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I don't mean to offend anyone. I just hate to see people work THIS HARD to shoot themselves in the foot. My nutritionist and doctor both say...."1200 calories a day by week 6. Beware the starvation metabolism. You need to learn to eat the right things and exercise to lose permanently and change your lifestyle." I tend to listen to them cause they've based their lives around studying this crap, going to continuing education seminars about the biology of metabolism post-surgery, bariatric endocrinology, etc. They're not just taking shots in the dark....they've watched a LOT of people go through this. I dunno....my fear is seeing people who are trading one eating disorder for another...because maybe the underlying issues are not being addressed. I just want to say...slow down...breathe...do it healthy. Not my place to judge really, and I apologize if my post sounds judgey. Just would really like to see everyone succeed long term, be healthy and happy.

Just stay focused. If there is a bariatric support group, go to it. And don't hesitate to reach out to your surgeon's office and tell them that you feel abandoned and ask for more specific advice and guidelines. Good luck. You've got this!

I agree with above, find a bariatric program and see if they have seminars. I did not need a referral from my PCP to enter the program. I attended a seminar and then made an appointment to do an initial assessment with the Bariatric Program NP. I did need a referral from my PCP for my insurance though before they would approve me basically detailing all the past weight loss attempts and any weight related issues I had.

Best wishes for safe surgery @Gnat ! Start of your renewal :-)

Generally if you suffer from severe acid reflux (GERD), RNY gastric bypass is the best choice because the sleeve can make the condition worse. We had one individual in our bariatric surgery support group that had a revision from lap-band to gastric bypass. His band started to wear into his stomach and that was a life threatening condition so he had to have it removed. Generally speaking he was happy with the revision. In his case there was a lot of scar tissue because of the lap band, so when they did the revision, his pouch was smaller than most. This meant that the volume of food he could consume at any time was less than normal. He compensated by eating more meals per day and he was fine with that.

I've been watching a LOT of YouTube videos from people who have had the VSG surgery as well as bariatric surgeons. It's cool to watch and see people's transformation over a period of months. Right now I'm especially interested in the videos from people who post their experiences during their surgery and first week post op, since I'll be having VSG on Jan. 11th. Just curious, what are some of your favorite YouTube VSG channels? I've learned a lot from a couple of the bariatric surgeons channels - one is Dr. Mathew Weiner and the other is Blossom Bariatrics from Las Vegas; their dietician has some really good videos.

According to the internet: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. Treatment recommendations for NAFLD are aimed towards weight reduction, thereby reducing insulin resistance. Unfortunately, lifestyle modifications have not yielded long-term success, while durable weight loss is routinely achieved with bariatric surgery. https://www.medscape.com/viewarticle/763056 So what this summary says it that lifestyle modifications such as dieting and exercise have not yielded long-term success but bariatric surgery has. Another article says: Nonalcoholic fatty liver disease is a progressive disease with potential evolution to liver cirrhosis and hepatocellular carcinoma. Another article says: Nonalcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. It encompasses a spectrum of conditions associated with lipid deposition in hepatocytes. It ranges from steatosis (simple fatty liver), to nonalcoholic steatohepatitis (NASH–fatty changes with inflammation and hepatocellular injury or fibrosis), to advanced fibrosis and cirrhosis. Studies suggest that although simple fatty liver is a benign condition, NASH can progress to fibrosis and lead to end-stage liver disease. The disease is mostly silent and is often discovered through incidentally elevated liver enzyme levels. It is strongly associated with obesity and insulin resistance and is currently considered by many as the hepatic component of the metabolic syndrome. NASH cirrhosis is now one of the leading indications for liver transplantation in the United States. I underwent RNY gastric bypass surgery because my health was deteriorating rapidly. I dieted and exercised and still could not shed the pounds but instead continued to gain the weight. I had the surgery to correct my health conditions. The surgery corrected a number of my health conditions including diabetes, high blood pressure, sleep apnea, acid reflux (GERD). It even corrected my asthma condition. If your focus is to become healthy and live a long productive life, then I would suggest the surgery. I dropped 120 pounds after surgery and my BMI went to normal. Weight loss was just a little gravy on top of health improvements. One of the factors that enter into the equation is cost. The operation is expensive and therefore it is important to have insurance that covers the operation. Therefore the guideline requirements from your insurance policy will dictate how easy it is to obtain this surgery. Many insurance policies are written very similar, so this will give you an idea: 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 your health insurance policy was similar to mine, you would not be able to qualify because of age; but the moment you turned 18, you would get a green light because your BMI is over 40. So the best advise I can give you is to dig out your health insurance policy and read the fine print.

Oh no. Switch doctors! Get the surgery! She/He clearly doesn't know much about Bariatric surgeries.

My surgery was 6 years ago - so maybe things have changed. My number was 111 - so also severe sleep apnea. What I was told is that the primary risk is the first 24 hours post op and the way my suregeon dealt with it is that I stayed overnight and was on monitors. Otherwise, I was healthy enough to do it outpatient/day surgery. I had no problems but I felt safer with the precautions. I too was frightened, but when I considered the risk of just dropping dead from being so obese, I decided that the surgical risk with apnea was less frightening than the very real risk of entering my 50s weighing over 300#. I had a niece (age 40) and a SIL (age 62), both very obese (probably heavier than me even), both died of sudden heart attacks related to the obesity - although the SIL passed AFTER I had sleeve surgery. Those deaths really hit home. Since I like facts to back up decisions, I would do research on the actual percentages. I get that terrible things can happen due to bariatric surgery but the vast majority of people do just fine and have no serious problems. For the sleeve, I'd be much more worried about reflux as a lot of people do wind up having to manage that to varying extent over the longhaul.

December 28th...tic toc, tic toc... Hi all, I wanted to make sure I have everything I need for the first couple week post surgery, here is what I have so far. Please add anything you think is a must have or would be helpful to have in the house ahead of time: Bariatric vitamins (the ones recommended by my nutritionist) Gas X Laxative A scale for weighing food Protein shakes What else should get food / liquid wise? What else? Thanks!

Hi. I'm just wondering if anyone has experienced vomiting old blood (dark, rust colored)? My other symptoms are: severe constipation, in ability to hold down food or water that only last a few days and then I can eat and drink normally again. When I can't hold anything down I have mild to moderate abdominal pain on the right side. Also, even sipping water causes bile to come up. I have only vomited the blood 4 times in 2 1/2 months. It feels nothing like the sensation of food becoming stuck and feels more like the flu without the other symptoms. None of this makes sense to the surgeon who did my lap band surgery but the general surgeon I've been seeing wants to blame the band. I really think I have a bleeding ulcer. Most recently I couldn't hold anything down for 3 days and the pain was becoming worse so I went to ER. The next day I ate fairly normally, although I took it easy and I was back to drinking my 8-10 glasses of water a day while just the day before water made me vomit? I have been unable to find anybody with my symptoms on here. If we ignore the presence of the band it all points to ulcer. I should also mention my band has been in for 1 year and 9 months, I have just over 5cc's. The nurse at the Bariatric surgeons took out 2 cc's tonight so we can rule that out. I'm not very happy about it because I was finally starting to make some progress. My surgeon will only allow very small fills each visit and it took more then a year of monthly fills to finally see some progress. I feel like I've gone back a year of this weight loss journey with the removal of fluid.

Genepro is crap. The company has been sued at least twice and just lost the most recent one. There is no such thing as "medical grade protein". It's whey. They came out and said it is just predigested whey that gets absorbed very quickly. It is not equivalent to 30g, it is at best 10g. The best thing to do with that crap is just chuck it in the trash. Yes it is on the bariatric store, but that is a store. It sole purpose is to sell things people will buy. And people buy Genepro because they want to believe it, not because it works. To your original question, mix your protein powders however you like. Whey, casein, pea, or soy... doesn't matter. It's no different than having a salad with chicken on top. There are some benefits to mixing proteins. BCAA content, absorption rate, bio-availability... experimentation in with this should be encouraged. And don't worry about taking in more than 30g-ish of protein at a time. RickM stated it well. You will absorb the protein eventually.

Hello bariatric world, I have a concern. I am about 12 days post vsg and I'm having a hard time getting the required amount of protein in. I don't have an issue with premier protein. I purchased Genepro protein to up my protein intake. I wanted to know if it's ok to add a scoop of 30g of Genepro protein to a premixed premier protein shake? I don't want it to harm me. But it sounds like an awesome thing to do and get protein intake out the way. Please let me know if it's ok to mix both proteins. Thank you

Keep in mind that not all of your initial losses are fat pounds. In the realm of bariatric surgery, fat loss is what matters. The nurses at the hospital or surgery center probably infused several bags of intravenous fluids into you before, during and after your procedure. These IV fluid bags weigh a substantial amount and make it appear as if you've gained/lost more than you truly have due to water weight. Also, you lose weight and volume as swelling decreases. Don't worry...this will probably be the last week you ever lose 16 pounds.

My program was 90 days when I went into it. You had to see the NUT 3 times (though I saw her 4 times because I was in the program 5.5 months because I chose to push my surgery date back), go to 6 support meetings, do 3 meetings with the Bariatric NP for psych eval and then see the surgeon twice. They have since changed the program to 6 months and require an exercise component ( 6 sessions of guided exercise at their facility). I still felt lost even though we got a packet for post surgery diets. There were ranges for advancement and I'm someone who likes definite. Also it was vague on what was allowed and what wasn't within a stage. I had to call my nut a number of times.

I was very fortunate to have two insurances when I started my journey. My primary required 6 months of "nutrition counseling" which consisted of a monthly call in to a nutritionist to discuss my diet history, habits, and plans for after surgery. I ended up only having two months of this as I lost my primary insurance when I retired. My husband's insurance did not have that same requirement, however, my surgeon's office has quite a rigorous program. I had several preop visits with my surgeon, three required nutritionist visits, and received detailed postop instructions including diet phases. Postoperatively, I had a one week, two week, one month, and six months visits. I also have monthly calls from a bariatric nurse which is required by my current insurance. It is very helpful to talk with her as she has also gone through this process. I have had fast food once since my surgery and could only eat part of the burger patty. Bread seems to fill me up fast so I don't eat much. I used to be a Diet Coke fiend and haven't had this since surgery. I seem to have list my taste/cravings for fast food. I'm seven months out and continue to follow my program. I faithfully log all my food & water intake and I journal daily. I'm not perfect and have had some instances where I've eaten too much which makes me SO uncomfortable! But all in all I'm happy with my progress. Surgery - RNY GBP Surgery Date - 5/16/2017 HW - 368 SW - 352 GW - 150 Sent from my Note Edge

It felt great to get out today and renew my gym membership it's just 25 a month! Getting my sweat on has been a go-to stress reliever for me for a long time, now I just need to not overdo it...oh look at all the shiny weights! I'm day 48 out and feel great.

You really need to get to the root cause of your anemia. I struggled with this for YEARS and it does make you feel lousy, so I'm sorry that you probably feel that way. Its my understanding that iron infusion are pretty dangerous. Vitron C -- I took that stuff for years. Celiac disease is a hidden cause worth considering, and easy to investigate if you are already getting an upper endoscopy pre-surgery. Bariatric vitamins come with and without iron, fwiw.

If you are having a bypass, NSAIDs are generally prohibited due to specific problems associated with that procedure; I have seen references to a few surgeons who approve NSAID use with a bypass under limited circumstances, though they are few and far between. The sleeve based procedures don't have the same problem as the bypass, so those patients are more tolerant of NSAID use, closer to a "normal" or non-WLS person - who should still be careful with these meds as they can do unpleasant things to even normal people. Many bariatric surgeons lump all the procedures together on this matter owing to their extensive bypass experience relative to their sleeve experience; those with greater sleeve experience tend to be more amenable to NSAID use, but it still shouldn't be a routine or everyday thing. Here is one prominent sleeve surgeon's view on the matter:

Yikes!!! That is like week 2 bariatric surgery level calories lol. It may be difficult to tell if that is from the fasting or from weird hormonal things happening because of extreme restriction. I wonder what it would feel like to do the all day fast and then have an 1800 calorie (healthy obvs) dinner.

Thanks, everyone! I bought some vitamins last night! Centrum adult chewables, lemon-flavored B12 sublinguals, I already take 5000 IU D3 so I'll keep using those, 65 mg iron, and calcium citrate + D3. Those are the five required by my bariatric surgeon. I bought the iron even though I don't technically menstruate (the booklet said "for menstruating women only") - between PCOS and my Mirena IUD, I don't get periods pretty much ever, but I'm assuming with weight loss my cycles will regulate, so I bought the iron just in case. Even then, the Mirena may still stop my period, though... LOL, I literally have no idea what my cycle is doing, ever. But better to be prepared I guess! I like the Premier Protein chocolate shake but I have not tried any others yet. We found a protein broth at Costco but not sure how many calories. On my liquid diet the broth has to have 10 calories or less. I wish there was a way to find samples instead of having to buy a big pack of stuff you aren't sure you'll like.

I didn't have a supervised diet before surgery, but i did receive very clear post op instructions as well as a lot of in person follow up. If I could give advice to any pre-sleevers (or other bariatric procedures) it would be to choose a surgeon/ surgical center AT LEAST as much on their support, education and follow up as any other factor. This bariatric thing is no joke, it's a lot of work and you may very well need the support in the long run.

Absolutely No Advil or no to any NSAIDS Tylenol is the only OTC Pain Medication allowable from our doctor & most all bariatric periodicals are the same. You should be able to call or email your doctor/nutritionist anytime there are questions about your choices about anything. Good Luck hope this helps answer your questions & hope you get to feeling better. Have a Merry Christmas & Safe & Happy New Year

Hey surgery buddy! I'm probably on the same timeline as you! I'm eating my surgeon/RD specified diet. Losing the specified amount of weight. Doing PT to re-build my strength and help my balance issues. Walking daily. Researching the hell outta dis. Annoying everyone on Bariatric Pals by over-posting and posting as if I know something about anything when I haven't even had surgery yet. I've bought protein, tested it, and stocked up. Tested and purchased my vitamins. Made bone broth and stewps. Cooked meats and put them away. Bought the cutest little silicone freezer trays that have lids so I can easily freeze 1/2cup of food at a time. Have darling little glass food storage containers at the ready. And there might have been some shenanigans involving wine and homemade olive oil/truffle popcorn while watching Christmas Vacation on Saturday night...but it's all foggy to me...

I think that would only be a concern if you drop below the benchmark of BMI 35. Many people who are undergoing bariatric surgery, like myself, have a BMI of 45 or 50 or 55 and it would take 100 lbs or more of weight loss to get close to BMI 35. We don't know the OP's weight so we can't say for sure. The less you weigh when you hit the table the day of surgery, the safer your surgery will be.