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I'm 4 months post op today from my SIPS procedure. I have lost 83lbs in total since the start in early June, and 68 lbs since surgery, however I was hoping to be further along and even at my last Dr appointment they indicated I could have lost more and were surprised I hadn't. I seem to be averaging 11 lbs a month over the last 3 months, but what keeps happening is that I lose 11lbs in one week, then NOTHING for 3 weeks!! Is this normal? At first I thought it was just a stall, but the last 3 months in a row have had exactly the same pattern. Don't get me wrong, I'm really happy to have lost the weight I have, but I was kind of hoping for it to go a bit quicker, because I have a total of 200lbs to lose and everyone tells me (including my Doctor!) that after the first 6 months it will slow right down. I took on board what they said and have been sticking to the food plan and going to the gym, because I was terrified if I didn't lose 100-150lbs in the first 6 months, I wouldn't get to my goal. But seems like my body had different plans. I also don't understand how I can have a daily calorie deficit of approx 1000 cals, but for 3 weeks out of each month, not lose anything? How is my body actually powering itself during that time? My hair is falling out in clumps and my skin isn't great, so I'm guessing thats what's happening instead, but seriously....how can I be running on negative?? My average daily food intake looks like this: Breakfast: either 1 boiled egg with a little mayo, or 1 protein shake (premier protein). Once a week I will have 1/2 a cup of rice cereal. Lunch: I batch cook chilli or soup with added protein at home to take to work. Usually have it with 1oz of pecans or macadamias (trying to follow keto) Mid-afternoon snack: cheese stick or protein shake (depending on whether I had one for breakfast or not) Dinner: Varies, but generally I go for pressure cooker chicken (between 3 and 5 oz) and green veg, or tuna salad, or 3-5oz of pork chop. 2-3 times a week I will have 3oz of sweet potato, but thats not every day and depends on how hungry I am. My average calorie intake is 99% of the time between 800 and 1150 and I hit at least 80g of protein every day. I try to keep carbs under 30g, but often average about 50g (gross) I count my water and get at least 64oz every day. I go to the gym 2-3 times a week, and on average I do 45 mins of cardio (cross trainer/eliptical and bike) and then 10-15 mins of weight training. Outside of this i try to be as active as I can, and I average round 6000-7500 steps daily (I have an office job so can be tricky) Does anyone have any advice or thoughts on what else I can do to try and speed this up? Should I do different things at the gym, or just try to go more often? Or should I mix up my food a bit more? I'd really appreciate any ideas.

I've been doing Keto WOL for past 15 months in preparation for losing weight prior to pursuing bariatric surgery and also seeking relief from inflammation - which doing Keto has helped me with greatly. I probably won't have my weight loss surgery until the end of June or the beginning of July and am trying to get started on taking vitamins/supplements to meet my body's needs that I feel are being missed right now. I also want to head off/reduce the chances of massive amounts of hair loss. I noticed my hair is thinning - I'm on a blood thinner which causes hair loss and I've hit menopause which also causes hair loss so I've been VERY stressed over this. Then I think about how much hair loss I've seen in ppl who have had WLS although my nutritionist said most hair loss was from not getting adequate amounts of protein each day (min of 80 grams she said). My surgeon gave me a pamphlet for Bariatric Advantage vitamins but it is a bit confusing as I haven't had weight loss surgery yet, but I need to bolster my intake of QUALITY vitamins/supplements. If anyone has any recommendations for what would be a good vitamin regimen PRE-SURGERY, I'd greatly appreciate it! I know I need extra calcium and vitamin D in a bad way as well. I appreciate any help you can provide!!

That week three stall hits almost everybody - it doesn't mean you're doing anything wrong. It seems to be the body taking some time to adjust to the surgery and the major change in how you eat. I wouldn't worry about comparing yourself to those who are eating less because a lot of things go into how we metabolize food: your age, activity level, previous dieting history (the more you've dieted in the past, the better your body is at adjusting your metabolism to compensate), your overall health, etc. If the scale is still moving downward then your calories are probably fine. As you continue to drop weight, there may come a time when you need to cut calories because the smaller we get, the less food we need. But for now, you're losing weight, you're hitting your nutritional goals and hydration goals, so there doesn't seem to be any need to arbitrarily limit yourself to 500 or 600 calories a day. Just stay the course. Edit to add: I went back to look at one of my early days when I ate around 600 calories. I'm a little weird in that I rarely eat a full meal, it's usually mini-meals throughout the day. Below is what I ate that day. The Evolve is a protein shake, the Tillamook is a cheese snack pack, the Kitu is a keto-friendly coffee drink and I think the rest is self-explanatory. I wasn't restricting calories, this was just what I could eat at that point (I eat 800-900 calories a day now).

I did a tour of SE Asia (Singapore; KL, Malaysia; Bangkok, Thailand; Hanoi, Vietnam) at 3 months post-op. I had no issues. I just kept to my keto way of eating and there was meat and green vegetables anywhere that I went. For the plane rides (and the long flight was 15+ hours from ATL-ISN), I took almonds, ParmCrisps, and some turkey jerky. I was in business class, so the food was more or less accommodating (especially considering the limited quantities I could consume at that point). I also took ziploc bags so that I could hang on to some of the meat to eat a little bit later. (I had the flight attendant put some ice in another baggie for me to keep it coolish. They looked at me like I was insane, but they did it....) I also took an entire tub of protein powder in ziploc bags in my checked bag (with a little bit in my carryon). All in all, it was pretty easy. I had to be very mindful of eating. But we always have to be mindful of eating. Have a great time wherever your travels may take you!

Ditto what dairymary said. I had an extensive knee surgery and researched it extensively. One of my questions to my surgeon was about which physical therapy protocols he follows. Every doctor formulates his protocols based on his training and experience. I had the same questions for my WLS surgeon, especially since I can't do keto. I didn't want to be at odds with my surgeon and her recovery protocols. sent from mobile device

Hi there...a week shy of 5 months post op RNY....down almost 80lbs. I will admit I am not taking my vitamins, water or protein like I should. I know...what a dumb f**k I am. I know. But I have started to take my liquid vitamins and my protein but did bad with water this week leading me to be SO constipated from Monday to today. All in all everything cleared out and I thought I was okay but the last couple of days I've been feeli my a sort of nauseas feeling and almost like indigestion but not fully since RNY...almost like a thick grease feeling in my throat. This is after I made and had about 3 oz of home made pulled pork. Since I am losing regularly I've been eating a keto inspired diet (including steak and bacon) am I wrong for this? I am going to make an appointment with my doctor but I'm leaving for Disney in 1 week...shoukd I just take the rest of the proposed prescription? Is it all lack of water? Please help, I'm nervous and d ont really want to see my doctor and have him tell me I'm failing Thank you Sent from my SM-G950U using BariatricPal mobile app

I am an old timer. I was sleeved January of 2013. I am short at 5’2” and my sw was 205. My lowest weight was February 2014 at 112. I have been up and down since with my highest weight post surgery at 161. I’ve been doing Keto since 1/7/2019 and am back down to 142. I’d like to get down to 125-130. Keto has really helped with the cravings and I don’t worry about calories. I eat lots of eggs, meats, taco salad with lettuce, ground beef, sour cream, salsa, avocado, etc. I always feel full after eating. I also try to skip breakfast and not eat after dinner. Basically I try to do 18:6 fasting where I stop eating at 6:30pm and I don’t eat again until 12:30 the next day. This seems to be helping. I do drink coffee with heavy whipping cream.

Hmmmm I'm perplexed then, esp since I assumed you weren't eating lactose because you said it caused you problem, but the butter and cheese are ok? Sounds like you could do keto with some plant based fats? Olive oil, nuts and nut butters. That kind of thing?

Interesting that milk and ice cream are the culprits as they both have high sugar content compared to the dairy you can tolerate. Good luck to you and your husband on keto! You can do it!!!

Hi Jabba, I had my wls October 10 2017. I was at a stall as well. I decided to go back to Keto and intermittent fasting. Gosh! I am longer at a stall! 10 pound loss in 2 weeks! My Sister is doing as well. ( she is almost at 4 year post wls) My Sis is losing quite well too! I'm not saying this WOE is for everyone, however it is working well for us atm. Good luck on your continuing journey. Di Sent from my SM-G930V using BariatricPal mobile app

Hi guys. Just an update. I' back on track. I'm at 97 kg now. I am muslim so i fasted through the month ramadan (6 may - 3 june). It did wonders for me. Lost a total of 10 kg in that month. Still 12 kg to go. I think within 6 - 8 months it should be possible for me. Also the Keto diet helped me alot. I advise this to everyone who is stuck on a plateau. Thanks for the reactions. Bye

I think it would be a safety precaution too - putting you in a better & healthier place for your surgery. My surgeon puts his patients on different diets based upon their weight, eating habits, weight loss & medical history. Some are on all shakes or 2 shakes & a meal (under the hospital’s weight loss clinic) or keto with a dietician which I was on. I did the 2 shakes & a meal for a good 3 months some years ago. My meal was at night. It is hard to begin because you’re breaking a lot of habits & addictions (salt, sugar, caffeine, etc.). The first week is usually the hardest but you will lose weight. You got this. Watch the pickles especially the number you eat. Those extra calories quickly add up. If you feel hungry, try a green or herbal tea. Also see if they have soups as well as shakes. (The hospital weight loss clinic program offered soup & shakes mixes as did the pharmacy brand program I followed.) Drinking soups can seem more meal like & can be more satisfying.

Hi y'all from the big ol' state of Texas. I'm a long-time reader, first time poster seeking long walks down the meat isle and gentle laughter in the produce department. I'm new to the whole WLS gig and am trying to wrap my head around new possibilities for living a successful, healthy, cancer-free life. I'm a 6 year breast cancer survivor who battles with stage II lymphedema in my left arm, a lovely parting gift of cancer treatment/surgery/reconstruction, so I no longer do much on my old blog. I was a very active writer | blogger specializing in low carb keto living. Now I'm just a noob, grateful for the information, knowledge, and wisdom of fellow WLS losers (veteran and newbie alike). I look forward to participating here and getting to know each of you. TIA by the way! (BTW, I'm not really seeking a date with ya --so don't be "skeered" I might be a letch or anything. I'm in a very happy 17 year relationship with my SO, Mr. Fluffy .)

Thank you so much for your input! I’ve been itching to reply all week but was having trouble logging on to BP. Anyway, I decided to follow your advice and consult with my Doctor. As I said they arent as great with giving detailed information on nutrition but this time they took their time with me on the phone and explained everything. They said if I’m going to be spending more than 300-400 calories per day on exercising (and I definitely burn 2-3x that amount accordinf to my fitbit), I definitely needed to up my calories. So they cleared me for 1,600 calories when working out,140g of protein (as long as I drink a lot of water to protect my kidneys), and the 36g of fat but said absolutely no more than 100g of carbs/day which made a lot of sense to me. My trainer said she can work with that. I’m going to try it for a week and see how that goes but will follow your advice and monitor closely. If I start to gain weight I’ll go back to keto for sure.

I am 50 and did keto this past year. Well, when I intensely focused on it, in about 9 months and NOT being able to exercise at all due to torn knee and it had not gotten warm enough to get in pool, I lost 45 lbs in that 9 months (although keep in mind I weigh a GREAT DEAL more than you so consider your possible loss on more of a % of ttl basis & if you can manage some things at this time of year like getting on pool, I still think you could lose a nice amt of weight...but I'm also so angry/frustrated on your behalf..but want to encourage you as well if Keto is your only option left) My primary dr. is huge fan of keto but my bariatric dr is not. I actually do not have cholesterol issues but my primary, who I have known now for over 20 yrs, has had other patients whose cholesterol,diabetes, etc. improved. However, I think 'impact' of keto on things like cholesterol can be very individualized. Also, my bariatric dr said if people didn't go to the 'extremes of keto' like eating a ton of beef each and every day, if they limited some of the things that we know often impacts cholesterol, then he'd be more a fan of the general approach. So yes, even at 50, I lost 45 on Keto and that was not working as hard as I could. 18 yrs ago, I lost 80 lbs on Atkins and kept it off for over a decade as I was finally able to be active and yes, was MUCH younger at the time, but hey, I did lose on Keto. I'm torn for you though and I apologize if you've answered this 100 times...does your insurance not have an Appeals process??

Also...both of these meals are heavy on the meat for me...and are more rare. The diet I follow is more like the Mayo Clinic Diet. Lots of whole grains, beans, legumes. Tons of veggies and fruits. Much less meat. I don't like Keto. I know most bariatric patients follow keto for rapid weight loss and I did a lot of research to find a group that had different ideas. We still have a protein goal of 60-80g per day....but my group works with those of us who like to include more plant based proteins, fresh produce and whole grains. We eat a lot of carbs. I say that and people freak out. LOL. But it's true. What we don't eat...are refined carbs. Anything high glycemic is a no-go with the exception of natural fructose in whole fruits. Exercise is a key part of my plan.

I'm only down 43lbs too and I was sleeved a week before you (10/27). I haven't really exercised thought yet. I've had a lot of long stalls so I started he Keto diet (super low carb , moderate Protein , high fat), and the lbs are melting away. It's tough at first and you have to talk to your doc if you have gallbladder issues but it helped me get over stalls. Sent from my iPhone using the BariatricPal App

I don't completely avoid carbs. I'm more into the "everything in moderation" mentality rather than doing Keto, not that there is anything wrong with either; we all have to do what works for us. I eat a slice of Ezekiel bread every day. I have never tried the Melba toast before though.

To preface, many moons ago I played soccer in college and despite my weight gain, I still identify as an athlete. Exercise is not punishment for me, it’s something I’m excited to do again and to have more successful with. That being said, I recently hit 4 wks and doc cleared me for cardio. I downloaded a couch to 5k app and for the last 5 days have been going on hour long run/walks for about 3-4 miles. Combined with daily activity I’m getting in 5-6 miles/day. Problem is that I get really tired in the afternoon and am constantly hungry. I’m eating about 800-900 cal/day but wondering if I need to up that? Also following a keto diet. I’ve been doing soft foods for a couple weeks and am capable of eating more but have been trying to stay less than 900...for no other reason than most people on here are eating so damn little after 4 weeks and I’m trying to follow suit. A typical day may be: 8am - Decaf coffee w/ half premier protein 9am - 2 scrambled eggs 11am - Half serving ground beef noodle-less lasagna 2pm - other half lasagna 5pm - Greek yogurt 7pm - 2 oz Smoked Salmon, one soft cheese wedge 9pm - 1/4 cup cottage cheese 11pm - Decaf coffee w/ half premier protein I’ve been keeping track in MyFitnessPal and you can see the breakdown. Questions - for those that exercise, how many calories are you consuming? Any suggestions on why I’m hitting a wall in the afternoon and need a nap? If I don’t eat every 2 hours my stomach starts grumbling and I get light headed. Should I be eating more at meals? I’ve been hesitant to because I’m nervous that I’ll still need the snack and will go too high on calories for the day. I’ve also been in a pretty major stall over the last 3 weeks. 10 days with nothing, then 5lbs in 2 days, now another 6 days with no loss. Thanks for any help! Sleeved 3/12/18, HW 270, SW 253, CW 238, GW 160, 5’9”

I am very sorry you worked at this so hard and didn't get the outcome you wanted. I belong to a lot of keto groups, which is how I eat currently post-op. I have a facebook friend that lost 250 pounds on keto, has kept it off and had their excess skin removed. Lots of women see PCOS improvements. Look into it, do your research. It is a way of life though, not a diet. You can't think of it as a temporary solution but a way of eating. There is a lot of scientific research, so just make sure you do your research. Even with the sleeve, I kept gaining and losing the same 3 pounds for weeks until I went back to strict keto. It works if you follow it and you like it.

Since being back on the blood pressure meds I dropped 5 pounds....jippeee,and the bounced back one pound.I've also been having an uncomfortable pain in my kidney area and tonight when I got on the scale at 23:00,yes I know I shouldnt do that at all ever, I am up another 1,5 pounds.Did the keto stick and my goodness,I am in deeeeeep purple ketosis for the first time ever in my life. A few things might be causing this.It is now up in the 100 degrees (and over) every day and very humid.I have been struggling a bit with the water intake but not too bad.So I might be dehydrated a little.However I dont look or feel it. Then it might be that I am high on proteins.I have found these nifty little chicken breasts (frozen with a lemon and herb sauce) and that has been my main food for the past 2 days.2 of them weighs 80 grams and I have 22g of protein and I have had 6 of them yesterday and today.Breakfast,lunch and supper.Add to that about 5g protein for milk in my tea and a little in the veggies (2 tiny pieces of broccoli and half of a very small yellow squash that comes from SA and is low cal and low carb) Say it was a total of 75g for the day.The carbs was about 50 as I had a teaspoonof hummus,milk and veggies and a SF popcicle as well. If the pain persist tomorrow I will phone the BP dr. However,I have realized that I will have to start exercising pronto.As in today.To be sure that I do the right things and to not drive myself crazy all the time second guessing weather I am doing the right things,am I eating to much (I know with my head this is not possible) but my emosions tells me differently. How I hate the way the scale freaks me out.the only way I know to control this is to back to dieting the way I know well.I didnt want to obsess with food tracking,low carbing but I will have to.I also believe I should now start making hay while the sun still shines and lose as fast as I possibly can,and believe me,I have put in no effort what so ever until today.It was just lovely for it to just happen but I cannot take this out of control feeling any longer. 1.I will start by just doing walk away the pounds or some dvd here at home.I will play squash twice a week. Next week I will start going to the gym. The thing is for the first time ever I am so self concious when at the gym.I just am not motivated to expose myself to all the thin people...lol.(and we have a ladies only gym at the club as well) So,this is me for today.Crazy,obessed over weight gain that is not real and petrified because I might fail. Tomorrow will be the positive,new me....lol I have read some of my friends blogs and it is all so upbeat and positive and it seems that I am the only one with this crazy roller coaster emotions...or I am just an external prosessor that talks about it.And maybe I have to start fake it until I make it and not express myself the way I do.Maybe I will pretend that everything is just perfect and maybe it will become just that. xxo

This is quite normal. When doing a low carb diet, one's glycogen (short term carbohydrate energy stores) levels are being kept at their minimal level in the hope that the body will burn fat instead. On average, the body will keep around 2 lb of glycogen on board, which is kept in solution by about 8 lb of water. The body wants to get those glycogen levels back where they should be if tehy are low, so any additional carbohydrate consumption beyond ones normal minimal "low carb diet" level will result in some quick short term water weight gain. The amount is limited, and doesn't happen if one is on a normally balanced human diet. I never ran into this particular issue as i kept the carbohydrates and fats in relative balance throughout the whole process, so my glycogen levels, and associated water weight, never yo-yo'd all that much (that, and I couldn't afford the side effects of the overly low-carb/keto type diets.) The flip side of this is when marathoners carbo-load before an event by loading up on pasta, etc. - they are trying to maximize their glycogen levels to improve their endurance.

I am happy WLS is working so well for you. I would like to lose weight quicker. Even when I eat small amounts the scale doesnt move much. So trying more of a keto approach of reducing my carbs. Replaced breakfast with a protein shake and lunch with a tuna salad. Heres hoping...

Just curious as to see who may be doing intermittent fasting 16:8 with or without keto or hflc?... and has had a vsg. I'm 9 months post op 3/12/16 I started IF last week but have eaten hflc for a while now...

Keto is mainly how I roll. Breakfast this morning was a handful of wasabi almonds, a slice of sharp cheddar and two slices of Swiss. Outstanding flavors. lunch is probably going to be an omelette of some type. dinner will most likely be grilled chicken breast as my son requested grilled chicken sandwiches with bacon and the works. I have yet to experience any type of hunger. I will get carb cravings if I eat sugar heavy foods like candy and other junk. Life is simply much easier if I avoid that mess and stick to hearty Protein and vegetables.