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Well, I'm 3 days post op and I've had such a wonderful experience with him. I would strongly recommend him to anyone considering bariatric surgery, he's amazing.

Hi there, I’m new to this site and 4 weeks post-op. I came across an article that said bariatric surgery puts us at risk of bone loss/weakness and also makes us more susceptible to fractures. Is this true? Does the calcium we take protect our bones?

I'm biased! We're releasing an Iron Free version of https://store.bariatricpal.com/products/bariatricpal-multivitamin-one-1-per-day-bariatric-multivitamin-capsule-with-45mg-iron in 2 weeks.

This is what everyone is taught. It's a controversial topic. I found this online "The absorption of calcium and iron is a controversial topic in the realm of bariatrics. Research has shown that Calcium does not interfere with non-heme iron found in supplements. Calcium does interfere with heme iron found in meat. For instance, you should not take a calcium supplement before or after eating a steak. NON-heme iron is the iron found in vitamin supplements. The medical professionals behind Bari Life feel that other vitamin / pharmaceutical companies require patients to take calcium and iron separately because it increases sales. There are virtually no studies performed with patients who have altered digestive systems by means of weight loss surgery (WLS). However, the New Life Center for Bariatric Surgery has a study that is pending publication for bariatric medical journals that proves NON-heme iron absorbs just as well when taken with calcium, as opposed to the iron being taken by itself. The study comprised of over 300 gastric bypass patients. Each patient was evaluated before their bariatric surgical procedure, then again at 6 months and 12 months after the procedure. The patients were evaluated for deficiencies in iron, vitamin D, B-1, B-12, and vitamin A. The vitamin deficiency rate of patients taking Bari Life multivitamins was compared to the deficiency rate of patients taking other leading bariatric vitamin brands (non-compliant patients)"

I take one of the Bariatric Fusion Multis (it doesn't have iron in it) twice a day and just take my iron separately, about 2 hours later. I agree about the calcium absorption, Alex. The BF multis have a good amount of calcium, so I haven't had to take a separate one. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I am also from the class of 2011, and my surgeon is 3-400 miles away (he was then, too.) Can your surgeon's practice do any remote consults - phone or email? Mine does, as they were used to many of their patients being non-local travelers. I have my annual labs faxed to them and they provide any comments as needed. They also have a semi-local support group, which is now shared with a local surgeon, but they welcome patients from all surgeons. By far the majority of my care is through our PCP with just an occasional consult with the surgeon if there are any issues that the PCP is uncertain of. There really hasn't been much change in the care of the VSG - most of the changes that we see in articles are the result of the influx of RNY based bariatric surgeons getting into the VSG business and bringing their RNY practices with them - there are a lot more of them than there are old time VSG and/or DS surgeons who know the sleeve best. Most of these things like NSAIDs and NG tubes are things that are well to be cautious about, though we don't have nearly the sensitivity to them as the bypass folks do. As to finding a new local(ish) surgeon, look into local surgeons' support groups and see if they welcome outside patients (many do,) and that can be an entry to a more involved relationship when needed; ask questions if you have any problems or concerns and that may spark an interest in your case. My preference is to look for an established DS surgeon if possible, as the DS is based upon the VSG and they tend to know the most details about its care and feeding, and from what I have seen, may be more welcoming of patients who have moved. (a very incomplete list can be found at https://www.dsfacts.com/duodenal-switch-surgeons.php, or check with those in one of the DS forums about surgeons near you.) Good luck in your continued health....

You are very welcome! I have the options set in my area, and also added bariatric surgery (we can add any specialties that aren't listed), but I don't know if many therapists think to do that. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Oh my gosh, Thank you Amanda for this as I had no idea on how to find a Pysch that deals with bariatrics/ weight loss and now with this website https://www.psychologytoday.com/us/therapists , I see I have numerous options. Google was doing nothing for me so Thank you!

There is a great website that we therapists use to list ourselves and makes it easier for people to find us. It's called Psychology Today. You can filter the therapies by location, insurance, problem (there isn't one for bariatric surgery, but weight issues and maybe obesity are options) and even preferred gender of therapist. Working with a psychologist or therapist is a huge help, and a letter from them should make your docs, surgeons and/or psychiatrist take you seriously. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Our support group had a plastic surgeon that specializes in bariatric patients as guest speaker and he said procedures such as this don't work for bariatric patients and are a waste of money. Our problem when we get to goal is not excess fat but excess skin and these procedures do nothing for that.

I wish you could have said " And you are too critical to be the working in a Bariatric Office!"

Congrats! I'm on puree/soft foods right now and refried beans are my go to. I add a little bit of cheese and sour cream and it's basically a feast. I also am obsessed with broccoli cheddar soup right now. It doesn't have a ton of protein, but kept me from going crazy after liquids for so long. I also made buffalo chicken dip (shredded chicken, cream cheese, hot sauce—I left out the cheddar cheese) and it was really good—made me feel like I was eating real food, even if I couldn't eat it as a dip with chips. I'm also planning on making crab cakes, which is hilarious because I don't like crab cakes, but I'm craving them now. I got the recipe from one of Sarah Kent's bariatric cookbooks. If you want more ideas, her cookbooks have a lot of recipes for all stages.

Hi Alex! Great question! I'm gonna attach the pic below from the Feosol website. So I'm having issues with low iron saturation and thought maybe I wasn't absorbing my iron supplement. Also my old one was chewable (and tasty! TY Celebrate Citrus chewable iron!) but it was ferrous fumarate which may not be well-absorbed. I've read the heme iron is the preferable iron source for bariatric patients cuz it's better absorbed than plant based iron sources? I think heme is animal based if I remember correctly. This one is supposed to be gentle on your system and not cause the nausea and constipation that other iron can cause. So I started using it. It is too soon to tell if it's helping with my iron status, but will hope to know more next month! See what you think, ok? I know a lot of bypass patients use this kind cuz of the heme iron! Thanks for all you do Alex! (Sorry about showing the ordering button. Not trying to pull people off the store!)

Hey Lolo, I am jettisoning shakes (to a point)! While they are really important for getting your protein in right after surgery (when it hurts to eat anything), they are still processed foods. Most of them are made up of some combination of soy or whey protein, which is ok--but this processed protein triggers a significant insulin response. I am able to meet my protein goals with whole foods as part of my regular intake, so the shakes are no longer necessary for me. That said, I still have my shakes handy. If I am having a day where I might be missing the mark on protein--or right after a workout (if I don't have time to eat), I may have half a premier shake. However, to the extent I can avoid them, I will. I was doing this on instinct, but my surgeon actually recommended that I cut them out at my one month follow up yesterday--so, great minds must think alike. I told him what and how I have been eating and he's totally on board. Apparently, he's been eating Keto for a few years. P.S.--when I say I am jettisoning shakes, I mean the premier shakes and muscle milk stuff etc. If you're doing healthy shakes with kale, etc. in a blender, those are great. I am not having those personally at this point, but not for any particular reason. Maybe I'll go that route in the future. It's hard to do a true Keto diet after WLS. If you're doing Keto correctly, you're eating close to 1,500-2,000 calories a day with 60% or more of those calories coming from good fats (hopefully). With that many calories, you can still meat your protein goals. Also, people who are successful on Keto also mix in intermittent fasting, where they will skip breakfast and go 18-20 hours without eating and have maybe 4-6 hour window of opportunity to eat. That won't work for someone with a sleeve (at least within the first few years following surgery). We can't consume that many healthy calories, so we need to make sure we are hitting our protein goals first. We can then consume the rest of our calories in the form of healthy fats. On most day since surgery, my macro will look something like 45-55% protein, 45-55% fat and 10% or less carbs. One month post-op, I am eating between 750-1000 calories per day of protein and good fat foods. Good fats will get your calorie count up, but neither sleeve nor keto require real calorie counting. I just keep track of calories to make sure I am not going off the rails and to set a limit (I don't want too much of a good thing, if ya know what I mean). I have been doing a little intermittent fasting--but not as long as most Keto adherents. I am usually asleep by 9:30 and I am up somewhere between 4:30 and 5am to hit the gym. I don't eat before my work out (you burn 20% more fat doing cardio in a fasted state in the morning). I may skip breakfast altogether and wait until lunch to eat (or I might have a small high protein snack after my workout, if I am really hungry--which I am usually not). I consume most of my calories between 12pm and 7:30pm. I also make sure to him my water goals--which is important no matter what diet/lifestyle you follow. This is as close to Keto as I can safely get at this stage in my recovery. It's working for me. I feel great and blood sugar is great for the first time in years. I am still only 3 weeks into "Keto" or should I say "Bariatric Keto", but it's awesome so far. Since I have been in ketosis (which happens to a lot of WLS patients anyway shortly after surgery), I am losing weight at a very rapid pace (for me). I have loads of energy now. I do feel hunger, but I am satisfied quickly. I enjoy the foods I am eating a LOT. Moreover, the diet I have been following is doctor approved for me. I had my one month follow up yesterday with my surgeon and I went over my diet and workout regimen with him. He cleared me for all activity and had no issues with my diet choices at all. Cutting out processed foods and carbs and eating a high protein,, high fat (good fat) diet melds is like rocket fuel for your VSG in his opinion (with the modifications I described). I am not sure what you mean? In terms of age, I am 44. I am doing full 60 minute spin classes 5 days a week (with 2 in a row on Wednesdays (5am and 6am classes). I am probably overdoing it, but I feel really good after my classes. I have also just been cleared by doctor for all activity--no restrictions. So, I am going to start weight training again, starting tomorrow morning.

Sure why not. If you don't have a prob with carbs like I do. I love the Zeroodles that @Alex Brecher carries in the Bariatric Pal Store. So damn good! Seriously. This one is the bomb.com! Love both the angel hair and spaghetti!

If they're as delicious as these Bariatric Advantage calcium chews I'll eat the whole bag! LOLOLOL

I had Emblem Health - GHI. Mine required me to go to a nutritionist monthly for 6 months before surgery. I also was not allowed to gain anything in those 6 months and was expected to lose atleast 5% of my body weight. In addition to all the other medical clearances (psych, gastro, pulmonary,cardio) I had to attend one hospital run bariatric support group. My first doctor's appointment was in October 2017, my surgery was April 27, 2018--so almost exactly six months.

My dieticians recipe website. https://insidekarenskitchen.com/recipes/bariatric-friendly-recipes/

I know that that handouts given to me by my surgeon's office said to limit grains/breads/pastas/starches the rest of my life. Some sites they recommended for food ideas included here at the recipes page on Bariatric Pal, skinnytaste.com, hungry-girl.com, and livingafterwls.com. My handouts said to make 1/2 of your plate always protein and eat it first, then 1/4 of your plate non-starchy veggies and eat them second, then 1/4 of your plate carbs and eat them last.

Hello, After 2 years of waiting I have an appointment at the bariatric clinic next month. I'm wondering what I can expect when I go for my appointment? My doctor asked if I wanted a referral a couple years ago and I said that I would but now that the time has come I'm not sure what I'm in for. I'm assuming this appointment is far from meaning I am qualified? I'm worried to get my hopes up and then go only be to be told it was a 2 year wait for nothing.

I just bought two cookbooks—Fresh Start Bariatric Cookbook and The Gastric Sleeve Bariatric Cookbook, both by Sarah Kent. I haven't made anything from them yet, but have looked through them and am excited about making several of the recipes.

Sophie don’t worry about the stall. I was told it’s normal. Just keep getting in your protein and water. My nutritionist told me I should be sipping from the time I wake up to the time I go to bed. Except when 30min before and after a meal. So one of the ladies in my post op support group said she sets her alarm for every 8mins and takes a sip. I’ve been doing that since Monday and it is working. I drink my Premier protein drink and then I eat high protein food like Greek yogurt, turkey, etc. I was taking the Celebrate Complete 45mg but it made me nauseous and I would vomit within 5mins of taking it. So I talk to my nutritionist and I order the bariatric advantage multi vitamin chew and the chewy Iron 30mg. I chew two a day. I also do the bariatric advantage chewy 500mg calcium. Works well for me.

VSG is contraindicated in patients with pre-existing GERD. MGB does a good job at helping resolve acid reflux; however, it does put some patients at increased risk for bile reflux. This is what happened to me. I had severe acid reflux prior to MGB surgery in Mexico. The acid reflux resolved post-op, which was confirmed with an EGD endoscopy, but now I suffer from bile reflux. If I had to do it all over again, my original bariatric surgery would be RNY, not MGB.

You shouldn't be embarrassed. I really think shame is a big part of why I am here at this point in my life and why my relationship with food is so sucky. Coincidentally, I was just reading a section entitled "Pushing for Perfection" in the bariatric manual from my surgeon's office. It starts out, "The desire to be the 'perfect patient' is going to leave you disappointed. If your personality is one who strives to be perfect at everything, be mindful of this trap. You are not going to be perfect. You are still encouraged to try your best..." So saying no more is a very good thing, but let go of shame. It usually serves its purpose in the first few minutes of feeling it, so it does no good to hang onto it.

It has to do with the amount of tissue loss and sag. At my largest i was a 40H. So going down 3 cupsizes, and going from a 50" chest to a 4 1" chest makes the lift they have to do more complex. Also I breast Fed two kids, and this is my second major weight loss (112 pounds in my early 20s). My skin has had it. The good news is that they usually can do the lift and implant at the same time. I am just a special case. I felt ok going to bariatric pal MX. The price was right, for sure. But my family just was not in board. And it felt really impersonal. As for their work I thought their tummy tuck looked on point with what you get in the states. The breast were...um, how do I put it it...a little porn star in appearance. 😅