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The orthostatic hypotension is not unusual with rapid weight loss, and is one of several ramifications of your body still trying to function at your old weight when there is substantially less of you at hand - we often feel cold for the same reason, that the body is still trying to cool what is no longer there. These things do improve over time, though it may be a year or two. In the meantime, as the docs and others suggest, more salt, lots of fluids (non-alcoholic), and also exercise is also a common prescription to "keep things pumping" On the exercise front - this should improve things, but let your trainer know that you have this problem so they can watch for it. Also, another side effect of the rapid loss is that your heartrate will likely be lower, at rest and in activity, so if the trainer is pushing to achieve some specific heartrate to indicate some level of exertion, (often it is 80+% of a theoretical maximum rate) their measurement scale may be skewed and they may push you harder than they should. When I was 2-3 months out, I noticed that exercise (brisk walking short of a jog) that used to get my heart into that 80% zone (140-150 for me at the time) would barely get me over 100; even today, years later, my resting pulse is low, often 50 or below, and doctors/nurses unfamiliar with me will question it (yes, it's normal) though my BP is normal to a touch high. So, the exercise should be OK, but let them know and don't let them push you too hard - your cardiac system may have excess capacity, but you may be evertaxed elsewhere. Your ketone levels have little to do with whether or not you are losing weight. They are in indication that you are burning fat. but that can be ingested fat as well as stored fat. If you want to burn your stored fat, you need a good caloric deficit, and it matters little what style of diet is used to accomplish that - low fat, low carb, keto, paleo, Atkins, whole 30 or whatever it may be. I used a relatively high carbohydrate diet (by Atkins/keto standards - 100ish g/day) and lost quite rapidly - because of the fairly high caloric deficit; ketones were there in the blood tests because I was burning my fat stores, but those readings weren't a goal. The high fat/low carb type diets a la keto and paleo are popular these days, but the high calorie levels that often accompany them can sometimes make weightloss difficult. Clinically, high fat/low carbohydrate diets are often prescribed to avoid or minimize weight loss after a non-WLS gastrectomy, so if you are trying to use such a diet for weight loss, you have to keep a close eye on calorie levels. Being four months out, you should still be fairly restricted in you eating volume so that you should still be losing at a reasonable pace, but if you are ingesting too many calories by "eating around" your wLS - drinking calories or very high calorie foods - then you can see low or no loss at this point.

I was expecting my tolerance to be one drink but I can have a bottle of wine and be totally sober even if my BAC says otherwise. I think I’m not absorbing the alcohol or something magical. Was really looking forward to being a cheap drunk.

How far out did you consume your first alcohol beverage ? How was your experience? (Not here to judge each other, but to learn from each other’s experience)

Dude, it was a Mardi Gras parade---I am sure you weren't the only one that didn't stop when they should. :-) Seriously though, unlike food, consuming alcohol is a choice. You don't need it to live. Have you tried setting a firm limit for yourself. For example, you can allow yourself to have two drinks over a 2 hour period and that's it for the night. You're there to be social, not to get a buzz or f---ked up. If you can't do that and you don't know when enough is enough, alcohol is not working out for you and you have to cut it out completely. The reality is if you feel this way now and you don't put the breaks on drinking, it's going to become a serious problem for you. You didn't get to 400 without abusing food---so, you have to be really careful with anything that is potentially addictive. You're picking up on this early before it becomes serious, so that's a great thing!!

Hey there. Thanks for the reply. I may go out to have drinks a couple times a month. I can go for long periods of time without a drink. That’s not the issue. I don’t consume alcohol during Lent every year. That’s 40 days that I go without a drink. However, if I am at an event that has alcohol and I’m not driving, I will partake. I rode in a Mardi Gras parade over the weekend. I started drinking and didn’t stop. Since the alcohol hits me so much quicker than when I was 400 lbs, I don’t know when to stop.

This was brought up during one of my group sessions. It seems that the body post WLS absorbs alcohol faster since the stomach is smaller. People tend to use the pre surgery amounts of tolerable alcohol as a guide when they drink post op. The body doesn't function the same way. There must be an adjustment in the alcohol intake amount so to not get inebriated when drinking post op. It was also stressed that one should refrain from alcohol post op since alcohol contains empty calories with no nutritional benefits to the WLS patient. In other words you get better weight loss maintenance drinking zero calorie non carbonated beverages.

My doctor let me decide though he suggested bypass. I chose the sleeve. First reason - dumping and alcohol. We entertain a lot with wine pairing dinners. Not willing to give that up. Second was purely anecdotal. Having lost a lot with band then regaining after it failed, I am completely averse to rebound weight gain. I saw too many examples of rebound weight gain in bypass patients as people’s intestines learned to absorb nutrients (and calories) again.

I heard that we don’t or won’t absorb alcohol the same way after surgery. I haven’t had any since my surgery (7mos sho)but I’m not really a big drinker. Maybe check w your NUT on suggestions.

Hey everybody. This is my first time ever going into a forum. I had my surgery in March 2010. Nine years ago in just a few weeks. Originally, I lost 175 pounds. I bounce up and down. But, overall I am doing well with maintaining. I’ve learned how to eat again and I do well with that. My issue is when I consume alcohol. Something is not clicking and telling my body that I’ve had enough. I am a social drinker. Unfortunately, when I do drink, sometimes I tend to just keep going. In nearly 9 years, I still can’t figure out how to get my body accustomed to it. Like I said, food is not an issue. I know when I’m full. I also know that my stomach cannot absorb alcohol like it used to. Has anyone else had this experience and if so how do you manage it? Any help is appreciated. I’m more than happy to answer anyone’s questions as well.

Yes I did. I had been doubting this for weeks. During the pre op diet I had been a good girl. (not a shake diet but i chose weight watchers, half portions) Everyone asked what my last real meal would be and up to half an hour before I took it, I was convinced I would just eat regular food. But then my husband asked if I wanted fries with shoarma (spicy fried meat pieces) I took it, at half a small portion and enjoyed it very much. And you know what? No guilt, for I had been working to lose several kilo's before the operation, my liver would forgive me. I am 3 months out now and haven't had that meal since, and don't crave it. So my advice, yes take a last cheat meal but do not go overboard. Like I said, take half of a small portion. And I would advice against taking alcohol the day before operation, it might linger in your body too long? Anyway, good luck either way

Anyone have any last cheat meals or drink of alcohol? I have a month until I get surgery and my doctor kinda gave me the okay to go enjoy myself a little, but do not go over board. Anyone have any last minute confessions before surgery? Is it ok if I just self indulge a few more times before surgery dine and wine? Let me know your experience. Will the surgery still go good?

i’m 7 months out and started dating again 3 months out. honestly, everything the person above me said is great, try and make plans for dates that don’t revolve around drinking/food. and most people don’t even notice the amount of food we eat or don’t eat, it’s really mostly something you notice yourself. also- not gonna encourage smoking weed cause that gets you nowhere on this forum, but before i was able to drink alcohol, i just suggested smoking instead of getting drinks. there’s alternatives for everything in life!! everyone has insecurities about their bodies, surgery or not! fake the confidence until you make it. anyone worth dating doesn’t care what size you are anyway, just try to remember that! although i am only 23 so my dating life might be very different from yours and some of this might be easier said than done.

I haven’t had a surgery yet but honestly, these sound like typical thoughts of a person that’s not been on the dating scene for a while surgery or not, these are all hang ups that people worry about when getting ‘back in there’. If you meet for drinks, make an excuse for not drinking alcohol, perhaps you had a few too many the night before (they’ll be amazed by how well you handle a hangover!) and as for food, just don’t arrange a dinner date? Maybe arrange a walk in a park or bowling? This way, you can always figure out if like a person enough before you give them your entire history? Good luck

I have just lost my first 50lbs and I am starting to get a lot more confident in myself. I have started using the dating apps and now that the possibility of dating is more real I am starting to get really freaked out. Has anyone starting dating soon after surgery? These are the things I am nervous about: - they will think my minimal eating is weird (I am not 100% open about having the surgery and don’t want to have to explain my situation to every tinder date.) - most people want to meet up for a drink but I’m still not drinking alcohol - even though I am much more confident I still have a ton of insecurities about my body so I’m not sure I will be ready for an intimate relationship if the time comes and I don’t want to waste anyone’s time. Anyways any thoughts and advice are appreciated. I’m just excited to start dating but also scared.

Due to insurance and scheduling issues, I had to wait 8 months before my surgery. This gave me a LOT of time to weigh the pros and cons, examine my motives, and get psychologically ready for the change. It is different from other surgeries - this is ELECTIVE. You are choosing to put yourself at risk. Like many others, I lost hundreds and hundreds of pounds on my own..... only to have it all come back, plus. After a life time of this, my metabolism was totally screwed up and the brain-stomach-hormone mechanism was also screwed up. I had no "stop button." I never felt full. I ate very healthy food, but could never stop once started. Meanwhile, I had given up, wheat, sugar, all artificial sweeteners, colors, flavors, alcohol, caffeine. I ate nothing fried, only healthy grains, my homegrown veggies/poultry/ and eggs. I maintained an active lifestyle with my garden and animals. One day, feeling afraid of the surgery, I suggested to my PCP that perhaps I should just try again to do it on my own. She very kindly told me, "If you could have done it on your own, you would have." She was right. I was just fooling myself, maybe thinking I was weak for not being able to do it on my own. But I came to the realization that my body would NEVER lose weight because of all the damage I had previously done. Weight Loss Surgery was the final tool I needed to bring my metabolism and hormone mechanisms back to a more normal baseline. I was still scared, even laying on the Pre-op bed, I was crying and told my surgeon I was just scared about making such a big decision for an elective procedure. He reassured me that none of his patients had ever come back to him and said they wished they had never done it. He was right. I am only 3 weeks post op. I did have a complication that has now been handled, and I can say that my life looks so different. I feel better already, having lost 31 pounds since beginning the pre-op diet. I am very, very glad, even at this early point, for having done the surgery. I think this is one of the best decisions I have ever made in my life. Preop, it is like you are looking up at a cloud layer that is obscuring the sun. All you see are shadows (doubts.) Afterwards, it is like you are flying above the clouds in the sunshine, looking down at the clouds that are now bright and white. It's all about the perspective of where you are, and you can never get above the cloud layer unless you bravely make the decision to go forward. That being said, you must be determined that you will do everything you can after surgery to be successful. No cheating, no compromise. Surgery is a tool - you still have to do your part. My best suggestion is to give up all addictions BEFORE surgery so you don't have to deal with them on top of the recovery. (Caffeine, sugar, simple carbs, processed foods, artificial anything, alcohol, and of course smoking.) Determine that these are lifestyle changes that you will never go back to. That is my slogan: "I'M NEVER GOING BACK!"

I wish! I was told zero alcohol for at least 6 months. I am not a huge drinker, but I used to have martinis once a week.

I just eat when I'm hungry. Sometimes that's 3 times a day, sometimes it's 6 or 7. I only eat small amounts, so it seems to work out OK. And because I eat when I need to, I don't feel deprived. The only thing I'm strict about its alcohol - I only drink it when it's an occasion with friends. I think wine was what piled on the pounds in the past, so I'm not going down that road again! Some people are really strict about food too, but you have to find out what's sustainable for you. If you're really very strict about food for a few months and then fall off the waggon because you feel deprived, then you won't keep off the weight. I have the occasional treat, but make sure I still lose a pound or two a week. I think I'll be able to sustain that in the long term. There won't be a single right answer - I think you've just got to experiment to find out what works for you.

Nobody will fully understand your struggles with obesity and the need for WLS like people that are going through the same thing. It's like a person struggling with an alcohol or drug addiction trying to get support from someone who thinks they have a handle on it. Until a person gets to the point where we are now and seeks out and joins a group like this, they will (in most cases) be ignorant to the battle. Education is key and most people in your life won't take the time to learn your struggles unless they're in the same boat. They will only use your predicament as fodder for gossip.

Yes! Exactly! We each have to figure things out and hack our bodies in order to develop those life-long new and healthy relationships with food, alcohol, and socialization that will keep us at our healthy goal weights for life rather than to returning to another day/night at the Obesity Ball.

About 5 years ago. I had gastric sleeve surgery. I lost weight for the first year. I had just lost my mom and I turned to alcohol and I gained all the weight back and then some. My sleeve is stretched. I went back to my Dr. to see what can be done and she suggested a gastric bypass which is what I wanted to do. I have to have an Endoscopy done before knowing the full picture, but I don't having dumping syndrome now and i was wondering if i will get it later? I has anyone had this surgery done? What advise would you give? I am going to make do diligence not to stretch my new pouch out. If I get approved. Sent from my SM-G930V using BariatricPal mobile app

I knew that surgery was going to be very hard, requiring discipline and a new way of eating. Wanting to give myself every chance for success, I tried to give up every addiction I could PRIOR to surgery, so that the battle would be less complex afterward. Prior to surgery I gave up sugar (my joints never felt better!), caffeine, soda, alcohol, artificial sweeteners, artificial colors and flavors, processed foods, and snacking. I also started 16/8 Intermittent Fasting. I had already given up wheat/gluten several years ago, I was never a smoker. The sugar, caffeine and snacking were especially hard, but I am SOOOOO thankful I am not dealing with those now that I am only 2 weeks post op. I would suggest this to anyone in their preop period. Get rid of the junk NOW! You don't need to deal with cravings after surgery - food deprivation is enough! It will give you the confidence to comply with the post-op restrictions, and will set you up for a much healthier life style for life.

I assume most of us had to attend nutrition and pre-surgery classes as part of this process. In our class, I think I could pick out a couple of people who are not going to be very successful. After being told that we could have neither alcohol nor carbonated drinks, one woman declared that she will NOT give up champagne. Another one said that her hectic schedule meant she had to eat fast food, and that would not change after surgery (which reminded me of "My 600-Pound Life). I'm not saying that I'm going to be a saint and never cheat, but I can't understand why you would be doing this if you were going in with the intention of cheating. Am I being too judgy?

I'm not saying this is an idea solution, but this is what I've done, in order of best to worst: Look up KETO recipes for sweets! You can make your own chocolate (yes, even bars!), use fat alternatives to reduce the fat in the recipes, and eat it pretty much GUILT free. Make it with erithrytol or stevia as your sweetener so you don't have an insulin response. You can also look into Lily's chocolate bars, your local super market may have them and they use stevia. Buy Slim Fast fat bomb peanut butter cups and have ONE. They're made with erithrytol so they're good! Or look at Quest protein bars or Atkins candy. Try to avoid Maltitol, which is a sugar alcohol that WILL spike your insulin and can perpetuate further cravings. In a pinch, get sugar free chocolate (like Russell Stovers SUGAR FREE) and only have a portion size or less. Definitely don't have more or you'll be married to the porcelain throne all night. Warning: they are dangerously delicious and, much like sugar, won't fully satisfy that craving and will leave you wanting more so exercise extreme caution and willpower here. Good luck!

Thanks everyone. It's a weird thing. Intellectually I feel no shame for WLS. It was an excellent decision and I should have done it a long time ago. I would never judge anyone else for doing it. Yet, part of me does feel embarrassed that I couldn't do it without intervention. Food is an addiction for me and I don't want to discuss something that private with others. Would an alcoholic or drug addict be expected to casually discuss their issues with others?

I bet if you bring something health-ish your friends will thank you! What about doing fruit skewers with strawberries, watermelon and grapes. You could make a sugar free (sweeten with Stevia) yogurt dip and add a little food color to make it pink. There are tons of ideas on pinterest. A good old fashion veggie tray always seems to be a hit! Pink or not! If you don't want to drink alcohol but want to feel like you are celebrating, bring some pink crystal light! Stick to your plan and try to focus on the companionship versus the food! Good luck and have a great day!