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This is my current situation except I’ve been on Wegovy for only 3 months. I haven’t lost any weight. The food noise is there and I don’t feel I’m eating less. I tried to get Zepbound (my insurance will cover it) but I haven’t been able to find a doctor who will prescribe it (because of my previous VSG surgery). I’m planning to meet with a Bariatric surgeon this week to discuss a possible revision surgery.

I gained and lost the same 2-3 pounds over a three month stall. 😡 So, yeah it happens.

I just checked and at 2 months, I was down 20.6 lbs from the day of surgery. There's really not a hard and fast rule for how much you'll lose. Everyone is different and it depends on your starting point and how much you lost pre-op, too. I had some months when I lost a lot and other months where I hardly lost anything, but overall it moved steadily downward. My weight loss has stalled for the past month or so, now that I am more than a year out. The only guidelines I was given was 60g minimum of protein per day and 64oz water. I am now almost 14 months post-op and I've gone from 225 lbs on surgery day (251 was my highest, which was 6 months pre-op) to anywhere from 162-165lbs. My exercise consists of walking and that's it. I'd like to lose another 10 lbs but I'm also pretty fine with where I am as long as I don't gain (which is why I do hope to lose a bit more). I've gone from a size 22 to a size 12. I think I could still lose a bit more if I focused on cutting out some bad habits that have crept in with sweets/simple carbs, and if I increased my daily exercise to something a little more challenging than a walk. I don't count calories and I don't really track macros at this point, either. I just try to eat reasonable meals that focus on protein and veggies, and not snack too much or eat junk food too often. A typical day is either spinach frittata, Kodiak protein oatmeal, or a Greek yogurt for breakfast, plus a serving of mixed fruit (strawberries, cantaloupe, blueberries, grapes. Lunch is a good size spinach salad with 3oz chicken and some black beans. Dinner might be a bowl of homemade chicken, bean, and veggie soup, chili, or maybe some grilled meat and veggies. Sometimes I eat chickpea pasta with marinara and meatballs but other types of pasta and breads don't settle well. For snacks, I like string cheese and an apple, or some mixed nuts or roasted edamame. I have to be careful of overindulging in things like popcorn, candy, and cookies because they are too easy to eat without getting full (and sadly I don't get dumping from them). Red meat fills me up very quickly. The hardest thing for me now is dealing with the head hunger that makes me want to reach for food if I am bored or stressed. Getting the stuff out of the house completely is the only strategy that really works for me with that. My only real advice is don't drive yourself crazy. Just do your best each day and pay attention to your body. That's more important than counting calories. You're not on a diet! You need to figure out what you can sustain for the rest of your life, while paying attention now to the basics (protein and water, plus vitamins) to keep up your health.

Some people tend to have more diarrhoea than constipation in the beginning. A friend did - she wore disposable knickers for a week after her surgery. It’s just one of those things we can experiences differently. It could be related to stomach acid (it takes a while for our body to realise we don’t need as much as we did because we’re not eating as much & the excess irritates the bowel). A PPI will help with this if you’re not on one. Could be a lactose intolerance. Some people develop an intolerance temporarily or for life after the surgery. Try a whey free shake if it might be this & see if it improves. Could also be your body excreting old blood from the surgery (especially if your poop is darker) or another way to excrete all the fluids. Or it could just how your body is reacting to the change to your digestive system until it gets used to the new system. If it persists check with your team though. All the best.

I went with mine the day of the op as it was higher than when I started the process - I enjoyed the few weeks before my surgery 😉

This is a question I'd recommend consulting your bariatric surgeons office about. Now having said that, everyone is different, I personally didn't have much pain following my surgery BUT my energy was low for several months (5-6 months) remember you will be on a significant reduced calorie change that your body isn't used to. Disney requires a lot of walking and I know I couldn't have done days at Disney walking that much only 4-5 weeks out. Again, everyone is different. Also, I was told NO travel for 3 months following my surgery: too much sitting on plane (blood clots), distance from surgeon if an emergency medical situation were to arise etc. So again ask your surgeons office. Sorry to not answer directly.

No capsule wardrobe in my house. I’m guilty of having far more clothes than I need. A example of the proof of me having too many clothes is this dress which I found in my wardrobe recently and couldn’t remember buying it. Obviously worn (no tags) but where and when I had no idea. Wore it last weekend because of my guilt & than I remembered the last time I wore it - to my friend’s daughter’s hens party three years ago. Oops. Where did you go for your holiday?

I am having DS in 3 weeks and I am quite nervous about this also. I would love to have someone to be able to run things past that may not need a doctor to answer. Thanks for sharing!

Wow!! Love this! You are rocking it! Major Wins! I do not own a scale, not good for my mental so I do not know where I am at, hopefully no stalls but if so not going to think much about it. I want to remain happy and stress free 😂. My 6 month post op is in NOV so we shall see. Like someone else on this post said we just have to do what's right like 90% of the time and everything will work itself out!

Nice! My date isn't until Jan 30th, but it's going to take that long for me to get everything sorted at work before I can take a couple weeks off. Where are you having your surgery?

So glad to hear you are doing well. Yea when the cravings come back it sucks. I have been doing okay. Tomorrow is my last day of the infused chemo. Surgery on 3 weeks then radiation in five. I will be on the immunotherapy another year and maybe oral chemo depending on the pathology from surgery. 🤞 I don’t need the chemo because that may mean I’m immunocompromised still and I’m so sick of the isolation of trying not to get sick and miss treatment. I got a tiny little cold that made me septic and spent 10 days in hospital which made me miss two weeks of chemo so I’ve had to be super careful to not get sick again and all along they have told me once I get to radiation I won’t have to be so careful. I mean sick would mean I would miss treatment but only for a day or two while I had a fever or felt really crummy and it wouldn’t be life or death. Anyways, I only read about the oral chemo on the patient portal tonight so I will ask Dr more about it this Friday when we chat. Maybe it’s not a big deal. I have pretty much maintained my weight till recently. I’ve gained a few pounds. I’m still on the heavy steroids and the immunotherapy caused thyrotoxicosis I think it’s called. I was hyper thyroid to start but then like 3 weeks later it went back to normal and then to hypo thyroid and apparently it usually stays that way. I reached out to my bariatric team and asked him if I could start on with Govee to help get me off of some of these processed carbs and he acted like I was being crazy to be worried about my weight at a time like this. I said I’m not trying to lose weight. I know I’m not supposed to and I haven’t Since December when I started the Chemo, but I don’t think that if you’re so concerned about me, maintaining my weight to fuel my body and help myself recover that the foods I’m eating in order to sustain an overweight body weight are really helping me recover from anything. I said all I want to do is be able to stop eating the garbage and start eating healthy nutrition again and I would be willing to log all my food again and check in with you to make sure I’m not losing too fast or anything, but he says no way not until I get the all clear cancer free from my oncologist. But I’m helping my oncologist can reach out to him and tell him that I’m not gonna get that for another year and if I wait that long, I’ll probably be as big as a house again without any help. Or I may just have to go through an endocrinologist or my family doctor or something. Anyway, anyways, trying to not worry about it too much but I didn’t appreciate that. He acted like I have some kind of eating disorder or something and I have like a death wish. I mean, I wasn’t saying that I wanna take something that’s gonna make me starve myself to death. I was just saying that I want to change what I’m eating and eat healthy obviously if the medicine made it where I couldn’t eat anything. I would stop taking it. I’m not insane. 🤣 but it is very discouraging to see the numbers on the scale go up even if it’s only 5 pounds.

My friend told me to bring these items and I was so happy I did: 1) A muumuu dress or a nightgown, your stomach will be so sensitive, even wearing shorts with elastic is uncomfortable, I lived in loose dresses for like 2 weeks 2) Chapstick, you will get thirsty and your lips will get dry because you're thirsty, a Chapstick will help with the dry feeling of your lips (can't do anything about the thirst unfortunately) 3) For when you get home, get a prop up pillow for sleeping, I didn't have a recliner anything to help me sleep, my first night home, I thought I could just go to bed like normal, nope, big mistake, it was painful to lay down, I used like 4 pillows to prop myself up like at the hospital and I bought a prop up pillow from amazon that same night I hope this helps, good luck!

Lemme see here....what order to roll with....I'll start with the No-Can-Do List. Gonna sound cornball...but then again....cornball is my wheelhouse, lol. Okay...here is the Top 5 that come to mind over my morning coffee: skydiving. hell to the NO. Added to that anything that involves heights. It wouldn't be cool for them to see me pass out from terror......although I did have a great conversation with a gal yesterday afternoon who has professional live saving medical skillz. So....she could probably take me to death's door....and bring me back. But no planes, roller coasters, wall climbing or the like. Wind tunnel is about the best I can consider.... Years ago she took me out for margaritas...took my arse out. We found solace as two souls in marriages that were struggling, no sharks. I grew up near the coast...snorkeling and scuba diving frequently.... continued it through college. At some point in my mid-20's I began to have sinus troubles equalizing the pressure when diving...made for painful surface intervals between dives. My Uncle had been through the same a few years prior. He tried surgical remedy....but it didn't help. My late wife, her brother, his wife and some other friends all took their diving certification stuff....and then for various reasons,...each of them dropped out of the class. I'd resigned myself to give the sinus surgery a chance....surgeon was also a diver and he felt like success was most probable. During my years diving I've been close....crazy close....to sharks a plenty. It was all good as I was most often near rocks, reefs, shipwreck structure, etc. Cover was close, if needed. The exposure and sketchy periods were when getting to the bottom & when resurfacing....there I sometimes felt like bait on a hook. Since then I have had some close calls when I was simply swimming on a beach day.....going for a swim to cool off from the sun. One time I had my early teenage son with us....We saw a sand bar a couple hundred yards off shore.,...there were surfers out there. He was deadset on making it out there. I finally caved in and told him we could go but he had to listen to me...currents and such. He agreed and out we went....all was well until it wasn't. I found out the scary way that baitfish were schooling in spots between the sand bar and the shallows. We were swimming amidst the schooling baitfish....joining them on the freakin menu. I saw one, two then three sets of dorsal fins surface in between waves. Then one came too close....got my son's attention and lied to him....told him to get in close with me and we were headed back to shore because I was cramping. He was pissed, but he did what he was told and then gave me a dose of ribbing later on...."Dad you wanna hand me a drink.....oh no...don't do it....you'll cramp up", "Dad....you want me to take the cooler back to the car....don't want you cramping up", etc. My favorite kind of vacation is to sandy places. Don't want to become baitfish again, though....ever. Never thought it would be an issue until recent weeks. Met a gal who is a diver....kept my shark aversions quiet, lol No yoga....period. Could be the greatest thing ever.....but I'm sidestepping. Same could be said of other types of group excursive. I'm a no-class sorta dude. Not going to line up and get into some torture. I prefer to do my torture in solo....lick my wounds and gain the benefits results. I have to protect my shout out knees and right shoulder and keep pre-habbing them until I can get schedules aligned to have joint replacements done. My geriatric-bariatric sorta gym stuff would likely have younger womenz laughing their butts off. So yeah....the gym is where I need to go it alone....for now, at least. Nothing illegal...or at least keep it mostly legal. I'm not robbing banks...but if she asked really nicely and had a killer smile....I may be her getaway driver and lookout. Snakes are off limits. So if they are into snakes as pets.....it is gonna take a HEAP of Dr. Phil-esqe counseling to make that something I can ease up on. My time in the woods has me averse to snakes. The part of Georgia where I live has many varieties of rattlesnakes, copperheads, moccasins, etc, etc. I've had some sketchy moments with 'em all and I went to guns every time. Probably wouldn't go over well with a date who had pet snakes. ......................................... Note that karaoke is now off the list. I'm averse to it. Averse as all hell......but developments yesterday have me sliding that one off my radar. I met someone who sings. I mean, sings at a high level, in formal events, etc. When the subject came up in conversation I was coy....thinking, "here we go with the freakin karaoke silliness"....but I kept my mouth zipped as she was discussing things she enjoyed....music...making music via singing wasn't a hobby....but a passion. My coy arse ...when asked about likes...simply said something cornball regarding singing. "Well...it is highly ironic that we have met...you being a singer, and all." Winked and nodded...knowingly (even though I no nothingsss...strong is my ignorance). She bit and wanted to know more. I deflected and said something about having a small bit of singing experience.....at a professional level....but didn't want to bore her with details....wanted to find out more about her. So it went for a few minutes until she went back to my singing and pressed the matter. "Well, young lady....here is the cosmic irony on this matter....you are clearly impassioned & talented with your voice.....so very odd that we would meet.....you see...you are now looking at the WORST singer on the face of the Earth.....or at least in this county.....I suck.....I've even been paid to NOT sing....had dollar bills tossed at me to put the mic down.....so there it is....I am in awe of your courage to stand up and rock your voice......I am in awe and I'm hardcore untrainable in that area". She laughed and took it all in stride. "So what can you be trained to do....." Mr Cornball here replied with something dumb like, "For starters, I am housebroken...errr mostly housebroken. I can bark...or not bark...roll over, shake and play dead, fetch....you know, stuff like that". She laughed again...but not laughing in the way of "somebody come save me from this nerd....somebody, anybody". Humored laughing....dare I hope, acceptance laughter....is that even a thing ? When I say we laughed....I mean throughout the afternoon and eventing we laughed. Either this gal is challenged or she was actually amused at my dipshyt self. I was intrigued of everything she volunteered about her life, likes, loves, views. @GreenTealael had recently stated major bigtime advice that was THE SURE 'NUFF TRUTH. it pertained to core values being integral to compatibility. Not realizing it was occurring, this lady and I spent hours yesterday covering so much ground that it was unreal. By dawns light this morning I am still shaking my head in amazement. Without me realizing it had occurred....we'd checked off a pile core belief simpaticoisms....yep that is now a word. Simpatico-isms. I was open and honest and simply went with it. Each topic was a new discovery of our views and feels about stuff. Been down this road a good bit lately....and there were always stumbling issues or categories where divergent views may be a red flag. I'm not talking about politics or stuff like that. I couldn't give a rip about that. I appreciate different viewpoints. I mean the bigger issues... Here are some of the hurdles or outright roadblocks that I've had recently in this bachelor living...and this is with even short term fun: No married women. As tempting as a couple have made it...No-Can-Do. I am NOT about to go there. DO NO HARM is the hill I will die on....regardless of the temptation. No coworkers...or at least within my work "zone". There is an engineer and another administrator in another "zone" where some interesting recent conversations have occurred. Even then, I waded much more cautiously than other situations. My sobriety will not be compromised. Long story...shortened version: haven't had a drop since February 2019. Quit for practical reasons to be a responsible caregiver 24/7. Considered myself a casual drinker...social drinker.....but in the years since I saw where I'd used alcohol as a crutch...a tool...a mechanism to distance myself from work stress....or marital stress... I later acknowledged it was a simply delaying those stress & ultimately combining them. So, after my wife passed in 2021...I maintained the sobriety...realizing it was in my best interest. Since then I have benefited hugely from it. I can go out with a girl and am A-Okay with her having a drink or three....I'll have my coffee, water and am just fine. I won't open a bottle or pop a top again, though. Matters of the soul. Didn't seem like this would be an issue for initial attraction and such. But I found that even in casual contact it can and does surface and diametrically opposing views are a non-starter....even if physical attraction is main the component the main draw. Back to yesterday's first meet with lil' Miss Singer....it--was--wonderful. Wunnerfull....I didn't want to be pushy,....or forward....but....wow. So refreshing, I was thirsty for more....and it was shared, clearly. She even stated such....boldly. Stepped up and put it out there....interest demonstrated. She made the first commit. I had been keeping my desires reserved...she was... different. I was having different feels and did not want to rush into anything. This was someone that, yes, major physical attraction is there...but all my no-can-do stuff were non-issues...taken in stride....acceptance. She probably has guys hitting on her all the time and I didn't want to be another schuck trying to come on to her. I mean...I DID want to...but there seemed to be "more than that" taking shape. Everything was.....different. Yeah, I know I said that already...having difficulty finding correct verbiage to accurately describe. Your ever had the thought that you'd love to go back in time and slap the cowboy shyt outa your past self..and do so at a most specific moment and change the outcome and improve the trajectory of past self ???? Yesterday at some point after an hour or so...it was almost as if I felt a hand on my shoulder....a warning hand...it was telling me to slow the roll...be real....look at the bigger picture....and boy howdy, there is a strong hint there is possibly healthy structure for a bigger picture. The hand on the shoulder clenched down more than once....the physical desires needed to be reminded of the cosmic slap that was needed. Dumb as it may sound.....and for whatever reason I can be grateful for....I was calm and didn't blow it....wasn't "that dude". It was rewarded with hours more talking, laughing, disclosing, supporting, etc, etc. --------------------------- So.... we have an actual, real deal, no kiddin' super official date next week...Wednesday. We had to plot through our work schedules to figure it out...but it is set. A date. Not a hook up.

You're only two weeks out, so it's absolutely fine to take things slow. It's also fine not to hit the targets that have been set for you this early on. Just do your best. I actually did okay for the first few weeks, but at one point around week 4, my stomach just didn't want certain solid foods and I started having vomiting. My doctor had me go back to liquids for another two weeks. It was no fun at the time, but it eventually went away. Your body will adjust over time and you'll go back to mostly normal. I really liked creamy tomato soup with plain protein powder mixed in during the soft phase. Also, refried beans with some melted cheese were delicious. Think of food as more of a "nice to have" thing right now, knowing you are getting what you need from your protein and vitamin supplements. It's okay just to have a bite or two, or to have the same things for a few days in a row and not get a lot of variety. The first few months you're retraining yourself with eating and your body is going to be doing all sorts of weird things until it recovers.

My surgery is in 6 weeks, looking for recommendations on what to eat leading up, what to have on hand after for food and comfort. Also is there anyone else going under on the 19th who wants to chit chat and support each other? I know I can do this, I just don't want to do it alone.

Hi all, I have been given an appointment for arm lift surgery the end of October, if all goes well, based on your experiences is this sufficient time (8 weeks) to be mainly recovered by Christmas with full motion etc.? I am due to fly home for Christmas and would want to be able to pull/push/lift suitcases without any issue, shower easily plus then enjoy my Christmas time and not have family and friends worried about me. Given the major problems I had with my sleeve surgery in 2023 I am a bit apprehensive as to how my body will react and recover. Plus I don't know how I am going to tell my family as I know they will have a total freak out considering I spent so long in hospital and had so many problems with leaks, pancreatitis, sepsis etc with the sleeve and how I live on my own with no real support network.

In the last couple of weeks I realise that I grieve being able to have a cup of coffee at the same time as eating a snack. Like at the moment I want one of my Christmas mince pies to take a bite out of in between sips of coffee. 😢 Instead I will have my coffee now and then wait about 30 minutes to eat the pie, not exactly the same satisfied feeling.

LOL! Mine are mostly grey now as well & have to get them dyed every 4 weeks too. I supposedly have a little scar tissue on the inner of my brows - deep, can’t see or feel anything. That’s the only ‘issue’ I’ve had and it doesn’t hinder the annual touchups I get. Find a reputable technician. I had a 30 min consultation where she went over everything, asked about allergies, experiences with other dyes, etc. & then I made the appointment to proceed after that. I’m given an antiseptic cream to apply twice daily for a week after. It dues bring tears to my eyes when I have it done even with a prescription strength topical anaesthetic.

You are killing it! Your point about calories is really on point as well. I recommend any bariatric surgery patient read up on Relative Energy Deficiency in Sport (RED-S). The simple explanation is that if you work out a lot, you need to eat more. If you don't, then you are a lot more likely to start having a hard time with things like fatigue, various injuries, getting sick a lot, lack of concentration and depression. At its worst, you can get really sick, leading to heart issues and worse. My personal experience is that women tend to struggle with this more, though anyone can be impacted. Some people here might think it doesn't affect them because they don't consider themselves athletes, but if you are working out multiple days a week, it is a risk, especially considering how hard it can be for us to get more calories in. Over time, you'll hopefully learn where your personal limits are. For example, I've found that right now I can maintain my weight reasonably well up to about 30 miles a week, but beyond that I lose weight whether I want to or not.

It is so good to hear an update from you. I am so frustrated for you that you had to go through a stall because of conflicting information but at least you’re on track now. I am on a pretty similar plan my breakfast every morning is a proffee which is a caramel shake with iced coffee on top. Then I eat every three hours so luncheon dinner with two high protein snacks. this actually works well for me to remember all of my vitamins too because I have to take vitamins at five different times a day. that’s so exciting to hear about the clothes fitting and you were so lucky but you have someone to borrow. I think for me my most exciting moment was clearing out some of the things that are way too big for me now. I was actually thinking of asking my team if we could do a clothing exchange at the support group meeting. for the wheats, if you don’t have any look on marketplace consider discount stores as well. I checked several thrift stores for mine, and apparently they sell them separately because I found them in several stores but only one. I ended up finding some at a discount store for 599 for the set. Alternatively, check your library, city, and county websites for classes that use weights. Mine has all the weights there for you to use. And the group classes are really fun, Inexpensive and there’s no commitment. At mine it’s a really cool environment too. It’s nothing like a gym. The women are just average women that are there to get healthy. Nothing competitive whatsoever everyone choose each other on to beat their own personal best or just totally mines their own business. They even gave me my first class free to see if I liked it. I’m sure I mentioned that I started with yoga. I never in 1 million years would’ve considered myself someone who would survive one yoga class never mind love it. Of course I’m horrible and can’t do half of but it’s still a workout and I am getting more flexible and my balance is getting a bit better because of it anyways, congratulations on your loss and finding your groove. Keep doing what you’re doing and keep us posted.

3 weeks post op. I don't remember ever getting car sick before. Today I left right after eating and got sick waiting to pick up my grocery order and again at a red light on the way back. My car idles rough. Has this happened to anyone else and does it go away? I know, in the future wait a bit before getting in the car, but I have a long trip coming up in June and I'll be eating in the car or driving all night.

I realised my response above was a bit lacking on practical recommendations. Let me try to summarize what I'd suggest: Since you're right where I'd want you to be in terms of weight loss per month, don't change anything at this point. Only consider changing if you find the weight loss completely stops for 2 months or more. If weight loss does stop for at least 2 months, I'd actually recommend UPPING calories by 250-300 calories a day. I know that sounds counter-intuitive, especially considering that a negative energy balance is the only way to lose weight, but let me explain. Remember when I said above that one of the main jobs of our metabolic regulation system is to keep us from dying? No matter what we do, our metabolism slows when we diet. The rationale behind upping calories (by a small amount), is that we want to convince that system that the "bad times" have passed, and it's okay to ratchet up metabolic processes again. I'd recommend eating this increased calorie amount for at least a month, but two months would be better. Somewhat surprisingly, most people won't gain weight if they do this because their metabolism will increase to compensate. After that diet break, only then do we drop calories for a month or two in order to drop some more weight. You can keep up this intermittent dieting (not to be confused with intermittent fasting), until you get to your goal weight. I know this sounds like a slow process, but I promise, in the long run it's actually faster than if you just tried to keep cutting calories to get to your goal. Please keep exercising for your health, but also so that once you do get to your goal, you'll have a much easier time maintaining the loss. I would strongly recommend a minimum of 3 days per week of aerobic exercise and 2 days per week of strength training. This will set you up really well to maintain weight, as well as for excellent health as you get older. Don't be afraid to seek out a good mental health counselor. None of us got as big as we were by having a healthy relationship with food. The vast majority of people that fail to lose weight or that regain lots of weight after bariatric surgery do so because they fall back into old poor eating habits.

To be honest not well. I’m not a breakfast person, never have been, and it just feels like a “diet” LOL I do better on a low carb diet so the fruit is throwing me. Honestly I’d rather be on a shake for breakfast and lunch and just have dinner. Oh, I also have to exercise 5 days a week and log everything. Exercise is the roughest part due to pretty painful arthritis in my ankle.

what @SpartanMaker said. increases muscle mass which drives up metabolism. good for physical health and side benefit of looking hawt. AND probably the number one, oft-ignored-yet-totally-obvious, underrated, oh-so-accessible producer of positive mental health...❤️ also...what @DaisyChainOz said. while it really doesn't matter what WE think you look like, you do look fab as ever. if u didn't see the number on the scale, would you still look pretty effing awesome in all those gorgeous clothes in your closet? but i get it, fear of going back to our pre-wls selves is a big thing in our demographic, no matter how unlikely that is your case. hugs. p.s. you know what i did last week when i was feeling down and annoyed? i bought a new pair of shoes. just saying...

I had my sleeve done by Dr. John Rabkin at St. Mary's (he also works out of California Pacific.) I was in LA at the time, but the Rabkins had more experience with the sleeve than anyone down there (they had been doing them as part of the DS for around twenty years then.) Other names to look into are Dr. Gregg Jossart and Dr. Paul Cirangle. Jossart did his DS residency with the Rabkins and Cirangle seems to have specialized with the sleeve. I like that all three are DS qualified, even if one is not particularly interested in that procedure, since owing to its technical challenges, only the better qualified surgeons perform it routinely. And, as it is based upon the sleeve, it means that the DS guys tend to have more sleeve experience than others. Also, while they are all fully capable of doing bypasses, they generally don't do them as a default, reserving them only for those patients have a particular need for it. If one has any liver related comorbidities (not uncommon in the obese population,) Rabkin would be the choice as he is also a liver guy, doing biliopancreatic transplants in his "spare" time. The other thing that I liked with the Rabkins is that their whole process is pretty straightforward - no extensive pre-op diets (other than the usual day before thing,) and a fairly rapid post op progression, as tolerated. Good luck in getting through all of this!