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Tough Love We tend to be toughest on the ones we love the most because we hold them to such a high standard. Put yourself in the elite category of people you love, and give yourself some tough love with the goal of making yourself better. You could buy an accurate digital scale so you cannot use inaccuracies or forgetfulness as an excuse for not losing weight. You could get rid of anything in your kitchen that is not going to help your weight loss goals. You could force yourself to log your food accurately even if it is not pretty because ultimately, it is in your best interest. Supportive Love You can show yourself love by supporting yourself in your weight loss journey the way you would support any of your loved ones in their own endeavors. What about…? Going on a shopping spree in the produce section of your local supermarket. Placing an online order for bariatric vitamins and protein bars. Making a few appointments with yourself to walk or do other exercises. Indulgent Love Spend a little one-on-one time with yourself to rediscover yourself, because sometimes in the hustle and bustle of daily living, we forget that we are people who need TLC. Give yourself a spa day or get a massage, watch a movie (no popcorn!), or buy yourself a present, such as flowers to brighten up your home. Social Love Spend a day with some friends. Go to the beach, a museum, or the mall, volunteer somewhere or make crafts at one of your homes. Your day together not only serves to give you a fun and uplifting day of relaxation. It also lets you see some role models. Your friends will be showing you that they appreciate and care about you, and that is a lesson you should take note of. Communicative Love When was the last time you told yourself you love yourself? How often do you remind yourself of your wonderful qualities? Do you regularly praise yourself for your accomplishments and efforts? Guess what: today is the day! Take pen and paper (or your smartphone’s note-taking app) and write down some positive words about yourself. Let yourself know if you admire… Your hard work in your weight loss surgery journey. The good job you do at work. The way you keep your household running. How well you take care of your family. Any of your qualities such as patience, generosity, intelligence, or kindness. Read this often! Selfish Love Show yourself some love by putting yourself first. This could be as difficult, but simple, as saying, “No” to someone else in favor of something you want to do for yourself. You can put yourself first by: Vetoing a night out at your family’s favorite restaurant that you cannot find anything WLS-friendly to eat in favor of your family’s second-favorite restaurant if it has something you can eat. Saying, “No, thanks,” when someone asks you to taste her freshly baked cookies because skipping them is more important for your diet. Telling your boss you need to go home on time to be with your family instead of staying late at work. Remember, if you ever are tempted to feel guilty for putting yourself first, that you need to put yourself first. You need to be healthy, happy, and strong to give your very best to others. From now on, work on your relationship with yourself every day. You may thank yourself!

After going thru the entire program in 2015-16 ,being never told I had completed and was approved, my job was terminated and lost insurance coverage. I thought I had only completed 5 of the 6 required dietary consults. I had not persued it at that time, I'm told recently former insurance only required 5 sessions. They were only waiting on a new # from new insurance carrier, they could have told me then but failed to. Hokay,I then[emoji7] started the process over last fall, did all my different requirements all over,had all done by the end of 2017. Have been waiting with somewhat baited breath for a surgery date, had 1 person call from surgeon's office and gave me February 15, turns out she was a minor peon and spoke out of turn. Official person called last Friday, said---'" oh by the way psychologist wouldn't clear you for surgery. "This person when I saw her face-to-face told me I had passed all requirements and she would be telling them that. 1st time thru I had talked to a full psychiatrist and things were fine, well I'm the same old me as I was then, Now I am told their commitee-' I call them the Bariatric Court of Appeals ---will be meeting February 20 to review my case. Do they over-ride the faulty assesment, does my surgeon have the necessary man bits, (I'd use the proper Spanish term but I don't want Alex to ban me,) to go forth with this surgery as I think he should? All the sudden I feel like like I've fallen into a beauty pageant and I'm being voted whether I'm Miss Congeniality. Does desire ,weight loss & commitment count for anything? I've cut my weight down 32 lbs ---and at my age and activity level it ain't easy! My Bariatric Facilitator Amber says to relax,and everthing will be All right, if everything is so okay then this isn't a game that should have been played. My past approval should count for something.I need this surgery, it is my last best hope for better health and a longer lifespan. If I wasn't depressed before, I am now. It is difficult to accept I am unfit and unworthy, I've fought that battle --'hearing that from family and so called friends.[emoji25][emoji25][emoji8] Sent from my VS880PP using BariatricPal mobile app

Hi, don’t be discouraged, even though that was extremely discouraging, going through this process with insurance is discouraging in itself if you ask me lol with all of the crap we have to go through...but to answer your question, my insurance requires that the 6 months be done with your primary care physician, so check with your insurance and my surgeon’s office required 1 meeting with their dietician, which costed $60, and could also be counted as 1 of your 6 appointments, but I couldn’t use it because I had already seen my PCP by that time for my appointment of the month and you can’t use 2 appointments in the same month. As far as psych goes, my insurance requires an intake appointment, which I had last month, but there’s this test that some people take depending on your psychiatrist, and mine is one of the ones who requires that her bariatric patients take the test,so we submitted to insurance that day to request that they pay for it, and if they don’t then I WILL be finding a way to pay for it myself because I refuse to let anything stop me from having surgery, the cost of it though is a believe close to $200. The best thing to do is contact your insurance to get the specifics, or find the handbook online, that’s what I did. Also, the surgeon’s office should tell you in vivid detail EVERYTHING that you will need. My office even gives us a check list to mark off as we complete everything.

I was just talking to my bariatric nurse today because I’m having problems getting water down (I used to drink a minimum of 128oz a day!) and she said she still has problems with cold water or any cold beverages. She said she gets what feels like a spasm.. I’ve been drinking room temp water and still can’t. Popsicles es do fine tho 😉 she is 2 yrs out.

Change PCP and Dr's report to an office manager, after you get a referral I would complain - opinion is not 'science'. Ask the Bariatric surgeon in your plan for a PCP that is supportive. Good luck.

YAY! Another Flinstone kid, like me! hahaha I swear, finding out I can take those was the best thing ever. Those giant bariatric vitamins are the worst!! Taking two was like torture for me.

You may not want to hear this, but if you have a true referral - driven H M O plan, it's likely that your doc gets financial incentives by keeping your medical costs down (i.e. keeping the insurance company's medical spend down). It's called risk - share contacting. This may be the reason they're against bariatric surgery, as in the short term it increases your costs as a patient and thus decreases their quarterly reimbursement from the insurance company. (edit: why is H M O... As in health maintenance organization... a filtered word that comes across asterisks?)

I didn't need a referral. I saw my PCP about 3 months after my consult and said, "I'm having bariatric surgery, here are my plans." (She was and is super supportive, thank goodness!) Many PPO insurance plans don't require referrals, so check that out before you find another doc and pay a copay. I'm usually against doctor hopping but unfortunately many still stigmatize WLS when it's the only thing shown to work for this population. In this specific instance I would definitely recommend finding a new PCP if your insurance requires a referral.

Ready for this- I saw a psychologist not a psychiatrist this 2nd try in the Bariatric Rodeo. Found out now that I had been approved in 2016, my job terminated and i lost insurance coverage,at that time. Now they tell me i had been totally approved and were only waiting on my new insurance# to assign,me a date. Never told me. Anywhoo, this independent psych broad from what i understand stated I was either emotionally or mentally too instable,for surgery. Never gave me an inkling of her backstabbing plans. Thought we had parted on good terms, even told me I had passed,everything that day. GOD I hate being,lied to and/or manipulated. Now I wait a week to find out if the impressions each of them had meeting or consulting with me is enough to over-ride her negative comment. What is this Miss America where I have to be Miss Congeniality,? I'm a little old to compete in a popularity contest. I'm sorry Fluffy --but it twists my knickers in a ball. Sent from my VS880PP using BariatricPal mobile app

Hi! What is the Bariatric app called? I’ve been using the MyPlate app HW 242 SW 236- December 20, 2017 CW 197 GW 160

I’m a 10 year bariatric gastric bypass member and devoiced due to my ex being very insecure by my weight loss; I have stayed my BMI for 10 years ( I weighed 400lbs) but having a life with a companion that understands the relationship with bariatric is like finding gold. Good luck hang in there!

I find most processed diet/bariatic snacks are not good in taste or quality. Many also inflate their vitamin content and my surgeon staff says a lot of vitamins even in good shakes are not absorbed well. I think most WLS patients have some dietary restrictions or surgeon eating plans, while industry guidelines are still loose. My diet did not include any pasta until year one, and it is recommended that it be whole grain and not be the bulk of meal (still focused on protein + veg/fruit). A lot of fruits were not on my diet plan for first 6 months or year because they were higher in sugar -- but many were. I would be very leery of an early diet plan that allowed or did not discuss how to make a good bariatric plate at each critical stage. Grains entered my diet at I think 8 months mostly, I did and do have oats on my high protein yogurt at an early stage or chia seeds. At over 1 1/2 years out and pass my 1st and 2nd goal weight, I still think about my balanced plate when eating and rarely have rice, pasta or bread. But, I do have them on occasion, when I do I try for whole grain versions, brown rice. Frankly, pasta just cannot be on a success plan when your meal is 4oz!

Has anyone tried any of the bariatric foods or snacks they sell? Weather is from this site or one like bariatric direct? Just curious.

That does sound like it is a bit on the low side. One time my mom was lying down on the couch, my daughter called me and said there was something wrong with mom. She was white as a sheet. She couldn't talk. She tried but no words came out, only a few whispers. She couldn't move. She looked like she was dying. We called an ambulance, they came in and measured her blood sugar and I believe it was in the 30's. So 58 is too low. So I think you are right about reactive hypoglycemia. Here is a link https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf According to their webpage: How can I prevent reactive hypoglycemia? You can help prevent reactive hypoglycemia by following your diet guidelines for bariatric surgery. • eat 3 healthy meals and 2 healthy snacks each day • space meals and snacks 2 to 3 hours apart • eat protein at each meal and snack time • avoid skipping meals and snacks • avoid or limit alcohol depending on what stage of diet your are at • avoid or limit caffeine depending on what stage of diet your are at • avoid sweets like cookies, cakes, candy, pop, juice and sweet drinks Instead of sugars and simple carbohydrates, eat complex carbohydrates because they release less sugar over a longer period of time. Having a complex carbohydrate with protein will slow this release even more.

“What can I do to prevent hair loss after bariatric surgery?” This is a common question I hear from my clients. Biotin has a reputation of preventing hair loss, but does it really work? Is there anything else you can do? A certain amount of hair loss is expected after bariatric surgery due to the stress of surgery on your body and the effect of rapid weight loss. Hair loss usually peaks about 3-4 months after surgery and may last up to 6 months. If you continue to have hair loss after 6 months then it may be nutritionally related. The three biggest nutrients that can affect hair loss are….drumroll please… Iron Zinc Protein These three nutrients have been proven in multiple studies to be helpful in mitigating hair loss after bariatric surgery. So how can you make sure you are getting adequate amounts of these nutrients? Check your vitamin and mineral levels before surgery If you are obese then you are at higher risk for micronutrient deficiencies. It is important to check your nutrient levels before surgery. In fact, The American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all patients are prescreened for nutrient deficiencies before surgery. This helps correct deficiencies before surgery and give you the best outcome. Start taking a multivitamin before surgery Taking a multivitamin before surgery may help you in two ways. First, it may improve your nutritional status before surgery. And second, it will help you to develop the habit of taking a multivitamin daily since this will be crucial lifelong habit after surgery. Take a quality multivitamin after surgery There are so many multivitamins out there it can become dizzying. Follow your surgeon’s team advice for which multivitamin to use. Ideally, it should be chewable or liquid form during the first two months after surgery and then after that you can switch to capsule form. Higher quality vitamins tend to be more money than generic brands but the micronutrients in the higher quality vitamins, such as iron and zinc, are usually easier for your body to absorb. Eat protein at every meal This tip should come as no surprise. Since your stomach size is smaller after surgery it is important to include protein at each meal. Ideally, it should be a high quality protein such as eggs, fish, poultry, or dairy (if you can tolerate it!). Most bariatric programs recommend between 60-120 g protein daily but please follow your surgery center’s guidance. Depending on how far out you are from surgery you will likely need to supplement with protein drinks to meet your protein goals. Check your vitamin and mineral levels after surgery Every bariatric center is different but typically your doctor will monitor your labs multiple times during the first year after surgery and then yearly after that. It is much easier to correct a nutritional deficiency early on. It is important that you attend your follow-up appointments so your doctor can monitor your nutrient levels after surgery. Eat your vitamins and minerals Lastly, focus on getting your iron, zinc and protein from real food. Even though you can get these nutrients from your supplements, food sources are the best. Good sources of these nutrients include beans, chicken, turkey, or liver. So what about biotin? Despite its reputation, biotin has not been shown to be helpful in preventing hair loss unless you have a deficiency. However, I know lots of clients who swear by it! Do you take biotin to prevent hair loss? Do you feel it works? Let me know in the comments below.

A certain amount of hair loss is expected after bariatric surgery due to the stress of surgery on your body and the effect of rapid weight loss. Hair loss usually peaks about 3-4 months after surgery and may last up to 6 months. If you continue to have hair loss after 6 months then it may be nutritionally related. The three biggest nutrients that can affect hair loss are….drumroll please… Iron Zinc Protein These three nutrients have been proven in multiple studies to be helpful in mitigating hair loss after bariatric surgery. So how can you make sure you are getting adequate amounts of these nutrients? Check your vitamin and mineral levels before surgery If you are obese then you are at higher risk for micronutrient deficiencies. It is important to check your nutrient levels before surgery. In fact, The American Society of Metabolic and Bariatric Surgery (ASMBS) recommends that all patients are prescreened for nutrient deficiencies before surgery. This helps correct deficiencies before surgery and give you the best outcome. Start taking a multivitamin before surgery Taking a multivitamin before surgery may help you in two ways. First, it may improve your nutritional status before surgery. And second, it will help you to develop the habit of taking a multivitamin daily since this will be crucial lifelong habit after surgery. Take a quality multivitamin after surgery There are so many multivitamins out there it can become dizzying. Follow your surgeon’s team advice for which multivitamin to use. Ideally, it should be chewable or liquid form during the first two months after surgery and then after that you can switch to capsule form. Higher quality vitamins tend to be more money than generic brands but the micronutrients in the higher quality vitamins, such as iron and zinc, are usually easier for your body to absorb. Eat protein at every meal This tip should come as no surprise. Since your stomach size is smaller after surgery it is important to include protein at each meal. Ideally, it should be a high quality protein such as eggs, fish, poultry, or dairy (if you can tolerate it!). Most bariatric programs recommend between 60-120 g protein daily but please follow your surgery center’s guidance. Depending on how far out you are from surgery you will likely need to supplement with protein drinks to meet your protein goals. Check your vitamin and mineral levels after surgery Every bariatric center is different but typically your doctor will monitor your labs multiple times during the first year after surgery and then yearly after that. It is much easier to correct a nutritional deficiency early on. It is important that you attend your follow-up appointments so your doctor can monitor your nutrient levels after surgery. Eat your vitamins and minerals Lastly, focus on getting your iron, zinc and protein from real food. Even though you can get these nutrients from your supplements, food sources are the best. Good sources of these nutrients include beans, chicken, turkey, or liver. So what about biotin? Despite its reputation, biotin has not been shown to be helpful in preventing hair loss unless you have a deficiency. However, I know lots of clients who swear by it! Do you take biotin to prevent hair loss? Do you feel it works? Let me know in the comments below.

Tomorrow is the big day...feeling happy but nervous. This is the second bariatric procedure I've had. Ten years ago, I had a lap band procedure, but the band was removed in an emergency surgery about one year ago. Turns out, 1/3 of my stomach slipped through my band. Very painful. I was really worried about putting the weight back on, and I had gained 20 pounds since the removal of the band. I was supposed to have the surgery on January 3, but it had to be postponed. So, Happy Valentine's Day to me!

I am more than slightly egg intolerate, as an example I can tell you how many eggs are in an omelet etc by the amount of gastrointestinal pain. And the smelly loose stool in a few hours, I know I know TMI. Hey things a little snafu for me, I'm in Mansfield now but when I Get home I've got to call Columbus. Lets say my case went to the Bariatric Court of Appeals at my hospital. A prayer at this time would not be unwarranted. Sent from my VS880PP using BariatricPal mobile app

*laughing* Your rant is a repeat topic. Not a new observation. Welcome to the world of bariatric forums.

Hi all. Just want to give my experience with the UHC process. I made the decision to go this route in may of 2017. I made the call to UHC who set me up with Optum Health which is part of the bariatric sub division. I was simply required to complete 6 months of guided weight loss which I did through the Center of Excellence facility that I chose as everything was on site there. I completed this process in December. The facility tried to submit my info to optum only to find out my case had been closed. Finding this odd I called them, got scheduled to a call with a case worker on February 8th. Had the call and at that point the case was ready for review with optum for the "letter of medical necessity" However, I found out today that I have to do another call with a place called CBA which will take place on Feb. 15th. It is nice to see however that it seems like once it finally gets to UHC for approval they seem to have a pretty quick turnaround. Once that approval is given, surgery will be 2 weeks from that day!

Continuing bariatric support is important. If you can't see a bariatric group, at the very least be vigilant about your PCP visits, make sure there is no other underlying cause to explain your weight loss.

Anyone Have This Happen...what to do now? 1 year out.I am to down to 114.5lbs (5'tall a little bony and 69 years young) ).... I look and feel great, however (I think) Seems I am losing too rapidly all of a sudden. We have relocated to a new city without bariatric support. When eating I can only hold so much ( small egg or walnut size pouch)... Many thanks!

Surgery with Dr. Sauceda in Monterrey, Mexico. Planned procedures today include lower body lift, inner thigh lift, breast lift and augmentation, brachioplasty. Facelift andd neck lift will happen on Friday. Today is the day! I woke up before the alarm went off and already was saying goodbye to feeling good for a few weeks. Those of you who have been through it know what it's like: Partly feeling like it's surreal, partly wondering what the outcome will look like. Will I be happy with the results? Will I be disappointed? Will I be crazy happy? And the pain/discomfort that is awaiting. Wondering what the 7 drains will be like (I know: uncomfortable as hell). Do I have enough to keep me entertained for the duration of my stay in the clinic? What clothes, if any, will I wear over the compression garment? I did some yoga this morning, the last time I'll be doing any form of activity for a long time. Surprised that I'm sad that I won't be able to exercise. That shows what a long way I've come since pre-bariatric surgery. It started to become real at the marking session last night. How's that for random thoughts in no particular order! Wish me luck, everyone, and thanks for reading my post! See you on the other side.

I reckon these are consistent themes over and over because not too much usually goes wrong except this list - and mostly we worry about this stuff. So, same old over and over - but with new people needing new reassurance, new hope, each new month. And I reckon we Post without first doing a Search because we want real warm-blooded real time people to respond - otherwise we could just google “why the hell aren’t I losing weight after my RNY” and just get research, or quacks selling gluten free water that will cure us, or surgeons’ websites. But I think for many, waiting three days to get a few personal replies to a (repeated) thread is actually more rewarding than finding an old thread with 37 replies. And as boards get new folk, old folk drift away, they are pretty self-renewing over time. Except the ‘old hands’ who like to stay - and I love that, but maybe the Rants and Raves Board should give those posts a red background so we don’t scare the new hope-seeking folk !!

Sleeved on Jan 30th and have lost 20lb in 2 weeks today. I am 5ft 8, starting weight was 265 and now 245lbs. I am feeling less exhausted and sick than I was. I think it's important to remember that while we may just have 4 or 5 small incisions, it is major surgery. And we need time to recover from that! I am still in the liquid diet phase, but moving to puree at the end of the week. My surgeons office provides all the puree meals because the dietician balances them especially for bariatric patients, but I am not convinced that beef stroganoff that has been pureed is going to be terribly appetising! How did everyone else cope with puree? Sent from my SM-G955F using Tapatalk