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It looks like there have been a lot of ppl who don't read. I eat 1000 calories or less and weigh 280. I was bulimic for years. I got the band and list then regained even though I was under 1000 caliries a day. I'm considering the surgery because the doctor says it changes your body's set point. My fear isn't that I won't lose, but that once again I'll regain because my body really wants to stick at this weight. I eat a whole foods diet, not a SAD. I do keto. I just don't lose. Sent from my SM-G935P using the BariatricPal App With a condition as unusual/clearly medical/atypical as yours, a public WLS forum where most of us got fat from overeating junk is probably not going to get you the responses you need and desire. Definitely come here for support and love as you go through the process, but as far as factual scientific advice? Your situation is so far out there in the atypical range, I'm sure there are very few here that are qualified to answer. Best to you!! I'm sure with your desire to succeed, you can make it happen. I wasn't the OP. I was just letting her know she's not alone and that there are said to be benefits for those who are not eating 2 meals at McDonalds for dinner and still unable to lose weight. However, I'm not really sure where else one would look if they were in my situation and looking for answers. I can't possibly be the only one in my situation. And doctors assume I'm showing them my food diary that shows whole foods and then running thru to get a milkshake. No one believes me. I don't care and im not offended. But when I do start a thread with questions it's because of can't possibly be the only one in my situation and I need help too. As far as the doctors are concerned there is no reason and I just need to exercise harder. I did that. 2 hours a day. Where else can I turn? Like I said I wasn't asking questions originally, but where else would I go? Sent from my SM-G935P using the BariatricPal App

It looks like there have been a lot of ppl who don't read. I eat 1000 calories or less and weigh 280. I was bulimic for years. I got the band and list then regained even though I was under 1000 caliries a day. I'm considering the surgery because the doctor says it changes your body's set point. My fear isn't that I won't lose, but that once again I'll regain because my body really wants to stick at this weight. I eat a whole foods diet, not a SAD. I do keto. I just don't lose. Sent from my SM-G935P using the BariatricPal App One thing I learned through this process is that my obesity is at least partly due to under eating as much as to overeating. Overeating is my bodies response to under eating (skipping meals, restricting, etc.). One of the biggest gifts of this program for me so far is a deeper understanding of nutrition and what my body really needs. Eating under 1000 calories in a day is no longer an option for me. Of I go over 1000, even on slow small increments, I gain. Ive been on many diets with many "coaches". I've been through different nutrition classes while in training for holistic health, while in college, and with docs. I understand the metabolic system. My doctor recently ran labs and told me how surprised she was to see sugars, and everything else perfect. I realize that for most people 1000 is not enough. I apparently have a really efficient metabolism. It doesn't take much to make me go. Sent from my SM-G935P using the BariatricPal App

I'm very sensitive to smells especially mouth odors... and now I'm on the offending end 🤢 I've worked in oral surgery for 28 some years and I can smell rotting enamel and perio.. Since surgery I have yuck mouth and I cannot make it go away. Granted, water intake isn't up to what I used to consume and my diet has been almost keto like... this morning my breath was so bad it made me nauseous..🤢 10 days post op sleeping 1/2 way seated upright.. I don't want to have that breath.. smells like I'm pooping out of my mouth...🤢🤢🤢🤢 Any suggestions? Will it go away soon? Lapband placed: 8/2011 Lapband removed: 3/2017 VSG: 8/2/2017

Here’s a link with some info: https://www.tasteaholics.com/keto-diet/what-is-keto-flu-how-to-help/

You can make your own sugar free gummie bear candy out of sf gelatin. And you can flavor it with essential oils, liquid stevia, and add citric acid to make them like sour patch. Then you start stepping down from the candy. But you will likely need to replace the cals with some other source cuz otherwise you will likely start losing again. Also, you can make keto candy like fat bombs with healthy oils/fats + cacao powder, nut butters etc. They add up VERY quickly. But they are usually more satiating. SF peanut butter cups are the bomb. You can also try getting delicious protein bars, cutting them in 8 pieces then freezing them. Pop them like a candy bite. I think you're in a pretty special situation because of your super endurance exercise. I think @Healthy_life2 and @BigViffer could help you with this. They are both power athletes and have to eat in a method to keep their cals high enough for training. Congrats on your losses. The candy is an addiction. Addiction to sugar is as powerful as heroine addiction. I'd also see your doc/RD and ask for help. They may have a temporary medication that can help you with cravings as you try to detox.

It looks like there have been a lot of ppl who don't read. I eat 1000 calories or less and weigh 280. I was bulimic for years. I got the band and list then regained even though I was under 1000 caliries a day. I'm considering the surgery because the doctor says it changes your body's set point. My fear isn't that I won't lose, but that once again I'll regain because my body really wants to stick at this weight. I eat a whole foods diet, not a SAD. I do keto. I just don't lose. Sent from my SM-G935P using the BariatricPal App One thing I learned through this process is that my obesity is at least partly due to under eating as much as to overeating. Overeating is my bodies response to under eating (skipping meals, restricting, etc.). One of the biggest gifts of this program for me so far is a deeper understanding of nutrition and what my body really needs. Eating under 1000 calories in a day is no longer an option for me. Of I go over 1000, even on slow small increments, I gain. Ive been on many diets with many "coaches". I've been through different nutrition classes while in training for holistic health, while in college, and with docs. I understand the metabolic system. My doctor recently ran labs and told me how surprised she was to see sugars, and everything else perfect. I realize that for most people 1000 is not enough. I apparently have a really efficient metabolism. It doesn't take much to make me go. Sent from my SM-G935P using the BariatricPal App What is your resting metabolic rate? Have you ever had it tested?

@Ms skinniness hi there glad you are back!! keto is working for you - great coming to this board is good for my health (and yours too) keep up the great job kathy

I did keto for a long time pre-op and even before I thought about bariatric surgery. My program is different, I guess, in that we don't do purees or full liquids and move onto soft foods like cottage cheese and yogurt, etc. on day 10. We are allowed chicken salad, even. She said to start with Greek yogurt, which I did.

12 years out. I had several blood transfusions after my WLS so I had big regrets. The issue was that I replaced food with alcohol (was not a drinker prior to WLS) 3 years ago I got my sh*t together and got serious about supplements and started Keto. I am now at a healthy weight 145 and plan to eventually get back down to my lowest weight (135) which was pre covid. I gained 10 pounds when the lockdown started. I don't regret the surgery as much now as most if not all the issues I had were avoidable and just really my fault for not following the post op way of life.

I'm on Omeprazole daily. And as of today I actually gained 4 pounds!!! Like, how?? Why??? It's so demoralizing because I didn't have these issues when I did keto. I steadily lost, I didn't have a fear of eating, I only had 1 short stall. My issue was that I couldn't keep it off once I lost 100 pounds (in 9 months). I'm finding it's 10x harder to lose weight after this surgery than it was with just doing keto. Only now I can't do keto again because I had the surgery and I have to have low fat instead of high fat (both require low carbs, low sugar, and high protein). I thought maybe if I did keto again, then it would be easier to lose and the surgery would help me keep it off. But then I read that you can't do keto once you have the surgery. So I ended up afraid to eat because it seems like everything causes weight gain....and now here we are. *sigh*

When you eat keto (basically high protein, good fats, no carb) your body enters ketosis. Eating carbs will stop ketosis. Your body will retain water again until you re-enter ketosis. That can take a week. One cheat can stall you a week or cause water gain. If you plan a cheat, ditch the scale. For at least 2 weeks.

Do ya'll think those low carb-keto snacks and desserts are a slippery slope to falling back into bad habits? Those "brownie thingies" sure look good. 😩

You asked precisely the right question and they didn't have an answer for you. The nutritionist is not your mother -- "because I said so" doesn't work as an answer. Try keto, see what happens, adjust your diet based on how your body responds. I am 11 months out -- at a certain point, it becomes less about what the nutritionist says and more about you finding a healthy way to live your life.

You're right. I've been trying so hard to follow their directions to the letter that I haven't been listening to my body. I know I can't go crazy with the fats, but more than 50 per day is needed for keto. I used to hit around 100-120g of fats per day, so if I look at maybe 75g of fats per day, while still keeping my carbs very low (the bariatric diet is 50 or less carbs per day, when I did keto I stayed under 35 per day) I'll see if it works well or needs to be adjusted again. And I always stayed around 80 or so grams of protein per day. And I went on sugar free and very low sugar when I did keto to begin with and just always kept it. The fats are really the biggest difference. So we'll see how it goes. Worse comes to worst, I can just go back on the bariatric diet and do a "pouch reset" and start again.

I've made keto Christmas baking with almond flour! Its more dense but a great option!

@whitesale Sounds like you are doing all the right things. Im going on three months post op and have had no less than 4/FOUR crazy long stalls. That's crazy, right! It happens. Trust me it will get better. I did the Keto diet starting at about a month ago to jumpstart weight loss again after an almost three week stall. It's not for everyone but it works for me. I was hungry as hell everyday until last week now I've suddenly lost all hunger. The one thing I've learned is that your body will react to this sleeve differently from week to week. If you stay on your plan you will progress eventually! I promise. I'm going to start working out on Tuesday and can't wait!! Sent from my iPhone using the BariatricPal App

I understood weight loss is required for everyone though not linked to insurance requirements in Aust as it is in the US. Basically, the weight loss is to reduce any fattiness around your liver which allows the surgeon greater visualisation & movement around your stomach when they operate. It also shows a commitment to the weightloss program. You will be sent to a dietician who will put you on a diet & will monitor your pre surgical weight loss. They will guide you through the post surgical weight loss journey as well. I was put on a keto diet for two weeks prior to surgery & lost 4.2kgs. My BMI was 35. Your surgeon will have his requirements as will your insurance company based on your individual case. You can’t really compare. Treat this pre surgery time as when you begin to re-educate yourself & start your new lifestyle - how you eat, what you eat & new exercise routine. This is a life long change.

I've used it in various things when I was doing Keto. Probably will continue to do so now since surgery if a recipe calls for it. I also use coconut flour when called for.

After surgery your body can be thrown into ketosis. Ketosis is a normal metabolic process. When the body does not have enough glucose for energy, it burns stored fats instead; this results in a build-up of acids called ketones within the body. According to the internet: The most typical source of energy used by the body is glucose. This is typically derived from carbohydrates, where the digestive system breaks down complex sugars into simple glucose molecules. On very low carb diets, however, the body is unable to utilize such a fuel. Instead, the liver utilizes the fat present in the body as an energy source, producing “ketones” in the process(2). This is known as “ketosis” – and is the process from where keto diets get their unusual name. These ketone bodies come in three common forms; acetoacetate, beta-hydroxybutyrate and acetone(3). In large quantities they are removed from the body in the urine or through exhalation. Ketones can have quite a characteristic smell; they often make the dieter’s breath smell quite sweet and fruity, quite distinct from typical halitosis. Excessive volumes of acetone, however, can smell rather different. Acetone on the breath is most commonly likened to the smell of nail varnish remover(4). Protein Excess A second possible cause of ketosis breath isn’t directly linked to the breakdown of fat as a fuel source. Instead, it is a side issue caused by typical changes to the diet. As those on keto diets try to minimize the consumption of carbohydrates, so the diet is often filled with other constituents; most typically fat and protein. A diet that is high in protein can have two impacts on breath. Firstly, the breakdown of protein in the body produces ammonia; this can lead to urine or breath smelling particularly strongly. If your breath has started to smell like a cat litter tray while on a ketosis diet then this may well be your culprit! Standard bad breath is most commonly caused by bacteria in the mouth. This bacteria breaks down its food, producing volatile sulphur compounds (“VSCs”). It is interesting to note that studies suggest that the most common source of VSC production is the breakdown specifically of protein, as opposed to other food sources. Higher protein diets, especially in the absence of suitable oral hygiene, can also therefore impact one’s breath. Some advise to normalize this condition are: Drink plenty of water. Rinse your mouth with an anti-bacterial oral rinse. Consider the use of calorie-free and carb-free mints or gum, or use a flavoured oral preparation such as a mint-flavoured breath spray or mouthwash. One of the other suggestion it seems you are already doing. Studies suggest that cleaning the tongue is almost twice as effective as brushing alone at removing bad breath. As a result, investing in a tongue scraper can be a worthwhile exercise. Ketosis often causes increased urination. This diuretic effect is due in part to your glycogen stores being emptied. Also known as “water weight,” one gram of glycogen necessitates around 3 to 4 grams of water in storage. This mass exodus of surplus fluids (aka pee) can cause dry mouth, and increased sensations of thirst. One of the other conditions that I encountered after weight loss surgery was dry mouth. I found that Biotène® Dry Mouth Oral Rinse helped with this condition.

I am just in the initial stages for pre op my surgeon appointment is on Tuesday but as I go grocery shopping I want to fill my fridge with the pre op diet foods, and have read most doctors diet pre surgery is keto. I have been doing the whole30 and have lost 30 pounds in the past 3 months and can transition to keto if that's what I'm going to be put on, in my research I'm seeing that keto is listed as the worst diet of 2017 and whole 30 was right with it. My bariatric may require 3 months dietician, exercise and weight loss. My insurance doesn't, Just failed attempts and need. I'm curious about keto diet recommendations, how much weight are you suppose to lose before surgery? How many carbs do you eat to be in ketosis, how do deal with the side effects? Thank you

At one year post-op, I have cut out pasta, rice, and carbonation. I will probably never have any of those things. I still follow a keto way of eating; therefore, I keep my carbs below 25 grams per day. So, I have little to no sugar. That is my choice, not my body's demands or anything. As far as alcohol goes, I have some sort of alcohol (usually vodka, water and Crystal Light Lemonade powder that I take to the bar with me) just about every weekend, and when I travel for work (60%-70% of the time), I often have a glass or two of red wine with dinner. I have found that my tolerance is now back to about where it was before the surgery. I have absolutely no issue with the alcohol whatsoever. Like @OutsideMatchInsidesaid, I just allow for the calories on days that I am going to have drinks. (Though, to be honest, I need to get my calories up some to make the weight loss stop, so I haven't been as much of a stickler about it lately.) I haven't tried beer, mostly because of the carbonation issue. And as much as I miss it, and I do, I've adjusted to drinking other things. For the record, I first had alcohol at three months post-op, and there has never been an issue. I've lost 217 pounds (from almost 400 pounds), and am happily at goal (180 pounds). YMMV.

October 3 here and day 7 of my pre op diet. I have already lost 12lbs in this 7 days. Crazy. I have been feeling so ready up until this morning when I noticed the keto breath and realized I am full on in ketosis. I keep thinking there are people out there that lose their weight with just a keto diet and exercise not surgery. I know it is just cold feet and I have been expecting this to happen at some point before the actual surgery. Anyway, off to have my Protein shake! Sent from my iPhone using the BariatricPal App

Thanks guys! I'll look into this Keto diet and, although I recognise it's a poor habit, I think I'll use them as a crutch in the first week of the 2 week protein shake pre-op diet. Will have to ensure I drink a lot of water!

I've used this before. It's high in protein.. But the spaghetti squash is the best and just add protein powder the unflavored kind to your sauce. But if interested here is the link http://www.uplateanyway.com/keto/fettuccine-low-carb-pasta/ Sent from my SM-G930V using BariatricPal mobile app

Thanks for this!!! It has been nice to get back into the gym, honestly. Even though I injured my neck last week/ 😂😅🤦🏻‍♀️ The part i am still SO SO co confused about is food and macronutrients. My dietician does not say no to anything, in moderation. Which is what I do. But prior to surgery and my whole life I have been on really extreme diets like keto or whole 30. So moderation feels wrong or like cheating. Really struggling with my mental relationship with food right now.