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That's the scary part, isn't it. And I am sure it's the case for everyone here. All of us have dieted for years or even decades and have ultimately ruined our metabolism. I am sure many have experienced how they can survive on low calories and after having metabolism affected, high calories become a living nightmare. I personally have experienced the same. And it isn't surprising to see such results in the study. And I do agree low calories do affect your body in a very complex fashion. I had done Dr. Bernstein's diet. And that diet (around 500 calories a day) had wrecked my body for over a decade. It's only now I have up and decided surgery it is for me. Anyhow, for me personally, I am petrified of going beyond 1200 calories cuz of my past experiences. I don't even know how I can lose weight if I go over 1200. So yeh, this calories fear will always be there. And not sure how it'll work for me in future. Let's see what calorie count I hit at in my 1st month of soft/regular diet phase.

No, it's worse in a way. They followed the contestants from The Biggest Loser and measured that even when they regained all their weight, they still burned more than 700 calories a day less than prior to being on the show. Meaning: if you starve your body, it responds by using every calorie more efficiently. Or - if you have dieted enough, your daily burn will be lower, even when you regain. There's a hypothesis gaining support that people who spend a year+ after surgery on extremely few calories (600-700 a day or whatever) end up having to maintain on 1000 calories a day. And we all know how that would work for most people (some manage, though). The alternative thinking involved in this is 'what if people *still* lose all the weight on 1200 or 1400 calories a day, will they then be able to maintain on a higher calorie level?'. All things equal, that would make it easier to maintain long-term. Again, nobody has the right answer here. What we do know is this: it's not just calories in- calories out. The body is a highly complex system.

It's actually interesting, and while I definitely benefited from a calorie goal (and from it being high, comparatively), I think this will be the future of bariatric surgery. I've been sponging up so many scientific studies on this area, because I am a huge nerd when it comes to things that concern myself. I want to know it all. And it does seem like bodies ... end up where they're supposed to end up (with some variation, mind you) after surgery. No matter the program. What seems to differ is the regain. And this might be where portion sizes and types of food come in, rather than calories. Maybe our bodies adapt to whatever diet we put it on while going to our new set point? The Biggest Loser study from Harvard is pretty shocking in that regard (bodies can get +700 cals/day more efficient - that's a problem if you want to keep the weight off - it's not just calories in, calories out). Anyway, it'll be interesting to see how it goes for you! And don't go ultra low on food just because you can - that'd be my advice. I had tremendous success so far, and I've had a lot more calories than most here.

Not to worry, Msleo88. Many bariatric veterans suggest that you not weigh for at least 3 weeks post-op due to the crazy weights fluctuations caused by fluid. I know it’s hard to resist weighing, but stick to the plan and you’ll see results.

I think most people are nervous before surgeries. I've had several surgeries and I'm always nervous before them Pain is all across the board, but most people seem to have little to no pain with these surgeries. I had none. They'll send you home with pain pills. I never even bothered to open mine, but if you do have pain, take them as directed and you should be able to stay on top of it. I started out at almost 400 lbs and had been on every diet known to man. Surgery is the only thing that worked for me. If you follow your surgeon's plan, you WILL lose the weight.

there's no way that's a true weight gain. I would guess you're retaining water or your intestines are full. a lot of people don't lose much the first week because of the IV fluids you get in the hospital. In fact, some people "gain" on that (not really a true gain, though - it's just the fluid). I've heard of people "gaining" as much as 10 lbs in the hospital! It can up to a week for all that fluid to work its way out of your system.

Hello, I had sleeve on 12/16 and my weight has not moved much and today I noticed it's back up 3lbs. I lost 13lbs on pre op but nothing after surgery. Is this normal? I'm feeling discouraged. I've been on full liquids. I get my protein in the form of shakes and yogurt. It's hard to get fluids in but I am doing that too. Any advice or help? Sent from my SM-A716U using BariatricPal mobile app

Pre-plan your meals. Seriously, make them and reheat them, that way when you're hungry it's "heat this up" not "ALL HANDS ON EVERYTHING". Can you get a DXA scan (InBody, BodySpec, etc.?) It'll tell you your body fat percentage much more accurately than a Renpho scale can, and you can track it (I get one every 3 months) so that you can see whether your weight is muscle gain or fat gain. I'm gonna say, though, that if clothes still fit, you're likely doing a body recomposition and not gaining fat. But only a body fat scan will tell you.

Hold on, I'm about to use SCIENCE! Your body has a set number of calories it burns even if you are completely inert (sleeping, G-d forbid in a coma, etc.). It's called your basal metabolic rate (BMR). It fluctuates with your weight and with how fast your metabolism is. For, say, a 40-year-old, 5'4" woman who weighs 250 lbs (not unusual for a bariatric patient), BMR is around 1800. Now add on any kind of daily living to that, which required calories, and you end up with a number called total daily energy expenditure (TDEE). If you're the same woman above and you're sedentary, your TDEE might be 2200; if you are one of those nutters like me who goes to CrossFit and goes running and works a physical job, your TDEE might be as much as 3000 calories. Now. You've had your surgery. You are not physically capable of eating anywhere near that amount. Let's say you're at 800 calories a day. Simply by eating those 800 calories and existing, your body will naturally be in a 1000 calorie a day deficit. Add in sedentary lifestyle, and you're in a 1400 calorie a day deficit. Generally speaking, about 3500 calories is a pound lost (this is not always true and can be overcome by fluid retention, fluid balance, hormonal changes, menstruation, eating really salty foods, vitamin deficiencies, etc.). Now let's say you're "overeating" and you're doing 1200 calories a day; you're still 600 calories short of your caloric needs just to exist, and 1000 calories short of what you need for a sedentary lifestyle. You are going to lose weight. You are not going to 'ruin' anything. What is happening to you is your body is rebalancing its fluids. That is why the "three-week stall" happens. Every body is subject to the rules of CICO (calories in calories out), and eventually CICO will take over from your body's rebalancing and the numbers will drop again. And do measure yourself once a week! Bust/chest, waist, abdomen, hips, thighs, calves, biceps, neck. This week I didn't lose a ton of weight BUT I lost a half inch off my waist, and I can tell because my trousers keep slipping and I had to put a new hole in my belt. One suggestion: don't weigh every day. And if you can't help it—some people just have to, I'm one of them—keep a running tally and then pick a day, let's say Tuesday, and average your weight over the last seven days. Then use the average weight to gauge progress, not the number on the scale that day. Where the thick smoothies and things come in is that your stomach is still healing from the trauma of surgery. But here's the thing—your body will TELL you when it doesn't like something you eat. It will clam up your stomach. Or make you nauseated. Or have unstoppable hiccups until your stomach empties. Or give you the sniffles (which is SUPER AWESOME during a respiratory pandemic, let me tell you). I ate a bite of an egg roll yesterday and got punished for it. So... tl;dr... don't worry too much about it, especially at first. Feed your body the protein and liquid it needs, and then move on to other foods.

So I could use some help. Had surgery Dec 20, 2019, but really started working out (lifting and running) in Oct. Since I increased my activity level, I have been just hungry. My eating habits are all over—trying to get protein, but hungry (so I’m grabbing handfuls of whatever). I haven’t been tracking food accurately due to being snacky. And unfortunately gaining weight (roughly +7 pounds—from 143 to 150). I can’t tell if it’s muscle or flab. Clothes still fit, but my body dysmorphia is in full bloom and I feel like I look like I’m back at pre-WLS shape. The working out has been amazing though, and I’m enjoying the weightlifting in particular. I know at 2 years it’s common to gain some weight. And for the body to begin to absorb calories more efficiently. I guess I’m at a loss as to how to “right this ship”. I need to get back to below 145 for my mental health, which sounds slightly ridiculous, I know. Tracking calories accurately and not snacking I guess? Thoughts or “been there / done that” experience ?

I have a spouse who doesn’t want me to have the surgery. I’m having the sleeve tomorrow and today I am 5’7 and 211. I am a severe diabetic and to the point I have to have this even though I’m at a 34 BMI due to the diabetes and health issues with that my insurance is paying 100% of the surgery. But Mr has brought me my favorite things, tried to take me to dinner and get mad when I say no during the liquid phase. The closer to surgery the more insecure he is becoming (married 20 years) I am seeing my therapist more the past week then my entire life. I will choose life and health over his insecurities and sabotaging me. I lost my very healthy thin father to diabetes when I was 17. I want to be here for my kids and grandkids. If you want this, you want life and choose, as someone here told me yesterday, to learn to love yourself then this will work and you will be successful. My sister had bypass 25 years ago and still maintaining her weight loss, her daughter had it 3 years ago maintaining her weight loss. I could go on and on but I won’t. I think the first step is seeing a therapist to find out why you are killing yourself with food. Because that is what is happening. It’s a tool, it’s up to you to succeed. And I am fighting against all odds with my Hubby but I will choose life and make this successful if that means leaving my 20 year marriage. If he loves me he will support me and help me - period

I am thank you. Im down to 185 now I'm almost to my goal. Weight Sent from my SM-N950U using BariatricPal mobile app

Another June gal here. I'm down 40 lbs (but that includes the liver shrink). I have 10 lbs to get to my doctor's goal, but 20 to get to where I'd really love to be. I was doing really well until I had a severe sciatica episode Thanksgiving weekend. I've had back issues for 10 years or so, with a few flare-ups, but this was the WORST. The nerve that controls my right leg was pinched and I couldn't use it at all. And unfortunately, I tried to stand on it and ended up falling and messing up my knee. Long story short, I was given a mega-NSAID by urgent care until I got to see the pain doc a few days later. And of course, I took it because I was in too much pain to care. Sometimes you gotta do what you gotta do. I'm able to walk now, but the only exercise I'm doing is PT. So hopefully I won't be tempted to go too far off my eating plan and gain. I've been cheating and eating more carbs than I'm supposed to. It's so hard when you don't feel well. Carbs are my comfort foods. But at least I can only tolerate a small amount of them. Best to all of you!

I don't agree with your correlation between those who are successful with the tool could lose weight without the tool. I do not agree at all. The restriction is HUGE for me. When I feel the restriction I stop eating. I am getting better at stopping before restriction, but without that restriction, I do not think I would have been successful in the first 3 months after surgery. The restriction also prevents you from deciding....well it is "name a holiday or special day" and I am going to cheat this one time. You simply cannot without a lot of pain and getting sick. Once you start cheating for special occasions, you will find more occasions and you will gain weight. the sleeve restriction prevents those slip ups from happening.

I tend to agree with your Doctor. It is scientifically impossible to consume 800 calories per day and not lose weight, especially if you are walking and/or exercising as recommended. It could be that you are not accurately recording your calories, not counting things like butter, oil, snacks, calories from sugary drinks etc, etc. Read about it...it is just not possible.

Team June 2021, I hit my 6 month mark today! Since surgery, I am down a little over 80 pounds and a little over 100 pounds. Overall, I feel so much better! My daily feelings vary though. Some days I feel on top of the world (very healthy/slim) and other days, I feel like I have a long way to go and wonder if I will ever make it to goal (very fat). I have more good days than bad and I am happy for that. I move much better and exercise daily, either walking 3 miles, lap swimming, or playing adventure fit on the nintendo switch (aerobic exercise). I also lift weights three times a week. I thrive on consistency and I track everything. In regards to the upcoming holidays, it has brought on emotional feelings and this is the first time I have had doubts about having surgery (so I can never eat three different types of dessert at one time again...like ever?) It has come on in the form of anxiety and I know my hormones are out of whack; I can quite literally feel them coursing through my body it seems. I am working through this and I think I figured out this wave of emotion is because I previously associated celebration, family, and relaxation with food very deeply. So, while I have no cravings or real fear about making healthy choices, I clearly need to re-read chapters that cover emotional eating and relationship with food. May this holiday season be everything you desire - time with family, time alone, rest, a time to get pesky tasks done, inspiration to set new goals - whatever you need! Take Care All!

What was your start weight and how tall are you? If you lost a lot of weight just before surgery your immediate post op weight loss is generally lower. It doesn't pay to compare ourselves to others in the first few months to many variables.

Exactly. Remember also we, all have a natural weight fluctuation, we just notice it more now because we ‘re more vigilant with weighing ourselves & recording our weight. I’ve discovered my natural fluctuation is a kilogram (2.2lbs). Any more or less & I reflect on what I’ve eaten or not eaten. Has my water intake been more or less? Did I have some alcohol? Am I constipated? Am I peeing more or less? … Should say I’m maintaining & am pretty vigilant but the principle is the same. If you’re still losing & your weight loss trend is still downwards your golden. If you’re maintaining, reflect on your last week & see what next week brings. Three pounds may be your natural fluctuation. Congrats on your weight loss. Whoo hoo.

As the others have said: it’s just a part of the experience. Your natural hair loss cycle accelerates as a result of the shock of the surgery, stress, anaesthetic, decreased protein intake, dietary changes, etc. The hair you lose was destined to be shed it just happens a bit faster than usual. Just keep on top of your daily protein goal & take your multivitamins. Taking additional supplements that supposedly stop hair loss or strengthen your hair will only help new growth not the hair on your head which is already dead if it does anything. Nothing happens to your new growth cycle so you still ate growing new hair while your losing just at it’s usual rate. A lot of us cut our hair shorter so the new growth doesn’t have as much to grow to catch up plus short hair always seems to look thicker. Same with your skin. Protein is important. You can try taking collagen & silica. Keep it well moisturised & regularly exfoliate. You may look more gaunt & tired for a while but it does settle once you start maintaining. Genetics, age, highest weight, length of time being obese all influences how much your skin has been stretched, how much will bounce back & how much loose skin you end up with. All the best.

Not sure... I'm not doing Keto, just kind of intuitive eating, trying to eat clean. I was doing pretty well, but have veered a bit. I'm very happy that I did NOT gain back the weight I lost on the pre-op liquid diet, so for me that's a win - I've lost 2 pounds since. Not a lot, and I hope I can keep it off during the holidays and make wise choices. After this week I am going to call and see what my options are and then make a decision from there.

My PS wanted me to try to lose more weight, but I was stuck for years as far as weight went. I was having reflux at that time and within the past two years after the tummy tuck, it got worse , I think due to all of the muscles being tightened, it put more pressure on my stomach, so I had to have the band removed. Now, I'm 8 months out of band removal and haven't gained any weight... yet. But I feel like it's only a matter of time, so I'm probably going to revise to RNY. At least when I do get to goal, I can finally do all of the plastics that I was planning to do right when Covid hit. But I understand about your age and the risks involved, and it will be a relief to get the excess skin removed. Best of luck to you!

I'm so excited and nervous at the same time. My surgery is on the 12th of January. Nervous cause i haven't had a surgery ever, cause i take neuroleptics that makes the weight loss harder but excited cause i so want it to go well. I even start my own blog in English about my journey: mybariatricstory.wordpress.com.

Thank you! I would love to have a plastic surgeon do it, but my BMI is still 42 and they won’t touch it. She said a panniculectomy is less risky with less risk of blood clots at this size. They all recommended I get the gastric bypass, but that means another two years of approval/weight loss/weight stabilization before I could have it done. I’m already 65. I just don’t want to wait that long, nor do I want the bypass. I have constant neck and back pain and know this would help, but I don’t want to look also don’t want to look odd. I’m so torn!

I am on bipolar meds which are notorious to interfere with weight loss. I have lost slow but steady and I am about ten pounds from goal.