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I’m at almost a decade post op and moved away years ago from where I had RNY surgery. Over the past six months I e had repeated abdominal pain that my Dr keeps trying me on Pepcid for and is referring me to a gastroenterologist. I’d like to find one with experience/interest working w post- bariatric patients but most bariatric specialists are surgeons. Anyone else dealt with this? Particularly in the Phoenix area? Ty!

Some good stuff being brought up about "big boned" being another denial. Being honest is important. That said...there ARE different frame sizes, different statures, different body styles. My bestie and I are both 5'6". She has size 6 feet, I have size 10. She looks great at 150 #, I look great at 170#. She has teenie little paws and can wear itsy bitsy rings. I have large hands that completely cover hers with an extra inch. Boob size can turn a size medium girl into an XL shirt wearer. Boobs are a wildcard, too. I definitely support not lying to yourself that "you're just big boned"....but also want to to balance this. There's a different body style inherent to being a fit Dutch girl, a fit Asian girl, a fit African American girl. Individual differences, too. We are not all the same....which is why Arnold Schwarzenegger had an obese BMI when he won Mr. Universe. Bodies vary.

Introduction Bariatric surgery is an effective treatment for obesity and obesity-related health conditions, including diabetes, sleep apnea, and hypertension [1]. With this transformative procedure comes a new way of life that often requires significant adjustments to dietary habits. One essential aspect of post-bariatric surgery care is ensuring patients receive adequate vitamins and minerals to support their overall health. This article will discuss the importance of using a one-per-day multivitamin capsule for bariatric surgery patients, address the misconception that these patients have difficulties swallowing capsules, and review relevant medical studies. The Importance of Multivitamin Capsules for Bariatric Surgery Patients Essential nutrient absorption: Bariatric surgery can lead to reduced absorption of essential nutrients due to changes in the gastrointestinal tract [2]. A one-per-day multivitamin capsule ensures that patients receive the vitamins and minerals they need in a single, convenient dose. A study published in the journal Obesity Surgery found that multivitamin supplementation significantly improved nutrient deficiencies in post-bariatric surgery patients [3]. Compliance and ease of use: A one-per-day multivitamin capsule is easier for patients to incorporate into their daily routine compared to multiple doses. This can lead to improved compliance and better long-term health outcomes. Research conducted by the American Society for Metabolic and Bariatric Surgery (ASMBS) supports the use of single daily doses to promote adherence to supplementation protocols [4]. Reduced risk of deficiencies: Post-bariatric surgery patients are at an increased risk of vitamin and mineral deficiencies, particularly in iron, calcium, vitamin D, and B vitamins [5]. A one-per-day multivitamin capsule helps to prevent these deficiencies and supports overall well-being. A systematic review published in the journal Clinical Nutrition found that multivitamin supplementation was associated with a reduced risk of micronutrient deficiencies following bariatric surgery [6]. Debunking the Myth: Bariatric Surgery Patients and Capsule Swallowing There is a misconception that bariatric surgery patients have difficulties swallowing capsules. However, no medical evidence supports this belief. Capsules are designed to dissolve as soon as they get wet, making them an ideal choice for bariatric surgery patients. Rapid dissolution: Capsules dissolve quickly in the presence of moisture, ensuring that they do not cause any issues with swallowing or digestion for bariatric surgery patients. A study published in the International Journal of Pharmaceutics found that capsules typically disintegrate within a few minutes of coming into contact with moisture [7]. Easier on the stomach: Capsules tend to be gentler on the stomach compared to tablets, as they do not contain binders or fillers that can irritate the stomach lining. This is particularly beneficial for bariatric surgery patients, who may experience increased sensitivity in their gastrointestinal tract. Enhanced absorption: Some vitamins and minerals are better absorbed in a liquid or capsule form rather than a tablet, ensuring bariatric surgery patients receive the maximum benefit from their supplementation. Research published in the Journal of Dietary Supplements has shown that certain nutrients, such as vitamin D, have improved bioavailability in capsule form [8]. Conclusion For bariatric surgery patients, a one-per-day multivitamin capsule offers numerous benefits, including convenience, compliance, and reduced risk of nutrient deficiencies. Contrary to popular belief, there is no medical evidence to suggest that bariatric surgery patients have difficulties swallowing capsules. In fact, capsules dissolve quickly and are easier on the stomach, making them an ideal choice for post-bariatric surgery care. Encouraging patients to adopt a one-per-day multivitamin capsule regimen can support their long-term health and well-being after undergoing bariatric surgery. Medical studies have demonstrated the benefits of multivitamin supplementation in preventing nutrient deficiencies, promoting adherence to supplementation protocols, and enhancing the absorption of certain vitamins and minerals. Bariatric surgery patients can feel confident in their choice of a one-per-day multivitamin capsule to support their journey toward improved health and quality of life. Empower Yourself: A Personal Testimony As a bariatric surgery patient and a knowledgeable expert in the field, I have personally experienced the transformative effects of incorporating a one-per-day multivitamin capsule into my daily routine. Throughout my journey, I have learned that self-care and attentiveness to my nutritional needs are vital for long-term success and well-being. The adoption of a one-per-day multivitamin capsule has provided me with the assurance that I am receiving the essential nutrients required to thrive in my post-bariatric surgery life. The Power of Community It's important to remember that we are not alone on this journey. As bariatric surgery patients, we are part of a supportive community united by a common goal: to achieve and maintain a healthy lifestyle. By sharing our experiences, challenges, and successes, we can inspire and empower each other to make informed choices about our nutritional health. I encourage you to connect with others who have undergone bariatric surgery, exchange stories, and discuss the benefits of incorporating a one-per-day multivitamin capsule into your daily routine. By learning from each other and sharing our knowledge, we can collectively overcome the challenges of post-surgery life and experience the unparalleled benefits of one per day multivitamin capsules. Stay Informed, Stay Healthy The world of bariatric surgery and nutrition is constantly evolving. To ensure that you are equipped with the latest information and best practices, it's crucial to stay informed and up-to-date with recent scientific studies, guidelines, and recommendations. Continually educate yourself on the benefits and best practices surrounding one-per-day multivitamin capsules and other nutritional supplements. By staying informed, you can make the best decisions for your health and well-being, ensuring that you are providing your body with the essential nutrients it needs to thrive. References: [1] Mingrone, G., Panunzi, S., De Gaetano, A., et al. (2012). Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes. New England Journal of Medicine, 366(17), 1577-1585. https://doi.org/10.1056/NEJMoa1200111 [2] Mechanick, J. I., Youdim, A., Jones, D. B., et al. (2013). Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient—2013 Update: Cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity, 21(S1), S1-S27. https://doi.org/10.1002/oby.20461 [3] Aills, L., Blankenship, J., Buffington, C., Furtado, M., & Parrott, J. (2008). ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patient. Obesity Surgery, 18(10), 1140-1142. https://doi.org/10.1007/s11695-008-9631-1 [4] Mechanick, J. I., Youdim, A., Jones, D. B., et al. (2013). Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient —2013 Update: Cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity, 21(S1), S1-S27. https://doi.org/10.1002/oby.20461 [5] Parrott, J., Frank, L., Rabena, R., Craggs-Dino, L., Isom, K. A., & Greiman, L. (2017). American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surgery for Obesity and Related Diseases, 13(5), 727-741. https://doi.org/10.1016/j.soard.2016.12.018 [6] Ernst, B., Thurnheer, M., & Schmid, S. M. (2013). Evidence for the Necessity to Systematically Assess Micronutrient Status Prior to Bariatric Surgery. Clinical Nutrition, 32(1), 66-72. https://doi.org/10.1016/j.clnu.2012.07.012 [7] Podczeck, F., & Jones, B. E. (2004). The In Vitro Disintegration of Hard Gelatin Capsules Exposed to Different Conditions of Temperature and Relative Humidity. International Journal of Pharmaceutics, 280(1-2), 197-206. https://doi.org/10.1016/j.ijpharm.2004.04.018 [8] Traub, M. L., Finnell, J. S., Bhandiwad, A., Ochoa, G., Sasson, N., & Kotsopoulos, J. (2014). Impact of Vitamin D3 and Omega-3 Fatty Acid Supplementation on Serum 25-Hydroxyvitamin D Concentrations in a Randomized Controlled Trial. Journal of Dietary Supplements, 11(3), 324-334. https://doi.org/10.3109/19390211.2014.921849 By continuing to learn from one another, staying informed about the latest research, and making informed decisions about our health, we can support each other in our shared goal of a healthier, happier life after bariatric surgery. The use of a one-per-day multivitamin capsule plays a critical role in this journey, providing essential nutrients, promoting adherence to supplementation protocols, and minimizing the risk of deficiencies. Embrace the power of community and knowledge as you embark on your new life and make the most of the benefits that a one-per-day multivitamin capsule can offer.

Had my surgery on Thursday. The pain has honestly been more intense than I had anticipated/hoped. I walk a ton. I think I’ve been overdoing it which is causing additional pain. My pain was a solid 10 day one and got a little better the next day, but I needed pain killers in order to fly home. Im hoping for some additional relief tomorrow! Regardless it’s all possible and manageable! I just remind myself it’s short term pain and it will get better and it will be worth it. Hope all March surgery buddies are doing great!

It’s been more effective than anything I’ve tried. I truly think it has the potential to replace surgery in the next decade or so for many. I’ve consistently lost 1-2 lbs a week since starting. Below my personal goal (but not underweight 😄). Like vsgchick, the 10 dose has been the sweet spot for me. Appetite control without appetite suppression. Easy to forget or skip a meal without minding but able to enjoy a meal as well. Total loss here in week 21 is 30lbs, which I consider great since I was already pretty far in my journey to a goal weight and relatively inactive.

Hello! Mounjaro has been great for me. I lost the remainder of my regain and 10 additional pounds. I am currently under my lowest sleeve weight and see my bariatric office in 2 weeks to discuss a maintenance plan. I didn't go higher than the 10mg dose (the highest doses are 12.5mg and 15mg). I didn't have any crazy side effects. GLP-1s seem to be a game changer for a lot of people...especially veteran WLS that need a boost but don't want revisions.

I started at 205 day of surgery on my 6 moth check up I was 156 in 4 months I have only lost 7 pounds. I'm now 149 been stuck there for 3 months. Total weight loss in 10 months is 56lbs is that ok?

For me, miralax every day until I'm going regularly (I totally keep notes ha) and then I take it every 2-3 days. I was diluting my shakes with Fairlife skim milk, it has 13 g of protein in 8 oz! So once I was tolerating cold liquids better, I'd fill a big insulated cup with a protein drink, 8 oz of Fairlife milk, and 8 oz decaf coffee. That was 43 g protein and 30ish oz of fluid 😁 plus the ice adds a bit more. It took me about 2 or 3 hours to drink that, but it is a bit quicker now. Also love Lonolife powdered bone broth! Especially the chicken and beef. Not sure about the Thai curry flavor. Anyhow, I think they are a tasty and that's 10g protein, and 8-10 oz fluid! Good luck 😃

When I see pictures of what people eat. I eat a lot more then that. I probably have 10 sugar free popsicles a day, they never hurt my stomach and I like them. My servings are always small, very small, in fact most of the time I am eating with a baby spoon, to be cautious. If I take to big of bites, it hurts me. I am still doing soups, I tried refried beans yesterday, and protein shakes a million popsicles. To much food?

9 months 9999 months 9 months post op. 115lbs. Only thing that hasn't shrunk are my ears! 🐘 I've gone from 26/28 to 12/14 and 3xl/4xl to large. I think I want to lose around 10-15 more pounds but I'm pretty content right now.

Congrats on the successful surgery (mine is on April 10) and I know it's a bit early but Happy Birthday! Best gift you could have given yourself.

tl;dr at the bottom I could use some advice. I went to see my dietician today (not a bariatric surgery dietician, I can explain why I am seeing her if you want to know). She knows I am going to have weight loss surgery as long as I hit the goal weight my insurance told me I need to be at. I have to be at the goal weight by June 24, 2023, in order for my insurance to pay for my surgery. I had a weigh in the doctor's office a couple of days ago and weighed 301, my scale at home said 302. However, on the same day, the scale at a friend's house said 313. I knew I had this Dietician appointment two days later and I knew she would weigh me. I continued to weigh myself at home (after getting new batteries) and I was at 302 then 299 and today at home I weighed 303, right before my appointment, when I got to her office I was weighed and it said 313. I am concerned about what to believe since the doctor's office and my scale show similar numbers. I also bought a new scale today and it said 313. The Dietician told me I needed to eat more protein, which honestly I struggle with. she said I needed 150 grams!! I said are you kidding? that seems like a lot. She used my weight to come up with this number. Should I really be trying to eat enough protein for a 300-lb person or should I be eating protein for a goal-weight person (mine is 170)? also, my clothing is loose like I lost the 20 lbs mine and the doctor's scale shows, and not 10 lbs like everyone else's scale shows. Also, I have always naturally been more muscular even when I was 120 lbs and did not eat any protein aside from what is in plants. tl:dr- should I be eating enough protein to support a 300lb person or should I be eating protein for a "normal" sized person? AND should I trust the Doctors scale more so than the Dietician's scale?

Everyone’s surgon is different. If yours is large then maybe he does need to do them at different times. My HH surgery was years ago & the recovery was pretty easy. When I had my GB my esophagus was it an L-shaped. I’m retired, the surgery itself was pretty easy. It’s getting your body used to your new stomach and your new way of eating. You are going to be weak for about a week to 10 days afterwards because your body is just gone through major change.

Hi Seif_s88, Yes I can relate. I lost about 100 pounds and have gained back about 50. 10 days ago I restarted a keto diet which has worked for me in the past. Down 10 pounds so far. I find that the keto diet helps with cravings and I like the discipline. I check my urine ketones every morning, and I find that to be motivating, as well as seeing the scale move down. I remembered to get baseline measurements, so I can see progress that way too. Omgoodness- body image issues. I get that too. I am 55 and was sleeved almost 10 years ago. The ups and downs sometimes make my head spin. Some days I look in the mirror and am shocked to how time has gone by. Overall, I try to be kind to myself. When I get too much in my head about my appearance, I try to remind myself that I am more than this body. So much more.. and so are you

Does anyone else with PCOS find that there still seems to be a struggle with weightloss? Background for me: I started at 220ish lost 6lbs during the pre surgery diet and lost about 19 lbs since surgery. When I talked to my surgeon yesterday she said it sounds like I'm doing the right things but she did agree that most people would be down a lot more. She wants to look at my gallbladder since I have been having trouble holding down food like chicken specifically so maybe there is something there. But I feel like the point of the surgery was I was struggling to lose weight on my own. I thought PCOS was making that harder and it felt like everyone and their mother suggested WLS for me to help and now I feel like it's failing. My doc didn't really seem to want to give nutritional guidance besides hitting 60g of protein and 60oz of water. She is more concerned with me holding food down which is understandable but my focus is this weight. Is there something I should be doing that maybe PCOS patients need to adjust compared to "normal" patients? Sent from my SM-S908U using BariatricPal mobile app

HI All, first time on here, I'm in Ireland and had my surgery on March 10th, I had a blood loss and my haemaglobin dropped but I'm so whacked out. I feel I have no energy. I do small jobs and thats it then. Anyone else feel like this. Food wise I'm flying.

Sorry it's been so rough! I had 24 hours of puking around 4 post-op and it was terrible, so my heart goes out to you. I hope your recovery starts snowballing now and a week from today you feel *normal*🤗 My plan counts protein drinks and soups towards liquids 100%. ( And for the record my "output" has been regular and the right color and whatnot, so I've not had reason to second guess it). I didn't love premeir protein's clear, but I could keep down propel (the individual sticks) either in hot water or well-watered down. I also love Lonolife powdered bone broth, it has 10 grams of protein and just settled really well. Lastly, a protein drink (fairlife or premeir), 8 oz of skim Fairlife milk, and then 8 oz of decaf coffee has really been helping me get down protein (43 grams) and fluid (~32 oz). It just seems to settle better than a straight up protein drink. It just takes a couple hours to drink, but I don't mind sipping on it that long 😅 Lastly, I did try mixing some powdered pb or regular pb into a blended shake because my plan okayed that. That can bump up calories 👍 I just need to taste something different/different consistency, so I haven't done it again. There were a few days there everything tastes weird and nasty, but thankfully that has gone for the most part!

My doctor and nutritionist said that anything other than water only counts as half the ounces. So 10 OZ water = 10 oz... 10 Oz Protein Shake (or anything besides water) = 5 oz water... So keep that in mind to avoid getting dehydrated.

My pathway advisor just sent me 10 attachments and all the stuff I need to track and daily habits and everything I know this is going to be to help me form a healthy habit prior to surgery but boy it is overwhelming. Anyone feel this when they started their process I’m excited but nervous.

If ever there was a day for Pizza Fest, it's probably good that it's on a day where you aren't going to feel like eating anyway! Lucky you with your 8am kick-off. Mine's 5pm 😭... I was chatting with my coach last night (she had surgery 10 years ago and went from 124 kg to a stable 66kg!) - and she had this to say: "You’ll be ok. One thing to remember is that your stomach is about to be reset. And the same way a baby learns to eat… fluids, purée, soft foods… you’ll start the baby journey too. All you need to keep telling yourself during this time is that it’ll all be worth it" Wise words!

Yes - decided to go with the sleeve as there were no contraindications from the gastroscopy I underwent as part of the consultation process. There's something about needing less "internal plumbing" work that I find reassuring. As for the clear fluids, I definitely wouldn't want to do it for more than a couple of days. I'm only 19 hours in and starting to go a little stir crazy. There's only so much water, bone broth and jelly (jello) a person can take!

I have no idea what my actual initial weight was because I refused to buy a higher capacity scale, so my heaviest measured weight was 396. But I’m sure I was more than that. All those things you mentioned struck a chord with me. I remember having to ask for tables, not booths, and then having to size up the chair to see if I could actually sit. I didn’t have an aneurysm but I had uncontrollable hypertension and was getting precursors to heart attacks. So I’m here to tell you that it all changes, and very quickly. I’m 18 months post-op. I didn’t hit the goal I wanted but I did get below 20% body fat and am within 10 pounds of my lowest weight of 262. (I’m six feet tall and built like a brick sh!thouse even without the fat). I eat intuitively now (after therapy to help get me to have a better relationship with food) and I exercise a lot. I’m running a 5K on Sunday and it’s… just not a big deal. I fit in booths and I can run up and down stairs and jump to a 30” box. I am not on any blood pressure or blood sugar medicine, and I no longer need a CPAP. I wish I would’ve done this a decade earlier. Here’s the thing, though: the program where I had my surgery done was not that useful. I ended up with a nutrition coach I hired, who got me eating correctly while still losing weight hand over fist. I had already been doing CrossFit (yes, at 400 lbs—the coaches simply scaled the workouts so I was getting the same stimulus as the jacked beasts in the gym but at a level I could do) and building muscle helped with fat loss and body comp. I needed therapy and psychiatric help to resolve my anxiety and depression. You’re gonna do great. Write down all the stuff you can’t do now and use it as a checklist for later. You’ll be stunned how quickly it happens. Just make sure you have the support team with you, don’t rely on the bariatric program; they’re a hammer and everything they see is a nail. I’m happy to pass along contacts for the nutrition program I started at 3 months post-op, or give details about my exercise program, I just don’t want to look like a spammer.

Hi I had a gastric bypass just over 10 years ago. I did fantastic and lost over half my initial starting weight. I have kept most of it off but 2stone is creeping back on and I am scared I do not want to go back to that place. Has anyone else had this challenge and what have you done to get back on track ?