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Hi, all. I had bypass surgery almost exactly four years ago. I've taken bariatric vitamins religiously and my bloodwork has always been perfect. Now, all of a sudden, I have iron deficiency anemia. My most recent bloodwork showed an iron level of 24. Then, after five weeks of iron supplements, it had dropped to 14. What?? (I'm not exactly sure what those numbers mean, but my doctor says they are concerning.) I know that bypass causes absorption issues. However, nothing has changed in terms of my diet or vitamin intake. You would think this would have shown up long before now. Even my doctor is perplexed and is running tests to see what the cause might be. Has anyone else experienced this issue years after surgery? I'd be especially interested in hearing from other men, as we are less prone to iron deficiency than women.

it may be hard to find a surgeon who'll be willing to place a lapband. That surgery has largely been replaced by the sleeve as the non-RNY option, because so many people had complications with the lapband. A lot of people had to have their lapbands removed. P.S. you might want to try posting on the Lap band forum here on this site. They're the only members of Bariatric Pal who probably have a lap band these days. I almost never see posts from lap banders on the major forums anymore. Here's the link to the lap band forum: https://www.bariatricpal.com/forum/4-lap-band-surgery-forums/

What is the best probiotic for after Bariatric surgery?

I think the fact that the one passenger was going for a tummy tuck was entirely coincidental in this situation. It was reported that they were not targeted for that, but because they were believed to be involved in the drug trade. I vacation in Mexico often, and if I stopped going because of every news story about cartel activity I would be missing out big time. I understand the concern, but I think the recent kidnappings/murder incident is not related to travel to Mexico for bariatric care, etc. so you should still feel safe to follow your planned trip/surgery. I have been to Hospital los Angeles in Tijuana and felt entirely safe during the entire trip, including at the hospital, aftercare hotel and walking around the vicinity of the hospital/hotel. I hope we have helped you feel comfortable with your decision and you don't worry while on your journey.

yes I've been thinking about people who go down there for bariatric surgery, too, and yes - some of those border towns can be dangerous, but they believe the cartel mistook them for Haitian drug smugglers. If you're in a car with a driver from the bariatric center - and esp if he or she is from the area, you're probably safer. Plus I don't really hear about tourists getting murdered there - it seems to be mostly tourists getting robbed (that is, when it happens at all). I think a lot of the more violent crimes are between competing drug smugglers and cartels. Although yes - after hearing that story, I was a little freaked out, too. P.S. I know you're not a tourist, but you're an American - so people will probably assume you're a tourist. P.P.S. the state they went to is also listed on the US State Dept's Web site with a DO NOT TRAVEL warning. Tijuana is in a different state. It definitely has a dicey feel to it, and there are only certain areas of Tijuana that are safe for tourists, but also, you'll be with someone from the bariatric center, so they'll know what areas to avoid. I do understand your concern, though. I think i'd be feeling the exact same way after hearing that story.

I don't watch the news, so haven't heard about the kidnapping. Was it from a bariatric surgery center?

I had surgery in Mexico on 3/3/23. I did not go to Tijuana, having heard too many negative reviews of the Bariatric groups in that region. I went to Dr. Alvarez at Endobariatrics. Dr. Alvarez's EndoHospital is across the border from Eagle Pass, TX. I was self-pay so money was an issue but not at the expense of my health and peace of mind. Dr. Alvarez's fee is substantially less than in the USA but more than the average cost of most of the Mexico bariatric centers. The old saying "you get what you pay for" could not be more apropos. Dr. Alvarez's credentials are most impressive and his memberships in American Society for Metabolic and Bariatric Surgery (ASMBS), Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) highlighted his expertise in the field of bariatric surgery. Dr. Alvarez's facilities incorporate the EndoHospital and the EndoHotel in a beautiful state-of-the-art building. Dr. Alvarez is very accessible to his patients and the staff is professional, personable and attentive to the patient's every need. All personnel are fluently bi-lingual. Off-site, the EndoSpa provides additional pampering. I am only 5 days out and feel great. I have had no nausea and only slight abdominal discomfort similar to muscle soreness experienced from exercising. The day after surgery, I joined the guided sight-seeing tour, had a HydraFacial and a massage (yes, I was able to lie on my stomach) at the EndoSpa, and finished my outing with a visit to a restaurant for a delicious smoothie. I have heard many complaints from others as to hidden fees from some of the Mexico bariatric groups....basically holding the patient hostage until they are paid. Dr. Alvarez's fees are all inclusive with exception to any optional spa treatments the patient choses to enjoy. My words of praise seem inadequate to my experience with Dr. Alvarez! I wish you the best in your quest. As self-pay, cost is a factor; but be cautious of placing pricing over health and safety.

Hi all. I am very pre-op, but I am planning to have hiatal hernia repair done at the same time as the bariatric surgery. It will be months before I have a chance to meet with a surgeon and I'm not finding great information beyond the surgery taking a little bit longer and potentially some additional discomfort post-op. Has anyone had this combo and how do you think recovery and post-op life differed compared to those who just had the weight loss surgery?

I spent the better part of my 40s as a self-hating shut-in who avoided going out, hated photos taken of me, and wanted to vanish when my skinny partner would introduce anyone to me. I missed out on a decade of life. Yeah, I would comfort eat, but that's the vicious cycle. Overeat - gain weight - feel miserable - eat more - gain weight. Food was never my friend pre-surgery, despite the fact that I ran to it for comfort. Now that I'm on the other side I am happy, I have my life back again, I love going out, will photo-bomb anyone anytime, and my partner has been teased more than once that he's "punching above his weight" when I'm introduced as his partner (they would not have said that a year and a half ago!). Food IS my friend now, because I've changed my relationship with it. I enjoy nourishing food, and will absolutely eat a couple of bites of something traditionally "naughty" as an occasional treat without guilt. A couple of bites is all I want now. It's been a lot of hard work, but absolutely worth it. Best distraction I found as the weight started coming off was moving. Started walking, then riding a bike. Even getting up and cleaning. And as others have suggested, if you have an emotional attachment to food, bariatric therapy is recommended.

He Hey guys !my insurance said they cover all the bariatic services my PA asked me to ask them. The requirements I believe they said there was no required supervised diet however I do have some history with phertamine. My bmi is right at 40.4. I’m gonna ass a screen shot of the blue home plan for bariatic ! I think it should be an easy process as far as what they’re asking for. I hope to have my surgery by June fingers crossed. Anyone have experience with novant ? In Nc Pasted what the picture has in case visibility is hard.  A thorough preoperative evaluation for bariatric surgery must include all of the following: 1. Evaluation of the patient's understanding of the procedure to be performed, including the procedure's risks and benefits, length of stay in the hospital, behavioral changes required prior to Page 8 of 21 An Independent Licensee of the Blue Cross and Blue Shield Association Bariatric Surgery and after the surgical procedure (including dietary and exercise requirements), follow up requirements with the performing surgeon, and anticipated psychological changes. 2. 3. Evaluation of the patient's family/caregivers support and understanding of the information in #1. Within 12 months prior to surgery, a thorough nutritional evaluation by a physician, registered dietician, or other licensed professional experienced in the issues of bariatric surgery, who has had a meaningful conversation with the individual regarding the dietary and lifestyle changes required to ensure a successful outcome over time. Nutritional assessment must follow American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines. Pre-operative assessment must document that the patient has a good understanding of the diet and nutritional changes that are associated with bariatric surgery and has the capacity to comply with these changes. Per the ASMBS guidelines, " *..it is essential to determine any preexisting nutritional deficiencies, develop appropriate dietary interventions for correction, and create a plan for postoperative dietary intake that will enhance the likelihood of success. Not only should the practitioner review the standard assessment components (i.e., medical co-morbidities, weight history, laboratory values, and nutritional intake), it is also important to evaluate other issues that could affect nutrient status, including readiness for change, realistic goal setting, general nutrition knowledge, as well as behavioral, cultural, psychosocial, and economic issues." 2019 guidelines for perioperative nutrition, metabolic and nonsurgical support are available at: 4. https://journals.aace.com/doi/pdf/10.4158/GL-2019-0406 Within 12 months prior to surgery, a formal psychosocial-behavioral evaluation performed by a qualified behavioral health professional (i.e., licensed in a recognized behavioral health discipline, such as psychology, social work, psychiatry, psychiatric nursing, etc., with specialized knowledge and training relevant to obesity, eating disorders, and/or bariatric procedures), which assesses environmental, familial, and behavioral factors, as well as risk for suicide. Any patient considered for a bariatric procedure with a known or suspected psychiatric illness, or substance abuse or dependence, should undergo a formal mental health evaluation before the procedure. 2019 guidelines for perioperative nutrition, metabolic and nonsurgical support are available at https://journals.aace.com/doi/pdf/10.4158/GL-2019-0406 5. Appropriate medical work up may include a chest x-ray, upper gastrointestinal series, endoscopy, appropriate pre-op labs and ECG. A complete physical examination by the attending surgeon and an assessment of thyroid levels is required. If the patient has comorbid conditions (e.g. diabetes or 6. cardiovascular disease) the patient must be capable of undergoing the procedure. Anesthesia clearance for surgery. The first five criteria must be met before seeking prior plan approval for adults and adolescents; the sixth must be met prior to surgery. Surgical procedures must be performed at a facility capable of providing gastrointestinal and biliary surgery (preferably JCAHO accredited), AND that has equipment and staff capable of managing a morbidly obese patient (appropriate instruments, beds, lifts, monitoring equipment) AND that can manage short and long term complications of bariatric surgery.

I know that with bariatric patients, abdominal pain shouldn't be ignored - no matter how far out we are. I'd really be inclined to ask about a scan, or ultrasound, or something.

If you're looking for a convenient and tasty way to supplement your protein intake, check out the wide selection of bariatric-friendly protein bars available at the BariatricPal Store. While some options are available in single servings, others are sold in bulk. This allows you to easily find the perfect protein bar without the risk of wasting money on a whole box of something you may not like. Here are some of the awesome protein bar brands they carry: - Atkins Nutritionals - BariatricPal - Bhu Foods - BSN - Buff Bake - Built Bar - CanDo - Convenient Nutrition - Dang - Detour - Eat Me Guilt Free - Epic - Evolved - Extend Nutrition - Genius Gourmet - Good To Go - HealthSmart Foods - IQBar - Keto Bars - Keto Wise - Kirkland - Love Good Fats - MET-Rx - Munk Pack - Muscle Foods - NuGo - One Brands - Optimum Nutrition - Organic Food Bar Company - Perfect Keto - Power Crunch - Promax - Proti Diet - Pure Protein - Quest Nutrition - Raw Revolution - Rawmantic Chocolate - Robert Irvine's Fit Crunch - SlimFast - Think! - Universal Nutrition - ZonePerfect

So what is a bariatric plan friendly way to drink decaff coffee? So before getting myself weaned off caffeine I enjoyed cold brew coffee with vanilla creamer. My surgeon does not allow caffeine after surgery (or at least for awhile). So I have already got myself drinking decaf cold brew with a splash of sugar free creamer. What does everyone drink in their coffee that is bariatric plan friendly? Also yes I know everyones plan is different but Id like to hear ideas.

I am self pay and hesitant about rny in Mexico. My insurance has a bariatric exclusion and won’t cover complications. In fact, I am pretty sure United Healthcare is so terrible that they would find a way to link any future issues to the surgery just to deny me. They stopped paying for a medication I was on for five years with other insurance. I am alone and have zero family and the sleeve seems like a simpler option. I know that I am not ready to consider rny at this time. I will wait until I can get more testing in the states. An endoscopy with my insurance is $1000. Eventually I will find the right answer. Many thanks.

Before moving forward with a bariatric procedure, you might want see a gastroenterologist to get to the root of the problem and see what treatments are available and which WLS would be best with your history and condition. Dr. Alvarez has done over 20K VSG surgeries and is a Master Surgeon of Metobolic & Bariatric Surgery but he focuses strictly on VSG, which may not be the best option for you. I can feel your frustration when reading your posts and my heart goes out to you. Please move cautiously and seek the proper specialists so that your GERD is not worsened. Once the cause is identified, a plan of action can be devised to address both the GERD and WLS. Best you you.

I just had my 1st tele-appointment with my surgeon and the dietician. I have been reading and talking to people the last few years about bariatric surgery. Friends with different surgeries, different goals and different outcomes. They have told me the good, bad and the real uglies too. They all seem to have had it slow movement the first couple months then within 10-12 months from surgery date they have lost right about 100 pounds. I know that there are recommendations for how much and of what needs to be consumed before and after…. It is very important to follow those as close as possible. Your body will not react how it should if you don’t nourish it enough . My Grandma always said your body is like a furnace; it has to have fuel or food to burn to work. So if you don’t put wood in your furnace then it won’t heat up to burn. (I think I may have not remembered it exactly right) but you can get the idea. Lol I am looking forward to the long term weight loss & will keep what you are going through in mind. Please do keep updating your status; I can’t wait to see how it goes once your body has healed and out of the “what the hell just happened” stage. That is all it is doing right now.

This is something you would need to talk to your HR dept about. My understanding (and I could be wrong) is that each company negotiates their rates with the insurance company, and there are things they can choose to not cover in order to keep the costs down for ALL employees. They can't just add it for one person. Bariatric surgery is getting more common, so maybe your employer might choose to add it durning the next open enrollment period, or, to cut rising costs, eliminate services. Unless you have a life event (like loosing your job, marriage, birth of a child etc) your husband can only add you to his plan during open enrollment. And your company's plan can't change until the next open enrollment. Most companies that wouldn't be effective until Jan 1 2024 (but not all, my company has open enrollment in the spring) Find out first if your husbands plan even covers it, and what the deductible/co-pay would be. You could start all the presurgery requirements now, as that usually takes about 6 months. Sounds like IF, everything works out, the soonest you could have the surgery under insurance (and a lot of things could go wrong to not align) would be Jan 2024. Or, do self pay and you could be recovering in a matter of weeks. There are low to 0 interest medical financing plans, and you can even pay those bills with an HSA or FSA card. It all depends on your financial situation and patience. I totally understand your disappointment, I felt the same way when I found out it wasn't covered under my insurance. I had determined the VSG was the right path for me and had my hopes up, and was crushed. I didn't want to wait any longer, and self pay was the best option.

My insurance didn't cover it either, as Catwoman mentioned, your employer needs to add it to their plan, and I was told no going around that. I ended up as self pay, and using my HSA savings. Because I have a high deductible plan, I figured even if I was able to go the insurance route, it would cost me 7K in my deductible, and I would lose months and months of time jumping through insurance hoops. There are clinics I'm sure all over the country that specialize in just bariatric surgery, I went through West Medical in LA and had a great experience, it was $10K and only took 3 weeks from 1st consult to surgery. Mexico clinics start around $5k, and while I know some have had great experiences that route, I just wasn't comfortable. It's very possible you have a local bariatric Dr. that takes self pay. There are also financing options with credit cards like Care Payment that offer no/low interest rates. Don't let money hold you back!

Is RNY not an option? If GERD is a concern but bariatric surgery is the goal, I would consider RNY and see if that fits your needs.

My primary insurance thru my employer (united healthcare) does not cover it. Im fortunate my husbands new insurance (Aetna) does have bariatric surgery coverage. But before he got this insurance I was seriously looking into going to Mexico for my surgery. There's some financing options available too.

Is self-pay an option? I found a great surgeon in Alabama because bariatric surgery was excluded from my insurance as well. I had very few pre-op requirements and the cost was $8995. You could always go to Mexico too which is the cheapest but I was too nervous to go that route.

most insurance companies will cover it, but it's usually not part of their "core" coverage. In order to offer it, employers need to buy a rider for it. So although her company uses Cigna, they probably decided not to have their policy include the optional bariatric surgery rider.

I got Cigna at the start of this year as my job switched insurance companies. My surgeons office was preparing me with steps toward surgery when I got a call today saying that bariactic surgery isn't covered under my plan. I feel so disappointed. Now what? How can I get coverage? Anyone experienced this? Sent from my SM-N970U1 using BariatricPal mobile app

The long term success of either surgery depends upon you. Many of the initial benefits of bariatric surgery fade over time. Your hunger comes back, your restriction can soften, it is possible to eat around your smaller tummy & your body’s new set point, etc. What the surgery does do is give you time. Time to make changes to your relationship with food: the why you eat, what you eat, when you eat, how you eat. Time to understand your cravings & develop strategies to better manage them. Time to establish new habits about eating & exercise. Time to work out how you want to eat in the future & what works for you & your body. Regain occurs for many reasons: psychological, physiological, behavioural. Bounce back regain (usually 20%+/- of the weight lost) around the third year is common. It can be because your body settles into the weight it is happiest at (your set point). Medication changes. The crap life can throw at you (employment, relationships, health, pandemics). Complacency. A too restrictive way of eating or too demanding exercise regime. Not dealing with your relationship with food. And for some it can be a deliberate choice as they themselves feel happier at a higher weight or they make adjustments to their food choices to better suit their life. Not failure of the surgery but the impact of outside factors. The average weight loss for both sleeve or bypass at the three year mark is about 65% of the weight to be lost. Of course as with all statistics there are some who lose more & some who lose less. If you are considering revision surgery of sleeve to bypass as a sign of the failure of the sleeve, remember many who have revision surgery do so because they developed GERD not necessarily weight gain. I have a sleeve & lost more than my goal and have pretty much maintained though at only almost 4 years post surgery I’m still somewhat of a bariatric baby. I settled at 49kg (48.5-49.5). I unexpectedly gained about 2kgs about 18months ago (50.5-51) but recently we discovered I wasn’t absorbing my HRT meds. Changed to a patch & my weight is slowly decreasing (49.2-50). Small numbers I know. Has it been difficult? No, not really. It was very obvious what I had been doing wasn’t working for me & I needed to make changes. I put myself & my health first. I changed my relationship with food. Made a decision to change what, when & how I ate. It became a new mindset. The changes have been sustainable & haven’t restricted my life. I still enjoy food & eating but my desire is for healthier, more nutritious foods. And no I’m not running marathons or spending hours in the gym just some at home stretching & resistance bands. Sorry long post.

I wanted to wait to respond until I could find the literature to back this. These procedures do not work solely through physical restriction/malabsorption of what you eat (that is part of it but a surface level reason), there are hormonal changes that occur. Not all of the ways that Bariatric surgery works is known but here’s what has been proven: Cellular changes to the gastrointestinal tract occur post surgically that are significantly different to a pre surgical obese people. One difference between your current GI tract and one of a post Bariatric person is the increased amount of active and local GLP-1 positive cells. Because of the (controlled) injury that happens during surgery, some of the cells are reprogrammed to permanently change the gastrointestinal track the lining into more Glucagon-Like Peptide-1 (GLP-1) positive cells. GLP-1 is responsible for many things but most notably here for regulating glucagon/insulin balance (glucose homeostasis) & delayed gastric emptying. GLP-1 is found in other places besides the the GI tract. It’s also found in the central nervous system where it help regulate the feeling of satiety. There are other hormonal changes (gherlin) however I focused on GLP-1 because new classes of diabetes/obesity medications called GLP-1 agonist have been very popular lately for their ability to mimic the hormonal effect of naturally occurring GLP-1. But once you stop taking those, the hormonal changes will likely revert. But the post surgical changes are permanent. No matter how much you diet, you will likely never be able to spontaneously create more GLP-1 positive cells that aid in glucose homeostasis. I hope that helps ❤️