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You have done really well with your weight loss and I understand your worry of messing up. I do too, which is why I calorie and protein count every little morsel that passes my lips. I still struggle to eat enough protein Your meal looks fine portion wise but it looks to me like you have lots of oily dressing on the salad, but I am a million miles away and wear very thick varifocals. If you are in maintenance , this seems fine to me.

Wow. It’s amazing that your work has healthy options. I can see where it’s kinda hard to measure things at work though. Just a thought if you are measuring by volume. Amazon sells containers that I find handy when I’m eating healthy to pack my snacks that you may be able to use now to measure your lunch. Mine are made by easy lunch boxes and these have four square sections (they sell one that’s bigger also but I usually tend to grab the one with 4) basically they make homemade lunchables. I just measured witb water and each section holds 1/2 cup if you fill it to the line (not overflowing). So half way would be 1/4 cup Maybe you can use or transfer your lunch to a container like this and that way you will have a better idea of how much you are eating?? It’s kinda Like having four measuring cups without having to use an actual measuring cup or a bunch of containers. Plus, you will likely love them later if you need to pack healthy snacks anyways. The ones I got are $11.99 for four and they come in handy to pack smaller portions of fruit, cheese, veggies, lunch meat, jerky, nuts, etc for snacks on the run.

Catwoman is right. It depends what's on your plate. By and large, at least according to two prominent surgeons (Dr. John Pilcher and Dr. Matthew Weiner), pouch stretching isn't really a thing. Your pouch is meant to regain elasticity as it heals, allowing you to eat the amount of food you'll need for maintenance. It's what you choose to fill it with that makes the difference. Bearing in mind I'm still in the early stages so this is just based on research instead of personal experience, this is what I have read and heard. You want to keep your protein serving to 3-4oz and your starch/carb serving to 1/4 to 1/2 cup (or 1 slice bread), and the rest non-starchy veg. That would be 1/2 your plate is veg and 1/2 your plate split between protein and carb. And a smaller lunch/salad plate, not a dinner plate bigger than your head! The meal you posted looks pretty healthy to me. I found this video really informative:

Thanks so much for your reply. I’m sorry to hear you are struggling a bit but glad you are tolorating at least some real foods and getting your protein in. I am trying low carb recipes each day and have found a few that are good for me. I just have to sift through the super high fat ones that I’m guessing won’t be ideal post op. I won’t get into specifics since you are limited in what you’re eating right now. I’m kinda shocked that you are still dealing with nausea and abdominal pain at four months. I know everyone’s body is differnt but Do they act like that is common for recovery? Is the vitamin deficiency related to the surgery?

Congratulations!! I am glad you had such a great team and that like you said you were still in hospital. I shiver when I think of if it was me and I was home I may not have even noticed my BP was up. If they specifically told me to take it every two hours, maybe but if not… Anyways, it sounds like you found a little gem of a team over there and I’m sure your sharing will be helpful to so many. I think for my revision I may ask to go ahead and stay the extra night if they give me the option now. I just wonder why they don’t have recovery houses for surgeries other than cosmetic. I assume they check things such as your vitals and make sure you follow all your post op instructions to the tee. That would be good option if you were still in a great deal of pain and lived alone or just live worn someone who has to work most of the day. Or they would have probably reported your BP to your excellent team and he would have requested they brought you back to hosptial. That and visiting nurses. I have had them come to my home for both “cosmetic” procedures I’ve had but never have they mentioned them for the others. Maybe you just have to ask? ignore me, my mind is just wandering. lol. Congratulations again on your goal. I’m so very happy for you!! For that and that all the surgery stuff is behind you.

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

What are you eating besides protein? Do you get fruits and veg every day? Does your diet have any fat in it? Make sure as you focus on protein that you also focus on getting a well-rounded, balanced diet and enough calories to keep your body going.

@BlueParis My skin has been so dry! I've been using more lotion than usual and my hands still feel like sandpaper. Maybe because I barely eat any fat right now? I'm not convinced the advice for non-fat milk and yogurt makes sense right now because I basically get no fat when all I'm having is protein powder and dairy.

So I had my surgery a couple of months ago and I feel so weak! Just walking round a supermarket drains every bit of my energy and my body aches after , I'm not strong like I used to be, I'm really trying to get my protein In , I've done well today with 80g but some days I only get 30g in , when will I get my energy back?

Yeah, not buying it. The medical community looks for what it wants to see. I married a statistician. They constantly remind me "Correlation does not equal causation!!" The medical community wants to believe that more physical activity will miraculously solve obesity issues because it puts the cause and the remedy right back in our laps, instead of admitting that this is a disease that is very complex and no one smoking gun is the cause or the cure. We need holistic approaches. I was a very active child. So were my siblings. My brother is a normal weight, my sister is often underweight, and I ended up over 300 lbs. My parents are normal weight though they both have siblings with weight issues. I gained a ton of weight while I was still active. Puberty hit and it was like someone switched on a helium tank and I just ballooned up. I've had more doctors than I care to count tell me that if I just got more physical activity and stopped eating McDonalds all would be well, ignoring the fact that I hate McDonalds and until my autoimmune disease got severe I was quite physically active. I know a lot of thin people who are couch potatoes. I know a lot of fat people who are active. These "studies" do nothing but continue to give doctors more ammunition in the shame game that is current obesity management. My partner is Chinese, was raised on traditional Cantonese food (which is very healthy in general), in a family where everyone is effortlessly thin except their grandmother who was diabetic... Several years ago my partner was diagnosed with diabetes. They've had weight issues all their life, despite being very active for most of it. Is it genetics? Perhaps. Is it current lifestyle? It probably contributed to it. Was it due to a childhood diet based on rice? Not likely, that diet also incorporated a ton of healthy protein options and a healthy variety of vegetables, including plenty of greens. A lack of exercise was certainly not the cause of it and increasing exercise is not going to be the cure for it either...

I dose out my vitamins for a whole month at a time using these pill cases: https://www.amazon.com/gp/product/B08QR78YP3 Sometimes you can find them (or a similar brand) with a coupon for a bit more off, but honestly they are cheap enough to get 4 and still not break the bank. Start with 1 or 2 though until you know you like them. I love how colorful they are, it helps me not lose them when I carry around the day's doses. Then I set a medication reminder (iphones have this in the health section, but you can get apps for it too). I have to take vitamins and meds 4 times a day, so doing this really helps me remember to take them and to not get behind. Finding movement you enjoy is important. Gyms aren't necessary and for many of us they hold a lot of negative associations. If you love the gym then disregard this suggestion, but if you don't, you might be much more likely to do an exercise that actually feels GOOD in your body to do. Also, I carry protein snacks with me at all times. And when I get off track and forget, I stop at a store or gas station to get little packets of nuts and jerky, instead of stopping at a fast food place or eating a bunch of simple carbs. I keep reminding myself that just because I'm cleared for "all foods" does not mean that "all foods" are "right now" foods. Some things are not for us in this first 18 months, even if we can technically digest them fine. When I relax into that awareness and get myself back into ketosis, I usually feel better and stop craving simple carbs so much. Except for chocolate. I will always want chocolate. LOL

In people with an intestinal component to their surgery (like gastric bypass, SADI, and DS) sometimes GI symptoms can happen like chronic gas. You might consider exploring a FODMAP diet to see if you can find the foods that are triggering the gas. Odds are something you are eating is causing this... You could also try adding a probiotic, sometimes the gut microbiome can get off kilter. And a reduction in the simple carbs you are eating might help too if you eat a lot of carbs as opposed to a protein heavy diet. As for the burping, it sounds like for some reason you are swallowing a lot of air. You might try drinking fluids a bit differently. If you drink from a bottle or a straw a lot, you might switch to a wide mouthed cup. My dietician said a lot of water bottles and narrow shaped cups (as well as straws) can cause you to swallow a lot more air than normal, causing burping and sometimes nausea. I'm sorry food doesn't feel good right now. I feel the movement of food in my esophagus and stomach a lot, as well as when I drink. Small sips and small bites help. Small is smaller than you think. I hear it gets better as time goes on... Sometimes I can eat relatively normally, other times (like this week) my restriction is super high and I can only eat half of what I normally do, or less. There is an ebb and flow to this. So on my high restriction days I eat less and drink more protein supplements. On my low restriction days I get more veggies in and a hefty dose of meat based proteins. I figure it all averages out in the end! I agree though, a talk with your doctor is in order. You shouldn't be experiencing pain at this point. On rare occasions bypass patients can develop strictures which could cause some of the symptoms you list.

You look amazing @ZeeGee!! And you look STRONG! @brandycsiz You are not the only one. LOL I went on vacation for 4 days for my birthday and managed to gain 6 lbs! Logically I know that I didn't gain 6 lbs of fat, it is mostly water, but it still panicked me and made me feel like my progress was stunted for the month... Part of it is my fault though. I was eating out for every meal so that means more sodium and more carbs. I wasn't hydrating well. I didn't hit my protein goals. And the bed was awful so I wasn't sleeping well. Life happens! I took yesterday to feel depressed about it and panicked over breaking my surgery. LOL Then this morning I got up, made a protein shake, and had lots of protein for lunch (baked chicken thighs and green beans). I made a tall glass of sour watermelon flavored water and am plotting dinner. Carbs are under control. I slept in today to help offset my sleep debt. And tomorrow when the weather clears up I'll be back walking... The issue is not that we get off track sometimes. The issue is that in getting off track we lose hope, start to get down on ourselves, and want to eat a whole cake. 😂 But if you know better, you can do better. So gently but firmly course correct in the ways that you can each day. Make steady improvements back towards your goal. And see these acts as self care rather than harsh discipline. In this, as is with most things in life, our journey is much more important than our destination. Journey well my friends. We can do this!! 😍

Difficult situation. Before making a final decision, find out what financial options you have to cover expenses while on sick leave.

Hi all Well I went to my x ray today. They started with a "Alka seltzer" type thing to expand my esophagus. Let me tell you the carbonation was amazing but downfall.... they don't want you to burp. So Dr takes images of empty esophagus and stomach then makes you drink some "stuff".... was thicker than a protein shake... chalky taste... not nice. Then they take different images. End result is there is no blockage or leaks or hernia. It looks like it was just the scar tissue healing. He did say how small my gnome is he can absolutely see why I feel so full all the time. The small barium drink absolutely filled my little gnome.

It sounds like maybe you would benefit from a stricter routine. At least, I know I tend to flounder when I am just let loose without many rules. If I have to figure out what to do every day and each day is different, I get totally off track with stuff. But when I get into a routine, it's way easier. I haven't gotten off track yet simply by virtue of not being able to eat very much right now, but I know that establishing habits and routines is the most important thing for me to do before I get to the point where I could. Here are some suggestions, just in case they help! Put your full week's worth of vitamins in a weekly pill case (I use this one: https://www.amazon.com/gp/product/B0C6XZN1YH). It's especially helpful if you get the kind where you can take the day's box with you for those later in the day doses like calcium. Make the same thing for breakfast and lunch every day, or have a rotation of things you can do that are all close to the same in protein value. Plan a dozen dinners that are also roughly the same in protein. Add them up and make sure any breakfast, lunch, and dinner chosen from your repertoire will hit your protein goal. If not, plan for a snack or two in the same way. Don't eat things that are not nutrient dense, and if you do have a treat on occasion, make sure you're limiting yourself to once a month, not once a day! (And if you happen to love chocolate, consider this for one of your daily calcium supplements: https://procarenow.com/products/calcium-dark-chocolate-500mg-calcium-500-iu-vitamin-d) Consider getting something like the Portion Perfection plates and meal prep containers if you struggle with portion size Buy a bariatric cookbook to help with food choices and portions Put your gym or exercise time on your calendar and treat it like you would a doctor's appointment (I struggle with this so much) Or, if you hate the gym, choose exercises you'll actually look forward to. Going to a gym is not a requirement but moving your body is. Put all your reminders for vitamins, mealtime, snack time, and exercise time in your phone so you get reminders

2 Tbsp in one sitting is a reasonable limit since the stomach capacity right after surgery is somewhere between 2 and 4 Tbsp (although 2 Tbsp is only 1/8 cup, not 1/4 cup). But the OP said she was only told she could eat 2 Tbsp in an entire day, which I've never heard before. Usually programs will say 2-4 Tbsp per meal, and then recommend somewhere between 3-6 meals spaced evenly throughout the day, with protein shake supplements to make up the difference. It just seems unusual compared to a lot of other programs, and the fact the discharge papers told her 1/4-1/2 cup per meal (which is too much) and the dietician said 2 Tbsp per day would definitely have me wondering if one hand knows what the other is doing in that program. I mean, it's possible the dietician has a good reason for the once a day limit, but it's also possible they misspoke or had a typo and it's supposed to be per meal (and they really need to address the discharge instruction packet). It's certainly worth clarifying, at least.

Lots of people just mix protein shakes with their coffee. Lots of flavor options and it helps jump start your protein too. I’m off to Amazon to search for your cold brew jar now. 😂

Strange the different advices we are all given... the day after my op I was given coffee by the hospital. Admittedly I found it disgusting, not sure if it was my taste buds as well as I had cut down on coffee prior to the op based on my own decision but I am back on it full time now I always drank my coffee black with sweetener so stick with that minus the sweetener and just add in a scoop of vital proteins collagen and it means I get some of my protein requirement in also. I also do a couple of cold shots of coffee with Alpro dark chocolate almond milk, a scoop of vital proteins collagen and scoop of protein powder over ice for a lunch sometimes. Works out at 21g protein.

I use 6 oz of Bananas & Cream Premier Protein and 2 Tablespoons of Flavorless Vital Protein Collagen Peptides which in total adds 24 grams of protein to my coffee.

my surgery went very smoothly. lots of gas pain but walking helps a lot! getting water and protein shakes to finally stay in my stomach.

The situation is interesting. Discuss your concerns and situation with your doctor. He may be able to offer alternative options or reconsider the timing of the operation.

This is a hard one because on the one hand, it's fairly easy to advise how to change your diet and lifestyle. Here are some basic things to try: drink at least 64oz water per day remove all processed foods and sweets from your house and diet and replace with fresh fruit and nuts/seeds (this includes artificial sweetener and protein shakes if you're past 3-6 months post-op) make sure you hit your protein goal (probably 80g) with high-quality lean protein every meal, every day (meat, chicken, fish, eggs, cheese, beans) decrease or eliminate your grains/starches and always opt for whole grain when you do have it eat only at mealtimes increase your vegetable consumption increase physical activity (for example, get 10k steps per day) keep a journal that includes both a food journal and an emotions journal, and use this to see if you can find patterns or triggers in your behavior The motivation is a whole other issue. None of these changes are likely to stick if you don't have the motivation and mindset you need to do it. Personally, I found a lot of information and motivation from reading Dr. Matthew Weiner's books, A Pound of Cure, and also the one that explains how weight loss surgery really works. I also get a lot of inspiration from watching YouTube vloggers and podcasts. Here are a few of my favorites: https://www.youtube.com/@LouisesJourneyxo https://www.youtube.com/@apoundofcure https://www.youtube.com/@nicoleislosingit https://www.youtube.com/@kakisrnyjourney5376 https://www.youtube.com/@thistothatlife Finally, if you can, get friends and family involved in supporting you by checking in on your progress, going for walks with you, maybe cooking meals together. And post here for support!

Hello @ms.sss I actually really do appreciate your response. You are pretty accurate in your assessment, lol, I definitely have my moments but for the most part I tend to be pretty agreeable and sometimes that bites me. i have taken A little breather after yesterday’s meeting with my surgeons’ PA and waking up to a stranger taking their time to say I should too makes me realize I’m not just being overly anxious. Thank you!! I did make a call just now to see if the only other surgeon I would consider does this procedure and he does not So I guess the most obvious options at this point are to just go with the bypass instead or to ask ALOT of questions and pose some really uncomfortable ones about the surgein and that team that I may not like the answers too. Regardless I realize I need to slow this bus down a great deal and really think this one through. My thoughts so far are, when the surgeon sits down with me and my list of questions IF I feel better that HE has done his research and both he and I are confident he has this, then I just need to worry about the aftercare. I need to be bold and require that he gives a way to get HIM, post op if I have any urgent concerns. And I need to know who he turns to if he doesn’t know the answer. I know for my first post op appointment I will see him but maybe I can see him ever so often past that. Especially if I am feeling lost. The PA said yesterday that I may get him or the surgeon if I called with questions immediately post op and he claimed he wouldn’t just give me an answer to give me an answer but it sorta felt like what he did for a half hour with my questions. I am just going to have to go out of my comfort zone a bit and bluntly say that I don’t feel like the rest of the team is prepared to handle my care with this particular procedure. I must get the point across that the PA just can’t answer all my questions at this point and I wouldn’t feel confident in his advice about any post op questions. Or, Perhaps he could just make the PA do the research now? I mean he is practically a doctor. They know how to learn things. I just don’t think he has tried with this procedure yet. He did seem to know alot about the DS, Just not this modified version. I can ask to meet with him again after he has had a chance to prepare and see how I feel with him. My gut has gotten me this far?? As far as the dietician goes. I think I just need a list of what macros he wants me to stick to and to know what type of carbs really count and I think I can take it from there at least witb the help of this community. I also think I can shop around for a different dietician once I have the requirements If I feel like I even need one. I’m hoping that the dietician gets the exact requirements from the surgeon in preparation for our meeting in two weeks. If not I will need to ask him that when I meet with him as well. I guess the skinny about the surgeon, though is that I am going to have to pump the brakes a bit and put on my big girl panties. I need to have some awkward conversations and just mentally prepare myself that the result could be that I don’t get exactly what I thought I wanted.