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Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.

I am in the same saggy boat. It is depressing isn't it to go through all this weight loss, still not be comfortable in our own bodies and just wearing smaller size clothes but still hiding the same areas? For me, I have bad lipoedema so from the knees down is horrible and nothing can be done really unless I want to go down the lipo route and then wear compression gear for life and even then no guarantees. Where I live in Europe, if you can prove justifiable reasons such as saggy skin interfering with your life and mental health following weight loss the national healthy insurance will pay 80% of the costs. I got approved last week for an arm lift so I am just waiting to hear back from the surgeon with a date. When I had my initial consultation with him he said he had a six month wait list so I have asked if possible to be fit in during October or else wait until January as I don't want any impact on my Christmas travel plans etc. I have not told my family yet as I live overseas and they got upset at just the thought of me doing something elective as I had such a bad post-op sleeve experience. My Mum actually broke down in tears when I told her I was going to schedule an initial consultation so not sure how or when I will say anything but will cross that bridge when I have an op date.

Exactly @Spinoza. It’s there all the time. Sometimes just a faint little voice whispering in the distance and sometimes shouting at you. Mine has been shouting a lot lately, Had to give myself a kick in the pants and getting it off my chest here has been a help. Always a such a supportive community here. Was actually thinking about asking my GP for a referral to a menopause specialist. She’s been great right from the start about prescribing HRT and putting me on alternatives when issues arose but I have been thinking I need some extra help. I reduced my estrogen a little last week (3 pumps down to 2.5) because of the bloating and sore breasts but now the daily headaches are back. Sigh! I see my bariatric follow up doctor later this month so I’ll what she says as yes, micro dosing had crossed my mind too. The man I was most surprised by with his bone loss was my cousin @SpartanMaker. He was a walker. Walked for miles, twice a day, up & down hills with his dog when he permanently retired. Still don’t understand that but he had a sedentary job which I think probably contributed and probably does for lots of men and women too these days. My dad was a farmer (horticulturalist) on his feet and lifting things every day. His bones were so hard that when he’d have his bone marrow tests for his multiple myeloma, the doctor would stand on the bed or kneel over my dad to put his weight behind the needle to get it into the bone Yikes!

Good points. I do think post-menopausal women are still almost 4 times more likely to suffer from osteopena or osteoporosis, but I'm not surprised at all to see the rate going up for men. We as a species are just more sedentary and this is one of many diseases that unfortunately are exacerbated by our inactivity. Us older folks were also lied to for a long time about the "dangers" of activities like running, being told it would "wear out our joints". It seems the reverse is now being shown, which shouldn't be surprising if we consider Seyle's "General Adaptation Syndrome" model that first proposed the idea that our bodies respond positively to eustress. We are now finding that "impact" sports actually improve joint health and even can reverse bone loss. Food for thought.

I think the thing many people get wrong when trying to transition between weight loss and weight maintenance is using an all-or-nothing mentality. By that I mean they expect to be either in "diet" mode, or "maintenance" mode, but that's not really how things work. To me, that would be like sprinting on a treadmill and thinking I can just stop running. Um, no. That would have really unpleasant consequences. You're not going to simply wake up one day and immediately go back to eating "normally". Instead, think of this more like a baby learning to walk. You're going to have some false starts. You're going to fall down a lot. In fact, you're probably going to fail more than you succeed. This is completely normal and is how you learn. Over time, you'll hopefully learn what works for you and what level of caloric intake is right. The point is, there are no "tricks" here. If you feel like you've lost too much, then just try different things to up your calories. Alternately, if you're heavier than you want, try different strategies to lower your calories, since there is no perfect solution for everyone. There's only what works for you. You didn't ask, but there are a couple of points I want to make here as well: There is no perfect number of calories for you to maintain. Let me say that again so you don't forget: there is no perfect number of calories for you! Our bodies are wonderfully adaptive and can maintain a healthy weight across a wide spectrum of calorie intake. It does this by up and down regulating your metabolism in response to intake. There is no ticking clock here whereby you have to lose the weight by a certain date after surgery or you won't lose anymore. It just does not work that way. I don't care if it takes you 9 months or 9 years to get to your ideal weight, you can get there and you can maintain at that weight. Best of luck.

Long post alert, just venting and catching up after so much time away... TLDR, I'm getting an arm lift. I want to hear from other people who got it and how it changed their body/body image, recovery, success stories, and whatever else you want to share! Wow, I haven't posted in a while. This forum got me through some dark times when I had my gastric bypass both before and after. I am posting today because I am FINALLY getting some plastics done. I have been waiting a while because I wanted to maintain my weight. I just turned 30, I'm not getting any younger and I've been doing excellent maintaining my weight loss so I finally scheduled a brachioplasty to start. I am getting an arm lift in other words. I included a pic of my arm and the skin hang-age. This is my before. Disclaimer, this pic is from a couple months ago it's the one I had handy on my desktop but I've been doing a lot of weight training and have built up my bicep a bit more. I would like to do a tummy tuck too (I have A LOT of loose skin in an apron belly shape and my boobs sag down to my ribs 😕 ) but I am okay with not getting it for now. I can't afford both and don't really have the time to recover from all that surgery. I am starting with just the brachio for now. I have spent my whole life hiding my body and after losing all this weight, I found I am concealing it even MORE because of how droopy and flappy everything has gotten. I am fed up of feeling uncomfortable in my own skin after all the hard work I put in. I'm sure a lot of people who get plastic surgery post-major weight loss can relate to this. At this point it feels like a necessity. My bat wing arms also smack against my body like crazy, I can't wear short sleeves without this happening and tops do not fit me right because of my wonky proportions. My bicep has very little fat on it and all the bulk on my arm is hanging under it so it's very uncomfortable. I've been holding off because of how expensive it is as well. I am paying out of pocket 15k and it's a chunk of my savings but I'd rather have this than a payment plan and I can start ASAP to recoup my savings. I have a lot of body image issues as one does from being morbidly obese their whole life... so honestly I am almost 100% sure this surgery is NOT going to fix the way I see myself. I am more looking at it as a way to feel more comfortable on a day-to-day basis whether I am exercising or just trying to wear a short sleeve outfit in this very hot state I live in. So that's basically my update. I have been doing well, maintaining my weight loss and a healthy lifestyle. Gastric bypass has completely changed my life and made it so much easier to make better choices for my body and my longevity. I am ready for the arm lift and I am so scared but also excited to see how this all goes. I want to hear from other people who got an arm lift or any loose skin removal and how the recovery went for you and how it helped you and your confidence. Thanks and you're all wonderful people!

Hi all! I had VSG back in Dec of 2016. I was very involved in this community for a long time. I lost 124 pounds over about 18 months and maintained a 105-110 pound weight loss for almost 3 years. Then the pandemic hit. Then I had some non related medical issues. I went on a medication that caused weight gain. I got frustrated. I fell off the wagon and tumbled down the road and I’m now facing a 60 pound weight gain in about 4 years. I made a lot of excuses! I also started picking up bad habits like drinking alcohol, not counting calories and indulging in carb heavy snacks. But hitting 260+ again shook me. I was only 15 pounds down from my surgery weight. It’s time to get off the pity wagon and get back on track. so I’m back. I’m counting calories. Eating low carb. Cutting almost all alcohol, bread as pasta out! 10 days down, forever to go! My Stats: SW: 305 SD: 275 LW: 181 MW: 195-200 RW: 263 CW: 258 GW: 200

Thank you @spartanmaker, @ms.sss & @DaisyChainOz. No I don’t work out as such. No gym and no running miles. Have never found any enjoyment in it at all which means I find it a struggle to do it & then I give it up. And I’ve done it all over the years. Plus I’ve been told by my retinal specialist not to do any strenuous activity which was when I gave up the 2x50 sit ups I used to do with my stretching & resistance band routines. Been doing these routines for more than two years now usually every day and even do a modified version if I’m away because I actually enjoy doing it. They include yoga moves and poses as that was the one thing I used to enjoy. Strength is pretty good. Had to buy all those new pants last year because my thighs had got larger thanks to the resistance bands & my shoulders are starting to look like I swim laps. Added a new stretch with my bands which is working on my forearms. I might end up looking like Popeye. LOL! Recently added some pulse squats to my routine as the other so called butt building things haven’t helped yet (it’s still flat and running down the back of my thighs 😁). So my metabolism should have increased at least a little over the last 2 plus years. Flexibility is good too as is bone density (had most recent scan last year). I started doing these routines because I was missing my old flexibility, to tone muscles and keep my bone density (was worried that my malabsorption may affect my calcium absorption too). Ugh, I don’t want to HAVE to add in another activity but …. Sigh! Actually bone density is becoming an issue for middle aged and older men too these days too @SpartanMaker. I know several men in their late 50s early 60s who have been diagnosed as having osteopena or osteoporosis. One was very surprised as he is an avid cyclist & thought himself very fit & healthy but cycling doesn’t help with bone density. He got tested after his wife, also a cyclist, was diagnosed & was worried. PS Buying shoes and clothing always makes me feel better @ms.sss. I bought a new dress last week & yes it made me happy (another Victoria Beckham) though I had to buy a larger size which then depressed me. It’s going to be my back up dress for my niece ‘s wedding. Waaah! PPS To add to my niece’s wedding & my 60th this year, I found out this week I have a school reunion too. Scheduling all my Botox, facial and hair appointments for the year now so I don’t look grey and wrinkled at any of them.

So question do the implants settle to look smaller? I am so up in the air about the size they're saying you know when they put it under the muscle it will look smaller so I might wanna go bigger. I can pull my hair out. I'm gonna be livid as **** if it looks like I didn't even get anything done.

So sorry you're struggling @Arabesque! I know how frustrating it is when you go from thinking you're got weight maintenance down, to finding that no matter what you try, you can't get things under control. You may not be looking for advice here, but as a guy it's in my nature to try to "fix" the issue. Please forgive me if I'm off base. I may be misremembering, but I think at one point you mentioned you don't really workout. While I'd never recommend exercise as a way to lose weight, we know from a significant amount of data that it is really beneficial in helping those that have lost weight to maintain that weight loss. You may not be in love with the idea, but it might be time to consider a change? Aside from the benefits for maintaining weight loss, we also know that cardiovascular endurance is actually a better predictor of overall health and longevity than any other single factor including obesity and smoking! This means the single best thing any of us can do for long term health is improve our cardiovascular health. In addition, we also know that regular strength training is important for several reasons, but in your case I want to point out three of them: Regular strength training improves muscle mass, which is probably the single biggest way any of us can actually improve our long-term metabolism. Overall strength is highly predictive of minimizing fall risk as we age. Since falls in older people can be catastrophic, it's something all older people need to keep in mind. There is a significant link between strength training and bone health. As I'm assuming you already know, osteoporosis is a particular problem for post-menopausal women. I wasn't very familiar with the Australian recommendations for physical activity, but unsurprisingly it's almost identical to the US recommendations: https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-adults-18-to-64-years Best of luck. I hope you get this figured out.

What you need to ask yourself is something I used to help me when my weight appeared to not be fast enough; did I put the weight on in just a few months? No, so I need to be patient and let the process work and do my part while not expecting the weight to come off in such a short time! Give yourself the gift of being patient with your body. I know its difficult, especially being that we're an instant gratification society now, but you deserve the grace, time and patience knowing you made the right decision for yourself having had the surgery! Follow the guidelines you were given by your bariatric team. But f you still don't feel the weight is coming off as fast as you think it should - schedule an appointment with your dietician/surgeon and ask for they're advice. You've got this! Lastly 13lbs is an average/"normal" weight loss for 5 weeks 🤗

So update-spoke with a surgeon today who recommended what I have been thinking--hernia repair and do the bypass. I had worries about lack of iron absorption with the bypass but I found out today because I am having to use so much famotidine I basically have very little to zero acid which is necessary for absorption so famotidine is REALLY unsustainable. Also found out on fluoroscopy, my sleeve is not dilated, but I have a kink at the top, which he said is not helping the reflux on top of the hernia. So now I need all the prayers, warm vibes and well wishes that my insurance can do the right thing and not make this a huge pain in the ass to the point I give up and go to Mexico. Also-just to get my ducks in a row--anyone SUCCESSFULLY fight and get a revision covered for use of medical need not weight loss where it normally wouldn't be covered? I'm not gonna lie, I'm not hopeful. Also, does anyone have experience with and can recommend the best Mexico center for sleeve to bypass with hernia repair? Just so I have plan B. Thanks for any insight or help anyone can give!! Sent from my SM-S908U using BariatricPal mobile app

You look lovely. And you had a bouncy castle. So much fun! Congratulations on your weight loss so far, your size 14 win (yay!) & your fifth year anniversary.

may not be a popular answer, but if you are looking for a high protein, high calorie, low density food, chicharron (aka pork rinds or cracklins) was my go to back in the day when i had very low stomach capacity and was trying to stop weight loss. worked like a charm. mind you they are also very high in fat (and depending which brand or how you make them, are also high in soduim) so keep that in mind.

Right after surgery, I would always get super light headed after a shower; I still do sometimes when its early in the morning or I have to do wash my hair (which means longer shower). I usually take super hot showers, but I had to stop after surgery, because it exacerbated it. I usually would lay down for awhile after and would have some low sugar apple juice on hand to drink. This helped me a lot!

My husband and I just had our 5 year anniversary. We got married right as everything was shutting down for COVID so we didn’t get to have our receptions. We decided to do a five year anniversary party to finally be able to celebrate with friends and family. I loved my dress I got for it (though I didn’t get a great picture of the whole dress 🤪). I am still hopefully only halfway done with my weight loss journey but it felt great to by a size 14 dress; it’s been a long time since I wore a size 14! Here are some picture i scavenged from people from the event to show off the dress!

Aah, stalls. The eternal battle of weight loss. But yes, you can continue to experience stalls of varying lengths until you stop losing. Plus you’re getting close to your goal weight (or your new set point) so your rate of loss can slow right down to what seems like nothing - like measuring loss in ounces not pounds. The last 11kg I lost took about a year so less than a kilo (about a pound) a month on average but in those last months it was almost at a dead stop with fluctuations until it finally settled & didn’t change. Did you carry most of your weight in your abdominal area? If so, this might be why you are still carrying weight there as it is where you had the most to lose. Losing an inch off your thighs will look like you’ve lost more than losing an inch off your tummy because it is a larger area. But it wouldn’t hurt to speak with your doctor about possible build up of lymphatic fluid or lymphedema given your history.

Hey! Stalls are really common, and I think around this point in the post-op journey it does seem to hit! My weight loss has stopped at the moment, but my surgeon did say to me that a stall is only really considered a stall when you have been stuck at the same weight for around 6-8 weeks! just keep doing what you are supposed to be doing, eating well, keeping hydrated and getting some form of exercise in and hopefully it'll break soon ❤️

Sometimes you have to do things differently than other people or use some of other people ideas to help with the pre-surgery weight loss task goal. When I started, I drunk two meal replacement shakes that was high in protein (30mg) and for dinner I would eat a small portion for dinner. The amount I would eat for dinner was the amount you are supposed to eat after surgery. I even started drinking my water 30 mins before my meal and 30 mins after my meal. I actually have been keeping this going for the past four months and within the last two weeks I did the full on liquid diet that helped me reach my goal weight before surgery. I know some people talked with their provider and got on medication to help them lose their goal weight before surgery. It will be okay; you will get there.

I am so excited; I am having surgery in two days. Everyone is asking me am I ready? My answer is yes, I am too prepared and ready to go! I was supposed to have my surgery last Tuesday but had to get it rescheduled because the surgeon was out ill and therefore had to reschedule for this coming Tuesday. I have been looking at all my before pics and looking at myself now, I am so filled with joy how far I have come. This has and is an amazing journey and I can't wait to get back to my old self again. I am so happy that I made the decision to do the surgery. I have no regrets about my decision. I know am I doing the right thing by investing in myself and becoming more healthier and looking at food differently now. I now know what it means by "Mindful Eating."

Hi there! I am getting ready to have surgery on Tuesday. I am so excited and nervous all at the same time. I did a lot of preparing for this surgery. Three weeks ago, I did the liquid diet that you are supposed to do post op. I just wanted to get a feel of how it would be so I can prepare for what's to come. I started implementing the things that my dietitian and providers told me that I need to do to be successful post op. I stopped drinking all pop and carbonated beverages. I was buying all the things that was zero sugar added and sugar free. I have been drinking my protein shakes and clear protein drinks. I have been keeping up with my water intake and getting in as much exercise as I can. When I decided to go ahead a do the surgery I was weighing at 291 lbs. My task goal weight loss for surgery was set a 5lbs. I actually lost way more than that, I surpassed what they wanted me to lose. I am now 254lbs. I will probably have lost a little more by Tuesday. Starting tomorrow I have to be on clear liquids to prep for Tuesday. Just want to let you know you got this and you will do great. Just stay focus and motivated. I was the same way on edge and excited. Make sure you have a good support team too! This will help and make things feel so much better. It is good that you are nervous and excited! Way to go!!!!

This is a toughest part of the surgery . No person in the world [or so it seems] has the same pre op diet as you, so its difficult to equate. Some have dieted before hand and some like me had lots of food funerals. I did mine for 3 weeks and lost 15 pounds. You are going well. Call your team if you have been in a stall longer than you think you should. Doing this process you will get lots of baffling losses and plateaus. Its just your body wondering why you are not feeding it the same as before. It took me 2 years to loose my weight, be patient . Stick rigidly to your teams regimen. Your liver will tell them if you have cheated or not. They won't operate if your liver is fatty. It makes it fragile to move away from the surgery site.

I started my pre-surgery diet just over a week ago, planning to be on it for four weeks - my surgery date is April 15th. After loosing a couple of kilos rapidly at the start that I assume were mostly water, I actually haven't lost any weight despite sticking to this pretty restrictive diet. I'm a bit confused about how that is possible, on the one hand, and worried that I won't be ready for surgery at this rate. Did anybody else experience this at the start of their LRD?

Firstly, congratulations on coming through it all and doing so well. I am like you, major complications post op resulting in almost four months of hospitalisation and multiple procedures has left me feeling anxious about any further surgery, even going past the hospital on the bus can make me feel queasy! I had my first consultation about plastics a few weeks ago and the surgeon I picked was based on asking on a local/private Facebook group, doing some internet searches and checking out reviews and medical file searches where possible (to make sure no reports that showed red flags). As I live in Europe I has had to make sure that the surgeon and his staff speak fluent English and the other main thing was I wanted a surgeon working out of a different hospital to the one I had by sleeve done at, I wanted to be sure I had none of the same team involved. I was very happy when I met the surgeon, he was honest with his opinion in that he told me that I did not need a breast lift and implant and he did not think my tummy area was worthy of surgery at this point so at least he is not operating just for the money. He has put me forward for approval for an arm lift and I am waiting for the health service to review my file and send their decision. I am a bit afraid they may say no as I had to submit pictures and only after did I realise that maybe I didn't take 'bad' enough pics. I would have preferred to submit a video of the wobble Anything else I would have to pay for myself so, given the sh*t show of my sleeve, I don't think I will do any other surgeries out of my own pocket. I would love to do something with my calves they are terrible and depress me a bit as I feel they take away the look of all the weight loss but nothing can really be done for them.