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If you’re reading this post, you’ll probably agree that losing weight is one of the hardest things many people will ever do. After months or years of attempts to lose weight (and keep it off), you may be considering bariatric surgery. In 2011, the total number of bariatric surgeries performed in the U.S. was 158,000. By 2015, the number had increased to 196,000. Patients who undergo bariatric surgery and follow all treatment guidelines can expect to lose weight and improve the quality of their lives. More than 85% of patients lose and maintain 50% of their initial weight loss. This post is designed to focus on what I learned, sometimes the hard way. Some things you can’t find out in a doctor’s office, no matter how skille d a professional he or she is. What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. Links https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

I had surgery on May 8th, and on June 20th I rode everything at Universal Studios Orlando for my daughter's b-day. I was fine. The biggest challenge was finding stuff to eat. I had a small side of grits and scrambled eggs for Breakfast (a few bites off my hubby's plate), for lunch I had a yogurt, and a Protein shake that I made with a Bariatric Advantage pouch and a carton of skim milk, and half a bottle of Water, then for dinner I had a side order of shrimp from Jimmy Buffets. I ordered a shrimp cocktail and just skipped the sauce, I used a few extra lemons and a dash of hot sauce to give them some flavor. It was hard watching my family eat giant cheese burgers, and fries, but I did it, and was satisfied after the meal. I was comfortable with what I ate, and went home without feeling hungry. I live about 3 hours away from the park in North Florida, so on the drive home I stopped at a gas station and bought some propel to help replenish my electrolytes. Just remember to stay hydrated, avoid the beer gardens at Busch Gardens, as the alcohol will hit you much faster, dehydrate you, and are empty calories. Do your research ahead of time on what they allow you to carry in foodwise, I have a card from my doctor explaining that I eat a limited diet, so they allowed me to bring in my little lunch box sized cooler with my applesauce and yogurt in it. I also had my little carton of skim milk for my Protein Shake. If you are on your regular food stage, then look at menus online to see if they offer anything you are willing/able to eat. Now that I'm further out from surgery I just get a grilled chicken salad or a grilled chicken sandwich with no bread, and I eat the chicken, and I ask for fruit in place of fries, or just order ala carte. I was fine on the rides, it was the other changes that surprised me.

Kiwijet it is hard working night shift. You need to keep yourself awake, your whole body clock is out of whack. Definately a challenge for you! Hopefully cutting back on the alcohol will help too? I don't really drink, but I do have the occasional sip of wine. Hopefully you can get some healthy Snacks you like and get into a better night routine. Good luck! Sent from my iPhone using the BariatricPal App

Kiwijet did you find that the alcohol went straight to your head or no difference? Sent from my iPhone

That’s three stressful things you’re dealing with in your life: new job, new way of eating and giving up alcohol. Yikes. Parties are hard with everyone eating & drinking around you ... esp here on Aust Day. 🤣 If you manage this, life post weight loss surgery will be a breeze. Have fun!

I guess this doesn't NEED to be in the Men Room, but here it goes... My doc told me no alcohol until 6 months after surgery. Then I told him i am taking the bar exam in February (3 months after surgery)... He said "Go ahead and drink after the bar! also, feel free to have that cigar you keep bugging me about." Now when he says I can have alcohol... Does he mean just wine? Or, will I be able to have some scotch with that cigar? What is the reasoning behind the alcohol statement? Is it too harsh on the wound area? Does it cause too much acid production? Too many empty calories?

I'm about 3 1/2 months out and have just recently begun mixing back in a little alcohol. Went to a football game last week and tailgated, probably had 4 drinks. Like Wishes said, there's definitely a different feeling, so be careful how much and how fast you drink.

10 months post-op here. I'd suggest toning down the rhetoric just a tad. I was advised / directed to observe 12 months off of all intoxicants. I've been good with that. I've had a few sips from my wife's glass, but nothing more than that, really. Funny thing is that I did some rather successful cultivation and infusions this year since it became legal to do so in my state. Great results, but I've avoided trying ANY of it. Really looking forward to January when I can allow myself the space to do that. On the technical / education side of things, I was informed that the recommendation to avoid intoxicants for the first year post-op is for a few reasons. First is that most of us didn't get to a pre-op condition by living a balanced life. And if we're going to successfully avoid using food as "medication" or for anything other than nutrition, it's very easy to transfer that pre-op behavior to something else. Intoxicants are an easy substitute to fall into, and a year of avoidance can help us find other more healthful habits, instead. As for me, I've been written a lot more music this year, among other things. Second is that alcohol is very caloric (or calorific for our overseas friends). So taking in those empty calories isn't going to help us down the path of reduction, especially if one is already finding it challenging to take in sufficient protein and water to keep up with targets. I don't know about you all, but that's still something I have to be very mindful about. Protein and Water. That's a mantra I've had to internalize. Third is that alcohol and other intoxicants can lead us to "let go" of our self-control and discipline around what else we're putting into our bodies. And some of those behaviors contributed to our getting to our pre-op states, to begin with. No point in going back to them post-op, at least without some mindful examination, first. For those three reasons (and others any of us could come up with), I have found the 12 month abstinence target is an easy to remember / explain rule of thumb ("I had some surgery in January and I'm off of alcohol for a year." - You'd be surprised how often the conversation / questions stop right there). It's a bit of a drag sometimes, but "eyes on the prize" seems to win out when I'm doing my in-the-moment evaluations. Best of luck and healthy outcomes to you all! Top: 320 Pre-op: 296 10 months post-op: 225 Goal: A long and healthy life. It's not so much about the numbers for me.

My Dr. Told me to never drink alcohol after surgery, and my NUT told me after 1 year. I know it stretches the stomach as well as soda.

My doc & my dietitian recommended no intoxicants for 12 months post-op. That is probably edge-case recommendation, but I'm not much of a drinker anyway, so I'm going with it (six months post-op, so far). They explained a counter-intuitive reason for avoiding it, which has stuck with me. I didn't get to where I was by being completely free of obsessive tendencies. It is quite common for folks to transfer their food habits to other self-medication options and obsessions. Obviously, alcohol is one easy ride to climb onto, so for that reason I'm pretty much staying away until I'm a little more secure with my new life. I've had a couple of tastes - literally a sip from my wife's glass. But that's it. I'm a fan of whiskey, but so far, I've completely set that aside since my surgery. My very nice collection sits in the case untouched, for now.

I recently had a girls weekend. At one of the bars, I noticed they had small cups (like the ones you buy for your bathroom to rinse your mouth). I asked the bartender to use those cups instead of the larger ones. The large cup just exhausted me to look at it. To know I had THAT MUCH to drink overwhelmed me. I had about 2 1/2 of the small cups. Mostly vodka with a splash of cranberry. I got a little buzz, but not too bad. Definitely could not have eaten and drank all of that. I opted for alcohol instead of food that weekend. lol...I didn't gain any weight and wasn't yacking either, so all in all, I guess I handled it pretty well.

So how is everyone whose married spouse taken this change? And do you think the relationship will change after you lose weight a lot of people get divorced after this or addicted to alcohol. I guess cause we are considered addicts to food. I would say I do become someone obsessed with things when I was younger I worked out 8 hours a day 5 times a week and other personal things I had to do 3-4 times a day I never done drugs or never been an alcoholic. Does anyone feel this way or know anything about this addiction thing .

I nearly drunk a whole entire bottle of champagne on New Year's. Whoops.... and I have had quite a scotch whiskey's and bourbon's throughout the holiday season. You will probably be fine. I would ask your surgeon directly what he means with alcohol consumption if you are worried. However, it hits me like a fire truck and leaves me in two seconds flat. Just be aware, alcohol doesn't sit the same as it used to.

Easy Andrew, indeed! I never drank and became overweight. Still don't drink. And also to the other not everyone who is overweight is addicted to food! Why do we generalize and why do we use the words addiction and alcoholic so loosely?? My oh my.

[MINI GASTRIC BYPASS THREAD – PLEASE CONSIDER YOUR SURGERY AND EXPERIENCES MAY NOT APPLY TO MINI GASTRIC BYPASS PATIENTS] Hi all BP’ers and lurkers out there; especially hi to everyone who had the mini gastric bypass (AKA the one-anastomosis gastric bypass/single-anastomosis gastric bypass/omega loop gastric bypass) It’s my surgiversary! I can’t believe it’s already been a year. But what a year it has been. Man. I wanted to share a lot of thoughts about my journey – there’s not a ton of MGB patients out there yet, and especially not in the US. I’ll admit I’ve been working on this for a while, because I want to share the good word about the MGB and contribute some of the things I simply cannot find out there. Well, now I know, at least how it’s been the first year for myself. So that’s my small contribution. Below, I’ll post the following posts individually so it’s easy to browse for anyone new: The surgery: what is it, how does it work, what does science say about weight loss and complications with MGB? My journey to weight loss surgery My weight journey for a year after the mini gastric bypass My diet and calories – stages + what does a typical day look like after a year? Exercise – what and when and how much? Alcohol and MGB What I wish they had told me prior to surgery Setting a goal Why I think you should consider the MGB What it’s like being a mini gastric bypass patient on BariatricPal – what I found useful, and why I needed a pause from participating on the forum What now? I hope you’ll find some of this enjoyable.

Hi MandyKay! Bubbles - nope. Probaly not. Alcohol? In moderation. I could have sat at my desk job on day 4. By day 7, I was almost perky. You ought to be just fine after a month. A full month would be best - because by then most docs will have you back to real food - but if it's only 3 weeks, you will still be ok. Aside from the lounge, there are several other forums in LapBandTalk.com where you might get useful information. You can either go to the "Forum Jump" bar at the bottom of this page - or you can go to the top and hit "new posts". That will bring up everything new since the last time you were on LBT. Welcome and good luck.

Hello, I'm June 18. I'm doing pretty well, I think, but I'd sure like to be able to get that 64oz. down. I've tried plain water, Kool-Aid, Gatorade. Anybody have some suggestions? This is when I miss my carbonated friends. Well, let me just say it, I also miss my alcohol friends. I'd give a lot for....you know....fill in the blank. I'm down 25#. Maybe not the fastest loser out there, but I'm absolutely delighted. Maybe struggling a teeny, tiny bit with humility these days. I'm so doggone proud of myself for having done this! I haven't told anyone but my husband and best friend. They keep secrets. I didn't tell anyone else because no one else needs to know. AND...it's kinda tough to put the toothpaste back in the tube. Good luck, everyone!!!

I totally agree with all of the above....don't sweat it. I cheated a little to (in fact I drank alcohol both Saturdays before the surgery and was told none was allowed) we're not expected to be 100% perfect. You're doing great!!

Hello! I've lost 140 lbs thusfar, and I don't exercise everyday. . I do drink sometimes with meals, and i do snack every now and then. . . but then i'm different, just like your different. . I lost 53 lbs in my first 7 weeks and now that i'm almost 1 year out I've lost a lot of weight, but I live life like i like it. . I'll eat whatever, in small amounts of course, I'll have my alcoholic beverages, I'll have my Snacks of whatever. . . not horde amounts though! I don't stress over my weightloss, and i definately don't weigh myself every day. . . I do that only if I think about it. . which usually is about 1 or 2 times a month if that. . . I'm living a "normal" life as per me. . .and its working great. . .I usually judge my weight loss by the clothes i wear. . .if they are too lloose, I go the store fit on something that fits and it usually is a couple sizes smaller then before then I glorify myself that way. . .I get alot of compliments from people, but this usually goes in one ear and out the other, because I know how people are and usually they are not genuine . . . but this is only how i do it, i don't expect anyone else to do it this way. . it works for me only. . . good luck to everyone, you are ALL doing very well and together everyone can get through this!

That is an amazing loss, you are definitely doing something right! I am also not too focused on weight loss at the moment, or should I say I wasn't - going to get back into it, been giving away all the chocolate and alcohol I was given over Christmas and New Year (I'll admit I did sample some of them 😉) I think I have had one piece of pizza since surgery, potato chips are my weakness but i always measure out a serving - like 14 chips and do not over do it. I'm not a sweet person, very savory and salty is my way to go. Happy New Year

It’s been 18 months since my surgery, and I am a work in progress. I recently posted about the decision to have the sleeve. See, “Down Over 140…The Decision: Fears and Tears” Now I want to write a bit about the emotional changes that I personally had to go through. Maybe some of this will ring true for you, too. As I contemplated this entry, I struggled with what to tell you, a complete stranger, about my process. Finally, I decided to be honest, so that you could know in your heart that if it’s possible for me to change, it is also possible for you. I still think about food all day, every day. I so wish I didn’t, but I have come to know that I am a food addict, and I have to treat it like an addiction. I grew up the oldest of 6 in a poor family. When I was 12, my dad left and my childhood instantly ended. Alcoholism, mental illness, chaos. That was to become my family life. At 18, my stepdad committed suicide. When I was 20 I was raped. When I was 21, I joined the Army. When I was 22, my brother committed suicide. When I was 28, my two-month old baby girl died. I struggled with anxiety attacks. I developed a life-altering auto-immune disease. There were good things, too. Love. My other beautiful daughter. My sister—who was my best friend, my soul mate, my rock--we went through everything together. Getting my college degree over a period of 20 years! Getting promoted. Writing. Photography. My home. Friends. But always, there was food…my constant companion. It never failed to nicely anesthetize me. One night, just before my surgery, I was watching a weight loss show where they were talking about how you MUST deal with the issues from your past if you are going to succeed. I don’t know why this struck such a chord this time, but I really began to think about the girl I used to be and all the fear I still carried inside me. It hit me like a tidal wave! I cried for the girl whose childhood abruptly ended at the age of 12. I cried for all that had been done to me. I cried because I had been so powerless. But then I realized with real clarity that I am no longer that powerless child! I had succeeded at everything I had truly worked for! I had a great job, and would never be dependent on anyone financially again! I had even learned to be assertive. That night, I spoke to that little girl inside me. I made a promise to her. I told her that she would never be a victim again. That she was no longer powerless. That I was going to take care of her forever. But could I do it without food? One of the best things I did for myself was to line up an appointment with a therapist for one month after my surgery. Although that person did not work out and I ultimately found a therapist who specializes in addiction, it was such a comfort to me to have a support system in place. I haven’t gone to her more than a few times, but she is an anchor for me, and I know she’s there. As I said in my previous post, my beloved sister died in my arms on December 28th. I had postponed having my knee replaced to take care of her, and I foolishly thought I’d be doing well enough by the end of February to get through it ok. Well, I wasn’t. March was one of the bleakest months of my entire life between the physical pain, drugs, bad weather, isolation, and grief. So how did I get through it? How else? I ate. Ice cream. Candy. Cookies. Let me tell you right now, you can put down a lot of calories every day in 100-calorie increments. That is why you need to know beyond a doubt that what they say is true: They operate on your stomach, not your brain. So I spent March crying and eating. And then one day, as I was sobbing to my husband about my out-of-control eating, I wailed, “The worst part is, I’m letting myself down!” “I’m letting myself down.” I could not back away from this statement. I called my therapist to discuss the grief/eating cycle. She let me off the hook, saying, “Sometimes you just have to be in survival mode.” I got off the phone and thought about that a lot and realized even though I had been given permission to eat badly, eating badly no longer felt like my authentic self. For the first time, I knew that I had truly changed. The old me believed that self care meant whatever felt good. The new me knows that self care can never equate to self destruction. The next day, all the junk food left the house. I’m still sad. But I am empowered. I am not a victim, even of myself. If you've hung in there through this long post I hope you'll leave me feedback and share your own story. In posting this, I sort of feel like I'm running down the street naked! Soon, I plan to post on some of the logistical things I've found to work for me since my surgery. More practical! Less emotional!!

KimNYC, I had to switch insurance 3 times to get this done. First I had Empire Blue cross, then I switched to Guardian, till finally I switched to Oxford and they approved it. They might be the most expensive, but they're the best by far. Good luck! Alsgyrl: Good for you for being able to hold back. In my head im still that same pig, and I want to be able to eat certain foods. Therefore certain preperations have to me bade :-D LOL. As for alcohol, I've had a few beers since the surgery, and it's just like soda. If soda works for you then beer is no problem. I also had a shot of Jack a couple of weeks ago, and if was no problem at all.

Hi all! I am new to the website. I am scheduled for my surgery in December. My goal is to lose around 100 to 110 lbs. I have to say I am overwhelmed with anxiety right now! My gyn and my primary care doctor are very enthusiastic about me having the band. They both feel that I will do really well with it. I have been overweight my whole life and have weighed over 200lbs my whole adult life. I am steady about following through with what my doctor and my PC are having me do. I am trying not to over analyze it too much. I look at the list of everything I can't have... YIKES ... LOL! No soda, no alcohol, stop smoking.... gees! I guess I'll start knawing on a stump for my coping mechanism! I am completely in tune with WHY I am overweight. I have a very unhealthy relationship with food. How does that go away? I read posts with people who really struggle and then I have a friend who was banded 9 yrs ago and she said the obsession just went away! ?????? Sorry for rambling but I really need to vent and would love some feedback :eek: PS... did I mention I'm self pay?

It's so individual... I'm still pretty new at this, but I would never risk chewing gum...swallowing it by mistake, and plugging the hole. I was told not to drink anything with bubbles so I quit Diet Coke...bought one and let the fizz go in my mouth and then swallowed, and decided it wasn't worth the effort. Things with casings are tough...sausage and hot dogs, so I either take the casing off or chew chew chew even more. Then there's the time of day. I can't do much more than drink a protein shake some mornings, but I can eat a small chicken dinner evenings. Let's see...I doubt if I'll try peanut butter, but I never liked it much anyway. It's really all about what won't plug the hole...and what you love enough to want to put in the effort to chew it enough..... But it's also odd that my tastes have changed. I used to love sandwiches and now I find bread too much of a hassle to eat. But I still love the insides of sandwiches. I used to crave chocolate, but I get enough of it in my protein shakes that it's no longer special to me (Muscle Milk Light---yum!). I probably won't drink alcohol because now that I have real restriction, it's hard to get enough protein in during the day, and I don't want to waste my calories on alcohol. That's kind of the gist of it. I'll also say this....until this last fill where I got enough restriction, it was really hard and I ate badly. When you get to that perfect restriction, it's a new world and there's truly freedom from some deeply ingrained bad habits!

Do not drink it from the bottle. Pour it into a glass and let it sit for a while before you start drinking. Sip it slowly and see how you go. Some people handle it fine, others don't . Just make sure that the 1 beer doesn't lead to 2 then 3 then a bowl of chips, peanuts, chicken wings etc. The problem with alcohol apart from the empty calories is that it often causes us to make poor food choices as well.