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My dietitian through my surgeon (the Cleveland Clinic dietary guidelines) suggests no more than 4 grams of sugar in a meal. To focus on protein first. As you progress through phases, liquid, purée, soft foods. You add soft vegetables. They don’t suggest complex carbs until maintenance. I keep things low carb. I have not counted. I count protein and calories to keep them both within a certain range. (Protein should at least be 0.36 grams per lb of body weight) I would guesstimate I eat below 20 net carbs a day. You subtract any fiber from the total for net carbs (or sugar alcohols) although my nutritionist said avoid those. I mostly avoid maltitol which is harsh on your guts but erythritol is not. Allulose seems ok. when you get to veggies, that’s where the carbs should come from. Mostly green leafy. For many people maintaining a low carb way of eating is beneficial.

I'm 14 months out and can share a bottle of wine no problem and sometimes more of the share ends up in my glass. Since I don't drink as much, I've gravitated to finer Italian and French wines. You can MOST certainly drink post-op, in fact my surgical team warned several times that alcoholism is a real problem post-op. I've had nothing but red wine, except that one day I had two mimosas and slept all afternoon from the sugar crash and the bubbly made me drunk very quickly. Life post op is way different then the picture your doctor is painting but use the honeymoon period post op to your advantage. I"m down 125 pounds and no matter what will never let it come back on but I am certainly enjoying life to it's fullest right now just in smaller bites. I'd give up any alcohol in a heart beat to keep my weight off but right now I'm at a happy balance and within the same 2-4 pounds for the last three months.

I do wish I had been prepared for the saggy skin, particularly on my neck (which can't really be disguised). The other big thing for which I was not prepared was the how much of my social life revolved around eating and drinking. It is still awkward to go out to dinner with people and only order an appetizer, with people constantly urging, "Oh, come on--one piece of cheesecake isn't going to make a difference--you are so thin!" I've also given up alcohol completely, and since we can't do carbonated beverages, that basically leaves tap water as my drink of choice when everyone else is having wine or champagne. I don't mind, but I get tired of telling people I really don't want anything else, particularly when they don't know I've had the surgery.

I totally hear ya and relate to this post. I "indulged" a little for the holidays and my birthday last week and gained 2 lbs and I know I have a real addiction to cookies, just like an alcoholic has an addiction to alcohol and I must fight it every day to keep it at bay.

I’m good almost everyday as boring as that sounds. I rarely weigh myself on a day I feel “heavy”. I stick to 1300 calories and track everything so I don’t get anxiety about food or the scale. I don’t have any off limit foods except, alcohol, popcorn and fries. I actually should probably gain a few pounds, my 18 month check up is soon and my Dr. didn’t want me to lose more weight. I’m hovering around 121 .

I'm having my sleeve on Feb. 3, and of course I am nervous and trying to focus on the positive. I am realizing how much of our social life revolves around food! I am 61 and married. We are taking a lovely trip in June to Ireland and Amsterdam with another couple; We often meet up with folks for dinner/drinks; my husband and son love breweries, I am a pretty good cook and we have people over for dinner a lot. This super bowl Sunday is the first in forever that I am not going to a Super Bowl party with my ribs and/or chili. (To be fair, I am from Massachusetts, so this is not a great SB year for us....) I am not that worried about the no alcohol part, I am a light drinker and am happy enough to substitute with water or herbal tea. But: 1. How do people deal with protein needs while traveling? Eating on the road, or worse, in the airports? 2. Do you still meet up with folks for dinner, etc.? Can you enjoy a small meal or appetizer and still feel comfortable in that setting? 3. Do people still enjoy cooking? I really enjoy making food for a group and then hanging out at the table, chatting and laughing. Will I still feel that way? I'd love to hear about other people's challenges and triumphs post surgery.

While I usually disagree with much of what you push, I am a proponent of the controlled drinking alternative to alcohol addiction. But where we disagree is that for WLS, controlled drinking runs parallel. With controlled drinking, one can potentially survive the addiction, but while doing so be vividly aware that they are still drinking (and becoming intoxicated). With WLS there is a bunch of bizarre and completely wrong "advise" out there that when, what and how much someone eats (or doesn't eat) does not somehow correlate directly to weight. The controlled drink argument under that same scenario would be" I control my drinking, but I don't become intoxicated". the AMA should fund a study to determine the correlation between short and long post WLS surgery failure with people reading bad advise on Bariatric forums.

Just on a hunch, there was another person that had this issue, and ended up being allergic to whey protein. This could be why your nutritionist mentioned milk based protein drinks- sensitivity to whey protein is actually a thing. Find some not based on whey- look at ingredients. Do small amounts at a time- most people it takes about 2 hours to drink a single 11oz. premade shake. You also could have issues with artificial sweetners, which all of them have. Look for some with monk fruit, or stevia, or specifically try to avoid sugar alcohols.

Some history: I am a 29-year-old American woman living in Denmark on a residency permit with my husband and his kids. We tried to get pregnant for a while, but after many failed attempts, we decided to bring our concerns to an OB/GYN. I was diagnosed with PCOS and was asked to lose quite a bit of weight before they would help via fertility treatments. It has been a struggle to get any assistance at all in regards to PCOS related symptoms because of my weight, never mind the fertility issues that come along with it. I decided to go for bariatric surgery, as recommended by my GP. Meetings held & requirements so far: A week prior to my meetings, I was required to get an EKG and blood test done. 12/09/2019 (141kg / 310lbs) - I had my first meeting with one of the doctors at the diabetes center. It was basically just the start of a medical journal. He got my starting weight, illnesses, medication, and allergies. I was told that I need to lose 8% of my current weight, which would put me at 129kg / 284lbs. He told me that it looked like I would be offered surgery since I met the requirements (a BMI over 35 with concurrent related diseases, which, for me, is PCOS, sleep apnea, and a history of hypertension), but I would find out on my next visit. The day before I left on vacation (12/17/2019), I weighed 136kg / 299lbs! While I had a great time visiting family, I ate way too much unhealthy food and shot back up to 142kg / 313lbs when I returned home (01/09/2020). Yikes! 😩 I managed to get the weight back off before my next visit though! 01/15/2020 (135kg /297lbs) - This was my second meeting, but this time it was with a senior doctor. He described the pros and cons of each option for surgery. Due to me having a history of occasional acid reflux and heartburn, he suggested that I go with the bypass surgery. However, he told me that I could choose for myself. I have decided to stick with what he recommended. By the end of the conversation, he offered me the surgery (as I figured at this point 😂) and set up an appointment for me to see a dietitian. He also said that my EKG and blood tests came back normal. Within two weeks of the previous meeting, I had to send in a stool sample. Upcoming meetings: 02/18/2020 - My first appointment with a dietitian. 03/06/2020 - Normally, I would be required to attend a patient seminar with other overweight people prior to surgery, but because I do not speak fluent Danish, I will have to participate in a 1-on-1 meeting with the details of how the operation takes place, how to prepare, and how to eat/live after the operation. This is a plus to me, as I am normally uncomfortable in large groups of people. As of today (01/26/2020), I weigh 133kg / 293lbs! With this current rate of weight loss, I imagine I will have met my goal weight for surgery by the time I have my first visit with the dietitian. This both delights and worries me, as I am not sure how they will take this information. I was told during the meeting with the senior doctor, that once I lost the weight, I would simply call up the clinic to tell them and I would get my surgery date some days later via email. However, the emails I received from the clinic prior to these meetings thus far have confused me, as they don't seem to suggest the same thing. Here's the list of requirements that I am still supposed to meet besides the upcoming appointments I have listed above: Lose at least 8%-12% of what I weighed the first time I visited the clinic and maintain that weight loss until the day of surgery. I need to have regular conversations (via meetings with a dietitian at the clinic or telephone) with approx. 4 week intervals to discuss: Agreements and goals for progress and weight loss Dietary changes Exercise Smoking and drinking alcohol Medical diseases Then, it says: after 3-6 months, I am to have a status interview and then a team of specialists will assess whether I can be offered an operation. 🤔 I guess what I am confused about is that I thought I was already offered the operation, but just needed to lose the required weight before I could get a date! Furthermore, if I lose the weight before my first meeting with the dietitian, would I really need to have so many more meetings after that? Eh, I guess I will make that phone call once I reach my goal weight to find out where I go from there. I am hoping it's as easy as the senior doctor said it would be during our meeting! Anyways, that's enough from me for now. I'm Steph! I recently joined the FB group and ended up finding my way onto the website. I look forward to writing with you all more in the future! Good luck, everyone! If anyone else has experienced a similar situation in the Scandinavian countries, I would love to hear what clarification you guys had gotten! And sorry if I sound totally spoiled -- I know the US insurance companies require a lot more in order to cover the operation! 🙈

I also have issues with my liver enzymes. Interestingly they have always been high in all the blood tests for the past 15 or so years. I think most doctors just thought that I was either an alcoholic or drug addict in denial. Since my rny my physician is now monitoring them carefully and has done heaps of extra tests. I have managed to put him off doing a biopsy at this stage. Your BMI is normal , you don’t need to gain weight. It may happen at some stage in the future but you don’t want to do it deliberately at this point. I requested a DEXA scan . It showed that the levels in my hip and spine are at osteopenia levels.I don’t know if this is because of the surgery or if it is just normal for age. Most people in Aus don’t get scanned unless they have had a break by which stage it is a bit late. Pretty ironic considering the TV ad campaign they had recently about looking after your bones. My Dr prescribed a prolix injection twice per year. I had to get it done as a private script as I do not qualify to be covered on the PBS but I figured it was worth it. There was a weekly meds option which would have been cheaper but it sounds as though it’s hard to take and it was doubtful that it would be absorbed correctly, there is also an annual infusion option.

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!

Yep, doing that too! More fluids, more salt, no alcohol (not that I was drinking any anyway), regular exercise to promote blood flow, smaller more frequent meals... etc etc etc

I told no one except my husband and kids. Not even my parents know. Yes, people have asked about my weight loss, "How did you do it?" My standard reply is "This is what I am doing............." By the time I get to no sugar and no alcohol, they usually walk away. My other standard answer, "Most people who lose weight regain it. If I am still thin in a year, you can ask again and we can discuss it." Because I tell them what I AM DOING, not what I DID, I do not believe I have lied to anyone. Interestingly, the only overweight people who have asked are ones who could stand to lose 20 - 40 pounds, and who would not qualify for surgery anyway. What I tell them about dietary, exercise, and lifestyle changes is spot on, and exactly what I AM doing and what they could be doing. A morbidly obese person has NEVER asked me about my weight loss. I have relatives who have lost a LOT of weight and then gained it all back. I saw them at Christmas, and they never even mentioned or asked about my own weight loss. I think it might have been a little threatening to them, and they might even be waiting to see if I gain it all back by next Christmas. I still don't intend to mention surgery to anyone. It's my personal business, and I have watched reactions about other people who have had surgery. It's the "easy way out," or "all someone has to do is eat less and move more," or "why would anyone want to mess up their internal plumbing." I am just not secure enough to wonder about what people would be saying behind my back or always putting an "asterick" by my name in their minds: "Sure, she looks good, but she had surgery...."

I am sorry to say that while this surgery has helped many, it has ruined 5 lives. My ex got this surgery without realizing that he probably had an underlying psychiatric issue which he medicated with food. After the surgery he never was relieved of pain. In fact, he almost died, even though the surgery was done in Princeton, New Jersey by an expert. He became septic because of a fistula. He lived through that. For 6 weeks after the surgery I had to stuff gauze inside the wound and change it twice a day. A nurse came to our house to change his IV. That was the summer of 2007. The entire month of July. The pain lasted more than 8 years. This pain and the lack of joy he Had previously derived from food, led him to a dark place which he medicated with alcohol while doctors prescribed antidepressants. His family thought he would be okay because he continued to make money hand over fist by surviving each office work day and spending the evenings and weekends soaked in alcohol, Drugged by medicine to mask his physical and mental anguish, and sleep. He lost interest in our children who were all under 8. He lost the ability to perform sexually. He eventually lost his job. We moved and in one weekend he took so many ambien that it is miraculous that he is alive. We eventually divorced because he felt “maybe [he] would feel less like committing suicide if we were divorced”. But it was not so. He continued to behave and feel the same way. It was, in fact, worse. When the police intervened and got him to a hospital, it was found that he had a vitamin deficiency which caused damage in multiple organs. He is now recovered. He is in his right mind and has a job. But from 2007 to 2018, that was the life we lived. My children were without a present, healthy father from the time my son was 2 until he was 12. My daughter barely speaks to him because she blames him for turning to alcohol. She spent her life to 16 that way. The middle daughter understands, but likely does not realize how it has affected her. She knows nothing else. She was 4 when this started. I hate gastric bypass. If people are fat, it’s because of a mentally unhealthy relationship with food. The exceptions to this statement are FAR LESS than the number of people getting this surgery. But doctors like money.

I remember having a very dry mouth for a couple of months - just had to sip water continually. I never had prolonged fatigue. I also developed lactose i tolerance. Once I stopped dairy products a lot of my gassiness and bloating resolved. I use plant based or soy products now - no big deal. I was never constipated - if anything, food passed through too quickly. I have the opposite problem with very soft, formed stools 4-5 times a day. They float, so I think there is some fat malabsorption. Of medical complications, I did get blood clots in one leg about a week post op, even though I was up and walking almost immediately after surgery and doing 10,000 steps by day 7. That required 3 months of Xarelto medication. I recently found out that I have an ulcer at the anastamosis, even though I do not drink any alcohol, do not smoke, do not drink soda or coffee, do not take NSAIDS, or have any other risk factors. I am on medication for that and will have another scope done in a couple of months. Those are complications that everyone is told about, and which everyone hopes will not happen to them. But they have not been a big deal to treat. I would still do surgery all over again. My new life is fantastic and I know I have substantially extended both my lifespan and my quality of life. What I am dealing with right now that I am really upset about however, is that I just got a bill from the PA-C, who acted as first assist during my surgery. She is sending a bill through the insurance for the hiatal hernia repair that I also had done, and as an OUT OF NETWORK provider!!!!!!. First of all, I never signed a consent with her, and I chose my doctor partly because he WAS in network. I understand the role of first assist, but they are not surgeons and she should have not submitted a bill that way. So I am all over it. I will pay her a fair IN-NETWORK fee, but not for something I was not informed about nor gave consent for. So THAT is something no one told me about and which I did not expect, especially since this bill came nearly a YEAR after the surgery!

My nutritionist recommended no more than 5 grams of sugar in a meal. And said no sugar alcohols. Although from personal experience they are not all equal. Maltitol causes the most gastric distress, while erythritol is generally better tolerated and doesn’t cause gastric distress. There is no fruit on my nutritionist plan. I personally limit sugar as much as possible due to metabolic disorders. But it’s not always sugar that causes dumping. I had my gallbladder removed due to chronic inflammation so now I need to be careful with fats. (And I love butter even more than I do sugar ...) I don’t seem to have trouble with protein bars but I am careful which ones I buy. Never too much sugar or carbs. In moderation they can be fine. I bought some BariatricPal bars and have half with tea for breakfast (depends what I plan for lunch) it’s always been my go to breakfast. i did try some fruit but then stopped. It didn’t cause dumping but it was also too tempting to keep having more ... but for some sugar is an addiction and you don’t want to temp addiction.

I will try to come up with a healthy fat that I actually like (dont like avocados) and will avoid sugar alcohols for the first few hours Sent from my SM-G950U1 using BariatricPal mobile app

FluffyChix, Thank you so much. Yes, my Sleeve still works and gets restriction to food. As far as the fatty liver, it is Non-Alcoholic. I know without a doubt that I have a vitamin deficiency, and wanted to keep taking my vitamins until I can schedule an appointment to meet with the Doc. I just am not sure how long I should wait?? At the present time, I'm taking the OPTISOURCE Post Bariatric Surgery chewable tablets (& I absolutely hate them), but I force myself. I'm looking to make the switch to perhaps a 1 a day capsule (BariatricPal 1 a day Multi-vitamin).

And what about sugar alcohols? I've not dumped because I've avoided sugar like the plague, but I ate 3/4 of a low carb protein bar the other day and my heart started pounding and I felt like I had to lay down. That may have been a dump on only 2 net carbs, so I suspect the sugar alcohols might have been the culprit...anybody else have problems with protein bars?

I'm on my two week pre-op too and it's the same. I can eat mostly normal, just no carbs, alcohol, or high fat foods. Sent from my Pixel 3 using Tapatalk

You can make your own refreezable ice pack with a gallon freezer bag. Fill it with 3 cups of water and 1 cup of rubbing alcohol and then just put it in the freezer. Make two so you can always have one ready to go while you are using the other one.

Ah, you're lucky you don't get the regular symptoms. Though throwing up DOES still sucks on its own. For me the absolute worst dumping symptom is the death feelings after the "expelling" of the offending food (weakness, lethargy, nausea, head spinning...sorta like a horrible non-alcoholic hangover) that lasts for like an hour or so.

I was actually surprised when my surgery/Nut group kept telling me "don't worry about calories, just worry about volume". It's a very proactive university based operations, which seems to be on the very cutting edge of the craft. So far it is working incredibly well. As such, here is the Post 6 week to 3 month plan: Diet plan: Three structured meals a day (B,L,D) A meal consists of: 2-3 oz protien (weigh after cooking) 1-2oz cooked or raw veg. * Portion size will gradually increase over time, but remember to stop eating when you feel content or satisfied, do not overfill. Remember to eat slowly chew well to allow yourself to feel full, before you take the next bite. Protein: there are no restrictions, but wait 3 months before having steak. Eat a variety of protiens. Protien will be the focus of your diet. Vegetables: eat at every meal. Limit starchy veg, like corn, peas, potatoes, pasta. Etc.. Drink 2 protein shakes per day to maintain minimum 60-80 grams protein. Combined fluid total of at least 64 oz daily, no caffeine, carbs, sugar, alcohol . Do not skip meals. Eat just enough, and slow enough to feel full. Do Not drink anything from 30 minute prior, to 30 minutes after each meal. Very important! Do not chew gum (For the rest of your life) Take your vitamins and minerals. So that's it in a nutshell. No calories defined, and I asked several times. They kept saying that if I follow the percentages (Basically 2/1 Protein over veg, with very limited starch) and eat till full, without drinking, it's a slam dunk. So far, a lb per day like clockwork. luck!

I have also loved this thread. It has been so supportive and so good to "talk" to folks at the same stages throughout the year. I reached my goal at 7 months and have maintained at about 5 pounds below, which feels good. My clothes fit and I am wrinkly, but not gaunt. I,too, am eating more normally than every before. I still have some restriction, but am finding that I need to watch portion control a bit more now. Being able to eat more at a time, however, is really helpful as I step up my exercise. Surprisingly, I still have a little trouble getting in fluids more than a couple of swallows at a time. It is my goal each day to get in 64 oz minimum, and sometimes it is a real push to do so. I have transitioned to a whole foods plant based (WFPB) eating plan now, and have developed lactose intolerance. In fact, it looks like the whey protein started an allergic reaction in my esophagus. So menu planning has become a bit more challenging with no gluten, no dairy, and no animal products. As far as complications, I developed blood clots in my legs after surgery, even with walking right away. I also got an ulcer at the the GJ junction which is being treated now (in spite of no alcohol, NSAIDS, coffee, soda, or anything else that would predispose to an ulcer.) But would I do it again - YOU BET! My life if so full and active now. My family is have a bit of a time getting used to the "new me," but it is the best decision I have ever made for myself! Year two challenges: I anticipate a lot more "head work" as I dig deeper into emotional eating issues and not wanting to stop eating once I start, especially with evening time munching. As the "honeymoon" period ends, I want to be strong and resilient to temptations, having good tools to fall back on - like IF, longer fasts, and exercise goals. Best wishes for all my Feb buddies. I hope you will all post and let us all know how you are doing and what your new goals are.

I gravitate to sweet for a different reason. Some time ago my taste buds stopped working properly. I couldn’t taste anything anymore mainly if it were strong sweet, salty, creamy or by texture. Sometimes it is worse than others. I tend to use sweet but without sugar. I use stevia in my tea or coffee. I buy skinny girl flavor syrup usually from either Burlington, Tuesday morning, tMarshall’s or home goods or tjmaxx they have them cheapest. be careful with sugar alcohols especially maltitol, that’s dangerous for dumping. but there’s plenty of healthier sweet options like protein bars, protein cookies, smart cakes, smart muffins, mug cakes, etc. BariatricPal store has quite a selection. Also Netrition.com. i haven’t had it in a while but if you crave bread great low carb bread company makes good bread, bagels, thin pizza crust, and other things even pasta. It’s a balance of fiber and protein. I try not to tempt myself with too much sweet and im not a snacker. So the sweet has to be protein for a meal. Of course that’s just me. I keep it little to no sugar, avoid sugar alcohols unless it’s a little bit of Erythritol. And stick to low carb and make sure it has protein. Fiber helps. if you like chocolate I found an interesting protein bar that’s called Built Bar, it comes in a bunch of flavors, 110 calories, 15 grams protein and low sugar. I bought a sampler box with a $10 coupon from their Facebook page. I tried mint brownie and it’s a bit like a dark chocolate peppermint patty. Not sure if it still works but the $10 off code is FIRSTBUILTBAR There’s even healthier gummy candies (smart sweets) that are sweetened with stevia and have lots of fiber. I think there are protein gummies too. halo top is one lower sugar, low calorie ice cream option.