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I think the vitamins can be confusing, at least to me. I studied Holistic health and nutrition and I understand it but not when it comes to my own blood test results 🤣 I have taken whole foods based vitamins since my gastric bypass surgery April 29th 2019. My vitamin levels have done well. my previously very low vitamin D even before surgery actually normalized. my Iron levels are within the normal range I try to get it from the whole foods based vitamin and food even the gentle iron supplement that claim no constipation cause severe constipation and I have too much problems for that. what is extremely low is my Ferritin. I am not sure it correlates with iron deficiency or is as simple as iron supplements. I know my hormones must be whacked since I went into surgical menopause after having my last ovary removed due to endometriosis. as well as existing metabolic disorders. but my doctor and my surgeon just assume it is that simple to just take iron. but my levels stay the same. and of course say speak to the nutritionist. but I could not afford an appointment since its no longer covered I paid for a set amount of visits they wanted the same amount for one appointment that it cost for what I needed to have before my surgery and the post op visits. I have a endoscopy today. so Im a bit distracted. Sorry I cant answer your question. It just seems to vary so much between each person.

I'm a guy but hope this helps. This came up as one of those "memories" timeline photos - MAY 2019 vs MAY 2020 on the same day. Surgery is a helpful tool, but you have to put in work as well! (VSG not bypass - but same concept)

first picture was me before I started my six-month supervised diet (2014). I think I was at my highest weight ever. Second picture (from 2017) is of me when I was two years out of surgery (this was before I had my skin removal surgery, though...I had that in Aug 2018 and March 2019). Last one was of me on my 60th birthday (last year). I've put on some weight since the 2017 picture - but excess skin is gone!

Surgery was October 10th 2017. August 2019 my weight was 150.0. I. Lost a total of about 179.0 pounds.

Encouragement! 38lbs is a great accomplishment. When you say you feel no restriction, it sounds like you may actually be unconsciously testing your limits at the same time. You may unknowingly (or maybe knowingly) trying to see how much you can eat. There was a few times I remember doing this as well when I was first able to eat a bit more. May I suggest trying trying my old trick... If it is not time for you to eat: (1) If you 'think' you are hungry or need/want a snack - drink a bottle (16oz) of water/hydration and wait 10-15 mins (2) After 10-15 mins, if you still feel the urge, drink another 16oz (3) After that, if you are still hungry: Eat Something! This will help you stay hydrated, aid satiety, and keep you busy stretching time between meals and grazing. I suggest planning, preparing your snacks in advance. Having set portions already ready to go helps keep you on track with what you should consume and keeps you away from snacking based on sight. Last one for now - protein and hydration. Proteins (low/no sugar or carbs) like shakes, bars and powders help get you the nutrition you need and curb your hungry. And you can never get too much hydration! I'm just over one year post VSG - down 150+ from start of my journey and am just getting back to the forums. teh best advice I've found is from 'my' Dr. and peers on this same journey. Wish well - keep on the path!

Just an update on my progress so far: Highest weight 254 (January 2020) when I started process to get VSG. 8/10/20. 239.6 (Started pre-op diet) 8/27. Surgery Weight 225.6 (end of Pre-Op diet WL 14lbs) 9/3. 218.4 (1 week post op) 9/10 214.4 (2 weeks post op) 9/17. 212 (3 week post op) 9/24 210.8. (4 weeks post op) 9/27. 210 (1 month post op) 10/1 205.2 (5 weeks post op) 10/8. 205.2 (6 weeks post op) 10/15 203.2. (7 weeks post op) 10/22. 202.4 (8 weeks post op) 10/27. 199.4 (2 months post op) 11/ 5. 197.4. (10 weeks post op) 11/12. 195.8. (11 weeks post op) 11/19. 194.2. (12 weeks post op) 11/27 190.4 (3 months post op) 12/3. 192.8🙄 (13 weeks post op) 12/10. 190 (14 weeks post op) 12/17. 190 (15 weeks post op) 12/21. 188.6 12/22. 187.2 12/24/20. 187 (16 weeks post op) 01/04/21. 184 01/13/ 21. 182

February 10

I’m in Florida and have Tricare East. I had to complete a 2 month supervised diet, dietary education, and diet history. My first consult with my surgeon was 11/11/2020 they did include that visit as part of the supervised diet. Medical clearance by PCM 12/7/2020. My dietitian appointment was 12/8/2020. My second supervised visit was 12/10/2020 and everything was submitted to Tricare for approval 12/11/2020 which was approved 12/12/2020. I received a call for scheduling of my surgery date within a week. Preop diet started 12/22/2020. I ended up scheduling my WLS on 1/6/2021. I will be 1 week post op tomorrow ☺️

Blimey, I am struggling to make 500cals a day (I am day 10 post surgery).....i know i know, patience [emoji16]

Mine was October 19.

SAMMC Bariatric Clinic: Weight-loss Surgery, Nutrition and Hair Loss (whmcbariatric.blogspot.com Weight-loss Surgery, Nutrition and Hair Loss by Jacqueline Jacques, ND Original content: http://www.obesityaction.org/magazine/ywm22/wlsandhairloss.php Typically, about 90 percent of hairs are anagen (in a growth phase) and 10 percent are telogen (in a dormant or resting phase) at any given time, meaning you are usually losing a lot less hair than you are growing so you don't have noticeable hair loss. But sometimes this can change. A common fear and complaint of bariatric surgery patients is post-operative hair loss. While for most of us as people, our hair is an important part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like your brain and heart and away from your hair. Hair loss has many causes. The most common type of hair loss after weight-loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Growing and Losing Hair Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states; anagen, a growth phase, and telogen, a dormant or resting phase. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase which lasts for about 100 to 120 days. Following this, the hair will fall out. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include: High fever Severe infection Major surgery Acute physical trauma Chronic debilitating illness (such as cancer or end-stage liver disease) Hormonal disruption (such as pregnancy, childbirth or discontinuation of estrogen therapy) Acute weight-loss Crash dieting Anorexia Low protein intake Iron or zinc deficiency Heavy metal toxicity Some medications (such as beta-blockers, anticoagulants, retinoids and immunizations) Weight-loss Surgery and Hair Loss Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight-loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into the telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss rarely lasts for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight-loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One would be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if: Hair loss continued more than one year after surgery Hair loss started more than six months after surgery Patient has had difficulty eating and/or has not complied with supplementation Patient has demonstrated low values of ferritin, zinc or protein Patient has had more rapid than expected weight-loss Other symptoms of deficiency are present Nutrition Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40ug/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemia, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after bileopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high dose zinc supplementation as a therapeutic agent for related hair loss2 in patients with vertical banded gastroplasty. The study administered 200 mg of zinc sulfate (45mg elemental zinc) three times daily to post-operative patients with hair loss. This was in addition to the multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies, and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus we cannot say that zinc would prevent hair loss after weight-loss surgery, and further study would definitely be needed to make this connection. A further note: The Tolerable Upper Intake Level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60 mg/day. Information related to this study has made its way to many a support group and chat room – even to doctor's offices – with the message of "high dose zinc will prevent hair loss after weight-loss surgery." Patients should be advised that high dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen or prealbumen. Limited studies suggest that patients with the most rapid or greatest amounts of weight-loss are at greatest risk.3 With surgical reduction of the stomach, hydrochloric acid,4 pepsinogen5 and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion, rather than malabsorption, is responsible for most cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2 grams of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Many individuals believe that supplementing with or topically applying the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include vitamin A, inositol, folate, B-6 and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS) and is influenced by genetics. Conclusion Hair loss can be distressing to bariatric surgery patients and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is mostly likely caused by surgery and rapid weight-loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. About the Author: Jacqueline Jacques, ND, is a Naturopathic Doctor with more than a decade of expertise in medical nutrition. She is the Chief Science Officer for Catalina Lifesciences LLC, a company dedicated to providing the best of nutritional care to weight-loss surgery patients. Her greatest love is empowering patients to better their own health. Dr. Jacques is a member of the OAC National Board of Directors.

I know this sounds odd but if you measured yourself before measure yourself now or during a stall ! When I went through my stall I was bummed out, then I measured myself and realized I had lost 19 inches. Sometimes you may not drop pounds but you may be losing inches when you are not losing pounds!! Try it, you may be surprised

I received my gastric sleeve on 12/29. I experienced that too. It was bad gas and possible constipation from pain meds and drinking the protein shakes. I had to take 2 gas x and drink warm water with miralax. Soon I was better. The pain and fullness had me in tears. I thought it was a blood clot or heart attack. Until the pain subsided, I was gonna go to the ER. I DID NOT WANT TO DEAL WITH THE WHOLE COVID-19 ISSUES THERE. Thankfully, I felt better within an hour. I had to back off all my vitamins and protein until I got this under control. Now I am on pureed per my doctor. I will pick back up on my Vitamins next week and see how it goes. I am now using protein powder and adding it to everything I can. It has no taste and has been working better than the heavy shakes. You have to try what works until you can tolerate all the new changes our body has to endure. I also had a hiatal hernia repair at the same time. Today, I am feeling so much better. I have to pace myself and not take big gulps of anything at all.

Good Evening! you took a big first step by posting!! It took courage to do that and I'm proud of you. And you are an inspiration as we all fear failing but many who have setbacks won't ask for help. I am 6 1/2 months out and at 91 lbs. lost And I'm still afraid I might fail. I have before so why is this time going to be any different? Before I had surgery I did a lot of work on my mental health and work on it everyday. Every morning I wake up and focus on 3 gratitudes in my life, write down 3 affirmations and 10 minutes of positive reading. This helps me stay strong and happy. It has been a game changer for me. I don't get down on myself, I find I am more resilient with challenges and I like myself! It is helpful to write down your gratuities and affirmations so you can go back and look at them. Great reminders of all the good in your life on those more challenging days. Start by focusing on your mental health. You are worthy of loving yourself!! Then make one diet change a week and focus on just that. I love BriarRose's "One cookie not eaten at a time"! We are all on the same lifelong journey and there is no perfect path. We are all flawed but are all also Flawsome. You can do this!!!!!

Just over a year after my surgery I have reached my goal! I am officially half of my starting weight. I do think I'm going to try to lose another 15 lbs, but woohoo! The not so good news, I've been sick for the last 10 days and that's the only reason I am down as much as I am in this two week period (9 lbs), and I fully expect a small bounce back once I feel better, but for now, I want to enjoy this moment as much as I can.

I know how "set" some of us can be on a specific number "goal" or "I am going to lose 50 pounds in X months." May I suggest that instead of looking at a number that seem impossible - and having a constant reminder of what you HAVE NOT done... that instead, pick a really logical goal or EVEN (horrors) a goal that WE KNOW we can attain. I was inspired by an acquaintance on facebook who said he goal for that year was to lose 20 pounds. I thought about it, for a couple months......and decided that I was tired of my weight gain and MY goal could be to stop gaining weight, and maybe lose 10 pounds in a year. Reversing habits that had snuck back over 8 years.... and heck....it started working. And instead of setting myself up for failure... I was; to myself; an amazing success !!! Maybe I COULD lose 20 in a year ! I had lost that and more by 7 months. I also knew what weight I COULD NOT maintain back when and how miserable I was trying to continually FIGHT and never win. So I set MY GOAL for 5 pounds over where I had managed to maintain for several years. NO, I won't be a size small or even a medium. But I started at 5'3 (now 5'2) and 320 pounds at age 53. I have lost 147 pounds. I am good with that. This may not apply to you. This may not be you. It is me. I managed to do this as a full time working 64 year old human with some auto immune disease - exercise is not something I can do much of. I practice meditational yoga, actively garden a few times a week. I take care of a small flock of a couple dozen chickens, so I rake and hoe and haul things around. I have a teenager who comes and hauls 40 pound bags for me on the weekends. But I am active even in times of Covid, grow some of my own vegetables and fruit and salad greens .... life is good. Find your Good.

I'm right there with you. I had my sleeve in December of 2018, lost a fair amount of weight, not a ton, but it was slow-going and stopped after four months. I kept it off for 15 months. Then during COVID I put on 10-12 pounds and I'm having a hard time taking them off. I want to kick myself for going through major surgery only to screw it up again because I'm such a loser. But then I focus on what I need to be doing and get back on track and have been doing really well for the last 15 days. You can do it. Go back to basics. Get the protein in. Get the water in. Watch the portion sizes. You can do it!

as long as you stick to your eating plan, the stall WILL break. I'd lost about 10 lbs when I hit my first stall, which lasted for two weeks. I went on to lose over 200 lbs.

So I am sadly in the same boat as you now... SW-130kg CW - 115.6KG - 1 month and 10 days post-op, struggling as I've reached the mysterious halt in weight loss everyone goes through haven't seen a change on the scale for a week or so. MOTIVATION NEEDED - the first month was SOOO good. Scared I won't lose so much in the 2nd month reading through the posts did help but - just want to be sure I WILL OVERCOME THIS RIGHT? *Freaking out a little*

Ordered from Amazon and having one for breakfast. I give it a 9 out of 10. Sent from my [smartphone] using BariatricPal mobile app

AWWWW Jaelzion - Thank you for keeping me in your heart !!! Yes, I am still around ! More than 10 years later you CAN take some control back. If Depression is a problem, talk to your doctor - even your regular doc and ask about a referral for therapy or for some medication - antidepressants are a wonderful help - and although they take 6 to 8 weeks to kick in well, they can really help you to lift yourself out of a chemical imbalance that causes us to have depression. (yeah, I am a therapist/social worker too !!) But do not allow yourself to be depressed about YOURSELF. Take one thing. Just one thing and turn it positive. Mine was "no more fried potato food" I stopped eating french fries and potato chips. Then I added more healthy foods back to my diet. I remembered how much I really liked eating healthier .... and I added more and substituting a healthy choice for a not so healthy one is a VICTORY EVERY DAY. And not eating out ? I forgot how much added salt is in things. THAT took weight off me too. No, it isn't easy. But I did it. I have kept those 45 pounds off since October 2020 and here it is January 2021 and .... I have lost another 2 pounds. I know, not alot. But I had told myself that at 45 pounds I was stopping and going to maintain my weight. Maybe lose 5 pounds in the next year. Maybe not. And look at that. 4 months and down 2 more pounds ! YES AND WHOOPPEE for meeee !!!! Celebrate your victories like crazy ! I will be 65 years old this year - actually in a couple months... and I will weigh what I did in graduate school when I was .... 25 ! I am not thin. I won't ever be thin. I am "overweight" for my height and age. And you know what ? I am okay with that. Because I WAS SUPER MORBIDLY OBESE. I weighed over 300 pounds. I now weigh 173. My BMI WAS 58 - it is now 31. And IF i were to have the extra skin removed ? I would probably lose another 10 pounds easily. But I don't need to do that. Or want to. I'm good. Figure out where you can be "good" with yourself. Then start on the road. YOU CAN DO THIS.

Omg Gradycat we got sleeved the same month 2 years ago ! I also have gaine 12-13 lbs with covid and some family tragedy . Working to take it off now and once I stop eating sweets after 7 it seems to be working . I feel so depressed about it but know I still have lost 60lbs and I will get this 10 back off ...protein first !

Yes, Dr. Francisco Sauceda! I had my surgery January 2019 and I am very happy with my results and he was fantastic, along with his nurse, Paty. She's an absolute gem! If you'd like to get more details and some feedback and some pictures, feel free to private message me. There's one very major thing that I would do differently, but I don't want to put that out here. Good luck with your decision!