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Adding to the good points that have been made here, metabolic rates are somewhat individual, beyond genetics but personal history and even your gut flora that helps digestion and absorption. The BMR tests are interesting as a reference, but they mostly tell you what the algorithm thinks your metabolism should be, but not what it actually is. Also, this is a somewhat tough time for a bypass post op, as the caloric malabsorption of the bypass dissipates after a year or two - you tend to lose that extra help in losing weight and become a more "normal" person in that regard. Some may never notice the effect if they lost quickly and early, but it can also bite you in maintenance if one gets used to being stable at say, 1700 calories, but then that stability point drops to maybe 1600 or 1500. So, stay flexible and try to keep the calories down as much as you can until you get to the weight you desire (or to where it just won't go down anymore) and adjust to maintenance Good luck....

I appreciate all of the info! Its nice to see a full circle of how someone started and and got to goal and maintains. Its all very helpful and no post is too long. The idea of the surgery plus the keto fat burning is why I'm so pro low carb in my head. I have done keto many times though (less than 40 carbs) and never lost any weight. I even used those ketone strips to make sure and they confirmed I was good, but even after doing the diet for 6 months, never lost more than 5 pounds. I never get the keto flu either, so I'm ok there but if it doesn't work for me, and you can maintain on higher amounts, I wonder if I can eat carbs and still be ok. I think I just have to try things out and see how it goes.

I found the standards I was given were quite strict and still reasonable. These are used Provence wide here and I found little deviation to different plans offered by other hospitals here in Ontario. My hospital is involved with The University of Toronto medical school as several hospitals are all involved together. A large group or team gives me confidence in their work and structure they offered me. I was also given the option to vary my plan slightly but I personally recommend being a bit more strict with yourself and allow your body to transition and heal. Time and your body mechanics will tell you when to progress. It is a long journey we are all in. I spent 30 years being fat and unhealthy and I will not loose the weight in fast succession. It will take lots of effort and time to make real permanent changes. I wish you all the best on your weight loss journey to better health. From Canada Cheers!

I just hit 50.5 pounds lost total, 36.4 since my bypass. I feel like my weight loss is slow but oh well. Nausea is finally waning and zero dumping! My taste buds have changed dramatically and I crave savory foods over sweet. My labs are great and my A1C is 5.1. It’s never been that low! Feeling pretty good!

Very validating! You may consider telling the state medical board about your experience.. it sounds like this doctor causes harm and could cause death due to his fat phobic approach to medicine. it certainly could have done you great harm to be untreated when some simple, medically standard tests could have gotten you treatment sooner. especially refusing to consider anything other than weight when you had symptoms that were screaming something is wrong (body temp etc) if you share your experience with the authorities it is possible he won’t be able to harm others (or other complaints will be taken more seriously in the future about him)

I thought he wasn't in the beginning... I'm still looking around for a new PCP, when I recently found someone I was seeking recommendations from who used to go to him too. She kept having pain and he told her to lose weight and she ended.going to the ER for having a ruptured ovarian cyst. At this point it feels quite validating. Plus, it took my nutritionist fighting for me with him to get a recommendation to see an endocrinologist. Normal PCPs can do a TSH blood test to see, but he didn't even do that, so I think I'll trust the other comments and my gut for now. Plus, I'm feeling much better on the meds and the weight is just sliding off! And, also one of the reasons I was hesitant as well was because I have super brittle hair and nails and I was afraid of the hair loss part of the recovery. I know it's a little shallow but I thought about trying to get vsg long and hard. I'm just so happy now that my body temp isn't at 92F anymore. Like I don't always feel so cold anymore. It's so freeing. Sent from my M2007J3SY using BariatricPal mobile app

So, when I was first talking to my nutritionist I had already been logging all my food into MyFitnessPal for around a year. And I've always had a problem with low body temp, brittle hair and nails, exhaustion, and high body weight set point. She tested for the standard TSH, T3, T4, Vitamin D, retook the standard ha1c, LH, FSH, cortisol, and something else I don't remember. It was quite a few vials. My intake was typically around 1200 kcal-1600 kcal. And I workout a lot. I typically spend 2 hours weight training on odd days and cardio on even days. And I had a symptom for when I eat I get super cold and my hands feel freezing. Hope that helps you also know what to ask an endocrinologist. That's at least what was afflicting me. For me I ended up having pretty high TSH (upper range teetering on over) and incredibly low T3 and T4. Sent from my M2007J3SY using BariatricPal mobile app

Sometimes too much info is bad. I follow what my surgery information booklet tells me. It lays out days and weekly schedule. It tells me food to eat during these times and I'm following it to the letter. I have added a copy of the guide I use. Hope it will help. It had guided me well and I only move on to my next stage only when I am ready I never get ahead of this schedule. That was the best advice I gotten from my surgeon and nutritionist and I'm greatfull for it. Best wishes on your weight loss journey. !! TWH_dietexcerpt_dec2013.pdf I also wanted to add that I use MyFitnessPal to track my food and nutrition and it help me track my calories, carbs and salt intake.

Wow reading this topic I'm very fortunate I qualified for surgery here in Canada. It did take about a year of screaming and follow ups. In the end all was covered under ohip . Ontario health insurance policy and did not pay directly out of pocket. Most people who start the process do not fill requirements. They don't follow guidelines or miss appointment or ignore preset goals. I was informen that 85% give up and of those that do the surgery 60 % regain the weight back in 5 to 10 years. I know of two people that did surgery and one gained weight back and the other is still keeping it off. So I am truly wishing you all positive thoughts encouragement and support in all of us on this weight loss journey!

I think this phenomenon is common. I certainly have experienced it. At my heaviest, I didn't think I was "that big" and conducted myself with confidence and style. Then I lost weight and I could not see the weight loss! I lost 70 lbs before I could see the difference in the mirror although everyone else was saying they could see a marvelous change. Now I've lost another 30 lbs and I'm going through another dysmorphic experience. I've gotten so many complements and positive comments that now I picture myself as smaller than I really am. It's shocking to look in a full length mirror and realize that I am still morbidly obese.

How very glad to hear you're still doing great and almost there to your goal. I have kinda stalled for the last 2 months or so. But it's also cuz I have been travelling and wasn't following the plan to the T. I do want to lose another 10 or 15. Let's see if I make it. I am kinda happy with 120 but a bit wary of the 10-20 pounds bounce that can happen in year 2 or 3. Hence, I want to make myself steady around 105 or so, so even if I were to gain a little, I'll be alright.

Hello lovely people. So im confused on how every forum including my own surgeons says all different times to start things after surgery. Some day week 1-2 u can have mashed pot some say no only creamed soups some say yogurts some say You can have some normal food at week 3 please tell me what you all did or are doing . My nutritionist even is saying different then what was on post op papers . I don’t want to mess this up but if I can attempt different things that won’t affect me and is “allowed” I sorta want to. Pre weight 210 surgery Oct 12/22 weight 199 Current weight 187

I feel your pain. I’m maintaining between 214-220 lbs at 1000-1200 calories. There really isn’t anything to cut out and still be healthy. I’m fighting to stay at this by logging meals, measuring but not being totally obsessed. The goal all along has to be as healthy as I can be, not wearing a bikini or posting on popular social media. I hope your health choices are what you can live with long term. That’s what I ask myself too, every day. Are you mobile, in reasonable health, can you continue to do the active things you love with people who love you? Is your health limiting your job choices? I feel that this is something that we don’t talk about enough on here. What happens when you stop loosing weight and you are not at goal, and the calories are as low as you can reasonably eat? I think this happens more often than gets posted.

Bariatric surgery is a major step, so I don't blame you for being scared. I just wanted to reach out and validate your feelings. I was scared, too, which is why I chose a non-surgical option (Endoscopic Sleeve Gastroplasty). It is not yet covered by insurance so it is not as popular, but in my experience thus far and per the medical literature it is safe & effective. Maybe ESG is something to keep in mind for later, if you still need a "tool" in the form of a sleeve. But I would wait until your weight stabilizes after the meds, exercise, and new healthy eating habits are established. FWIW, I do not think your PCP is fat phobic. Obesity is a serious health risk, the older and the bigger you get. No one sees this more than a diligent PCP. Mine is 100% in favor of my new tool because she is the one who has been prescribing all my meds for hypertension and pre-diabetes, referring me to specialists, etc. I am just glad you went to see an endocrinologist and found a medical reason for your obesity. In case no one else has said it lately, great job!! Even with new meds, losing that much weight is an accomplishment. I agree with the other suggestions here re: strength training and all. Best wishes to you.

I don't know that I agree that using sugar free creamer is an automatic one-way trip back to Fattown. However, ANYTHING you consume that is a) easy to use much more of than you realize or b) previously didn't consider to be caloric or worth logging, can make you gain weight. Know what your limits and capabilities are, and if it's too much temptation, don't. At the risk of inciting the "I only eat 'real food'" crowd, I drink sugar free creamer every day, but it's measured and logged like anything else. I use 30 calories' worth, and I know that because I measure it. TL;DR I don't think it's the creamer, it could be anything you don't consider to be "food". You could easily make the same mistake with condiments, salad dressing, cooking oil, butter, or anything else. If it has calories, measure and log it.

I too had a lot of UTIs post sleeve! Isn’t that weird? And with the antibiotic restrictions post weight loss surgery they were hard to treat! Post revision I haven’t had one yet so yay! I’m glad I’m not the only one who experienced that with the sleeve…I thought I was just gross 😬

My husband says I need to exercise more too. I walk about 45 minutes to a hour a day and that’s about it. The thing is I lost the weight without doing any more than that so it doesn’t make sense that I am gaining now because of that. The doctors keep blaming my antidepressants and my bipolar I just think that there is more to it. The weight gain did all start around 25 though which is also when the symptoms of my illness began so idk. I don’t need a referral for a specialist though, so I think I am going to see one just to rule it out if nothing else.

An endocrinologist works with pretty much any issue related to the endocrine system, meaning your thyroid, pituitary gland, hypothalamus, adrenal gland, etc. Basically most anything hormone related is something they can help treat. You can always ask you PCP for a referral, but depending on your doc and your insurance, they may be loathe to do so if you don't have anything showing up on your blood tests. If you're insurance does not require a referral to see a specialist, the you can always just make an appointment. There definitely are some hormone imbalances that can slow your metabolism such that your maintenance calories will be pretty low. Alternately, it may not be a hormone imbalance at all. It may just be what's normal for you. One additional thing for you to consider is that exercise, especially strength training, would allow you to eat more without gaining. What's your exercise routine look like right now?

Do you know what all an endocrinologist tests for? It’s not just hypo and hyperthyroidism, right?? I am in maintenance and struggling big time. I feel like the only way to maintain my weight is to be on a diet (and hungry) for the rest of my life cause I add in a few calories and I gain. I feel like there is something going on with my hormones that my primary doc is missing. I see him today and plan to ask a lot of questions. Just wondering what conditions cause weight gain that I should be questioning him about.

Hello, I had found out about my HH during my WLS pre-op process. They saw it in the scope. I had severe GERD for YEARS and never heard of a HH (on 2 prescriptions plus TUMS), my doctor never even looked into WHY I may have acid reflux so bad. I didn't even know it was a thing, he did say my weight doesn't help it though. Anyway, long story short. Major damage to my esophagus and a huge HH. My bariatric surgeon fixed everything during my WLS. I had bypass, I have ZERO regrets and only wish I had done it sooner. My GERD is completely cured, off all GERD medications and have eaten just about everything I would have before surgery as far as "trigger foods". Otherwise I only had slightly high blood pressure and now it is always low, sometimes even too low. So again, ZERO REGRETS! Good luck on your journey!

I too have been struggling with similar issues over the last two weeks. I’ve gotten away from logging my food into the Baritastic App, I’m not drinking enough fluids, and I’m definitely not hitting my protein goals most days. I also have found myself snacking on foods that I would’ve chosen pre-surgery and I really need to nip that in the bud. I think that it’s no coincidence that they harp on fluid and protein intake when you’re in the pre-op phase. I really think those two things are key for successful and sustainable weight loss post surgery.

To add to everyone’s great advice above, don’t forget, your rate of loss slow as you get nearer to your body’s set weight. This is the weight your body is happiest at & will settle at. The surgery resets this from where it was but it may not be the weight you want to be. To get below this weight you will have to consume less & do more. It will be more of a struggle & difficult to maintain that lower weight because you’re fighting your body. Personally I’d put on weight at 1500 but I’m short at 5’3”, not very active, more finely built & 57. But before surgery I couldn’t lose eating 900 calories. But don’t think your weight loss is over yet. You’ll get where you’re supposed to be in your time & there’s nothing wrong with that.

I know this is hard to read and even harder to hear, but one of the worst things you can do is compare yourself to others (I am no different and have been having this problem for the last few weeks myself). You’re the only you and there is no one else like you that has your exact situation, weight, metabolism, etc. Just try to stay focused with your post op and doing the best you can. That’s all any of us can do.

Howdy! I've been so busy enjoying this new freedom called get up and MOVE! I have joined a fun dance group called Body Groove and it is a fantastic way of getting up and get moving with low impact. It's an app you can download on your TV and dance along. Overall I have been able to resume normal eating, but the raw food are still kinda iffy. I think I'll wait awhile before introducing salads. I need to stay focused on protein and hydration. With my morning protein drink (coffee replacement) and adding liquid protein to my water, I haven't had any issues with meeting my protein requirements. I find more than anything is that I'm tired. I was successfully able to give blood and my iron count was 13.5 so I know my nutrients and supplements are absorbing. I go for my 3 month checkup soon and they'll be analyzing my blood labs a bit closer. Constipation is a real issue. even though I take a Dulcolax chew about once a week, I think I'm gonna have to up it to every other day. Suppositories work real well, but I hate when it has had to get that far. I also started drinking a green smoothie most days to get in my trace minerals in wheat grass powder, veggies, and adaptogens from mushrooms. Anyone else try Ka'Chava? I really like it My weight stalled around 207/208 for about three weeks but I dropped a considerable amount of inches. So far I am staying within the healthy weight loss bracket. I'm anxious to post my Onederland scale picture soon!!

(Warning: this is long) tldr; for ME, in MAINTENANCE, carbs consumption makes little difference to my weight. K. My NUT didn’t give me a carb goal/limit per se, but did instruct me to aim for my meals to consist of 25% carbs/starches (with another 25% being protein and the remaining 50% to be low-glycemic veggies). With that said, i did my own thing (and told her so): i ended up doing ultra-low carb, i.e., less than 25g NET carbs per day. Got to goal in 7 months, remained carbophobic, lost a few more pounds and basically still went out of my way to avoid them. I wasn’t ultra-low carb as during weight loss phase, but i was still pretty low. Eventually, i started eating more and nowadays (4 years post), i probably eat as much carbs as a “regular” person. I have remained under goal weight this entire time. These are my takeaways of going low-carb (and this is from MY experience, YMMV) 1) weight loss is rapid. but you need to remain low carb for an extended period. If i carb up on a day, the weight loss slows down or pauses. There is a science to this phenomenon regarding ketosis, the explanation of which is beyond the scope of my post (just google it if ur interested). Also want to say that i was also ultra-low calorie so obvs that contributed! 2) there is a period of a few days that, once passed, my cravings for carbohydrates went away. (Which is why once u start, stick to it because u may have to go thu the “white-knuckle” phase again to alleviate urself of the cravings (see note 1 above) 3) now here is the kicker: during MAINTENANCE (i cant say if this applies to weight loss phase because i didn’t try it)…i discovered that, for ME, it does not matter if my 1800 cals average i eat a day consists of 20g of carbs or 200g. My weight stays the same regardless. What does make a difference is CALORIES. So long as my calories stay at around 1800 (however it is comprised) then im good. 4) carb consumption affects my looks. When i low carb, my body is more defined (which i like) and my face more gaunt (which I don’t like). These days my face is lovely (lol), but my body could be better. Mind u i have also been slacking on the exercise front so that is also a factor, but i digress. In any case, the point is i am still basically the same weight as my low-carb maintenance days. And that concludes my dissertation for this evening lol. P.S. I want to point out also that i am NOT insulin-resitant, nor suffer any other medical conditions that affect my weight, nor take any medications that would either. So this may not be everyone’s experience. P.P.S. Sorry this was so long!