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I am so confused about all the insurance stuff - and I know that this isn't the best place to get specific help, but I'm hoping that it can just be made clearer for me. I'm not American - I'm from the UK and we have universal healthcare, so the insurance thing has always confused the feck out of me! I live in upstate NY, my husband works for the State and therefore has very good insurance. It covered our IVF and my breast reduction surgery 100%, for example. It's United Healthcare - but is also apparently the NYS Empire Plan. But it is Blue Cross Blue Shield if there is a hospital stay involved?? Anyway - I went to my primary care doctor. She has the same problems as me (PCOS - an endocrine issue, one of the main symptoms of which is weight gain with the inability to lose, and ultra low metabolism). She has had weight loss surgery herself, and so was quick to recommend it. She gave me the name of a surgeon, but didn't give me referral letter. I signed up as a new patient on his website, completed the mandatory seminar, and set up an initial consult. I went for the consult last Thursday (06/07/18) and they weighed me and took a history. The nurse said my insurance requires 6 months of weigh ins, which have to be done every 28-30 days. This threw a spanner in the works, because I go home to the UK for the summer, leaving early July. Because I am not back until the middle of August, I was told that I would have to start in September - I wanted to come in August, but was told that it had to be in September because it goes in 4 weekly blocks. Maybe she meant from the date of the consult? So they said I would have to see the nutritionist, have an endoscopy, a psych eval, an EKG, a colonoscopy. I pretty much expected that as I had looked up our insurance plan's rules for surgery: https://www.empireblue.com/medicalpolicies/policies/mp_pw_a053317.htm I am right at 36 BMI and the policy for BMI with co-morbidity (I have PCOS, diabetes, high cholesterol) is 35. I was not told to lose weight - but what will happen if I fall under 35 while doing the weigh ins? Also, they said that after the 6 weigh ins and other procedures, they forward it to the insurance. Does that mean that it could still be denied? Am I essentially doing this blind right now? I read about people hear calling their insurance - am I supposed to be doing that? Do I need to get prior authorisation for this, or is the weight loss centre supposed to deal with it? Again, I'm sorry if Im being really dumb - I just want to understand the process.

The research group that I'm with believes that eating very low calories for too long...will set you up for a bad metabolic reset and more rebound weight gain at five years post op. You don't want a starvation metabolism. You want a hot burning furnace that supports lots of activity, healthy muscles and exercise. We are encouraged to eat 1200 calories per day as soon as possible after surgery. I've eaten 1200 calories daily since my third week post op. I feel terrific. Am almost to goal. It's important to listen to the professionals. Their advice is based on a broader perspective than just our own. And they've seen the consequences of lots of well intentioned nutritionally disastrous efforts. Be safe, be well, and best wishes!

i have seen alot of people say they have a small weight gain and it is normal.

This is lateral femoral cutaneous nerve syndrome - it's a sensory nerve that gets affected by either rapid weight gain or loses. It's common, and harmless (but annoying)

It makes some sense, as there has been a genetic test available for a while to check is one is predisposed to diabetes, insulin resistance and a genuine carb sensitivity (many who claim a carb sensitivity are just noting the normal effect of carbohydrates causing some water weight gain when one is on a low carb diet.) My wife is a bit of a bread-o-holic but it doesn't bother me - I can take it or leave it, and used it for specific added nutrition part way through my loss phase. My loss trend actually improved with it added.

Dear Buddy, Thanks for the information. I agree with you on the point that weighting Everyday lets you know if your weight has increased and take actions before it is out of control. I think the reason for not weighting Everyday is more of the mental perspective. Some will get stress over a pound gain and start to panic which is what I experienced and it back fired, I increase my exercise up till a point my body cannot take it and just break down. Only during my resting period I realised why the weight gain and it will stop at a point ( gaining back water ). So I think weighting Everyday has its advantage but we also need to keep a cool mind once we see a gain in weight and really understand the reason before going into increasing exercise. One could also measure weight and waist to confirm.

I wouldn't worry too much about the weight gain. Even at 2 months out I'll fluctuate 1-3 pounds either way throughout the week. It's likely water retention and it will level itself out. 500 calories doesn't seem like a lot. My nutritionist advised to focus on proteins first and foremost. On my 2nd follow up appointment later this month they are going to give me a template on calories, carbs, etc. Just stick to the foods you can eat, try to get the 60-80 grams of protein and try to make sure it's quality protein too. You're doing fine. I worry a lot too but it you are doing what your doctor said, you will be ok.

It is hard to not want to look at the scale every day, buuuut you need to stop doing that to yourself! It is negative reinforcement and doesn't help the psyche either. Also the 1 pound weight gain could simply be due to increased water intake, I went through that a lot post-surgery two years ago. It was hard to not want to step on the scale every day and see what was happening. You should pick one or may two days out of the week and use those as the days to hop on the scale. By doing this you will be able to keep a healthy routine and not stress yourself out so much about what is or isn't happening. I wish you the best on your journey and keep up the great work, just keep active and take care of yourself and everything else will fall into place... just be as patient as you can

I saw amitriptyline there, awful stuff, I hate it. Gabapentin & amitriptyline... Sleep issues? Sorry not my business, but I have them and have been on both for them. If so, vistaril doesn't make me gain weight, but I do Ambien too. I know A LOT about those meds, I feel like I've taken them all and weight gain because of my meds scares me too

Hello. I’m in Australia so I went to the local private hospital. It’s been good so far, I was well hydrated before the procedure and have been on drips since. I’m going home tonight. My surgeon likes to keep people a few days post to up your fluids before they send you home. If I keep drinking as well as I have been I will be good, now the focus is protein. I’m one of the lucky ones, I can still drink, and enjoy, water. My weight gain was due to bad food choices, overeating and neglecting my health. My nutritionist has told me to stay on liquids for another week and then purée/soft for 4 weeks. I’ve been told to stick to 1/2 cup per meal of food rich in protein.

I just attended a support group and a someone asked how to prevent and reverse regain and here were some things mentioned: Start planning and timing your meals again Dont eat and drink within 30 mins of each other Hydrate for the majority of your day (calorie and sugar free) you cant over eat if youre drinking No random snacking, this is grazing and leads to weight gain Weight yourself weekly, youll always know whats really going on Attend support groups Mental health is as important as physical, dont neglect it Any major changes call your Doctor immediately

If your out of control you have to regain that control. 1. track everything you eat 2. prioritize water 3. stop eating sugar - includes all the foods loaded with sugar 4. get out all those papers from your surgery and read the avoid these list again. 5. highly refined foods loaded with simple carbs are your path back to weight gain. how much of your grocery basket came from the 3 walls ? 1. produce 2. meats 3. dairy how much is from the center of the store ?

walk daily , weight training 3 days a week if available lots of water get your protein daily for your size no sugar - as close to this as you can no simple carbs - avoid the middle of the store - shop the 3 walls - veggies , meat , dairy highly refined foods are your worst enemy no fruit if your weight is not going down no snacks after dinner dont fear the fat it makes it easier to go longer between meals try to go at least 12 hours from last calorie in till first calorie next day. your asleep most of this. get enough sleep - most people don't start day with protein and fat not carbs good luck and i am sorry meds have set you back it is always tougher when other factors fight against you and so many meds cause weight gain

My go to stress reliever for the past MANY years has been alcohol. Did the gym thing when I was younger but it was always kicking back with my boys throwing some back that always took the edge off. Well look at me now. More than 200 pounds over weight and a full fledged alcoholic. The past 3+ years have been the worse as I started having back issues which led me to not be able to work anymore and not provide an income for my family. More weight gain more pain and more drinking. This is the 1st year since I can remember that i'm not getting wasted every night. Not sure what finally flipped the switch but I don't want to die anymore. I still drink but I've come along way from what I was doing. Will completely stop soon, who knows maybe last week was my last. But know for sure if I do get approved for this surgery It is over. Hope to bring the gym back into my life and other activities that can be the new stress reliever.

Hi there I'm new to WLS so I still attend support groups and here's what they say to consider about regain: How much have you regained? Have you changed your habits? (Eating, exercise, sleep, work, etc.) Any new medical issues or life changes? Have you seen your Primary or Surgeon recently? I've also heard some chatter that something happen around year 3-4 that are unavoidable that prompt weight gain (idk the validity I'm 6 months out) But take a strong honest look at yourself then seek MEDICAL ADVICE from your Medical team first And you totally got this ... Again

I am not a religious man; I have not been to church in over 20-years, and I enjoy my freedom shopping at wally-world, or going to the early movies while everyone else is at church... But I do pray. Most recently I prayed for intervention. I prayed that a power higher than myself give me strength, because in the past I have had little when I needed it most. And "boy-howdy" do I ever need some help now! In my prayer I made sure to ask for exactly what I needed and nothing more; and right now I needed Him to ease my burden, so that I might get healthy... The power in prayer; My office mate gave me a book, titled Made to Crave by Lysa TerKeust. This is a weight loss journey the author tells of from a religious point of view. Now, it is geared more towards women, but I have found I can relate to most everything she writes about, albeit from a religious stand point... and I am not a religious man. But the book is about her carvings, and how she had to deal with those demons, it is a very good read, I am half way through the book [reading it at work] Other than this forum, I am also an avid member on a hobby forum called The Rocketry Forum (I am an avid model rocket flier). On this forum I started a thread on weight loss, and the trouble I had in the past. From this discussion noise, a member came through and contacted me privately. He asked me to read a book, a book that helped him a lot. He said that if I promised to read it, he would send it to me free of charge. I did promise, and a few days later Amazon delivered me a copy of The Obesity Code written by Dr Jason Fung. Once I realized that not only did a complete stranger offer up his help, he actually "gifted" me a copy straight from Amazon. No doubt I felt obligated to read the book. The book basically debuncts decades of research that has told us that "less calories in and more calories out (exercising)" means weight loss. Dr Fung basically says that obesity is directly related to our bodies insulin, or insulin resistance. Insulin has been know to cause weight gain for years, anyone having to give themselves insulin can attest to that. I am half way through this book as well, but I have one major take away so far... Now I have known for some time, that artificial sweeteners are bad. They are a bad replacement for sugar, that in my opinion, is pure evil dressed in white. Artificial sweeteners have been one of my many hold outs, the last enjoyable sweetness that I can run across my pallet. I have been averaging 6 to 10 packets of sweetener (2 per cup) in my coffee daily. In the Obesity Code, Dr Fung stated that these "fake" sweeteners, while providing no calories, still cause the body to produce extra insulin... interestingly enough, I have been recently diagnosed with elevated insulin levels, and I am now taking Metformin to help lower them (insulin). This past Saturday my weight crept back up from 293.8 to 297.4, about the time that I read the revelation about the affects of artificial sweeteners. Then and there, I stopped cold turkey, no more of the little pink packets for me... It seems that the immediate effect was weight started to shed off of me; I went from 297.4, and this morning I am 291.2 I have been so moved by the generosity of a total stranger; my office mate, my wife, everyone reading and commenting on my posts, and my family, that I have been humbled. Just when you thought you were alone you come to realize just how blessed we all are... I did another kitchen clearing; all cans that contained any kind of sweetener, fake or other wise, went into a bag, and I brought them to work. One of my final holdouts, fake sweets, has given up "the ghost" so to speak. I am not a religious man, yet prayer works in mysterious ways... You never know where He is going to send you help, and "That's all I got say about that"

keep in mind most everyone here has years upon years of weight loss / weight gain and try and fail. This pattern is ingrained and can be our undoing if we don't recognize it and guard against it. Post op is a mental game and we are the enemy. build a plan around your doctors instructions then work out how to do this day in day out without huge effort. The key is it must work with your life or like a DIET it will fail over the long run. Everyone will have a slightly different plan that fits the life they are building. good luck and i hope you have a great week and get back on track.

You are still in that perfect honeymoon period where you can turn this around!! I had the sleeve in 2014 and I did great. I got lower than my goal, but then life got hard. I ate “slider foods” as they feel better going down than dense protein. I became obsessed with frozen coffees that are full of sugar. I hurt my neck and I had an ovary removed, the other tied, and had major hormonal changes. Boom, 40 pounds back on. It’s a struggle!! I am converting to bypass due to damage from severe reflux, not the weight gain. I am also looking at it as another chance to do it right. I refuse to fail.

I take currently 10 psych meds 4 during the day and about 8 at night some are repeats ok the only thing you have to worry about are things like extended release meds which if you work with your psych doc you can get switched to rapid release or a different med all together also enteric coated pills at first do not absorb as well so switch to something different then you can switch back several medications are in the same class and are just as effective because they have the same action mechanism in your brain for example if you take geodon you can switch to Latuda it is also a safer med should you get pregnant soon after surgery if you take lamotragine which is the generic for I think lamictal you can switch to trileptal things like klonipin have under the tongue doses for more effectiveness also seraquel can and should be swapped for trazadone the reason being seraquel has the latent weight gain possible night time eating and a chance to cause insulin resistance. If you need a sleeping agent try belsomra it works in a different area of the brain and you don’t sleep walk for migraines impulsive behavior and mood stabilizer topirimate or topamax is great it also helps with weight loss hope this helps btw my mil is a shrink so if you need advice pm me

Hello. I’m a post-gastric sleeve from March 1, 2016. I was 325 at my highest and 189 at my lowest. Even had 7lbs I’d excess apron skin and fat cut off. I’ve gained about 40lbs back and am getting scared. It’s my Surgeons advice that I do a reset, a liquid diet for two weeks and follow the original post-op plan starting with puréed foods. Doing the reset doesn’t bother me and I know it’ll force me out of some addictions I’ve developed... but I cannot stand drinking plain water! It’s been over two years now and I don’t remember if crystal light or V8 was allowed on the original plan or not... and can’t get a hold of the surgeons office or the nutritionist to ask either. Help???

I am a year post op and am gaining weight. Are there others who this has happened to and what can I do to get back on track? I only lost 52 pounds in a years time and feel as if I lost control over my eating. Exactly how much should I be eating per meal - how much protein? 3 ozs meat? 1 cup of veggies? Can someone help me out? I was told to "reset" my pouch by starting the 5 day diet - liquids on the first day, etc. Thanks!

Most of these issues are aggravated or appear by weight gain so weight loss is always the remedy. It may not be as simple as prejudice when a doctor gives you this advice ... It's annoying and it's just a hard pill to swallow when you're not ready to hear it (not you personally) You could have been borderline and not qualified for some tests like the sleep study, personally although necessary for my surgery I am left paying for mine because insurance loves to play games.

I don't think they've ever distinguished whether the weight gain is from people having an increased appetite or actual changes in your body that prevents you from losing weight anyway. I'm not too worried about it, just curious on other experiences. Seeing that most patients are on anti-depressants isn't too surprising either.

My surgeon said most of his patients are on antidepressants (they are possibly overprescribed in Australia and also, depression/anxiety is a bit of a comorbidity with morbid obesity) and he’s never seen it prevent anyone from losing weight. I currently take prednisone (which generally makes you gain weight like crazy) and antidepressants and I’ve lost weight. Lots and fairly quickly. And I’ve done so without exercising much because I’ve had rheumatoid arthritis. I don’t want to trivialize the feelings of anyone who does take medication that causes them to struggle. I would say that (in my experience) you can still overcome it if you work hard. So I wouldn’t worry (I don’t think you’ll have any problems if your antidepressant isn’t even known for weight gain) but use this awareness as extra motivation to distinguish real hunger from head hunger.

The Mayo Clinic diet looks really good. How do you do the portions? Just follow bariatric guidelines set forth by your team and then follow the Mayo food plan? I am also looking for my forever diet... Fad dieting was part of what led to my weight gain over the years. Any tips?