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I am following my Nutritionists recommendations. She was head of bariatric nutrician at MT. Sinai in NYC. She prefers that i get nutrients from a healthy diet. I do take b complex and calcium in addition. Sent from my VS996 using BariatricPal mobile app

I'd like to respectfully disagree. I wrote an article on this exact topic a little while ago... Flintstones Multivitamins: Tasty and Inadequate for Bariatric Surgery Patients “Complete” But Lacking Essential Nutrients What does a “complete” multivitamin contain? It could provide anything from all the essential nutrients to just a few. There is no legal definition for “complete.” In the case of Flintstones “Complete” multivitamin chewables, “complete” apparently means that it has all 13 vitamins, but only 6 of the more than 15 essential minerals that you need. Quantity Is Critical For bariatric surgery patients, it is not only important to get each of the necessary vitamins and minerals, but also to have the right amounts. You need high amounts of some of the vitamins and minerals, and Flintstones chewables simply do not deliver. For example, the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests at least 12 mg thiamin (vitamin B1) per day, while a chewable has 1.5 mg. You will also be short on: Vitamin A Vitamin D Vitamin E Vitamin B12 Iron Calcium And more. “Doubling Up” Does Not Work If one tablet is not enough, can’t you just take two? Well, not really. First, getting twice as much as certain nutrients may still leave you short. For example, 2 Flintstones chewables provide 1,200 IU of vitamin D, while recommendations for post-op gastric bypass patients are to get 3,000 IU per day. And no matter how many chewables you take, you will never get enough of essential minerals such as selenium and chromium, since the chewables have none. Multivitamin: What Is in a Name? We usually refer to them as “multivitamins,” but most often, we really mean, “multivitamin and mineral supplements.” Sometimes, a “multivitamin” that you buy off the shelf really is literally a bunch of vitamins with few or no minerals. Do not get confused by the name when purchasing your supplement. Read the supplement facts label to see which nutrients are in the supplement, and how much there is. Safe Choices, Your Way To be sure that you are getting the right supplement for bariatric surgery post-op needs, you are best off choosing a bariatric supplement. It may be a tad more expensive, but it could prevent deficiency diseases such as anemia or peripheral neuropathy. Choosing a bariatric surgery-targeted multivitamin instead of a kids’ supplement does not mean you have to choke down capsules if you cannot stand them. You can always opt for another form, such as Powder or a Soft Chew. For help figuring out which vitamin and mineral supplement may be right for you, you can look at the attached ASMBS guidelines or check out our Bariatric Vitamin Guide, which breaks down recommendations for each surgery type. Also, be sure to talk to your doctor about your individual needs before trying a supplement. ASMBS-Nutritional-Guidelines-2016-Update.pdf

Probably by her doctor or Bariatric Clinic. At least that is MY Guess.

Great idea! I would totally listen, and wold love to contribute too. I’m 4.5 years post-RNY and ran my first marathon yesterday. I try to stay engaged with the patient group from my surgeon, to both give and receive support, but there’s no one else like me there and most are in a very different part of their journey. The Bariatrics specialists haven’t been any help in my journey since I hit my goal weight, and the non-Bariatrics nutritionists and trainers haven’t had much idea what to do with me either. PM me if you want to talk more.

Hi! Did you return to your team for help & tips first? That might be the place to start. But also motivation may be hard to find on your own so maybe returning to bariatric support groups if you've stop attending. Have you attempted to refine your diet again? Perhaps removing the foods that arent on your initial plan may kickstart weightloss immediately. Good luck 💜 YOU can do it 🏆

Hey guys. I was wondering, if there was a podcast that focused on Bariatric fitness and nutrition once we get to maintenance, would anybody listen? I feel like trainers and nutritionists that understand caloric needs for a Bariatric patient who wants to excel at physical fitness are hard to come by. So I had the idea of starting up a podcast to talk about it. A little info, some guests, discuss some research, whatever. What do you guys think?

walking I could do right away - in fact, I was encouraged to do so. Other exercises I had to wait about a month on - strength training they said to wait even longer than a month (may have been eight weeks for that, I'm not sure) 8-9 lbs the first week is great. You are not "My 600 lb Life", so do not expect to lose as much as quickly as they do. The average range for weight loss for the first month seems to be about 15-25 lbs for us more "normal" bariatric patients, so you are just fine. I lost 16 lbs that whole first month, and I started off at over 300 lbs.

The night I went to my seminar and found out what was required I adopted a "bariatric" lifestyle. That was one month before my first surgeon's visit and 5 months before surgery.

The scientific literature is pretty clear about weight loss...calorie restriction is a much larger part of weight loss than exercise. It's simple math...if you figure out how much exercise is required to burn 300 calories vs how easily you can consume an extra 300 calories in a day then you'll see my point - ex. one Boston cream donut can complete undo 45 mins of exercise. It's also psychological - if you could eat a perfectly isocaloric diet and exercise without any compensatory eating (eating more because you're exercising) then sure you can slowly lose weight with exercise alone. The problem is most of us do not know out isocaloric point and most of us can not maintain this lifestyle over months/years without seeing significant progress. With surgery it's also much easier to go into an extreme calorie deficit - how much exercise would you need to do to burn 2200+ calories per day? An immediate deficit many bariatric surgery patients experience pre vs post-op. This is not to say exercise is not important. Most of the adaptive physiological changes working against us (loss of muscle mass and the subsequent decrease is resting metabolic rate) can be minimized with exercise post-op. It's also important to realize calorie restriction gets the weight off quickly but most of us didn't gain weight quickly - it was relatively slow over years/decades. If you gained 100 lbs over ten years that means an average excess of just 100 calories per day over that 10 year period. You can see how even moderate exercise post-op/weight loss can help to tip the scales towards weight maintenance. Of course post-op diet is still king for long-term weight loss and maintenance....the old saying you can't out-train a bad diet is true.....

I’m sorry you are dealing with this. I’ve had difficulty with thinning hair for some time. I started to keep it short because everything pulled my hair out in clumps. Even just to comb it. I can’t afford to lose hair, mine is like baby hair, very thin strands. I usually keep it extremely short. But then it’s hard going for haircuts. Post op. I’ve been taking gummy vitamins but I make sure they are Whole Foods vitamins. Garden of life makes a good Whole Foods women’s multi vitamin. (There are others as well I might try rainbow light chewable multi vitamin next time) And Natures Way makes a good hair skin and nails gummy with extra collagen. Even if you can swallow pills gummies or liquid vitamins absorb better. And even better if they are Whole food based. I also take omega gummies for the EFAs. A b complex. And of course calcium. For hair, You need vitamin A, b complex vitamins too especially biotin and also collagen. I get my vitamins from vitacost and always get coupons. I haven’t bought bariatric specific vitamins because the multi vitamin all have iodine and I’m allergic. Some basic vitamins like centrum do nothing and don’t absorb any benefits at all. I use cleansing conditioner on my hair and a scalp massage brush in the shower. Since a healthy scalp helps healthy hair. I’m not as far along so I don’t know what will happen with my hair. I’m just taking it one moment at a time. I hope you find the answers you need.

Hi, everyone! Hope all of you are well and doing great after your surgery, or you are all ready for your big day! Just a quick update on me, in case anyone wants to see what a few weeks out may/can look like. I will be 4 weeks out of my RNY on Monday. I think I am finally starting to feel more like myself again. I am feeling like I have a bit of a bariatric routine going for vitamins, food, and water so it isn't quite taking over so much of my daily focus and I am starting to feel more energy, too. I am able to eat some soft chicken, fish and shimp now without trouble. (I weigh each "meal" out with a scale, about an ounce worth or less, and log it down.) I have a calorie limit of 300 calories this week, which bumps up to 400 next week. I have never felt nauseous, but I only eat till I feel any pressure at all and stop. For those on only liquids still, hang on! It does get sooo much better with just a little bit of real food. I have been just meeting the low end of my 60-80 grams a day protein goal- though I think it will be easier with a few more calories to use, if I need them. So far I have still needed a whey protein shake to meet my daily protein goal. UGH!!! Good Lord, if I never, ever taste another whey shake again that would be great... I am SOOO over those puppies. I feel like I can taste that stuff all the time. GROSS!!! Honestly, the hardest thing for me is getting that 64 ounces of water in daily! I am full for so long after eating, I think I just don't want to drink even. I am doing better everyday though. Wishing each of you the best in your journey and looking forward to reading more about everyones great progress !!! 💙

I am going back to Mexicali Bariatric. Dr. Aceves did my sleeve and I wish he were around to do my conversion, but Dr. Ungston will be my surgeon. And yes...the no calorie counting thing is a huge bonus for me. I know that I still need to “count” protein but not having to focus on the balancing act of protein within no certain caloric goal will be nice....no more balancing act! Yay!

So is butternut squash, sweet potatos and even pumpkin. A little Google, a little YouTube and a lot of Bariatric Pal also Pinterest. There are recipes tasty but yet not too bad for you. Its worth the Search!

yes - starting BMI is definitely a major factor in rate of weight loss. I think a lot of people are disappointed in their initial loss because of just what you said - "My 600 lb Life". Most WLS patients do not weigh anywhere near 600 lbs when we start, so it would be very unusual for us to drop as much weight at first as they do. Although I don't have any research data to back this up, just from my own observation of hanging around on various bariatric boards for the last five years, I would say the average is in the 15-25 lb range the first month. Of course there are people who lose more or less than that, but I'd say that's pretty average for the typical WLS patient.

Wanted to share my before and after pics! While my weight loss has been less than a some bariatric patients, I have lost over 30% of my starting weight and as of today, have a healthy body fat percentage, for the first time since childhood! Still working towards my goal weight and healthy BMI!

FOR ANYONE IN THE FUTURE THAT MIGHT STUMBLE UPON THIS AND WANT TO KNOW... I will also update after my WLS. Can Weight Loss Surgery Help Polycystic Ovarian Syndrome? Polycystic ovarian syndrome (PCOS) is the most common endocrine system disorder in women. About 10% of all women of reproductive age have signs of PCOS, which is a hormone imbalance that can cause weight gain, acne, extra hair, irregular periods, and other problems. Perhaps the most significant problems experienced by women who suffer from PCOS are hyperandrogenism (the presence of excess of male sex hormones), and anovulation, which causes a woman to stop ovulating, rendering her infertile. Many women who suffer from PCOS are also obese. Recent studies have indicated that women who are significantly overweight may achieve improvement with PCOS through the significant weight loss that bariatric surgery can bring. Below we discuss the role of weight loss surgery as a potential tool to assist patients with PCOS. The Connection Between PCOS and Excess Weight Almost 60% of women with PCOS are obese. Many women with PCOS are also insulin resistant and/or have a reduced glucose tolerance. When someone is insulin resistant, their body does not use its insulin effectively to store glucose in the body as fuel. Too much glucose is the system slows the breakdown of fat in the body and creates new fat cells. This is why someone who is insulin resistant tends to gain weight. The problem worsens when the insulant resistant person’s body makes more insulin, trying to compensate for the inefficiency. This increase in supply only makes the body more insulin resistant. It is estimated that over half of women with PCOS are resistant to insulin and eventually will develop metabolic syndrome, a cluster of serious metabolic conditions (high blood sugar, high HDL cholesterol, high triglyceride levels, abdominal obesity, and high blood pressure) that increase risk for coronary artery disease, stroke, diabetes, and heart disease. Since bariatric surgery treats weight gain and obesity, it can have a positive effect on the metabolic processes – including how the body metabolizes insulin. This in turn may be able to treat the symptoms of PCOS that relate to problems processing sugar, such as weight gain. This relationship may explain why weight loss surgery seems to affect PCOS symptoms. Studies Show Bariatric Surgery Can Help PCOS Research has shown that weight loss surgery can reverse the conditions associated with metabolic syndrome (such as high blood pressure, high blood sugar, etc.) or prevent them from occurring. Additionally, scientific studies have shown a positive connection between bariatric surgeries and relief from PCOS symptoms. The basis of these assertions is the relationship between PCOS and obesity. One study of 33 women with PCOS who underwent weight loss surgery at the Cleveland Clinic Foundation found that bariatric surgery resolved many key characteristics of PCOS, including enlarged ovaries and excess androgen. The study concluded that women should consider weight loss surgery as an extreme remedy for PCOS. Still, the women with PCOS who did undergo bariatric surgery did report positive effects on their symptoms. Sent from my SM-G965U using BariatricPal mobile app

This kind of goes along with my post about low protein. More lab results came back today, and I am also deficient in vitamin A. I am waiting to hear from the surgeon about this, but imagine I will need a prescription vitamin A supplement. Any one else deficient in vitamin A? I do take a high quality bariatric multivitamin twice a day. Sent from my SM-N960U using BariatricPal mobile app

It's a medication to help prevent gallstones due to rapid weight loss in bariatric patients.

Okay so even though it’s a bajillion degrees outside today, I made the “ramen” again for lunch. What I do is take a packet of the bariatric cream of chicken soup and add a scoop of beef bone broth. I run 8oz water though my Keurig then stir in some little torn up pieces of seaweed snacks (the wasabi flavor is full of awesomeness). Then I take my angel hair tofu, rinse in a colander form 30-60 seconds, throw in a bowl and microwave for about a minute. I don’t care if it’s wet because I’m gonna throw it into the broth anyway. I also added a dollop of wasabi (not pictured) into the cup to give it some pep. All in all, I’m only able to eat about half at a time, so it serves me 2 meals during my eating window. Each half gives me 14gm protein, 90 calories, 5 gm carbs.

Slimfast, that is a blast from the past. I remember me and the guys at work using that stuff to lose weight in the 90's. It always worked at first then the weight always came back. I don't think there is a bariatric surgeon or nutritionist that has Slimfast on their post op menu.

What does your optifast diet consist of? I just bought a ton of different protein shakes from Bariatric Pal and a variety pack of broths and those broth sticks then some calcium citrate. I swear I can't find citrate calcium in stores its always the other one (I cant think of the name off the top of my head). I grabbed some protein shakes from the store the other day to try them. Premier Protein everyone talks about them. I liked the Akins ones but they only have 15g of protein rather then the Premier it has 30g so that's a no brainer. My surgeon didn't tell me to start anything yet, but I wanted to have it all ready for the 2wk pre surgery diet. I see him the 12th of July I assume that's when he will tell me to start it.

A general surgeon did one of my endoscopies, came out Looney as heck, sore throat, sore chest, felt drunk for a day and half, don't k,ow if he gave me enough sedation to perform a hysterectomy, but learned my lesson. Bariatric Surgeons or gastroenterologist from now on, when I tried to talk to him about my reactions he was NASTY, basically told me to shut my 👄 mouth. He'll Never Touch my body again!

I guess a general surgeon could do bariatric surgery, as they do all kinds of different procedures, but I'd want someone who specialized in bariatric surgery, had a proven track record, was Board Certified, and had done it thousands of times.

Because our hair grows in cycles, my dietician instructed us to start taking our Bariatric vitamins and biotin now. And to make sure we get in our daily required protein!!! Hopefully, this will help prevent hair loss post op.

And Just like A Wounded Animal you want only to retreat to Your Cave until You Feel All Better! I know you feel impatient, among other things, But Do Give Yourself permission to heal! You and Your Body have been through a lot This Week! Not all of Us leave the Bariatric Center singing the" Battle Hymn of the Republic" more of us are Muttering Under our Breath, holding on to someone or something, saying Why Me Lord? Why DID I AGREE TO ALL THIS? But like sunshine after the ☔ rainstorms, 8t Really Gets Better! We all, in some way, have limped and flinched, We Got Better, and in just a little while THINGS DO GET BETTER! Stay strong, still Sip Sip Sip, lick your Sugar Free Popsicles, remember almost everyone, this is what it takes, You have now paid your Dues, You are now a Part of the POST SURGERY CREW- Hurts Now, WON'T FOREVER!