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This is the most obscene, and ridiculous thing I have ever seen. My partner of 12 years is thin. I have a large circle of lesbian friends, and they too are healthy not fat. This is outragous! There are heavy set people in every group. Thats like trying to associate blacks with sports and all red necks have mullets. This is a very scary statement. I am so proud of my sexuality, and my weight gain at one point in my life had nothing to do with who I date. That sounds like a vauge statement an uneducated man would make. Ive been to several lesbian bars with some beautiful thin women. People should get out more before making such general statements. SICK

Thanks Chickie and Sue Magoo for your insight. I think if I can use the lap band as a tool to keep me honest I will stay on track. On past diets I will work hard for 3 weeks and lose some weight then gain it back in one weekend. If the lap band limits my portions and makes me sick or uncomfotable when I over eat I will learn my lesson fairly quickly. If it helps me get over a bad spell sooner and with less weight gain I think I will be sucessful.

I am a few days away and so excited and nervous all at the same time. Thank you all for sharing and keeping us updated. It helps so much for us who are waiting and have questions. My surgery is a revision from sleeve to bypass due to Hiatal Hernia which my surgeon will repair, GERD and never getting to goal with some weight gain. 2017 HW 284 I’m 5’3 LW after sleeve 194 after I juiced for three days to break the 200’s. Then two years ago I gained up to 224 and I turned vegetarian. Got down to 187. Then COVID hit. I have gained and lost the same 30 lbs for the last few years. Now my current weight is 225. My revision is set for Thursday, 2/17. I am hopeful all my efforts will get me to goal this time. I’m scared to end up the same. Wish me luck.

I don't think you fully understood what you signed up for. I work out 6 to 7 days a week and do not have any bulk muscle. I had the Sadi DS 10 years ago and I can eat a horse without weight gain but also no bulk muscle. Instead, I have excellent muscle definition and can work out at a level not possible before wls. The DS fortunately keeps the weight off, so you will never bulk up. You signed up for this, and it's a fantastic thing for you to be able to work out, eat what you want, and be healthy, especially given you previously weighed over 400 lbs.

Linda ~ Sorry to hear about PMS. Yucko. :tired I'll be joining you next week. Don't worry about the weight gain. Concentrate on following the rules. Now, you remind me of this next week, O.K.? I've heard some say they feel more restriction when it's that time. Let me know if you experience any tightness or such. Hi Myra ~ Well, your just the little lap band trooper!!! Good for you my friend. Yipee.....15 lbs....WTG!!! I don't have much to complain about either. I keep looking at the weeds that need pulled, but I've been a chicken to get out there b/c of DeAnn pulling her port muscle. Maybe I'll stick gloves on my boys and direct them on which ones to pull.

No, you absolutely do NOT. Only about 1/3 have significant "dumping" in the first place, and most of those lose that so-called benefit after a year or two. And the body adapts so that there is less malsorption over time. It is these things, plus the distended, non-adjustable pouch, that causes rebound weight gain in the majority of bypass patients.

When I first started pursing the band, I had a bmi of 39. A low bmi plus my absolute determination to get banded = last supper syndrome. I ate and ate and ate, gaining about 25 pounds in a shockingly brief period of time. I finally came out of it in January and haven’t binged since. To tell you the truth, I'm kind of sick of food altogether and looking forward to the liquids phase. I haven't been making great food choices, but I'm not bingeing at all. Right now I'm working on making better choices because the choices I'm making now are 100% based on convenience (e.g. skipping lunch because it's a pain to pack it or to go out and wait in line somewhere, then going through the drive thru after work so I can eat in the car and be done by the time I get home so I can do other stuff.) I haven't been exercising at all. I was really having a problem with that because the rapid weight gain has put a LOT of stress on my body. (Back pain, leg pain, footpain, etc.) I am 31 but I feel 81. I can barely walk half a block. Plus, it's also a mind thing. I keep thinking of exercise in terms of what I <b>used to</b> be able to do. I used to be able to do 45 minutes of aerobics or walk 45 minutes and the thought of even trying that right now is overwhelming, so I don’t try. BUT! I had a revelation over the weekend. I bought a pair of pants to exercise in and on Saturday I put them on and put on my tennies and was able to walk much longer than usual. Yesterday I went on a ten minute walk around the block. It was hard, but I did it! I'm going to do my best to do that every day from now until May 1. I think that helps with the mental thing and with the waiting. Now I feel like I'm doing <i><b>something</i></b>, not just waiting around for my surgery date. I'm doing a lot of work in that area. The great thing about Cedars-Sinai is they take the weight loss as a done deal. You ARE going to lose weight. So they focus on ways to live your life post band. I had to see a social worker as part of my eval. The social worker really wanted me to think about how I've handled weight loss in the past (very badly, hence the regain) and what obstacles I might face this time around. I will have to overcome a lot of challenges in order to make this THE LAST TIME I am ever obese. I have a lot of issues. Unfortunately, I am one of those who is battling depression (I'm on meds for it) and I have very low self confidence and self esteem. I don't have any friends here and am completely isolated socially (all my own doing. I’m too fat to look at myself so I don’t want anyone else looking at me!) I'm used to being invisible. I LIKE being invisible. I also tend to be an obsessive all-or-nothing type of person, so whenever I slip in terms of food and exercise, I don't just fall off the wagon, I jump off and run the other way. These are all issues I've had for a long time and they're not going to change just because I'm losing weight. In fact, things are going to get a lot scarier for me. In the past I have not been able to handle all of the changes. So if I want to succeed, I have to do something about all of this. Planning for it in advance is a luxury that I fully intend to take advantage of. The day after I met with the social worker, I went out and found a great therapist. I've been in therapy before and it was mostly me talking and crying with no real end in sight. My new therapist is very goal-oriented and we are focusing on the things that will ultimately be most difficult for me. It's only been a month, so I still have all of those issues, but I feel like I am making progress and I am confident that when the time comes to deal with these things, I will be able to handle it. If have to pay someone to hold my hand through this process, then dammit, I will do it! So, in a way, it’s a good thing to have five weeks until my surgery. The waiting sucks, but it’s nice to be on the other end – waiting for a confirmed surgery date, rather than waiting for insurance approval! At least I know I'm definitely going to have it and I know when. These next weeks will give me time to ease into the changes gradually, which I have already started to do. I won’t lie though, I wish it were sooner! And sadly, I am looking forward to it as a week away from my job!

If you are having difficulty talking to friends and family...... I was TERRIFIED of telling anyone. I did not want the negative comments or the "you can lose weight if you really tried" comments. I put it off for months. When my sister in law's mother had GB, I came out of the closet with my sister in law. She was so supportive it shocked me. She has dealt with her mother being obese and has insight to what it means. She actually encouraged me to tell my parents. After weeks of agonizing, I called my mother and started at the begining.....my weight gain. I went on to tell her about the various health issues that have cropped up with my blood pressure, my sleep apnea, etc. I gave DETAILS. I tried to be shocking.... saying things like "I am 35 years old and I cannot walk up stairs without being winded, I cannot wash my own hair without my hands going numb..." I wanted her to know that I have been to doctor after doctor and specialist after specialist. I told her what they told me. Lose weight or die. I told her about all the weight programs I tried and how they failed. I told her that this proceedure was MEDICALLY NECESSARY if I wanted to live a normal healthy life. Then I told her that I was too young to have to take 3 blood pressure meds and sleep with a machine helping me breathe. I ended by telling her that this has been a long hard road and I am tired of failing miserabley. I asked for her support and to my ASTONISHMENT there was no hesitation from her. She supported me 100%. The entire conversation was repeated for my father and his response was "you have to do what you have to do-and you have to do this". I really cant believe that they are being so supportive. My parents are typically the devil's advocates. My point is, if you explain the REAL reason why it is so important to get the weight off, the surgery makes sense. We don't want to die young, we dont want to live life on the sidelines. I dont want to live with the MENTAL TORTURE that comes with gaining weight. I dont want to be in the ER with malignant hypertension 3-4 times a month. This is not about fitting into a size 6 or looking good. It is about feeling good...because we are healthy. The looking good and fitting into smaller sizes is an awesome bonus. The benefits of this surgery should be looked at as HEALTH benefits, not vanity benefits. I learned that my parents truely care about me and my health....not how I look. They jumped on the bandwagon because this is about my health not about my appearance. I am soooooooooo glad that I told them because I have my share of support, plus the weight from my shoulders is gone (figuratively speaking). Tell whoever it is you need to tell. You will feel so much better! On the otherhand, I did not tell my work as I did not want to divulge all my health issues. I have my close friends and family to support me, and that is plenty for me.

Just got home from weigh in, I was up 1/2 lb. Thats my first weight gain in 4 months... Must of been the ribtips...... Will I'm glad to see more joining the May band group, Angie you and I have the same date. 3loves I"m glad you final got your date. How exciting! and before your birthday. May 4th. will be my new BIRTHDAY!

I had the band done in 08 and recently 10 months ago I had it emergency removed due to prolapse. I did have success in the very beginning, losing about 70lbs. I do have to admit it was not easy!! I was working out twice a day and watching every little calorie. I had 5 to 6 fills and became very sick do to restriction and had it emptied. After that it all went down hill as far as weight gain Today I weigh only 10lbs less then the day I had the band put in. I'm two weeks from my Gastric bypass surgery!!! I'm praying all goes well! Good Luck on your journey Sent from my SGH-T999L using the BariatricPal App

I came across this article at our local support group this week. Found it to me a good list for personal evaluation and focus when I am off track. Wanted to share... http://www.nawls.com/ In a November 2005 poll conducted by NAWLS, the following were identified as the top 10 mistakes WLS patients make: 1st Mistake: Not Taking Vitamins, supplements, or Minerals Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results. Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include: Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning. Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible. 2nd Mistake: Assuming You Have Been Cured of Your Obesity A “pink cloud” or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it’s hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back. A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don’t change what you’ve always done, you’re going to keep getting what you’ve always gotten — even after weight loss surgery. 3rd Mistake: Drinking with Meals Yes, it’s hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating. 4th Mistake: Not Eating Right Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals–don’t skip. Don’t keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren’t as tempted to make a poor choice. And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your “absolutes” based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you. 5th Mistake: Not Drinking Enough Water Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too. 6th Mistake: Grazing Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It’s one thing to eat the three to five small meals you and your doctor agree you need. It’s something else altogether when you start to graze, eating any number of unplanned Snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement. 7th Mistake: Not Exercising Regularly Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest! 8th Mistake: Eating the Wrong Carbs (or Eating Too Much) Let’s face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta–in moderation, of course. (Kamut Pasta doesn’t have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as “condiments,” rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies. 9th Mistake: Going Back to Drinking Soda Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS–because when you’re drinking soda, you’re not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there. 10th Mistake: Drinking Alcohol If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it. Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while Protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations. If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn’t make it any easier, and could make you a lot sicker.

P.S. tomorrow will be one week without Pop. It hasn't been a problem. It is all the food and the continuous weight gain (ooops). My brain thinks that because I'm having surgery- I can eat what I want. Totally backwards I know- but it does. So this 6 month for insurance has really done nothing positive for me. Oh well

In preparing for surgery, every evening consists of research for me. Whether it be browsing threads on BP, watching videos on YouTube (actual surgeries & success stories, etc) , following WLS people on Instagram for meal and excercise ideas, watching My 600 lb Life, and now Fat Doctor. I just have to say- Fat Doctor hits home the most for me. Dr. Summers is my favorite part of it all! His outlook on obese patients is heartfelt. I absolutely love to listen to him talk about the obese and what contributed to their weight gain. He also discusses how society views "fat people" and the prejudice they experience. Fat shaming is a real thing and I know we have all experienced it on at least one occasion. I guess I respect this doctor more because I have been to doctors who chalked excercise and dieting up to being a cake walk and not understanding my lack of success or believing that I was fully dedicated to the program. I have PCOS and while I don't blame it 100% for my weight, it does play a significant role in my inability to lose weight. My younger brother who pitches in the minor league (very fit & healthy) thought something similar about me and my efforts. So when he was home in the off season last year, we walked every morning, went grocery shopping and cooked together (meal prepped for the entire week). He quickly realized that my body did not react to clean eating and excercise like it should and changed his entire perception. For the record, he was always loving and never disrespectful when addressing my weight. He just thought that I did not know how to determine exactly what my body needed to succeed. So, it's nice to see that Summers recognizes that there are multiple factors. I highly recommend this show to everyone! I watch it on Hulu and I'm on season 3 out of...6 I believe? It truly does show the good, the bad and the ugly (and I mean...the UGLY). It's filmed in England so it took me a quick second to get used to "stones" over "pounds." Oh....and it doesn't hurt that Dr. Summers is nice on the eyes

My Story: I'm from Chicago but now live in a suburb just outside of Chicago. I've been dealing with being overweight since my sophomore year of high scool. Prior that I was the skinniest kid in my home. My weight gain started with taking birth control to regulate my periods and from there it was all down hill. I am 39 with a husband and a step-daughter who just turned 18. I've been in her life and help to her raise since she was five. My husband and I have been trying for 13 years to get pregnant with no success. After going through surgery to remove my gallbladder I paid a visit to my new Gyne for the first time quite a few years back and I was prepared with tons of information on what I thought I have. After two sentences she looked at me and said "You have PCOS". All of the symptoms were in plain view including the embarrassing dark ring around my neck, horrible acne, and coarse facial hair. Finally I had a doctor who had a concrete answer for why I was feeling like crap and experiencing these emotional highs and lows. Fast forward I attempted to ask my PCP about Bariatric Surgery and she looked st me with a stern cold expression and said you'd have to be on a six month supervised diet and your insurance may not cover it. I was already having enough of a hard time so feeling defeated I gave up and kept suffering through attempting to lose the weight only to gain it all back and then some. Moving forward its been eight years since I've seen that PCP and I've been with my new PCP a couple of years. He keeps pressing me to lose weight and I want to but it is hard having PCOS. I am now on two blood pressure medications and Metformin for my PCOS. So thats infertility, insulin resistance, borderline diabetes (Pre-Diabetes), and high blood pressure that I am dealing with and all with a BMI of 51. Tall and wide is definitely not the look that I am going for. I just want my life back. I have alienated all of my friends, and most of my family. Most of the time I lock myself in my home and comfort myself by sitting behind a computer learning computer programming languages. I breakdown inside every time I see a baby and pray that its not too late for me. I recently looked back into having Bariatric surgery and discovered that BCBSIL no longer requires the six month supervised diet. With all that is going on with me I am not even sure which surgery is best for me. I don't know where to start or how the process goes but I am going to schedule an appointment with my PCP to discuss my options.

@Serengirl I checked my stats. I lost 34.8 pounds at my 3 month mark. Are you on any medications? I talked to my Dr after I read about a medication I was on (beta blocker) caused weight gain, I switched meds and it helped speed up my metabolism a bit. It wasn’t dramatic but it did help. I also switched up my diet and ate pretty clean for 3 months and avoided processed food. Keep moving, journal everything you eat and research any medications you are taking.

I had a band and lost 40lbs but was always slimming and was disappointed with my weight loss. So, I had a revision to the sleeve. At first I lost 12 lbs, and then stopped dead. I followed the diet, exercised intermittanly but still didnt lose. The nutritionist where I had surgery had me take Metformin as I take anti-psychotic meds and they are known to cause weight gain. It didnt work. I have been in touch with the doctor that did my revision and he feels the problem was due to too much scare tissue from the band.He has only had this happen one other time. I am going back on Dec 6 for a "Re" revision. I am not going to name the doctor as everyone I know, or have seen on the boards have had excellent results. I am fearful that the same thing will happen again. I know I will have to lose weight if my stomach is smaller,but I am not sold just yet. Oh, the doctor is doing the new surgery for free. I cant get much better than that. Has anyone else had this problem?

TSH is to measure your thyroid hormone levels. A high TSH means you are hypothyroid (your body needs more thyroid hormone). If your TSH is too low, you are hyperthyroid. Hypothyroidism is easily corrected through syntroid medicince. Sypmtoms can include fatigue, weight gain, depression, sensitivity to cold, dry skin. Though there is a range of acceptable TSH levels, I find that when mine are closer to 1-2 I feel better.

Thanks for getting back on track all you May bandsters! I think the farther I get out of surgery the harder it becomes. I tend to lose some of that rigidness and can become softer in following the rules. Listening to your stories/successes/struggles help me out tremendously. After all, we are all going on this journey together. I, myself, just had a 1 pound weight gain following vacation. I could look at it as a failure that I didn't lose weight but I can also look at it as it could have been a lot worse. Back in the day, I would have had the mindset that I could eat anything because I was on vacation. I didn't this time, or rather, I couldn't. Did I make the best choices? No, not 100% of the time but I did make much better choices than I would have had I not been banded. Thanks to y'all for your support.... Katie

I am SO glad to hear from some of the nymphs! Wow, it's been so long! I have wondered how everyone has been as well. I had been doing well. I didn't get to goal, but was okay with the weight I had lost, and then I got pregnant (3 years ago), had a complete unfill. I did okay and didn't gain too much during the pregnancy, then lost a lot of the weight again a few months after the baby was born, but THEN I started to put the weight back on. I have always been grateful I got the band because I know I would have gained and kept gaining without stop. The band stopped the weight gain and helped me get my normal body back (for a little while at least). I do have concerns about some foreign object in my body and what exactly is going on in there. I hope it doesn't give me cancer or something. I know, sounds weird, but I am a bit of a worrywart with things. I've gotten a few fills since the baby was born but honestly I have just been so tired with two kids that I haven't wanted to deal with getting stuck all the time. The band did get me to lose weight but not the way it should have - the way I lost weight was when I was so tight that I couldn't eat anything. I would get stuck, throw up, get an unfill, heal for a month, get a fill, get stuck, throw up, and the cycle would repeat. That is how I lost the weight. I guess bulemia would have been cheaper! lol! (just kidding of course) I just don't want to go through that again, although right now I don't know the alternative because I am back to my overeating ways where I can't seem to stop myself. Every day I start out like I should on "program" but by noon I'm throwing back the junk food. Once I get on program for a good week, I am always okay and do really well. It's just the starting I can't seem to get past. We are in the process of selling our house and moving to a new city which is extremely stressful on me because I love where we live right now. So just lately it has been hard. I wish I could hear from more of the November Nymphs!

My name is heather and I'm a scalaholic. lol. I've done the same thing and experienced the same thing with the weight gain after peeing. Or even seeing the scale stay the same! I weigh myself about 2 or 3 times a day. Usually 1st thing in the morning. If it's a weekend I'll wait an hour and weigh myself after the morning weigh in and then I usually weigh myself at night just to see how much i'm up from the day. So no it's not just you there are others out there just like you!

What kind of protein shakes are you drinking? You have to be very careful because some of them are formulated for weight gain.

I had posted this on the WLS Veterans forum, but thought it would be a good idea to post this on this forum as well. I had gastric bypass surgery 5 years ago. I was incredibly determined and managed to lose 180 lbs. in a year's time. I'm 5' 9.5" and I went from a size 28 to a size 10. Now, I've regained a lot of weight and I'm starting over. I thought it might be helpful to list the steps that caused my weight gain. My goal is to tackle these 6 and starting moving in the right direction. Does anyone else have additional things that contributed to regaining weight? Stop weighing yourself Stop tracking your food intake Stop exercising Drink liquids with meals and ignore the 15 minutes before/30 minutes after rule Start eating your old favorite foods Stop visiting Bariatric Pal forums

Okay the latest. I called my doctor and a medical tech called me back. I can't eat hardly anything. She said that it was okay to eat soft foods. From what I know this can cause weight gain cause you start eating your unhealthy foods again because they go down easy. She said that eating chocolate Malto Meal was fine to eat in the morning. Yesterday I ate Chipotle and barely had anything. I did notice though you could only eat a couple Beans at a time or a tiny piece of chicken. Is this normal. That is so small! Last night I had just shrimp and it came up. So then I wanted the rest of a chocolate sundae that I have had a couple of times. Stopped eating that and forced myself to eat some turkey from a frozen meal. That went down fine. People who have gastric lose weight so fast. How is that when I see that we talk a lot about not eating enough then not losing any weight or hitting a plateu? So is my band too tight or I am just not eating the right foods and size. I had some pancakes and an egg on Friday. First time trying that with this fill (#8) and it all came up.

Hey, I thot my family was nuts, but I am truly lucky. But from a psychological point of view, do any of you think that the abuse or just wierdness in the family may have contributed to your weight gain and obesity in the long run? I know that while I was little my mom was a little nuts because her mom (my Mama Di) treated her like she wasnt worth the dirt she walked on, so Mom pushed me to be the perfect little girl, especially since my Mama Di took away my sister from my mom after she was born and told everyone that she had had a baby when she was about 35 (which isn't old btw) but everyone saw Mom pregnant, and never saw Mama Di pregnant, but she honestly believes that everyone thinks that my biological sis is her daughter (weird huh?) My family is WACKY! That's all, when I was little Mom used to make me do pagents, to this day I dunno where that money came from because my Mom worked for Mama Di in her conveniant store making $50 a week, and Dad made about $6,000 a year. I am a natural blond haired, hazel-eyed girl, with dimples, and it was more than anyone could stand (I was soooooooo cute) but I started gaining weight when I was about 3 or 4 like CRAZY!! And have never lost it, I was born big, but I mean I blew up and Mom did everything she could to stop it which led me to being a Binge Eater from the ages of abour 4 until I was about 12, then I became a short-term anorexic (when school ended I started eating a lot in the summer). Now I am just huge and in a lot of pain, but I am so lucky to have the parents that I have, and you all have shown me that, thanks, you all are an inspiration Oh, wanna here something funny!!!! My other grandmother (Mamo) got arrested about 5 weeks ago for public intoxication, she had went to the doctor and faked serious depression to get Xanax and Trazadone and took some on the way home, and did not make it 2 miles before she hit someone in an intersection but drove off to Casa Ole (mexican food place) and hit someone else then freaked out, turned around and almost hit another person trying to back out of the police baracade!!! All they gave her was a PI tho, but we made her sit in jail until she sobered up!!! My family is just plain ZANEY!!

First off, what is a ketogenic diet? The ketogenic diet is a very low carbohydrate, very high fat, low-moderate protein diet. Historically, it has been used to control epilepsy in children. When you don’t give your body carbohydrates (your body’s preferred fuel source), it begins to use and break down body fat as a source of energy, which is called ketosis. The breakdown of fat leads to the production of ketones, and the ketones are what begin to fuel your body (instead of the carbohydrates you were feeding it before). This process can take a few days to achieve, and when done correctly, can be tested by measuring the ketones in your urine with a dipstick. If ketones are present, this means you’re in ketosis. What does the macronutrient profile look like? FAT – A ketogenic diet should include healthy fats such as fats from fish, seafood, eggs, nuts, vegetable oils, dairy, and some meats. There is a lot of poor information on the internet that encourages people to have the majority of their fats in the form of cream, lard, bacon, and fried foods, which are not good for our heart. CARBOHYDRATES – The ketogenic diet is described differently depending on the source, but on average it means limiting your carbohydrates to 5-10% of total daily calories. For bariatric patients eating around 1200, 1500, or 1800 calories/day, this works out to 22, 28, or 34 g of carbohydrates/day, respectively. That’s very little! Foods rich in carbohydrates that are limited/eliminated in a ketogenic diet include: grain products (e.g. pasta, rice, bread, etc.), fruit, many vegetables (e.g. potatoes, corn, carrots, squash, etc.), some dairy products (e.g. milk, yogurt), legumes (e.g. chickpeas, beans, lentils), and sweets and sweetened beverages (e.g. chocolate, ice cream, pastries, juice, soda, etc.). That’s a lot of food groups being restricted! PROTEIN – On a ketogenic diet, protein is considered low-moderate (depending on your protein requirement), or around 15-20% of total calories. For bariatric patients eating around 1200, 1500, or 1800 calories/day, this works out to 52, 65, or 78 g of protein/day, respectively. Are these protein targets in the range that your dietitian has recommended for you? For many of you, likely not. FIBRE – Fibre falls under the umbrella of carbohydrates. Because you now know that carbohydrates are very limited on a ketogenic diet, you can guess that fibre will also be very limited. A diet very low in grain products, fruits, most vegetables, and legumes means that constipation is going to be a real issue! I heard that a ketogenic diet leads to rapid weight loss. It’s true in the beginning, but the important factor here is to understand what kind of weight loss this is. Yes, it’s true that reducing carbohydrates leads to weight loss, however the weight that’s initially lost is mainly water weight, not fat. Here’s a behind the scenes look at what’s going on: Your body always wants to keep your blood sugar well controlled, so it stores some sugar (or glycogen) in your liver. When you’re sleeping, or fasting, your body uses this stored glycogen to send some sugar into your blood, to be sure that your blood sugar doesn’t drop too low. Glycogen is stored in your body by attaching glucose to water. So when we empty our glycogen stores, we’re actually losing a fair bit of water as well, and that’s the initial weight loss that you see. The weight loss that follows from there is partly muscle loss if you’re not meeting your protein needs (which as discussed above, might be the case) and fat. While ketogenic diets have been shown to be better for weight loss than other low fat diets, the results are only true in the short term. In the long-term, there doesn’t appear to be any difference. You’re also more prone to rebound weight regain on a ketogenic diet once you re-introduce carbohydrates again (whether by choice, by cravings, or by obligation because you feel unwell without them). But I thought that the ketogenic diet was proven to be effective? The ketogenic diet isn’t a new diet at all. It’s actually been used for almost 100 years to treat children with severe epilepsy who don’t respond to medication. However, even these children don’t stay on the ketogenic diet their whole lives, they only do so for a temporary amount of time. These children are followed very closely by their doctor and dietitian to very slowly bring carbohydrates back into their diet. Despite what you dietitians say, I want to try the ketogenic diet! Ultimately, it’s entirely your decision to try what you want. We (as dietitians) are only here to guide you through the evidence that’s out there, and as of now, there’s no research on the ketogenic diet after bariatric surgery. There’s also not enough long-term research to know and understand if the ketogenic diet is safe for your heart in the long-term (i.e. more than 12 months of being on the diet). Three of our biggest concerns as dietitians are: 1) Are you meeting your protein needs? 2) Are you emphasizing healthy fats; 3) Are you just looking for a quick fix? If you’re using the ketogenic diet as a “reset” just like the last fad diet you tried, you’re only feeding the yo-yo dieting pattern (just playing devil’s advocate here!). Can I be on a ketogenic diet my whole life? The honest answer is we don’t know. We don’t have research on the long-term effects of following a ketogenic diet. It’s suspected that it may lead to higher cholesterol levels which may lead to heart disease, but more research is needed to conclude this. Does being on a ketogenic diet guarantee that I’ll keep the weight off? While more research is needed, one study showed that the participants who were very strict about following the ketogenic diet were able to keep off the initial weight loss for up to 56 weeks (or a little more than one year). We don’t have the research to say if in 10 or 20 years that their weight will still be stable or not. We do know however, that if you don’t find the ketogenic diet realistic for your lifestyle and you end up coming off of it, you will regain the weight (if not more), as with any temporary diet. Is the ketogenic diet safe? While it may be generally safe (meaning you’re not going to die) for most people, you should always check with your doctor, especially if you have heart disease, liver disease, and diabetes, as this diet may put your health at risk. The ketogenic diet is not considered safe for those who have chronic kidney disease. The ketogenic diet has received a lot of criticism because it’s a very restrictive diet, eliminating many foods and therefore many nutrients that are important for health. Following this diet puts you at high risk for micronutrient deficiencies. Make sure you discuss additional vitamin supplementation with your family doctor or dietitian. What are the benefits of a ketogenic diet? Aside from weight loss, following a ketogenic diet has been shown to improve blood sugar control in those with type 2 diabetes, lower triglycerides, lower LDL cholesterol (the ‘bad’ cholesterol), and raise HDL cholesterol (the ‘good’ cholesterol). Although these benefits sound attractive, know that other low fat diets have produced similar results, and would be safer in the long-term since they’ve been better studied and are less restrictive overall. What are the risks of following a ketogenic diet? Liver disease? – More research is needed, but several rat studies have shown an increased risk of developing liver disease. While results from rat studies don’t 100% translate into humans, animal studies often give an indication or at least a starting point for how something will affect the human body. More research is needed in human subjects. Muscle loss. – Another risk of following a ketogenic diet is muscle loss, because most patients aren’t able to meet their protein goals. Losing muscle may put you at risk of weight gain. Working with a dietitian while following a ketogenic diet can help you be sure you’re meeting your protein needs. Earlier death? – Like we’ve mentioned, there isn’t enough research yet on the long-term risks of following a ketogenic diet, but a recent study found that low carbohydrate diets (less than 40% of calories from carbohydrates) was linked to earlier death, compared to having a moderate-carbohydrate diet (50-55% of calories from carbohydrates). Remember that a ketogenic diet has around 5-10% of calories coming from carbohydrates. How did they explain this increased risk? The risk with a low carbohydrate diet seems to be because the carbohydrate calories are often replaced with more animal protein and unhealthy fats, rather than plant-based protein and healthy fats. Note that this study was not on bariatric patients, but again, the findings are interesting. What are the side effects of a ketogenic diet? Side effects during the adaptation period (i.e. in the beginning of following a ketogenic diet) include: brain fog, fatigue, headaches, nausea, strong smelling sweat and urine, constipation or diarrhea, and poorer exercise performance. Long-term side effects include: bad breath, micronutrient deficiencies, and muscle loss. What are common misconceptions of the ketogenic diet? Many people believe that it’s a carbohydrate-free diet, meaning no carbohydrates at all. This isn’t the case. You can have in the range of 20-50 g of carbohydrates per day (depending on how many calories you’re eating). If you don’t know what this looks like in terms of food, speak with your dietitian. Another misconception is that a ketogenic diet is high in protein. This also isn’t the case. A ketogenic diet is moderate in protein for the average person (who hasn’t had bariatric surgery), and is therefore typically low in protein for a bariatric patient. As you likely know, low protein puts you at risk of losing muscle which will affect your overall weight loss, and put you at higher risk of weight regain in the future. Other than muscle loss, what are other negative nutrition consequences of following a ketogenic diet after bariatric surgery? Low in fibre – The smaller food intake that you have after surgery already makes getting in enough fibre difficult. This partly explains why so many people are constipated after surgery. A ketogenic diet significantly limits most fibre-containing foods including fruit, most vegetables, grain products, and legumes, so your fibre intake decreases even more. Constipation is therefore even more of an issue! High in unhealthy fats – Many people don’t follow a ketogenic diet correctly and include too much saturated fats (or unhealthy fats) in their diet. For example, they may choose bacon, sausages, and lard, over fish, nuts, and vegetable oils. A diet high in saturated fats has been linked to heart disease. Low in many micronutrients – A ketogenic diet is also low in important vitamins and minerals such as thiamine, folate, vitamin A, calcium, magnesium, iron, and potassium. While you’re prescribed vitamins and minerals supplements after bariatric surgery, these standard prescriptions don’t account for you following a ketogenic diet. If you do decide to follow a ketogenic diet, it’s important to have your doctor or dietitian re-assess your vitamin and mineral supplements and for you to continue doing blood work regularly. Will I be able to exercise just as much while on a ketogenic diet? The downside to following a ketogenic diet is that it may actually reduce your exercise performance (across anaerobic, aerobic, and strength related exercises) in the short-term. If you’re doing low intensity exercises such as walking or a leisure bike ride however, you shouldn’t notice a difference. More research is needed to understand how a ketogenic diet affects exercise performance, especially in the long-term. I’ve been having episodes of low blood sugar after bariatric surgery. Can I follow the ketogenic diet? If you’ve been experiencing low blood sugar after surgery, it’s not recommended to start a ketogenic diet. It’s important to understand why you are experiencing low blood sugar as soon as possible. Here are some of the most common reasons for low blood sugar after bariatric surgery: Dumping syndrome due to high sugar intake Going long periods of time without eating Not eating enough carbohydrates or not spacing your carbohydrates out during the day Excess exercise An overactive pancreas Diabetic medication that is not adjusted properly Speak with your dietitian to figure out why your blood sugar keeps dropping. I plan to try the ketogenic diet for a few weeks and then come off of it. If that’s the case, then don’t bother. The reason this diet works for weight loss is because you are in ketosis (which in itself takes a couple of days to achieve because you need to use up your glycogen stores). If you come out of ketosis, you will no longer see the effects, and thus begins the yo-yo dieting effect. Always remember – Temporary changes yield temporary results! I’m already on the ketogenic diet, how can I come off of it safely? If you’ve already started the diet, reintroducing carbohydrates can lead to bloating, unstable blood sugars, and weight regain. To minimize these effects, begin by including whole grain products, rather than refined processed carbohydrates (e.g. white bread, breakfast cereals, pretzels, etc.). Whole grain foods include quinoa, brown or wild rice, oatmeal, bulgur, and barley. Sweet potatoes would also be appropriate. Include 1 to 2 tablespoons at only one meal per day for up to one week. If you’re feeling okay, begin including one fruit at one snack for a few days, and then try reintroducing yogurt and milk. But aren’t there doctors and health gurus out there promoting the ketogenic diet? Yes, there are, but there also were doctors and health gurus promoting the Atkins diet, the Pritikin diet, and the Dukan diet back in the day. There will always be people out there trying to capitalize on the newest fad diet to sell you on the weight loss dream and to take your money. It’s easy to point fingers and put the blame on specific foods or food groups, but ultimately the only way of eating that has been proven effective time and time again, is moderation. As dietitians, we know very well that ‘moderation’ (which means something different for each of our clients) isn’t sexy, but it’s key to having a healthy long-term relationship with food. I’m pregnant and I want to follow a ketogenic diet. Following a ketogenic diet during pregnancy is not recommended. While your body can handle being in ketosis, the production of ketones is harmful to your baby’s development, particularly their brain development. SUMMARY… – A ketogenic diet is very low carbohydrate, very high fat, low-moderate protein diet. – A ketogenic diet should emphasize healthy fats, but many sources online emphasize online unhealthy fats (e.g. bacon, sausage, lard, cream, etc.). – A ketogenic diet is very low in carbohydrates. This means that it’s not only grain products that are limited (e.g. pasta, rice, bread, etc.), but also fruit, many vegetables, some dairy products, legumes, and sweets. – By default, a ketogenic diet is also low in fibre which results in constipation in many patients. – A ketogenic diet is considered low-moderate in protein. Most bariatric patients aren’t able to meet their protein needs on ketogenic diet which results in muscle loss. – We don’t know the effects of a very high fat diet on health long-term, but it likely isn’t good for heart health. – Many of the benefits of a ketogenic diet (e.g. weight loss, improved blood sugars, lower triglycerides, lower LDL cholesterol, increased HDL cholesterol, etc.), are similarly seen in low-fat diets (while being way less restrictive overall). – There are many unpleasant side effects to following a ketogenic diet including constipation, poorer exercise performance (at least short-term, no research on long-term performance), muscle loss, bad breath, and micronutrient deficiencies. – You likely need to take additional vitamin and mineral supplements while following a ketogenic diet. Regular blood tests are still very important. – A ketogenic diet is not recommended in a variety of health conditions, and is even considered dangerous for some (e.g. patients with chronic kidney disease and pregnant women). Always check with your family doctor and dietitian before making drastic changes to your diet. – The ketogenic diet has not been studied in people who have had bariatric surgery, so the short-term and long-term effects are unknown. – The ketogenic diet is very restrictive and is therefore not sustainable for the majority of people. Eating out and socializing around food become almost impossible. Our final thoughts… Many patients are quick to blame carbohydrates for weight regain. Instead of jumping to a ketogenic diet, we recommend reviewing the bariatric basics and booking an appointment with your bariatric dietitian. If you absolutely insist on trying a ketogenic diet, we suggest a “modified keto diet” that consists of more plant-based protein and healthy fats, with enough protein to be sure you’re maintaining your muscle mass. What are your thoughts on the ketogenic diet? Have you been tempted? Are you currently following a ketogenic diet? – Lisa & Monica, your bariatric dietitians P.S. For more tips on healthy living after bariatric surgery, follow us on Facebook (@bariatricsurgerynutrition) or check out our highly praised book HERE!