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I am finding that to be so true! I sometimes feel “hungry” after I began eating and believe it is acid (the gurgling). I did have atypical GERD before surgery (although my medication isn’t that effective since the ones that are were taken off the market due to cancer concerns or caused me diarrhea). I had read info from a Bariatric surgeon who recommended a gaviacon chew with each meal in the early months. Worth a try!

It’s 3:21am on July 6 and I leave for the hospital in 3 hours to have the sleeve procedure done. I have considered and deliberated the decision to get bariatric surgery for 4 years while I was in while getting my bachelors and now I’ve just graduated with my MBA. I’m 54 and have questioned “why now?”, “am I too old?”. The truth is I don’t feel or think of myself as 54 but my body won’t let me forget it. I’ve always thought that in all aspects of my life I was in full control but my relationship with food shows me otherwise. I don’t seek to be a size 2 from a size 22, I don’t imagine myself emotionally and spiritually any different however I am changing and will be changed by my commitment to put me first. This procedure is another tool to help me to make the outside match the inside. I expect some pain and small disappoints as I walk this journey but I know that changing my relationship with food is actually me changing my relationship with myself. I want to be the best version of me and the extra 100 pounds Is a burden on my spirit as well as my frame. I wish us all a safe and healthy journey as we step in to the next chapter of our lives.

Three people in the last week have commented about how tiny I am. One, in a nursery, said I was so tiny I’d fit in the plant pot I was buying. (That was a very odd & upsetting comment.) These were the first times anyone has ever used the word ‘tiny‘ to describe me. It’s so weird. I see just average in the mirror. I also bought a pair of skinny jeans - Aust size 6/US2 - and I swear they are so small they’d fit my 10yr old niece so I hear you @2Bsmaller18. Right before my surgery, I was approached to be part of a Bariatric study here in Australia. I agreed because I felt their findings could help others in the future but I have not heard a word from them in almost 14 months except for a letter thanking me for being willing to participate. I wonder if I’ll get a letter at some stage thanking me for my contributions.

This excellent annual conference is available for free online for everyone this year because of the pandemic. Great opportunity to learn from experts in obesity and bariatric surgery, thanks to the Obesity Action Coalition. Online registration details are here. Event Details The Obesity Action Coalition (OAC) is excited to announce that our 2020 Your Weight Matters Convention & EXPO has been transformed to YWM2020 – VIRTUAL! Once again, YWM will be bringing together the most sought-after health and weight industry experts to present science-based information in an easy-to-understand format, designed to help attendees navigate the complex topic of weight management…. all easily at your fingertips in a VIRTUAL PLATFORM! YWM2020 – VIRTUAL is offered as a FREE virtual event series that is crafted with a one-of-a-kind program designed to help individuals seeking answers about their weight and health. This year’s virtual program will allow you to dive into the science behind weight, while learning key strategies and gaining access to valuable tools. If you’ve simply wanted the answers as to why weight can be such a struggle, then YWM2020 – VIRTUAL is an event you won’t want to miss! Events Program Agenda and Schedule Click here to view the full schedule. Event Dates Event 1: Saturday, July 11 1:00 pm – 3:00 pm EST/10:00 am – 12:00 pm PST Event 2: Saturday, July 18 1:00 pm – 3:00 pm EST/10:00 am – 12:00 pm PST Event 3: Saturday, July 25 and Sunday, July 26 1:00 pm – 4:00 pm EST/10:00 am – 1:00 pm PST

... but not for the reasons you might think. I questioned whether I should make this post in the preop section or here, but since it's my first post on the forum, it might as well serve as an introduction as well. My apologies in advance for the verbosity, as I have a tendency to ramble. At age 54, I've been morbidly obese since I was a teen. I have no personal frame of reference as to what it means to be fit or eat healthily. Sure, there's the cognitive recognition of what those concepts are and what they should mean, but nothing in my own life experiences that are relatable. I'm 6'1" and at my heaviest weighed 410. Five years ago I was diagnosed with high blood pressure, which medication has fortunately kept under control. In June of 2019, when I weighed 385, I was diagnosed with Type 2 diabetes. It was at this point, that I realized I actually needed to do something about losing weight beyond paying lip service. I've been feeling it more in my knees and ankles the last few years, and the notion that should I ever need a knee replacement or other major joint surgery, that I would likely be denied due to my weight wasn't an enticing prospect. I've made token efforts at points in my life to dieting and exercise, but nothing consistent; nothing that "stuck". So I spoke with my primary physician about bariatric surgery options and started down this road. After consultations and doing my own research, I decided on the sleeve gastrectomy. Over the several month "trial period" (not sure what the technical term is), meeting with dieticians, the surgeon, the psychologist, etc., my surgery was approved and scheduled for mid April of this year... well, you can guess what happened. Thanks to COVID-19 everything was put on hold. I freaked out a bit at that point. My work schedule is such that certain times of the year are no-go as far as being away for extended periods. What if my recovery takes longer than expected? What if due to the quarantine and stress eating (believe me, it's a thing), I gain weight again and they kick me out of the program? Having all this uncertainty on top of all the uncertainty going on in the world... being in a high-risk group for COVID, the business I work for having to completely retool how it does business, the financial market crash (at the time), the civil unrest in an election year, etc.,put my head in a not very happy place. I'm also stressed by the fact that I have no immediate support structure in the event things go wrong (either medically or if I slip with respect to eating habits). I have no family, no significant other, and I live alone. Under normal circumstances, I'm perfectly fine and dandy with all three of those things, but for the first time in my life, I'm faced with the prospect of not having support when I might need it. I've never head surgery in my life, outside of two colonoscopies, which all things considered, I've been blessed in that regard, but again I have no frame of reference of what to expect and what to do in the event things don't proceed as planned. I've avoided reading many of the threads here simply because I don't want to read about worst-case scenarios, as I know that my mind will tend to drift there, and I don't want the negatives of what *might* happen to dominate my thoughts right now. So back to the present... at the beginning of June things started to open back up in the state, at least as far as allowing elective surgeries to be back on the docket. I'm scheduled for surgery on July 13. The 14-day preop diet (which I started on June 29) that my hospital prescribes is more restrictive than many others. No meat in addition to no carbs or fats. It's a 1000-1150 calorie per day diet. As someone who normally would eat 3000-5000 calories per day, that's effectively a snack. So I'm in the middle of day 6... and everything is fine. And I have no idea why. I *SHOULD* be frothing at the mouth, hangry, threatening to eat the neighbor's cats, etc., but for some reason I'm not hungry at all, and this cognitively makes no sense to me based upon my "normal" eating habits. I've been actually eating less than 800 calories per day, not even up to the recommended 1000-1150 calories. Breakfast: protein shake (30g protein, 140-160 calories depending on brand) Morning snack: Yoplait light yogurt (90 calories) Lunch: 12-oz pouch of steamed vegetables with garlic and pepper (80-140 calories depending on what mix I use) Afternoon snack: apple slices (50-80 calories) Dinner: Another protein shake (140-160 calories) Evening snack: another yogurt (90 calories) I'll mix in sugar-free jello (5 calories) throughout the day or some celery sticks as needed, and if feeling peckish will do an extra pouch of steamed vegetables. What's freaking me out is why I'm not freaking out... if that makes any sense. It shouldn't be this easy, and I worrying that I ma be lulling myself into a false sense of security/complacency. Or is my brain somehow making this easier on me, as somewhere deep down in the depths of my subconscious I fundamentally realize that I *have* to make this work? I don't know; it's hard to convey. I was at 351 on Sunday prior to starting the diet (and yes, I pigged out on Saturday and Sunday knowing what was ahead) and am now down to 339 as of this morning, which is a good thing. Just trying to get a handle on why my brain is operating the way it is... At any rate, good to be aboard.

There are *many* evidence-based clinical bariatric surgical and nutrition guidelines available to health care professionals. They are updated regularly based on the quantity and quality of the best available scientific studies. I’m attaching just one example here: it’s the most recent (2019) guideline provided by the American Association of Clinical Endocrinologists, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologist (and endorsed by the American Society for Nutrition, American Society for Parenteral and Enteral Nutrition, International Federation for the Surgery of Obesity and Metabolic Disorders, International Society for the Perioperative Care of the Obese Patient, and Obesity Action Coalition). In my experience at the intersection of biology and medicine, I've observed that eminence-based medicine tends to be the rule, not the exception. Medicine functions in the gulf between ideas/beliefs and science. Science is based on doubt. Medicine is a road built upon a foundation of good ideas and beliefs put into practice, but it is also a road literally paved with the cadavers of every good idea and belief that didn’t pan out. Even when they do pan out, they still need to be meticulously studied and regularly verified and updated to determine precisely how, why, and which patients benefit the most and the least. The results are not straightforward because bodies are not straightforward: there are incalculable external/environmental variables that are constantly in flux colliding with incalculable internal/genetic variables that are constantly in flux. I don't know any good scientist or clinician that wouldn't trade everything they know for everything they didn't know in a heartbeat. All researchers and practitioners, including bariatric clinicians, should ideally continually examine and assess their own results, making changes where and when necessary, to ensure they are delivering the best outcomes for their patients. Even though this inevitably leads to variations in form -- but not function -- it's just good medical practice. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures 2019 Update.pdf

You're welcome! My clinic -- and it's not alone in this -- also advises patients to be cautious about where and how time is spent on online bariatric forums. The main reason is that they are rife with false and inaccurate information, and BariatricPal is no exception. It's not as unbridled as Facebook, but it's still social media: brimming with opinions and beliefs and thoughts, not evidence-based science and medicine. Given the vulnerabilities many bariatric patients face in the immediate pre-op period -- but especially the hormonal, emotional, and interpersonal vulnerabilities that can arise during the post-op period -- and the numerous studies correlating the link between social media use and stress, anxiety, and depression, perhaps it would be wise to limit time on bariatric forums in order to mitigate the potential stress-cortisol-nutrition-weight connection.

Thank you both so much, I really appreciate the compliment! Confession: I do sell photos (just not for a living) and also had a food blog for many years, so have taken a food pic or two before 😉. I haven't updated it for a number of years now, but let's just say that I never used tricks such as hairspray or glue to enhance anything: I cooked the food, styled it naturally, then ate it afterwards... now here I am on a bariatric forum, so we'll leave it at that 😂😂😂😂. I kept a few of the food styling props like dishes and bowls, and have a good camera, lenses, lights, reflectors, etc. Since I haven't been able to do photography outside of my home during the pandemic, I set a goal of taking a photo a day during this time just to keep up -- and hopefully improve -- my skills. Sometimes it's food, but usually it's not 😊.

In her essay, Gay described the decision to have bariatric surgery as "the last straw", clearly a pragmatic choice shaped by a lifetime of cultural and personal indignities and abuses. Her exquisite honesty is balm for a crude world, and a lesson in humanity. Attitudes and decisions about weight, body image, and health are profoundly personal, but burdened and fraught. Many people make the arrogant assumption that they have a vote in what obese strangers – particularly women – decide to do (or not do) with their bodies, something Gay herself doesn’t subscribe to. She's never condemned the choices of other women, advocates for (and fully embodies) having painfully honest conversations, and makes it abundantly clear that she has "nothing but empathy for anyone who decides on weight loss surgery... or not." Weight management, including bariatric surgery, is a complex, multifactorial decision, just as obesity is a complex, multifactorial disease. It should begin and end with respect for the individual, with the goal of improving health – nothing more, nothing less. It was the right decision for me at the right time in my life, but I fully identify with the ambivalence, the resentment, the resistance to surrendering, and the replacement of one set of anxieties with another – and this is without the unimaginable, colossal pressure of worrying about publicly betraying fat positivity.

Stomach Intestinal Pylorus-Sparing (SIPS) surgery has been around for about 8 years. It's a simplified DS procedure, and lots of bariatric surgeons perform it. Long term SIPS outcomes are similar to any other bariatric surgery.

You have difficult decisions to make and it’s completely understandable that you’re obsessing about all of it – how could you not? I, too, am a strong advocate of the “think a million times, cut once” philosophy. With regard to being a pioneer patient, from extensive research conducted prior to my own bariatric surgery, and as a medical scientist, please allow me to offer an assessment: no surgeon would select a ultra-low or even low-volume surgeon for him-/herself or his/her relatives for any surgery. The correlation between high volume and quality of surgical outcomes is empirically well documented, meaning that the outcome of every surgical procedure is directly dependent on the number of operations performed at a given hospital as well as by the designated surgeon. In other words, the higher the number of operations of a specific type a surgeon performs, the more likely optimum treatment results and low complication rates are achieved. This fact is supported by a large volume* of studies and meta-analyses that have been conducted, peer-reviewed, and published between 1979 and 2019. Because of comorbidities and lower cardiopulmonary reserve thresholds, bariatric patients are often high risk patients. In complex procedures like bariatric surgery – and particularly with riskier procedures such as RYGB, BPD/DS, and SIPS – it is worth paying extra attention to the correlation of procedure-specific skills of the surgeon and the complication rate. Since you’re several months away from surgery, I’d encourage you to keep researching extensively, and talk with as many people as possible who have recently had DS and VSG, and particularly those who are at least 5 years out from both surgeries. I hope that by the time you reach a final decision, you’re able to do so with clarity and a sense of ease. Wishing you all the very best! ****** *A small sampling of available data includes: 1. Zevin B, Aggarwal R, Grantcharov TP: Volume-outcome association in bariatric surgery: a systematic review. Ann Surg 2012;256:60-67. 2. Nguyen NT, Paya M, Stevens CM, Mavandadi S, Zainabadi K, Wilson SE: The relationship between hospital volume and outcome in bariatric surgery at academic medical centers. Ann Surg 2004;240:586-593; discussion 593-594. 3. Birkmeyer NJ, Dimick JB, Share D, Hawasli A, English WJ, Genaw J, Finks JF, Carlin AM, Birkmeyer JD; Michigan Bariatric Surgery Collaborative: Hospital complication rates with bariatric surgery in Michigan. JAMA 2010;304:435-442. 4. Birkmeyer JD, Finks JF, O'Reilly A, Oerline M, Carlin AM, Nunn AR, Dimick J, Banerjee M, Birkmeyer NJ; Michigan Bariatric Surgery Collaborative: Surgical skill and complication rates after bariatric surgery. N Engl J Med 2013;369:1434-1442. 5. Chowdhury MM, Dagash H, Pierro A: A systematic review of the impact of volume of surgery and specialization on patient outcome. Br J Surg 2007;94:145-161. 6. Luft HS, Bunker JP, Enthoven AC: Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med 1979;301:1364-1369. 7. Birkmeyer JD, Siewers AE, Finlayson EVA, Stukel TA, Lucas FE, Batista I, Welch HG, Wennberg DE: Hospital volume and sugical mortality in the United States. N Engl J 2002;346:1128-1137. 8. Amato L, Colais P, Davoli M, Ferroni E, Fusco D, Minocci S, Moirano F, Sciatella P, Vecchi S, Ventura M, Perucci CA: Volume and health outcomes: evidence from systematic reviews and from evaluation of Italian hospital data (Article in Italian). Epidemiol Prev 2013;37(suppl 2):1-100. 9. Pieper D, Mathes T, Neugebauer EAM, Eikermann M: State of evidence on the relationship between high-volume hospitals and outcomes in surgery: a systematic review of systematic reviews. J Am Coll Surg 2013;216:1015-1025. 10. Al-Sahaf M, Lim E: The association between surgical volume, survival and quality of care. J Thorac Dis 2015;7(suppl 2):152-155. 11. Maruthappu M, Duclos A, Lipsitz RS, Orgill D, Carty MJ: Surgical learning curves and operative efficiency: a cross-specialty observational study. BMJ Open 2015;5:e006679. 12. Schrag D, Panageas KS, Riedel E, Cramer LD, Guillem JG, Bach PB, Begg CB: Hospital and surgeon procedure volume as predictors of outcome following GI resection. Ann Surg 2002;236:583-592.

Hi, I’m going through Kaiser too. I’m in San Diego. Down here the protocol once done with 12 week classes is second set of labs, then appointment with psychologist, then appointment with surgeon, and then that department will submit to my insurance for approval. Once I get approval it will say if I get a Kaiser surgeon or a Scripps Surgeon. Kaiser is contracted with Pacific Bariatrics through Scripps Mercy. I have already done majority of steps but I’m waiting on my last appointment with the psychologist so I can finally meet with the surgeon. I’m almost there! How did your appointment go?

Hi Bariatric Family! Regarding post sleeve, what are your thoughts on this cauliflower crust pizza? Thanks!! Sent from my Note 9

Thanks for the link! I heard her on This American Life talking about fat acceptance, and it's really interesting to read her WLS experience. I thought this was crazy: "A nutritionist cautioned us not to visit online forums about bariatric surgery, and I heeded her advice" What kind of frigging advice is this? I understand doctors don't like patients to hear competing medical advice. But this is also a terribly emotional process, and the medical staff often don't understand those issues if they haven't been through them. So many of the issues she talks about are things people here talk about. I feel like Roxane wouldn't have to feel so bad and confused about how the surgery has changed her life if she had the chance to talk more with others going through the same things.

I began the WLS process 16 months ago at 292lbs. I lost 50 lbs during the 6 month wait for surgery by following a 1100 kcal/day whole-foods plant based lifestyle (which I'd already been following for over 6 years), and exercising at least 150 minutes per week (beginning with daily yoga and simply walking as far as I could each day, slowly working up to 10,000 steps/day and adding weight training, cycling, hill hiking, and indoor rowing). After surgery, I reached my goal weight in 7 months, and am continuing to lose rapidly without the slow-down that is commonly experienced at the 6 month mark. Currently, I have lost not only 100% of my EBW, but 58% of my entire body weight. I now expect to reach the weight I was in high school, 112-114 lbs, and to maintain long-term in the 115-120lb range. The rapid loss window after surgery is finite: only about 6 months. How much weight one loses in those 6 months is primarily determined by genes, but all gene expression is dependent upon environmental variables, so I did everything I possibly could to maximize loss during that time. For me that meant: protein first veggies second; eating only nutrient-dense whole, clean, plant-based foods (meaning no processed or packaged foods, no animal products, no nutrient-poor foods); staying hydrated; waiting 30 mins before and 45 mins after drinking to eat; consuming no more than 600-800 kcal/day; practicing portion control; being mindful while eating and chewing food extremely well before swallowing; no snacking or grazing or emotional eating; weighing and tracking all food; taking all of the required vitamin and mineral supplements; weighing myself daily; using a fitness tracker and logging all exercise; exercising upwards of 15 hours per week (because I really enjoy it; I never had to force myself); meditation; taking good care of my emotional and mental health, and sleeping 8 hours minimum per night. I still do every single one of these things, except now I eat more (not too much, but enough to healthfully support my activity levels) and exercise more (upwards of 25 hours per week training for eventual distance cycling and triathlon events, as well as many other sports including weight training and squash especially). Though it's all just my regular, everyday, normal life now, I'm still only 8.5 months out from surgery, so it’s all relatively effortless. I'm fully committed to doing all of these things for the rest of my life, however. I will *never* forget how disabled I was -- how limited I was, and how limited my life was -- because of morbid obesity. Edited to add: According to several bariatric experts that I've spoken with, the "honeymoon stage" basically ends when people resume some or all of their old habits: making poor food choices, eating too much, not exercising, and not following evidence-based best practices for long-term weight loss and maintenance (based on observing 5 and 10 year outcomes for hundreds of thousands of bariatric patients). Obesity is a disease and WLS is a treatment, not a cure. If you have heart disease and undergo a triple bypass but start eating burgers and fries again 6 months after surgery, you’re still going to die of heart disease because you’re not addressing the underlying cause of disease unless you change your diet and lifestyle. 50%-60% average weight loss after VSG is just that, an average. So if you don't want to end up with average results over either the short or long term, then definitely do not do what the average person does. Use the first year after surgery to entrench yourself in an entirely new way of eating and moving your body (including weight bearing exercises to build muscle), regularly examining what's working and what isn't, and adjusting or pivoting as needed over time to continue seeing the desired results.

The amount, and speed, of weight loss in the first six months after bariatric surgery is mainly determined by genes, so one person's results are in no way predictive of anyone else's. There are gender-specific differences in weight loss that you'll also likely benefit from. Genetic expression, however, is dependent upon environment, so we can all help our DNA along after surgery -- and for the rest of our lives -- by following key evidence-based bariatric rules such as no liquids 30 mins before or after meals, staying hydrated, practicing portion control, mindful eating, protein first veggies second, chewing food extremely well before swallowing, not slipping back into old eating behaviours and food habits, reading labels if you eat packaged foodstuffs, getting in at least 150 minutes of moderate intensity aerobic physical activity per week, getting enough sleep, and taking all of the required vitamin and mineral supplements. Wishing you well with your surgery!

After bariatric surgery 👍👍👍👍: Before bariatric surgery 😂😂😂😂:

Today was what I think will be my last consult. Planning to go with the doc in Port St. Lucie. However, today's visit left me quite emotional. The doctor poked, prodded, pinched (gently!) my abdomen, arms, and thighs. He asked "how much more weight do you think you need to lose?" When I told him my bariatric surgeon and I set a goal weight of 160 he said "nope. No more. You're done. All you have left is loose skin, no fat. You'll lose those last 16 during surgery!" I was stunned! He told me to stop restricting intake as of today, and to try to get my protein up from 70-80g/day to 100g/day in prep for surgery. I burst in to tears and felt so silly! This has been such a long journey for me, and although it was on my radar that I'm getting close it was shocking to hear him call "done". I've got my 1 year follow up with my surgeon next month, will be waiting to consult with her and my nutritionist. I feel like I need some time to process this!

Surgery is scary. Not only is the actual surgery and recovery a big thing to go through, but it will make a permanent change to your body and you don't know yet how you will feel long after the surgery is over. It would be weird if you were not freaking out a little bit. I just want to tell you to trust yourself. No one knows better than you why you decided to do this in the first place. You can do it tomorrow, wait a little while, or never do it. You are the best person to make that choice. However, I do want to push back hard on any thoughts you have that it should be easy to lose 100 lbs without surgery because you recently lost 11 lbs. Studies are very clear on this. Losing a few pounds over a short period is something almost anyone can do - losing a significant amount of weight for more than 2 years is very rare. Depending on what you count as success - your chances of doing it on your own are about 5%. And even if you do succeed, you will be fighting against your body the whole time - you will be hungry and tired because your body will think you are starving to death. In contrast, bariatric surgery succeeds 60-80% of the time, and comes with similar big improvements to diabetes, cancer, and long term mortality. A year after surgery, people end up with a metabolism that is fairly normal for someone of their size - the surgery really resets your body's weight set point. Don't buy into this weird moralistic view of obesity that says the problem is just lazy gluttons with no willpower. The data shows that surgery is the best treatment there currently is for obesity. That's why I decided to go ahead with mine.

For me, it was getting back to eating very intentionally - protein first and foremost then vegetables. Then fruit and a sprinkle of carbs. I was never able to do protein drinks - ever. i react to every kind of artificial sugar and artificial type ingredient with horrible digestive problems that put me in the hospital..... but YOU DO know what will work and what will not for YOU. Go back to what you were eating at the start - and start from there. You may want to see if another doctor took over your surgeon's practice or find a doctor who is knowledgeable about post surgery issues for bariatric patients. Mostly it is diet and getting enough vitamins and minerals into you and then exercise / moving more ! Personally, I started in the 300's had a sleeve 10 years ago. Lost about 140 pounds then gained back 40. I have spent the last year losing 5 pounds at a time. My first goal was that 5 pounds with a desire to lose 20 in a year. I have lost to date 36 and a half pounds. I am still "overweight" according to BMI for my age (64) and obese if you don't put in my age... but I am very pleased with where I am !!! One meal at a time, one healthy snack at a time, lots of water. Be safe out there !

So sorry to hear you're not feeling well! That bloating, and stuff is just such an awful feeling. I am a VGS person but when that starting happening to me, my dietician told me it might be the effect of a lactose intolerance that bariatric patients sometimes develop after surgery. Have you had milk products lately, like pudding or ice cream or cheese? I found out that even the protein drinks I was having every day are milk-based. Once I cut out the lactose, my symptoms improved immensely! Anyway, just a thought Hope you are feeling better soon!

it looks like the content of your original post is gone, but did you say that your glucose level is high? If so, that shouldn't stop your surgery - there are a number of bariatric patients who have Type 2 diabetes (and it often goes into remission after surgery)

Although I've never seen any actual medical research to back this up, just from hanging around on this and other bariatric internet forums for the last 5-6 years, I'd say the average bariatric patient loses 15-25 lbs the first month. I think we go into it expecting more because of shows like "My 600 lb Life". You have to remember that those people are NOT normal bariatric patients. In fact, I've been working with pre-op groups for the last four years, and I've never seen anyone near that big in the pre-op classes. Most of us are between 200-450 lbs. And as you've probably heard, starting BMI is one of the factors that affects your rate of weight loss. So although you will see some people who lose 30+ lbs the first month, they're the exception. Most of the people who lose that much start out much heavier than the majority of us. I started out at over 300 lbs and lost 16 lbs the first month, if that makes you feel any better... also, I should add that rate of weight loss doesn't really affect your ultimate result - your level of commitment to your program does.

I'm scheduled to have gastric bypass on August 4th, and so I'm finishing the pre-op testing. My EKG came back abnormal. Possible left atrial enlargement, and borderline arrhythmia. They want me to go see my PCP to clear me for surgery, and my appointment with him is on Monday. But now I'm freaking out! Firstly, is there something wrong with my heart?? But mostly, is this going to tell me I can't have the surgery? I have been working towards it and looking forward to it for so long now. I mean, I think that he'll approve me, considering I don't have any history of heart problems... But I also don't know how he feels about bariatric surgery in general. I've just been going to the surgeon's office for all my tests an appointments because it's easier. Anyone have this problem in the past?

check the blog "The World According to Eggface". She's a long-time bariatric patients who loves cooking, and she has recipes for every stage.