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Look up Bariatric surgeons in your area and make some calls. Once you find some who will help you, then you can decide which is the best fit for you. Good luck.

I don't claim to be an expert here, but a few thoughts come to mind for you to consider: MGB is extremely rare in the US. (It's much more common on other parts of the world, especially Asia.) Part of the reason it's so rare here may be due to the fact that it's not an endorsed procedure by the American Society for Metabolic and Bariatric Surgery. I would suspect revisions are even less common, so there's probably not a lot a data on success rates? Because there's not a lot of data, it's a bit unclear if MGB will even address your GERD issue? I'm seeing a few studies out there, but results are unclear. Roux-en-Y GB is actually sometimes performed specifically to treat GERD due to its effectiveness in alleviating those symptoms. I would think if GERD is the main reason for the revision, this may be an important consideration?

The mini bypass has been kicking around for a long time - it was around the periphery of bariatrics some twenty years ago when my wife and I first started looking into WLS, and it's still there today, not having achieved mainstream status (and many, if not most, US insurance companies still don't cover it.) in the meantime, the BPD/DS, VSG and now the SIPS/SADI have gone mainstream, gaining acceptance by the ASMBS and insurance industry. It would pay to understand why that is. When I last looked into these things, 2-3 years ago, ASMBS was fairly positive about the SIPS/SADI, but they didn't yet have the data to recommend it; they apparently do now. I would suggest looking through their site to see if they have any current opinion on the MGB and why it doesn't get on their recommended list. Amongst the MX surgeons, the MGB seems to mostly be sold as a cheaper alternative to the RNY rather than a technically better one. Classically, bile reflux is one of the problems with these simplified, single anastomosis procedures. There are claims that some techniques have been developed to mitigate that problem, but I don't know how much of that is real progress and how much is marketing. The MGB does seem to be more mainstream in other countries, so there may be something to the claims of improvement, and it simply lost its best opportunity to be sold to the US industry and authorities. Given that, I would be apprehensive about getting it done while living here in the states, if for no other reason than long term support - how many US doctors, bariatric or otherwise, understand it, and how to treat you in the years ahead should there be a problem. It's something like owning a French car here in the States - parts and service are a problem. My wife has a DS, which has something of that issue, despite being mainstream and approved, as it is still something of a niche procedure, with few surgeons understanding it. It, however, has the redeeming value of having demonstrably better performance - both initial loss and most particularly regain resistance; the MGB doesn't, as it's not markedly different than the RNY or VSG in performance. Have you had your GERD evaluated as to its cause? A hiatal hernia or shape issue can usually be corrected while still maintaining the sleeve, though some surgeons may not be well practiced at that and would simply revise to a bypass to correct it (the old "VSG + GERD=you need an RNY" thing rather than fixing the basic problem - it might need an revision, or it might not.) In correcting regain, these revisions seem to be only moderately successful - count on maybe twenty pounds or so - about what one would expect from the intense dieting required around surgery time, and one can expect similar results from a hiatal hernia repair. Basically, you have already learned how to eat around a small stomach, so shrinking it further with a revision doesn't yield nearly as good a result as your virgin procedure. Some do show remarkable improvement, but they seem mostly to be those who take the regain seriously and swear to "not let that happen again" and really buckle down and get with the program. One can almost consider the revision to be a placebo. If I were looking to seriously tackle a regain problem, I would lean more toward the BPD/DS as that more directly addresses the metabolic problem, though not the GERD as it retains the sleeve - that would remain an issue as to whether the sleeve itself is the cause of it and that can be corrected.

You are definitely not alone. That's why I caution others not to do what I did. I just put away in a box, a zillion different protein powders, unflavored and flavored, Bariatric soup and chili packets ... Etc. I think after the first 2 weeks, I found more delicious, natural and appetizing ways to get my protein in. But here is the weird part, I still buy them from time to time if someone mentions one that I think I will like. After one serving or two servings, back in the box.

At the end of last year, my life was over eating and especially lots of sugar. I binged on little debbie cakes, guzzled icees, had many high calorie starbucks drinks and a lot of fast food. I ate and drank so unhealthy that it really was a slow suicide. It was killing me and frankly I did not care, but rather welcomed it. After several things snowballing, the first of 2022 I started to take control. I made a choice to live. I struggled to work out the pain of the past and even current circumstances which lead me to cover the pain in food, especially sugar and non nutrient dense carbs. The pain that brought me well over 400 lbs and climbing. I journaled and cried and started to stand up for myself. I also did take Ryselbus which helped give me a leg up to do the work. My husband took it but the effects wore off some because he didn’t change. I knew i needed to change if I wanted to live. Over a few months, I did the very hard mental work. I broke addictions to fast food and the sugar. Going through the process sucked. Slowly, I repeated over and over again I was worth forgiving to getting into this unhealthy state. I could heal and forge a new way. I didn’t need sugar or binging on pizza to make me feel better, I could finally start to find empathy and forgiveness for myself. Now I am two days from life changing bariatric surgery in a good place. I am ready for the huge changes this surgery brings. No longer do I binge on sugar, bread, processed food. I don’t even want to binge 90% of the time and I have self soothed myself with forgiveness and understanding the other 10%. I have changed my eating patterns, my portions, my outlook. Sugar isn’t forbidden forever, but it will now be a treat, a sometimes indulgence. It feels amazing to be able to make that choice instead of being ruled by cravings. I feel lighter from not having to carry as much of the huge burden of self loathing and self hate I used to carry. I am worth forgiving myself. I guess really why I am writing this is I know the struggle is so real. each one of you has your own issues and challenges. Each one of you is worthy of self forgiveness and embracing good things in your life. shed the tears, embrace your flaws and find a way to accept yourself and move forward in a way you want. Even if you struggle, It is worth it.

I would reach out to your bariatric team, I would think they have someone they refer patients to. Once you have someone, you could do your own research and get a warm and fuzzy about the person before moving forward.

Congrats! Like you said, there are definitely some things that make your pregnancy higher risk, but in other ways, you are actually in a much better place. For example, you're much less likely now to end up with gestational diabetes. You probably already know this, but the things your doctors will be most concerned about will be your ability to eat enough, as well as the potential for vitamin and mineral deficiencies. These can all be overcome with your doctors help. If it's available to you, going to a multidisciplinary hospital system where they have more experience with pregnancy post gastric sleeve would be a good idea. In most states, this would be large teaching hospitals or the like. Maybe talk to your bariatric surgeon for an OB referral to someone with experience with post WLS pregnancy?

Generally, I don't think doctors give med schedules, but it certainly doesn't hurt to ask! You could also speak with your pharmacist, who may be able to help. There are a few good points to remember when timing your meds/vitamins: You can only absorb about 500mg of Calcium at one time. Most bariatric patients are encouraged to take ~1,000mg so you'll probably want to split that into 2 doses at least a few hours apart. Some research indicates calcium can inhibit the absorption of iron so if you take an iron supplement or a multi-vitamin with iron, you'll want to take it spaced out from calcium by a few hours. Early out your supplements may very well upset your stomach. Spacing them out even further, taking with food, etc. can all help. So don't get too hung up on a rigid schedule. Getting them in is most important; you can adjust as you go. Personally, I take my multi, a biotin, and a calcium along with my regular meds (no interactions) after I've had a protein shake each morning. I take another biotin and another calcium in the evening after dinner. My multi does NOT have iron, but when it did, I would take my first calcium with lunch instead. Hope that helps!

Yep, 2 shakes a day and then 1 meal from the list of acceptable meats/veggie in very small portions. I am using the Nectar chocolate protein powder in milk. I am continuing to see my bariatric therapist that my bariatric center had me go to for my evaluation. She's amazing. I'm so glad to hear that it normally gets better for most. This week has been tough. I don't know how people do it for longer than 2 weeks or even stricter diets pre-op.

Are you doing shakes. It could be the shakes causing the heartburn and all that?? Maybe try a different brand of shake. In terms of it getting easier it does for almost everyone. Most of us (with the exception of a small few) lose our hunger hormones post surgery so we only have to fight with head hunger which is usually a little easier to ignore. If you do continue to fight head hunger and it’s difficult for you, some people find it helpful to work with a bariatric therapist to get to the bottom of the cravings and learn different ways to cope with them.

It's not actually "soup", but one thing I really appreciated having at that stage was "Millie's sipping broth". It's basically like a tea bag, but instead it's herbs and spices. Maybe a little pricey for what it is, but they are very tasty. I mostly just used them to help me get my liquids in, but if I was also needing a protein boost, I also added them to my homemade bone broth. Both ways worked well. My fave was probably the Pho, but the Spicy Tortilla is also very good. Edited to add: They are available here on the bariatric pal store, as well as Amazon, etc.

I had sleeve and I was told to take a bariatric multi with iron and two calcium citrate daily to start. They do blood work at the three month follow up and adjust from there if necessary. My labs were good at 3 and 6 month and one year. That seems to be working for me. I take the procare health multivitamin with 45mg iron. That and the bariatric advantage chewable were recommended by my team. I started with the chewable and I didn’t think it tasted bad (some people hate the chewables though) but it was more expensive and you had to take it twice a day so I switched to the capsule at about one month out and that’s been fine for me. I have it on auto ship which is convenient and it qualifies me for free shipping. I did keep my leftover chewables in case they ever didn’t arrive on time but a year and a half later that has never been an issue. The calcium citrate I take is just a normal vitamin from Amazon (just make sure it’s “citrate” though. The other one doesn’t absorb as well for us.

Which surgery did you have? If you had the sleeve, a multi may be all you need. This is a question you really need to ask your Dietician or Nutritionist. Depending on what your blood work says, you may need something else, or you may not. I take a lot of supplements daily, but I had a bypass, am vegan, and have my Dietician guiding me. It can't hurt to take a hair and skin supplement though, to help your body through any upcoming hair loss. Won't stop it, but the extra supplements will help with the eventual regrowth. A good bariatric-multi should be covering most bases, though.

Ask 10 nutritionist if popcorn is "good for you" and you'll get 11 different opinions. Here's some of the reasons I've heard bariatric patients should avoid it: I honestly think this one is more urban myth, but some people claim popcorn kernels or pieces can get stuck in the staple line and cause issues. If true, this is obviously a bigger concern the closer you are to surgery. Even if the popcorn itself can be an okay choice, we tend to add toppings that aren't so good for us. It's easy to overeat since it feels like there's not much there. This can catch up to you though. Also, because it has very little protein, eating too much popcorn may prevent you from meeting your protein goals for the day. Popcorn is high in insoluble fiber, meaning it will draw water into it and swell in the gut. Now normally fiber is a good thing for a healthy gut, but especially for bariatric surgery patients that are not used to it, you run the risk of the popcorn swelling while it's still in your stomach and causing significant discomfort. This risk is probably reduced if you eat it slowly. Eat it too fast and you may regret it. Anything you eat in a mindless way (as we all tend to do at the movies), could lead to you eating too fast or too much. See #3 and 4 above. No question that alternatives such as those suggested above may be better for some people. The concern for me is that especially while at the movies, I have to make sure I don't fall into that "mindless eating" trap. That's so dangerous for me. I'm trying to learn to stop associating "movies" with "snacking". (I even do this at home, so Netflix is no relief.) I think at least for me, that may be the better option long term?

My surgery was 9/20. I went back and looked at my log and I'm currently eating between about 500 and 800 calories a day. Like many, I was not told a specific calorie goal, mostly to focus getting in my protein and water. Since I'm at about 6 weeks now, I don't have any restrictions in terms of food, but getting to my protein goals is hard on food alone, just because I can't physically eat that much. This means I have to rely on protein drinks some still. It's been said a million times already, but your bariatric team is your best source for your concern. Plans are different and we all progress at different rates as well.

Hello! My name is Sasha. I was sleeved in 2016 and since my surgeon has retired. I lost my binder moving states and I need some help. Are we allowed to take antibiotics? I am suffering from a UTI and have been taking Uricalm. It’s helping but I might go to urgent care today. I’m so cautious trying new meds without a bariatric surgeon telling me it’s okay. Please let me know your experiences with antibiotics post surgery!

Hello! My name is Sasha. I was sleeved in 2016 and since my surgeon has retired. I lost my binder moving states and I need some help. Are we allowed to take antibiotics? I am suffering from a UTI and have been taking Uricalm. It’s helping but I might go to urgent care today. I’m so cautious trying new meds without a bariatric surgeon telling me it’s okay. Please let me know your experiences with antibiotics post surgery! Thank you!

I finally got a call back from Kaiser and the person I talked to said that anything with protein in it DOES NOT count toward the liquids. I even double checked and asked if I make isopurr with 16 oz of water does that water count she said NO. It only counts toward protein. They also said that they would send a referral so that I could go to the support groups. It isn't a drop in thing, I need a referral and then someone will call me. I am feeling less than supported by kaisers bariatric department. I have an appointment with the surgeon next week so I hope that goes well. Scared but excited.

I have almost the exact same stats- started at 240, now at 175 a year later. Still losing very slowly - less than a pound a month. While I’m not unhappy with where I’m at, I did hope to lose a little more. And my surgery team would like to see me at a bit lower bmi. At my one year appt Tuesday, they gave me a sample of Mounjaro to try. I am surprised at how much appetite suppression it gives- I feel like the first weeks after surgery, when eating was a chore. I’m pretty sure this is going to kick start the process all over and I would not be surprised to see it become a standard adjunct in bariatric practices as we get further out, stall, slow or regain.

First of all, I'm so sorry you are struggling. Know that you are not alone and that many folks experience some wonderful things after WLS as well as some more difficult things. That is just part of the process; its definitely not always sunshine and roses. 1- Constipation is VERY common. Are you taking an iron supplement? They are notorious for exacerbating constipation. If you're taking any additional iron, it may be worth getting your labs checked - if they are normal, maybe you can drop that? Another option would be to add a prebiotic fiber supplement. I take about 15g of Just Better Fiber daily and it is a HUGE help. Make sure you are well hydrated, especially when taking laxatives, stool softeners, etc. Lastly, are you getting in any fiber in your food? This goes with #2.... 2- The return of hunger is normal and expected. Your body is doing EXACTLY what its supposed to do. It may be helpful to start introducing more fruits & veggies, which will help you feel fuller longer and help with constipation. Also, are you hitting your protein goals? If not, definitely focus on getting that protein in. If you're hitting your goals, adding in nutrient rich fruits & veggies, and STILL feeling uncontrollably hungry, then it may be time to consult with a bariatric dietitian. Hunger is normal, feeling miserable is not. 3- I think a LOT of us struggle with body image before and after surgery. There is a trade off that happens - we lose the weight and are healthy, but it can make the physical effects of a lifetime obesity more obvious to us. Therapy therapy therapy. I can't encourage it strongly enough. Learning to cope with those feelings, learning to be kind to our new bodies, learning to love ourselves well, THAT is the hard work of weight loss and it is truly a lifelong process. Get help, and keep getting help. Outside of that - buy clothes that make you feel good, as much as you can focus on what you LIKE about your body instead of what you don't, if its practical for you, you can always look into plastic surgery, and of course, you could just refrain from looking in the mirror naked. I know, easier said than done, but if its causing your harm emotionally, then maybe hold off for now. You aren't alone and you aren't crazy. WLS is hard work and there is a lot that comes with it that doesn't get talked about much. We are rooting for you.

Papa johns makes pizza bowls, I tried it once. Also, very greasy. I wasn't a big fan of it but people rave about it on the FB Bariatric group that I am in. Mine was cheese, pepperoni and veggies so not even a lot of meat. But, full fat cheese gets greasy when melted so I get it. But my pizza bowls aren't greasy like that. I use full fat cheese and turkey pepperoni so maybe that makes the difference.

A year ago, I did gastric sleeve. My weight was originally 230 pounds. Now, it's 117 pounds. I feel pretty ecstatic that my weight has gone down. However, that's where the happy list ends. I'm concerned with the direction my life is heading after the surgery. I suffer from the following problems: Chronic constipation. I must take Dulcolax laxative every day for relief. Miralax powder doesn't work. My GI doctor performed a colonoscopy, but nothing malign was found. It's debilitating not to be able to get the relief I desperately need, and to feel dependent on medications when I thought this would be temporary. Increased appetite. It's becoming more difficult to control my eating habits. I'm constantly hungry. Excess skin and fat. It's impossible to look at myself naked without judging my body. Has anyone else been going through these problems? What has worked well and not so well for you?

I will be seeing my primary on Monday and we are going to discuss this as the bariatric center only asked for Vitamin D blood tests.

I think they meant the protein shakes. I can currently drink the clear protein water and the nurse from the Kaiser support group and my doctor said it was fine and counted. I think you should start attending some of the sessions and/or join their Facebook support group and ask your questions there. Your local Kaiser bariatrics should have that info.