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I got some interesting pictures of my insides today. Reason for Multidisciplinary Case Review: lap adjustable gastric band by Dr. Johnson on 6/6/2011. Had emergent fluid removal from band with dr. Svendsen on 9/10/21. She had been experiencing severe reflux, regurgitation, choking at night, night time cough, vomiting nearly everyday and abdominal pain after eating, Some of the symptoms have resolved after the fluid removal. She continues to have heartburn and epigastric pain. A comprehensive review of imaging and relevant past medical history occurred. Upper GI Series (9/8/2021): Gastric band located below the diaphragm with widening phi angle measuring 66 degrees. The proximal pouch has migrated into the chest consistent with a hiatal hernia. There is dilatation of the distal esophagus and esophageal dysmotility Upper GI Endoscopy (10/6/21): - Tortuous esophagus. - Normal esophageal mucosa. Biopsied. - Z-line irregular, 38 cm from the incisors. - 2 cm hiatal hernia. - Gastric band slipped 2-3 cms distally. - Body and antral gastritis. Biopsied. - Multiple duodenal polyps. Biopsied. biopsy Results (10/7/21): A) DUODENUM, POLYPS, BIOPSY: 1. Gastric (fundic) heterotopia 2. Normal background duodenum; negative for celiac disease 3. Negative for dysplasia and malignancy STOMACH, ANTRUM, BIOPSY: 1. Normal gastric antral mucosa 2. Negative for Helicobacter C) ESOPHAGUS, DISTAL, BIOPSY: 1. Normal esophageal squamous mucosa 2. Negative for reflux changes and eosinophilic esophagitis 3. Negative for columnar mucosa Staff present from ANW, UTD, MCY & Shakopee Weight Management including Surgeons, Advance Practice Clinicians, Bariatric Nurse Clinicians, Registered Dietitians, Psychologists She has completed her preoperative evaluation and has been judged to be a good candidate for surgery. Plan: A Laparoscopic conversion of adjustable gastric band to roux-en-y Gastric Bypass and hiatal hernia repair would be an excellent choice to meet her goals for weight loss and comorbidity resolution. The plan is to proceed with scheduling for surgery.

I have not had lap band but I have had two prior bariatric surgeries that failed. I am now going to have RNY Gastric Bypass revision at age 73. I have learned a lot since I started on this path 6 months ago. Good for you for moving forward toward a healthy weight. However, I'm concerned that you have not learned how to eat differently yet. Consider the possibility that you are a sugar/food addict. If you are, Keto is not the answer for you. You need to change your habits entirely. I strongly recommend some reading for you. Choose at least one book from each of these groups. Finally, conclude with Success Habits of Weight Loss Patients. Get started now. Apparently you have already had the surgery, so there is no time to be lost.

I am a person who always wants to know the "why" behind a rule (unfortunately!). So, as I've slowly been progressing through my surgeon's plan (still on pureeds for two more weeks, and I'm 7 weeks out), I've started wondering if we will always have to drink protein shakes. I hate them, they taste gross, and the ingredients list is like 5 paragraphs long full of things I can't even say - besides that, they're full of carbs and often high calorie. And if we do have to always drink them, why? Why can't we meet our protein goals through eating real food? For example, an egg and a morningstar breakfast sausage patty is 16 grams of protein and 150 calories. The protein shake I drink is almost 300 calories (bariatric advantage with PB2 over a plant based milk). Also, bone broth, cottage cheese, greek yogurt, tuna are all high protein, low calorie options that taste way better than protein shakes. If a person is able to meet protein goals and still stay around 600 calories a day during weight loss phase, why the shakes? (I don't know if that's feasible, I haven't tried it - I am still drinking the nasty protein). So, I posted the question to the online support group my surgeon keeps on Facebook. I asked if a person can meet their daily protein goal through real food, are protein shakes still required. Man! You would have thought I asked if I could eat a full meat lovers pizza from Papa John's! People launched on me, accused me of eating too much food, told me if I wanted to lose weight and maintain it I HAD to drink protein shakes for life. Then the surgeon came on and publicly shamed me, said I was way off track and wasn't following the plan. What bomb did I set off??? And nobody ever explained WHY the shakes are required??? The previous time before this when I asked a question, almost the same thing happened. I asked if I could drink the Unjury ready made shakes instead of the powder because they taste so much better. People berated me, and told me the ready made shakes were not good for me. Then the surgeon chimed in and said the ready made were not as good because they are protein caseinate instead of whey isolate. Um, the packaging clearly says the Unjury brand is whey protein isolate. So now why are they bad for me? The next day, my surgeon posted a long post about people having this surgery and not taking it seriously. I can't help but think it was in response to my question about protein shakes. I didn't even have Facebook, I deleted it in 2016 when things started to get so nasty online. I only started using it again to join my surgeon's group. I cancelled following the page. I was really ticked off at the responses. I'm so angry I don't even want to continue with my surgeon's office. AND, by the way, I am not way off track, I've lost 41 lbs. in these last 7 weeks, and I'm really happy with that. Started at 235, now 194 (and have been losing about 1 lb a day for the last few days). I know I'm being a baby, I think I just needed to vent. I do like my surgeon when we meet one on one for appointments. Facebook is evil. Sent from my SM-N976V using BariatricPal mobile app

Have I misunderstood? You've lost 56lb in about two months or just a little under that? I think what you've lost is great. Some professionals or those who deem themselves to be seem to set some unrealistic expectations. Were you happy with your weight loss up to the point in time your dietician told you otherwise? 10kms a day is quite a lot. I assume you are followng your post op guidelines for calories, volumes of food, types of food etc? Protein intake? Liquid intake? And hopefully consuming sufficient to sustain 10kms a day. If so and your are averaging a reasonable weight loss you are doing great. Editied to add: You mention you stopped losing weight? How long since you've lost some weight on the scale? Stalls are not uncommon, most of everyone who has WLS has a stall or more than one, even in the first few weeks.

Hi Peeps, I had my Gastric bypass (RnY) on Aug 17. My stats are as follows. SW: 302 lbs Height: 169 cm. CW: 246 lbs. Total lost: 56 lbs Exercise: Walking 10km daily However, I'm feeling I'm not losing fast enough, my dietitian thinks I should be losing about 4 lbs a week. I'm worried that I'm going to ruin this. Any tips on how to lose faster. Would really appreciate the help. Thank you.

I’m soo distraught, I’m 9 days post op..just began purred good stage… since then I have been gaining weight. My stats are as follows highest 240… final weight before surgery was 210, during the clear liquid and full liquid stage I lost 7lbs… and was at 203. Since I started the puréed stage about 2 days ago… now I’m weighing 208….I’m following the diet…and only consuming about 400-450 calories a day with my 64oz of liquids a day. Has this happened to anybody!…. I’m freaking out.

No I have not tried that. I’ll have to though. I love this site, so many ideas that would never cross my mind. And I hope so. It will make 3 weeks on Friday and same. Have had no more than 600 calories a day and I work out 2-3 times a week depending on my knees and ankle. And still Not a pound lost since the initial weight loss after surgery. I do feel feel relieved knowing this will pass. Lol. Thank you for the encouragement and the advice. I will try that!

I lost much less than I thought I would on the pre-op diet. 9 lbs., but given my starting weight I thought more. It's not at all predictive of weight loss post-op, so don't worry.

I didnt poop until 10 days after coming home…if you include the days i was in hospital, my first poop showed up in 12 days. Oh, and it was a doozy. *shudder* Being regular was a challenge the first 5-6 months, honestly. Here was what I did to combat it: - benefibre every morning in my protein shake, drank lots of water - if no poop in 3-4 days, took a dose of Milk of Magnesia for 1-2 days. - if no poop 1-2 days after the round of MOM, glycerin suppository time. I got much more regular after weight loss phase when i started eating more (thanks fatty foods, lol). I’m 3 years out now, and i poop every 2-3 days, so thankfully its no longer an issue. P.S. Not sure if you are on them, but pain meds and iron supplements will back you up considerably…so keep that in mind.

like others have said, if you lost a lot of weight prior to this, you may not lose all that much on the liver-shrinking diet. Big drops are usually mostly due to "water weight", and if you lost a lot of weight before this, that "water weight" may be long gone. I wouldn't worry about it. This diet is to shrink your liver a bit so it's easier for the surgeon to get in there - the primary focus of it isn't weight loss. Definitely get your protein in - you need it to stay healthy.

With FEP BCBS dis you have to submit proof of other weight loss programs that you have tried in the past and did not work?

The average weight loss post weight loss surgery at five years is around 65% of the weight to be lost to be in the healthy BMI range. I think that is the 75% your surgeon is probably referring to - the difference could be based upon your specific surgery, the stats of his patients & possibly you & your situation vs another patient. As with all averages some lose more & can maintain it, some lose less & happily maintain at that weight. In years 2-3, it’s not uncommon for people to put on 10+/-lbs from their lowest weight as they settle into their new eating style. Some lose some of that weight others are happy to stay there because it’s an easier weight to maintain. As you’re losing you likely will experience stalls or (plateaus) almost everyone experiences at least one. It’s part of losing weight. Think of it as your body taking a break to try & catch up with the weight loss you’ve had so far. They break & you will start losing again if you stick to your plan. The goal is to reach a weight you are happy with, can enjoy your life at & can maintain with out gaining or losing (not including our natural weight fluctuations of course). Congrats on your weight loss so far.

2litres or 64 ounces is the recommended volume of water (mix of fluids) everyone should drink a day to be fully hydrated not just people who’ve had weight loss surgery. If you are in a very hot climate, exercise a lot or just sweat a lot you should drink more. I was advised (my dad had kidney issues) you shouldn’t actually reach that I’m really thirsty/dying of thirst point. Your pee should be light in colour like straw. Once you get to a sunshine yellow you really aren’t drinking enough. If it’s dark you are very dehydrated. Of course multivitamins can make your pee very yellow even if you are fully hydrated.

Some people do drop a lot more pounds after plastics, especially if there is still some stubborn fat deposits under the skin (or just lots of leftover skin in general for those who had massive amounts of weight loss). My surgeon said he removed a grand total of 400g of “material” from me, which is just shy of 1 lb (and i had a tummy tuck, arm lift AND breast lift!). But despite the minimal weight difference, the VISUAL changes were significant (well, at least to me, lol)

Total Scale Victory and Random Observations: I now have lost more than I weigh. I have lost 190 lbs. from my highest weight of 374. The first 50 was using Victoza for Type 2 diabetes. My bariatric program has my starting weight as 343. SW=325. CW=185. My program doesn’t give goal weights. For my own satisfaction, 174 would give me a normal BMI. I’d like to end about 170 knowing that some gain/loss is possible as things settle. I’m 5’10”. I have gone from a size 30/32 to a 14. I haven’t been this size since early high school. I look forward to doing things rather than dreading them. I’ve been off all diabetes meds since surgery. I am still using my CPAP although I’ve had the pressure lowered twice. I see the sleep program in December and we will re-evaluate then. I suspect I will still have a need for it. My cholesterol medication will be re-evaluated in December as well. My doctor thinks it likely I will remain on that med due to family history. That is the only medication I take other than my vitamins and supplements. I track in LoseIt. I track every bite, every day. It keeps me accountable to myself and I foresee it as something I will need to do forever. Today is the first time I ever exported my progress to a spreadsheet. On other groups, I see so many questions that ask how much someone has lost at a given point. I honestly never knew what I did. These are my totals lost from first to current month: 16, 19, 17, 15, 15, 18, 4, 9, 17, 10. I exceed my liquid goals every day and never tracked that after the first week. I’ve never had any trouble with liquids and I know roughly what I drink each day as I know what my mug holds. I also ran my macros for the first time. Since surgery, I’ve kept protein to 40-50% of my diet with fat and carbs 25-30%. I’m still at 800-1000 calories per day. My program has said that is relatively low at this point but as long as I am losing and not feeling hungry, it was fine. My hunger has not returned. I am grateful for that. I’ve tried to build successful habits that will serve me for the long haul. I’ve been walking since coming home from the hospital. I started at 5-10 minutes per day. Now, I try to walk 45-60 per day at a moderate pace. I use 5 lb. weights and do toning exercises for 10-15 min. most days. I’ve started seeing virtually a therapist recommended by my program. I don’t have a history of trauma or eating disorders but I didn’t get to my weight by having a healthy relationship with food. Plus, I was very moody and short-tempered following surgery. I feel great and have more energy than I have in years. But This. Is. Work. I’m ok with that and try to keep my focus on progress and health. I follow what my program suggests and make my own decisions within that framework. There is no short cut to this. There’s no pouch reset, fasting, diet pills and how soon can I eat at McDonalds. I ranted on here one time about hating the word “pouch.” I still do. I hate pouch reset even more. 🙄😫 I don’t believe in it. We don’t need to reset. We need to make the best decisions and choices we can without needing to be perfect. Sure, you lose weight with it, but it’s simply because you are going back to not taking in many calories….and most of us have been down that road before. I continue to absorb the wisdom I get here from those who have gone down this road before me or are on it now. I still hate shopping even though it is not as difficult as it once was. I’m still not sure who I see in the mirror and am uncomfortable with focus on my weight loss. I could eventually benefit from plastic surgery, but I don’t know if that will be in the cards. Enough for now……thanks for reading.

Yes, plateaus/stalls are common, and only indicate a pause in weight loss, not the end of it. You just keep following your program and the weight will continue to come off eventually.

I’m 5 weeks post op and I’m losing weight at a fairly good clip. Question: when the doctor says you should expect to lose 75% of the total amount you need to lose (or whatever the percentage is) from the surgery, should you expect that to happen continuously? Or will should I expect to hit a plateau before the 75%? Does that make any sense?

It seems to me that your loss is pretty normal (unless you had an extremely high BMI). Some of us are slower losers than others but time and time again I hear of people who lose the weight even if they are slower losers. I’m not sure where you read about 5-15 pounds a week but maybe they meant per month??

I'm just 2 months postop. I lost about 50 pounds preop. Since surgery, I've lost 24. I've been losing basically around 2 pounds a week. My dr office said that by 6 weeks they like to see 15-25 pounds....so I'm right in the middle there. But I get your frustration. I knew that losing weight beforehand would give me a slower weight loss rate -- but it's a "healthy" rate (1-2 pounds per week). AND I look at it as I'm 50 pounds ahead of the game. And if I didn't have the surgery, I probably wouldn't still be losing weight every week AND I most likely would have gained back what I already lost.

I am going to get the TDS in a few months. I dont want a long cc just in case I would have a lower weight loss goal. I am going to talk to my surgeon tomorrow-video pre op appointment and I am going to confirm with him that I want a short cc-ideally 100cc. He measures the total bowel so he has to go in there to measure it then.... I could truly know what my cc is , you know?

I’m on Week 19. Had my first post-surgery vacation, at Walt Disney World for 2 weeks. I learned I don’t have any food intolerances. Yes, some stuff will sit “heavy” but no nausea or vomiting. I still kept up my protein intake so that balanced things out. Shared most meals & snacks, usually I can only eat about 3oz protein and some veg/carb and I’m full. The nice thing, I’m only up 0.6lbs from the day I left. So, I’m expecting that water weight to drop off this week as I return to my normal diet that is much lower in sugar & carbs. Prior to vacation, my weight loss has been steady with no stalls. Anywhere from 0.6 to 4 lbs per week. I have lost 51lbs. i still don’t really have real cravings. I did pass up on treats I’d normally get at WDW because I was either full from regular meal or simply not interested. That was kinda weird 🙂

Exactly as @catwoman7 said. There is no wrong or right amount to lose each week. Yes, there are averages & ranges but treat them only as a bit of an idea of what you MIGHT lose not what you will. There are too many factors that influence your individual rate of loss & it will change day to day, week to week, month to month. Remember you’ll lose at your own rate & every pound you lose is a win. Congrats on what you have achieved so far.

Straws can bring air into your stomach which can cause gas like pains. Some people don't have problems other do. I imagine if someone was going to have problems it would be in the first six to 12 weeks, while the stomach is healing and is still tender and they are getting use to restrictions etc. I am not one to typically use a straw, so didn't have a need to use one or test it out. I think using straws is one of those variable things about weight loss surgery - depends on your surgeon and/or what you may read. Some were told never to use a straw again, others maybe in time, others were not told anything. These two links were just the first two I found, I've linked them for no other reason. https://www.obesityhelp.com/articles/drinking-through-a-straw-after-wls/ https://mexicobariatriccenter.com/bariatric-surgery-myths/

I think you're doing really good. That's an incredible 4.2 lbs. loss per week.