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I know that my regular Dr. orders my blood work I have a list from my surgeon so she just adds the extra blood work that is required from my Bariatric Surgeon. Then they fax them the results. I'm far enough out that I only need mine done once a year now. As far as a counselor, I would try to find a Bariatric Nutritionist. I tried someone here locally and she had no idea about WLS. Check with you Primary Care Dr. for referral. I'm not sure about your options where you live. Good Luck My hubby had WSLS in Mexico. Luckily, he didn't have problems.

My disclaimer for anyone pre op or new to bariatric eating. Stay on your plan and learn how to eat and fuel your body. Yes, Dieticians plans work. I have great recipes with riced cauliflower. (I have a stuffing recipe just in time for thanksgiving) Many reasons for dieticians instructions not working (no judgment for anyone struggling with theses issues) Complications, medical issues, medications, wrong type of surgery, hormones, pregnancy, Grazing -eating above macros and calories. Dietitians may change to a new eating plan due to the reasons above. Some choose an eating plan on their own.

Yep. She's the nutritionist in my surgeons office that only works with bariatric patients. I just don't think they're used to patients hitting their goal weight so soon. I lost almost 90lbs in the 6mo pre op before the surgery, so I was at goal about 7 months post-op. I think another issue is that 90% of their patients are women who just want to get and stay skinny. The nutritionist struggles with me being a guy who is now interested in GAINING weight (muscle) after the sleeve. I just don't think she's had this scenario before.

You didn't mention this, but their flour was rationed and consumption extremely limited, as were fruits. You just listed a host of confounding items. Also limited as you mentioned is sugar. So during this time, they limited sugar, flour, fruits, baked goods. They ate high fat tinned meats, high fat butter (limited), real meat was limited, eggs/bacon as was alcohol and beer were limited...many fasted but def observed a calorie restricted diets. BUT, the issue with the people who do low carb or keto is NOT that it's our way or the highway, or that we believe and say that ALL people MUST low carb or die...the issue is with having alternate agendas so rudely and repetitively shoved down our throats and lambasted for believing in the efficacy of our woe (way of eating). The other issue is having our dietary choice misrepresented by nonfactual BS. And most of us are sick of it. Cuz the OP posts it OVER and OVER and OVER ad nauseum. Like it's being shoved down our throats with the force of Thor's mighty hammer. Most of us who are objecting are all in the same camp: THERE IS NO ONE DIET that is suitable for everyone! LOL. We pretty much all agree that we must find our own path through the woods to arrive at a sustainable liveable diet that turns into a forever lifestyle. And that is A-okey-dokey with us!!!! I'm glad this high carb diet works for OP and others. I am. More power to them. They clearly did not have the same degree of metabolic derangement or medications that necessitate a low carb, adequate protein, lower fat diet as I have. LOL. That's ok. LOL. The even bigger question is why then, if they can now magically tolerate all manner of carbs, why did they get so fat they needed bariatric surgery? And how is their lifestyle modified so they won't repeat history? But I do hope we all agree, that you wouldn't give a diabetic or pre-diabetic heaps and heaps of carbs and expect their insulin levels and blood sugars to improve. At least I hope that's a universal understanding cuz if it isn't, then someone is engaging in magical thinking. And btw, wouldn't it be fun? Let's all make a pact to meet back here in 3-5 years and measure our success with pics, weights, and tape measures.

It was extreme and I doubt many could stick it out like he did. It's great that he lost weight and regained health, be good to see his outcomes a year or two down the track. Also good would be see to his body composition...body fat vs lean body mass. He ate between three to four kilos of potatoes a day, three kilos of potatoes (with skin) has approx 70gms protein, 48gms fibre and 387gms of carb. No one is saying there is anything wrong with carbs it is the way that the argument or topic is being presented. There are many bariatric post op diets - some focus on carbs, some focus on protein, some vegetarian, some vegan.

For those VGSers who have had little or no hair loss and are at least 6 months post-op....... 1. How was your protein intake and hydration during your 1-month post-op period? Did you reach or surpass protein and water intake goals? 2. Did you take bariatric vitamins and supplements? Which supplements? Thanks!

I think your weight loss total is awesome. Stalls are mentally so hard! My nutritionist gets me to do screenshots from a bariatric app that I use to track my meals etc. She looks at the time between eating, what I'm eating etc and it's shocking what she picks up that i never would. I imagine you have a nutritionist on your recovery team maybe do the same and just get them to look it over for you.

I've had a BMI between 40 and 45 for ~20yrs. A lot of obesity in my family. I've tried a number of diets and medically supervised weight loss programs. Only to lose weight and gain more back. I have very high blood pressure and cholesterol (on meds), I've developed pulmonary hypertension, a heart murmur, I have a bad back, and the Ortho just told me I will need total knee replacement very soon. I've researched WLS for over 10 years and have been to seminars with 3 different bariatric centers. I'm over 50 and I decided it's long been time. Because I have some dysfunctional, rude and shallow people in my family, I've elected to tell no one but my wife about WLS. I really don't want people to think about WLS everytime they see me. I don't want the questions. And most of all, for their own sake, I don't want to give them a chance to say something ignorant. Just the thought of it makes my blood boil. So, if you have unsuccessfully tried to lose weight a number of times, medically qualify for WLS, and have done your homework on WLS, you have the right and obligation to improve and even save your life.

https://mayoclinichealthsystem.org/-/media/local-files/eau-claire/documents/medical-services/bariatric-surgery/bariatric-surgery-keys-to-success.pdf?la=en&hash=62E02F70DE090F422E066410072C2500D4E3BF54 https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/gastric-bypass-diet/art-20048472 The second link was last updated in Sept 2018 so still valid. Not sure about the first link. I would have previously assumed before now that most people would know that what works for them may not necessarily works for others. For every single bit of research there is an opposing research that proves the opposite of the other. It's hard to sift through and find truly independent research..at the end of the day each one of us should go with what works for us. There will be trial and error, but determination should see us reach the best outcome for ourselves.

@Rexcom: I started bariatric multivitamins immediately after surgery. My protein goal up until week 10 was 75 mg/day, and I was diligent at meeting that goal daily. At week 10 my protein goal was decreased to 60, and that's where I think things went wrong for me. I started losing hair right around that time, but didn't put 2 and 2 together because I was meeting the prescribed goal. I had my second post-op visit about 2 weeks ago, and the nurse practitioner said I should have stayed at 75 mg. This got me pretty upset because I had been following the instructions in my patient handbook to the letter, and the handbook clearly said to decrease to 60 mg at week 10. Maybe my hair would have been ok if I had stayed at the higher level all along, and maybe my weight loss would have been more consistent (I alternate between long stalls and big drops instead of steady progress). I feel like I wasted 2 months. I increased back to 75 mg and started taking biotin at that point, but no improvement yet. Any advice would be greatly appreciated. Thanks!

The average bariatric patient does not get a massive amount of anything. At almost 6 months out I use about 7 ounces of premiere protein shake daily in my coffee...you said before that you do this to. I do not eat protein bars, only an ounce or less of natural cheese a day, plain Greek yogurt maybe 3 times a month and have not had milk in over 6 months. I do take the recommended calcium citrate. Sorry but this particular rant is really crazy. Fat people are getting cancer because that eat massive amounts of dairy? Post a link to that study please, I would really like to see it and share with some of my friends at high risk for breast cancer due to family history.

The average bariatric patient gets a massive amount of their protein from protein drinks, protein bars, yogurt, cheese and milk. And they are encouraged to. Dairy products are strongly correlated to breast cancer, ovarian cancer, prostate cancer . No one discusses this, and fat people are getting thrown out of the frying pan into the fire. And it sucks because they work so hard to be healthy. The lack of education is staggering.

I had arguments like that with my nutritionist post surgery, too. Just more fodder on my fire and whimsy to get into nutrition for bariatrics as a Registered Dietitian. Does your nutritionist specialize in working with bariatric patients? I know the first one I went to pre-op had placed me on a very very bad diet and so I found a better program and set of professionals to work with through my process almost 3 years ago. Given the amount of future medical issues that can arise post-op, I am interested in and currently work with people on a local level going through their own weight loss journey. There is so much to be taken into consideration on an individual level when going through nutritional counseling and putting together your macros, I managed to get a hold on it before surgery and haven't let myself slide from meeting my daily macros though I eat roughly 1300-1500 calories a day (and up that to over 2,000 when I am doing the longer hikes and trail runs a few days a week between grad classes). Definitely fluctuates depending on activity, but I enjoy getting in my trail runs most days and lengthier hikes, kayaking, or swimming, when I am not bogged down in school or medical work for school). It really is interesting learning what other's have found helpful and not helpful in their own experiences going through bariatric surgery. Thank you for sharing

I have a call on Monday with the bariatric nurse to confirm my medications. I think I need to discuss this with them. Because I've been on other diets before and lost more than this in a shorter time. So something isn't right... unless my body is in starvation mode and it's going to drop a TON all at once. It's really hard not to get discouraged, though, when you actually do what you're supposed to. =( I lost more weight in September when I was eating Taco Bell once a day. lol. Not kidding. Sent from my SM-G930R4 using BariatricPal mobile app

I wake up, take my bariatric vitamins. 8am, protein shake. 12, healthy choice or Atkins meal, 5, protein shake. and the immuno recovery drink shortly after. second dose of bariatric vitamins around 7. that's it. Sent from my SM-G930R4 using BariatricPal mobile app

The full conclusion of the study provided is.... "A low-carbohydrate diet based on animal sources was associated with higher all-cause mortality in both men and women, whereas a vegetable-based low-carbohydrate diet was associated with lower all-cause and cardiovascular disease mortality rates." Another fact is that different people have different levels of "carb-sensitivity" based on their own physiology. The only helpful take away from this research/discussion, for bariatric patients, is to make a continual effort to replace animal proteins with vegetable proteins in their diets. Healthy, non-processed carbs should be added carefully, over time, as your healthy BMI allows.

My psychologist is also a Bariatric patient and Bariatric specialist. She attends conferences all over the world. She told me that all of the latest info points to starting patients off on bland purées and soft foods asap. We talked about this well before my May surgery. She advised me to follow my surgeons program but that for the last few years the research has been in place to support this purée/soft food out-of-the-gate method. It just takes surgeons and doctors a long time to let go of old ways.

I’ve seen people on other threads say that if their surgeon is an ass so what, surgeons are known to be assholes and as long as they’re good at their work who cares about bedside manner. What you’re experiencing right now is EXACTLY why it matters. I hope you find a great doctor to take his place, and I hope bariatric hopefuls keep in mind: this is going to be a long-term connection that lasts past the surgery, if your doctor is someone you wouldn’t want guiding you through a worst-case scenario? DITCH HIM.

*Ahem* Bariatric Crap I Eat At My Desk..

I was unable to locate specific guidelines for the BC Complete Medicaid program dealing with bariatric surgery. I don't believe they have a separate criteria but I may be wrong on that; however here are their guidelines for other plans. I've included a LINK and the PDF. Good luck! Michigan BCBS Bariatric Medical Policy I've also attached the PDF file in case the link doesn't work. BCBS Michigan Guidelines.pdf

Interestingly enough although I work for BCBSM, I can't don't have access to information for the Medicaid side of this business. I know a lot of plans updated their requirements this year. I'm hoping someone could give me the Bariatric requirements for BCBS complete. Thanks!

I apologize for starting a new thread as i cannot locate where i posted the initial information that i want to update LOL. To recap: I had my pre-ops done on the 10th and my Surgery is scheduled on the 8th of November. My EKG came back abnormal and i was very nervous because i did not have a Primary Care Physician since I am self pay and the results requested both a Dr. Medical Clearance and a Cardiology Clearance. So i was fretting and getting nervous about all of that. I found a PCP that does takes Patients without insurance ( after about 5 phone calls to other doctors) and am really glad though now that I have him in hindsight because it is a very family friendly oriented office and i don't feel like just a number. Anyhow on to the update : ) I went to my PCP and he asked me a lot of questions since i was a new patient and all and we even discussed my past diets and my successes and failures and let me tell you i have never felt more like i had found a friend instead of a professional even though he was professional. My point being is he listened and conversation rather than be opinionated. I felt very welcome. He asked me at what weight would i tell him that "if I weighed _____ I would not do bariatric surgery" I gave him my realistic answer of 150 pounds. Because his office runs a medical weight loss program he wanted to see if that would be an alternative option. I appreciated that insight from his end. He realistically told me that his program would not accomplish that as good as bariatric surgery since i am currently 298.6 pounds. Since it was his first day seeing me as a patient. In the end he stated that he would give me medial clearance if i agreed to have an echo cardiogram completed. He also said he could do them in his office where the cost would be a quarter of the cardiologist and that it would be accepted by my surgeon since his directions said Medical/Cardio and not both. This was on Tuesday. He got me in for an echo yesterday and the tech while technically not a doctor told me "if you see me run out or say i will be right back then you may not have your surgery on the day you want, but if i let you leave here without calling the doctor in, you are good to go :)" At the end she said, unofficially i believe you will have your surgery on your date but i cannot Officially tell you that LOLOL.. I am on cloud 9 today and am looking forward to the 8th. I now just hope she didn't miss something and the results from the cardiologist reading the echo doesn't change LOL. Happy Weekend to all! 5 more days before i begin my liquid pre op diet!

You haven't made an update so I am hoping you got things under control. I recently had to have my band checked out--three doctors were certain my stomach problems were caused by the band. They gave me an MRI. and sent me to my lapband doctor. I had to have an endoscopy. My lapband doctor said he had to do it because only a bariatric doctor with band experience knew exactly what to look for. Had it yesterday, and there is nothing wrong my band. So it looks like you need to find a lapband doctor near you who will take you as a patient. I'm in N CA and the only lapband doctors I know about are in Ukiah and Sacramento. There are probably a few in the Bay area, but I am north of that.

I am almost 4 years post op RNY and I don’t eat anywhere close to a bariatric diet. I am a runner and triathlete now, so I eat quite a lot of carbs as fuel for athletic performance. I work closely with a sports nutritionist who struggled mightily to get me to break from my obsession with protein and embrace the carbs. I have to eat about 6-8 meals a day to keep myself properly fueled, which is a bit annoying but a small price to pay. I am not able to tolerate much sugar or fats (ice cream, pie, cake, cookies, brownies), but otherwise eat whatever suits me in the moment LOL.

The bariatric center I go to has VSG patients start on pureed food on day 3. I know it's uncommon, but there are others that do this also. They tend to believe recovery comes faster this way. Note: My bariatric center and the team of surgeons are highly rated and certified by BCBS (Distinction) and MBSAQIP. They've performed 1,000+ VSGs. Anyone else start pureed foods during week 1?