Search the Community

A good way to remember the difference is to ask yourself "Is this processed? If so, how much?" For instance, white flour is a simple carb, it has had the fiber and such stripped from it, which causes the carbohydrate in it to hit the system faster and spike blood sugar rapidly. Stone ground whole wheat flour is more of a complex carb, because it has the fiber intact along with all the nutrients that come with it and spikes the blood sugar less rapidly because of that fiber slowing the release. Eating it with protein and fat will slow the spike of blood sugar even further. Potato chips? Simple carb--they are white, starchy, and fried. A baked sweet potato? Technically a complex carb, though it does have a lot of sugar in it. Still, much better choice nutritionally than potato chips! Most fruits and vegetables are complex carbs, as their fiber and nutrients are intact. But some can be higher in sugar than others, so it is good to be mindful of their glycemic load as well. Whole grains like quinoa or brown rice and beans are complex carbs, though due to their high carb content they are best eaten in moderation. Most white, starchy, processed things you buy in boxes or bags are simple carbs. Cakes, cookies, white rice, sugar, semolina pasta, ice cream, all simple carbs. Most SADI and DS patients have issues with simple carbs causing gas, or large amounts of complex carbs. So, a big slice of cake may cause gas. A large fruit salad could also cause gas. Their sugar sources are different, but the digestive system sees sugar as sugar and reacts in kind. Apples in chicken salad? Probably fine once you are far enough out to digest fruit. A wedge of watermelon with a bunless hamburger? Also fine once you are far enough out to digest fruit. A few bites of cake or fruit salad? That may also be fine if you are able to practice restraint! Personally, at 6 months out, I have never had any issues with onions like I used to. But I cannot eat beans in any form, not even pureed on the soft food diet, they immediately went through me and caused gas! I can eat small amounts of a cooked fruit, like blueberry muffins, or frozen blueberries microwaved and stirred into yogurt. But I cannot yet eat fresh/frozen fruit. The nutritionist suspects it is because berries are really fiber dense. This is likely to change in the next year. But that first 18 months is prime weight loss time and prime weight loss is boosted by being in ketosis, which means I have to keep my fruit portions small anyways for now. Once I'm at maintenance I'll worry about adding fruit and complex carbs in. Right now I focus on protein, then low starch veggies, then a bit of starch if I have room, like a bite or two of potatoes (I'm Irish, I can't cut them out forever), or a few bites of quinoa.

I can relate to being afraid of gaining weight after working so hard to lose it. We all deal with that here. But it's a fine line between being mindful about it and developing disordered eating habits. I can speak to this because it happened to me. I was dropping weight like a champ, then I hit stall after stall, and each one lasted longer than the previous one. And I would panic. And I would restrict the amount I ate, I would kick up the intensity and frequency of my work outs. I would have anger and confusion and fear anytime I either didn't lose or I gained a little (turns out, I'm one of the ones that gains 3-5 pounds during a stall and then just sits there for weeks and weeks. Then when the stall breaks, I drop like 6-7 pounds all at once). I had to actually go to a therapist that specializes in bariatric disordered eating (not easy to find, btw) to get my head on straight. And it's still a struggle sometimes. Especially since these last 11 pounds absolutely fight me tooth and nail and just don't want to come off. I said all that to say just be very careful. I never started out intending to have these issues. I thought I'd have the surgery, lose the weight, get healthy, and bada-boom bada-bing, life would be great. But it's never that cut and dry, is it? We can become obsessed with losing the weight, seeing how low we can get the scale, getting into that lower size, looking thinner, never gaining weight again, getting that bmi just a little lower.....and before you know it, you have a whole new eating disorder that's even harder to get out of and we're doing even more damage to our bodies without even meaning to. And we can justify what we're doing because HEY, we got off our meds, we're getting healthier, we're losing the weight, we're EXTENDING OUR LIVES damn it!!! And that's harder to overcome and harder to recognize and going too far than being obese is. We knew we needed help. We knew we were doing wrong. That's why we had the surgery. But now? Now it gets harder to see what we're doing because HEALTH!! WEIGHT LOSS IS GOOD!!! NO MORE MEDS IS THE GOAL!!! JUST A LITTLE MORE WEIGHT OFF CAN'T POSSIBLY BE BAD!!! So please please just be really careful with where you're at now and where you're wanting to get to. Lastly, on the days you're working out (especially the really hard weight days) increase your protein and calories. Your body thinks it's starving, so you need to reassure it that you're not. The heavier the work out, the more your body needs. You can't run a car without gas and you can't run your body without food. So give it what it needs, in the amounts it needs, and it'll do what you want it to. Make sure you also have a larger amount of fluids than you normally would on those days, too. Dehydration can really do a number on the body, as well.

Congratulations on your loss and thanks for your input (I love your comparison to driving instructors who have never actually drove). If you don’t mind me asking does that amount of fruit cause bathroom issues? I think it was the fiber that I read if you have too much after SADI it causes malodorous gas. Also, can you please give me an example of a day for you (in terms of food)?

I’ll add to @SleeveToBypass2023 response. We all carry our weight in different places. If you carried it in your tummy, this will take the longest to go simply because it has the densest volume of fat. For some it might be their thighs or their butts. Even when you get to your goal you may still carry some weight there. But yes as @SleeveToBypass2023 said, this will also likely be where you have the most loose skin after too. Out of curiosity, have you had children? There could have diastasis recti where the abdominal muscles that separate during pregnancy don’t rejoin after. It can cause your tummy to protrude. Congrats on your weight loss so far. Wonderful.

A few thoughts from my Sadi experience after nearly 10 years: - Nutritionists are like driving instructors who read a book about driving but never drove themselves. The same can be said for many doctors since only weight loss specialists understand the procedures. - Eat the basics everyday (protein, fruit, fiber), then mostly anything else. - Hydration is vital, I get mine from fruits, tea and water. I eat between 20 to 30 lbs of fruit per week (not kidding). It doesn't add weight. - Get exercise everyday, even just steps are fine. I'm a 6'1 male, 63 yrs old, weigh about 166lbs today. I lost about 152 lbs in year 1, gained back 25lbs after 3 years. Recently gained about 5lbs but working out a lot. I prioritize eating the basics daily, taking the vitamins (less than a DS'er), then eat whatever I want. I get exercise everyday by walking my dog, hikes, biking and going to the gym. It took me about 4 years to get in decent shape after surgery. Now workouts are just a thing I do everyday like any other activity.

Constipation is very common. So your pain may be from that. Remember even though you’re only drinking liquids, those shakes & soups have nutrients that end up as waste once your body has got what it needs from them. Your poop may be small &/or softer or you may have bouts of diarrhoea from all the liquid. Don’t expect to go every day either in the beginning. Back pain can also occur because of your weight loss. Many of us experience this as our bodies try to rebalance ourselves as we get smaller. Our muscles, tendons, etc. have been compensating for our heavier weight & now it doesn’t have to. Our posture & centre of gravity changes too so don’t be surprised when at odd times you lose your balance. The back pain can be from being moved about during the surgery too. But as with all things, if this seems strange or unusual for you or the pain isn’t manageable, contact your medical team. Better to be sure it’s nothing than something. Congrats on your surgery!

Oh it's fab to se your loss OP! Joyous actually. Enjoy those size 38 jeans and look forward to the 36s and the 34s. Welcome to the rest of your life.

So...I'm struggling with how to answer this because I want to give you helpful information, but I still have questions. I guess I'll jump right in and see how it goes. 1) You started off at a lower weight to begin with, so your body is likely at the point now where it's at it's healthiest. As of right now, you're 5'5" and 136 pounds with a bmi of 22. You're exactly where you should be. If you lose 15 more pounds, you'll weight 121 pounds and have a bmi of 20. On paper, that's still healthy. But my concern is you're becoming addicted to losing the weight and even though you're exactly where you should be (and could even gain 10 pounds and still be where you should to be) you'll panic and possibly go about things in an unhealthy way to drop those pounds. 2) Were there other reasons besides your weight that led you to getting the surgery? Did you have any comorbidities such as high blood pressure, diabetes, cholesterol, etc? You didn't mention that. My fear is, if you only wanted to drop weight and your bmi was 33 to begin with, and now you're wanting to continue to drop even though you're being told you look "stick thin" (and you're in the healthy range now but still want to go lower), that this might have more to do with the number on the scale than getting healthy. 3) Stalls are normal, and happen all the time. The fact that you haven't had one until 4 months out is actually kind of surprising. They do break on their own, but honestly, you may lose little weight going forward (and what you DO lose will likely come off slowly) since you're already well within the healthy and normal range and your body feels it's happy at its new set point. 4) Your body likely thinks it's in starvation mode, based on how you're working out and lifting and what you're eating. The harder the workouts, the more calories you need. Prioritize protein first above all else, then veggies, then carbs and healthy fats. But you definitely need to increase your calorie intake. This isn't necessarily advice for dropping more weight (although that tends to happen when things like this go on) but for healthy purposes. If your body thinks it's starving, it'll hold on to every single calorie and bit of fat. And it'll eat away at muscle before fat just to make sure you survive. So my suggestion is to increase your calories. I don't do heavy lifting, but I DO do weight training, and on those days, I go up to 1400 calories. Core and strength training, I go up to 1300 calories. Cardio I go up to 1200 calories. Non work out days I eat around 1000 calories. 5) You didn't mention what surgery you had, but I'm assuming it's the sleeve. If I may ask, what made you choose having surgery versus doing anything else for weight loss? Have you tried changing your eating habits before, did you try medication, or did you go right to surgery? How have you changed the way you eat, and what you eat, since the surgery? How much fluid are you taking in every day? How much protein and carbs are you taking in each day? Are you taking your vitamins every day? How many days per week are you working out (should give yourself 2 days off ideally, but for sure at least 1).

The little things are sometimes the best NSV. Just going into regular shops will never get old to me. Congratulations on your weight loss and the NSV.

I had VSG in 2017 and found myself pregnant with my first! I have not taken vitamins as I was supposed to post op. But I have been taking prenatal vitamins since finding out. I lost a total of 150lbs since surgery, and this last year another 20 due to stress. I’m concerned the weight loss will continue (I know I’m just stressing more, it’s kind of my thing) For you bariatric mommies, were you able to hold enough food for you and the baby?

Total Vs net carbs aren't really a thing this side of the pond. Disclaimer - I am writing this post with a glass of wine (completely useless carb) beside me, so make of it what you will. While you're in the active phase of weight loss post op IMO you should be minimising carbs. If you're not quite full after your protein and veg then have a little more veg. Or protein. Carbs are what make people fat - what made US fat. There are NO essential carbs (there ARE essential amino acids - i.e. protein - AND essential fatty acids - ie fats). Nobody needs refined carbohydrate to survive. If you absolutely have to incorporate carbs into your diet while still losing then keep them healthy. Carby veg, fruit, oatmeal, wholemeal bread/crackers, wholemeal pasta, brown rice, etc.

Compounded Tirzepatide is Now Available via BariatricPal! Tirzepatide has garnered considerable attention in recent media coverage, with patients reporting enhanced weight loss, improved blood sugar control, and fewer side effects than Semaglutide.

So I was 6 days out from VSG surgery when I tested positive for COVID-19. I mostly feel fine, apart from my throat. It's really prickly and sore. To the point that I am really struggling to get anything down. It has gotten worse over the past 12 hours, to the point that I'm wondering whether the remedies I have used (Saltwater gargle, sugarfree difflam) have done more harm than good. My weight loss clinic doesn't open till Monday. I am really struggling here! 😫

I am contemplating revision and have to choose between bypass and Sadi so I am curious to follow this as well. Not sure if your surgeon does the Sadi revision but I was told that the weight loss should be a little better than bypass. There are drawbacks too though with more absorption issues it can cause more malnutrition than the bypass and also bathroom issues seem to be a common complaint. I was told with proper nutrition that both of these are less of an issue.

I am a stubborn b**ch so I used that strength to get me through on the days I knew what was going on but a lot of the time I had no idea how sick I was. It was only afterwards I found out how bad I was and how worried all my family and friends were. I didn't mention it above but I also had a blood infection and then an allergic reaction to one of the medications - basically anything that could go wrong/happen did. They couldn't do the feeding tube via my arms as my arms got infected and the veins collapsed, I think I had 8 different IVs in my ams over the months, they just kept switching from left to right until all veins had collapsed. I ended up having to have blood draws from my foot at one point and had my IV in my neck. I actually thought I was going to be physically ill when the first told me they had to put the IV in my neck and had to be given a xanex to calm down and go to the the procedure room but it was actually ok then afterwards and so much easier than my arms. I know what you mean about the health anxiety side of things, I was worried about everything when I came home finally, it was a shock to my system to suddenly be without the constant checks from nurses and doctors and not know if a little twinge or cough etc was a bad sign or just normal. I had to take my blood pressure during the day and do temperature checks to make sure I was at a normal range. I was also afraid to go for a walk of a few minutes in case I then didn't have the strength to get back home so I just walked the bus route on my road as figured if I could walk to the end of the road and get stuck I would just get the bus back. Now I can do 1.5km or so around the block at a steady pace. I am not sure where you are in the food reintroduction phase but once you are able to eat more protein it should also help with the energy levels but I do think rest is key. Once I got into a decent sleeping pattern again, took a few months at home after the nurses rounds at 11pm 4am 7am etc., I really saw the improvements in my energy. That is great that you got the appointment for next week. Just keep asking them to check everything and be honest with them about your fears so they can discuss with you. Just give it time and let your body recover, it has been through a shock to the system with the weight loss and then the infection on top. I figure my horror show can only help others to not feel as bad if they are struggling a bit. It has taken me a long time to start to feel better and more positive but I think I have turned a corner in the last couple of weeks.

I have yet to see a nutritionist or dietician that truly understands the optimal diet for a SADI or DS patient. Most of the time we just get a modified version of what they give Bypass and Sleeve patients. But as you say, you aren't absorbing as much as they are, therefore to give you their requirements would leave you malnourished. 15 grams of fat is absurd by all medical standards. Most medical studies show we need 60 grams of fat for proper hormone function and even if you ate 60 grams of fat, with an altered digestive tract, you aren't absorbing that much, so you need to eat a little more than that. Even the ASMBS recommends 60 grams of fat by 1 year out!! Your dietician is not following best practices. Most SADI/DS patients I know follow the vets that have been living with this surgery for 10+ years and maintaining their weight loss. We figure they know more about optimal diet than a surgeon who has never lived with this surgery, or a dietician that has never even researched best diet for bariatric patients of various surgeries. Most patients I know are eating 100-120 grams of protein, less than 50 grams of carbs, and over 60 grams of fat, usually around 100 grams of fat for SADI and 150 grams for DS. You can increase your carbs once you have reached your goal weight, they tend to slow/stop weight loss, so in active weight loss it is important to keep them low so you stay in ketosis. A calorie range makes dieticians feel better, but it makes no sense for a SADI or DS patient because we malabsorb so much fat we can't even begin to properly calculate our calories. You could eat 1200 calories, but that wouldn't be what your body is absorbing. I'm sorry this is so complicated. In the end you have to decide what you feel best at. I don't feel good following guidelines like your dietician gave you and when I go over 50 grams of carbs I stop losing weight. So...yeah. I'm going to follow what allows my brain and hormones to function, what makes my skin, hair, and eyes feel best, what gives me the most energy, and what allows me to lose weight steadily. I'm the one that has to live in this body. It is sad these surgeries are so uncommon there are no good studies about optimal nutrition for them. But there is no way I'd go below ASMBS guidelines, they are the closest thing bariatric surgeons have to a standardizing body. Your dietician should be able to give you ASMBS guidelines for your surgery.

That seems like a good loss so far! Read up about the 3 week stall , it happens to most people after WLS...

I am so sorry that this has happened, it must be so traumatic. Lots of us get the ' was it worth it feeling' with out the issues you have had to get through. When you feel more in charge of your pain and more sure of the process, you may feel it really was worth it. I did. The rapid weight loss and anaesthetic also makes you feel weak and tired. As you eat a little more you will regain your strength and start surging ahead hopefully. Good luck and good healing

This one took a little more math since they give you pounds lost instead of what weight you will be, but I liked that I could see it month my month. The funny thing is the risk calculator one is more aggressive/optimistic in terms of my weight loss. The Mexico one says I'll be 195 at 3 months but the Risk one says 5lbs lower. Oh well, as everyone says, this is just an average, no matter which calculator you look at. But I do find it helpful to have an idea of what to expect. It keeps me realistic.

Sorry to hear what you have gone through and are still going through. I know exactly how you feel about wondering if the surgery has been worth it, I wondered the same for many months after mine but I can now say 10 months later that I see the light and know I could not have lost the weight I have done so far without the surgery and I can now finally feel the benefits. I have posted about it before on the forum but a recap to show you how s**t things can go..... I had my surgery 4th July 2023 and suffered severe pancreatitis brought on by the surgery (iatrogenic according to the medical reports) which resulted in me having a drainage tube fitted to my belly area and being hospitalised for one month. Three days after being released I collapsed at home and had to return to hospital via ambulance. There it was discovered that I had a leak in the stomach where the sutures hadn't sealed. I spent a further two weeks in hospital where I had to get clips put in to close the hole/leak. I then lasted 13 days at home before becoming ill again. I went in for a gastroscopy to check on the clips and turned out the clips did not do their job and I had leak back plus two abscesses (1 on stomach, 1 on pancreas). Spent a further three weeks in hospital on a feeding tube before getting all clear to go home after another round of clips were put in and passed their tests. Next time I lasted 15 days at home before having to be readmitted for another month! I never felt fully better but wasn't sure if that was just me recovering from all the trauma or still symptoms. I had a blood test one morning and that afternoon got a call to say I was to come back to the hospital immediately as my CRP was 180. Turned out the hole had opened again and I had an infection. Was put on a feeding tube again for the month and had a drainage tube fitted to my back, had so many different medications, a transfusion, tests etc it was exhausting. I was then sent to a hospital in Belgium to have a tube/coil like thing inserted in my stomach help the hole heal. I was finally released from hospital November 1st 2023. Like you I couldn't do things, I couldn't even stand at the kitchen counter to chop veg without feeling like I was going to collapse. The effort of having a shower and getting dressed some days was too much for me and it took me many months to get to my energy up to more than being able to something small each day. It is really only since mid-February that I can say my energy improved. My weight loss was also slow when in hospital as they were pumping me full of nutrition (via the feeding tubes) but it sped up once I was at home. I had the tube in my stomach removed three weeks ago and had another round of tests to make sure that the hole had healed and I have passed with flying colours. So far so good, no pain or discomfort which is such an improvement. The only thing I suffer with now is a bit of reflux and occasional terrible exhaustion. I was out for dinner on Sunday night and almost collapsed at the table the exhaustion came on so suddenly but I was ok a while later. I don't let it stop me, I have so much more energy than pre-op but I just know I have to pace myself and rest when I can. Basically, I just want to let you know that after all of the above that I have been through I now feel the relief of the surgery and the weight loss. I am now at the weight target the surgeon set for me, 75kg, though I will aim for a bit more and I no longer cry myself to sleep with pain or stress or the fear to make plans for the future. It has taken 10 months for me to get here, I am at the stage now that probably those who have a successful surgery would have been at months ago with their recovery from the op and getting back to a 'normal' life. I am going to see a psychologist through my hospital service for the medical trauma which has helped me as well. Do make sure that you go to the hospital if your symptoms worsen, or don't improve, and ask the doctors to check your levels just to be sure that there is no infection still there etc. Rest when you can, I don't know your situation but if you don't have to get up and go out during the day for work/kids/shopping etc. then don't, just take the time to heal and recover. Also ask for help if and when you need it and also say no to things that you may not want to do if you don't feel up for it - being a control freak these are things I am trying to learn to do.

I find the calculator on the Mexico site to be rather inaccurate for me, but everyone varies. Age and surgery type, as well as co-morbidities all impact weight loss rate. It thinks I should be at 212lbs at 6 months but I'm at 240 with 6 days to go. Not gonna happen. It also thinks I should be at 170 by 12 months, but that's not very likely either. I've always used the following one as it takes into account the different surgeries and looks just like the one my surgeon uses. They calculate from the highest weight, it is important to include that because if you have a lot of weight loss before surgery your percentages may track differently and your post op weight loss may be slower. I've seen this happen to several people with surgeons calculating it improperly, or applying the bypass trajectory to a DS patient, which is a disaster and very stressful for the patient! This one takes into account much more like your age, ethnicity, and pre-existing conditions: https://riskcalculator.facs.org/bariatric/?_ga=2.112690692.1282950073.1698781773-393992475.1698781773 According to this one I should be at 78 lbs down for my DS surgery at 6 months. I'm at 80 lbs down. My weight loss has tracked along with this thing pretty steadily, give or take 15 lbs, since surgery, except for my 6 week stall. It puts me at 202 by 12 months out, but DS patients lose for 18-24 months post op, so I should be at 170 sometime in that 12-24 month period! In the end these are all just estimation tools. Our bodies do what they will and we make the most of it. Still, it is nice to have a loose guideline to follow.

Your experience is totally within normal limits of loss OP! I know you'll be reading the posts here of others who have lost really slowly but still reached or exceeded their goal. I lost really steadily but most of us don't. If you stick to your programme you will lose lots more. I did, and my last few months saw me lose 1 or 2lbs max per month - still a loss! Keep the faith.

Hey Karen. There are two doctors in that area that are highly recommended in my DS group. Doctors who are skilled enough to do a DS usually also do various complex revisional surgeries. I wouldn't consider yours a revision so much as a repair, as you aren't looking to change surgeries for significant further weight loss. I wouldn't hesitate to see either of these men for an opinion. You are very lucky to live where you do, it is hard to find surgeons with this much skill! https://www.ultimatebariatrics.com/jayroberts Dr. Roberts does revisions and his patients seem to love him! https://weightlosssurgeon.com/drway/ Dr. Ayoola is by all accounts an incredible surgeon and his patients seem to love him too.

This is totally normal---but freaks you out just the same because what if it stops, right!?! The first 3 months are normally fastest. But the closer you are to your goal weight, the slower it gets. Each surgery has a bit different loss rate, but if you stay the course, even as you slow down, you will get to goal. If you have hit 50% of your excess weight by 6 months you are doing really well according to most surgeons. I definitely didn't lose 50% in the first 3 months, most people I see lose 50% by month 5 or 6. But it also depends on how much you have to lose and your individual body's pace. Some lose it really rapidly and are at goal by month 7 or 8. Some take 18 months to hit the same goal. My body is a slow poke and likes to have 6 week stalls! So I hit my 50% mark at close to 5 months but have been stalled for a month since and actually regained 6 lbs, lost it, and then just gained 15 lbs in fluid from surgery again. My weight tracking app looks like an absolute mess. LOL Working out can seem to cause stalls and slowing down too, because you are trading fat for muscle and muscle weighs more. Plus the act of working out changes the fluid balance and such in your body, so sometimes you appear to gain some weight when you start working out in earnest, but it'll balance out over time.

A good phlebotomist once said it's not about what you see, but what you feel. I don't have any medical issues that relate to vein issues, but many many times it was a hunt for a vein to have my blood drawn. I've been poked up to 3 times and have had to have blood taken from the top of my hands on several occasions and once from my wrist (do not recommend that one hurt like a /@%$*). On the day of surgery, the anesthesiologist also poked me 3 times before finally placing the IV and that was with the use of a sonogram thingy(?). I won't lie, that hurt like heck - one because i'm already not a fan of needles and two that one is larger than a standard blood draw needle. Thankfully that was honestly the worst part of my entire in hospital experience start to finish. I was also told that drinking plenty of water helps a lot to plump the veins and I have found that has worked. Obviously that won't always be fail proof when you are restricted from both eating and drinking several hours beforehand. Oh and nothing really changed for me from before or after major weight loss as far as visually finding veins. I've just been lucky the last few blood draws to have someone who knows how to feel around for a good one and only poke me one time.