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From what I know if you look at your BMI range, it is the top figure weight, say in my case, 78 kg. You now take your current weight, which when I started surgery was say 128 kg. Sorry I work in Metric but it works the same in imperial. 128-78 equals 50 kg. That 50 kg is my XS weight, so if mini gastric bypass has a predicted loss of 70 to 85% of the XS weight then it is 70% of 50 kg to 85% of 50 kg. I.e 35 to 59.5 kg is what I am expected to lose with the procedure. When it comes right down to it from what I understand. If like me, you have been obese all your life. Then you will have thicker, heavier bones to support that weight, more skin to wraparound it and a larger heart to pump blood around your body, so that means no matter what the general BMI limit is it is not totally relevant and there has been some suggestions by bariatric surgeons that to aim for a BMI of 30. BMI is intrinsically a flawed concept as it does not take into account, body muscle mass. You will know the example of the brick **** house musclebound New Zealand rugby player with no fat, looking like a crazy obese person on paper because they have a BMI of 45. I am 52 this year, so I think I would be happy with something above the BMI range. Otherwise my skin will waft in the breeze! 🤣

I kept losing for almost another year after I reached my goal. It began at a similar rate of loss as I was experiencing but gradually got less & less until it stopped. Over that time I increased my calorie intake (added more & more snacks) & my portions got a little larger. I was eating about 1300 calories when I initially stopped losing but eat about 1500/1600 to maintain at about the same weight now. Like @Spinoza, I’m a believer in our changed set point. This is the weight my body is happy at & this is the weight it wants me to be thanks to the surgery. Could I eat my set point up? Yes, if I wanted. I mean that’s what we did before - ate our set point higher. Our original set point wasn’t an obese weight. Don’t forget you may initially stop at a lower weight than you expected but it may give you wriggle room if you experience the bounce back regain around years 2 or 3. Give your body time to resettle. Lots of things change when your weight starts to stabilise. Just give it time. Slowly increase those calories. Get in touch with your dietician for ideas of what you can add or how you could adjust your current eating plan. Good luck.

OK. I would email the person saying you need to lose this set amount well in advance. Set out your loss to date. Explain what the surgeon told you and how you formed a reasonable expectation that anything under 130kg and you would be good to go. Explain that you have been restricting your diet in the expectation of a surgery date and that your loss since referral is actually 11kg, far in excess of the required 3.5kg. I hope that you CAN lose something ahead of your date but I think stacking up the evidence about the conflicting advice you've been given might give you grounds to complain if you're turned down. Don't wait till the day of surgery to say all of this. Call them out right now on what they're asking.

Hi everyone! This is my first post, so please be kind 😅 I'm currently 18 years old and my surgery date is set for March 26th, 2024. Only two more weeks to go! Both of my parents have had weight loss surgery, and the main difference between the program they went through and the one I'm going through at my children's hospital is how long it took. I had to complete a six-month program which started in July, plus other miscellaneous appointments. I'm just curious if anyone here had their surgery in their teenage years or as an early adult. How was adjusting to the new diet while also being in school? Is loose skin more or less common in younger patients? Please comment if you have any answers, tips, or words of encouragement. I look forward to hearing from the people! Lol

I am so excited for you!! Yaaaayyy!! It is really crazy how changing fluids and sleep can make a difference in weight loss! I too notice it immediately on the scale when I slack. It is common knowledge, yes, but so many people brush it off as unimportant when compared to food or exercise. But man, sleep and hydration will undermine your efforts elsewhere if they aren't on point. You are doing an awesome job, pat yourself on the back for changing two habits it would have been easy to ignore!

These things can & do happen. Constipation is often an ongoing issue for many of us at least until we’re eating a broader range of food like vegetables & fruit. Try adding a soluble fibre to a drink, shake, soup, yoghurt, or similar to help. I used to take a stool softener if I hadn’t gone for three days to keep on top of it. Remember too you’re not actually eating that much so you don’t have much to actually poop out especially in the first couple of months. So don’t expect to go every day. Meeting or being close to your daily fluid goal is extremely important because of dehydration. Sip, sip, sip. I still drink during the night to ensure I reach mine. (Have a drink whenever I wake.) Your throat can be swollen for a little while after the surgery though it does generally pass in a couple of days. Do mention it to your surgeon when you go for your check up if it’s soon otherwise give them a call. Try drinks at different temperatures in the meantime. Many of us found warm or hot drinks more soothing than cool or cold drinks. And again sip slowly. Also remember we all heal & recover in our own way & time. This is a pretty major surgery & some take a little longer or can experience some challenges with certain aspects like hitting fluid or protein goals, or experience a little more surgical pain, have more gas pain, take a little longer to get their strength back, tolerate or not tolerate certain flavours, textures, smells, etc. Like your weight loss, your recovery may be a bit erratic. Easier today, but tomorrow not as much, then the next day is okay. Look back over a week to better see your progress. You can be sure that it does get better & easier in time. All the best.

I am currently almost 6 months post op for my original procedure and am writing this from my hospital bed. I am unable to tolerate oral intake of food or fluids of any kind and am being fed via a nasojejunal tube (NJT) and TPN via a peripherally inserted central catheter (PICC) My surgeon along with many others that have consulted on my case are at a complete loss for what is going on and why I can't tolerate anything. I'm reaching out to fellow people who have undergone bariatric surgery in the hopes of finding someone else with a similar experience to maybe get some opinions/answers. In order to do this I will start from the beginning and tell you all my entire story. I know it's long but I am desperate so please bear with me and read to the end. I will try to explain everything but also be as brief as possible to keep it as short as possible. I had surgery at the end of November 2023. It was a One Anastamosis Gastric Bypass or "mini" bypass. The surgery was routine and there were no issues whatsoever. I couldn't tolerate fluids and my intake was too poor to be released from hospital and progressed to vomiting every time I drank anything. Was diagnosed with a stricture and it was dilated and I finally started progressing. I was discharged from hospital finally almost 2 weeks post op (booked in for further dilatations at regular intervals to slowly stretch the stricture) and was home for less than 24hrs before it began again and my surgeon readmitted me and I underwent another dilatation. Upon getting back to my room I started violently vomiting and no amount of antiemetics would settle it. Emergency CT scan confirmed the stricture was perforated and my stomach contents were leaking into my abdominal cavity. I developed sepsis and had a nasogastric tube inserted for drainage. I underwent IV antibiotics and was later rushed to surgery to repair it, however due to the damage from the infection, it required a conversion to a Roux EN Y Gastric Bypass (RYGB) and I needed my abdomen washed out and other infected tissue removed. It took about 5 hrs. I spent a further month in hospital recovering, initially on TPN to supplement my oral intake but was wraned off as my tolerance improved and was finally discharged. At this point in time I had progressed to a pureed diet. I was by no means meeting my requirements but the benefits of being home vs hospital given everything outweighed the negatives and my surgeon planned on seeing me weekly as well as my dietician. Now here is where is starts to get weird and my real troubles began. Just over a week later I woke up one morning and had a sip of water (with a few drops of cordial to break the surface tension) however as soon as it went down I experienced a wave of nausea. It was different from before, I can't really explain the difference but I just ignored it believing it would go away (Denial as I just wanted to get on with my life and get back to work and due to the conversion surgery, my surgeon had created an extra large opening to account for my body closing the join so that it would end up a normal size.) I started experimenting with foods and fluids, different textures, consistencies, temperatures, etc. I tried absolutely everything I could think of. About a week or so later and my intake was getting progressively worse and I was once again admitted and went straight for an endoscopy (My 3rd since 1st surgery) to dilate the suspected stricture but there wasn't one. I then underwent a barrage of tests and every general and GI surgeon/specialist in my town came and consulted on my case, as well as my surgeon consulting doctors from all over. A NGT was eventually inserted and enteral nutrition (EN) started but was not tolerated and the tube was advanced into my intestines to be a NJT, which was then tolerated but the focus was on trying to get my oral intake to be adequate. I spent weeks in hospital trying different medications, getting tests and ruling out different conditions. I was discharged on EN with the NJT on 16 hour feeds at a rate of 50ml/hr which was not enough to meet my nutrition requirements but was the Max rate I could tolerate and the belief at this stage was that the nausea would go away and I'd be able to eat again. On the 8th of May I was admitted for a gastronomy tube insertion into my remnant stomach via laparoscopy as it was finally decided that this problem was not going away and by this stage I had lost 38kg (84lbs) and was severely malnourished, despite increasing my feed rate to 60ml/hr (still not enough to meet nutritional requirements) The purpose of the gastronomy tube was not only to have a more discreet way of feeding and for comfort and whatnot but because the tube is in my remnant stomach, I should be able to tolerate a much higher rate to actually meet my nutritional requirements and spend less time attached to the feeding pump. Feeds were commenced at 20ml/hr the next day but I developed severe pain and discovered feed had soaked the dressing around the tube. I was yet again rushed into surgery as the tube was leaking. Another NJT was inserted along with a PICC line and both EN and TPN were started to maximise my nutritional status while we wait for my body to heal around the tube in order for that leak to stop happening again. I've been on IV antibiotics and whatnot since as well. I developed a fluid collection in my abdomen and needed a percutaneous drainage which failed as the fluid was too thick to aspirate and a minor infection at the insertion site and it was believed that there was a fistula however luckily that was not the case. However yesterday I had a fluroscopy in which contrasted was put into the tube to see what happens and whether it's now working correctly and that caused me to violently retch as my body tried to expel the fluid from my stomach but as its not connected to my oesophagus anymore, it was unable to do so. This has now lead me to start worrying about whether whatever issue is preventing me from tolerating anything going into my pouch is affecting my remnant stomach too. I'm now facing the prospect of permanent EN and TPN for the rest of my life and I'm not even 30. So if you or anyone you know has any ideas or similar experiences or literally anything, please let me know. Even if it's just a chat because I feel so incredibly alone in this. To anyone that made it this far, I appreciate you taking the time to read this and thank you in advance for any responses. I'm happy to answer any questions you may have as well.

I know it’s hard, it’s almost inbuilt, but try to avoid comparing yourself to others. Our weight loss experiences can be so different & comparing only leads to frustration, annoyance & sometimes depression. There will always be those who lose faster or those who lose more slowly than others. There isn’t a time frame in which you must lose your weight. You’ll get there in your time. Weight loss is erratic. Better to watch the general trend not the daily fluctuations. If the general trend is downwards you’re golden. Yay! As I always say: celebrate every pound you lose. P.S, @BlondePatriotInCDA - Ten pounds a month is still averaging about 2lbs a week which is generally accepted as a good rate of weight loss. And you’ve lost 80lbs! Worth being happy about.

Yep, stalls are a very normal & common part of weight loss. In fact they’re important. Your body shuts down to reassess your needs based on your changing weight & alters digestive hormones, metabolism, etc. The stall will break when your body is ready to move forward again. It will take the time it needs. Don’t stress it more by making more changes to your diet or activity above your plan. They can be frustrating but you really just have to ride it out. Yes, to only waiting 30 minutes before & after eating to drink too. Check with your team about collagen. While it does contain protein it is not a complete protein as it doesn’t include all the necessary amino acids so usually can’t be counted towards your goal. I believe there is a collagen powder which has added the missing amino acids but I can’t recall the brand. Use unflavoured protein powder instead to add to soups, shakes, porridge, etc. All the best.

I have never measured myself on any diet. Am totally focused on weight loss and have absolutely no idea of any body measurements, LOL. I know that others do the opposite. @GreenTealael your post is super interesting including the before and after bodies. Thank you for sharing!!!

I don’t know. That would take more research to figure out because the SELECT Trial was conducted on the basis of participants being 45 or older, having preexisting cardiovascular disease and a BMI of at least 27 but no diabetes (link 1&3) However some of the improved cardiovascular metrics occurred before significant weight loss (link 2 explains). Interestingly, on Novonordisk’s website under their R&D pipeline (link 4) Semaglutide is not listed (yet) as being in trial for cardiovascular disease as a primary treatment. If anyone else has more info please chime in! https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=166301 https://www.tctmd.com/news/full-select-results-affirm-cv-risk-reduction-semaglutide-nondiabetics https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 https://www.novonordisk.com/science-and-technology/r-d-pipeline.html

Dr. Josh Roller (Roller Weight Loss) has a GREAT segment on the podcast he’s on going over best surgeries if you need revision. I just finished listening to it. It’s on Spotify (& others) “The Skinny Truth”. I’m set up to get the Modified DS in the next few weeks with him.

Yes it is very normal. Do not get discouraged. Remember your body just went through a major surgery and it will take time to adjust to such rapid weight loss. This is normal throughout the process and won't just be one time. Stalls and small fluctuations are par for the course. You have lost a major amount already and you've just begun. Keep in mind that it's not 5lbs of fat gained. It can be anything from water retention from a little more sodium and/or carbs or not having had a BM or something else. Further in when you're actively working out, it can be muscle gain. Your hormones and internal system are trying to find their place and rebalance. Stick to the program and if you weigh everyday, try not to for awhile if it makes you anxious or gets you down. It will move again. Also if you haven't already, take measurements and pictures. A lot of the changes can happen that are non scale related you'd be surprised.

I am so glad that you are still reaching out to your team and posting here. I won’t get too far into my story but because of “confusion,” about my mental health, interactions with meds and embarrassment the help I got from my team was not working for me and I gave up. I continued to gain and now I am back here facing revision weighing a little more than when I started this journey. People here are very helpful and understanding but your team should be giving you answers too. Sounds like they have a plan for the next step if need be and that’s great. if all else fails, The phentermine is the one medication that I could try which did work amazing during the day for me but I suffer from insomnia and when I can’t sleep I eat. So, the meds worked wonderfully during the day but at night, with my larger sleeve and being awake so many times, I was able to consume too much for the whole day and I still gained. But I can see how if you sleep throughout the night it really could work. I didn’t get to try mountjourno or any of the other brands it’s sold under because of financial reasons but if you can swing it, I have heard AMAZING things about that medicine too (there are some side effects for some people to consider). People claim they think they must know how skinny brains feel after taking it. They just don’t ever have to think or worry about food. One lady has to set alarms if she is busy to remind herself to eat something. Another drawback is how long you have to take it. Some say when you go off it you start to gain. They are doing studies now where they are trying to work out a maintenance dose that may be less than the regular dosage though. There are also places that are starting to “compound” it at compounding pharmacies. I wouldn’t necessarily trust the stuff from random sites online but my PCP was telling me they were working on getting it in their office and it is less than half the normal cost that way. I don’t know much about the other weight loss drug options because I couldn’t take them with my bipolar meds Interestingly, i just seen an ABC special Oprah did on weight loss injections the other night. (Ironically it was the day I went back to see my surgeon so I thought maybe it was meant to be which is why I inquired about them with my PCP). I’m really hoping that reached someone that has the power to change how accessible these meds are. I asked my pcp and she said it’s probably going to take a little while like everything else and she thinks at this point I shouldn’t wait on surgery for that but if your interested keep asking questions because these things tend to just change in the middle of the night and the word takes a while to reach you if you not the one asking. Anywahs, kudos to you for not giving up. Let your team do all they can to help you and keep posting here!!. I think when I stopped that I lost all hope. I was so isolated. Surrounded by skinny family and having only one heavyset friend who is perfectly content being that way I don’t have a lot of real life people who understand me the way that this community does. I felt so ashamed and I didn’t want to drag down the vibe here with my failures. Since I have returned I have been welcomed with open arms and honestly don’t know why I ever doubted that I would be. Keep doing what your doing and you will work this out. I know it. 🤗

I am 7 weeks post op revision to bypass and loss 20 lbs. I am currently in a stall for a week already. In April which is only a few weeks away, we have a family trip taking my young children to Disney World. It’s a 9 days trip where I will be away from home. I would like advises and Suggestions from all of you who went on trips post op. I feel like it might be hard for me to find something healthy when I am on this trip. Help

Well you are being such a trooper I’ll tell you. I hope you get it worked out real soon. Probably stuff you already know about the low carb if you’ve had a sensitivity to gluten. I just going to say that I learned that fajitas and Italian sausage witb peppers and onions which I like both (minus the rice of course) are relatively low carb. And cauli rice isn’t bad as long as it’s mixed in something witb flavor. Night before last I learned that crustless quiche is super easy to make and In the muffin tin it’s perfect little portions. Last night I made a low carb Italian bake that was Italian sausage with spinach and cheeses (the recipe called for mushrooms but I substituted onions). That one I’m not sure about the fat though. It wasn’t listed but for 6 servings it has two cups of mozz cheese, a quarter cup Parmesan and 16 oz of ricotta. I’m waiting to hear from my surgeon what my post op fat requirements will be and I need to work that out and see if it’s on plan. That recipe worked out to 373 calories but I didn’t calculate the fat before I tossed all the packages. Tonight I had leftovers of the Italian bake that is probably too fatty and I baked instead of cooking . I made low carb banana muffins that another poster shared with me and they are pretty yummy. They use almond flour and allulose to cut the carbs. They are surprisingly tasty. Basically I am not really a big cook and I did not experiment with healthy dishes last time around. I Just tried to commit to eating like you have to now (meat and veggies) but for life and I couldn’t do it. I got board and I found things that were within the allowed calories while the portions were small but once I could eat more they actually added up too fast. This time I’m just trying ti find at least A handful of things that are actually tasty to me that will work when I finally get back to regular foods. Something to look forward to while I’m in the weight loss stage. And it’s kinda weird but I’m not hating the cooking as much as I used to. It’s kinda like knowing that it’s actually something good for my body makes it a little less of a chore to me.

Expansion on the use of Semaglutide: “The popular weight-loss drug Wegovy, which has helped millions of Americans shed pounds, can now be used to reduce the risk of stroke, heart attacks and other serious cardiovascular problems in patients who are overweight or who have obesity, federal regulators said Friday. The U.S. Food and Drug Administration approved a label change requested by drugmaker Novo Nordisk that expands the use of semaglutide. The decision was based on the results of a study that found that Wegovy cut the risk of serious heart problems — including heart attack, stroke and heart-related deaths. Higher-weight patients with heart disease but not diabetes were 20% less likely to experience those problems compared with patients who took placebo, or dummy shots, the study found.” https://www.npr.org/2024/03/08/1237133257/fda-approves-wegovy-heart-attack-stroke-risk#:~:text=Hourly News-,Wegovy approved to lessen heart attack%2C stroke risk in overweight,have obesity%2C the FDA said.

Firstly, well done on losing the pounds pre and post op. I had similar happen, put on some lbs in the initial weeks after the surgery and it worried me at the time and made me question if everything I was going through was worth it. So while it was slow going at the start I have made up for it since. Our bodies are all different so don't upset yourself by comparing your timeframes and losses to others but just let your body go at its own pace while it adjusts. Even when you think you are not loosing lbs you are making healthier choices and loosing fat. As an example, I bought a pair of trousers a few weeks ago for work and they fit beautifully, last night I tried them on for going to the office today and they were massive through the hips and thighs even though in that time I had only lost 2kg/4.5lbs in that time. Of course I had taken the label off so can't return, another item for donating!

I unfortunately only spent a few months following surgery without being overly hungry, but after about the three month mark it came back with a vengeance, so I decided to do some research. I now consume Non digestive or Resistant meladextrin. Its a corn fiber that your body can't digest so; no calories, good fiber and probiotics purported to help with the following: Resistant maltodextrin is believed to enhance gut health by [19, 29, 30]: Promoting the growth of good gut bacteria Improving stool weight, consistency, and bowel movements According to some researchers, resistant maltodextrin has potential against obesity, diabetes, and heart disease because, in various studies, it has [31, 32, 33, 34, 35, 36, 37, 38, 39]: Reduced belly fat and body weight Decreased food intake Increased satiety hormones (glucagon-like peptide-1 and peptide YY) Lowered the production of the “hunger” hormone (ghrelin) Reduced blood sugar levels and insulin resistance Blocking the growth of cancer cells and tumors ** hasn't been proven** Decreasing endotoxins, inflammatory cytokines and oxidative stress markers (TNF-a, IFN gamma, MDA) Increasing protective antibodies and anti-inflammatory substances (IgA, butyrate, IL-10) In clinical studies of over 200 people, resistant maltodextrin enhanced the growth of good gut bacteria, including [19, 29, 44, 47, 48]: Bifidobacterium Ruminococcus Eubacterium Lactobacillus Lachnospiraceae Bacteroides Holdemania Faecalibacterium As a resistant starch, this type of maltodextrin will help keep your blood sugar level stable after meals. In a meta-analysis of over 900 people, resistant maltodextrin blocked the increase of blood sugar after meals (postprandial glycemia) [37]. resistant maltodextrin decreased blood glucose and insulin levels. It increased a weight-loss protein called adiponectin that blocks glucose production. 3) Obesity In several clinical studies of over 300 overweight people, resistant maltodextrin reduced body weight, body mass index (BMI), and body fat. In one 12-week clinical study of 30 people with metabolic syndrome, it decreased waist circumference and belly fat [31, 55, 35]. In clinical studies of over 160 overweight men, resistant maltodextrin decreased feelings of hunger, increased satiety, and reduced and food intake. In another study on 32 healthy people, it decreased levels of the “hunger” hormone (ghrelin), lowered feelings of hunger and improved satiety [31, 32, 33, 34]. In rats, resistant maltodextrin reduced body weight, belly fat, and suppressed excess food intake [56, 6, 50 I found numerous research studies that pretty much said the same things above..so I figured I'd give it a try. It has no flavor and desolved completely so I just add it to my water plus it has no calories and helps regulate Ghrelin (hunger hormone). It really seems to help! I just make sure its non GMO etc etc. Perhaps it can help you, I figured it couldn't hurt and I do feel less hungry...still by try but less.

Well, I think you look spectacular and very healthy. The transformation is absolutely stunning! I also think as our population trends heavier, we don't see the extra weight as much. I was a chubby kid, and I was like one of maybe 3 chubby kids in my entire grade, not just my class. I dieted like an idiot as a teen and got down to 126 lbs and I was nowhere close to the thinnest person in my friend group. Nobody said anything about me getting too skinny, for sure. I gained weight in college and by the time I graduated, I was overweight again, and obese by the time I hit my late 20s. I always felt like the biggest person in the room (at, like 210 lbs). But by the time I was in my mid-30s, I started seeing bigger people than me all around. Everyone was getting bigger. My weight went up to 225, but many of the parents of kids in my daughters' grades were way bigger than that. It almost had an insulating effect from my own weight gain, because I was no longer the biggest person in the room. I just kind of looked normal. When a friend heard I was getting bypass, her first response was "but you're not that big" and at this point I was 250 lbs with a 40+ BMI, plus high blood pressure, prediabetes, and high cholesterol. And this was from a person who is in the healthy BMI range and never been overweight. So I definitely think we've become so used to seeing larger people that we think "obese" is a term reserved for the people on television shows who weigh 600+ pounds. And, of course, the rapid weight loss from surgery is jarring so people notice it more. But don't let their comments get to you!

I have a question for folks that may have experienced this. I'm not convinced it is 100% related to my surgery since I had some of these symtpoms, albeit milder, prior to my surgery. I felt like the dizziness and general weakness went away the first 4 weeks following surgery, and I was able to walk 2 miles easily without stoppoing, and 4-5 miles a day with minimal rest. I was really looking forward to going back to the gym once I was cleared to lift weights. However, I caught Covid, and was mostly stuck in bed for 2 weeks over Christmas and New Years, around the time I was working in solid foods again. Since then I'm barely able to walk 1 mile without stopping, and even then I need to rest for over an hour to feel right again. It's gotten progressively worse, especially in the last two weeks, to the point that I don't feel comfortable driving when the vertigo and extreme fatigue hits. It's to the point that I'm falling off my treadmill if I go more than a half mile. It went from being somewhat disruptive previously to debilitating now. Luckily I work from home, but even that is starting to get disrupted. Over the past year I was evaluated for heart issues, had 3 MRI's, a CT scan, echocardiogram/ultrasound, had my carotid checked, been to two opthamologists and tried two different pairs of glasses, checked out by a Neurologist and Neurosurgeon, evaluated by an ENT, went to a hearing and balance specialist (no Menieres disease, inner ear crystals, etc), normal BP (between 110 and 130 systolic, and 70-85 diastolic), Blood Sugar has returned to my pre-diabetic levels (92-98 fasting, and no higher than 130 when checked 2 hours after eating). Pulse Oximeter is showing O2 staying between 95-98. CPAP was re-titrated to treat sleep apnea following the weight loss. Blood labs showed Total Cholesterol and LDLs somewhat high, but decreasing steadily since my surgery in November, High levels of Iron and Calcium though, but everything else plus thyroid were normal. Heart rate has dropped from pre-surgery rate averaging around 80-90 bpm down to 40-55, but my PCP wasn't able to determine why. My father and grandfather (currently 92) both have a normal heart rate between 45-55 for their whole lives, so maybe that one is hereditary. Thanks for reading and any advice is appreciated!

Hi all, I am writing this for the >1% of gastric bypass patients who have the unusual complications that I had and, like me, couldn't find any information about it online to ease your mind. I had my gastric bypass surgery on September 7, 2022. I chose gastric bypass over the gastric sleeve specifically after months of research because of the higher rate of successful weight loss, particularly in women. My first week post-op went great, but after day 8 or 9 when I tried progressing my food intake from full-liquids to pureed foods I began vomiting and feeling really nauseous at every meal. I let my surgeon and dietitian know immediately and stepped my food intake back down to full-liquids. Pretty soon, I couldn't even take in full-liquids and was limited to hydrating fluids and chicken broth. I could keep down hydrating fluids and broth about 80% of the time, full-liquids 50% of the time, and everything else came back up. My surgeon was very responsive and had me get an endoscopy. Under general anesthesia, the endoscopy explored my new stomach pouch and roux limb connections that make up my new tummy system. Typically, gastric bypasses can result in constriction of the connection between the stomach pouch and roux limb, and my gastroenterologist was prepared to use a balloon to inflate the area to ease that restriction. In my case, however, that area looked fine, but further down the roux limb there was a stricture that was almost impassable for the narrow scope. This is what was causing my problem. I had an external compression on my roux limb that was making it impossible for anything more viscous than water to pass through. My layman's understanding of what had happened is that my surgeon brought my small intestine / roux limb up to meet my new stomach pouch through the transverse mesocolon. This involved cutting a hole through the transverse mesocolon to put the roux limb through and then stitching it up a little on either side to make sure nothing else will slip through the hole and cause a hernia. Apparently, this is typically sufficient and there is space enough in the hole in the mesocolon for scar tissue to form but still allow the roux limb to operate appropriately. Not in my case! xD My body and over-active immune system saw a hole and decided that hole must. be. fixed! The scar tissue that formed to close the hole closed tight enough on the roux limb and it was tight enough that barely anything could get through. I had a second laparoscopic surgery on October 12, 2022 to remove the scar tissue and loosen the compression on the roux limb. My surgeon decided to remove the small stitches on either side of the hole in the transverse mesocolon to reduce the chance that any new scar tissue will close the hole up as completely again. Immediately after this second laparoscopic surgery, I felt tons better! I stayed overnight in the hospital and was put straight on full-liquids, which I was barely tolerating before! The reason I am writing all of this out is because, in the month-long interim between surgeries, I couldn't find anything in my online research to figure out what was wrong, or what I could try, or what the next steps looked like, or how long, or why this was happening. I went for more than a month on little to no substantial nutrition, and I found so little information on what to expect or how long I would have to live like this. I even looked in these forums to see if anyone had asked about symptoms that are similar to mine and I didn't find very much information. So, I'm writing about my experience and using as many of the keywords I can think of that I've been searching for over the past two months! So! If you had gastric bypass and you start experiencing nausea and vomiting after what seems like typical food progression, please speak to your surgeon. It could be an internal stricture of the roux limb or the connecting bits, or in my case an external compression of some sort. From the very few resources I could find online, my type of external compression of transverse mesocolon on the roux limb seemed to occur in 0.9% of gastric bypass patients and it seems to happen within the first month. My surgeon pretty much immediately knew what was wrong, and her PA said she had seen it before, but not often, and it was new for my insurance caseworker. The inability to eat made it very difficult to complete normal daily tasks like my job, housework, walking the dog, etc. I wasn't in pain, I just couldn't get enough energy to do anything! My doctors moved quickly to get me back in for surgery, but it still took 4-5 weeks from starting to vomit at each meal to waking up from my second surgery feeling much better. I am so thankful that my surgeon was able to fix what was wrong with the scar tissue compressing around the roux limb; it made a world of difference! I'm not out of the woods quite yet, however. Six days after the surgery to repair the hole in the transverse mesocolon, I had a bad food day and nothing stayed down. I immediately reached out to my surgeon's office and today went in for an upper GI in which I intake contrast dye while a doctor observes how it flows through my new gastrointestinal system with an X-ray. That doctor said it looks like the connection between my stomach pouch and roux limb looks stenosed now. I am grateful that they found something and that there is an explanation for why everything I put in my mouth makes me nauseous and that there's a reason why I don't want to eat anything. I will be having another endoscopy in the following couple of weeks and, as ever, I am hopeful that this will be the last surgery that I need for my gastric bypass.

Thank you!! I am incredibly happy. Getting my Vitamin D from 13 to almost 100 has done wonders for my depression. The extra energy DOES feel amazing, especially because I have Chronic Fatigue Syndrome and I never really expected the surgery to impact that favorably. The first 4 weeks were hard energy-wise. I remember how exhausting even taking a shower was until I was past a month out. Bariatric surgery is major surgery and it takes our bodies a while to heal from that. Add in our dietary restrictions as we slowly incorporate food again and it is a great recipe for fatigue. I'd say by about week 8 the nausea disappeared and I noticed I was gaining energy steadily. I could stand in the kitchen and cook. I could go for a short walk. I could shower and actually leave the house without a nap first. I had not been able to do those things in several years so it was a striking difference. Hang in there!! It is a good sign you feel about back to normal energy-wise right now! Yes, according to everything I've read, the goal is 50% by 6 months for a DS surgery, so I'm ahead of my goal. I really hope things continue on steadily. A lot of people lose a chunk early on and then taper down slower after month 3. My body doesn't like to follow general trends, so I stalled out for most of that time and then suddenly my weight loss sped up! It is quicker now than it has been since about a week post op. Isn't that funny? Everyone's body has its own rhythm. It is so, so hard to trust that, but it seems to be true the more people I see go through this surgery.

It really is. I am absolutely certain that I would never *ever* have lost the weight I did if I hadn't been here from day 1. 20lbs loss in a month is amazing. Compare that to ANY diet you did in your life before surgery - unbelievable. Yes there will be stalls and regains, but if you stick to your programme then the general trend will be downwards. I hope you will be happy with where you land 🤩