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Thanks guys, and I'm glad you posted Tiffkins. I knew you had a revision also, but couldn't remember the details. So, Tiffkins question for you as you seem so knowledgeable about the different surgeries. I'm really leaning towards the Sleeve, but I feel I really need to understand the other options out there but scooping information up from this website and that website and on and on is getting overwhelming and still not really giving me a really good way to understand what my best option would be. I understand speaking with a Bariatric surgeon is a good start, and I will do that as soon as I finish a couple of their hurdles- but a concern I have is that that surgeon typically will specialize in certain procedures which is fine- but then I'm still not going to have all the facts on all the different WL procedures. I'm considering calling my PCP tomorrow and see if he might be any help with helping me digest the information- but as a GP, I'm not sure that's going to yield me the results I want either. I just don't want to hop on the latest fad because its popular right now and then regret it later. Keep the comments coming.

Let me tell you about protein shots! Lol Bariatric Choice has them for 3.79 and it's 42g of protein per shot. I just ordered 4... I'd rather drink a shot than to sip on Isopure all day.... It doesn't taste so good and I bought a whole case of them. Ask me where it is lol

I also waffled back and forth about having the lap band surgery. In fact, this is the 2nd time I am going through the bariatric program in Binghamton, NY because I was "convinced" by what others said to me about the band failures (people gaining all their weight back). I am still consider myself a newbie and only at the beginning of my journey. But as I read this forum and some others, I see that the success totally depends on you being able to follow your program. This time through the program, I am more than convinced that this is the tool I need to drop 120 lbs I have been desparately trying to lose in the last 20 years. Another thing I've discovered is that the lap band (or any other surgery option) is not the answer by itself -- you have to be willing to work with it to accomplish your goal. You sound like the kind of person that is committed and knows what is good for your body. Keep searching for information and whatever your decision, make it your own and do it because you know you can stay with it. Good Luck!!!! Phyllis326

I can't believe I'm even writing this. I had heard great things about Dr. Arif Ahmad and Long Island Laparoscopic but after my various interactions with the office, medical staff and the group meeting, I'm seriously considering looking elsewhere. My initial consultation went wonderfully, I felt comfortable and excited for the next step. Then...the other shoe dropped. I scheduled my first battery of tests (blood work, pulmonary, ultrasound, nutrition and psych evaluation) and off the bat something was wrong. I'd speak to one receptionist/scheduler who would tell me my insurance won't allow me to do everything on the same day so she schedules the tests on various days - then I got a call from someone else who asked why I did it this way and when I said someone in the office had told me to do it that way she said "oh, don't listen to her...she doesn't know anything". I scheduled everything for 10:45am (I had planned other things later in the day), I got a call 3 days prior and was asked to come in at 12:15pm as they had a scheduling issue (I rescheduled the rest of my day). I then show up at 12:15pm and was told everyone had been waiting on me! They rush me into the room for blood work, then into another room for the ultrasound then a 3rd room for a pulmonary test. I'm then told due to a scheduling error (again) I have an hour and a half until my next appointment. The nutritionist, bless her, was a fresh faced college grad who clearly had never struggled with food or weight and spent 20 minutes telling me about sugar free Jell-O. I was then rushed into a meeting with the psychologist (who is not a psychologist but a licensed master social worker - not the same). She spent, at max, 30 minutes with me (10 of which were telling me it's her birthday and then she was fielding calls from her mother) asking if I've ever been suicidal, what diets have I tried and have I decided who is going to drive me home from surgery. I was disheartened and confused -- I have friends who had the surgery with other doctors and who had wonderful pre surgical experiences, that's what I was hoping for. But, I thought "hey, you've already spent the $250 program fee and you have the group meeting tomorrow...it could turn around!". I just left the "support group" and I'm completely disappointed. The "meeting" started with a 30 minute sales pitch from a Bariatric Advantage salesman. We were then "discussed" surgery...by discussed I mean we sat around in a circle, introduced ourselves and talked about how we can't drink after surgery. WHAT? I didn't come here for AA, I came to ask questions and be informed. The "group meeting" was again run by stick thin dietitians, not people who have gone through surgery and could give first hand experiences. Bottom line...I don't feel comfortable. I don't think this is a competent group of people and I don't want to put my life and future into the hands of a bunch of halfwits. I run a business and had been conducting my meetings/schedules (I perform wedding ceremonies) based on the idea that I'd be having surgery in the middle of July, now I have no idea if that's possible and I could have potentially lost hundreds of dollars from clients. Has anyone switched surgeons? Is anyone familiar with Dr. Arif Ahmad? I'm thinking of using Dr. Brathwaite at Winthrop - any tips?

I know that there are a lot of posts about surgeons in Mexico, and even about Dr. Aceves, however I'm hoping to get in contact with anyone who had their surgery with Dr. Aceves of Mexicali Bariatric within the past year, and to ask what your thoughts are about the experience. I was banded back in 2009 and am going for a band to sleeve revision. I have done lots of research and believe that Dr. Aceves is the way to go for surgery in Mexico. I'm about to go ahead and book my surgery and flights, etc. But, I would LOVE to hear from anyone who has gone down their more recently to see if the standards are still the same, how they felt, etc. Also, if there is anyone who had the band-to-sleeve revision with Dr. A, would particularly love to hear from you! Very excited and nervous, but mostly excited! :-)

Hello... I thought I would post this must read article by the surgeon who invented the "Green Zone" and how the band should "ideally work".... http://bariatrictime...1/#comment-2133 Gastric Banding and the Fine Art of Eating BT Online Editor | September 22, 2011 by Paul O’Brien, MD Dr. O’Brien is from the Centre for Obesity Research and Education (CORE), Monash University, Melbourne, Australia. Bariatric Times. 2011;8(9):18–21 Funding: No funding was received for the preparation of this article. Financial Disclosure: Dr. Paul O’Brien is the Emeritus Director of the Centre for Obesity Research and Education (CORE) at Monash University, which receives a grant from Allergan for research support. The grant is not tied to any specified research projects and Allergan has no control of the protocol, analysis and reporting of any studies. CORE also receives a grant from Applied Medical toward educational programs. Dr. O’Brien has written a patient information book entitled The Lap-Band Solution: A Partnership for Weight Loss, which is given to patients without charge, but some are sold to surgeons and others for which he receives a royalty. Dr. O’Brien is employed as the National Medical Director for the American Institute of Gastric Banding, a multicenter facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding. Abstract The author reviews the physiology of eating and what the adjustable gastric band does to the function of the distal esophagus and upper stomach of the patient. The author also provides the “Eight Golden Rules” on proper eating habits for patients of laparoscopic adjustable gastric banding, including what, when, and how they should eat, in order to achieve optimal weight loss results. Introduction Laparoscopic adjustable gastric banding (LAGB) has been shown to enable patients with obesity to achieve substantial, durable, and safe weight loss,[1,2] which can help reduce or resolve multiple diseases,[3] improve quality of life, and prolong survival in patients with obesity.[4] LAGB is a weight loss surgical procedure performed solely for the purpose of affecting a key physiological function in weight loss, appetite control. In 2005, we conducted a randomized, blinded, crossover trial that showed that the LAGB controls the appetite.[5] However, if the LAGB is not placed properly or if the patient does not eat properly, it will not perform at an optimal level. For example, if the band is placed too loosely, then it will not provide the proper level of reduced satiety and appetite, and likely will have little effect on the patient’s weight and health. If the band is placed too tightly or if patient eats too fast or takes large bites of food, slips and enlargements can occur, leading to reflux, heartburn, vomiting, and sometimes the need for revision. Optimally, the band should be adjusted so that it squeezes the stomach at just the right pressure. If the patient eats correctly and the band is placed correctly, the LAGB should adequately control the patient’s appetite, resulting in optimal weight loss. The Physiology of LAGB Dr. Paul Burton, a bariatric surgeon at the Centre for Obesity Research and Education, Melbourne Australia, has studied the physiology and the pathophysiology of the LAGB closely. He used high-resolution video manometry, isotope transit studies, endoscopy, and contrast imaging to understand what happens during eating in normal controls, eating in patients who are doing well after LAGB, and eating in patients who have symptoms of reflux, heartburn, and/or vomiting after LAGB.[7–15] In Burton’s series of articles, he concluded that in LAGB, it is not the band that fails, but rather the patients who receive the band and, more importantly, the doctors who care for them. Many years ago at the Centre for Obesity Research and Education (CORE), my colleagues and I developed the Green Zone chart, a conceptual way of identifying the optimal level of band restriction (Figure 1). When a patient is in the yellow zone, it is an indication that the band is too loose. When in the yellow zone, a patient may be eating too easily, feeling hungry, and not losing weight. When a patient is in the green zone, he or she does not feel hungry, is satisfied with small amounts of food, and is achieving weight loss or maintaining a satisfactory level of reduced weight. When a patient is in the the red zone, it is an indication that the band is too tight. The patient experiences reflux, heartburn, and vomiting. The range of food the patient in the red zone can eat after undergoing LAGB is limited and he or she may start to eat abnormally (so-called maladaptive eating), favoring softer, smoother foods like ice cream and chocolate. While in the red zone, patients will not lose weight as effectively and they may even gain weight. Burton measured the pressure within the upper stomach beneath the band in numerous patients when they were in the green zone. He found the optimal pressure was typically 25 to 30mmHg. The art of adjustment is to find the level of Fluid in the band that achieves that pressure range. That level of pressure generates a background sense of satiety that persists throughout the day. The patient, when correctly adjusted, normally will not feel hungry upon waking in the morning, and throughout the day should feel much less hungry than he or she did before band placement. In my experience, it is common for LAGB patients to have no feeling of hunger in the morning. Then, during the day, a modest level of hunger will develop, which a small meal should satisfy. One of the key lessons learned from Burton’s studies was that each bite of food should pass across the band completely before another bite is swallowed. There is no pouch or small stomach above the band and there should never be food sitting there waiting. The esophagus is a powerful muscular organ that typically generates pressures of 100 to 150mmHg, but it is capable of generating pressures above 200mmHg. Esophageal peristalsis squeezes the bite of food down toward the band and then progressively squeezes that bite across the band. Each bite must be squeezed across the band before the next bite starts to arrive. Figure 2 shows a bite in transit across the band. A single bite of food, chewed well until it is mush, will move down the esophagus by peristalsis. At the level of the band, the esophageal peristalsis will squeeze that bolus of food across the band. It takes multiple squeezes (usually 2–6 squeezes or peristaltic waves) to get that bite of food across in a patient with a well-adjusted band (Figure 2). Those squeezes generate a feeling of not being hungry and stimulate a message that passes to the hypothalamus to indicate that no more food is needed. If a single bite of food is able to generate between two and six waves of signal, a meal of 20 bites may generate 100 or more signals. This is enough to satisfy a person and is enough to signal him or her to stop eating. We recognize two terms for appetite control, satiety and satiation. Satiety refers to the background control of hunger that is present throughout the day regardless of eating. In the LAGB patient, satiety is generated by the band exerting a constant compression on the cardia. Satiation is the early control of hunger that comes with eating. In the LAGB patient, satiation is generated by the squeezing of the bolus of food across the band during a meal. Each squeeze adds to the satiation signal. There are sensors in the cardia of the stomach that detect this squeezing. The exact nature of these sensors is still to be confirmed but they must be either hormonal or neural. We know that satiety and satiation are not mediated by one of the hormones currently known to arise from the upper stomach.[16] Ghrelin is a hormone that stimulates appetite. A number of hormones that can be derived from the cardia of the stomach are known to reduce appetite. None of these hormones are found to be raised in the basal state after gastric banding and none can be shown to rise significantly after each meal.[16] Vagal afferents are plentiful in the cardia, and one group of afferents has a particular structure that lends itself to recognizing the compression of the gastric wall associated with squeezing of the bite of food across the band. In my opinion, the intraganglionic laminar endings, better known as IGLEs, are the most likely candidate as mediator of the background of satiety throughout the day and the early satiation after a meal. The IGLEs lie attached to the sheath of the myenteric ganglia and are known to detect tension within the wall of the stomach. They are low-threshold and slowly adapting sensors and therefore are optimal for detecting continued compression of cardia of the stomach over a 24-hour period. The several squeezes that go with the transit of each bite stimulate the IGLEs further. The signal passes to the arcuate nucleus of the hypothalamus and the drive to eat is reduced. The lower esophageal contractile segment. Burton developed the concept of the lower esophageal contractile segment (LECS). It is made up of four parts: the esophagus, the lower esophageal sphincter, the proximal stomach (including the 1cm or so above the band and the 2cm of stomach behind the band), and the band itself (Figure 3). As the esophagus squeezes the bolus of food down toward the band, the lower esophageal sphincter relaxes as this peristaltic wave approaches. It then generates an after-contraction, which can maintain some of the pressure of the peristaltic wave as a part of the food bolus is squeezed into that small segment of upper stomach. The upper stomach, including the area under the band, is sensitive to these pressures. It generates signals to the hypothalamus. These signals may be hormonal but are more likely to be neural. A correctly adjusted band will generate a basal intraluminal pressure of 25 to 30mmHg, providing a resistance to flow. The segment of the bolus that is squeezed through generates more signals from that area. Keeping the LECS intact is a key requirement for success with the gastric band. Bad eating habits (e.g., insufficient chewing, eating too quickly, taking bites that are too large) hurt the LECS. If those bad habits go on for long enough, stretching occurs and the power of peristalsis is lost, leading to the return of hunger (Figure 4).[11,12] The Fine Art of Eating A quality aftercare program is essential to successful weight loss in patients after LAGB. Before making the decision to proceed with LAGB in patients, I promise my patients three things: 1) to place the band in the optimal position safely and securely, 2) that they will have permanent access to a skilled aftercare program, and 3) that I will give them the information they need to obtain the best possible weight loss from the band. In return, I ask for three commitments from my patients: 1) that they follow the rules regarding eating after undergoing the procedure, 2) that they follow the rules regarding exercise and activity, and 3) that they always come back for follow up no matter how many years have passed.[6] The “Eight Golden Rules.” At my facility, we summarized guidelines for eating after LAGB into what we call the “Eight Golden Rules” (Table 1). These rules are included in a book and DVD given to every patient who undergoes LAGB at the facility.[6] The rules are also posted on www.lapbandaustralia.com.au and are reinforced at most aftercare visits. These eight golden rules must become part of each patient’s life. The effect of the LAGB procedure on hunger facilitates a patient’s adherence to the rules, making it more likely that he or she will follow them. However, achieving positive results with LAGB requires a working partnership between the physician and patient. Adhering to these rules is the patient’s part of the partnership, and he or she ultimately is responsible for the success or failure of weight loss following LAGB. What to eat. After undergoing LAGB, patients should eat small amounts of “good food,” meaning food that is Protein rich, of high quality, and in solid form. Each meal should consist of 125mL or 125g (i.e., about half of a cup of food). This measure of “half a cup” is a concept rather than a real measure of food, as some foods, such as vegetables and fruit, are composed largely of Water and this has to be allowed for in some way. Thus, I allow exceeding the “half a cup” limit a little for vegetables and fruit. We instruct patients to put each meal on a small plate and to use a small fork or spoon. The patient should not expect to finish all of the food on the plate, but rather he or she should plan to stop when he or she is no longer hungry. Any food left on the plate should be discarded. Protein-rich foods. Protein is the most important macronutrient in the food a LAGB patient eats. At our clinic, we recommend that our patients consume approximately 50g of protein per day. We have measured protein intake of our patients (Table 2) and have monitored their blood levels. We have not seen any protein malnutrition after LAGB, indicating that a daily intake of about 50g a day is sufficient. Table 2 shows the energy and macronutrient intake of 129 consecutive patients measured before and at one year after LAGB. Note the mean energy intake is reduced by approximately 1500kcals.[17] The best source of protein is meat; however, red meats, such as beef and lamb, tend to be difficult to break up with chewing in order to be sufficiently turned into mush. It is much easier to break up fish with chewing, and many fish are high in protein, including shellfish. chicken, duck, quail, and other birds can also be cooked to be easily chewed to mush before being swallowed. eggs and dairy, including cheese and yogurt, are also excellent protein sources. For nonanimal sources of protein, a patient should consider lentils, chickpeas, and Beans. Half of the “half a cup” allotment per meal should comprise protein-rich food. The other half should be made up of vegetables and/or fruits. I recommend to my patients that they eat more vegetables than fruit because vegetables have less sugar. Any space left in the “half a cup” can be used for the starches, (e.g., bread, Pasta, rice, cereals, potatoes), though I recommend to my patients that they eat a minimal amount from this group of foods as they tend to provide no important nutritional benefit. High-quality foods. High-quality food are foods that are minimally processed, natural, and whole. We encourage our patients to look for quality over quantity—for example, they might try sashimi-grade tuna, smoked salmon, duck breast, lobster, or even a simple poached egg. It is also important to remind your patients that there is no limit to the amount of herbs and spices that can be used to enhance the flavors of their foods. Solid foods. The patient should choose solid foods over liquids whenever possible. Liquids pass too quickly across the palate and, more importantly, too quickly across the band. There is no need for the esophagus to squeeze liquid, and without the squeeze, there is no stimulation of the IGLEs and no induction of satiety; therefore, eating calorie-containing liquids may negatively impact a patient’s weight loss. When to eat. After undergoing LAGB, a patient should eat three or less times per day. If the patient is in the green zone, meaning that the band is adjusted correctly, there should be no need for him or her to eat between meals. In fact, even three meals a day may be more than needed for satiety. In my experience, patients have little interest in eating in the morning. By late morning or early afternoon, patients may start to notice some hunger, which indicates that it is time to have a first small meal. In the evening, patients may have another meal. Most importantly, patients should be instructed that a meal missed is not to be replaced later on. The typical human body is satisfied with a maximum of three meals per day but often is happy to accept two or even one meal per day. Patients should be reminded that there should be no snacking between meals. If a patient finds that he or she is hungry by late afternoon, encourage him or her to eat something small and of high quality, such as a piece of fruit or some vegetables, just to tide him or her over until the evening meal. The patient should then visit the clinic to check whether or not he or she is in the Green Zone. It is important that the patient adhere to the aftercare program to monitor whether or not he or she is in the green zone. If not in the green zone, the patient will need to have fluid in the band increased or decreased. How to eat. Take a small bite and chew well. The “half a cup” of food should be placed on a small plate. The patient should use a small fork or a small spoon to eat. A single bite of food should be chewed carefully for 20 seconds. This provides the opportunity to reduce that bite of food to mush. It also provides the important opportunity for the patient to actually enjoy the taste, the texture, and the flavor of the food. Encourage your patients to enjoy eating more than they ever have. After chewing the food until it is mush, the patient should swallow that bite. Swallow, then wait a minute. The patient must wait for that bite to go completely across the band before swallowing another bite. Normally, it will take between two and six peristaltic waves passing down the esophagus, which can take up to one minute. This is probably the biggest challenge of educating the patient who has undergone LAGB. You must instruct the patient to eat slowly—chew well, swallow, and then wait one minute. A meal should not go on for more than 20 minutes. At one bite per minute, that is just 20 small bites. The patient probably will not finish the “half a cup” of food in this time. In this case, the patient should throw away the rest of the food. After undergoing LAGB, the patient should always expect to throw away food and to never eat everything on the plate. If it takes between two and six squeezes to get a single bite of food across the band and each squeeze generates satiety signals, then 20 bites should be generating 40 to 120 signals. The actual number will depend on the consistency of the food, the tightness of the band, and the power of the esophagus. With good eating practices and optimal band adjustments, the patient should not be hungry after 20 bites or less. As soon as the patient is no longer hungry, he or she should stop eating. After undergoing LAGB, the patient should never expect to feel full. Feeling full means stasis of food above the band and distension of that important part of the LECS above the band. This destroys the LECS, the mechanism that enables optimal eating behavior and appetite control. A patient should always keep this process in mind. If the patient finds that after eating the “half a cup” of food he or she is still hungry, he or she should review his or her eating practices, correct the errors, and consider the need for further adjustment of the band. If this is occurring, it is usually an indication that the patient is not in the green zone. Eat a small amount of good food slowly. These eight words are the key to success. Small amount refers to small bites, the small fork (e.g., oyster fork), and a total meal size of half a cup. Good food refers to protein-rich, high-quality, and solid food. Slowly refers to chewing well, swallowing, and waiting a minute. Try to repeat these eight words to every patient every time you see them. Get them to repeat it at every meal. The failure of the gastric band can almost always be traced to failure of this process. Addressing the Challenges The two principal challenges after LAGB are weight loss failure and the need for revisional surgery due to proximal enlargements above the band. Weight loss failure will occur if the band is not placed or adjusted correctly or if the patient does not adhere to the guidelines of proper eating and exercise. When a patient is not achieving results after his or her LAGB operation, the doctor should check to ensure that the band is correctly and safely placed. The most common reason for weight loss failure is poor eating behavior, which leads to enlargement above the band. There are three common eating errors: 1. The patient is not chewing the food adequately. Food must be reduced to mush before swallowing. If it cannot be reduced to mush, it is better for the patient to spit it out (discreetly) than to swallow it. 2. The patient is eating too quickly. Each bite of food should be completely squeezed across the band before the second bite arrives. 3. The patient is taking bites that are too big to pass through the band. Each of these errors leads to a build up of food above the band where there is no existing space to accommodate it (Figure 4). Space is then created by enlargement of the small section of stomach or by enlargement of the distal esophagus, both of which can compromise the elegant structure of the LECS. If the LECS is stretched, it cannot squeeze. Without the squeezing, satiation is not induced. When satiation is not induced, hunger persists, more eating occurs, and stretching continues. If our patient continues this each day for a year, it is inevitable that chronic enlargement will occur, the physiological basis for satiety and satiation is harmed, and stasis, reflux, heartburn, and vomiting supervene. The doctor should continually review the Eight Golden Rules for proper eating and exercise with each patient. For optimal weight loss following LAGB, the patient should have access to a comprehensive long-term aftercare program for clinical support and optimal band adjustments and he or she must follow the guidelines regarding eating and exercising for the rest of his or her life. “Eat a small amount of good food slowly” is the key to optimizing the gastric band.

Congrats! I'm on puree/soft foods right now and refried beans are my go to. I add a little bit of cheese and sour cream and it's basically a feast. I also am obsessed with broccoli cheddar soup right now. It doesn't have a ton of protein, but kept me from going crazy after liquids for so long. I also made buffalo chicken dip (shredded chicken, cream cheese, hot sauce—I left out the cheddar cheese) and it was really good—made me feel like I was eating real food, even if I couldn't eat it as a dip with chips. I'm also planning on making crab cakes, which is hilarious because I don't like crab cakes, but I'm craving them now. I got the recipe from one of Sarah Kent's bariatric cookbooks. If you want more ideas, her cookbooks have a lot of recipes for all stages.

Many (but certainly not all) bariatric patients experience improvement of autoimmune diseases after surgery. What a wonderful side effect!

Hi sunyinflorida, i liked your post and then i thought about it how to answer without offended you or anyone else that works in insurance... that is exactly my point you were or are a bariatric patient "i am fat" so you "i had empathy" with those claims that came through.. We all should have the privilege tp have someone like you to review our case especially when we have everything that we are suppose to submitted. like i said we all pay for our insurance and its not a pretty penny especially if its ppo and i do understand knowing and reading your policy and knowing whats in it. i can tell you for sure there are many people who has not registered onto their insurance website. i did and i actually spoke to a doctors office of mine that submitted a claim for a visit that i had cancelled instead of calling my insurance first i called the doc and asked if i was charged even though i cancelled and they said no and i said well someone did and that i didn't want to get anyone in trouble but they better fix it asap because it shows that they put the claim in. i guess they were shocked office manager called me and said they were going to reverse or whatever cause i did not have that appointment. So , i say this to say we need more people on our side WLS . i mean really can a dentist reviewer tell me if i need this or not if it is covered in my policy .. can a skinny person if they are not mad at the world for something else approve even if its in the policy. i do feel like someone above said we have to deal with mood swings skinny people and just woke up on the wrong side of the bed even if our insurance covers it. IM JUST SAYING..

OK I know I am not dating...but I can tell you this. Both my husband and I are banded as you know... When we are out to eat or we are at an event, I can almost feel us "judging" each other and our choices of and amounts of food. Now my band is fickle, but so is my stomach and was even before I was banded. Eating out has never been an easy thing for me to navigate. There are certain things I know that I can manage and then there are somethings that might have made me sick before and don't now and vs/verse. I know my hubs looks at going out and not finishing the food as wasteful, so I watch him eat to capacity and I can see it in his face when he is full but there is always that drive to finish the food. There is also this idea that we can't share the food...or purchase one entree to share....but that would be less wasteful and less expensive. We have been banded nearly 2 years now and we still don't get this. When I am out at an event, my go to was always NOT to eat just in case I would get sick, and then after to go home and indulge. This little mind tickler is still there. I have to have a conversation with myself when I am out at an event that it is OK to actually eat what I want, and not have to worry about it because I rarely get sick these days. Sometimes I will run across a food that does not agree with me, but it's very rare and since I am not eating much of it, I never have to make a run for it. I also need to self talk about not going home after and feeling the need to indulge in more food since I didn't deprive myself. I know it's a little more self conscious of a feeling when you don't know the person you are with all that well. Your judging yourself, and wondering if they are judging you...but you know what I think it's important to just enjoy the moment. To be honest with yourself and the person you are with. If your not hungry you don't eat. You eat healthy and cautiously, and you enjoy the food that you choose to eat. I would be weary of not talking about it, lest people think you have an eating disorder. Of course you don't have to tell anyone it's a bariatric surgery at all ever if you choose not to. It's just your way of eating mindfully, for your health and well being end of story Then enjoy the wine and the company and the music or what ever you are doing. Sometimes I feel like I am so fixated on food...even more then I was before bariatric surgery.

Dr. Philip Schauer. Cleveland Clinic https://my.clevelandclinic.org/departments/bariatric Revison Lap Band to RNY 9/6/18.

This doctor has been brought up many many times before. Search him name and you'll find lots of posts. In short, he has an agenda to disparage the lapband so that patients will get the mini gastric bypass from him. It should be noted that this is a procedure that is not well-regarded amongst bariatric surgeons. In fact, I think you'll even find a post from a surgeon somewhere around here that talks about that fact. Anyone that advertises on youtube and has such an incredibly awful website should give you a pretty good indication of what he's all about. Oh, BTW, the 'studies' that he references are not at all comprehensive and are extremely limited in their scope.

Most Doctors do not put obesity/bariatric surgery as a reason on the sick note. Most put abdominal or gastric surgery. Just ask your hsopital doctor or GP and they will do this for you.

It is best to do your homework on all surgeons before making a decision of this magnitude and I would not pick a surgeon solely based on price no matter where that surgeon is located as it is possible for a surgeon in this country to make mistakes as well. I would talk to as many people possible and check into their background, and find out just how many of these procedures he/she has performed. I myself went with a surgeon who has performed over 3,000 bariatric procedures. Many of the surgeons in Mexico do offer financing options and many of them advertise on this site. Keep in mind however, Mexico surgeons rely on the fact that their patients will either recommend or not recommend to others their services and it seems to me strive harder to offer outstanding service to their patients for the word of mouth recommendation as most of their patience are from the US. Good luck to you in making your selection.

Hi I have Blue Precision HMO I chose this because this was only plan i could some what afford with my part time income. And it said they covered bariatric surgery. Then the insurance person at the place I will be getting the surgery done called me on Friday and told me there is an exclusion and it not covered.... I know it is a HMO i know I need to go through my PCP first but why is it saying it's not covered when i went through the exclusion packet part and it does not say anything about it. And right before I bought the insurance the reps said it is covered on my insurance, this was only reason I bought the insurance and paying a whole paycheck for it... idk any info or insight would be nice. I have 8 days to opp out of this insurance if i don't like it so kinda running on time.

Hi, My name is Becky and I am from San Antonio, Texas. I am married and have 3 kids (15 yr. old daughter and 7 and 4 yr. old sons). I have 3 weimaraners and 3 cats so we have a full house! I just had surgery on Wed. June 25th at Foundation Bariatric Hosp. through Weight Wise. Dr. J.J. Gonzales did the surgery. I am doing good...just sore and REALLY tired of chicken broth. Looking forward to losing weight though.

I had surgery 12-20-11. I have tried fish, and ground beef with no problems at all. I tried steak this past week. It did not go so well. I have tried most veggies just no lettuce yet. For fruit I have tried strawberries, bananas, apples, blueberries, raspberries, plums, mangos. I only had one piece of fresh fruit of each of these and they went ok. I eat the Adkins bars a lot and the Quest bars. I start each day with my Bariatric Advantage Protein shake and try to get in one Isopure drink a day as well. I also use the Kellogg's protein Water mix in all the water I drink. Oh, I use the bariatric pantry Soups. Love the tomato Soup from there also I use the protein tea from there.

If your pain meds are making you ill, then call your bariatric team and get a RX for a different one. One pain pill does not fit all. Recovery is so much faster and "easier" if you aren't fighting the pain. Work with it. Feel better and don't forget to call. Prayers going up...

What was your start weight? I currently weigh about 162 and i sure as heck don't feel like a failure... guess it is all relative. I lose weight best when I limit carbs, exercise regularly, drink lots of Water and basically follow the bariatric rules.

Is your insurance company paying to have the band removed? My surgeon refuses to talk to me about removal of my band even tho I am vomiting for 3-5 days STRAIGHT (no food and unable to take meds) EVERY MONTH. He tells me the band is fine... move on to another idea (like see G.I. doctor which I have done with no solution or even a diagnosis). He also tells me that "the board" wanted to fire me as a patient... basically refuse to treat me or even discuss what might be happening to my body with me. While in the E.R. this same surgeon yelled at me, and my mother, telling me that if I don't get myself under control nobody is going to help me. At this point I've lost my job, had to cash out my 401k with major penalties, and I still don't have a proper diagnosis and none of my doctors have a plan for controlling the monthly vomiting episodes. This bariatric surgeon, after telling me to "move on", then said, "do you want me to talk to your insurance company about taking it out based on your personal preference?" I'm having to apply for disability because a person who is vomiting/retching so hard, to the point of losing bladder function, is not employable. I'm not saying the band is causing this cyclic vomiting/abdominal migraine but I find it really hard to believe that after a year of this my surgeon will not discuss removal of my Lap-Band. It is as if it belongs to him, not me.

Hair loss usually happens a few weeks to months after surgery because of the 2 different phases that your hair can be in at any given time. Each phase lasts a certain amount of time and depending on how much hair was in a certain phase DURING surgery determines how much you will lose. Biotin will help with regrowth, but it won't prevent hair loss. This explains it well: https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/# Sent from my SAMSUNG-SM-G930A using BariatricPal mobile app

<TABLE cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=top> <TABLE cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=top> <TABLE class=tborder id=post808534 cellSpacing=0 cellPadding=6 width="100%" align=center border=0><TBODY><TR vAlign=top><TD class=alt1 id=td_post_808534 style="BORDER-RIGHT: #d9d9d9 1px solid">Believe it or not I rushed into this <HR style="COLOR: #d9d9d9; BACKGROUND-COLOR: #d9d9d9" SIZE=1>It's taken me almost a year and a half of work but it's over at least. This...meaning insurance approval with Cigna. I was Denied because I was shy a 40 BMI by 10 -12 pounds when I submitted everything they were looking for I jumped thru every hoop and paid out every last cent to docs. etc. but I should have know (and not listen to people on this site that said Cigna does cover with no co mobidities - NOT TRUE) they clearly state that they do not cover those under a 40 BMI unless you have grave illness that don't respond to meds.. Not only that but they will not approve any claim even related to this one in the future. Meaning if I gain 10 pounds in the next year.even if I maintain that for a year and..easy to do at my age...they won't even consider it. My fear is of dying of a heart attack like my twin sister did of obesity last year. My chest is so huge it strangles me at night and causes sleep apnea that doesn't appear on the "test" ...another few hundred bucks there. My warning to those seeking insurance approval with CIGNA....if you're not starting out with a 40 BMI save your money until you are or get a loan unless you can clearly prove a comobidity. __________________ financing </TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE><TABLE class=tcat style="MARGIN-TOP: 3px" cellSpacing=0 cellPadding=0 width="100%" align=center border=0><TBODY><TR><TD vAlign=center width=7></TD><TD class=tcat vAlign=center width="100%">food and Nutrition</OPTION> <OPTION class=fjdpth2 value=82> Cooking, Baking and Recipes</OPTION> <OPTION class=fjdpth1 value=81> Fitness & Exercise</OPTION> <OPTION class=fjdpth1 value=11> Doctors and Hospitals</OPTION> <OPTION class=fjdpth1 value=20> Fill Doctors</OPTION> <OPTION class=fjsel value=8 selected> Insurance & Financing</OPTION> <OPTION class=fjdpth1 value=12> Cosmetic and Reconstructive Surgery</OPTION> <OPTION class=fjdpth0 value=122>Lap Band Support Groups</OPTION> <OPTION class=fjdpth1 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You'll have to contact your insurance company to answer your specific plan coverage. They vary widely. Otherwise, all the advice above is correct. Most bariatric programs will have a qualified dietician to help you with your supervised weight loss plan. Good luck!!

It's amazing how a good office staff can make or break a practice. When I first started exploring getting my lap band out, I went to the closest bariatric office, three hours away, I liked the surgeon and his PA, but the office staff was a DISASTER. You could never get hold of anyone on the phone, and they gave me a lot of incorrect info about Medicare benefits. So I started seeing the next closest surgeon, 5 hours away. The difference was like night and day! The office always answers your questions, and if they can't, they get you an answer the same day. There are a lot of good surgeons out there, so if the office staff is bad "shop around" if there are other options where you live.

I agree with most of you alls points & I think sadly a lot of people get on here & look for answers instead of contacting their doctor. There are credible sources that say the body does what they termed "hibernation mode" about 3 weeks into the post surgical phase. It's around this time your body is like what happened? And it needs to convert some stores to readily available energy. I think many forget we didn't wake up obese one day so we aren't going to wake up thin. That surgery is just a tool, that diet, exercise & other lifestyle changes must accompany it. And the biggest is moving everyday & owning what we put into our bodies. How can your nutritionist help you if you can't actually tell them what your eating? Plus it helps keep you honest. And yes every program has its own set of rules. Carbs are ok, carbs are not ok. Protein shakes are a good source of protein but you can only have them for so long... Read the materials your program gave you, in need be reread them & call for clarification. We all went thru major changes & have changed a lot of things to get this surgery. We need to remember most mainstream advice doesn't apply to us anymore, and your Bariatric center is your friend. If you have moved since getting your surgery find one locally & see if they can help you out when questions arise. I just want us to all succeed & not fall back on half truths to make something we have learned is not acceptable with our new life acceptable(like eat more lose more). There are times when we are just not feeding our body enough & it will metabolize muscle & not fat so adjustments need to be made. But again your nutritionist & your doctor will know what that magical calorie number is for you based on you & not someone else. Ok off my soapbox ????