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I'm not sure where you are but I'm in Australia and there is a protein bar called Aussie Bodies and it's whipped inside like a three musketeers used to be. They are only small but soft. I think the bariatric pal shop sells some kinds too or protein muffins or flapjacks. I am 3 months out and I can eat most things. No dry meats or nuts so most bars are out for me too. I bought a box and ate them but I don't know if I would do it again because I don't want to rely on sweet snacks again. Usually I have a bottle of protein water with me. Sent from my CPH1607 using BariatricPal mobile app

Researched and found this: http://vonbeau.com/offer/free-building-blocks-vitaminessential-bariatric-supplements-samples.htm https://www.celebratevitamins.com/sample-pack.html Sent from my XT1650 using BariatricPal mobile app

My surgeon recommended Flintstones Complete. I take two a day. The Bariatric vitamins didnt’t agree with me so I’ve been doing the Flintstones for three months and my test results have been great!

I've heard that FLINTSTONE Vitamins are good, I tried them after I changed Bariatric DR.'s and that is what they told me. They are so nasty!!! I have always taken CELEBRATE capsules. No taste, just swallow and go. CENTRUM chewables are too sweet for me!!

Help! I ran out of Bariatric vits before I got a chance to order them. What would be a good substitute till they arrive?

HI there, call your insurance company and ask for a written copy of your policy for Bariatric Surgery. Your group has some bearing on this. And, ask your surgeon what s/he requires, too. MY insurance company required 6 months of supervised diet (and they mean a whole 180 days, not just 6 visits). My surgeon required a TON of pre-op testing.

My insurance didn’t pay for anything. There was an exclusion clause that says it doesn’t cover any type of Bariatric surgery. That sucked! Although, next year my insurance will cover it. That doesn’t help me now, but knowing it may someone else makes me happy.

Thanks for answering! I am following the program but I was constipated too and went to the ER and gain some weight without eating anything!,, I think it was something that they put on my IV that has a lot of proteins and vitamins ( they call it the bariatric fluid) . I will be more patient!!! Thanks

Welcome. During my 6 months of pre-op diet and exercise, I attended bariatric surgery support group meetings. They were a good way to connect with other people that were also going through the same process. Since you are in the middle of this process, I would recommend three things. 1. Take a good before photograph of yourself, so that you have something to compare to after surgery. Many times we are blind to our obesity. We do not see ourselves. Therefore when the weight begins to drop off rather dramatically, we question if this is really happening. Photographs are a good visualization of our success. Many people carry a before and after photo with them, just to remind themselves of their success. 2. Walk 30 minutes each day, every day until surgery (or equivalent exercise). Walking helps the recovery process go smoothly and minimized the pain levels from surgery. 3. Wean yourself from caffeine and carbonated beverages now. After I gave up my 6 diet coke a day habit, I suffered from a week of severe withdrawal syndrome consisting of severe headaches and body aches. I was miserable. You don't want to combine the effects of caffeine withdrawal with the effects of surgery.

I as well have blue Cross through Texas. They required 3 months of supervised weight loss through my provider, to see a psychiatrist with testing ( it was crazy easy), see dietician, pre-op Bariatric support class. Sent from my XT1650 using BariatricPal mobile app

I was given pain relief in hospital but then I was already on it for arthritis. They mostly did paracetamol in the drip but I take Targin and Endone daily. You can't have NSAIDs due to ulcer risk. Things like endone which is oxycodone or codeine can cause constipation which they did with me. Pre surgery no problem post surgery as long as I am on the pain meds I need a laxative drink. For the trip home something simple like Tylenol or Paracetamol should be OK. I'd check that out. Vitamins. I take BNMulti which is a chewable bariatric vitamin. Calcium citrate and D. 948 mg cal 200mg D also chewable. I also have Vit B injections which I've had for a long time. I recently found out because I developed kidney stones week 7 that you should take the calcium directly after or with food. If you have them by themselves the residue attaches to the kidney which can cause calcium oxalate stones but with food it digests with the food molecules. I had five calcium oxalate stones! Sent from my CPH1607 using BariatricPal mobile app

Today was pretty difficult for me. As much as my life post bariatric surgery has changed for the better, in many ways wls is still a struggle for me. Sometimes I worry it will always be this way. Feeling “normal” again- maybe I’ll never feel that again. In 20 years I will still be the same as I am now and what are the long term repercussions on my health? I really struggle with food. Protein is a constant challenge. I find it very very difficult to eat dense protein. It gets stuck so easily, even if I take care to chew the f**k out of it. Chicken and I- not friends. Fish is very challenging. Steak is easier but still, it can go badly. I can’t count the number of times I’ve puked up dense protein. You know that rule, eat your protein first? If I did this I would still be anorexically thin. Once I take a couple bites of protein my restriction is so high I can possibly eat any more. Three bites and done. That’s about it. Lately everything I eat gives me horrid gas. I’m constantly constipated. I try to get enough water but drinking between meals, when I need to eat at least six meals a day to get enough calories, is incredibly difficult. When I drink with my meals it’s a gamble as to wether I will dump or throw up, so I try not to. But in my busy busy life I find it so hard to drink outside of my 6 meals, to grab that bottle of water and get it down when my stomach still only takes sips even after so many years out. I get incredibly thirsty when I eat as well. It’s exhausting. I’m hungry so often. Not physically hungry, although that happens too. But more of a mental hunger or a deep physical anatomical hunger that just feels like I can never really get enough food. I can never, or very very rarely, get quite enough that my body feels truly fed. I’m always in this limbo of not quite satisfied. My stomach prevents me from eating even if my body wants and needs more. I watch other people eat and I envy them. I miss the feeling of true satisfaction and resent the feeling of restriction, especially when I know my body really needs more food!! Sugar and I- we have a very mixed relationship. I love sugar and I don’t fear it will make me gain weight. Carbs are easier for me to digest than protein and so I rely on the a lot to get the calories I need to not become skeletal again. But carbs can often give me dumping syndrome. I’m constantly playing a game of Russian roulette. Will I dump after this meal? Tonight I dumped horrible after a meal of a turkey sandwich and raspberries. I assume it was the raspberries. It’s a constant condition, one that I go through really hard times over and while sometimes I want to just say- ok! No more carbs- see above issues with protein. Following the “rules” doesn’t provide a solution to me. Protein is too hard to get down. Water is so hard to get in. My calorie needs are high. I’m having jaw problems now from the stress on my jaw from so much chewing. I’ve seen my surgeon- he says no sugar. So what’s left for me to eat safely! Protein shakes? That’s not realistic. And I can barely keep weight on as it is. What can I swallow and know 100% it won’t get stuck and I won’t dump. So many people on these forums painting the perfect picture of life after wls. And those feeling like failures when they don’t lose weight. Well I’m a “success story”. I’m thin. And I struggle Every. Single. Day. I wish people would talk more openly and honestly about the long term effects of wls and what it’s like to live with it. What’s it like in an imperfect world for an imperfect person. My best friend had wls and we talk all the time about these things. It’s nice that I have someone who gets it. When people are considering wls they only want to see the positives but they don’t understand the choice they are making. Would I make this choice again? Would I trade my health and freedom with food for a day in the body I have now? Probably. But I’m not sure what that says about me. Will you do the same? Think about it. I’m not saying don’t have surgery. I’m not saying I would go back into my old body. That body had lots of problems too. My mind, my body, my life.. I’ll take it now. But wls isn’t for everyone. I’ve had a few friends chose not to do it, and at the time I didn’t understand their decision. In the honeymoon stage you’re on a weight loss high. I rode that high for a long long time. But now.. years out I’m beginning to understand. Today was a rough day. I have better ones. It would be nice to have a place to get some support for the hard things we go through. Most other people in my life, they can’t understand. For me, having wls is living in a body with chronic digestive illness.

Hey there smith.99, I hope the procedure works out for you and your sister. The one advantage you’ll have is having it done with your sister so you can both support each other as well as motivate one another. It sounds like your sister had a more difficult time with this than you did. After reading so many peoples’ posts about their procedure your post is proof that each individual will react differently. You didn’t have any major discomfort while it looks like your poor sister had a rough postop. I guess I’ll just have to try my luck. To be honest this is not what worries me the most about this procedure, what I’m concerned with is whether or not it will work (meaning if I’ll lose weight) and how it will affect my stomach long term. Some say you can revise if restriction starts to get less while others say you can always revise to a sleeve and still others say you can not have a sleeve done afterwards b/c of scar tissue. I’m very confused about that part of this procedure. Either way, if I do get an esg done it will be an only procedure for me as I need this to be successful. I must go in with the mindset that this is it and I have to make it work no matter what. I also believe that every bariatric surgery or procedure can fail if you don’t do your part to change your eating habits and adapt a healthier lifestyle. Please keep us updated on you and your sister’s progress. Your BMI is very close to mine and it would certainly give me great encouragement to move forward. Thank you so much for your post. 😊

What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. Links https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

My surgery isn't until Jan. 11, but I am going to start on my vitamins early. I just purchased the Tespo liquid vitamin dispenser and ordered the Men's Bariatric Plus vitamin subscription. My surgeons office uses the PatchMD vitamins but I feel like I'll have better absorption with a liquid than a topical vitamin.

I also use bariatric advatage but, my Dr didn't allow me to use them until I was one month post op. I also take Noscabel which is a B12 inhaler (prescription needed). My insurance company pays for it with a $20 a month co pay.

I just buy all my supplements directly from my doctors office. They sell the bariatric advantage stuff, and they sell them for cheaper than anywhere I could find online. I'm not a fan of their protein so I'll use something else going forward, but your surgeons office could be a good place to start

Sorry I'm taking up your thread chit chatting with you. The topic is just hitting home with me. Eating higher calorie goals can be an all day process after bariatrics..Right? Eating higher calories to fuel is against my bariatric instincts. but it was a necessary evil at the time. (distance running) Now I'm back in weightloss mode after a gain. Had withdrawals going back to 1300 calories and low carb. Took time but I'm back at it. I think it's not realistic to think hunger goes totally away with surgery. Hunger is a built in survival mechanism. It's more manageable after surgery for me. Before..Hungry all the time Still working on how the scale changes my mood. How fast how slow and gains still mess with me at three years out.

If you’re reading this post, you’ll probably agree that losing weight is one of the hardest things many people will ever do. After months or years of attempts to lose weight (and keep it off), you may be considering bariatric surgery. In 2011, the total number of bariatric surgeries performed in the U.S. was 158,000. By 2015, the number had increased to 196,000. Patients who undergo bariatric surgery and follow all treatment guidelines can expect to lose weight and improve the quality of their lives. More than 85% of patients lose and maintain 50% of their initial weight loss. This post is designed to focus on what I learned, sometimes the hard way. Some things you can’t find out in a doctor’s office, no matter how skille d a professional he or she is. What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. Links https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

When you say 'groups,' are you referring to bariatric support groups? If so, the bariatric surgery practice that sleeved me offers support group meetings every Tuesday evening.

Hi everyone, well I had my lapband removed yesterday and I feel great. The operation went very smoothly and relatively speaking...it doesn’t hurt. When I had it put in I was laid up for 2weeks. I think advances in anesthesia has a lot to do with it. . So glad to be able to eat a fruit, salad, veggies without getting that weird look on my face. First off I’m soooo glad I got the lapband in the first place. The trajectory of my life changed so much for the better. But the band is a tool. We must still put disciplines in to achieve our goals. The reason i had it taken out, a few months ago I had a really bad virus and I think from throwing up my band slipped. So coupled with the fact I’m at my goal weight ... I felt it was time. Would I do it again? In a heartbeat. I’d probably go with the sleeve since I hear maintenance afterwards is easy. The band has quite a bit of post-surgery management. If one does choose the lapband... make sure the doctor’s staff is knowledgeable, efficient and they like their job. You’ll work with them on a lot of things. Dr Spivak (Houston) put mine in and I can’t say enough about his staff. They were wonderful. And a few of them had bariatric surgery so they totally understand what we were going through. Unfortunately for us he moved to Israel. Dr Erik Wilson took the lapband out yesterday He is great. Smart, efficient, etc. As great as he is......The workings of his office aren’t great. I haven’t worked with him long but the staff was not that nice and everyone told me to contact someone else for answers. Could never find anyone. So I’m not sure I would have him put the lapband in based on that fact. On surgeries that don’t require a lot of follow up, I most definitely would use Dr. Erik Wilson (by the way there are 2 of them...his brother is Dr Todd Wilson )

I finally found some time to write about how I got into this mess to begin with. It's a very long story told short, believe it or not, I know it looks long already, lol, but I did cut out a lot of unimportant stuff, I wanted to focus on things that were direct contributors to my weight journey. I hope you enjoy the read I was still skinny in my young adulthood, when I met my husband 15 years ago I was at about 115 lb. As we dated we would go out a lot but I never worried cause I also worked out a lot, yet one day I noticed weight creeping up (my x-small clothign felt too small). Doctor diagnosed me with hypothyroidism and that took a while to get under control. When we got married a year later my weight was about 140 and I started worrying. Felt huge and tired and disgusting, so we decided to move to Florida in hopes of being able to spend more time outside and helping me to get back in shape. That backfired, cause I didn't realize the severity of daily levels of humidity in that state. I was miserable outside and sweating more than I should, just for being out there. I did join a gym, but somehow my motivations were shut and although I liked to spend time at the pool or splashing around in the gulf of Mexico as I had to keep upgrading my swimwear from x-small to large size I also lost confidence to wear it out. My body was changing and I didn't like any of those changes, while my thyroid kept getting worse. We also were trying to get pregnant and that seemed to be very frustrating and put additional toll on me. Eventually I was informed I wont be able to have children, cause of other issues within my body. We accepted the fate and on top of 2 older cats we already had we decided to add 2 kittens. About a month after that I got pregnant (and I was at about 160 lb then), and my doctor worried about me a lot, reminding me that it will be a tough ride and I will have to see him often to make sure all is good, cause I was in high risk category of losing the baby, especially towards the end of the term. I took it very seriously and easy on myslef, but kept active as much and as smart as I could. Unfortunately problems started appearing very soon. First one observable and related to rapid weight gain due to pregnancy (I was also showing very early on) was pain in my feet, both of them. I noticed it while durning my morning jog/walk time on the track behind my house. It was my heel spurs pain that went on undetected for months. Then I started having problems with my hips, did PT for it, but since I was pregnant I didnt have any x-rays done. I was recommended to take it all even easier, to rest a lot, do simple exercises but not to overdo it. Then other pregnancy related issues popped up, like gestational diabetes, preeclampsia and I was eventually put on bed rest. Weight only kept creeping up and when at one point I took a longer look in the mirror I cried, cause I didnt recognize the person in it. I was about 250lb shortly before delivery, felt miserable and unable to do anything to help the weight, my sole focus was to make sure I can carry to term. With preeclampsia my doc didnt actually want to wait till my due date and suggested earlier c-section, cause that condition was dangerous for me more than for the baby. Since I was also breastfeeding my baby I coudlnt go on diet asap, nor deal with the heal spurs the way my doc suggested (I had only one cortisone shot in both feet - which was super painful and did relieve some pain, but cause it was meant to last for few months and wore off after 3 weeks I decided not to go through that pain of it anymore). Finally when I could I started dealing with those spurs and signed up for nutrisystem delivery. I was doing ok, and moved onto the steroid treatment of my feet, but as it failed and the doctor knew I had already suffered enough we decided to get on the track for foot surgery. That's when my husband announced his office will be closing and we were faced with a decision to either stay and look for another job or move within the company (relocation) and keep the employment. With 4 cats, new baby and my health issues we thought we cant afford to lose the income or insurance, but on the other hand we had just refinanced the mortgage in our house, and did a lot of major renovations, including new windows, new AC system, pool and backyard upgrade (basically making it safer for the baby, adding a safety fence and replacing existing concrete with nice pavers). So we were in a catch-22, either way we'd chose to continue we'd lose a lot of money, and in the still very unstable market then (my son is 7 now) having a steady income won over huge losses from sale of the house. After we moved my search for a foot doctor started and it was a painful process, not only cause I was still hurting a lot every time I walked, but also cause of the type of doctors I happened to come across. After a year of seeing 3 different ones I gave up and thought the universe is against me. With nutrisystem I came close to 200 lb but never under, and as I continued to have my food delivered to new place I saw that it eventually wasnt helping me at all, so I decided to quit it. Then as I became less and less mobile cause of pain and weight gain I also became a recluse, didnt want any pictures taken, avoided family gatherings and descended into the world of online gaming and constant snacking. Finally 3 years ago I had some eye opening facts presented to me, as my weight got close to 300 lb and I was moving out of the pre-diabetes stage. With my reg doctor we tried to fix my diet and habits, but the foot pain prevented me from most activity, it got so bad that I had to line up chairs between sofa and bathroom so I could make it there. That was no way to live, another huge wake up call was that I wasnt fitting on my son's school bus to get him strapped in (he takes the short bus cause he is autistic - and that diagnosis was also as if someone was putting up more obstacles in my way to recovery, my full focus - or whatever was left of it, cause I wasn't really myself anymore - went into trying to help him instead of helping myself). During the year of work with my doctor I slowly changed my diet, and although I didnt lose any weight I also didnt gain anymore, but other problems came to light, like sleep apnea and high blood pressure. I finally had to also do somethign about my feet, and took it very seriously to find a doctor that will want to operate on them and I finally got lucky. She had actually listened to me, and only suggested one type of therapy that I didnt try before - laser, but when after a few weeks the results were not what she expected we moved fast track into surgery. I had one foot operated on before thanksgiving 2 years ago, and the other before christmas (chose those dates for 2 reasons: 1. cause my son woud have time off from school and hubby some vaction too and I could rest post op, when I couldnt really walk much at first and each foot was beign kept for safety in a postsurgical boot, 2. another "good" excuse to not join any of the family events). Those surgeries gave me a green light to living, but as I started walkign again I noticed other problems I had no idea about their severity before, cause I was never up long enough to notice. My lower back was a mess and my knees were useless, I couldnt kneel at all, not even on the sofa while leanign over to reach for the blinds behind it. My life was pretty much a constant pain ever since pregnancy, and I felt liek trapped in a vicious cycle: one step forward - 2 steps back. I also didnt take many of the pain pills, cause they didnt really help much, and when I took the harder ones I was basically sleepign all day and I coudnt do that either cause I had to be awake for my son, besides sleep apnea was affecting my awake hours enough and often when my husband came home I was asleep on the sofa. It was a really tough time, but very slowly I was making some progress. Eventually it was a conversation with my doctor which made me realise that my problems can only get bigger if I can't lose any weight, and staying at or around my current number (I was fluctuating between 285-298lb) wasnt an option either, so she strongly suggested I looked into bariatric surgery. I finally did so a year ago, Nov 2016 and cause my insurance then didn't allow for the surgery to happen without a monitored and documented prequalification process that was supposed to take 6-8 months, I did some research to find better insurance and get accepted when I was ready to go through with it, after completing one sheet of steps. Ironically cause getting some of those required appointments was very time consuming I ended up having my surgery done 9 months after initial visit, but I was glad to have spent that time researching it thoroughly and learning about how it actually works. To think back then I struggled with the thought that it was an easy way out, lol, there is nothing easy about it, it takes commitment, discipline and a complete lifestyle change, but I knew I had to do it, I coudln't live like that anymore, avoiding people, family, having trouble to keep up with personal hygiene, and most of all not being able to assist my son when he needed me - that hurt me the most of all the pains I ever had. So here I am now, 4 months post op and feeling great. I'm still having some pain, mostly in my knees, but also in my hips and back. I had finally taken the x-ray of my hips and the reason for my back and knee problems emerged, and am currently working with 2 doctors to treat it. Still not there health wise, and not skinny yet, but feeling hell of a lot better then a year ago and a world of difference from 2 years ago. I'm glad to have had people in my life who inspired me, guided me and made me want to see the beauty of life at the time when I was ready to give up. Also ironically I met some of those people while playing those stupid online games. Isn't life funny that way? I guess in the end all that happens in our live is somehow fated, and we are constantly faced with choices, and its only up to us what we chose to do. I'm happy to be alive and to be here, and am looking forward to skinny and healthy me2.0 Thank you all for reading, I did write this once before and cause of a misclick I lost all progress right before posting it, and since the site didn't save what I typed I didn't feel back then to type it all up again. Today I used wordpad to save the story as I write it Lesson learned

I get my fills in Tucson at the Bariatric Center on Camp Lowell/ Swan. Scott is who does the fills. He is great

THANK YOU!!!! This is dead on and 100% true! It isnt about staples "magically melting away", its (quite literally) about organ donation! This topic seems to be commonly breezed over. Alcoholism is the most commonly traded addiction for bariatric patients. Instead of food... its alcohol. Your post bears repeating! 5' 5" HW: 259 CW: 235 GOAL: Healthy and hard 140-ish?