Search the Community

I think the thing that makes me look at vitamins differently is my two pregnancies. I had bad levels my first one and was so constipated (tmi) from iron supplements I started having contractions.. my second pregnancy I took one that was food based and noticed a dramatic difference. The main difference is vitamins and minerals that are manufactured vs made in nature. And the prenatals are cheaper than the bariatric vitamins my Dr recommend. But any vitamin is better than no vitamin. My mom had bypass 5 years ago and hasn't taken anything in a year and is now dealing with iron infusions and b 12 shots :/

I know somebody that had by-pass. He lost almost 200 pounds in a little over a year. 3 Years after that he had gained it all back thanks to Budweiser. The surgery may work for you but need to look at cutting back a little more on the alcohol. It's empty calories. All carbs and sugar. I binge every few weeks or so but not on a regular basis. Another thing to keep in mind is that alcohol causes the loss of inhibitions and if you get a good buzz on you may decide to hit the buffet. I'd definitely discuss it with a bariatric surgeon and nutritionist.

I tend to defer to my NUT, she was with me in the 4 months prior to the surgery and is now my contact after. I also will continue to take classes and go to support groups post-op to continue to be motivated. I am big on doing my own research too, so that is why I come here and other bariatric message boards for more knowledge and experiences. I don't see my surgeon (or his office) again for a year. I am with Kaiser who is big on health education.

The Latest on Nutrition and hair Loss in the Bariatric Patient by Jacqueline Jacques, ND Nutrition and Hair Loss A common fear and complaint of bariatric surgery patients is postoperative hair loss. While for most of us as people, our hair is important as part of our self-image and body image, it is not very important to our bodies. For this reason, nutrition can have a great impact on hair health because when forced to make a choice, the body will shift nutritional stores to vital organs like the brain and heart and away from hair. Hair loss has many causes. The most common type of hair loss after weight loss surgery is a diffuse loss known medically as telogen effluvium, which can have both nutritional and non-nutritional causes. Whether you are aware of it or not, for most of your life you are always in the process of both growing and losing hair. Human hair follicles have two states: anagen, a growth phase, and telogen, a dormant or resting stage. All hairs begin their life in the anagen phase, grow for some period of time, and then shift into the telogen phase,which lasts for approximately 100 to 120 days. Following this, the hair will fall out. Typically, about 90 percent of hairs are anagen and 10 percent are telogen at any give time—meaning that we are usually losing a lot less hair than we are growing, so the hair loss is not noticeable. But sometimes this can change. Specific types of stress can result in a shift of a much greater percentage of hairs into the telogen phase. The stressors known to result in this shift, or telogen effluvium, include the following: high fever, severe infection, major surgery, acute physical trauma, chronic debilitating illness (such as cancer or end-stage liver disease), hormonal disruption (such as pregnancy, childbirth, or discontinuation of estrogen therapy), acute weight loss, crash dieting, anorexia, low Protein intake, Iron or zinc deficiency, heavy metal toxicity, and some medications (such as beta-blockers, anticoagulants, retinoids, and immunizations). Nutritional issues aside, bariatric surgery patients already have two major risks of major surgery and rapid weight loss. These alone are likely to account for much of the hair loss seen after surgery. In the absence of a nutritional issue, hair loss will continue until all hairs that have shifted into telogen phase have fallen out. There is no way of switching them back to the anagen phase. Hair loss will rarely last for more than six months in the absence of a dietary cause. Because hair follicles are not damaged in telogen effluvium, hair should then regrow. For this reason, most doctors can assure their weight loss surgery patients that with time and patience, and keeping up good nutritional intake, their hair will grow back. Discrete nutritional deficiencies are known to cause and contribute to telogen effluvium. One should be more suspicious of a nutritional contribution to post-bariatric surgery hair loss if any of the following occurred: 1. Hair loss continued more than one year after surgery 2. Hair loss started more than six months after surgery 3. Patient has had difficulty eating and/or has not complied with supplementation 4. Patient has demonstrated low values of ferritin, zinc, or protein 5. Patient has had more rapid than expected weight loss 6. Other symptoms of deficiency are present. Iron Iron is the single nutrient most highly correlated with hair loss. The correlation between non-anemic iron deficiency and hair loss was first described in the early 1960s, although little to no follow-up research was conducted until this decade. While new research is conflicted as to the significance of ferritin as a diagnostic tool in hair loss, it has still been found that a significant number of people with telogen effluvium respond to iron therapy. Optimal iron levels for hair health have not been established, although there is some good evidence that a ferritin level below 40mg/L is highly associated with hair loss in women.1 It is worth noting that this is well above the level that is considered to be anemic, so doctors would not be expected to see this as a deficiency. Zinc Zinc deficiency has been tied to hair loss in both animal studies and human cases. There is data linking zinc deficiency in humans to both telogen effluvium and immune-mediated hair loss. Zinc deficiency is a well-recognized problem after biliopancreatic diversion/duodenal switch, and there is some indication that it may occur with other procedures such as gastric bypass and adjustable gastric banding. In 1996, a group of researchers chose to study high-dose zinc supplementation as a therapeutic agent for related hair loss2 in patients who had undergone vertical banded gastroplasty. The study administered 200mg of zinc sulfate (45mg elemental zinc) three times daily to postoperative patients with hair loss. This was in addition to the Multivitamin and iron supplements that patients were already taking. No labs for zinc or other nutrients were conducted. Researchers found that in patients taking the zinc, 100 percent had cessation of hair loss after six months. They then stopped the zinc. In five patients, hair loss resumed after zinc was stopped, and was arrested again with renewed supplementation. It is important to note that in telogen effluvium of non-nutritional origin, hair loss would be expected to stop normally within six months. Since the researchers conducted no laboratory studies and there was no control group, the only patients of interest here are those who began to lose hair again after stopping zinc. Thus, we cannot definitively say that zinc would prevent hair loss after weight loss surgery, and further study would definitely be needed to make this connection. A further note: The tolerable upper intake level (UL) for zinc is set at 40mg in adults. This study utilized a daily dose of more than three times that level. Not only can these levels cause gastrointestinal distress, but chronic toxicity (mostly associated with copper depletion) can start at levels of 60mg/day. Information related to this study has made its way to many a support group and chat room—even to doctor’s offices—with the message that “high-dose zinc will prevent hair loss after weight loss surgery.” Patients should be advised that high-dose zinc therapy is unproven and should only be done under supervision due to the associated risks of toxicity. A lab test to check for zinc deficiency would be best before giving a high dose such as this. Protein Low protein intake is associated with hair loss. Protein malnutrition has been reported with duodenal switch, and in gastric bypass to a much lesser degree. Little is known about incidence, as only around eight percent of surgeons track labs such as total protein, albumen, or prealbumen.3 Limited studies suggest that patients with the most rapid or greatest amounts of weight loss are at greatest risk.4 With surgical reduction of the stomach, hydrochloric acid,5 pepsinogen, and normal churning are all significantly reduced or eliminated. Furthermore, pancreatic enzymes that would also aid in protein digestion are redirected to a lower part of the small intestine. It is thus likely that maldigestion rather than malabsorption is responsible for many cases. Some studies have also implicated low protein intake.6 Research also indicates that low levels of the amino acid l-lysine can contribute to hair loss and that repletion of lysine stores may both improve iron status and hair regrowth. In a study of anemic patients with hair loss who were supplemented with 1.5 to 2g of l-lysine in addition to their iron therapy, ferritin levels increased more substantially over iron therapy alone.1 Biotin Many individuals believe that supplementing with, or topically applying, the nutrient biotin will either help to prevent hair loss or will improve hair regrowth. To date, there is no science that would support either of these presumptions. While biotin deficiency can cause dermatitis, hair loss is only known to occur in experimentally induced states in animal models or in extreme cases of prolonged diets composed exclusively of egg whites.7 Other Other nutrients associated with hair health include Vitamin A, inositol, folate, B6, and essential fatty acids. Hair loss can also be caused by systemic diseases, including thyroid disease and polycystic ovarian syndrome (PCOS), and is influenced by genetics. Conclusions Hair loss can be distressing to bariatric surgery patients, and many will try nutrition themselves to see if they can prevent it. Unfortunately, there is little evidence that early hair loss is preventable because it is most likely caused by surgery and rapid weight loss. Later hair loss, however, can be indicative of a nutritional problem, especially iron deficiency, and may be a clinically useful sign. Educating patients about the potential for hair loss and possible underlying causes can help them to make informed choices and avoid wasting money on gimmicks that may have little real value. References 1. Rushton DH. Clin Exp Dermatol. 2002;27(5):396–404. 2. Neve H, Bhatti W, Soulsby C, et al. Reversal of hair loss following vertical gastroplasty when treated with zinc sulphate. Obes Surg. 199;6(1):63–65. 3. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc. 1981;78(2):135–140. 4. Segal A, Kinoshita Kussunoki D, Larino MA. Postsurgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg. 2004;14(3):353–360. 5. Behrns KE, Smith CD, Sarr MG. Prospective evaluation of gastric acid secretion and cobalamin absorption following gastric bypass for clinically severe obesity.Dig Dis Sci. 1994;39(2):315–20. 6. Moize V, Geliebter A, Gluck ME, et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):23–28. 7. Mock DM. Biotin. In: Shils M, Olson JA, Shike M, Ross AC, eds. Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkins; 1999:459–466.

To Hawaiian Chick... My email didn't go through, so will just post to you here. My surgeon is in Mitchell, which is about 60 miles form Sioux Falls. His name is Dr. Andrew Reynolds and his collegue is Dr. Michael Haley. They are in a Bariatric Clinic together. In Sioux Falls, I know there is a Dr. Thaemert and a Dr. Strand, but I really know nothing about them as surgeons.

Every insurance company has different requirements. The best advice I can give you is to call your insurance company, find out what exactly they require and what the total amount is covered. If they absolutely do not cover bariatric surgery, then your only options are to pay for it out of pocket or switch health insurances to one who does cover it.

Did you also see your PCP once per month or just the dietician? My bariatric center gave me a form that my PCP had to fill out every month. Plus, I had my PCP scan my food log into my medical record every month. I was approved after six months, but I had 3 comorbidities (HBP, cholesterol & sleep apnea) & a so maybe it had nothing to do with the medical record? And I didn't have BCBS but I dunno...I thought I'd throw it out there... just trying to help? So sorry! /P2P

JUSTIFY ME ---to---> MOLLIFY ME---to---> ADVISE ME GENTLY---to---> GIVE ME **REAL** FEEDBACK---to---> KICK MY ASS IF NEED BE This would be a cool tool. But as co-laborers in helping one another succeed, you need a deep tool kit and have the discernment to know which tools to use and where to use them (almost always privately): For some, listening ears and a gentle word in the moment of weakness (Proverbs 25:11; 25:20). Others, a sharing in weakness, doubt and failure; and the hope of renewal (Proverbs 15:2; 19:11). Certain others, the hard face and stern challenge (Proverbs 27:17). Occasionally, reprimand or reproach (Proverbs 9:8,17:10). For each of these, your goal is restoration of the person and, as quickly as possible, a continuation of the work. However, when necessary, you must separate and terminate (Proverbs 14:7). These are tools of leadership and healing; like a doctor’s tools, they should be used for the good of the others always, the patient if possible and never for yourself. Never. I have reaped the bitter fruit of my own failure to heed this last point many times.

Fortunately, I haven't met any of those kinds of doctors. I had surgery in Mexico, and have had excellent "regular priced" followup care from my PCP and gastroenterologist. And really, the only surgery related followup I've needed in the last year is bloodwork...don't need a bariatric specialist for that. The gastro got involved over a non-surgical issue, and he could care less if I had surgery in Mexico. In fact, he supported my choice of getting WLS despite it not being covered by my insurance. He said it was obvious my surgeon knew what he was doing and was impressed with the results.

Wow... This is a problem unique to banding: mainstream medical professionals haven't a clue when it comes to our situation. Our bariatric caregivers are generally not available for emergencies, sinçe many of us live far away from them and their office hours/days can be limited. What people don't understand is that when an organ is cut off from its blood supply, there is very little time to figure out what the problem is before the organ dies. Did you have a hiatal hernia? This sounds like you did....but I'm only guessing.

Agree 100%. I called my insurance to ask if I was covered, and they provided the full coverage policy for gastric sleeve. This helped a ton! When my bariatric place did the initial check on the insurance they said that I was not covered and would have to be self pay. I told them that I had already checked with my insurance and that they should try again. Come to find out I was covered and the person she spoke to thought she was checking on plastic surgery vs. bariatric surgery.

I agree with the others - I've never heard of that, and I've been hanging out on bariatric boards for a few years now. It's probably just a coincidence.

I got lucky - I belong to Kaiser, Richmond Ca. Their bariatrics department is number 4 in the nation! We all were given a 1200 calorie diet to follow - most of the girls have lost 20 to 30 pounds on it pre op! some of us have a hard time with it due to the high carb count. Once we lose the 10% required body fat, they schedule the surgery. If you are interested in a copy of it, let me know and i'll get it to you. Good luck!

Wow! Insurance really is a tough nut to crack. I have Cigna Open Access as well, but since my employer has a bariatric provision, I was able to at least submit the auth to them. They denied due to lack of consistent BMI and 6 month diet (i had docs for 4 out of 6 months). I appealed and they approved. I think it starts with the employer and how your insurance plan is written.

Hey ladies!! just thought I would share...2 more days until I hit the big 4-0 on Thursday. I had to go to DMV at lunch today to renew my driver's license. I was afraid of failing the vision test because I am supposed to wear reading glasses and didn't want to have to be told to wear them while driving. I was so preoccupied with that and not thinking about anything else. I also had to take a new picture. Well, I did not recognize myself. My old pic was taken like 8 years ago when I was like 350 and I never changed the weight. Well today not only did I get to change the weight to 225 but I got to say "who's that girl?". Big difference in the two pictures. I even look younger in the new picture and I'm even smiling & wearing a fuschia shirt:teeth_smile:

I will have UHC as of May 1, I can't wait. I have Aetna now, and the company I work for does cover bariatric, and will with UHC also. That was a requirement before I agreed to pay another year of insurance premiums. I went to orientation 2 weeks ago, and am calling to find out when my first appt is with the surgeon tomorrow. No referrals needed.

Hi everyone. I am brand new here, as in I joined maybe 20 minutes ago and this is my first post here. I haven't made a firm decision about surgery, but am definitely leaning that way. I just signed up yesterday to attend an information seminar at Atlanta Bariatric Center at Emory Johns Creek in a few weeks. I've already done a lot of research, and am so excited by the possibility so I can't wait to read here and see everyone's insights.

What stage are you in? You will have may more options once you get back to regular cooked food. For me that was 4 1/2 weeks. Before that, I used baby foods for purees. For soft foods, I just took what I wanted and put it in the blender with enough broth or Water to make it the right consistency. If you are already in the regular stage and lost about menus, go to: theworldaccordingtoeggface.blogspot.com She is one of us and understands what we are going through. She has many recipes and bariatric - friendly menu ideas and wonderful stories about world-wide travel while newly sleeved.

The statistical average of weight loss for bariatric patients is about 80 pounds in six months. Sent from my iPhone using the BariatricPal App

On another thread someone said they got a veggie spiralizer and made zucchini noodles. I just got mine form amazon today and haven't tried it yet. I did go on Pinterest and put in spiralizer recipes and found tons that look really good. I would suggest that. Apparently you can spiralizer all kinds of veggies and make awesome low carb paleo meals that fit into the bariatric guidelines. I don't know about rice. I have completely avoided it so far until I can talk with my Dietitian about it. Mich W Hw 223, SW 217 CW 200 GW 135

I won't speak to your specific surgery because it sounds like you've done your research and trust your surgeon's advice on it. What I will speak on is being healthy and getting bariatric surgery, which I know well. The first surgeon I met with didn't want to give me surgery. I am short and was about 80-100 lbs overweight. I have PCOS and struggled to lose weight for 5 years after giving birth to my daughter. I gained fifty pounds in that time instead. Even when I completely overhauled my life during my last pregnancy, I lost 20 lbs in two years... knowing full well that regain was lurking in my future, because that's just what the odds are. But my sugars are great, my blood pressure is fine, i have some joint pain but I'm not disabled by it, etc etc etc. The first surgeon I met basically said to me "I am looking at a woman who on paper is completely healthy, but obese, and I don't think surgery is worth the risks." He was speaking complete sense and I 100% respect his opinion and his choice not to take me on as a patient. The second surgeon I saw disagreed, though, and thought that I was a good candidate for surgery and had made a lot of changes that suggested I could be very successful post-op. Could I survive without surgery? Yes, definitely. With a lot of effort, I may have been able to maintain my lifestyle changes and my modest weight loss... but I could also backslide, regain, gain more, and get even sicker than I'd been at the very start. Type 2 diabetes is riddled through my family. My dad is on the verge of losing a foot to it. I saw the pattern of my life and was afraid. And I saw so many women in their mid fifties, sick and in pain and with BMIs over 50, saying they wished they'd done it earlier. I figured, what better time? I'm young, I'm healthy, I'm at good odds to get through surgery safely and bounce back in my recovery. I haven't done too much lasting damage to my body yet. Why wait for the stuff like the joint pain and insulin resistance and PCOS and depression to just get worse and worse and worse, perhaps irreversibly so? I'm not advocating for some twenty five year old who's 20 lbs overweight and is worried she might be 50 lbs overweight thirty years from now once she hits menopause to have this surgery, but I think if you are already obese and have good medical evidence you will continue to get more obese and MORE sick... then getting the surgery preventatively is a valid choice. I wasn't overly sick from my weight, but my life is still exponentially better now that those 50 lbs are gone off me, too. My knee pain has vanished. I have higher energy. But best of all, I'm not AFRAID anymore. Regain could still happen, of course it could, but it's not a given anymore. Type 2 diabetes isn't a given. I feel like I am in control of my own future, and that matters. I'm making healthy choices secure in that knowledge, and encouraged by that knowledge. As for "the nuclear option", my surgeon initially suggested the RNY because that's the surgery he does most and he considers it the gold standard. I told him no, I wanted the sleeve. I felt it was wayyyyyyy too invasive for my situation and tipped the balance of the "benefits vs risks" of getting the procedure, and I didn't think it fit the lifestyle I envisioned for myself after surgery. he respected my choice. if you're confident about getting the DS, then do it. but if you think it's too extreme for your specific situation, you CAN talk to your surgeon about that. I expected to have to argue my case for why I didn't feel comfortable getting the RNY, since my surgeon was so gung ho about it, but he immediately was on my side when I told him I wanted the sleeve. your opinion does matter. it's your body, and you have to live with this surgery for the rest of your life. so make YOUR decision. and if it aligns with your surgeon's opinion, then be confident about that!

Thank you! I definitely agree because it feels so good when the numbers start dropping again. I had my an appointment with my bariatric doctor and I am now down to 226! I'm over the moon.

@@KristenLe - Yes, I'm taking Iron in the form of a nasal spray prescribed by my surgeon and bariatric multis.

It may be helpful to call your bariatric surgeon and ask them for additional information on what diet you can safely follow that would also be affordable. You are definitely doing the right thing to exercise, and sometimes it helps to change up the speed and type of exercise as well.

What about bariatric advantage