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Hi! So I have an anxiety disorder and it makes talking on the phone really difficult for me. I already got set up and had my call with an Optum BRS nurse (who was super sweet) since I have UHC PLus. I got the ok to set up my first appointment but have been having lots of anxiety over calling to see how the process goes with all the COVID restrictions. well today I finally did it! It may sound small but for me it’s a big deal. I go to an online seminar this Saturday and then I have an appointment with the dr I’d researched and liked most (Dr. Emil Graf) September 2nd as this is the soonest availability. a couple questions.. A. What can I expect from the seminar and first appointment? I’m very nervous as I have a lot of experience being shamed by doctors. My weight is very emotional for me as I’ve tried my entire life to lose it. B. Has anyone worked with Banner’s bariatric clinic in Gilbert? Or specifically Dr.Graf? I’d love to hear personal experiences. they’re In network for my plan and a COE. Dr. Graf had pretty good reviews and his little intro video seemed very warm, which is why I chose him.

Hi! I'm scheduled for my Safe Sleeve on Aug 28th at Blossom Bariatrics. I'm so tired of the struggle and so excited to start my new life.

Nope. From my consults and research skin issues such as candida rashes that require nystatin powder (or other types) would count but a time frame (6/12 months) of continued use without improvement is necessary in order for insurance to consider it & It must be WELL documented. For breast reductions, a specific amount (tissue, not skin) needs to be removed/removable for insurance to cover it. This is the process my Bariatric Surgeon started but I decided to self pay to expedite the process.

My bariatric center says goal for every VSG patient is 60% of excess weight. If you do better than that long-term, then great. But they discourage unrealistic self-set goals. Will set up a lot of patients for disappointing results. The average weight loss for VSG over thousands worldwide is 60% excess weight. Sent from my SM-T580 using BariatricPal mobile app

When did you start Biotin? Also, how much Protein is your goal. My bariatric center says 80g per day. I have been taking 10,000 mcg Biotin since day after surgery and 90g Protein per day. Am only 8 weeks postop so probably have a month yet to see how bad my Hair loss will be. I heard limiting hair washing and brushing as much as possible will help from pulling out hair. Don't think Biotin Shampoo will be helpful as biotin not absorbed through skin. It is just part of the process. Do the best you can and know that it will be over in couple months. Sent from my SM-T580 using BariatricPal mobile app

I remember that man and his outfit. How horrible that "old, not improved, and we're all sick of him" fat-shamed him. Just wait a couple of years until our resident world authority on bariatric surgery starts regaining weight..

You can get a sample pack of Celebrate for $9.95. If you buy in the future, the $9.95 applies to future purchase so sample is free. I ordered the sample pack and glad I did. I didn't like any of the pills/chews. First month I took FUSION Bariatric chewables which is $25 per month at my bariatric center. I received 3-month supply of BARIATRIC ADVANTAGE Multi EA and calcium chewables. I received cinnamon calcium which I really like. The multi EA is strawberry which also palatable. These are quite expensive so will likely return to FUSION when free ones are gone.

I can tell you for sure that if I hadn't been in my pre-surgery weight loss stage when the pandemic started, I would have gained weight. I find it very easy to stick to my diet when I'm at work, simply because there is no food around. I bring my lunch every day and do not keep snacks at my desk. I usually avoid food that other people bring in due to hygiene concerns (it's amazing how few people take the time to wash their hands before they eat or handle food). So if this had happened a year ago, and I was stuck at home all the time with constant access to my kitchen and all the yummy food therein, I would have been snacking all day long. I also got most of my exercise by walking around at work, so that would have been a double whammy. I had a period of unemployment several years ago and that's exactly what happened, and I gained a lot of weight. As it went, I lost 60 pounds in the 5 months before my surgery. I often thought about how much I would have been eating if I weren't trying so hard to lose weight before surgery. I was kind of proud of myself and expecting that I would be the only one to lose weight while everybody else gained weight, but actually, most of my coworkers lost weight (or at least said they did), too. Nobody even noticed that I lost weight because I'm still the biggest person in the office. As far as how people use their time, sure, they could use it to exercise more and plan healthy meals, but for some people, it is really hard to get motivated to do this stuff, especially when they're stressed, scared, and possibly mourning the death of loved ones. Plus, many people work out at the gym and haven't had access to gyms during the pandemic, and although there are plenty of options to work out at home, it could be a big change and get people out of their exercise routines. The bottom line is that there are many, many factors for all of us that can lead to weight gain, and probably nobody knows that more than bariatric patients. I can easily see how major changes to our lives and our world, like a pandemic, could result in weight gain.

I really need some help and advice on what I can do. I have lumbar stenosis and have to get injections to be able to walk like normal people, otherwise I get stuck and cant move my left leg and have awful pain trying to do so. I also have bad neck that gives me horrible headaches which go on day and night sometimes and need injections for those. I truly cant handle all of this pain. I am so overwhelmed at the moment. I was told today by the bariatric team that if I must have them to space them out and stay on my Dexilant ( I dont know if I will ever be able to get off of it) Now I am scared. She didnt tell me what can happen by doing these injections. Any advice would be greatly appreciated . FYI I was revised to Bypass 2 months ago and had been able to have the injections with the sleeve with no issues.

Holy Cow! I haven't been on Bariatric Pal in couple of years (or more). One of the big reasons I dropped off the online forums is that I had adopted a WFPB diet, and not only was that completely out of line with the mainstream WLS thinking, but I didn't even like to hint about it as I would get extremely negative feedback. Imagine my shock when I logged back in to Bariatirc Pal today to see a vegan forum with a WFPB post. My mind was blown to say the least, LOL.

I’m so sorry for your loss. Of course no one can blame you for turning to anything that might bring you comfort during this difficult time, so don’t beat yourself up for eating the ice cream and candy. Maybe you can find a treat that won’t derail your progress, say, Halo Top ice cream or your favorite protein bar. Maybe you can enlist your husband to make your favorite bariatric recipes.

I saved you some time and did a search on this site for the "three week stall" (I think you're just experiencing this a little early, as some do. Mine was weeks 2 &3). 17,501 posts on this as of today. This happens to almost all of us and we see at least a couple of posts a week on this. Bariatric clinics REALLY need to mention this phenomenon to their patients because it's almost certainly going to happen, and everyone freaks out about it (unless they're aware of it beforehand). Here are the 17,501 posts: https://www.bariatricpal.com/search/?q=three week stall re: the four lbs - as long as you're gradually trending down - and you will have occasional stalls along the way where you won't lose for 1-3 weeks - you're good. There's not much you can do about your rate of weight loss other than follow your surgeon's plan. Other things that factor into this - like genetics - you don't have much (if any) control over, but you DO have control over how closely you stick to the plan. If you're committed, the weight WILL come off, whether fast or slow. I was behind the curve the entire journey, yet I lost all of my excess weight.

I thought I would share more about my Brachioplasty. I know that I scoured these forums and reddit trying to get info and advice before hand, so it only seemed fair to share my story too. I had the surgery a few days ago. Despite concerns around scarring, nerve damage and the surgery triggering an autoimmune response (I dealt with a ton of horrible illnesses after my VSG), I decided to go through with it. My first consultation was July 7th and I had the surgery on the 23rd of July when a slot became available (probably due to a cancellation from the pandemic). I felt like the universe was giving me a nudge and I had to take it!! While I'm only a few days post op, I'm so thankful that it went well. Minimal pain (particularly compared to my VSG). I was so relieved that I could still move my arms a bit, I was concerned I wouldn't even be able to feed myself! I can't lift anything heavy, but I could drink from a glass of water after the surgery. I actually ended up staying the night in hospital. I could have gone home, but the general made me pretty groggy so the nurse suggested I stay. My family was quite relieved as my VSG was quite tough on my body - my blood pressure wouldn't go down and then my body freaked out with a range of autoimmune disorders from the shock a week or two later. While the drains are pretty gross, it's manageable. I've been able to sleep really well in my bed (I read about people having to sleep upright in a chair but I didn't have to do this). There also hasn't been any horror movie style blood on my sheets (OK, a few small spots through my PJs). My hands are a bit less swollen today so that's exciting. It really feels like I'm already on the mend and it's only been a few days. I'm looking forward to getting the drains out in the next few days. I can't wait to walk the dogs again. I know that I've got a lot of work ahead in terms of scar management, but I'm hopeful that they won't be so noticeable with time. I've been so busy the last few years, that it's felt weird to just lie in bed and watch Netflix. Even with the quarantine, I was working crazy hours from home. Never just relaxing. Then I started a series of projects at home. I went through my closet, organised the pantry, took longer walks, did craft, cooked and baked etc, helped a friend with her studies, etc. There's always somewhere to be, something to do. After a few days, I'm starting to enjoy this forced rest and relaxation. I don't need to be busy all the time, I can be still. I'm so thankful that I found a surgeon and anaesthetist who took such great care of me. Even though, I have (diagnosed) anxiety, I was able to get through it all because they kindly answered all my questions. My key learnings from surgery: Keep the old button up PJs and zip up hoodies when they get too big for you as you lose weight. They might come in handy for plastics - they're easy to put on and fit loosely around drains and swelling. Have a surgery plan (people to take you to hospital, meals in the freezer, someone to care for pets, children, plants). Have lozenges on hand (my throat still hurts from the surgery), lip balm, a good book, pack light for the hospital (someone else will have to carry your bag). Find the right surgeon, go to multiple consultations. Make a list of questions. Call them up with more questions. Keep up hydration and walking after surgery. Hope everyone is doing well at the moment! Much love to my bariatric pals. Other than some of my family, I don't share that I had the sleeve and plastics. Sometimes I feel really weird about my "secret life" that I keep from everyone, but that's what makes me comfortable. Here with you wonderful people, I feel less lonely. I'm one of the many vets who dropped off a bit. You start living life and it gets busy! However, right at the time in my life, I'm happy to be in this community with such supportive, lovely ladies (some of the guys here are OK too). Anyway, wow - that felt like an essay. Whew! Some pics below in case anyone is interested.

I know at least a couple of people here take good ol Flintstones (with iron). Apparently, they are nutritionally pretty close to bariatric ones. Compare the stats and adjust accordingly? Good luck!

Everyone's experience with vitamins is different. I had the Loop DS and I take 1 Bariatric Complete (orange flavored) vitamin (with iron) and 2 Celebrate (grape flavored) without iron (I apparently process iron REALLY well as my iron levels are perfect with just the one iron, more than one makes me constipated, tmi I know). As well as two Bariatric Advantage Calcium Citrate (I used to take 3 but my calcium was high). And I also take 10,000IU liquid Vitamin A every other day. It just really depends on how your body handles the vitamins. Some can take less, some have to take more and some have to add extra like my Vitamin A. You'll figure out the process as you go. Just choose an initial brand and take what they tell you to and adjust as needed. As for recipes... I get a lot of recipes here: https://www.bariatriceating.com/blogs/recipes

27 lbs is A LOT! I've been hanging out on various bariatric forums for the last 6-7 years. It seems like most people lose somewhere in the 15-25 lb range the first month - so you're actually above average. I think sometimes people expect to lose 30+ lbs the first month - but that's actually not all that common. I think that expectation comes from shows like "My 600 lb Life", but you have to remember where those people are starting. WAY more than most of us - and of course, starting BMI is one of the factors that determines your rate of weight loss. So you are just fine!! also - eggs. An egg intolerance isn't uncommon the first few weeks or months - but for most people, it's temporary. So I'm betting it was that...

I had the same issue at first. I started with capsules and chewables, both of which made me nauseous. I found that Bariatric Pal "soft chews" work for me and I've used them for more than a year without any issues. I use the strawberry/watermelon and actually like the taste. https://store.bariatricpal.com/collections/soft-chew-bariatric-vitamins/products/bariatric-advantage-multivitamin-chewy-bites-flavors

I’m about 9 almost 10 weeks ago. I have been struggling with vitamins. They had me start with the celebrate tropical twist bariatric vitamins, made me sick no matter when or how I took em. Tried one of the bariatric advantage capsules, makes me sick. Barimelts made me nauseous, what do y’all do for your vitamins???

I am 56, and eight weeks out (would have been 16 if not for Covid-caused cancellations) on my revision from a lapband to a sleeve (plus a hiatal hernia repair). My surgery went fine, weirdest thing was not being able to have someone with me. I woke up super nauseated , I mean bad, so bad, but it was much better overall after 24 hours. The first few days were rocky - bad reaction to the oxycodone, the scopolamine patch tanked my blood pressure, but very little discomfort from the procedures. The big problem was that my GERD was still present, maybe even worse. I get it badly - my chest, back, neck and stomach feel like they’re on fire. I was shocked when my surgeon’s assistant told me that the sleeve was a GERD-inducing surgery, and if it did not subside after a few weeks a revision to a bypass would be the next step. At that point - and now- I’m like NO more surgery, ever! I honestly don’t know why this was never discussed, or that I didn’t discover it during my pre-research. No explanation. Fortunately, the GERD did almost completely subside, and I was rolling on smoothly (Although, I am able to eat more food and quicker than I should be able to...but still I’ve lost 21 pounds.) Overall, doing good, but I also realized surgery does not take away an eating addiction so I am getting a therapist to help me with that and feel confident about improvement. However!!! Yesterday I started getting slightly nauseated and a little heartburn which has exploded into full on mouth watering nausea and some of the worst GERD I’ve ever had. Carafate, protonix, dexilant and a ton of Tums later, I am in pretty serious pain, and even drinking water makes me nauseated. I called the surgeon and he said at this stage that is probably from having food stuck in the small opening of my stomach. I hope he’s right but it’s just hard to imagine going from feeling great to feeling like I am on fire, and I haven’t eaten much in two days so I don’t know what food it would be. I’m very upset and worried right now because there’s no possible way I can live decently like this, but another bariatric surgery is just absolutely out of the question. I know this is really just a recount of my experience and not so much an answer to your question. If you would have asked me two days ago, I would have strongly recommended the revision but if how I’m feeling now is how it’s going to be, no way. Of course, I’m hoping tomorrow I’m just miraculously better. I think the really important thing is just to discuss thoroughly and completely the GERD situation with your surgeon......Best of luck to you!

ASMBS Guidelines/Statements Safer through surgery: American Society for Metabolic and Bariatric Surgery statement regarding metabolic and bariatric surgery during the COVID-19 pandemic Executive Council of ASMBS Published: June 05, 2020 DOI: https://doi.org/10.1016/j.soard.2020.06.003 The surgical treatment of obesity and its complications has been postponed in many parts of the world during the COVID-19 pandemic, similar to the postponements for nonurgent surgical treatment of many other human conditions and disease processes. Many have characterized bariatric and metabolic surgery along with cosmetic plastic surgery as clear-cut examples of elective procedures that must be postponed during COVID-19. Some U.S. states have included these types of procedures in their state-wide order as examples of “elective” surgical procedures that should be the last to be restarted. For those who define “elective” surgery as not necessary or optional, the American Society for Metabolic and Bariatric Surgery (ASMBS) asserts that metabolic and bariatric surgery is NOT elective. Metabolic and bariatric surgery is medically necessary and the best treatment for those with the life-threatening and life-limiting disease of severe obesity. The definition of elective in the Merriam-Webster dictionary is “relating to, being, or involving a non-emergency medical procedure and especially surgery that is planned in advance and is not essential to the survival of the patient.” Metabolic and bariatric surgery is life-saving surgery, with multiple studies confirming the survival benefit for patients treated by surgery over those treated without surgery [1]. Metabolic and bariatric surgery creates long-term changes in metabolism and reduces or eliminates multiple serious obesity-related diseases improving long-term health and quality of life as well as survival. The ASMBS supports the use of the term “medically necessary time-sensitive surgery,” as proposed by Prachand et al. [2], or “medically necessary nonemergent surgery,” as far superior to the term “elective” surgery and what it connotes. Metabolic and bariatric surgery should be restarted when it is safe to do so. The ASMBS disagrees with the concept that bariatric surgery should be postponed until the pandemic is declared over. The global nature of the pandemic, the potential for a second wave or persistent ongoing infection in some parts of the world, along with more traditional risks, such as annual influenza outbreaks, make postponement potentially indefinite. There is clear evidence bariatric surgery improves survival [1] and significantly improves the disease of obesity and several critical obesity-related conditions (including diabetes, hypertension, and cardiovascular events). Obesity and obesity-related diseases have been identified as independent risk factors for adverse outcomes in COVID-19 infection [3], including need for intubation, ventilatory support, intensive care unit care, and mortality. From a patient-centered and public health standpoint, it is critical to resume metabolic and bariatric surgery. We also understand that obesity and related diseases are the same risk factors that must be taken into consideration for temporarily postponing bariatric surgery in certain higher-risk subsets of patients. The risks and benefits at that particular time for that specific patient need to be carefully considered. Factors to consider in making that decision also include the local prevalence of COVID-19, the availability of testing, the available resources, including hospital beds, ventilators, and personal protection equipment, as well as strategies to protect healthcare workers and patients. However, delay in the life-saving surgical treatment of obesity and its complications for many months or years is not in the best interest of our patients. The ASMBS has advocated for many years that patients suffering from the disease of obesity and its many serious associated diseases should strongly consider metabolic and bariatric surgery as a life-changing intervention that improves health, quality of life, and long-term survival. COVID-19 is the most recent of many diseases in which underlying obesity worsens the prognosis. Before COVID-19 began, it was clear that patients with obesity were “safer through surgery.” In the era of COVID-19, “safer through surgery” for patients with obesity may prove to be even more important than before. PIIS155072892030318X.pdf

American Society for Metabolic and Bariatric Surgery (ASMBS) calls for safe resumption of bariatric and metabolic surgery before COVID-19 pandemic is declared over Newberry, Fla. — Jun. 23, 2020 — The American Society for Metabolic and Bariatric Surgery (ASMBS), the leading organization of bariatric surgeons and integrated health professionals in the nation, declared metabolic and bariatric surgery "medically necessary and the best treatment for those with the life-threatening and life-limiting disease of severe obesity" and called for the safe and rapid resumption of procedures, which have been largely postponed along with other surgeries deemed elective amid the COVID-19 pandemic. In a new position statement entitled, "Safer Through Surgery," published online in the journal SOARD, the ASMBS strongly rejects classifying metabolic and bariatric surgery as "elective" and prefers the use of the term "Medically Necessary Time-Sensitive Surgery" or "Medically Necessary Non-Emergent Surgery" to better characterize the effectiveness of the intervention and the progressive nature of the many diseases it treats including obesity, type 2 diabetes, hypertension and heart disease. "COVID-19 may be a factor for quite some time and the longer the treatment of obesity, type 2 diabetes and other related diseases are postponed, the greater the chance they will become worse," said Matthew M. Hutter, MD, MPH, president of the ASMBS and professor of surgery at Harvard Medical School. "Each state, doctor and patient must make a decision as to when conditions for metabolic and bariatric surgery are right, but the sooner it can be safely performed, the more quickly obesity, type 2 diabetes and other diseases can be reduced or resolved." The ASMBS recommends that the precise timing for surgery be carefully considered based on factors including an individual patient’s health status, local prevalence of COVID-19 and the availability of resources including hospital beds, ventilators and personal protective equipment (PPE). The ASMBS statement concludes, "Before COVID-19 began, it was clear that patients with obesity were ‘safer through surgery’. In the era of COVID-19, ‘safer through surgery’ for patients with obesity may prove to be even more important than before." Obesity has been identified as an independent risk factor for adverse outcomes including death among COVID-19 patients. Metabolic/bariatric surgery has been shown to be the most effective and long-lasting treatment for severe obesity. 1 Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S. including gallbladder surgery, appendectomy and knee replacement. 2 An estimated 252,000 bariatric surgeries were performed in the United States in 2018, which is approximately less than 1 percent of the population eligible for surgery based on BMI. 3 The U.S. Centers for Disease Control and Prevention (CDC) reports 42.4 percent of Americans had obesity in 2017-2018. 4 Obesity has been linked to more than 40 diseases including type 2 diabetes, hypertension, heart disease, stroke, sleep apnea, osteoarthritis and at least 13 different types of cancer. 5,6,7 About the ASMBS The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org. ### 1 Weiner, R. A., et al. (2010). Indications and principles of metabolic surgery. U.S. National Library of Medicine. 81(4) pp.379-394. https://www.ncbi.nlm.nih.gov/pubmed/20361370 2 Gastric Bypass is as Safe as Commonly Performed Surgeries. Health Essentials. Cleveland Clinic. Nov. 6, 2014. Accessed October 2017 https://health.clevelandclinic.org/2014/11/gastric-bypass-is-as-safe-as-commonly-performed-surgeries/ 3 https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers 4 https://www.cdc.gov/obesity/data/adult.html 5 The Effectiveness and Risks of Bariatric Surgery: An Updated Systematic Review and Meta-analysis, 2003-2012. Accessed from: https://jamanetwork.com/journals/jamasurgery/fullarticle/1790378 6 Steele CB, Thomas CC, Henley SJ, et al. Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity — United States, 2005-2014. MMWR Morb Mortal Wkly Rep2017;66:1052-1058. DOI: http://dx.doi.org/10.15585/mmwr.mm6639e1 7 Centers for Disease Control and Prevention. (2015) The Health Effects of Overweight and Obesity. Accessed from: https://www.cdc.gov/healthyweight/effects/index.html

I took the time before I received a surgery date to figure out which shakes I liked best. I also tried eating certain meals as if I was post op. For example, I made very loose farina for the second post op stage. I also chewed more thoroughly to get used to doing that instead of eating fast. Practicing sipping water is important too because I read that we can get pain afterwards if we gulp. There’s really plenty to work. One last thing I did was to listen to Bariatric themed podcasts by Reeger Cortell. She is a nurse practitioner for a Bariatric program and she has these lengthy podcasts on subjects of interest to those seeking weight loss surgery. Before you know it your surgery date will be on the horizon!

Hi There! I had this EXACT same question regarding the Cigna insurance monthly diet requirements back in June. I even posted about it and received answers all over the board. I know that all policies can vary but I was running into the same situation you are where I was reading it online and even took the step to call Cigna twice and couldn't get a straight answer out of them - it was odd like they had no clue and they also kept reading what the online policy stated. Which omits any type of monthly dietary requirements. However, when I went to my bariatric surgeon for my first visit they immediately stated that my Cigna insurance no longer required the 3, 6 or 12 month diet program as they had done in the past. I completed all the necessary steps (endoscopy, cardio stress, psych eval) and my surgeons office submitted it to Cigna for approval today. So, now we wait and see....

My surgery is Aug. 4, 2020 with Dr. Louisiana Valenzuela at Mexico Bariatric Center. Keeping my energy on high vibrations. There is so much information to take in. My passport has not arrived yet, but my patient coordinator has assured me that my birth certificate and ID are fine (due to the delay during these times). I’m just a bit bummed my support companion cannot come to the hospital with me. I’m flying from Ohio to San Diego. It’s nice to “meet” everyone! 🙂

I hope I'm not fooling myself, but I keep telling myself that pain and misery I can handle. Complications, however, scare me quite a bit. No matter where I go I'll be flying, so at some point I'll return home and I want to do everything in my power to make sure I have no complications, particularly once I've returned home. If I can get results similar to some of the results I've seen, it looks like a game changer. It's a bit like bariatric surgery all over again. It's a little terrifying, but even more exciting. Bariatric surgery was absolutely a game changer and I have high hopes for plastics. Thanks for weighing in!