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Obviously all plans are different, but my Cigna plan required 3 months of meetings with a dietician or a doctor's order for three months of a formal weight loss plan. I found out that going to Weight Watchers for the last two years didn't count, it would need to be doctor's orders. So, in my experience, the three months would start with your first dietician appointment. Your bariatric office should be able to help you verify that, but that's how it worked for me.

I just met with Dr Patel with Texas Bariatric Specialists. He suggested this route for me and quoted 5k with the hernia. 9k without. I am pretty sure he has an office in Austin. I am in SA.

Good luck! My surgery is at 7am. Have to be there at 5:30. My mother was supposed to come from out of town today but there's still too much snow where she is, so I had to scramble to find a babysitter (who could come to our house at 5am tomorrow) but thankfully I found one. I'm getting more scared and second-guessing myself all over the place. I've lost 20 lbs since I first met with my surgeon on 9/22 and I keep thinking maybe I should just be more disciplined and do this on my own but then I know the sleeve will make it easier to do. Did anyone see the Vox series this week about bariatric surgery? Very interesting (and timely) to read: The main story is about a teenager and her mom, who both got the sleeve: https://www.vox.com/science-and-health/2017/12/18/16707428/bariatric-surgery-teen-weight-loss-jewel Then there were other pieces where they talked to a bunch of people who had the surgery a few years ago, to see how they've done with it: https://www.vox.com/science-and-health/2017/12/19/16742884/weight-loss-bariatric-surgery-pros-cons-stories And a more general overview of the surgery: https://www.vox.com/science-and-health/2017/12/7/16587316/bariatric-surgery-weight-loss-lap-band Good luck everyone!

I went to my PCP on Dec 15 to get the referral for a bariatric surgeon. We discussed my weight and how to best lose it, and she gave me the referral even though she is against weight loss surgery (for anyone). I have a three month diet requirement, and my bariatric surgeons program sets all of that up for me. My question though is whether I can use the Dec. 15th appointment as my start date of the three months, or do those appointments all have to be with same provider? I prefer to go a dietician for those three months and I will not be returning to my PCP for several reasons. I will be setting up a new one at the beginning of the year.

Glad you have a meter to monitor what's going on. I was diagnosed with reactive hypoglycemia. (complication from surgery) I worked with my bariatric, sports medicine and diabetes dietitians to get better control over my blood sugars. Here is an article: If you are diagnosed, Work with your team to find what foods and meal frequency work for your body specifically. June 2015 Issue CPE Monthly: Nutrition Tips for Reactive Hypoglycemia After Bariatric Surgery Reactive hypoglycemia (also called postprandial hypoglycemia, hyperinsulinemic hypoglycemia, or noninsulinoma pancreatogenous hypoglycemia) is characterized by recurrent episodes of symptomatic hypoglycemia occurring two to four hours after a high-carbohydrate meal (or oral glucose load). Patients who have undergone bariatric surgery, especially those in whom the pylorus is bypassed (gastric bypass, biliopancreatic diversion/duodenal switch), may experience reactive hypoglycemia. The dietitian is key to helping these patients manage symptoms. Symptoms Patients may experience any of these symptoms one to three hours after a meal high in carbohydrates: hunger, feeling shaky, dizziness, sleepiness, sweating, anxiety, feeling weak, confusion, heart palpitations, fatigue, aggression, tremors, fainting, or loss of consciousness. Dietary Modifications Work with your patients to help them identify and eliminate from their diets simple sugars, concentrated sweets, high-fat foods, alcohol, caffeine, and lactose (possibly). They also should avoid skipping meals or consuming meals comprised only of carbohydrates. Focus on how you can help patients modify their diets, including the following: plan mini meals spaced equally throughout the day (three to four hours); make low-volume choices; consume high-protein levels at each eating occasion, pairing protein choices with complex carbohydrates, fruits, and vegetables; choose healthful fats; and separate food and fluid intake by 30 to 60 minutes. Soluble fiber from guar gum, glucomannan, and pectin and alpha-glucosidase inhibitors, (eg, acarbose) or somatostatin analogs (eg, octreotide) can help delay gastric emptying, increase small intestine transit time, and slow glucose absorption. Patient-Specific Tips Acknowledge that everyone may have different triggers for low blood sugar or reactive hypoglycemia. Advise patients to keep detailed food journals that you can review to identify patterns (eg, timing and amount eaten as snacks, meals, and drinks; blood sugar levels; feelings). Encourage patients not to use foods or drinks with added sugar to boost low blood sugar levels, as this can cause blood sugar crashes and spikes.

actually, most RNY'ers can eat anything, too, once we're a few months out. Some of us, of course, dump, but a lot of us don't (unfortunately - I wanted to be one of them!). The statistic I see thrown around a lot is that 30% of us dump. I don't know if there's any hardcore research behind that, but suffice it to say, I've been hanging out on bariatric boards for about five years, and there are a lot of us who don't dump.

I did not get any bariatric specific items, I got quite a few last year ahead of my surgery, but my Dad gave me cash so I could pick out the fitbit I want so I will be doing that. I got a lot of clothing and it's nice because I desperately need it, I'm now moving into a small/medium and it's so cold here sweaters were a big hit for me!!

I just ordered the Tespo with the bariatric women's formula. I should get it in early January. I got mine for 50% off at gettespo.com. Sent from my SM-G920T using BariatricPal mobile app Candy

I just discovered a boatload of recipes for all phases and types of surgeries on Pinterest. Just search for Bariatric Recipes. Sent from my SM-G920T using BariatricPal mobile app Candy

It's always possible to lose weight, no matter how far out you are. The whole point of VSG is to provide a way to limit your stomach capacity. But as you learned very quickly it only works if you put good food into it. Your restriction will work with protein and veggies. You already know the secret to losing weight. You HAVE to cut out the carbs or your surgery will be a waste. Go back to basics ....high protein and plenty of water. Sadly, you are one of the examples of the Bariatric industry focusing too much on surgery and not enough on the psychological aspect of weight loss. In the end, obesity is the product of addiction, not stomach capacity. Surgery took less than an hour, but it takes a lifetime of mental health support to achieve and maintain weight loss. Your story is unfortunately all too common. For me, committing to changing my behaviors and developing new emotion coping stategies is the key to my success. I read dozens of self help and addiction books, joined an online addiction recovery program and saw a therapist for a year. Every day is still a struggle, but at 4 years out, 104% EWL and still within 10 pounds of my lowest weight, it has been worth it. I suggest reaching out to whatever mental health support programs you may have available. I will try and compile a list of the best resources I found.

I am In Bay too and had mine 12/20. Wondering if you know any good personal trainers in Sf who work with bariatric patients?

My consultation with Dr. Gangemi at UIC, and I’ll be starting the 6 month process in January. Anyone have experiences at UIC that they wish to share? Complications? Recommendations? TIA!

Thank you, Alex. This is really helpful and I'm going to look for the bariatric dinnerware Sent from my SM-G920T using BariatricPal mobile app Candy

this sounds almost exactly what happened to me. the last time i was able to lose weight (without bariatric surgery) was in 2012. it took me almost 2 YEARS of very, very strict no-carb keto (like spoon-feeding coconut oil) with a lot of intermittent fasting to lose just 30 measly pounds. my will/discipline would not break, so my thyroid did. i woke up one day without the energy to put my socks on. i gained those 30lbs back in about a month. then kept gaining, despite being on Armour thyroid. 20lbs a year for 5 years until i was 370lbs this spring and i finally had enough and got the surgery. long story short, YES, it fixes subclinical hypothyroidism which is what it sounds like you had/have. definitely keep doing deep thyroid blood panels after the surgery, but my thyroid function was completely resolved. my last TSH test (i'm 6-mos post-op) was a 1.5. all the energy and weight loss in the world. it's funny, i asked my surgeon the same thing in our initial consultation. i was like "yes, doc, this sounds great, but my thyroid is f'ed up. will this surgery still work for me?" he didn't hesitate to say "yes. any other questions?" p.s. - i'm really sorry for all the bad fortune you've been thru lately. good lord. please do yourself a favor and get this surgery. you deserve it. p.p.s. - no, malnutrition did not cause your son's cancer. that said, find a top-notch surgeon. do not settle for anything less than the best. even if you have to pay out of pocket. a good surgeon almost ensures no complications. bad surgeon = strictures, leaks, etc.

Hello everyone! I'm new to posting on the Bariatric Pal forum, but have used the forums to help me understand about people's experiences with the gastric sleeve. I am exactly 3 weeks away from D-day! I'll be having the gastric sleeve procedure. A bit about me - I am 27 years old, female, current weight is 97kg (213.8lb), I am 5'2 so that gives me a BMI of around 41. I have had some weight related health issues, but nothing overly drastic just yet. I am getting the surgery more as a preventative step so I don't end up on a bunch of pills or dead at a young age. I should also mention that I suffer from anxiety and panic disorder, particularly in relation to my health... somewhat of a 'hypochondriac' you could say ! To say I have been a complete ball of anxiety and worry would be an understatement. I am extremely scared and worried and have been stressing out about absolutely everything that could go wrong! Research and knowledge is great to have, but I think I overdid it . So with that, I come to you, the veterans of VSG, for some wisdom and guidance. I would love if people would share their positive experiences and any tips or bits of information you wish you had known prior to and after the surgery which may have helped you to get through recovery and learning about your new stomach. I have started a journal for myself that includes all rational thoughts to help me when I am feeling anxious and irrational. I would love to put any tips and words of wisdom you may have in my journal and know that it has come from experienced people. I understand everyone has a unique journey of their own, but I believe there is value in learning about others' experiences. Hope to hear from you all and get to know you and your journey .

Are you having bariatric surgery or a baby? Those small serving freezer containers are actually a really good idea!

The Perfect Plate idea helps you make diet-friendly meals with a minimum of fuss. Just put the right amount of each food group on the plate, and you can be confident that you will be on your way to a balanced meal. The Perfect Plate was not designed specifically for bariatric surgery patients, but you can use it for losing weight. Just make modifications as needed! The Basic Perfect Plate The classic perfect plate is designed for a full solid foods diet., but you can use it for losing weight if you are eating solid foods, you can tolerate vegetables, and you are not having trouble hitting your protein goals. Here it is: Fill half your plate with vegetables or fruit. Divide the rest of your plate in half. Fill one section with lean protein, such as chicken, egg whites, tuna, cottage cheese, or tofu. Fill the rest of your plate (1/4) with a nutritious starch, such as whole-grain pasta or cereal, brown rice, sweet potato, corn, or oatmeal. Add the occasional healthy fat, such as olive oil for cooking, salad dressing, or a slice of avocado. Examples include chicken breast with broccoli and brown rice; hash with bell peppers, tomatoes, and onions, sweet potato, and lean turkey sausage; yogurt parfait with toasted oats and berries; and a Greek whole-wheat pita half with sprouts, lettuce, and tomatoes, and falafel. WLS Modifications Now, that classic Perfect Plate may not work perfectly for you. You can still use the concept, but may need to modify it slightly to meet your dietary goals. Compared to someone who has not had WLS, you might notice these differences. You get full more quickly. You might need to skip the starch and/or take a smaller helping of vegetables. You need more protein. You can increase the protein and decrease the vegetables You cannot tolerate vegetables as well. You can take fewer vegetables, and/or cook them very well. Fruit does not fit. It might give you dumping syndrome or have more sugar than you want to have. You can focus on vegetables for that half of your plate. You are eating low-carb. You do not need to have a starch at every meal. You can skip it entirely at some meals, or replace it with an extra vegetable or protein. Pureed and Semi-Solid Foods Stages You will move through the pureed foods (“mushies”) and semi-solid foods stages before you get to the solid foods stage. While protein is your main focus soon after weight loss surgery, you can start to think about laying the foundation for a healthy, balanced diet. Protein comes first. Your first job is to eat 65 or more grams of protein per day. This may mean you do not have space for vegetables and starch. Extras do not fit. Your sleeve or pouch is small. You probably will not have space for non-essential foods, such as refined starches. Creamy, not crunchy. Cooked carrots, pureed green beans, and steamed zucchini are in; lettuce, broccoli, and apples are out. Perfect Plate Helpers Bariatric Dinnerware can make it even easier to make your Perfect Plate every time. Bariatric Dish Sets and Place Settings have stylish designs for your table, with easy-to-see markings for serving yourself. Bariware Portion8 sets are portable containers that you divide using movable rings so each section is as big or small as you need. The Perfect Plate can help you put together a nutritious meal without doing any measuring. Adapt it to your needs, and it can be another weapon in your weight loss arsenal.

The Basic Perfect Plate The classic perfect plate is designed for a full solid foods diet., but you can use it for losing weight if you are eating solid foods, you can tolerate vegetables, and you are not having trouble hitting your protein goals. Here it is: Fill half your plate with vegetables or fruit. Divide the rest of your plate in half. Fill one section with lean protein, such as chicken, egg whites, tuna, cottage cheese, or tofu. Fill the rest of your plate (1/4) with a nutritious starch, such as whole-grain pasta or cereal, brown rice, sweet potato, corn, or oatmeal. Add the occasional healthy fat, such as olive oil for cooking, salad dressing, or a slice of avocado. Examples include chicken breast with broccoli and brown rice; hash with bell peppers, tomatoes, and onions, sweet potato, and lean turkey sausage; yogurt parfait with toasted oats and berries; and a Greek whole-wheat pita half with sprouts, lettuce, and tomatoes, and falafel. WLS Modifications Now, that classic Perfect Plate may not work perfectly for you. You can still use the concept, but may need to modify it slightly to meet your dietary goals. Compared to someone who has not had WLS, you might notice these differences. You get full more quickly. You might need to skip the starch and/or take a smaller helping of vegetables. You need more protein. You can increase the protein and decrease the vegetables You cannot tolerate vegetables as well. You can take fewer vegetables, and/or cook them very well. Fruit does not fit. It might give you dumping syndrome or have more sugar than you want to have. You can focus on vegetables for that half of your plate. You are eating low-carb. You do not need to have a starch at every meal. You can skip it entirely at some meals, or replace it with an extra vegetable or protein. Pureed and Semi-Solid Foods Stages You will move through the pureed foods (“mushies”) and semi-solid foods stages before you get to the solid foods stage. While protein is your main focus soon after weight loss surgery, you can start to think about laying the foundation for a healthy, balanced diet. Protein comes first. Your first job is to eat 65 or more grams of protein per day. This may mean you do not have space for vegetables and starch. Extras do not fit. Your sleeve or pouch is small. You probably will not have space for non-essential foods, such as refined starches. Creamy, not crunchy. Cooked carrots, pureed green beans, and steamed zucchini are in; lettuce, broccoli, and apples are out. Perfect Plate Helpers Bariatric Dinnerware can make it even easier to make your Perfect Plate every time. Bariatric Dish Sets and Place Settings have stylish designs for your table, with easy-to-see markings for serving yourself. Bariware Portion8 sets are portable containers that you divide using movable rings so each section is as big or small as you need. The Perfect Plate can help you put together a nutritious meal without doing any measuring. Adapt it to your needs, and it can be another weapon in your weight loss arsenal.

Hey everyone! *waves* THE SHORT STORY I've been hypothyroid for fifteen years. Is bariatric surgery effective and worth the risk for hypothyroid patients? THE LONG STORY So, I'm considering WLS. I can't believe I'm actually thinking about it. My husband had WLS about three years ago and is doing fine. He's regained some weight but is still far ahead of where he was. My son had WLS around the same time. He did not do well. He had extreme absorption issues and had to have a feeding port installed just weeks after his surgery. We lost him in November 2015. The official cause of death was cancer, but we wonder if the malnutrition contributed to his developing cancer. For me, my thyroid died somewhere around 2002. I was on the Atkins program, had lost about 70 pounds, and was on my way to single digit clothing size! Then, bam - one week I gained four pounds. The next week six. And then eight. All while still working out daily and eating the Atkins way. DNA? Age? Splenda? Who knows the cause, but my thyroid was done ... completely. The weight gain, it turns out, wasn't the worst part of hypo for me. It was the depression. My doctor put me on synthetic thyroid that didn't help at all. Finally, in 2009 I found Nature-Throid and a doctor who would prescribe it. Nature-Throid eased the depression, but my weight slowly and steadily continued to climb. In 2015, my hair began falling out. My skin had always been dry. Now it peels off in sheets. And I put on an additional fifty pounds within months. I chalked a lot of those symptoms to stress. The last few years have just been awful. In January 2015, my husband had emergency surgery to place a stent in his heart and I blew out my knee. Mid 2015, I had to shop for a nursing home for my mom. If you've ever done that, you know there aren't any good nursing homes. Mom died on Christmas Day 2015 ... six weeks after losing my son. August 2016, my brother was diagnosed with inoperable brain cancer. Next, I made a super poor career decision and lost my job in December 2016. My brother died January 30, 2017. Yet, I'm still standing ... just barely. Because both knees are now bone on bone. My blood pressure is fine. I'm not diabetic. No heart disease. Except for that damn thyroid, my blood work is all healthy. But I'm at an all-time high of 311 lbs. It hurts to move. It hurts to stand. I carry a lot of the weight in my hips and thighs which even makes it hurt to sit. I hurt and I don't want to hurt anymore. If you've read this far, thank you for letting me rant. I'd love to hear from other hypothyroid patients. What has been your experience with WLS? Pros? Cons?

Hello, I am wondering if any one on here knows of any good personal trainers in the Bay Area who work well with Bariatric clients? Thanks for any ideas..

Your surgeon and dietitian would be best equipped to answer this question since all bariatric programs have differing requirements. Some programs require pre-surgery supplementation, whereas others don't. Personally, I wasn't required to take any vitamins or supplementation until the first week after surgery.

I think you're right with this introductory statement to your paragraph. That's what BariatricPal is and is for! Sadly, some folks use it to promote their businesses, their pyramid schemes and their wacky non-bariatric related ideas. Some of those ideas/ads have been stopped in my 3.5 months here by moderators or the site's 'owner'. Anyone is able to start a thread about almost anything. When he/she does that, scrutiny or response is okay. There had been much experience of presenting thoughts and having them challenged. While the majority of people in English-speaking countries are nominally 'christian', very few practise any of the manifold christian brands by going to church or living fully in the ways Jesus or his early followers would expect. The great majority of people are signed up to the various christian brands without thought. Modern commercialism and marketing promote xmas, easter and other christian days (all stolen from pagans) as a way to profit retail and service industries. When someone opens a thread with a 'hook' statement about xmas being all about Jesus' birth, it deserves challenge as we have much new knowledge in the last 25 years of Jesus' exact life history. In the name of fair debate, I made a few points. I still believe the key role of the site is pre-op and post-op WEIGHT LOSS SUPPORT. I facepalm (really or figuratively) when I see gullible people follow ANY religion, christian or otherwise. I still respect their choice to use the weight-loss forums (as I do) to glean help for their questions and concerns before and after surgery.

Super long post alert---my apologies. Hi guys, I totally forgot to post this. So on 12/20/2016 i celebrated two milestones. It was my birthday, but most importantly it's the day that i finally made it to the loser's bench and took control of my life back. So this year i had a milestone birthday and my gift to myself was my progress. I've spent so much time beating myself up because i'm still not at my goal yet, and i do realize that i will get there. But i forgot to actually look back at my progress and see how far i've come and actually enjoy that. Not just physically but mentally. I'm so grateful not just for this tool, but for the support of all the other amazing wls patients i've encountered thus far. I've learned to trust the process, actually stick with it and that i can stick with it because i'm not alone and there's tons of people out there can relate to everything i've experienced on this journey. So thank you! i've been getting lots of questions about what i did (which is basically the same thing everyone does lol) but a long time ago i posted something in the rants section called "what's wrong with overly sensitive assholes..." it pretty much explains all the things i do. There are a few things i've added along the way since then so feel free to ask and i'll share. Before: Life in general just was starting to suck, it was more than just my weight and i realized that i was not happy at all and a little depressed. In regards to my weight- it was spiraling out of control. I had tried every possible diet imaginable, even prescription weight loss drugs. Nothing was working. So one day i literally just started researching all of my options. I had never even heard of the sleeve before. I thought i wanted the lap band because that's really the only thing i had heard of. I went to a weight loss surgery seminar in my area and i realized that there were so many other procedures available. I was overwhelmed and about to give up. Then one day at work the elevator broke down and i had to go up 7 flights of stairs with my laptop bag and i literally thought i was going to pass out. I was soooo out of breath and out of shape and this was after starting to regularly go to the gym. I was so humiliated because i walking up the steps with men twice my age and twice my size and they were just fine. They could clearly tell that i wasn't. I've never been that embarrassed before. I interviewed 5 different top notch bariatric surgeons in the DC area i finally just decided to go for it. I was finally mentally ready. That was key because if i wasn't, i definitely would have kept old habits. I really didn't tell anyone. I didn't tell my family until the day before because i didn't want anyone talking me out of it or judging me. Especially when everyone in my family is naturally thin so they wouldn't be able to relate. After: Literally the best spur of the moment decision i've ever made for myself. I'm so much healthier, to the point where i never even wear makeup because my skin is always glowing. I have so much energy. I'm happier overall. Everything else in my life is finally on track. I've met amazing life long friends through this process. Nobody is ever judging me for being the "big" or "funny" friend anymore. I accidentally found my passion- i realized that i love helping support and mentor other people who are struggling to lose weight. So i've started volunteering in my spare time at my local surgery center. Now i view working out as therapeutic instead of a chore. I literally couldn't be happier. I'm amazed at how i've changed mentally, i'm a lot nicer, less judgmental and more determined to accomplish other goals that i have set for myself. That alone is the one thing that i'm most grateful for. I realized that if i can stick to this which has been my biggest struggle my whole life, there really isn't anything life could throw at me that i can't handle. I also learned to stop comparing myself to others because who really cares, it's easier to focus my energy on the things that i really want to do. Now i'm doing everything i want and enjoying it. I've realized that there's so much more to life. Happy holidays to everyone btw, wishing everyone continued success on their journey and a prosporous 2018!!! Merry christmas! Anyway- enough of me rambling. Now for the fun stuff: bombarding you with a million and one progress pics lol 😊 Hw:244 Sw:227 Cw:155 Gw:anywhere between 115-130 Size: 4 Height: 5'1 ** and no i have not had any plastic surgery yet...someone really asked me that 🙃

I'm scheduled for the Gastric Sleeve on January 9th with Dr. Alejandro Gutierrez from Mexico Bariatric at Mi Doctor Hospital in Tijuana, Mexico. I'm kinda nervous and excited at the same time. My husband and I fly in the 8th and fly out the 12th.

The operation can be expensive and therefore it is very good if it is covered. Review your policy statement for surgery. Many of the health insurance policies are written very similar. Mine reads: Surgical treatment of obesity (bariatric surgery) is covered only if: - eligible enrollee is 18 of age or over - clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following: * Type II diabetes mellitus (by American Diabetes Association diagnostic criteria). * Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications. * Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications). * Obesity–induced cardiomyopathy. * Clinically significant obstructive sleep apnea. * Severe arthropathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity). - Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration. So if you are healthy, no co-morbities, it would mean that you have to have a BMI of 40 or greater to qualify. Also some insurance policies consider RNY gastric bypass surgery to be the standard for bariatric surgery and might disqualify gastric sleeve because it has not been around as long as gastric bypass. Anyways the first step is to read the fine print on your policy. Many health insurance policies are on-line today, if you do not have a paper copy.