve around food and alcohol, it may be time for some new friends. You don’t need to drop your current friends (although maybe you do, if they’ll never do anything besides drink), but you can always find more. If loneliness is the problem you’re having, go find people. You can look for gastric sleeve and other WLS patients to be able to talk to people who know exactly what you’re going through. Maybe you can join a support group if you haven’t already, or put out a shout on these boards for someone in your area or someone who wants to be your buddy. You can also find new friends that have interests other than food and alcohol. All three of the activities you mentioned can easily be social ones! Reading groups are great, and they may be more common than you think. Ask your local librarian. You can take a drawing class and be confident that everyone in there loves drawing just like you, and that’s a great starting point for a friendship. Or look for a walking group on meetup or start your own. Good luck. I know it’s tough when everything changes and nothing seems fun anymore. But know that you’re right – this is the worst of it.

Thank you, everyone, for telling your stories and sharing tips! It is very reassuring. Keep 'em coming! I don't have a surgery date yet (probably late June). I have a BMI of 32.8. I'm most concerned about: -micronutrient deficiency. The longer-term sleeve studies show this is very, very common. Any of you long-termers who can report that your regular Multivitamins are enough to keep your blood levels normal? -being too fatigued and fuzzy-brained to work for weeks after the surgery. I don't need to account for vacation days at my job, and I can work from home if necessary, but I've got a huge project in August that will need focused thinking and writing for most of June and July. More than a week off work will compromise that. So I'd love to hear from folks who were back to a desk job and reasonably efficient, a week after surgery! (Or if not, please tell it too me straight - how long did it take for your brain to return?) -surviving the pre- and post-op liquid diet phases. I like Fiber and crunch! But I suppose one can endure anything for just a few weeks. I'm pretty active (cardio daily) and eat nutritiously (although way too much) with lots of Protein. I don't smoke, drink (alcohol, coffee, soda). So the maintenance phase doesn't seem too difficult (knock wood) - just much smaller portions, starting with protein, and much more chewing! I hope that having a lower (although still obese) BMI and being fit now, will help me bounce back to regular activity (and brain) after surgery.

Sharon- my own grandmother was HORRID to me! Seriously horrid! I was third youngest of 35 first cousins. I was blessed with having 2 parents who actually gave a crap about me. My dad had 7 siblings. Most alcoholics who were lousy parents. My cousins are all awesome. But I digress- if you didn't NEED my grandmother- whether financially, or to "save" you from a bad situation, she had no use for you. And I was that lone person. She was mean, spiteful I could go on and on. She always lived either next door to us, or upstairs from us. One day she came into our house- I was 14- and started railing at me in her usual fashion. Well, that was it. I told her all of the things I felt about her, being mean, whatever, and she stood there and asked my father how he could let me speak to her that way. My father stepped aside and said "Mom, you've had that coming a LONG time". Of course, after she left he chastised me for speaking like that to a grown up, but he stood up for me where it counted!!! Just adding my story. Tell your mom that if she can't live nicely in Your home with Your rules, she is welcome to leave. And then walk away so she can't debate it!

This is not a study, only a recommendation by the ASMBS for certain surgery types and the introduction of certain foods during the post op diet phases. It is only an excerpt of a very lengthy article. I am not going to argue this point, everyone needs to do what they feel is best for them based upon their surgeon's and nutritionist's recommendations. There are polar opposite opinions by the medical professionals on carbonation stretching your stomach, so it is not something that they seem to agree upon. I guess err on the side of caution if you want to feel safe. This document is intended to provide an overview of the elements that are important to the nutritional care of the bariatric patient. It is not intended to serve as training, a statement of standardization, or scientific consensus. It should be viewed as an educational tool to increase awareness among medical professionals of the potential risk of nutritional deficiencies common to bariatric surgery patients. The goal of this document is to provide suggestions for conducting a nutrition assessment, education, supplementation, and follow-up care. These suggestions are not mandates and should be treated with common sense. When needed, exceptions should be made according to individual variations and the evaluation findings. It is intended to present a reasonable approach to patient nutrition care and at the same time allow for flexibility among individual practice-based protocols, procedures, and policies....... .....Similar to AGB and RYGB, programs offering DS/BPD procedures reported that the clear liquid diet phase is employed for one to two days after surgery. The full liquid phase was most commonly noted to last >10 to 14 days, while the pureed phase was reported to be >14 days. Most programs report that a ground texture phase is not utilized. The soft diet phase was reported to last >14 days. Finally, those programs offering DS/BPD most often reported advancing patients to a regular diet five to eight weeks after surgery. **Foods commonly restricted ** The American Society for Metabolic and Bariatric Surgery members reported in the survey that patients were instructed to avoid or delay the introduction of several foods as noted in [Table 9](#tbl9). Research to support these clinical practices is limited, especially with regard to caffeine and carbonation. Practitioners might theorize that certain foods and beverages will cause gastric irritation, outlet obstruction, intolerance, delayed wound healing, or alter the weight loss course; however, much of the information is anecdotal and lacks empirical evidence. In addition, although practitioners recommend that patients avoid or delay the introduction of these foods, little information is known as to whether patients actually comply with these recommendations and whether those who do not comply have altered outcomes or clinical histories. One retrospective survey suggested that many patients are noncompliant with diet and exercise recommendations [[174]](#bib174). food type Recommendation Sugar, sugar-containing foods, concentrated sweets Avoid Carbonated beverages Avoid/delay fruit juice Avoid High-saturated fat, fried foods Avoid Soft “doughy” bread, Pasta, rice Avoid/delay Tough, dry, red meat Avoid/delay Nuts, popcorn, other fibrous foods Delay Caffeine Avoid/delay in moderation Alcohol Avoid/delay in moderation The article: https://asmbs.org/resources/integrated-health-nutritional-guidelines

I mean make make it sound pretty, but he stated as a -fact- (a fact being something repeatedly medically proven by testing) that drinking pop would stretch the sleeve and sabotage the surgery.. He never talked anything about how unhealthy it was (which certainly has its merits but wasn't something he even addressed) In any case.. he stated this as -fact-.. but it is not a fact.. it's actually been proven that that's a complete myth.. so.. to me.. if you perpetuate your OPINION and BELIEF as a FACT rather than your own opinion - that is a lie. That said.. I don't distrust him as in like... an incompetant surgeon.. I don't distrust him to handle any complications that come up or advise me on those - he has a great record in that regards.. I just don't trust him to distribute nutritional / eating / sleeve / food / how to live after surgery advice.. which is fine with me.. I can live with that.. I can talk to my PCP (who knows a great deal about bariatrics, has doctored me for a decade and who I would trust unquestioningingly) . I can read medical articles.. I can come here to the forum and find very knowledgable people.. but I really don't have the option to seek out another surgeon.. So I'm making due with what I've got and making the best of the situation. The only other way I could fund my surgery would be to go to Mexico and self pay and I'll just say that's not.. even an option at this point so.. I just have to make the best of the situation and look out for myself. In terms of what you said about alcoholism - I think that's a good comparison - for a lot of people it is.. for others its not.. I don't think you're in the minority in wanting to choose ONLY healthy things for your body because that is the way you feel safe.. and that's GOOD. I believe everyone should do what works for them and feels good for them personally. In my case.. I don't feel like my relationship to food is an addiction that I have to be wary of (i.e. that's not how I became overweight) so I don't fear that drinking some diet pop or what not.. will draw me back to the state I'm in now. But for some people that may not be true.. I can only state what I believe to be true in my own personal case.

Clearly all the information regarding stretching of the sleeve, effects of diet soda on weight loss etc are observational as far as I can tell. I haven't seen any studies on stretching of the sleeve and what causes it besides the obvious overeating and there don't seem to be any causal studies on the effects of diet soda on stretching. That being said I don't think a surgeon telling you he believes it will cause stretching or issues or is generally unhealthy and therefore suggesting that you avoid diet soda or carbonation in general makes him a liar, it just means that is his opinion and recommendation. In the absence of evidence physicians often form opinions and care plans based on their personal experience and belief. I would be more concerned if 9 out of 10 surgeons disagreed with that advice but clearly those numbers don't always hold up. @Beck90- I would never let a surgeon operate on me if I didn't trust him! You have really got to address this issue with him. Take your studies and have the conversation and satisfy yourself that he is coming at this issue with your health in his mind. If you feel he isn't you need to find another Dr and or another way to fund your surgery. If you have complications this guy is going to be advising you and recommending treatment if your starting position is mistrustful that could be very dangerous. @ladyinthsouth- It is great that you can do all that stuff and suffer no ill effect. I have never understood the smoking thing but ce la vie. I have eaten cake, pizza and all the other stuff you can imagine the net result of which is that I weighed 420lbs and had to have my stomach removed in an attempt to change my life so if it is all the same I will operate on the theory that I will NEVER cake and NEVER eat pizza because quite honestly I have eaten enough of those things for probably 10 lifetimes. For some of us this is like alcoholism I want those things, I can have those things, I just choose not to have them today. That is what works for me. Maybe I will feel different later but for this moment that is how I feel. I don't want to be where I was and not eating those things makes it possible. Same with diet soda it was part of an unhealthy life style which I am trying to distance myself from. I don't feel that I can make changes without altering my behavior and my relationship with food. I no longer use food as a treat or a reward. I want to just make the healthiest food choice I can today. I don't think I am in the minority here but maybe I am.

Yes - number one is to check with your own medical team, and not anybody else's. Philosophies and rationales vary all over the map with different surgical programs depending upon their own background and experiences. With my doc, it is no alcohol at all as long as we are losing weight - it's a liver health issue (our livers are usually in poor shape to start with from our obesity, and are further taxed with their job in metabolizing the fat that we are losing and they don't need the extra load of metabolizing the alcohol.) Overall, this is one of the many "when can I..." (drink, eat pizza, Cookies, cake, lattes, etc. etc. etc.) that we see where the first question should be "why is it that important to me?" and how does that desire relate to the condition that has got you into WLS? Can you enjoy a birthday without drinking or cake once? Do you need to have pizza with your kid's little league team after the game (instead of something more WLS friendly)? That's not to say the we can never drink or have cake or pizza, but it these things are no longer all that important to us, then we are much better able to tolerate them when they may be appropriate due to various social situations and not be as vulnerable to their addictive qualities.

When can I drink again I'm 5 weeks out I'm not looking to drink now but my birthday is next month by then I'll be 11 weeks out do you think it will be ok to drink by then Sent from my iPhone using the BariatricPal App

Re Protein intake -- I'm in maintenance and still eating a lot of protein -- 90 to 100 grams a day most days. Right now, my protein comes mostly from animal sources (poultry, fish, beef, dairy, eggs), but also plant protein (vegetables, whole grains, Beans and other legumes). For what it's worth (?), I hardly ever have a planned snack without including some protein -- even if it's only an ounce of cheese. Like @@Inner Surfer Girl I now eat more protein than I did before having WLS. I do keep an eye on my levels of creatinine (which reflect the health of my kidneys). So far, no problemos. I don't recall having even a UTI in the last couple of years. EDIT: To be clear, I don't eat low-carb. I eat protein, carbs and fats -- most of which is pretty darned nutritious stuff. I also (now that I'm in maintenance) do have a little alcohol and treats, but only if my weight is holding steady at 135 pounds.

I am 7 weeks out, and I just went to a group therapy session for post op patients, with my number one problem being the social divide I now feel from friends and family. EVERYTHING revolves around food, or alcohol for me. Just think that it will eventually get better, and you made this decision for YOU to be healthy and happy, and nothing can get in the way of that. Stay strong and happy because the same reasons you had this surgery in the first place are still there, you just need to look back and find the strength to bring them back to light. I am going to a festival this weekend, with LOTS of alcohol and food, but fuck it.. because I know I will still have fun. I realized I was part of the problem dividing myself from others- changing your way of thinking may help - and it never hurts to explain how your feeling to the fam. If they love you they will understand.. Good luck!

Yeah some people don't get that for a lot of us going through this (not all but still quite a few) there is an addiction aspect. Why should you HAVE to learn to eat just one cookie? There is no reason why you have to eat a cookie at all. So if you choose not to have any, that should be fine. Just like it should be fine for someone to eat just one cookie. I applaud you for knowing yourself and your triggers well enough to know what to avoid so you don't fall prey to the addiction side of it. Seriously - would she tell an alcoholic they have to learn to drink just one beer? or a heroin addict that they have to learn to just shoot up once?

I live and work alone, so I am alone most of the time. My solution was to get a dog. My rescue took away my loneliness and being a pet owner helped me meet people in my neighborhood. When we walk, we talk to everyone. Most social events involve food and alcohol. You might as well learn sooner rather than later how to be a skinny girl. Show up and drink water. Don't dodge life just because there is temptation.