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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????

On your current weight loss journey, what was the easiest change for you or was much easier than you thought ? so far for me it has been not consuming a lot of sugary stuff. I used to crave it all the time and thought I always would, but since I reduced it down and mostly cut it out I do not have constant cravings anymore. Occasionally I get a little twinge but something small and sweet but not sugary will often satisfy. what about you?

+1 i had like 4-5 partial drinks during entire weight loss phase. Now, i am what one would call a regular drinker (some may even, dare i say, call me an alcoholic). I was a drinker before surgery as well. (Though before surgery I would drink lots in a short amount of time, every few weeks, now i drink less at a time, but more often). My increased drinking frequency had a lot to do with Covid lockdowns starting in 2020 though. From a weight-loss perspective, what little i did drink during weight loss phase did not seem to affect ME in getting to goal. Nor does the amounts i drink now seem to affect my ability to maintain my current weight (note though that i simultaneously keep an eye on my total calories - alcohol or otherwise- , so there’s also that) I get tipsy quite fast post-wls (and on small amounts), but I also sober up in record speed. As others said above, if you really want to, try it out and observe how you react, and then decide if want to again. Or, don’t. Up to you…you know yourself best. Sincerely, An alcohol-drinking-DRINKER (from Canada). (i also smoke, drive above the speed limit, and am late paying my taxes this year…)

Great suggestion. Dr Weiner just made an instagram post about the GLP-1 the other day for weight loss. It’s hard to get insurance to cover it though if your not diabetic but since you are this may be a really good option for you, OP. Also his book, a pound of cure was really informative.

It's not uncommon that bariatric programs warn people not to drink alcohol post-op. Some, like your team seem to take a "never again" approach, while some say avoid it for a specific length of time, such as the first year. As I understand it, here are the biggest concerns those programs have: The biggest concern by far is that there is an increased risk of developing Alcohol Use Disorder. As @Starwarsandcupcakes mentioned, some research suggest that susceptible patients transfer disordered eating onto alcohol. Some studies have even found that the incidence is as high as 20% of bariatric surgery patients. The second concern is that alcohol affects our altered biology differently. Honestly this is worse for gastric bypass patients, but sleeve patients still have have issues with getting drunk much faster, on much less alcohol. Further, it can take a lot longer to metabolize the alcohol you do consume, meaning you'll stay drunk longer. Bottom line, it's really easy to overdo things and end up completely drunk on a lot less booze than before. There is also the concern that this is wasted calories that provide no nutritional benefit and can slow your weight loss. Obviously for those in maintenance, this doesn't really matter, but for those still losing, it might be a concern for some.

If I were you I would consider trying the nutritionist and bariatric therapist first. Those two things are often a huge part of why the surgery is successful and they very well could just be enough to get you there without surgery. I understand that you have tried everything and can’t lose and I get it that you need to do something. I was lower BMI as well (35). But, I had the sleeve a year and a half ago and I still didn’t get to my dream weight. This surgery is a great option for many people but it is still major surgery. Post surgery you cannot take NSAIDS for pain and you may struggle with constipation plus have to take vitamins all for the rest of your life. These are all things that you can live with and of course if you still can’t lose the weight they may be things you have to live with but I wish someone had told me to give it one last try with the nutritionist and therapy before I committed to all this. I may still be exactly where I am by now but at least I wouldn’t have to wonder if I could’ve done it on my own. Having said that, ask your doctors of course because you do have medical issues that I did not have and maybe losing the weight asap is really important and the surgery is definitely a faster way to lose it. Also, IF your insurance will cover you can kill two birds with one stone if you get the process started while trying to lose. For many insurance companies you have to do 6 months of physician managed weight loss attempt anyways so you can do all that while you see if the nutritionist can help and maybe even talk to a bariatric therapist to see if you have any disordered eating behaviors that they can help you with. In terms of getting the surgery if that’s what you choose you may have to wait until you get to a BMI of 30 to qualify, BUT. If you haven’t been measured in a while your height may be shorter than you think because we shrink as we age and your BMI will be higher than you think. (BMI goes up almost an entire point just because of one inch). Also, I would still call around because I believe anything under 35 you will have to be self pay so maybe with your medical issues they would consider doing it just under 30. I’m pretty sure it’s up to the doctor.

decided to hop on the scale a little earlier than usual today. I normally only weigh myself once a month. Sure enough... I have officially lost 100lb in just 6 months post op. So exciting. and this was done basically with almost zero exercising. I work full time and i get home and i go straight to sleep lol. I do need to go shopping for clothes. So yesterday the new Black Adam movie came out. So i was getting dressed to go see it and realized nothing fit. My nicer clothing was too big, I literally wore my work uniform to go to the movies because thats all that fit haha. So i am off today so i am heading to the mall. To the stores that i normally can never go buy anything in because they sell clothes for smaller people. Lets keep this weight loss train going!!! Want to get under 200lb and i am almost there lol. OHHHHHHH and so the movie theater. Its reserved seating and they are very nice comfortable seats that power recline and such. SO before surgery i would normally buy two seats because 1 would be soooo tight that it was not enjoyable. Yesterday i fit in the seat with so much room to spare. Looks like i am going to sign up again for the AMC A list lol

I don't think I understand. If you've been a non-drinker all of these years and decided to get weight loss surgery and have had much success so far... why suddenly do you feel the need to drink? Even one drink? Drinking completely stops the process of burning stored fat for... (I believe... 48 hours???). The liver can't convert the stored fat to energy (fat burning) while it's busy trying to process the alcohol. So I agree with everything @Starwarsandcupcakes said. Obviously I'm not a drinker and don't advocate drinking. I see no purpose in it. It's a poison and hinders weight loss and has no benefits. I think the bigger question here is if you have never been a drinker, why do you want to start now?