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Hi guys. Today I’m exactly 2 months out and wanted to give you all an update! I’ve lost 43lbs. Since my revision to sleeve. And 23 inches all around. This is so much faster than I ever lost with my lapband. I still have an aversion to certain flavors and I can only drink my protein shake if its in coffee. On its own it sends me running to the bathroom. Which is weird. My dr told me to stop drinking the protein shakes anyway and that I should start getting my proteins only from meals. I think I’ll be able to do that even though I can usually only fit about 4 ounces (we’ll see) the problem is that I’m not really a cook or kitchen person so I find myself eating the same things over and over and then making myself sick of them. This in turn means I’m quickly running out of choices. I weirdly can’t see the changes in my body but I know that they’re there because I’d definitely fit differently in my clothes and differently into seats and things like that. But the body dysmorphia is real y’all! I usually take pictures at every month anniversary and when I look back at what I looked like from the beginning to now, I still feel like I look the same—which again is weird because I thought that the pictures were supposed to show me that I actually am losing weight but oh well. Luckily I have a therapist, so I think I’m gonna bring this up at my therapy session tomorrow. I don’t come on here often, but I do read every single comment that gets posted so I really do appreciate people continuing to post here and talk about how they’re doing…it makes you feel a little less lonely, so thanks!

Hello all its been years I think since I've been on the boards. Weight loss wise I am doing well maintaining my 100lb plus weight loss from my sleeve surgery on Mexico 3 years ago. Relationship wise things have been great until recently. A little background we have been married 20plus years and have adult children. My husband was okay with my surgery and very supportive of the surgery. We work in the same industry and for the past 6 years have been working together in a predominantly male dominated field. This has never been an issue until now. My husband recently was switched from the shift we worked together and moved to another one. When he was notified he'd be moved he had them move me as well so we could continue to work together....no big deal whatever even though I was very happy where I was. So now we are on the new shift and not in the same building and it is eating him up he has become very insecure. He doesnt question what i wear or anything like that he is jusy super insecure. Since we are on a new schedule and delegated to specific buildings he can't pop up in my work area anymore and lay eyes on me,we don't have lunch at the same time,and he is attempting to get that changed. He hasn't said anything to me directly but he gives coworkers mean looks when they look at me and tries to stay stuck to me as much as he can. I'm genuinely not understanding why he is behaving that way and it's very shocking. I don't plan on leaving him I'm just concerned as to why he is doing this all of a sudden. Anyone else dealt with an issue like this where you work with your spouse and they became insecure? I think I'm gonna talk to him about it soon I just wanna vent because this is coming out of nowhere. At first I told him about things coworkers would say to me because of transparency but now if I feel it's too much I'd just go to hr if it's bad because I'm sure he would blow his fuse. Lately anything I tell him a coworker says he wants to confront them. I have convinced him not to but this puts me in a bad position and I wonder if I should continue working with him or find something else. Advice?

My ex's uncle had this. Usually it's stumbled upon accidentally during an emergent surgery situation. Which is what happened with his uncle. He had emergency appendectomy probably about 50 years ago and the surgeons were just dumbfounded when they opened his abdomen. So of course this has nothing to do with weight loss surgery, but my advice would be if you live close to a university that teaches medicine, and has a bariatric center, reach out to them. They would LOVE to get their scalpels on you, lol. Sorry, bad joke. But yeah, they love hard cases, and atypical cases. They publish papers on these cases. You're in North Carolina. How close are you to Wake Forest, they have a bariatric center https://www.wakehealth.edu/treatment/b/bariatric-surgery I wish you the best! Keep us updated!

Lap Band to RNY for severe GERD. I haven't dumped yet and don't think I will be a dumper. I gave up Celebrex seven months before revision surgery and have been fine. (RA patient here) I have virtually zero pain. Losing weight helps reduce inflammation and reduce the need for nsaids it seems. And you're right, you don't want wls induced GERD. It sucks. Meds won't even help when you get this type of GERD. All I can speak to is my personal experiences and comparing RNY to lap band, which I know is antiquated now but RNY feels completely natural to me and I'd do it again if I had to all over again and could choose from any wls. Best wishes!

I had a banded gastric sleeve on 15th September so I'm just over 5 weeks post surgery. Things are very different over here in Australia I first saw my surgeon in July and a few weeks later booked a date that suited me based on what days the surgeon operates at my chosen hospital. I am not insured so I was able to withdraw the funds from my superannuation account. I had 2 weeks of pre op diet which consisted of 2 meal replacement shakes and then dinner of approx 100gms of protein and 2 cups veggies so found it quite easy to follow. I'm currently on a soft diet slowly reintroducing foods to see what I can and can't tolerate it's certainly a learning curve. I take 2 multivitamins a day which have everything in them that I need. So far I've lost just over 20kgs since I saw the surgeon and 11 kgs since surgery so 21kgs all up. I'm really happy with the changes so far and don't regret having the surgery at all. I journal most days and weigh myself once per week. I also take measurements. Everyone will cope differently. Some of you will lose tonnes of weight quickly others may be a bit slower. I'm going to try and not compare myself to others. Good luck to you all on your journey Sent from my SM-S906E using BariatricPal mobile app

Look into Mounjaro. It is a diabetes med that is showing early success with weight loss. It's currently in fast track FDA trial to be approved as a weight loss drug. Patients using it report appetite suppression, decrease in food thoughts and slowed gastric emptying. I think it has the potential to be revolutionary.

Hi David, I'm in Washington also. I have just started my journey, spoke with the Dr. and am making sure I have everything done, my insurance requires 4 months of medically supervised weight loss so I'm starting that in November, and I need the Endoscopy so I'm thinking I won't be ready for surgery until Feb-March 2023. Who are you seeing for your procedure? I'm going through MultiCare.

In the weeks before surgery you’re on the restrictive pre surgery diet so no alcohol for about two weeks +/- prior to your surgery. After surgery you’ll be advised to avoid alcohol too for a period of time. Alcohol is high in empty calories, dehydrates you & will slow your metabolism & weight loss. Plus there is the concern that if you have an addiction to food you will become addicted to alcohol as you can’t satisfy your food cravings.

ooo exciting time. So tell us about yourself since you have not filled out your profile... Weight, height, surgery you chose, is insurance paying or are you self pay?

A chose bypass due to GERD, but I also had some reservations around dumping and medications. Medication-wise, the reality is over time, a lot of the medications you take may end up going away. Especially if they are for conditions like high blood pressure or diabetes that are often reversed with weight loss. Personally, I was really worried about NSAIDS, because I have a number of physical issues that have had me on prescription NSAIDS for over 35 years now. My surgeon agreed that even with bypass, I could keep taking them as long as I continued to take a PPI to limit the risk of ulcers. I'm also hopeful that as I get closer to goal, I may be able to give them up entirely. For the rest of my meds (if you include supplements, I take over 30 different pills a day), no mention has ever been made about me needing to adjust the dosage in any way. Honestly, I think the whole "malabsorption" thing for bypass may be a bit overblown? As far as I'm aware, the only ones where you might run into a problem are extended release versions of medications. For most of those, there are non extended release alternatives. If you have specific medication concerns, my suggestion would be to talk with your bariatric team. They can best advise you if bypass would be an issue for you with that medication. As far as dumping is concerned, dumping is far from guaranteed with bypass. I have not experienced it and many others here have not either. Plus, we've had first hand reports that even some sleevers have end up with dumping syndrome. Certainly it's much more likely with bypass, but I'm not sure I'd worry about this too much. If you do end up with that issue, it can certainly help you stay on plan and may help you do better in the long run by controlling your intake of things you probably shouldn't be eating anyway.

I went down to 200lbs the day of surgery, I'm 3 weeks out & have lost 15lbs. I read a passage in my bariatric handbook that basically said, 'Your metabolic rate is higher when you weigh more, meaning you lose more doing less. Weighing less will slow that down. Essentially, the surgery will help you when losing weight is at its hardest.' Aka, this will help us lose those stubborn last pounds! Its very encouraging for me

Medical Groups Replace Outdated Consensus Statement that Overly Restricts Access to Modern-Day Weight-Loss Surgery NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery. The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it. The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world. "The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.” In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied. New Patient Selection Standards — Times Have Changed The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.” But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5. Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.” It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide. Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S. “The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.” The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.” About IFSO The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity. About ASMBS The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

First of all, I am so, so sorry you are dealing with such a heartbreaking diagnosis. My best friend of nearly 25 year received a stage 3 HER2+ IDC diagnosis earlier this year, so it is all too familiar to me. My heart goes out to you. Secondly, I would say, right now you just have to focus on your health & healing. Your body is going through tremendous stress, fighting a terrible disease, and being bombarded with incredibly difficult medications. I know its hard to see the scale go up, but your body is doing exactly what it needs to. Additionally, much of that weight is likely to come off once treatment ends. So for now, maybe just be patient and let your attention be on healing, knowing the weight can be dealt with later. Truly, I wish you the best.

I listened to this female-centric podcast during my walk today, which somewhat addresses this temporary cognitive dissonance following bariatric procedures: https://drmariza.com/435-most-effective-way-to-transform-your-self-image/. It's on Apple Podcasts. The guest speaker has lost a lot of weight, in addition to making other significant changes in her life. She suggests you change your environment (e.g., the contents of your bookcase), your personal style, etc., to allow the external match the internal. Kinda interesting, but OP is male so his mileage may vary.

Well I’m guessing your maintenance diet is a little different than your weight loss phase of the diet. I’m thinking you just have to go back to the weight loss phase. I have gained too and that’s my plan. I am going back and forth as to whether I should start with a week of my liver shrink diet which was basically two shakes and a lean protein and veggie dinner.

I have seen people on here who have gained back 30 or 40 pounds and they have been able to lose it. Your restriction should still be there. You most likely have just changed WHAT you are eating throughout all of those stressors. Change it back to your post surgery plan and you should lose. It will be a little more difficult because you probably have your appetite back but you can do it. I am saying all this for myself too as i have gained some back and I’m struggling to lose. I have an appointment set with an endocrinologist because I thought something may be wrong with my hormones because I didn’t think I was eating that bad but my husband told me last night he thinks maybe I have been splurging more than I realize (don’t quit tracking folks). I’m still going to make sure but I’m thinking that I’m right there with you. I have heard of people going all the way back to their liquid diet but idk if that extreme is necessary. I was thinking of going back to my liver shrink diet. It sort of detoxed me from all the junk and mine wasn’t too bad. Actually the more I think of it it kinda looks the same as the post surgery regular diet. It was mostly lean meat and veggies (just a little more veggies) with a couple shakes as best as I can recall. I guess what it really amounts to is just getting back on plan 100% for dinner with a couple shakes a day to cut calories a bit further. I am expecting the loss to be slower this time cause I can eat more now and I have my appetite so I can’t cut calories AS much but I’m hoping it will still come off eventually. I will be rooting for you too. We can do this.

be proud that you know you need to act and are reaching out! life is hard and we all need to start again sometimes. how long ago was your surgery? what eating style made you successful in loosing weight last time ? what do you think your biggest issue is that is causing weight gain ?

😪Has anyone dealt with weight can after cancer treatment? I have breast cancer and from the chemo and steroids I’ve gained 20 pounds after 5 years of maintaining. I’ve also had to have a complete hysterectomy so menopause was added. How do I get the weight off??

I’ve gained 15-20 due to chemo, steroids and forced menopause and have no idea how to start with the loss

I'm embarrassed to admit that I have regained all 40 pounds that I lost. The weight gain started with the pandemic, add to that some very serious health issues with my child, and menopause, and numerous other excuses, here I am. I just don't know what to do at this point. Every single day, I wake up and say it will be a brand new day, but again, here I am. Help me please...

Same thing with the lack of sugar cravings. If I start getting a craving for chocolate I just have part of a Fairlife chocolate shake. The other part that's been easy for me is the lightened mental load of this weight-loss process. I used to agonize over calories and carbs eaten. I would track everything and make a point to workout several times per week. I would beat myself up over slip-ups and cheats. I was always thinking about my next meal. Now I'm less stressed and making better choices in general. The weight is steadily coming off and for the first time I don't have to fight my metabolism tooth and nail.

This is a good point. Especially if you are someone that has non-alcohol related fatty liver disease (NAFLD), or especially the more severe form non-alcohol related steatohepatitis (NASH), regular drinking probably isn't in your best interest. A lot of obese people end up with NAFLD/NASH since obesity is the leading cause. Depending on the severity of your disease progression, you may have caused sufficient damage to your liver that frequent drinking on top of that could put you on a one way path to cirrosis, liver cancer, and/or liver failure. Now that said, one drink or even a few now and again isn't going to cause severe disease. Also, weight loss often can completely reverse NAFLD, so if you didn't actually damage your liver permanently, this may not be a factor. I totally get those that say alcohol is a poison and don't understand why anyone would purposely poison themselves. Objectively though, ALL of us are here because we purposely poisoned ourselves with food. I'm in no position to judge anyone that chooses to drink. (By the way, my main hobby pre-surgery was winemaking, so stopping drinking was an even bigger challenge for me. I had to give up not only nightly glass of wine, but my main hobby.) In the end, I think we're all grown-ups and everyone needs to decide for themselves what's right. Just know the risks and decide for yourself if the risks are worth it to you.

I had VSG at HospitalBC and they also do plastic surgery, specializing in post-weight loss stuff. I'm not familiar with that side of their work, I just know that many patients return for plastics. I did have a wonderful experience there for my bariatric surgery though,

As you note, the scales and calculators are mostly a "best guess", as they are highly algorithmic. The more direct measures like the vox tests and the like are better, but still have some population algorithms in there that can go astray of one is far outside normal population standards, as WLS patients often are. Similar for body composition checks - the scales are OK if you know how to correct them, but the more direct measures such as bodpod, water displacement and even dexascan are trying to solve for more variables than they can measure, so they are comparing to norms. Getting into BMRs and the like, of course there is the judgement as to burn rates and exertion levels above resting, but then with our WLS of different flavors, that impacts the intake caloric level that we consuming and absorbing, and how the body adjusts to the insult of surgery over time, what the surgery that you had does to the absorption of different foods (fats absorbed differently from carbohydrates which are different from proteins, simple carbs different from complex carbs.) In short, you may get a number from some lab testing as to what calories are appropriate for you, but the ultimate test is whether your weight is stable at that point, or gaining or losing so that you need to make adjustments.

Hi everyone just checking in since all of us have or are near our 2 year anniversary date. Started at 220 I stopped loosing weight current weight fluctuates 146-140 My eating habits have been pretty much the same eating every 2-3 hrs and my drinking of fluids is about 40-50 oz some days more some days not even close but try to stay on track with that as I noticed when I don’t drink enough fluids I eat more junk. Started to develop dumping síndrome or what ever it might be but mid morning I have to rush to Amy bathroom afraid of an accident :( How’s everyone else????