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Hey, you’re not alone. I asked for help from my dietitian. I went to meetings with other bariatric patients. I watched videos online. I got a therapist. Obesity is a disease and if one thing isn’t working, go to your doctor and tweak something else. I found I have to weigh and measure everything. I prep my food. I’m really boring and do better when I eat mostly the same things for breakfast and lunch. I’m someone that needs to eat breakfast. I have to have a regular schedule most days. When I need to loose weight, I need to also concentrate on more aerobic activities, very low weights. What you need for you is going to be very individualistic for you. In the bariatric groups I attend or stream, one person got the DS portion done. One person uses gl-1 meds, another need’s metformin. A different person needed more yoga and Pilates and made it her career. Another person found starting her day with morning mass and volunteering in the community filled her with energy that wasn’t food. My coworker got a dog that needed lots of walks AND agility training. She got back to goal and found a stress relief and joy. So you’re going to have to do some research on yourself, because getting healthy and staying healthy is a multi pronged approach. It’s a little like finding the right combination of medical, physical, emotional, spiritual tools, and realizing the ruby red shoes on your feet can help. You can do this!

So I had gastric sleeve surgery in 2017 and ever since I have had severe GERD. I just went through an upper GI endoscopy and it was found that I have a huge hiatal hernia, like half of my stomach! My surgeon says the only real way to get relief is the have a gastric bypass but my current insurance does not cover any bariatric surgery. Is there a way to get them to pay since the surgery isn’t for weight loss? I have BCBS of Alabama.

That looks delish. Maybe you could do a bariatric food blog or something.

Thank you so much. I’ve talked with a therapist before, but she wasn’t even knowledgeable to the Bariatric issues I was facing months ago.

Hello SammyGold, Welcome to the Bariatric Forum. I was on a GLP-1 since 2013 without knowing it was a GLP-1, and it changed over time. I was prescribed it by my endocrinologist for my diabetes. What I did once I started on Mounjaro was to lose about 70 pounds, and changed my eating habits to protein and veggies. That's all I ate. More Veggies than protein. I have a bad hip and decided I would take the next step and get the Roux-en-Y Gastric Bypass Bariatric Surgery. While I am only 7 weeks out since surgery, I have seen a huge difference on the scale, and in the size clothes that I can wear already. My face doesn't even look like my picture anymore. I had to lose weight and get my BMI down so I can get a new hip, and I'll be getting that in August, I have exceeded the goal, and plan to keep on going. With the GLP-1s that I was on, I never experienced nausea, but that is a huge side effect for many. It has to be the right dose for you, so look carefully at the different meds, and find out what your insurance covers before you ask for a specific medication from your provider/doctor. Insurance companies are getting ridiculous about weight loss drugs and surgery. They deny due to the cost of the medications. 6 months worth of GLP-1s can cost what it would if you had a gastric bypass surgery!! So contact your insurance company to find out what they cover for weight loss. That is my big take away!

For anyone that may be confused by this thread, here are some things to think about related to vitamin supplements: The most important thing is to follow your doctor's recommendations. All bariatric programs I've seen have specific recommendations and you would be well advised to follow these. The vast majority seem to recommend a bariatric specific vitamin supplement. Some may also recommend specific brands of over-the-counter vitamins as well. That said, at least from what I've seen, typically when recommending over-the-counter options, they will suggest taking these twice a day (AM & PM) instead of just once. There are a few reasons for the above recommendations. First of all, you'll be eating a very low calorie diet and thus vitamin supplements formulated for "normal" people may not be sufficient. Also, while malabsorption for bypass patients is a concern, sleeve patients aren't immune to reduced absorption. Some vitamins & minerals are dependent on stomach acid to be properly absorbed. Since all WLS patients will have reduced stomach acid production (at least for a while, if not forever), higher than normal amounts of some vitamins are needed. From a cost perspective, yes, bariatric vitamins tend to be more expensive, but if you have to take twice as many of an over-the-counter supplement, the costs aren't very different after all. Especially if you take advantage of subscriptions like those offered by sites like bariatricpal, the cost of a good quality bariatric multivitamin isn't that much. Keep in mind your food bill should also drop, so at the end of the day you should still be spending less per month. If for some reason you still think vitamins are just too much for your budget, please discuss this with your surgical team. They may be able to help you find a less expensive option that still meets your needs. It's never a good idea to make decisions that can impact your health simply based on things you may have seen on the web. Aside form the cost concerns I mentioned above, there is very little to no downside of taking bariatric specific vitamins, even though some have really high levels of certain vitamins. For some specific vitamins, there is no established upper limit, meaning there's no health risk in taking too much. If you take in more than your body needs, then you'll just safely eliminate the excess. Yes, there are established upper limits for a few vitamins & minerals and this is taken into account in the vitamin formulation. Iron, is an example. The established upper limit is 45 mg/day, which is also the max you'll see in most supplements. Keep in mind this upper limit was established because some people had digestive upset at higher doses. You'd have to take considerably more than 45 mg/day to actually have a significant impact on your body. Further, remember when I said that some vitamins & minerals need stomach acid to be properly absorbed? Iron is one of those, meaning that you're probably not actually getting a full 45 mg/day dose as a bariatric surgery patient. Regardless of which surgery you have, you should be getting regular blood tests for life that check for nutrient deficiencies. if you don't get these from your surgeon (for example, you went out of country for surgery), then please get them from your primary care physician. This is really important because some studies have shown up to 30% of WLS patients end up with nutritional deficiencies post-surgery. Don't be a statistic. Human bodies are not all the same, nor are our diets. This means one person may be successful stopping vitamin supplementation, whereas someone else that had the exact same surgery from the same doctor won't be able to do that. Please don't decide what you should do based on another person, even if it's your best friend, a family member, etc. Only with your doctor's blessing should you consider changing or stopping your vitamin supplementation routine. Regardless of which surgery you have, there is a real possibility you may need to take at least some form of supplements for life. The effects of nutritional deficiencies can be severe, so think of your vitamin supplements as insurance against potentially debilitating or even life threatening problems. Best of luck.

There are no limits to what you can lose, nor is there anything that says you will regain any specific amount, or frankly that you will regain anything at all. I think we do ourselves a HUGE disservice (and bariatric doctors are bad about this), by thinking in terms of what's "normal" or "average". Keep in mind that averages are determined by people that regained everything, as well as those the are clinically underweight. I would strongly urge you to stop thinking about what you can expect, and start thinking about what you want.

I differ from what SpartanMaker says, I wouldn't try any more of the options that are out there. Obviously you first need to recognize that obesity is a disease and it never goes away. You tried to starve yourself to death and the body will automatically save every morsel you put into your body and store it as fat, especially on a 300 calorie diet. Increasing the calories is not necessarily the fix either, you need to look at the foods you are eating. Is it protein heavy or are you still eating salads, which are carbs by the way? Are you thinking that a baked potato is a veggie, it is not it is a carbohydrate, then add all the stuff you put on the potato. Diet wise, you may be choosing the wrong foods. And certainly the amount. You passed out probably because your glucose levels went into the basement with such a low calorie intake. I agree with SpartanMaker, and seek out a Bariatric center that has a whole host of options. Surgery is a tool that the obese person uses and it is a life long commitment to make lifestyle changes. You may need to see a therapist and nutrition expert both to help you, and maybe they have other options other than going straight to surgery, but for certain I feel you need better education on what is an appropriate "diet", and not all "diets" are really diets but ways to spend more money that is just wasted. You obviously have the willpower and stamina to take hold of a new life, it won't hurt to inquire. I would also urge you to watch some of the YouTube videos from BariNation, they have Podcasts with bariatric physicians and other healthcare providers every week and most recently there was discussion about Obesity being a disease and using something other than weight or BMI (Body Mass Index) to determine if someone is obese. My plan has always been to go the cautious or conservative route first. In my case I jumped right in and happy for it. I had an excellent surgeon and team that all worked together to ensure I had a good experience and did. Never had any pain with my surgery, and have had good results so far and today is Post op week 3, day 1. I wish you the best in your journey to seek out further information and a good bariatric group!!

There are lots of studies that show weight loss (and thus also bariatric surgery), can lessen depression and anxiety. The thing to keep in mind though is that it won't help everyone. It all comes down to the underlying reasons for those negative emotions. As you point out, weight loss has has a considerable effect on how we feel about ourselves, so it follows that for some people, weight loss will help lessen anxiety and depression. There is also some belief that excess body weight can impact how certain hormones in our body work. By losing weight, this can help normalize some of those and that may also help mental health. Like everything, I think the real answer is "it depends".

I like Celebrate brand tropical twist chewable, but they also make soft chews in fruit flavors (and maybe chocolate?) if you prefer a less chalky texture. Any bariatric brand should be fine.

I was on tricare for a short time years ago but didn’t have it for my bariatric surgeries. But after dealing with the revision process with any insurance I I learned that them covering it for GERD would be far more likely than just for weight regain. GERD it would be repairing a complication or side effect of surgery instead of just doing another bariatric surgery. They consider that more of a medical necessity If that makes any sense.

Hi, NeonRaven! Thank you so much for your reply and sharing your experience! I find it so helpful to hear how other NHsers have experienced the process since it seems so much more elongated from the U.S. process. And you make such a good point about the London privilege - now it makes more sense why I’ve seen more internet presence and response from London NHSers. (And quite a few from the far north of England as well!) About three or four years ago during my annual diabetic review, my nurse had suggested bariatric surgery and that gave me a lot of hope - she was able to refer me for Tier 3. I had my dietitian appointment yesterday and it went really well! It was about 30 minutes and went over the Tier 3 lifestyle changes, continued lifestyle changes (balanced meals, regular exercise, blood sugar monitoring, weight maintenance, etc), medications, and then any questions I might have. She was very positive and said she would be recommending me to go forward for surgery when the MDT meeting happens 🥲 (once I meet with the next consultants - psychologist, anaesthetist, bariatric nurse, and surgeon - how soon? No one knows.) Needless to say, I am so relieved, so happy, and so excited to be moving forward even if it’s one step. I’ve found out that my hospital trust now does their “one-stop” clinic as separate virtual appointments, rather than in-person. (So, perhaps it will be quite some time before that MDT meeting?) And then the endoscopy and ECG will be done at the pre-op assessment once a surgery date is confirmed. I am so glad to hear your NHS experience has been so good and positive. I am so sorry to hear about your mother's complication and her passing, but it is so hopeful to hear she was able to put her diabetes into remission (that’s one of my big hopes!) Congratulations on your weight loss and wishing all the health and success! 💕 PS - funny enough, I have not had any group sessions whatsoever in this process. I am wondering if I’ll have a group session with the bariatric nurse?

I've been taking BariatricPal Multivitamin ONE capsules recently, and I've found them really helpful. They're flavorless, and you only need one a day, which is super convenient. There's a deal where a year's supply is just $99, which seems like great value. If you're interested, you can check it out at https://store.bariatricpal.com/99. One thing I appreciate about these vitamins is that experts in the field specifically design them with bariatric needs in mind. Just a heads-up, though – taking a separate calcium supplement is recommended, as it can affect iron absorption. If you're looking for options, BariatricPal has a range of calcium supplements that might suit your needs, available at https://store.bariatricpal.com/collections/calcium. Also, if you're exploring different brands or types of bariatric multivitamins, there's a variety to choose from at https://store.bariatricpal.com/collections/multivitamins. It's always good to have opt I've been taking BariatricPal Multivitamin ONE capsules recently, and I've found them really helpful. They're flavorless, and you only need one a day, which is super convenient. There's a deal where a year's supply is just $99, which seems like great value. If you're interested, you can check it out at https://store.bariatricpal.com/99. One thing I appreciate about these vitamins is that experts in the field specifically design them with bariatric needs in mind. Just a heads-up, though – taking a separate calcium supplement is recommended, as it can affect iron absorption. If you're looking for options, BariatricPal has a range of calcium supplements that might suit your needs, available at https://store.bariatricpal.com/collections/calcium. Also, if you're exploring different brands or types of bariatric multivitamins, there's a variety to choose from at https://store.bariatricpal.com/collections/multivitamins. It's always good to have options.

Maybe, if you are not already, make your own shakes? That is what I do most weekends - cup of coffee chilled down, scoop of a flavoured protein powder (vanilla or salted caramel are my favs) and then some milk and shake it up over ice. I also bought sachets of powdered protein coffee that I keep in the office for just mixing with water. Bought it on Bariatric Pal and its nice.

During my bariatric journey and I'm only one year postop I have learned that I do not force food in if I'm not hungry. I just don't eat. hunger fluctuates during the month one week I'm ravenous, one week I can eat OK, one week I cannot eat it's just I don't force it, but I think it's different strokes for different folks. I have heard people go back to some Hardy bone broths which are always yummy during those times.

Today's win ? Returned to weight lifting after what seems like a 200 year hiatus. 🤣 Nothing extreme or crazy....very light weights with lots of reps. Injury avoidance is key concern. Other win is the overall feeling like I have things dialed in and the cruise control is activated. The positive feels from this are so welcome. The last 6 years or more have been chaotic and hellish at times. Things are slowing down and falling into place. Sure the scale is giving lower numbers every week, but the real improvement has been with the pure simplicity of returning to the initial advisements of the professionals at my bariatric center.

Did you have any psychological input during your Tier 3? (I don’t know if you had to go through Tier 3?) I had about 4 sessions with an NHS bariatric psychologist, but I believe I’ll still be having a Tier 4 psychological consultation to sign me off 🤞 for the MDT. Also, two weeks post-approval for the LRD! That is AWESOME! I think my trust tends to do the two-week milk diet. Even though I currently eat fairly low calorie keto, I think the milk diet would help lose a bit of pre-surgery weight at least. 💗

All excellent information and points which is why I always direct my patients and anyone I give advice/an opinion to that it's best to discuss your specific medical needs with your bariatric provider to choose what "tools" are best to fit your goals. Every "tool" will have non-responders or "failures". Having a open, close dialog with your provider will ensure a better rate of success. No ones medical history is the same nor will be what they need to do, take or undertake to achieve said goals.

It always makes me a bit sad when medical professionals that should know better tell you what you can expect from surgery based on averages. Please know, there are no limits on weight loss after bariatric surgery of any kind, thus saying that you'll only get to 300 is in my opinion doing you a huge disservice. Whether you get to 300, 200, or beyond is all up to you and your behaviors post surgery. As you leaned the first time around, bariatric surgery does not fix your brain, so I would strongly encourage you to work with a mental health professional to understand your eating behaviors and how to address your unhealthy relationship with food. It would really be a shame to go through with a revision to bypass, and end up back at 400 again. As far as dumping, some people dump, and others don't. For some, dumping can be a blessing in disguise because it forces them to eat better. Most people that dump tend to dump on either simple sugars and/or fats. The vast majority of people that do have an issue with dumping can manage it well with diet modifications alone. For those that need it, there are some medications that can help, and in the worst cases, there are even surgeries that can help dramatically. My advice would be to not continue to put your life at risk by staying at your current weight simply because you're worried about something that may not even happen.

For me, it may have been 5 or 6 days, but like you said, everyone is different. Also, in terms of the gas bubble feeling you have mentioned a few times, that IS NOT surgical gas. The gas used during surgery is not inside your digestive system. It's in what's called the peritoneal space. This is used to allow the doctor to help visualize all your organs. My point is that's not what's causing your gas bubble feeling. I can't say I actually experienced that feeling, but it makes be wonder, are you drinking with a straw? Typically using a straw is a no-no right after bariatric surgery because it can cause you to swallow air. Since you have such a limited amount of space right now in your stomach, We don't want any air in there.

I will! I'm currently debating proteins with my husband. LOL He's sold on bone broth protein powder, but I keep reading about whey isolate. Which is better for bariatric patients?? I guess I should post this in the protein section?

I am 6 weeks out and I take Bariatric PAL MV and I take a calcium soft chew by Fusion. I also do protein powder in my tea in the morning, 2 scoops that’s 30 grams, then I make the rest by what I eat. It’s funny, I loved coffee before surgery, but now it makes me feel awful🥺

50+ years ago I was operated on by butcher. He opened me up from my pubic bone to the middle of my ribs. He sure needed lots of room for what is now laproscopic surgery. This mahoosive scar has terrible internal adhesions. My bariatric surgeon kindly repaired a bunch of these. I am telling you this because the adhesions would feel like they were ripping at times. It hurt. I wonder if you are suffering with something similar. Big hugs

I had the Sadie and my research on it from my doctor says that the Sadie is only 25% more mall absorptive than the bypass. Whereas the traditional Didal switch could be up to 80%. I don’t use Bariatric vitamins. I take the same vitamins and supplements. I have always taken, but I raised the amount by 50% to cover the 25% loss and my blood work is just fine.

Not sure how new this is but I just stumbled upon a multi vitamin that is specifically for DS/SADI that includes 60mg of iron, ADEK and some other stuff that is specific to the switch surgeries. Just thought I’d share in case someone else didn’t know about this. It’s made by procare health. They actually sell it in the bariatric pal store but currently it’s cheaper on the manufacturers site if you do multiple months and/or subscribe for auto ship.