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There are two schools of thought on bariatric surgery nutrition. The old school theory...is that you should take advantage of inflammation and nausea and severely restrict caloric intake in the early months after surgery. The newer research, however, is showing that starvation levels of calories are more associated with metabolic slow-down, more malnutrition, more hair loss, and rapid weight loss is tough on the skin. (there are limits to what skin can recover from...but slower weight loss has somewhat better results) The newer research supports that both groups lose approximately the SAME amount of weight over 18 months. The severely calorie restricted crowd loses more, earlier. People from groups like mine...where there is a focus on returning eating at normal levels earlier...will lose weight slower, but will lose just as much in 18 months. Also...the people fed higher calories earlier will maintain weight loss more successfully at 2 and 5 years. Some clinics are oldschool...and it pays to be oldschool...because all of your clients become drastically noticeable living advertisements for how fast and effective your surgery works. (even though the newer research is proving this is probably not the healthiest approach) But it's hard to tell a clinic...."you're doing it wrong" because bariatric nutrition and endocrinology is an emerging field. You pretty much have to work with the people you choose and their protocol. I'm very comfortable with my clinic...put some research into finding the best fit with my diet preferences, and generally prefer using research hospital based protocol over for-profit private clinic protocol.

My insurance, although really good, excludes bariatric surgery. I am looking at options in Mexico but because of many factors, I would like to get it done here if possible (US). I saw someone mention secondary insurance and am wondering what that is about? Can you get more insurance to cover something like this?

https://www.nationalbariatriclink.org/bariatric-blog/gastric-sleeve-surgery-whats-your-bougie-size/

Hi Chris..I'm 72 5ft8in 323lb down from a high of 355, BMI close to yours. Resident grandma of Bariatric Pal since I'm older than dirt. Should be having RnY...early-mid March unless a miracle happens this month. Mother to 3, 2 living, my son who I call Tomkitten on here and his older sister known as RD, short for Rotten Daughter. She lives 7/8 mile from me. After not speaking to me for 6 months her best friend died of a heart attack Christmas . She started calling and texting me, Will it last?Don't know, she should know I love her cause I've told her repeatedly over the years,,i just don't like some of her past actions. Hurts me she doesn't want to be closer. Sent from my VS880PP using BariatricPal mobile app

Hi Salazar. You clearly have made attempts at weight loss and aren't where you'd prefer to be. I can relate with you there. You may know that a nutritional plan is followed as part of the Bariatric (autocorrect keeps capitalizing) process. Many patients who could not lose weight with other attempts do lose on this plan. It's going to sound super-obvious...for me, the goal was to get 80-90 grams of protein, 64 oz. or more fluid, 1/2 c. whole grain, 1/2 c. veg/fruit (veg preferable to fruit), and no sugar. Even when I've followed high protein/low carb, my protein goals were not THAT high (and I didn't know that they "should" be). I did lose some weight - in 2 1/2 months I lost 16 pounds. Perhaps it's worth trying a Bariatric food plan? Like you, my husband is 6'1" but he weighs 256 lbs. He is currently trying to lose weight as well. His goal: 210 lbs. Everyone has different goals but his happens to be the lower end of your current weight. Doctors have said no to you for a reason. There's nothing you can do to "convince" most doctors to do surgery on you. You simply are not obese. I applaud your thought regarding not gaining so that a doctor may be compelled to perform your surgery. Many doctors, even most, are not likely to perform your surgery since you have no co-morbities and will still have a relatively low BMI. A few of the responses you rec'd gave suggestions of where to go to seek surgery. Wherever your next step leads, I wish you great success. [emoji458]

Hi Salazar. You clearly have made attempts at weight loss and aren't where you'd prefer to be. I can relate with you there. You may know that a nutritional plan is followed as part of the Bariatric (autocorrect keeps capitalizing) process. Many patients who could not lose weight with other attempts do lose on this plan. It's going to sound super-obvious...for me, the goal was to get 80-90 grams of protein, 64 oz. or more fluid, 1/2 c. whole grain, 1/2 c. veg/fruit (veg preferable to fruit), and no sugar. Even when I've followed high protein/low carb, my protein goals were not THAT high (and I didn't know that they "should" be). I did lose some weight - in 2 1/2 months I lost 16 pounds. Perhaps it's worth trying a Bariatric food plan? Like you, my husband is 6'1" but he weighs 256 lbs. He is currently trying to lose weight as well. His goal: 210 lbs. Everyone has different goals but his happens to be the lower end of your current weight. Doctors have said no to you for a reason. There's nothing you can do to "convince" most doctors to do surgery on you. You simply are not obese. I applaud your thought regarding not gaining so that a doctor may be compelled to perform your surgery. Many doctors, even most, are not likely to perform your surgery since you have no co-morbities and will still have a relatively low BMI. A few of the responses you rec'd gave suggestions of where to go to seek surgery. Wherever your next step leads, I wish you great success. [emoji458]

[emoji307] it and loved you for,doing it, I seldom feel valued out in the outside world. Love being on Bariatric Pal, people seem to accept me as I am and make me feel like I'm good enough. Yeah I've had a self-esteem problem probably why,i drowned myself in food. Sent from my VS880PP using BariatricPal mobile app

Certain triscuits have protein than others I only can eat maybe three or 4 with hummus or any bean dip and I'm 10 months out .Bread is still a no go for me and if I do eat a tiny piece of Naan bread it is like the size of a triscut so I stay away from bread all together.Veggies are a source to go with hummus Pinterest also has tons of ideas for bariatric patients.

Oh elforman I love it,i really do. I'm having one of those days myself, my surgery got postponed once again. Bariatric surgeon was supposed to fax local gastroenterologist so I could get upper GI with contrast done locally. Was supposed to occur yesterday, doctor#2 says doctor#1 hasn't faxed anything yet. Was gonna get it done today if the order was in, now I have to make another trip out on another day. Seems like I change my schedule for them but they are. inflexible. Far as I know that's the roadblock in my way, to anyone. else it would,be a mere speed bump. But it's my verdompt speed bump. Some days I think I want the operation more than they want to operate.Threatened that I'm going to invest in a bowie knife, some fishing line and a package of steri strips and,operate on myself . a little vodka or summthin similar and I might not feel any pain. Sent from my VS880PP using BariatricPal mobile app

I think you are correct with the correlation between tracking and the fastest weight loss. Tracking is a great tool to use if you are not losing or to find out the nutrition content of food. However, the idea is that, we of all people, have proved that dieting doesn’t work. So if you are treating your life right now as if you are on a diet, eventually you will tire of it, stop tracking, and start gaining. I would bet a very large percentage of people on these boards have been on a low carb diet before and yet here we all are having bariatric surgery. Hence, being on a diet, tracking and eating low carb is not the answer. I think we all need to take this year not only to lose as much weight as possible but to learn how to eat all kinds of food in balance and in the right portions. To get to a weight where we feel good working out and feel good enough about ourselves to eat food that is good and good for you. I tend to watch my skinny friends and family. They do not track everything they eat. They do not avoid carbs. They indulge once in a while. They work out and move a lot. They make good choices like “I had a big weekend so this week I am eating lighter”. That is the life I want. Not one tied to a tracker and having my brain dominated by thoughts of what I can and cannot eat.

Alex is the Big Kahuna of Bariatric Pal. He started it up himself. Sent from my VS880PP using BariatricPal mobile app

Ain't it the truth! I may wear beer level Goodwill clothes but I want champagne,level,bariatric surgery. Sent from my VS880PP using BariatricPal mobile app

I'm not a fan of small independent bariatric clinics. I would only use a major trauma center and center of excellence for major surgery. I also want my surgeon to be the person following up on my case permanently. But that's my personal preference....and I do understand why people sometimes make other choices. There are a lot of things I'll bargain hunt for. But medical care isn't one of them. In a better world, people wouldn't have to do this.

Right now? 30-50g a day because I'm on the liquid diet, lol. Post-surgery, long-term, I'll probably be at 65-70% of my diet as carbs because I'm a vegan. (Those carbs will be from fruit, veggies, beans, oatmeal, potatoes, bread, rice, and other whole grains, and very few if any from sweeteners or processed food.) That's way more than most post-WLS patients, who tend to severely restrict carbs, so this might not be the answer you're looking for. I recommend reading How Not to Die by Dr. Michael Greger or watching Forks Over Knives on Netflix for some info on how plant foods like I mentioned above help you maintain a healthy weight and protect you from disease. You can also check out Dr. Matthew Weiner on YouTube, who's a bariatric surgeon who promotes plant foods ahead of the standard protein diet. Just thought I'd share my opinion in addition to the many keto and low-carb comments you'll see on this thread. *makes angel face*

Thanks, you guys To make a long story not quite as long extremely long, sorry, once I got started I couldn't stop, I did this to myself by accident. In December I asked to get a sleep study done to see if maybe the reason I can't sleep on my back is due to breathing issues, and possibly get a CPAP machine to help me get through the post-surgical period where the incisions make sleeping difficult. I didn't realize this is a months-long process, which one of the nurses in the sleep lab has been graciously expediting for me by finding cancellations every chance she has. Unfortunately, I failed my in-home study because I could not use the machine properly - it would stop reading and flash a yellow light in my face every time I rolled on my side, and, again, I can't sleep on my back. They want me to repeat the test in the lab, which I'm fine with, but I said because my surgery date was already scheduled, I would need to do that after surgery. They said fine, we hung up, everything was okay. Except not. Because. Even though I passed all the apnea questionnaires, and no medical professional ever told me I have sleep apnea and need a sleep evaluation, because I took it upon myself to ask for the referral, almost as an experiment to test my hypothesis, now they have it in their system that I have a pending sleep study. So now they need the resolution of that before we can proceed with surgery. Because liability and legal issues. Which I was made aware of last week, when the coordinator told me she would be getting in touch with the sleep lab to sort it all out. Cool. Except when I called yesterday to find out the status, she told me I had been taken off the schedule because of this issue. Um, what???? Why wouldn't you tell me that upfront??????? So, yesterday in my no-carb liquid diet stupor I was frantically trying to be the go-between with these two offices, explaining that I need some kind of document or note faxed to the bariatric office saying that the sleep doctor is okay with me waiting until after surgery to repeat my test. For some reason I can never get in touch with the bariatric coordinator until the end of the day and the offices all close at 4:30. So the best the sleep lab could do was send a note to the sleep doctor's MA. She called this morning and said she spoke with the bariatric coordinator to clarify what was needed, but that the sleep doctor was not in the office. She said she'd talk to him tomorrow. So... I'm hoping that when I call tomorrow, they will have faxed over the necessary document and the coordinator will give me some good news about the date. We will lose our health insurance on 2/28 unless we can get my husband back to work, which is a jungle of red tape and hurry-up-and-wait situations. And we have no idea what's going to happen if he doesn't go back by 2/20 which is the end of his 2-year disability period. He doesn't have to work, he's on SSDI, except that I don't work because I'm in school full-time, so that's our only route to health insurance unless we want to derail our entire life plan and have me go back to work before I finish my degree. (And he wants to work, anyway.) So to have all of that happening at the same damn time is just... overwhelmingly overwhelming. The coordinator, who really is very nice and is trying her best, answered "I can't say that," when I asked if the 15th was completely off the table. So there is a chance that that slot was not filled and she can put me back in. I also said I could do it earlier. But the thing is I have to attend a class which is ONLY ON WEDNESDAYS FOR SOME REASON before I can have my surgery. So it's either tomorrow (today) which is obviously not happening, or next Wednesday as planned, or else the earliest my surgery could be is 2/22 if I can attend the class on 2/21. You can see why all of this mess causes intense full-body shutdown. I don't know what's happening and that's the worst part. I'm just desperately hoping that everything can go ahead on the 15th. We've planned everything out, my mom has taken time off, we're moving ourselves and our cats into her house this weekend (surgery is in a different city), I've notified all my professors and my family, etc. Since I've gone this far I'll confess I cheated my liquid diet last night out of stupidity and stress. I fasted for most of the day today not to punish myself but because I felt like crap physically. I ended up having 3 protein shakes over the last 6 hours or so, so I'm at 495 calories and 90g of protein. I'm a hot frickin mess, y'all.

What kind of surgery are you planning? On age alone I would guess sleeve but I have been wrong before. I live in Ohio, in a city 14 miles from Ohio's Geographic Center. I,will have my own surgery, a RnY at Mount Carmel in Columbus. I could be a surgery twin of yours. All my prerequirements are completed,, just waiting on a surgery date from my surgeon's office. Thought,it might be as soon as February 15th but found out today my surgeon Dr Miller asked that I have an upper GI done, the kind where you swallow something like Barium or another contrast medium. That's not always required so don't worry that you haven't had one. When I had,my EGD they found I have a small stomach,ulcer as well as gastritis. Dr Miller wants this test to pinpoint its exact,location in the stomach. I guess I got the ulcer from too many NSAIDS. Where in Kentucky are you located? We have Kentucky chicks having surgery in Ashland, Hopkinsville and Lexington , A little more about me. I have a son about your age , weight. and height. His real,name,is Bryan but on Bariatric Pal I call him my Tomkitten. He is main support person and the joy of my existence. I've been a widow,for 5 1/2 years, late hubby died on the 4th of July 2012. I'm 72, yeah old to be having this surgery, many of my prexisting conditions WLS will cure or lessen the impact on my body. I am 5ft8in, in my prime i was a shade under 6ft but we all settle down as we age. My current weight is 323 down from an all-time high of 355 last October. PCP gave me diet pills and my weight went up instead of down. I have had 2 knee replacements due to wear and tear and the fact of having arthritis since I was 25. I have 2 living children, Tomkitten and his older sister known as RD on here, she is 49, RD stands for Rotten Daughter. She lives 7/8th to a mile from me, largely estranged by her idea. I hadn't heard from her directly for maybe 6 months, her best friend died suddenly last. Christmas day of a heart attack. She started calling and texting me again. Will it last? God only ,knows. She knows I love her but I don't care for some of her past actions. Ah we all have some sorrows in our lives and I'm sure not immune. I hope you'll want to friends, you'll find I will always be here for you. I'm a pretty good source of information, both from living forever and a lot of studying. I should have been a doctor, if I had had my druthers I would have been an immunologist and worked for the CDC. Have a good evening and text,me back if you ever want to talk. Sent from my VS880PP using BariatricPal mobile app

Good Evening. I was looking at/working with Virginia Bariatric in Reston with a BMI of about 35. They were willing to do mine as I was "self pay". They hinted at appx $18,000. I opted out and am scheduled in March in Tijuana with Dr. Illan. Like you, I didn't want to gain weight just to be approved. There is a form on Bariatric Pal website you can fill out to see if you would be approved, if interested.

In some people that are very muscular BMI is not the best indicator of a healthy body weight. You may have to really shop around to look for a surgeon willing to operate because if something were to happen to you, would he or she perhaps be scrutinized as to why they were performing a bariatric procedure on a non bariatric patient? Is it ethically frowned upon by other surgeons to do this? I do not know the answer to this. I hope you find the solution you are looking for and let us know. We all know how frustrating it is to battle our weight.

Oh, it is my little pouch cramping up! It spasms and cramps. No specific trigger or reason, other than it is healing. My surgeon actually witnessed one of the attacks. My Oxycodone scrpt has been renewed for when it gets bad. Otherwise I take liquid acetaminophen daily. He wants to give me a muscle relaxer, but I don't want to be drugged up all day. Other than that, I am doing great. My food does not bother me. No nausea. No spitting up. Nothing. Water is going down easy. I figure the cramps will subside with time.

Looking at my claims at my insurance site (Blue Cross Blue Shield Michigan), have the actual bills in front of me. Billed cost for the hosptial, OR, surgical supplies, staff, recovery room, room and nursing care $47,290. My Surgeon $11,913 Anesthesiologist $2,560 Bunch of other stuff under $1000 each, pathology, etc. About $65,000 in total. My first quote was low. Was a center for excellence and a major trauma hospital affiliated with one of the best research hospitals in the nation. They perform over 300 bariatric procedures per year and have one of the lowest rates in the region for complications. They have a 24/7 hotline for bariatric patients 365 days a year. Bigger price tag, but I enjoyed the confidence of statistically better outcomes....and the knowledge that I had access to the best talent in the field in case anything went wrong. My insurance was excellent. Was out of pocket less than $2000.

Welcome Salazar. I flatter myself that I have all the answers since I'm probably the oldest chronologically on Bariatric Pal. I am actually 72, nearly old enough to date Methuselah. Now there has got to be someone in the whole Delmarva that would take your case. Let's take it out a little bit, i know you're in Northern Va, try maybe the Maryland suburbs. I know there's someone in Prince George county on here. If I remember her name I'll let you know. Golly,most,of us worry about insurance. comorbities, here you are money in hand and still having trouble., it does boggle the mind.Hey I noticed on my tablet one of the highlighted surgeons today was Dr Masoud Resvani in W oodbridge Va. Did you try him? Just wondering. I will be having a RnY in early-mid March , date is still labile at this time. All my prerequirements are done just waiting for a date from my surgeon. I will,have,my surgery at Mount Carmel in Columbus Ohio. I'm so grateful,they don't think I'm too old, many programs won't touch anyone over 60. I have low bp, no diabetes,,no cholesterol and a proper motivation. I am in it to win it just like all the younger people. . Sent from my VS880PP using BariatricPal mobile app

From now until February 14th at midnight the WLSFA is offering a 10% discount and 14 raffle tickets if you register for the Making a Difference patient conference Who should be registering? pre and post ops WLS patients support people of WLS patients (there will be a special session for them) medical professionals who work with bariatric patients WLSFA patient conferences are more than a meeting with great sessions, they include meet & greet opportunities, an expo where samples and services are shared, and lots of fun. Your attendance at our event helps save a life and give hope to someone who is in desperate need of a surgery grant. The 23 grants that have been awarded over the past 7 years are a result of hundreds of WLS patients and businesses that have had the vision to save a life ... one grant at a time. Won't you join us in our 8th year and help make a difference in the life in at least one more person who is in need? Find out more information or register here: http://www.wlsfa.org/2018-2/

Thanks! They should look into a section for Bariatric people.

Hi Folks, I am new to the forum, but have gotten a lot of good information over the years from you folks, so thank you! A bit about me, I am a corporate attorney in the D.C. market (I live in northern VA), an author, an avid outdoorsman, a husband in about as perfect a marriage as I could dream existed (I got together with my wife when we were teenagers), and the dad of an adorable toddler. I have finally settled on a gastric sleeve as the right surgery for me, but I have been quite disappointed to learn that insurance will not likely pay for the procedure, and at least at the first level of contact at different institutions that perform such surgeries tell me that they will not likely even consider me, even if I pay out of pocket, which I am quite prepared to do. My BMI is right now at 30, and although I know this is not as high as is generally the case for bariatric surgery, I have made Herculean efforts to lose and maintain a good weight for the past 14 years (since I was 16), and no matter how hard I tried, nothing worked. I was a high school athlete (football, lacrosse, daily weightlifting), and am used to pursuing physical goals in a very disciplined way. Some examples of ways I have tried to lose weight have been running 28 miles per week, extreme dieting, even bulimia, and basically my body just seems to want to be between 210 and 230lbs, regardless of what I do. I still lift freeweights every day, hike, fish, and do lots of physical activities. My mind boggles that I have such high physical endurance and strength - I am, if anything, more athletically able now than I was as a high school tight end/linebacker - and still cannot get down to what is considered a health weight. I know that my BMI is partly artificially elevated by the fact that I have been lifting weights since I was 12 and have a very large amount of muscle mass, but I still have a noticeable gut and I know that I will have a healthier future if I can drop about 70lbs. My goal for weight loss is not to look great like I did at 15 again - my awesome wife is very supportive of me and met and fell in love with me when I was 19, so she has never seen me at my trim, 6'1 165 figure from high school football - but to decrease my risk of obesity-related illnesses. For that reason, I want to get moving on this as quickly as possible. I have researched and tried weight loss procedures, including reading all the scholarly articles I could find on bariatric surgery since I was 24, and I think that now, while my blood pressure, cholesterol, and heart rate are all excellent, is the best time to slim down, as it is harder to correct these health problems once they start than it is to head them off. I am particularly hoping to hear from folks on where they went and how they went about getting a gastric sleeve done when they were below the 35-required BMI. I do have sleep apnea (I've had it since I had a BMI of 22, so it is not obesity-related), so I would be able to get insurance coverage if I got to 35, but I do not feel like gaining 40 pounds in order to qualify for a surgery I can easily afford out of pocket. I know that Mexico and Brazil are options a lot of people use due to their low cost, but my wife really wants me to spend the extra money and get it done in-country. For those of you that have gone the foreign route, what were your experiences with it, and is there anyone in particular you would recommend? For those who have had it done in this country, are their doctors or clinics around that are willing to hear you out and accept that you have made the decision that you need it? I understand that doctors have to be gatekeepers for people who want this kind of thing for a vanity goal on a whim, but I have been dieting, exercising, meeting doctors and nutritionists, and researching all possible weight loss methods for 14 years, and now that I have decided on a gastric sleeve, I do not want someone to patronize me or condescend to me. I hope to find a doctor who will listen to me, then take my money, and cut off part of my stomach! Thanks again, and I look forward to hearing your thoughts.

You're welcome. Sainthood - you're too kind. You've written poems for other members. Here's one for you: Bari-sisters on the scene Have you met Little Green? She's cool, She's alright, But mess with kakatlady, She'll call you really shady Creekimp has your back When under attack From f'ed up professional error Or Bariatric member terror Then there's FluffyChix Let's get her in the mix She gives a humor fix Along with gentle (hugs) But she can be your thug KatFight has been there too When doctors' associates have no clue So, yes, puddycat do what you gotta do Even if you leave some kitty poo In the end (hee hee) you'll be great And eat from a little plate You'll be really lean Bari-sisters on the scene