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I was in the same situation and i'm finally getting revised to RNY on 1/30. I had to jump through all the hoops again. Had my Sleeve done in Delaware and when i moved to Washington State my new Bariatric Dr said i should never had the sleeve in the first place on account of my Diabetes. I also had no restriction and gained all of my weight back. I had a few tests done and it showed that my pouch was also made too large. Not that i stretched it but just cut wrong it was essentially the same size as most normal stomachs so either i had a huge stomach before or it was not cut right. I didn't have a choice on wether to resleeve or do RNY i had to go to RNY. My Sleeve also gave me a bad case of GERD and Bypass is supposed to help with it. I'm sorry i don't have any stats to provide you but i wanted to let you know that you are not alone

I know..each surgeons instructions are different. I'm wondering why some surgeons have a list of bariatric vitamins that are specific. I was told no centrum one a day or flinstones. their lists included swallow type vitamins

Optisource bariatric chewable vitamin $29.99 at walgreens

I'm currently researching the Bariatric Choice all in one vitamin. My Dr mentioned that brand at my last appointment. You would still need to take B1 and B12, but it is only $21.95 for a month's supply.

Things look different as time passes. No way you can eat like a bariatric patient if you are have an above normal fitness level.

Statics are interesting. My surgeons office follows patients for five years. Many patients stop coming to follow up appointments at two years out. They admit, Statistics are not accurate. I agree with @blizair09 What I have noticed...is if you don't change behaviors you will gain. Is that the same for all bariatric surgery types? I knew early on I didn't want to be a statistic. Lost 120 pounds in six months and maintaining three years seven months out. Hope for the best in the years to come. I want this long term.

I’m willing to bet it’s poor wording. I can’t imagine an insurance company willing to pay for bypass but not the sleeve. It’s probably because bypass is the more known procedure and people not familiar with bariatric surgery don’t know about or think about the sleeve.

I have been enjoying Bariatric Pal, reading others submissions and giving my viewpoint where I thought I could help. I just lost my participation heading, still getting notifications, Alex and company-what gives? Sent from my VS880PP using BariatricPal mobile app

Many times people question which type of weight loss surgery should they choose. The following article discusses the results from the latest studies. Bariatric surgery can successfully deal with the excess weight, and both prevent the occurrence of diabetes and, in some cases, cause its remission. However, there are several procedures that can be used: Roux-en-Y gastric bypass; sleeve gastrectomy; adjustable gastric banding. How to choose among them can be gleaned from a group of articles in the Journal of the American Medical Association (JAMA). Two of these involved trials in which participants were randomly assigned to various treatments (e.g., types of surgery), and compared the outcomes with respect to various parameters. In the third, surgery was compared to medical management. Weight Loss Salminen et al. (1) compared the amount of excess weight loss five years post-surgery in 240 severely obese patients (average BMI = 46) who were randomly assigned to receive either Roux-en-Y or sleeve gastrectomy surgery. All surgeries were performed via laparoscopy. Most of the patients had some co-morbidity — diabetes, dyslipidemia, and hypertension. Those who underwent the sleeve gastrectomy had lost 49 percent of their excess weight by five years, while those in the gastric bypass group lost 57 percent. This difference was not statistically significant. The comorbidities were ameliorated in both groups — 37 percent of those in the gastrectomy group had partial or complete remission of their diabetes, compared to 45 percent of those in the bypass group. The dyslipidemia was similarly impacted: medication was discontinued in both groups —for 47 percent of those with gastrectomy and 60 percent of those with gastric bypass. Discontinuation of hypertension medications occurred for 29 and 51 percent of those in the gastrectomy and bypass groups respectively. Similarly, Peterli et al. also compared the 5-year effects of gastric bypass and sleeve gastrectomy on weight loss in severely obese people. In this study, 107 participants underwent sleeve gastrectomy, and 100 had gastric bypass surgery. They were randomly assigned to each treatment. In this study, the average BMI was 44. Five years post-surgery, those undergoing sleeve gastrectomy lost 61 percent of their excess BMI, while the gastric bypass surgery resulted in a 68 percent loss of excess BMI. These differences were not statistically significant. However, 32 percent of patients undergoing sleeve gastrectomy experienced a worsening of gastroesophageal reflux (GERD) symptoms, compared to only 6 percent of the bypass group. By five years post-surgery, 19 percent of the gastrectomy group had had to have re-operations or other interventions, versus 22 percent of those with the gastric bypass surgery. Surgery vs. Medical Management (diet and exercise) In a third random controlled trial, Ikramuddin et al. examined the impact of either Roux-en-Y bypass surgery or medical management on indicators of diabetes control (hemoglobin A1c or HbA1c[4]), heart risk (LDL cholesterol: goal <100 mg/dl), and systolic blood pressure (<130 mm Hg) 5 years post-intervention. The study included 120 individuals whose initial BMI ranged from 30 to 39.9; their HbA1c levels were 9.6 percent. After five years, 23 percent of patients in the surgery group vs. only 4 percent of those in the medical management group had achieved the goal levels for the three indicators, although further observation suggested that the differences between the groups tended to wane over time. Also, 16 of the surgery patients achieved partial or full remission of their diabetes, compared to 5 of those in the non-surgical group. As expected, those in the surgery group lost more weight as a percent of initial body weight — 22 percent vs. 10 percent of those receiving only medical management. Thus the results of these randomized trials support the efficacy of both Roux-en-Y gastric bypass surgery and the gastric sleeve surgery when it comes to weight loss, and gastric bypass was also superior to medical management. However, anyone considering such surgeries must also consider adverse events — for example, the sleeve gastrectomy exacerbates pre-existing GERD, and thus wouldn't be recommended for such patients. Both of the surgeries involve some modification of the GI tract — most extensively with the bypass type. And thus the bypass is more likely to result in nutritional deficiencies than the gastric sleeve operation. A positive aspect of these studies is that the benefits of the surgeries were durable — an important issue for anyone considering undergoing them. https://www.acsh.org/news/2018/01/22/which-bariatric-surgery-procedure-best-it-depends-12442

You are not alone!!!! There's a few of us who are doing a mostly plant-based bariatric adventure. I plan to supplement protein via shakes/bars for the first few months since as @Creekimp13 pointed out we do need more to get by as we heal and lose significant amounts of weight. But I definitely plan to eat as nutrient-dense as possible - focusing on all areas, not just protein alone. I'm still planning out what I want to try - and I know it will be trial and error with my new stomach anyway - but some of the things I'm thinking about are mashed bananas/banana ice cream, veggie juices/smoothies, blended oatmeal with bananas, flaxseed, and protein powder, blended veggie soups, and whole fruit sorbets as ways to get nutrients and fiber (and FLAVOR) in during the soft food phases. It doesn't all have to be ricotta bake and yogurt! I LOVE Dr. Weiner's videos. He is the first person who made me believe I could be successful at permanently changing my diet. All of the low-carb, high protein, "fruit is so unhealthy, too much sugar!" stuff that is often preached in bariatric circles was so depressing to me. Really, beans and fruit are unhealthy? Eat a chicken breast and then if you have space, a bite or two of broccoli? I just didn't think I could live that way and that was all I saw when I read about post-op diets. Now I know, thanks to Dr. Weiner as well as Dr. Garth Davis, that bariatric patients can thrive eating veggies and fruits and legumes. I also firmly believe that just because a diet helps you lose weight doesn't mean it's nutritionally adequate or protects you from disease. Fruit intake (2+ servings a day) is strongly associated with reduced risk of cancer so it bums me out reading posts from people who say they just don't bother with fruit because of carbs. Hope this post is not too inflammatory! Don't hate me, y'all! I just got excited for you, OP, cause I love where your mind is!!! I totally agree with you and hope you can find a happy place where you and your surgeon will both be happy with your choices! Good luck

If I knew then, what I know now, I wonder if I still would have made the same choice to have weight loss surgery. I can wholeheartedly say, “Yes.” But, I would have invested more time and made the commitment to be better prepared for what my life as a bariatric patient would require. It has been quite a journey these 20+ years and I am pleased to share with you what I have found to be "3 essential things that you need to know and do BEFORE you have weight loss surgery." If I knew then, what I know now, I wonder if I still would have made the same choice to have weight loss surgery. I can wholeheartedly say, “Yes.” But, I would have invested more time and made the commitment to be better prepared for what my life as a bariatric patient would require. It has been quite a journey these 20+ years and I am pleased to share with you what I have found to be 3 essential things that you need to know and do before you have weight loss surgery. This article is not about choosing a surgeon, a bariatric program or a particular procedure. It is about you! About your knowledge, motives, and mindset as you embark on this journey of a lifetime. I had weight loss surgery in 1995 and it has been my privilege to work with thousands of weight loss surgery patients all over the world. I am excited to share with you what I have learned about the importance of these 3 things for your long term success. If you are just beginning to consider weight loss surgery or, if you are in the midst of what can be a very challenging pre-op process, please answer a few quick questions and get the instant download of this article. Looking forward to sharing survey insights and more helpful articles. Take the 1 minute Survey - Get the Full Article

I see this is your first post. Welcome to BariatricPal! There are over 4,000 topics in just this specific Mexico forum. The majority of these topics aren't about surgeons that are affiliated with BariatricPal or the newly launched BariatricPal Hospital in MX. We make no secret of the fact that we own and operate BariatricPal Hospital MX. I'm actually quite proud of this undertaking. Unlike other WLS patient support sites (OH), we do not take any money from Bariatric surgeons, in the US or Mexico that are listed in our surgeon directory. We never have and never plan on it. It's not publicized info but BariatricPal has done away with any and all Bariatric surgeon marketing and promotion for quite some time now. WIthin the US and elsewhere. I've been involved in the medical tourism industry for well over a decade now. There are some extremely talented and skilled surgeons in Mexico. There are also a few surgeons that have SERIOUSLY made a HUGE dent in Mexico's medical tourism reputation. Yes, I'm specifically referring to Dr. Carlos Altamirano, Dr. Mario Almanza, and Dr. Ramos Kelly just to name a few. I'm not sure what relevance the store pop-ups have to do with the topic you posted in? We sell over 1500 Bariatric products to Bariatric patients. We don't take money from Bariatric surgeons or the Bariatric Pharma companies. I personally funded this community as a hobby for many many years. I decided a few years ago to stop and actually make the site self-sufficient. Customers have the ability to post negative and positive product reviews. We post ALL product reviews, no matter if they're good or bad. Search and read some more. You'll surely find the info you're looking for.

I agree with you, Sparkle. I'm 210ish right now and I need to get to 170. I've got 16 months left to lose 40 pounds. I could lose 3 pounds a month and be completely on target and happy. I'm in no hurry. My bigger priority is finding a Lifelong Diet I can live with, with healthy foods I really enjoy eating.... and lose the rest slow so my skin has the best chance of catching up as I go. (I'm not delusional about this...just want the best chance) I'm also interested in finding exercise that I genuinely enjoy so I can develop lifelong habits that enhance my life. My focus is health and longterm success...forever changes.....not being a walking advertisement for how fast a clinic can reduce me so other people want to go there. I also refuse to eat an animal protein centric diet for an extended period of time because they're linked to higher cancer rates. My preferred diet is Mediterranian or Mayo Clinic Diet...both are balance with healthy carbs, fruits, veggies, legumes and nuts...and have far less meat than American diets. Right now I'm hitting my protein goals by balancing healthy low glycemic carbs, animal and plant protein...and I love my diet:) Losing slow and steady and i'm content. Not saying that reaching your goals isn't important, and you should definitely work with your nutritionist.....but keep in mind that there are different schools of thought about how to best approach bariatric outcomes. You should work with people who are on the same page you are. People you are comfortable with who have advice that makes sense to you. There are a LOT of ways up this mountain. Choose the path that's best for you, and the professionals who share your vision. Best wishes:)

Hey has anyone heard from Jason in Florida- his Bariatric name is @offonthe go.He should have surgery last Wednesday. Just wondering how he's doing. Sent from my VS880PP using BariatricPal mobile app

I really liked Dr. Krook and the rest of the bariatric staff are wonderful too. I first started my WLS journey at Park Nicollet several years ago and it never worked out because I was never ready, and I was hesitant about going to HCMC too, but I was very pleasantly surprised by the whole staff. The main reason I went to HCMC instead of going back to Park Nicollet though was because I work for the county and the surgery was 100% paid for by my insurance.

I felt the same way as you do. But I have no choice but to have my band out because it is causing an issue which could cause me to develop a severe gastric bleed (I've already had one, lost half my blood and was in the hospital for a week). After a year of diagnostic tests, we discovered it was an issue with band slippage (due to dilation of upper pouch, which I must take responsibility for, too) creating blood vessels inside my stomach around the lower side of band. Anyway, since it must come out - I was left with: do I revise to sleeve or just have the band out. My gastroenterologist doctor is fully supportive of the revision. Part of me is worried that I'll just stretch again and cause more problems. Part of me is worried that with no restriction I will gain even more weight. In the end, I decided to do the revision. My insurance does not cover bariatric at all, so I am off to Mexico in 2 weeks. By the way, my best friend just had his out a few months ago (no revision) and is struggling with the new found freedom of once again being able to eat anything he wants. But his doctor and my doctors all agree - everyone who has a band will likely have to have it out at some point due to a complication.

I am 7 1/2 years into my band and it is being removed and revised to the sleeve in about 2 weeks. It was great the first 2 years. I lost 90 pounds of the 110 I wanted to lose. Then came the GERD and vomiting, then issues with dilation of the upper pouch (which I of course am likely responsible for, too), which causes food waste to be trapped in the upper pouch, and then recently a gastric bleed from the band slipping down and causing a blood vessel inside the stomach to pop (likely from a violent vomit from food stuck), which caused me to lose half my blood and spend a week in the hospital. I got so paranoid about vomiting after the blood loss incident, that I was just eating mushy food that was high calorie and most of the weight is back. After 2 endoscopies, CT Scans with contrast and Pillcam video of my entire upper bowel, my gastroenterologist said he wanted it out of me asap due to the risk of another bleeding episode. I have been advised by doctors involved that it just seems like everyone who has the band will need to have it out at some point. My gastro doctor is a very respected guy in his field and sees no issues in a revision in same surgery since there's no evidence of erosion. But of course, every one is different. My insurance will not cover bariatric so I am off to Mexico.

I am 7 1/2 years into my band and it is being removed and revised to the sleeve in about 2 weeks. It was great the first 2 years, then GERD and vomiting, then issues with dilation of the upper pouch (which I of course am likely responsible for, too), which causes food waste to be trapped in the upper pouch, and then recently a gastric bleed from the band slipping down and causing a blood vessel to pop, which caused me to lose half my blood and spend a week in the hospital. My gastroenterologist said he wanted it out of me asap due to the risk of another bleeding episode. I have been advised by doctors involved that it just seems like everyone who has the band will need to have it out at some point. My insurance will not cover bariatric so I am off to Mexico. $18,000 here to remove band. $4500 in Mexico to remove and revise to sleeve.

If I knew then, what I know now, I wonder if I still would have made the same choice to have weight loss surgery. I can wholeheartedly say, “Yes.” But, I would have invested more time and made the commitment to be better prepared for what my life as a bariatric patient would require. It has been quite a journey these 20+ years and I am pleased to share with you what I have found to be "3 essential things that you need to know and do BEFORE you have weight loss surgery." If I knew then, what I know now, I wonder if I still would have made the same choice to have weight loss surgery. I can wholeheartedly say, “Yes.” But, I would have invested more time and made the commitment to be better prepared for what my life as a bariatric patient would require. It has been quite a journey these 20+ years and I am pleased to share with you what I have found to be 3 essential things that you need to know and do before you have weight loss surgery. This article is not about choosing a surgeon, a bariatric program or a particular procedure. It is about you! About your knowledge, motives, and mindset as you embark on this journey of a lifetime. I had weight loss surgery in 1995 and it has been my privilege to work with thousands of weight loss surgery patients all over the world. I am excited to share with you what I have learned about the importance of these 3 things for your long term success. If you are just beginning to consider weight loss surgery or, if you are in the midst of what can be a very challenging pre-op process, please answer a few quick questions and get the instant download of this article. Looking forward to sharing survey insights and more helpful articles. Take the 1 minute Survey - Get the Full Article

NuHi there sorry I haven't posted in a while. I've been busy with work and playing catch up. So my status report is that I have been losing about 1lb to a 1lb and a half a week give or take. Protein shakes still are a No Bueno! I ordered the Fruit ones from the Bariatric Pal store. (They gave it to me in the Hospital) I could stomach it pretty well. I have been walking quite a bit which was directed by the surgeon. He says I can get a bit more into working out 2nd or 3rd week of Feb. As for food I've had 3 bouts of the food revisiting me this is after using my saucer as my serving plate. I have been eating baked chicken 1 wing with bones but super soft. I have had it with Roasted beets. Super soft. Or 2 tbsp of mashed potatoes made with broth. I think I ate it too fast. Breakfast was 1 egg scrambled soft with cheese that was ok just ate half. I am drinking plenty of water and vitamins make me sick. I'm taking all the recommended list items but just ordered the patches. I am hoping this helps. We are doing good and I'm so proud of us. Thanks for the updates it helps!

Even at 22 years post op, I still clearly remember that fateful day when I reached the "End of Invincible" That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. Even at 22 years post op, I still clearly remember that fateful day when I reached the "End of Invincible" That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. # 1 YOU START 'FREEWHEELING We are so careful early on. We are committed and sure we will become the most compliant patient ever! We measure our food and water, use a shopping list at the store, prepare meals in advance and eat what we plan, exercise, weigh weekly and take our vitamins. Then, one day it seems that we can forego one or more of these good habits and still loose weight. "Hmm, this is awesome! This surgical tool is my answer, hooray!" If you find yourself boasting about how you ate... or how you don't exercise... or how get away with things you were warned not to do. BEWARE! I promise it will catch up to you. Our Success Habits Research clearly shows exactly what successful long term patients do to reach and maintain their weight. Learn what they know and do what they did. It is important to realize that you will not be the exception to the rule and while you may feel invincible now - know that it is easy to be lulled into a false sense of security. There is a reason it is called the 'honeymoon phase.' When it ends, if you have not used the time to commit to, implement and own your Success Habits you will be in find yourself struggling to learn how to maintain your weight. Commit once to a specific set of daily habits and stick with them. All of them! #2 PEOPLE STOP RAVING ABOUT HOW YOU LOOK Boy, do I remember this. Of course I would, it was all about me! Like many of you I enjoyed months and months of friends, family neighbors, work associates and even strangers, raving about how great I looked. One of my favorite comments was “Look at you, you are going to blow away!” Loved it! I think I even walked at little taller, and had a new strut and swagger as I showcased my success. When I knew would be seen by someone who didn’t know about the new me, I was ecstatic! Then over time, people started to get used to my new size. I slowly began to fade into normal, the newness wore off and all of the attention nearly stopped. I missed the rave reviews, I kept wondering to myself, “Do I look fat?” Am I gaining weight?” “Why doesn’t someone say something!” Messed with my mind to be sure. If that has not happened to you yet, trust me, it will. And it is important to be prepared for the emotional and mental grief it may cause. When it does, it will be a good time to do a little evaluating of your true motives for choosing weight loss surgery. Ask yourself why you made this decision in the first place. Did you do this for someone else? To look feel better for yourself? For revenge? To improve your health? This is a time to reconnect to your personal why. Remind yourself of what motivated you in the first place. Pat yourself on the back and learn to improve your ‘self-talk.’ Then, move on. Rather than having it be all about you, now is a great time to turn and support those coming along behind you. Opportunities abound for successful patients who want to give back by paying it forward. Motivate, encourage and support new and prospective WLS patients. Help with an event or patient celebration, work as a hospital volunteer, share your story or become a Support Group Leader. Share your successes online and participate in one or more of the many Facebook Group discussions. You look great – now be great by helping others. #3 THE SCALE STARTS TO GO IN THE WRONG DIRECTION Perhaps like me, you spent many years not knowing what you weighed. I hated the scale and would avoid it at all costs. But, I loved nothing more than weighing myself during the first year after my surgery. It seemed as though I could weigh in the morning and lose even more weight by the time I returned home in the evening! Talk about motivating. For the first time in almost forever, the scales were tipping in my favor and it was exciting! As many do, I reached a plateau a time or two on my way down to my goal. So, perhaps you too have plateaued along the way, but this time, you sense it is different. You have reached your goal, stayed there and celebrated your success, but then, your weight starts to climb back up. Panic sets in and you know that glory days are over. Thoughts like, “I was afraid this was too good to be true.” or “I knew this couldn’t last.” keep surfacing. Self- doubt sets in and you worry that like so many times in your life, you lose, then gain. (And often with a bonus). You hoped it would be different with a surgical intervention, you hoped it would be easy. And in some respects, it has been but now reality hits and you know it’s time to pay attention. At this critical juncture. it is time to ensure that you have put into place the Success Habits you must rely upon every day for the rest of your life in order to maintain your weight. We all know how to lose weight, we have spent so many years on diets, off diets, thinking about a diet, researching a new diet, cursing diets, getting on and falling off diets. But learning how to maintain weight is a completely different mindset. Take this time as you transition from losing to maintaining to remind yourself that obesity is a disease. And one that you will struggle with for your entire life; surgery or not. You have a remarkable surgical tool to help you manage it as long as you learn to use it properly. Commit the time and effort to learn about your own personal metabolism, your triggers, and your relationship with food. It is up to you to evaluate your behaviors, stop doing what you might have gotten away with during the rapid weight loss phase and focus on everything you have learned. Memorize and internalize Success Habits of Weight Loss Surgery Patients. #4 YOU REALIZE YOU SHOULD HAVE PAID MORE ATTENTION TO YOUR BARIATRIC TEAM It seems that through the years the bariatric medical community has made great progress in ensuring that prospective patients are better educated and more prepared for surgery. As many of you know, there is a long checklist of todo’s prior to surgery. Consultations, evaluations, exams, tests, support groups and the list goes on and on. An interesting thing happens though. When surgery is imminent, our focus is primarily on the details surrounding the actual procedure, hospital stay, pain management, how it will feel, etc. The classes and information are helpful, but unfortunately, we are not really listening. We are trying; we nod our heads at what our dieticians, nurses, mental health and exercise professionals are telling us. We commit to being compliant, eat right, exercise, take our vitamins and attend our follow up visits. But are we really listening? Are we learning? Perhaps not. Following surgery, it’s “Whew, I am alive!” And once we are released from the hospital we begin our journey, sticking closely to what we have been advised. We start to really pay attention. Then, something magical happens. Our surgical tool starts to work, just like we had hoped. The weight starts to fall off! But, then we learn that no matter what we do, whether we follow the rules or not, the weight still continues to fall off. A dangerous realization. You see, once we think of ourselves as invincible – we stop listening. Sadly, we see that it is only when people reach a plateau or heaven forbid, begin to gain weight that they are really ready to listen and learn. We are told so often, surgery is a tool, it’s a tool, it’s a tool. Again, we nod our heads. Now that our honeymoon is over we must be ready to learn. I mean really ready to learn. We have “graduated” or are have been “released” from our bariatric clinic and may wonder if we missed our shot to learn. Surgery was a success; we have lost weight and now we need to learn how to maintain. Wishing we would have paid more attention earlier on, we might wonder where can turn. For me, I turned to all of the successful patients I could find, to learn what they knew and do what they did. As I expected, there are very particular habits that those most successful have made part of their lives. In fact, I have spent the last 22 years seeking out the most successful wls patients, identifying their habits, learning from these long term losers and sharing my research all over the globe. So often, we hear struggling patients comment that they did not learn these important principles during their initial weight loss. If that is the case with you, it is not too late. Read the book, take a class, participate online. Remember your surgical tool will serve you well for a lifetime as long as you learn to use it properly. Learn what you might have missed, learn what successful patient have to teach you, learn all you need to know about your own body, metabolism and food addictions. It’s never too late. Learn more about Success Habits Resources Then, move on. Rather than having it be all about you, now is a great time to turn and support those coming along behind you. Opportunities abound for successful patients who want to give back by paying it forward. Motivate, encourage and support new and prospective WLS patients. Help with an event or patient celebration, work as a hospital volunteer, become a Support Group Leader. Share your successes online and participate in one or more of the many Facebook Group discussions. You look great – now be great by helping others. #5 YOU STOP ATTENDING SUPPORT GROUPS THINKING THEY ARE FOR NEWBIES We always suspected that those who regularly attend support groups after weight loss surgery are more successful than those who don’t. Thanks to our collaboration with Stanford University Medical Center, we now have the hard data to prove it. Put simply, “Successful WLS patients are 3 times more likely to participate in support groups than their less successful counterparts.” Unfortunately, sometimes we find that support groups focus on and cater to the newbies, leaving the veteran patients bored, un-motivated and less likely come back. If the topics in support group are not of interest to you, suggest some that would be. Work to be part of the solution. Perhaps offer to do some research, share your experiences or even prepare and teach a lesson. If you have found that you have lost interest in your support group, please consider that if you don’t need the support group, perhaps the support group needs you. I, for one am so very grateful to the two WLS patients who at 10 years post op volunteered month after month to share their story, coach, encourage and teach those of us coming along behind them. Perhaps it’s time to give a little back by paying if forward. Consider becoming a BSCI Certified Support Group Leader. There is nothing more motivating than having people look up to you, learn from you and help keep you on track as a good example. For many, support groups go way beyond, “What is the topic?” People view support group attendance as a commitment to themselves to stay connected and accountable. Support groups offer opportunities to connect a network of like-minded people who understand your journey as many do not. So many life-long friendships are established at support groups. Make support group attendance a must do on your calendar to help you stay on track and accountable. If you are unable to attend a live group, web-based forums, Facebook groups and telephonic groups are easily found. BSCI’s DreamTeam of educators host free telephonic support groups every week. Fun, easy and a great way to stay connected. Telephonic Support Group Schedule

Even at 22 years post op, I still clearly remember that fateful day when I reached the "End of Invincible" That fateful moment when the honeymoon phase ended and the real work began. I am anxious to share with you what I have learned about the top 5 ways to recognize that your personal WLS honeymoon is over and what to do about it. # 1 YOU START 'FREEWHEELING We are so careful early on. We are committed and sure we will become the most compliant patient ever! We measure our food and water, use a shopping list at the store, prepare meals in advance and eat what we plan, exercise, weigh weekly and take our vitamins. Then, one day it seems that we can forego one or more of these good habits and still loose weight. "Hmm, this is awesome! This surgical tool is my answer, hooray!" If you find yourself boasting about how you ate... or how you don't exercise... or how get away with things you were warned not to do. BEWARE! I promise it will catch up to you. Our Success Habits Research clearly shows exactly what successful long term patients do to reach and maintain their weight. Learn what they know and do what they did. It is important to realize that you will not be the exception to the rule and while you may feel invincible now - know that it is easy to be lulled into a false sense of security. There is a reason it is called the 'honeymoon phase.' When it ends, if you have not used the time to commit to, implement and own your Success Habits you will be in find yourself struggling to learn how to maintain your weight. Commit once to a specific set of daily habits and stick with them. All of them! #2 PEOPLE STOP RAVING ABOUT HOW YOU LOOK Boy, do I remember this. Of course I would, it was all about me! Like many of you I enjoyed months and months of friends, family neighbors, work associates and even strangers, raving about how great I looked. One of my favorite comments was “Look at you, you are going to blow away!” Loved it! I think I even walked at little taller, and had a new strut and swagger as I showcased my success. When I knew would be seen by someone who didn’t know about the new me, I was ecstatic! Then over time, people started to get used to my new size. I slowly began to fade into normal, the newness wore off and all of the attention nearly stopped. I missed the rave reviews, I kept wondering to myself, “Do I look fat?” Am I gaining weight?” “Why doesn’t someone say something!” Messed with my mind to be sure. If that has not happened to you yet, trust me, it will. And it is important to be prepared for the emotional and mental grief it may cause. When it does, it will be a good time to do a little evaluating of your true motives for choosing weight loss surgery. Ask yourself why you made this decision in the first place. Did you do this for someone else? To look feel better for yourself? For revenge? To improve your health? This is a time to reconnect to your personal why. Remind yourself of what motivated you in the first place. Pat yourself on the back and learn to improve your ‘self-talk.’ Then, move on. Rather than having it be all about you, now is a great time to turn and support those coming along behind you. Opportunities abound for successful patients who want to give back by paying it forward. Motivate, encourage and support new and prospective WLS patients. Help with an event or patient celebration, work as a hospital volunteer, share your story or become a Support Group Leader. Share your successes online and participate in one or more of the many Facebook Group discussions. You look great – now be great by helping others. #3 THE SCALE STARTS TO GO IN THE WRONG DIRECTION Perhaps like me, you spent many years not knowing what you weighed. I hated the scale and would avoid it at all costs. But, I loved nothing more than weighing myself during the first year after my surgery. It seemed as though I could weigh in the morning and lose even more weight by the time I returned home in the evening! Talk about motivating. For the first time in almost forever, the scales were tipping in my favor and it was exciting! As many do, I reached a plateau a time or two on my way down to my goal. So, perhaps you too have plateaued along the way, but this time, you sense it is different. You have reached your goal, stayed there and celebrated your success, but then, your weight starts to climb back up. Panic sets in and you know that glory days are over. Thoughts like, “I was afraid this was too good to be true.” or “I knew this couldn’t last.” keep surfacing. Self- doubt sets in and you worry that like so many times in your life, you lose, then gain. (And often with a bonus). You hoped it would be different with a surgical intervention, you hoped it would be easy. And in some respects, it has been but now reality hits and you know it’s time to pay attention. At this critical juncture. it is time to ensure that you have put into place the Success Habits you must rely upon every day for the rest of your life in order to maintain your weight. We all know how to lose weight, we have spent so many years on diets, off diets, thinking about a diet, researching a new diet, cursing diets, getting on and falling off diets. But learning how to maintain weight is a completely different mindset. Take this time as you transition from losing to maintaining to remind yourself that obesity is a disease. And one that you will struggle with for your entire life; surgery or not. You have a remarkable surgical tool to help you manage it as long as you learn to use it properly. Commit the time and effort to learn about your own personal metabolism, your triggers, and your relationship with food. It is up to you to evaluate your behaviors, stop doing what you might have gotten away with during the rapid weight loss phase and focus on everything you have learned. Memorize and internalize Success Habits of Weight Loss Surgery Patients. #4 YOU REALIZE YOU SHOULD HAVE PAID MORE ATTENTION TO YOUR BARIATRIC TEAM It seems that through the years the bariatric medical community has made great progress in ensuring that prospective patients are better educated and more prepared for surgery. As many of you know, there is a long checklist of todo’s prior to surgery. Consultations, evaluations, exams, tests, support groups and the list goes on and on. An interesting thing happens though. When surgery is imminent, our focus is primarily on the details surrounding the actual procedure, hospital stay, pain management, how it will feel, etc. The classes and information are helpful, but unfortunately, we are not really listening. We are trying; we nod our heads at what our dieticians, nurses, mental health and exercise professionals are telling us. We commit to being compliant, eat right, exercise, take our vitamins and attend our follow up visits. But are we really listening? Are we learning? Perhaps not. Following surgery, it’s “Whew, I am alive!” And once we are released from the hospital we begin our journey, sticking closely to what we have been advised. We start to really pay attention. Then, something magical happens. Our surgical tool starts to work, just like we had hoped. The weight starts to fall off! But, then we learn that no matter what we do, whether we follow the rules or not, the weight still continues to fall off. A dangerous realization. You see, once we think of ourselves as invincible – we stop listening. Sadly, we see that it is only when people reach a plateau or heaven forbid, begin to gain weight that they are really ready to listen and learn. We are told so often, surgery is a tool, it’s a tool, it’s a tool. Again, we nod our heads. Now that our honeymoon is over we must be ready to learn. I mean really ready to learn. We have “graduated” or are have been “released” from our bariatric clinic and may wonder if we missed our shot to learn. Surgery was a success; we have lost weight and now we need to learn how to maintain. Wishing we would have paid more attention earlier on, we might wonder where can turn. For me, I turned to all of the successful patients I could find, to learn what they knew and do what they did. As I expected, there are very particular habits that those most successful have made part of their lives. In fact, I have spent the last 22 years seeking out the most successful wls patients, identifying their habits, learning from these long term losers and sharing my research all over the globe. So often, we hear struggling patients comment that they did not learn these important principles during their initial weight loss. If that is the case with you, it is not too late. Read the book, take a class, participate online. Remember your surgical tool will serve you well for a lifetime as long as you learn to use it properly. Learn what you might have missed, learn what successful patient have to teach you, learn all you need to know about your own body, metabolism and food addictions. It’s never too late. Learn more about Success Habits Resources Then, move on. Rather than having it be all about you, now is a great time to turn and support those coming along behind you. Opportunities abound for successful patients who want to give back by paying it forward. Motivate, encourage and support new and prospective WLS patients. Help with an event or patient celebration, work as a hospital volunteer, become a Support Group Leader. Share your successes online and participate in one or more of the many Facebook Group discussions. You look great – now be great by helping others. #5 YOU STOP ATTENDING SUPPORT GROUPS THINKING THEY ARE FOR NEWBIES We always suspected that those who regularly attend support groups after weight loss surgery are more successful than those who don’t. Thanks to our collaboration with Stanford University Medical Center, we now have the hard data to prove it. Put simply, “Successful WLS patients are 3 times more likely to participate in support groups than their less successful counterparts.” Unfortunately, sometimes we find that support groups focus on and cater to the newbies, leaving the veteran patients bored, un-motivated and less likely come back. If the topics in support group are not of interest to you, suggest some that would be. Work to be part of the solution. Perhaps offer to do some research, share your experiences or even prepare and teach a lesson. If you have found that you have lost interest in your support group, please consider that if you don’t need the support group, perhaps the support group needs you. I, for one am so very grateful to the two WLS patients who at 10 years post op volunteered month after month to share their story, coach, encourage and teach those of us coming along behind them. Perhaps it’s time to give a little back by paying if forward. Consider becoming a BSCI Certified Support Group Leader. There is nothing more motivating than having people look up to you, learn from you and help keep you on track as a good example. For many, support groups go way beyond, “What is the topic?” People view support group attendance as a commitment to themselves to stay connected and accountable. Support groups offer opportunities to connect a network of like-minded people who understand your journey as many do not. So many life-long friendships are established at support groups. Make support group attendance a must do on your calendar to help you stay on track and accountable. If you are unable to attend a live group, web-based forums, Facebook groups and telephonic groups are easily found. BSCI’s DreamTeam of educators host free telephonic support groups every week. Fun, easy and a great way to stay connected. Telephonic Support Group Schedule

Hello, I will like to share my experience with Dr. Ramos Kelly, I had my surgery about 1 month ago and so far my experience was great. The staff was AMAZING and very professional, they answered all my questions and I also had a couple of phone consultations with Dr. Kelly (about 20-30 minutes each one, no surgeon in the states will ever do that for you as a patient). I review all his credentials and affiliations to all Bariatric associations, we should look at that while reviewing a surgeon. To anyone who has doubts, move forward with the surgery, his staff is super helpful and he is an amazing surgeon. One thing most people forget is that this is a major surgery not a walk in the park, again place the trust in your decision. Best of luck !

Here is the group for all of us having a February surgery!! On FB Bariatric February 2018

Hi Martha, I’m Crystal. I had my DS February last year. So I don’t have much experience for long term success. So what I gathered is from your recovery from hysterectomy and infection that your current weight is approximately 177 lbs? What was your lowest weight? Martha, as a healthcare worker I can say I’m glad that you are better. I would just first realized that you are still not where you were. You can get back to where you are comfortable happy and complete. Your are at a good starting point and you have to stay positive. I would visit a Bariatric nutritionist for tips on how to get back. Return to the gym get a personal trainer if it’s in your budget and start out slow and work your way up. Also, the liver reduction diet might be a great way to jump start your body. But I’m not a professional and I would encourage you to seek advice from a medical professional. 😉. I hope I helped and didn’t hinder.