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Hello @ihoneyyou, You are doing so well. I think you look great too. Have you had children ? I ask because you may need a muscle repair to rectify your tummy shape. It may not be all weight loss related

Long rant ahead sorry ... So, I'm slightly angry (understatement). I saw my french primary care doctor yesterday. She's never been great to be honest. I've been seeing her for 6ish years. 5 years ago I gained over 80lbs pounds in a year and a half going from 118lbs (that had been my standard adult weight since my teenage years with a BMI of 19) to 200lbs ( BMI 32.3) after taking antidepressants. I stopped the antidepressants after a year because the weight gain was making me more miserable than I was being slightly depressed and thin. I have been struggling to loose the weight since... loosing and regaining the same 15-20 lbs again and again. As I've mentioned before, I have slight cérébral palsy - nothing too bad but enough to make walking pretty painful on my legs when I hit over about 130lbs and to make me generally clumbsy - I also lack gross motor coordination and don't have the best fine motor skills either... I can't really do any sports that require coordination and can only really ride a bicycle in a flat straight line and it takes a lot of mental effort for me to keep my balance, crowds freak me out because I'm scared of tripping and falling and don't even mention jumpy little dogs, my nemisis as my balance is so precarious. However I've always made do and It's never stopped me having an enjoyable fufilling life and a pretty decent career. My weight gain really really made me suffer, emotionally of course, my self esteem, my self worth etc ( I live in Paris which is the thinnist city in a thin country ... and it's not a place where people are kind to overweight people at all - I checked and the mean BMI of a Parisienne woman is 22.3 - so when you hit a BMI of 30 here you're really a fat outlier and are basically scorned in all public spaces ). It also made me physically miserable and I lost the little flexibilty I had - constant pain when walking - loss of gross motor skills, trouble showering standing up at 30 years old, not being able to put my socks on etc etc. For the last 4 years I have been to my Primary care doctor about 5 times asking for a referal to a nutritionist - she's always refused as told me "but it's simple, you just need to eat less and move more, it's not magic, No need to waste money on a nutritionist if you have no willpower "No **** sherlock! She has no idea the willpower it takes to get out of bed at 200lbs with cerebral palsy when you feel like your legs are litterally going to snap, when your feet are burning with weight stress induced neuropathic pain. In January I finally cracked after a lot of introspection and thought and booked my VSG for February in Turkey. I've now lost 35lbs since my preop diet so in just under 2 months. I already feel a lot better, the pain when I'm walking is lessening, I'm fitting back into the "second round" of fat clothes I got myself. So I walked into her office yesterday ( I had the intention of "fessing up" to having had a VSG and asking her for iron supplement ideas as I'm still being sick when I try and take iron ) She took one look at me and said "ah, you've finally found your willpower, loose another 20kg (40 pounds) and you'll be an attractive young woman again" I had a surge of red rage inside me, I kept my calm, but didn't tell her about the surgery, I just smiled and told her I needed a refferal to a dermatologist for a mole on my face and left. I'm never going back to see her again. I spoke to my physical therapist on the phone this morning and he sort of helped he said "can I be unprofessional ? Honestly, qu'elle aille se faire foutre, (she can go f*ck herself)" Lets find you another doctor." My physical therapist knew about the surgery, as did my orthopedic surgeon and booth agreed that with my CP anything is better than being even slighty overweight and that the surgury was worth the risk as they've both seen me loose my mobilité over the last few years and has seen how its affected me. They said that if I could afford to go private abroad I should because If not I'd have to jump through hoops for years in france because my BMI (32) wouldn't have been considered high enough as a stand alone. So yeah... this weekend I find myself another doctor who's not a fatphobic arsehole and has a minimum of human compassion. And for the iron I'm just going to go and ask directly at the pharmacy what the have to propose. Sorry that was long but I just had to get it out, I'm slowly realising all the **** I've put up with because of my weight these last years and I am ANNNNGRYYYY!!!! Hope everyone is having an okay hump day!

I had Petersens hernias 2 years out - the membrane that holds in your guts is pulled apart by the weight loss and the intestines slide in and out and loops can get trapped. It never shows on X-rays and not always on ct as it moves about. General emergency docs in uk missed diagnosis and it was finally seen by bariatric department and repaired- more than half my gut out of place when they sewed it back up! thing is because it moves around the scans don’t always catch it. I spent ages trying to figure out what foods caused it. If I got on hands and knees and rolled hips/back I could often soothe it which we realise now may well have helped move things back. it needs exploratory surgery to be entirely sure/ rule it out. Make a fuss. Make sure you see bariatric surgeon, use name Petersens xx

I supposed the OP has already worked this out since the post was 2015 but I just want to add that the surgeons do then to weight loss drugs as one of the tools in their belts post surgery now. They have quite a few in addition to phentermine nowadays too. For anyone out there experiencing weight gain please touch base with your team. I was unable to take the meds because if interactions with other meds I was on but that was definitely an option that was presented to me early on and for someone with only a fair amount of weight to lose it could help. I have taken phentermine in the past and it did reduce my appetite significantly. My problem is I wake up several times and night and eat too so once the med wore off I was hungry. For those reasons they didn’t work for me but they do work for many people.

I do. currently I take one by ProCare Health (with iron) also a hair/skin/nails and collagen

Right now I am not getting a great deal of help from his team. I am trying to decide between SADI and bypass but I honestly think I may be one of the first patients to get the SADI with him. A fact that if it is true scares me a bit but the possibility of greater weight loss has kept me interested. I do have an appointment tomorrow with his PA and in two weeks with the dietician to help in my decision. I hope I get quite a few answers between the two. I am just really trying to figure things out so I can eat that way now to see what I am possibly getting myself into. Lol

They have vitamin patches. However, the drawback is they aren't as good from what I understand. I'm certain your doctor will find something to help you. My insurance does cover rehab for my knee. I did it for two months, but I can do the samething at home. It was just stretches and certain movements to strengthen other parts of the knee to help stabilize it. The doctor did a couple injections but that only helps for a couple weeks. I'm at 100 lbs weight loss since October when I weighed in at my first visit to the bariatric center. I dropped nearly 70 lbs before I had the surgery. Thanks for the comment. I'm not a very photogenic, but I will post some pictures at some point.

Hi- I had my ESG done around the same date as you and hoping to hear an update. I live in San Diego so opted to have it done in Mexico. But I’m wondering if that was the wrong choice. I feel very little restriction 6 weeks out. I can eat a significant amount of food before a sudden full feeling comes on. I have no issues meeting protein or water goals. I can comfortably drink a protein shake in a minute.. I’ve had 10lbs weight loss and no weight loss since starting solid foods.

Congratulations to you, on your upcoming weight loss surgery.

I am so glad that you are still reaching out to your team and posting here. I won’t get too far into my story but because of “confusion,” about my mental health, interactions with meds and embarrassment the help I got from my team was not working for me and I gave up. I continued to gain and now I am back here facing revision weighing a little more than when I started this journey. People here are very helpful and understanding but your team should be giving you answers too. Sounds like they have a plan for the next step if need be and that’s great. if all else fails, The phentermine is the one medication that I could try which did work amazing during the day for me but I suffer from insomnia and when I can’t sleep I eat. So, the meds worked wonderfully during the day but at night, with my larger sleeve and being awake so many times, I was able to consume too much for the whole day and I still gained. But I can see how if you sleep throughout the night it really could work. I didn’t get to try mountjourno or any of the other brands it’s sold under because of financial reasons but if you can swing it, I have heard AMAZING things about that medicine too (there are some side effects for some people to consider). People claim they think they must know how skinny brains feel after taking it. They just don’t ever have to think or worry about food. One lady has to set alarms if she is busy to remind herself to eat something. Another drawback is how long you have to take it. Some say when you go off it you start to gain. They are doing studies now where they are trying to work out a maintenance dose that may be less than the regular dosage though. There are also places that are starting to “compound” it at compounding pharmacies. I wouldn’t necessarily trust the stuff from random sites online but my PCP was telling me they were working on getting it in their office and it is less than half the normal cost that way. I don’t know much about the other weight loss drug options because I couldn’t take them with my bipolar meds Interestingly, i just seen an ABC special Oprah did on weight loss injections the other night. (Ironically it was the day I went back to see my surgeon so I thought maybe it was meant to be which is why I inquired about them with my PCP). I’m really hoping that reached someone that has the power to change how accessible these meds are. I asked my pcp and she said it’s probably going to take a little while like everything else and she thinks at this point I shouldn’t wait on surgery for that but if your interested keep asking questions because these things tend to just change in the middle of the night and the word takes a while to reach you if you not the one asking. Anywahs, kudos to you for not giving up. Let your team do all they can to help you and keep posting here!!. I think when I stopped that I lost all hope. I was so isolated. Surrounded by skinny family and having only one heavyset friend who is perfectly content being that way I don’t have a lot of real life people who understand me the way that this community does. I felt so ashamed and I didn’t want to drag down the vibe here with my failures. Since I have returned I have been welcomed with open arms and honestly don’t know why I ever doubted that I would be. Keep doing what your doing and you will work this out. I know it. 🤗

I get low blood sugar too when I drink enough water it’s frustrating it’s not something) I’ve had to deal with too much and it feels like I’ve just flopped from one end of the problems to the other without getting to reap the weight loss reward. Hopefully your stall breaks and that’s all it is, a stall. I recommend getting a tape measure and doing measurements of yourself at least bc I’ve been losing inches even if the scale is refusing to budge.

Kind of yes and no. I met with my surgeon team and was told try to stay around 1000-1200 calories, 130g or less of carbs, and to be at least 80g of protein. They said they don’t know why for some people the metabolism reacts differently and changes greatly with surgery while with others the metabolic response is very minimal. They said obesity is a chronic disease that the body settles into. They said that the journey though is my own and that I shouldn’t be comparing myself to the substantial weight loss others have. I think it’s really hard to not compare sometimes though because many here get the surgery and become very healthy very fast. They are planning to meet with me again in about a month and will discuss various weight loss medicine additions such as ozempic, wegovy, metformin, topiramate, phentermine, mounjaro. It could take one or a pair of these medications together to get the metabolic rate to be where it needs to be for weight loss for me.

Thanks!!! I’m super curious to hear the answer to that one. I assume altering the sleeve with increase the risks and complications as well as recovery time but I think that there may be some value to it. I recall him saying your sleeve worked last time though so I may really need to stress this one. It worked because I used the advantages of less hunger hormone and acted like I was on a diet. Not because I ever felt full. I may need to be sure he understands that. Also it Seems like the percentages of weight loss I found in my research are for virgin surgeries so just doing the other part without touching the sleeve I’m guessing my weight loss will be considerably less. I’m curious what that looks like.

Honestly all you have to do is ask here and someone will do their best to help. More people will be along shortly too with much better suggestions. I cannot thank this community enough for all the assistance I have had. Given the (minimal) information given to me before, during, and after my surgery I attribute 90% of my loss to you all. I wouldn't have had a clue otherwise.

Okay this is long and boring at parts but here it goes. I am 3 years post sleeve and I have gained all my weight back . First of all I was on the smaller side to have the sleeve but I do still have all the same struggles and if I had waited until I was older it was just a matter of time until I was a higher bmi having the surgery. The fact that I have lost and then gained it all plus some within less than years is probably proof of that. Anyways, with the sleeve I did lose a big chunk of weight. I went from 235 to 168 which I could not have done with regular diet. But, i was always able to eat a little more than I should at every given stage and everything was easy for me. From day one I had no gas pain and water was easy to get down, then fluids and protein which were easy to keep down, I had no food intolerances and advancing through each stage. I was living my best life watching the pounds fall off but I was alway able to eat just a little more than everyone else at the same stage. Well, while the hunger hormone was gone and I was focused I was able to eat exactly what I SHOULD be eating and I measured my portions to the Amount I should be eating and I was satisfied. So lost most of the weight the dr suggested I would. i held that weight for a few months but then the hunger started creeping back and between the hunger and the extra room in the pouch I started gaining in spite of still making healthy food choices (my food was fine but my portions were too large and too frequent). Well, even though I knew I was losing control my friends and family continued to look at me as doing great..I was still on the road to getting to where I needed ti be in their eyes. I was ashamed. I was failing yet They kept complimenting me and offering me food. They were saying things like your doing so good, you can have one slice or pizza or one brownie. It won’t kill you. It’s okay that you’ve gained a couple pounds I’ve gained a couple it’s Christmas. You can lose that. Well I have since learned that no I cannot just have one of anything to do with carbs or I crave them for a week but I didn’t know that back then Anyways, was still going to my surgeon asking for help but I have bipolar disorder and the meds I take for it limit what other meds I can take so I cannot take many of the weight loss meds they had to offer. And the one I can take worked wonderfully during the day but when it wore off I ate all night Fast forward a few months and I stepped on the scale and I was back over 200. That sucked but I wasn’t giving up. went back to my surgeon asking about revision to bypass. I have heartburn gerd whatever you call it and clearly the sleeve wasn’t working so I wanted to know my options. Well let’s go back. I knew I didn’t want to have surgery if I was going to just repeat the yo-yo that had just happened so I decided I wanted two opinions this time. Well the second opinion dr had a cancellation so I seen him first. He was on board. He was going to bypass a shorter amount of bowel so i had less absorption issues and my meds Would work fine he said which seemed to be his concern even though it wasn’t really my question. I just needed my dr to say that it shouldn't be a repeat of last time and I was going forward. Well even though the bypass was an option he presented to me to start he said he wouldn’t do a bypass for me. He thought it would be a bad call with my mental health issues. This was confusing to say the least because I have one dr saying it’s fine and another dr I really respect saying it’s not and I started this thinking bypass was always an okay option in terms of mental health but worried the surgery just wouldn’t work for me. I am of course concerned about my mental health so took some time to think about it. I tried for a while to find a bariatric therapiest but none near me are taking any new patients. I even asked the surgeon and he said he would look into it but be never did. Anyways I called around for the better part of two days. They all just do the evaluations now for surgery. I have had every hormone test and lab they have that could possibly be the problem. I changed all my meds in case they were the issue. I tried everything myself and my doctors could think of but I kept gaining. When I revisited the idea of surgery I was scared. Anything that was going to upset my mental health again just isn’t an option I decided. I already know what life without my medication is like and I do not want to go back there. I continued to gain. I got back up to 245 and I am miserable. I am so depressed when I look at what I have let happen to myself. I had a chance and I blew it. I am disgusted when I look in the mirror. I decided that the weight is causing me to be more depressed so I needed to get some real answers. I went back to my surgeon. Not to ask him to do the surgery but exactly why he thought it was a bad idea. The plan was to take that info and talk to the other surgeon to make sure he had considered that and see why he wasn’t worried about it. Well, surprise…my surgeon is on board now with doing a revision for me. When I asked why he said no before he said something about a nite in my chart that said I wasn’t complaint with my meds back them and he didn’t know I have a psychiatrist and psychologist and take my meds but now he is comfortable doing surgery. So, frustrated I had to wait until I gained almost 50 more pounds to get here but excited he is willing to do it I am researching the other surgery he thinks will be a better fit for me called the SADI. At the same time I am still not buying the note in my chart thing. Cause that was never true. I guess the important takeaway for those of you here that are just starting out is even if you do regain don’t lose touch with your team and don’t give up. I feel like my dr wavering in whether he would do the surgery didn’t help but I could have asked more questions sooner and I wouldn’t have so much to lose this time. Plus, hopefully you guys can take the weight loss meds and won’t be facing a second surgery.

Exactly this - think of the extra loss as money in the bank unless you or your team get concerned.

you can always increase calories to gain weight (or to stop a loss), but keep In mind that a vast majority of us experience a 10-20 lb bounce back regain around year 3. You might want to factor that in. I purposely went below my goal just in case I had a rebound (and I did...actually closer to 30 lbs for me...).

Well, I think you look spectacular and very healthy. The transformation is absolutely stunning! I also think as our population trends heavier, we don't see the extra weight as much. I was a chubby kid, and I was like one of maybe 3 chubby kids in my entire grade, not just my class. I dieted like an idiot as a teen and got down to 126 lbs and I was nowhere close to the thinnest person in my friend group. Nobody said anything about me getting too skinny, for sure. I gained weight in college and by the time I graduated, I was overweight again, and obese by the time I hit my late 20s. I always felt like the biggest person in the room (at, like 210 lbs). But by the time I was in my mid-30s, I started seeing bigger people than me all around. Everyone was getting bigger. My weight went up to 225, but many of the parents of kids in my daughters' grades were way bigger than that. It almost had an insulating effect from my own weight gain, because I was no longer the biggest person in the room. I just kind of looked normal. When a friend heard I was getting bypass, her first response was "but you're not that big" and at this point I was 250 lbs with a 40+ BMI, plus high blood pressure, prediabetes, and high cholesterol. And this was from a person who is in the healthy BMI range and never been overweight. So I definitely think we've become so used to seeing larger people that we think "obese" is a term reserved for the people on television shows who weigh 600+ pounds. And, of course, the rapid weight loss from surgery is jarring so people notice it more. But don't let their comments get to you!

Thanks, everyone! Let me ask, how'd you handle the comments of "You're too skinny?" I get that from several people and it's infuriating. They are older and I respect them, so I don't want to give a mean comment. Oh, and the stares and jealous looks. In my mind I tell myself, "if your (talking to them in my head 🤷‍♀️) weight were that big and issue to you, then do something about it. That's all I did." An 126 lb weight loss in less than a year is massive change but the comments and looks...so isolating sometimes. Thankfully, another friend of mine has had the surgery as well, so I can talk through it with her. But what really iced my cake is she doesn't get the same stares and comments from the same group we run in. Unless, I'm reading too much into it. People who didn't know me from before look at me or comment me like a "normal" person. For example, I was at the doctor's office yesterday and we were discussing a dose change for a medication, and he said, "for people of healthy weight, such as yourself... " I just want to video it and play on repeat. Sorry, my passive aggressive fell out 😂

From what I know if you look at your BMI range, it is the top figure weight, say in my case, 78 kg. You now take your current weight, which when I started surgery was say 128 kg. Sorry I work in Metric but it works the same in imperial. 128-78 equals 50 kg. That 50 kg is my XS weight, so if mini gastric bypass has a predicted loss of 70 to 85% of the XS weight then it is 70% of 50 kg to 85% of 50 kg. I.e 35 to 59.5 kg is what I am expected to lose with the procedure. When it comes right down to it from what I understand. If like me, you have been obese all your life. Then you will have thicker, heavier bones to support that weight, more skin to wraparound it and a larger heart to pump blood around your body, so that means no matter what the general BMI limit is it is not totally relevant and there has been some suggestions by bariatric surgeons that to aim for a BMI of 30. BMI is intrinsically a flawed concept as it does not take into account, body muscle mass. You will know the example of the brick **** house musclebound New Zealand rugby player with no fat, looking like a crazy obese person on paper because they have a BMI of 45. I am 52 this year, so I think I would be happy with something above the BMI range. Otherwise my skin will waft in the breeze! 🤣

Would I be right in thinking your nutritionalist is recommending a keto like diet? They are big on no root vegetables & no corn, peas because of their naturally high sugar content. (Potatoes are often a no because they are considered a starch.) I regularly ate carrot & sugar snap peas. I threw frozen corn & peas into soups, mince dishes, some slow cooked dishes, omelettes, etc, I usually just microwave my vegetables with a splash of water & a dab of butter but also will stir fry & occasionally roast (especially cauliflower with a little hummus & zataar to serve). I love vegetables & enjoy them best simply with salt & pepper but don’t be afraid to try herbs & spices. The only vegetables I don’t eat is potato, sweet potato & pumpkin (they tend to sit heavily) except a very small piece (bite or two) with a roast dinner. My thoughts were & are vegetables are vegetables (except potato). They are highly nutritious (all those vitamins, minerals & fibre) so a valuable addition to our food choices. And the little we eat, especially in the first months will have minimal impact on your calorie intake & weight loss. I mean 1/4 cup peas is 30 calories if you can eat that much. Plus the ‘sweet’ vegetables are naturally sweet so they don’t count towards your sugar intake. Certainly didn’t affect my weight loss or maintenance. I say eat your vegetables, just watch portion size & what you serve or add to them. Like no honey glazed carrots, sour cream or cheese sauces at least for a while.

From what I know if you look at your BMI range, it is the top figure weight, say in my case, 78 kg. You now take your current weight, which when I started surgery was say 128 kg. Sorry I work in Metric but it works the same in imperial. 128-78 equals 50 kg. That 50 kg is my XS weight, so if mini gastric bypass has a predicted loss of 70 to 85% of the XS weight then it is 70% of 50 kg to 85% of 50 kg. I.e 35 to 59.5 kg is what I am expected to lose with the procedure. When it comes right down to it from what I understand. If like me, you have been obese all your life. Then you will have thicker, heavier bones to support that weight, more skin to wraparound it and a larger heart to pump blood around your body, so that means no matter what the general BMI limit is it is not totally relevant and there has been some suggestions by bariatric surgeons that to aim for a BMI of 30. BMI is intrinsically a flawed concept as it does not take into account, body muscle mass. You will know the example of the brick **** house musclebound New Zealand rugby player with no fat, looking like a crazy obese person on paper because they have a BMI of 45. I am 52 this year, so I think I would be happy with something above the BMI range. Otherwise my skin will waft in the breeze! 🤣

I kept losing for almost another year after I reached my goal. It began at a similar rate of loss as I was experiencing but gradually got less & less until it stopped. Over that time I increased my calorie intake (added more & more snacks) & my portions got a little larger. I was eating about 1300 calories when I initially stopped losing but eat about 1500/1600 to maintain at about the same weight now. Like @Spinoza, I’m a believer in our changed set point. This is the weight my body is happy at & this is the weight it wants me to be thanks to the surgery. Could I eat my set point up? Yes, if I wanted. I mean that’s what we did before - ate our set point higher. Our original set point wasn’t an obese weight. Don’t forget you may initially stop at a lower weight than you expected but it may give you wriggle room if you experience the bounce back regain around years 2 or 3. Give your body time to resettle. Lots of things change when your weight starts to stabilise. Just give it time. Slowly increase those calories. Get in touch with your dietician for ideas of what you can add or how you could adjust your current eating plan. Good luck.

Interesting question. Some say it’s the weight you need to lose to put you at a healthy BMI. Some say it’s the weight they personally want to lose to put them in their happy weight zone - a weight that worked for them in the past or they think will work for them in the future. Personally, I think of it simply as the weight you want to lose to get to your goal regardless of how you worked it out or chose it. Not as a sort of standardised amount of weight defined by someone else (surgeon, dietician, etc.) or statistical data. This (weight loss) is all about you & your experiences & no one else’s. As you know not every one reaches their goal & statistically average weight loss with sleeve or bypass is about 65% of the weight you are to lose (based on BMI defined excess weight). And then there are those who find they’re happier at a weight that is more or less than the goal they initially chose. They all lost excess weight & are healthier for it.

Differences in size never cease to amaze me. I am almost exactly the same weight as you but 3 inches taller and I am a US size 8-10. No idea how that happens. OP I am a firm believer in the concept of a new set weight after bariatric surgery. I would have been happy 15 or 20 pounds heavier than where I settled. That was my goal actually. After I got into that ballpark I didn't try to lose any more, but it just happened. And then, eating very much the same stuff, my loss then stopped. And I've maintained thereabouts for a year or more with very little effort. If you can keep eating healthy and nutritious foods then could you just see where that gets you to? There are lots of healthy people with a BMI of 25+ and lots with a BMI of 19-. You'll find yourself somewhere in the middle eventually I suspect.