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Dietary science, as we experience it at the consumer level, is equal to how we approach witchcraft. And even acknowledging this my sense is we are being offensive to witchcraft. Again, at the consumer level, we are given such nonsensical and arbitrary rules to follow because most consumer level dietary science is people just like us reading the same non-scientific articles on the current fad approach to losing weight, with every author's personal beliefs mixed in. If there were any kind of consensus there would be one generally accepted program with minor variations. Instead we get every fad diet with as many variations as there are patients. So, we are stuck with telling everyone to do what their surgeon's program demands, no matter how disconnected from reality is is. That is the only advice we can give because it's just as likely our program was one of the crazier programs. Of course there are good programs out there. Each of us are so lucky that the program we picked is one of the good ones. It's hard to go on a rant such as this and come back to a positive landing. Perhaps we should talk about something less controversial, like politics. Good luck, Tek

It’s a strange one, because I can now fit into some size US8/AU12 clothes which was always my “goal size”, yet I’m still 4kg from my goal weight. I could stop now and do maintenance and be perfectly happy. Weight loss is very slow at this point. But I personally still want to lose this final 4. If I can’t, however, I won’t be disappointed. My results have been better than I could have hoped.

Certainly no experience here since I just had surgery, but I'll provide my perspective. 😁 For me, I could care less what the number is on the scale. I did this to feel healthy again and not be ashamed of my weight. I don't want to travel and see the disappointment and disgust on my seat-mates when they see the fat guy is sitting next to them. I want kids to be proud of me, not ashamed. I want my wife to get her "knight in shining armor" back that she had all those years ago. I want to feel "normal" in public, (whatever that is), instead of like a pariah. I want to be able to go to places I always wanted to go but couldn't because of my lack of physical fitness. I want to feel strong and powerful again. I probably could go on and on, but my point is I'll know I'm "done" when I look and feel healthy again. Whether that's at 220, 170, or somewhere inbetween, it really does not matter.

This is just a rant. If you have a good deal of faith in medical science, just skip this one. Keep that faith, you'll sleep better at night and the placebo effect will work better on you. I'm intensely frustrated by having to deal with the arbitrary nature of the bariatric surgery process. So, I'm a scientist and I work in medical research. I know from the back end exactly how arbitrary and non-evidence based much of medical practice is, from the trivialities to treatment of life-threatening conditions. (And boy howdy, you would not believe it and it is frightening.) I'm at peace with it; we're working on it and we know that we're all doing are best. What I am not at peace with is knowing this on one hand (and my dietitian openly admitting this), but having to pretend that it's not the case. I hate lying and pretending. It's very difficult for me to pretend that I believe that it's critical that I don't eat consume any fiber during my pre-op diet, which has to be liquid because reasons. (I'm dumb and I asked why it has to be liquid, curious what the justification is. I was a little surprised to find that they don't even make something up. Honestly, disappointed, low effort guys. If you're going to torment us, at least have a plausible rationale.) It's very difficult for me to be presented with an arbitrary set of rules and just... follow them, because. Not because there's a reason to follow that rule or because there's research backing it up, but because people who have power have chosen that set of rules, for no particular reason, and if I don't follow them, they will stand in my way. I understand that this is how the system works. We are noncompliant, untrustworthy, stupid, and, most of all, we are unworthy. I'm losing over 1% of my body weight weekly, pre-surgery, by dieting and exercising, but If I don't stop drinking a cup of caffeinated tea with 15 grams of sugar in it (the only added sugar I consume at all) 6 months before my surgery date, I'm going to be denied. My dietitian was very explicit that she would not approve me. I mean, there's really nothing else she can put on her little goal sheet for me to show that I'm worthy and compliant. And I definitely need to prove that I'm worthy and compliant, even beyond what is necessary because I'm fat, because during my first meeting with the dietitian, she told me to seriously consider whether I wanted to go through with the surgery, because research showed that, unlike with weight lost through diet and exercise, people who have bariatric surgery have radically slowed metabolisms afterward. They did a study with the Biggest Loser people! I was stupid and impolitic and I questioned this, because that study is one of the (many) reasons I'm seeking bariatric surgery. (It showed the exact opposite of what she told me it did, and even more so with the follow-ups.) So naturally I was very concerned that I had gotten my facts wrong and instead of being smart and shutting the $#%^ up and looking it up on PubMed when I got home, I questioned her. (I wonder how many people she's talked out of surgery because she doesn't understand it. Best not think about that!) It chaps my hide extra knowing that her next patient will probably be someone who is barely maintaining their weight, is being coaxed into giving up their multi-can-a-day soda habit and doesn't know what a protein is, while I'm worried about eating too much fruit and having a teaspoon full of sugar set as an ultimatum. And that person will have less difficulty than I do accessing surgery. Obviously, I understand that the answer is to either follow the arbitrary rules or to lie my increasingly saggy butt off like a psychologically normal person. And obviously I'm going to do that, because that's what I need to do to get what I want. But I don't have to @#$ing like it!

Actually maybe the correct question is - how did you know when you were done? I am within a couple of pounds of my original (completely arbitrarily chosen) goal weight. Which by the way I never really believed I could reach. I was sleeved 10 months ago and am still losing around half a pound a week on 1200 calories (ish) a day - a bit more at weekends because I drink some alcohol then. I am hungry at times but I can keep that at bay by eating lots of protein snacks alongside my 3 meals a day, which are protein and veg for the main - still not much in the way of carbs. My question is - did you just select a goal weight and stick to that? Did you achieve/maintain this by intentionally increasing your calorie intake once you got there? I'm thinking I could easily go up to 1600/1800 calories a day and probably maintain at that or thereabouts. Or did you just keep going as long as you could, staying on the right side of hunger (AKA deprivation, LOL) and see how low you could go, and does the weight loss then fizzle out? If I did that would I ever be able to up my calories again without gaining? So many questions, LOL. I would really appreciate your thoughts and experiences.

Amazing amazing amazing. What a transformation. I really look forward to the rest of your weight loss journey @SleeveDiva2022

So my dr confirms that because its a liquid that it just flows out and they are actually happy when someone does not have restrictions to liquids because it makes hitting the water goals so much easier and dehydration is the biggest worry right at 1st. Restrictions should be more with food. He told me to eat slower now that I can have puree (yay!!!) so that maybe I can start feeling the change. He said I'm doing so well that I can progress at my own pace through the next food levels. He recommends at least 1 week of puree and 1 week of soft before getting too adventurous. If at any time I start having issues, just back up a stage and give a few more days. He wants me to still not pick up more than 20 lbs but to get back to a normal schedule and life as soon as possible. 3 weeks from now he expects me to be fully healed, able to eat real food and no restrictions on movements or weight. I almost cried at all of this good news. Just to be able to eat puree sounds amazing and free to me. To think I'll be starting my life with my new normal so soon is just amazing. 1 step and week at a time though. I have my 1st ricotta bake in the oven and I can't wait for it to be done. Today was a great day

I'm gonna repeat what the others have said - I hope that isn't too annoying! If you're eating 1000 - 1200 calories a day you will be losing fat. Whatever water shifts are happening are making it appear that you're not. This happens to everyone. You have lost 21lbs since your surgery - I lost 17lbs in my first 6 weeks so you're doing better than I did (not that it's a competition, LOL). If you stick to your plan you will see sustained fat loss - it's not possible not to. Keep the faith - I know how disheartening it is not to see a change on the scale but I promise you - if you stick with the programme in a year you'll be here posting how you're at your goal weight. Post here lots - everyone is so supportive and helpful - we are really rooting for you!!!

You're welcome! Both medications delay gastric emptying, so that can definitely bring back the restricted feeling. I haven't had any side effects with Mounjaro yet. I ended my Saxenda run at the highest dose, so the beginning dose of Mounjaro (2.5mg) probably won't be an issue. I move up to 5mg next month, so we'll see what happens then. My side effects with Saxenda happened early on and were very mild...fatigue and a little nausea during the first week. I was fine after that. I am grateful to have a bariatric doctor that is educated on GLP-1s and open to prescribing them when needed. I didn't want to go the revision route (and probably wasn't a candidate because even with the regain, I've maintained over 70% of my original weight loss). I just needed an additional tool. [emoji4]

I have lost over 200 pounds. WLS was excluded from our insurance when I had it done, so I paid out of pocket, which I had to dip into my 401k to do. As is the case with most people who have lost a lot of weight , I have tons of loose skin. I'm cool with most of it, except my pannus, because it's uncomfortable, out of proportion to my body causing my clothes not to fit right, and I have rashes and always have to use powder. Panniculectomy is normally covered under the insurance we have so I saw a surgeon and was pretty excited at the thought of possibly having this large amount of lower stomach removed. I was prepared to hear that I didn't qualify or whatever.I was prepared to may maybe have to repeal a rejection. I was NOT prepared to hear that it was EXCLUDED from our plan. Now of course, I should have checked myself, but I didn't even think to since often times this surgery is medically necessary. I stupidly assumed it wouldn't be excluded. Stupid me. I am so angry and bummed about this. I feel like I've done all this work just to be left with this bowling ball hanging from my body, and since I wiped out half my 401 it's not like I can pay out of pocket again. I'm not asking for a total body makeover or even for my body to look good (it does not lol). I'm 51 years old and my most attractive days are far behind me. I was never in this for looks. I just wanted to have my life back and feel good and be active and have a chance to live longer. I just want this discomfort removed and I don't think that's too much to ask. I have a skin condition called hydradenitis supparativa that really can't be fixed except by removing the affected area and under my stomach is where it's the worst. I'm tired of living with this awful skin condition. I've had it for like 30 years now, but it became much worse as my pannus grew. I'm scared to death I'll gain all my weight back and I know people who do skin removal have a better chance of not gaining it back. I'm just so frustrated and angry and probably rambling about this but I had to vent. I'm feeling sorry for my self too and thinking how unfair things are which I know, as my mother always told me, life is not fair. But that doesn't mean I should have to be ok with that! Anyway. Thanks for letting me vent. My husband, always the optimist, did make me feel somewhat better but I knew people here would also understand. Sent from my Pixel 5a using BariatricPal mobile app

First: This is my concern with people going out of the country for any type of surgery. Cut and dump. They get their money and that's the end of your care. I am sure this is not the case with every surgeon but it isn't a rare occurrence either. Unfortunately that is the risk you take. Second: Everyone is different and everyone stalls. Your body is in shock, and now you are eating a fraction of the calories it was used to before surgery. It basically goes into starvation mode and stores EVERYTHING it can until it realizes it is not actually starving and this is the new normal. Your body will adjust, the human body is quite amazing. I lost like 12 lbs the first week and then nothing for like a month but then my body was like oh ok and I started dropping weight like crazy. (102 lbs in 6 months) I am currently in another stall and have lost 2 lbs in a few days shy of a month now. It does suck but it will pass. The bottom line is if you have a calorie deficit you WILL lose weight. The surgery helps you be able to eat less, resulting in less calories. Try to stay off the scale for a while, measure yourself and find other ways to see the results. Smaller clothes, non-scale victories, etc. be patient, you got this!

Hi! I was sleeved in 2014...original loss was 185 lbs. Regained 40 lbs during the pandemic. I started Saxenda in January of this year and lost 35 lbs. I moved to Mounjaro last week (off label, as I am not diabetic) because I was tired of Saxenda's daily injection. I don't view GLP-1s as a pouch reset, but they definitely help turn off the "food voice" in my head. I am on the beginning dose of Mounjaro, so haven't experienced the full power yet. I still have decent restriction, so capacity wasn't my problem. Slider foods/snacking caused my weight gain. I know medication isn't for everyone, but I honestly believe GLP-1s should at least be mentioned to WLS patients dealing with regain. I see it as a 1-2 punch for me.

My Dietician consistently says there is no such thing as a pouch reset. The calorie deficit is what makes you lose weight during said "ouch reset phase" by going back to liquids for so many days it is simply less calories. In addition, the restriction the same reasoning. Being on a liquid diet for a week, so when you eat solids your stomach reacts quicker because it is used to only have liquids again. You had to have surgery to shrink your stomach, so just drinking liquids for a week is not going to magically shrink your stomach. Everyone has different opinions on this, but if you really think about it it makes complete sense. Regardless, if your friend thinks it is and it is working for her then that is great! And, no reason not to reset if you want to.

My surgiversary is 6/18/19. Three years out and I look and feel great! I weighed 280 pre-op and lost 140. My biggest complaint is gas. I was feeling terribly self conscious because I thought I lost too much weight. Took me awhile to get used to it.

Mounjaro is a GLP-1 and GIP agonist medication specifically for diabetes treatment. It is not yet FDA approved for weight loss, though some doctors are prescribing it off label. It absolutely does NOT "reset" your pouch, there is no such thing. Your post-op stomach is what it is and over time the restriction will naturally decrease. However, the medication does work in part by making you feel fuller sooner and stay fuller longer by slowing gastric emptying. This is temporary though, and will revert as soon as a person stops taking the medication. Most doctors agree that for these types of meds to work their best (Wegovy Ozempic are similar), they need to be taken long term, if not indefinitely. They are NOT a quick fix for weight loss. That being said, they can be helpful in long term weight maintenance, blood sugar management, etc. If you're interested, I would strongly suggest speaking with your PCP and/or bariatric surgeon and make sure you understand how the medication works, what it does, what the side effects are (there are many and some are quite unpleasant), as well as what treatment looks like long term. Lots of doctors are seeing success in their patients with these new meds, but its really important that the patient understands them, they aren't a magic pill.

Hi everyone! I have a friend who had WLS a decade ago and regained a bit of weight. She recently went on the new medication called Mounjaro to try and re-lose that weight. She has done very well but said the most amazing thing that she found was that it reset her pouch. She said the restriction is back like it was right after surgery. She is encouraging me to use this mediation to reset my pouch. I have maintained my weightloss for the most part but with menopause, I've regained about 20 pounds, mostly in my lower tummy which is never where I used to carry weight. I do admit that with the years passing, my restriction isn't what it used to be but it's not gone. I was thinking of trying this but wondered if anyone else has tried it and what their experience has been? Thanks!

21 pounds in 5 weeks isn't zero... That is normal. Stalls in the first month are also super common, and I would say that the majority of us have had them. Normal weight loss with a sleeve is 10-12 pounds a month. you went beyond that. Having the colonic emptied your system, now you are adding back to it. The water that went in, did eventually come out, along with anything else that came out. Just be patient and stick to your program.

Hello all! Just found this site. I have my procedure on Friday! Super nervous. I started my journey at 323lbs from my first visit about 5 months ago. I'm on day 4 of my liver shrink diet. I'm currently 295.8 LBS. My Goal weight is 210. I will then see how I feel and maybe try for under 200!

I don’t think the stomach they remove really weighs much. I didn’t lose any weight in the hospital. It’s possible that you were slightly dehydrated and lost more water weight in the beginning since you didn’t spend as much time at the hospital hooked up to fluids. Then when you got rehydrated your weight loss that week didn’t show because you added fluid weight?? There are honestly soooo many factors when you just went through major surgery that could cause weight gain or loss. It’s best to not even weigh yourself for the first few weeks. I would just look at the overall if I were you rather than trying to account for every pound because for six weeks out you are going great.

This is very independent to each surgery center and insurance company. My insurance required a 4 month process, but my surgery center required a 6 month minimum with the "potential for fast tracking". They said that they require the 6 months to show your dedication and make sure you really understand the process and the life long changes. I was fast tracked, about 5 months total. Once I finished all of the insurance requirements and did my final weight check for the surgery center I had my last apt with the surgeon and surgery was scheduled. It took about a week for insurance approval and I had surgery about 3 weeks after my last apt with the surgeon.

It really depends on your program and more importantly your insurance. Some companies require a 3 or 6 month medically managed weight loss attempt. Most clinics just have you go there monthly to check your weight and sorta use it as an opportunity to spread out your other requirements a bit so they aren’t so overwhelming. Sounds like you probably have the whole list of requirements though unless a medical issue pops up that they need to investigate further to clear you for surgery. It really varies whether you will get a date before or after you have completed everything and receive your approval but obviously the timeframe itself will not Change you may just know it sooner. My whole process took about 6 months from first appointment to surgery day.

there are so many factors when it comes to weight loss and gain. you can restrict too much and the body is in starvation mode and tries to conserve fat on the body. you could be nutritionally imbalanced causing problems; not eating enough OR taking too many supplements. you could be exercising more and loosing inches but gaining muscle. the body could be retaining excess fluids due to an imbalance of some nature. too bad you do not have a surgically support team following you. maybe get in touch with your gp and have baseline tests. glad you are talking to a nutritionalist. also don’t just rely on the scale… what are your measurements ? are you staying the same weight but loosing inches?

You can eat way more than I could at 6 weeks out. I had a tough time of nausea and sickness. For months I only managed about 300 calories a day. Even now at 10 months out I can only manage 800 to 1000 Cals a day. This made me have slow weight loss because my body was holding on to everything, I managed to give it. So, let's see if we can find out what's going on with you Are you on regular foods now or still on pureed? We are all given different plans so we don't know what yours will be. Can you show a food diary for a typical day ? How is your protein intake ?

Two pounds lost in five weeks? How is that normal? It’s making me feel like something is wrong. The other 19 was legit the first week and included whatever the weight of my stomach was that came out and water I was retaining. So what has changed since then? I went and did a colonic hydro cleanse and came home heavier than I went in too. ps. Thank you for your reply I do appreciate it ❤️

21 lbs in five weeks is very normal. We started off at about the same weight, and that's about where I was at that point I think shows like "My 600 lb Life" give people unrealistic expectations about their weight loss. You have to remember that those people start off at MUCH higher BMIs than the average WLS patient. Most of us lose somewhere in the 15-25 lb range the first month. So your loss is perfectly normal! I went on to lose over 200 lbs - so the surgery works as long you're committed and stick to your plan. Edited to add that almost all of us hit our first major stall sometime during the first month after surgery. It's usually the third week, thus we call it "the three week stall". That may explain the 2 lb drop over those couple of weeks (367 to 365 lbs). If you search this site for "the three week stall" you will find over 17,000 posts on it (and no, I am NOT kidding). but overall, you have lost 21 lbs since surgery. Again, that's a normal loss for the first five weeks.