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Well heck yes you want both and you will get both!!!! My calorie intake has fluctuated by 200 calories or so per day depending on what's going on and the scale doesn't seem to reflect either higher or lower (I like to think that by confusing my body I can lose faster). BUT, my water intake does reflect in my weight gain or loss. Our bodies are very interesting and very different. It's actually fascinating. Keep up the good work! Short and bathing suit season is right around the corner!!

Hey everyone! I am Juuuust starting the journey. Have spoken with my insurance and will be picking out a doctor in the next day or so. I have been over weight for far too long. All through high school and even throughout my time in the military, I was too skinny. (5'8" 120 - 129lbs). I got married my last year in the military and within a year, I gained over 100 lbs. The weight kept inching on over the years and no matter what I did, I would drop a few pounds and then gain back double. Finally, I began working for the post office where I had a walking route. I walked over 9 miles per day. I went from 270 lbs down to 218. I felt great and swore I would never gain the weight back. Unfortunately, I was hurt on the job and out of work for 6 months. When you walk 9 miles a day in the South GA heat, you have to eat...and I ate a lot. When I was out of work, I kept eating. I gained all the weight back and then some. When I was allowed to go back to work, I started working in IT, where I sit most of the day. I gained up to just a hair over 300 lbs (I'm now 5'9"). I did the same roller coaster weight loss and weight gain over the years. Last year, I started on a plan offered free through my work called Real Appeal. I was able to lose about 35 pounds and have for the most part not gained much back. I changed jobs at the beginning of this year and was surprised to find that my new insurance covers WLS, so I am in the process of going with the VGS. So you're probably wondering why I ask about going crazy in my title. My ex-wife had gastric bypass. She traded her eating addiction for alcohol and drugs. I then met a really nice girl, who, as it turns out, had bypass surgery also. She, traded her addiction for a sex addiction. I have had several friends and acquaintances over the years that have gotten bypass, or lap-bands, or VGS, and nearly every one of them have developed really bad habits and "gone crazy" I am a pretty normal person, or so I think. I don't feel like I'm addicted to food, I'm just lazy, so I am hoping I wont go crazy when I finally get the surgery. Anyone else have experience with this?

1) It depends on the insurance company, but generally you don't want to be gaining weight at any point during the process (different companies may have different thresholds, for example mine was no more than 2 pound weight gain). 2) Requests for approval is usually submitted when all of your requirements are completed, which is usually after your final weigh-in/nutrition class (because they take the most time). When you say pre-op testing I'm not sure what specifically you are referring too. If you are talking about like preop bloodwork then that could be before or after approval request. If you are talking about things like pulmonology, cardiology, sleep study, stress test, PFT, etc (obviously you may not have to do many of these) then approval isn't usually submitted until they are all complete. 4) Of course they can, but since you usually needed them to sign off on the referral for surgery it usually isn't an issue. If you foresee it being an issue then address it with them now, and if necessary change PCPs.

I have a few questions that I am hoping to get some help with. Thank you in advance for any help 1) Do insurance companies that require you have no weight gain during your 6 months mean from month to month or from your first appointment to your last? I have Amerihealth Northeast Caritas. 2) Is my approval request sent to my insurance after my last weight in appointment or do they wait until all of the pre op testing is complete? 3)Has anyone here used Amerihealth for your surgery? Please share you experiences with me. 4)Can a PCP refuse to do a pre op clearance on you just because they don't want you to do weight loss surgery?

Cheri, Thanks for this insight. I understand the control element; in so much as when I eat when I shouldn't/not hungry/'naughty' food, I feel that I have no control. Stupid as in reality, if someone was watching, they would not look at me as an out of control eater! However, I feel that I don't have control over my body - early menopause started that train of thought... and now weight gain and not being able to lose it. I've lost my mojo and am hating this head space I am in... one of constant exhaustion and disappointment (not just with weight but many areas of my life). But, life goes on and the world keeps turning... we keep on fighting the good fight! Stay safe and well my friend x

Just downloaded this app today. My surgery date was 4/18. First 4 days were rough but starting to feel better. I was anxious due to the weight gain in the hospital but it has all come off now. Thank god!

Found an encouraging article online: https://www.sages.org/meetings/annual-meeting/abstracts-archive/band-over-sleeve-a-safe-alternative-to-achieve-further-weight-loss-and-reduction-of-co-morbidities/ BAND OVER SLEEVE: A Safe Alternative to Achieve Further Weight Loss and Reduction of Co-Morbidities Amy Banks, MD, R Harrell, MD, J Foote, MD. Grand Rapids Medical Education Partners, Michigan State University and Grand Health Partners. Introduction: The vertical sleeve gastrectomy was traditionally performed as part one of a staged bypass procedure in the super obese patient population. The weight loss achieved from this surgery alone is often substantial and frequently patients do not require or desire the second stage malabsorbtive procedure. The vertical sleeve gastrectomy is one of the most common weight loss surgeries performed today. Over time, however, weight gain often occurs and we present a new technique of using a laparoscopic placed adjustable gastric band (LAGB) over a vertical sleeve gastrectomy (VSG) to aid in further weight loss and reduction of co-morbidities. Methods: A retrospective review was performed of five patients who underwent LAGB placement following a VSG. BMI, weight loss from VSG alone and weight loss from LAGB plus VSG were reviewed. Percent excess body weight loss (%EWL) for LAGB alone and for LAGB plus VSG was calculated. Co-morbidities and their resolution as well as any postoperative complications were evaluated. Results: All five patients achieved further weight loss after placement of the adjustable gastric band over the vertical sleeve gastrectomy with an average of 40.4 lb (range 31-64 lb) and an added %EWL of 32.2% (range 12.7% – 44.1%). Total %EWL following VSG plus LAGB placement was 57% (range 43% – 67.5%). The average BMI decreased from 56.6 pre-operatively to 43.9 post VSG and down to 37.6 after VSG plus LAGB. No major complications occurred during the 31-month average follow up (range 15-46 mo). An average of 3.6 adjustments to the gastric band were needed post operatively. Several co-morbidities resolved after VSG, and there was even further resolution of co-morbidities after LAGB plus VSG. One patient was intolerant of the band and required eventual removal. Conclusion: This case series introduces a novel approach to add to the repertoire of bariatric procedures following a vertical sleeve gastrectomy. There are advantages to placing an adjustable gastric band over a sleeve gastrectomy in lieu of converting patients to a malabsorptive procedure such as Roux-en-Y gastric bypass or a biliopancreatric diversion with duodenal switch. We demonstrate that certain patients can achieve further weight loss from laparoscopic placement of a gastric band over a vertical sleeve gastrectomy without complications. Further studies still need be done to determine the efficacy of this procedure to provide long-term weight loss in this patient population.

For many years I gained weight strictly due to being lazy and eating poorly. But for the last several years, I have been driving myself crazy because I feel like I have been doing everything I should be doing in terms of eating the right foods (Whole30 and Paleo) and exercising intensely (Obstacle Course Racing and Weight Training) and nothing worked for weight loss. I have often felt like my body and brain were working against my heart and preventing me from achieving what I wanted. In my ongoing research, I recently found another Bariatric Surgeon that post his bariatric videos on YouTube: https://www.youtube.com/user/DrMatthewWeiner I found his Informational Seminar video to be much more informative than any other I attended during my search for a local surgeon. One point in particular is the slide I've attached to this post. The stats he shows in this slide are my exact stats. His explanation here is that to gain 100lbs over a 20-year period, a woman only has to eat an average of 50 additional calories per day. Which is basically nothing. This takes into consideration pregnancy weight gain, weight loss, and weight regain over this time period. He affirms that significant weight gain from such a low number of additional calories means that there is actually something else going on besides just eating more calories than you burn. And as many of us suspect, it is due to hormonal and metabolic changes because of both age and changes that occur from diets you go on. This alone lifted a huge weight off my shoulders. Because I am not crazy after all, my brain and body were working against me. And surgery can help me get back to where I want to be. It further confirms my decision to have this surgery and use it merely as one tool in my arsenal to regain my health! I wanted to share this for anyone else has felt like they were crazy and wondered endlessly why diet and exercised worked from everyone else but you...

I think that @FluffyChix makes a good point, and you should really evaluate your diet. I am over 5 years post-op. I had diabetes prior to surgery and that problem is still in remission. But I control what I eat. I strictly avoid processed sugars. I have a sweet tooth and that is one of the major causes that contributed to my weight gain over my lifetime. I limit myself to artificial sweeteners (such as Splenda and sugar alcohols), to natural low calorie sweeteners (such as Stevia) and to the natural sugars found in fruits and milk. I had diabetes. That went into remission when I left the hospital two days after surgery and I have not taken any diabetic medicine ever since and my blood sugar levels are good. I test my blood sugar levels periodically. I read the labels of all food that I consume. I look at the grams of sugar per serving. If it is above 5 grams, I look at the ingredients. The ingredients are listed in order by highest percentage, and if the first 5 ingredients contain processed sugar (in any of its many forms), then I avoid this food, like a plague. I also restrict myself to about one meal per day containing complex carbohydrates (such as pasta and bread). I also avoid all carbonated beverages. I lost 20 pounds pre-op solely on eliminating carbonated beverages from my diet and I will not go back.

Hello fellow Bariatric pals! I am 6 days post gastric sleeve surgery. My surgery was performed April 18th, at St Francis Indianapolis by Dr Shamseddeen. Some Background info on me and my choice to have bariatric surgery: I am male, age 48 married with one adult child and two teenage children. I have been married for 21 years. We have a Noah's ark of pets but our primary pets are two cats, and three dogs (Lucretia a 6yr old female Newfoundland, Freya a 4 yr old female St Bernard, and Vivien a female 5 month old Newfoundland pup) I am a Registered Nurse who had specialized in geriatric/hospice/long term care before having a heart attack in 2016. I switched to homecare and work primarily with special needs and medically fragile children. After my heart attack with stent placement I started to number my health issues and I had a lot, obesity, smoker, copd, sleep apnea, Congestive heart failure, High cholesterol. I began to treat these with medicines, cpap, quitting smoking, light exercise. The one issue I did not really tackle was my obesity. With quitting smoking my weight went up as I replaced smoking with snacking. I had grown accustomed to being larger and just came to accept I was the fat old man, thats just who I was now so no use in fretting over it. Then my primary doctor handed me one more diagnosis... diabetes. I was just taking metformin, and was so far non insulin dependent. As a nurse who cared for older patients I have witnessed diabetes ravage my patients, I have prepped toes for amputation, then parts of feet, then legs... I was 329 lbs at this time and was fearful of dieting turning into yo yo dieting that would lead to greater weight gains. I began to research bariatric surgery. My first visit to St Francis Bariatric Clinic was September 14th 2017 (From first visit to surgery was about 7 months). I started my journey with the monthly meetings, nutrition appointments, pysch evaluation, and getting numerous surgical clearances from my other doctors. I started my preop dieting and got down to 317 lbs. When I started my preop liquid diet I was my worse enemy when my friends would come over to celebrate my surgery.... by offering me "one more for the road" food offerings of pizza, white castles, take out chinese food, etc. I appreciated the sentiments but I should have been stronger in my resolve to say no. But even with temptations, day of surgery I was about 311 lbs. My Surgery Day experience: Pre-Op prep was no problem, no complaints. IV placed, skin scrubbed, some labs drawn. Basic stuff. Rolled back for surgery, again no problem, introduced to surgical team as I was wheeled into surgical suite, moved to operating table and arms positioned at sides. I don't even remember when they administered sedation as my next memory was waking in recovery. Waking in Recovery: I won't lie..I was in intense pain and either due to sedation or just the level of pain I couldn't say how much I hurt, all I could do was moan..loudly and forcefully. I have never given any pain I have had a rating of 10 on a 1-10 scale, even when I had my heart attack, but this rated an 11+ After a minute or so I think i was given something for the pain and I passed out again. I awoke in my hospital room. Day 1 post op: In my room I was greeted by my wife and nurse. The nurses I had over the next 24 hours were great in treating me, as well as caring for my family. I was allowed one oz of ice chips to sip on and I had my PCA (pain medicine pump) to hit every 15 minutes as needed. I was wearing a truss, had a drain ball on my abdomen below the large incision site where my stomach portion was removed. I also had a foley cath placed. I have placed thousands of foley caths, but have never had one myself. I had an intense urge to urinate that made resting difficult. I kept joking with the nurses I was going to swipe a 10cc syringe to empty the cath balloon and remove it myself. Later that day I had two small 1 oz cups of chicken broth brought in for me to try. I was able to down 1 over 20 minutes and couldn't even start the 2nd. I had a 1 oz cup pf ice chips now and then but was not worried about dehydration because of the bags of saline and antibiotics they had running in via my IV. I started doing my inspiratory spirometer and I say this as a nagging nurse who has had many patients post op refuse to do them, now as a patient i can say that the inspiratory spirometer does help a lot. My first day I was walked a short distance, and that night I slept in the recliner as I found it more comfortable then the bed. I had still had pain but between the PCA and re-positioning it was manageable. Discharge day: I was walked again a little farther then before. I had my foley cath removed (Yay!) which led to 48 hours of a burning sensation on urination that eventually faded. I had my IV discontinued, and started on liquid pain meds which about a little less then 1 oz took forever for me to sip. The only notable pain I had that day was when they pulled my drain tube out. I knew it was going to be uncomfortable, but the nurse didn't just pull it out quickly, or even as 1 long pull but did it in 3 jerky pulls that sent pain rocketing from my navel down to my toes. Aside from that all was well, I had moderate pain, was sore and hurt to stand from sitting or to bend but it was all tolerable. Back Home again and starting my new reality: Since being home at first I tried to religiously follow the instructions I was given on nutrition, being on the modified liquid diet, taking my vitamins, and staying hydrated. I ran into several issues. First I had no appetite, you really do have to force yourself to eat, but also to eat properly over 20-30 minutes to get down a 2 oz cup of broth or yogurt. To quickly and I would feel nauseous and full. I would not drink within 30 minutes of either start or end of eating. I had no thirst for the first few days. Even taking small sips I found it hard to get in 40-60 oz's of water a day. I have been struggling to get in 70g protein a day. First the shakes would make using the Premier dry whey protein mix would froth a lot and give me a very full/gassy feeling. The thickness of the shake even after thinning would fill me up quick after a few sips. The taste wasn't good, but not terrible but you won't catch me saying "Ya know what would taste good right now? a protein shake" The vitamins. All of my vitamins right now are chew-able. Only problem I have is I have no teeth so I have to suck on them until they dissolve over time. Again not the best tasting, but they also seem to trigger fullness or nausea in me. I may switch to liquid vitamins, pills (when I can), maybe even the patches I saw advertised here. Some solutions I have found. I was looking over youtube videos and saw some people make Popsicles out of their protein shakes and I did the same with Powerade zero. Doing this I was able to get down at least half my shakes in a day (40g protein) and it really helped top off my liquid intake by sucking on the powerade pops I made but still limited the intake over time so I wouldn't get sick. It is day 6 for me and it is a learning process. I see that we all have many things in common but that everyone's experience with bariatric surgery is very much personal and individualized. The highlight of my week has been actually going under 300 lbs for the first time in many years and passing gas on day 5 (Hey to nurses passing gas is as much a sign of life as a pulse or respiration plus shows our digestion is working) I have been reading many of the forums and have enjoyed the stories and humor, and appreciated the advice given and I hope to read many more over the next year. Good Spring (when it gets here, I am from Indiana after all) to all

I have a screwed up thyroid and my endo suggested the surgery as well as I was just not able to get on top of the weight gain. Both the endo and my surgeon said mine won't be the type that will go away after surgery but I would go down in dosages and so far they are right. Surgeon did say a lot of people are able to come off the meds. I was on 3 thyroid pills a day (T4 and T3 in the am and another T3 in the afternoon). After close to 4 months, they re-tested me and my levels have gone up so they just took away my afternoon pill. I'm hoping it doesn't slow down my weight loss because I felt absolutely fine on the dosages I was on...guess we'll see this week. Good luck to those still waiting for surgery.

I had a I had a Lap band removal and vsg conversion in June 2014. I started at 252 as my highest weight and 237 as my surgery weighty. My lowest weight was 201. I followed the diet faithfully for almost 2 years and kept the weight off give or take a couple of pounds.. I found that's spinning was my favorite exercise and still is. I was active on and off the 4 years because of complication so with my knee and then plantar fascititis. The last year has been hard cause I my plantar fasciitis and lower back pain. ( which restarted since I've put on weight again) has been really bothering me... so new activities that I love like 5k and 8k runs... well their increasingly difficult to complete. I now weigh 248. Which is above my surgery weight. My GERD isa real problem... I still drink my proteins shakes... take my vitamins.. I eat most things but not in excess because of my sleeve...my weight gain has been a plateau for about for almost 2 years now.. I have not gained and only loose 5lbs here Andy there's and regain it back. I guess give the fact that I really didn't lose as much weight as I expected to with the vsg and gaining all that weight back, has me thinking that the malabsorption piece of weight loss surgery is the tool that would help me final loose weight and be healthier. This extra weight gain is causing me physical pain now and I wann do something about it.

I had a I had a Lap band removal and vsg conversion in June 2014. I started at 252 as my highest weight and 237 as my surgery weighty. My lowest weight was 201. I followed the diet faithfully for almost 2 years and kept the weight off give or take a couple of pounds.. I found that's spinning was my favorite exercise and still is. I was active on and off the 4 years because of complication so with my knee and then plantar fascititis. The last year has been hard cause I my plantar fasciitis and lower back pain. ( which restarted since I've put on weight again) has been really bothering me... so new activities that I love like 5k and 8k runs... well their increasingly difficult to complete. I now weigh 248. Which is above my surgery weight. My GERD isa real problem... I still drink my proteins shakes... take my vitamins.. I eat most things but not in excess because of my sleeve...my weight gain has been a plateau for about for almost 2 years now.. I have not gained and only loose 5lbs here Andy there's and regain it back. I guess give the fact that I really didn't lose as much weight as I expected to with the vsg and gaining all that weight back, has me thinking that the malabsorption piece of weight loss surgery is the tool that would help me final loose weight and be healthier. This extra weight gain is causing me physical pain now and I wann do something about it.

Not sure if this applies to you. However, my doctor reminded that since I am of “child bearing age” (lol loved how he phrased it) that I might see the few pound weight gain with ovulation and pms. I track my periods and noticed my stall/gain this week is happening during my ovulation time. The gain is less than before, but in the same time frame. I also noticed I felt the same hunger that I have during this time. That helped me not worry about it. It’s just my body doing what it does monthly. Lol

I’m about 3 weeks shy of my 2-year surgiversary. My husband and I are expecting our 2nd child, 1st one after WLS. My surgeon’s goal weight loss was 100 lbs. I lost 90 lbs prior to this pregnancy. I still track my daily intake on MFP and make support group meeting when possible. Prior to this pregnancy I consumed about 150 less calories/day. My OB/GYN says she thinks I can make it through this pregnancy with only a 10lb weight gain. Unfortunately, any amount of weight gain terrifies me[emoji30]. At 18 weeks visit I was up 3 lbs [emoji1430]. Baby is healthy, we are expecting a girl & hoping I can make it with very little weight gain and reach goal weight ASAP after our baby girl is born. [emoji120]

It sounds like you are asking if there are options to help you gain weight, but I suspect you really are asking if there are options to help you continue to lose weight or to fight weight gain? One suggestion is to go back to basics if things get out of hand--substitute protein shakes for one or two meals. You can also track your food intake if you don't usually do that and see exactly how many calories, how much protein, etc., you are getting. I find the MyFitnessPal website useful for this. If I've misunderstood your question, I apologize.

are There option after. Surgery to help you with weight gain?

He was less than professional. All he needed to say was let's get you back on track. I'm sorry your feeling hurt. I don't do any follow ups with my bariatric program. I get my check up and blood work up from my family doctor. The great thing is your not on your own. You can contact another bariatric program out of your area. The dietician can mail or email you the food plan instructions. Many people here on bariatric pal are willing to share their diet instructions for you to use. None of us are perfect. Many of us have had weight gain. Getting back on track can be done. You have our support.

Hi Everyone, I had the sleeve surgery in 2015 at 54 and it was unsuccessful. I may have lost 25 pounds and began experiencing heavy GERD and weight gain. I got very discouraged from the lack of weight Loss and the extra weight gain so I've done nothing the past 2 years relating to my weight. I'm currently 5'2 , weight 232 and 42bmi. I'm 57 and in a better mental place and considering a revision to gastric bypass. I am a little worried to go thru this again but I'm tired of the weight. Has anyone been thru this? Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app

I had an open Gastric Bypass back in 2001 when my weight was 235lbs. After 1+ years I weighed about 120lbs, but over the years since the surgery, I have gained almost 70 lbs. My current weight is 185lbs+/-. Recently, I read about Revision Surgery for those Gastric Bypass patients who have experienced significant weight gain: StomaphyX revision is a completely endoscopic revision technique[12] used to tighten a stretched gastric pouch using internal sutures or fasteners. It may be used in patients who have had prior Roux-en-Y gastric bypass surgery and have a stretched stomach pouch. Has anyone had Revision Surgery to lose weight post gastric bypass and if so, can you tell me/us about your experience with it? I have an appt with my Surgeon on May 30th so I am hoping I can learn from others before I broach the subject with her. Thank You!

Additionally, anesthesia itself can cause many patients to retain water longer than usual. I am still pre-op, but have had surgeries previously and always know to avoid the scale for about 2 weeks until all the weight gain attributed to the hospital fluids/medications/anesthesia have worn off.

I did the samething you are doing, researched like crazy. Then my brother, whom is a surgical nurse, had the sleeve done. It was a breeze for him. I had SIPS. We both had our surgeries in 2015. He is now gaining again. I am steady at 148-150lbs. Zero weight gain. I have no regrets! In fact, I wish I had it earlier. Feel great. Have any questions, just ask.

Greetings, I am getting the DS and ohh so excited, I had the sleeve and had weight gain now I am close to my original starting weight, I started the process of DS a few months ago with the intention of sleeve revision or gastric bypass, and my surgeon discussed my options and DS it is! So good people of this forum, I am seeking advice, pearls of wisdom, any info you care to share. I am an RN and have researched all the data, pros and cons, now I want to listen to those who have experienced the surgery and their story. Thanks a million

1st let me say I am glad to have found this Forum. I found it yesterday after google 'ing bariatric support groups at the suggestion of my nutritionist. Along with a list of "what to start doing to get used to it" items she said I should find a support group for obvious reasons. I have very little knowledge on the subject bariatric surgery other than what I have learned from my visits with my surgeon and his group so far and what very little i learned from my brother having lap-band several years ago. Well gotta figure no better way to learn than to ask those that have gone through or are going through what I plan to. I've been reading topics here since yesterday and have come across some things I didn't know or even think about. So I figured I'd give details of my current situation and see if others have anything in common and if they could give me some ideas of what to expect. It's been just over a month since I first saw my surgeon and came to the decision to go through with the sleeve surgery. I did not initially go to see him for it though. His name was on a list I received from my primary care doc after she told me the lump on my belly button was an umbilical hernia. When I went to see him he said he could repair the hernia but there was a high chance of either it reopening or another opening somewhere else due to my weight and big ass gut (not his words). After his, what I 1st felt was a sales pitch, He showed me some videos gave me some info to read and suggested I take some time to think about it and talk it over with my wife. We read, I showed her the video, we talked about it and decided it was probably the smart thing to do. Over the past few years I've put on a significant amount of weight and it seems every time I try to diet it off, I pack more on. A little bit of medical history for ya...... According the old trusty BMI system I've been heavy since my late teens early 20's but that is because of my height. I was pretty fit and muscular back then. Stayed pretty fit but did gain weight heading into my 30's and put on more the older I got. I've had back issues since my late teens due to a vehicle accident but it was never anything more than a good cracking my back couldn't relieve. My line of work has always been very physical, so along with getting older and the weight gain my back issues became worse. Now about to hit my mid 40s I've been out of work for going on 3 years due to osteoarthritis, slipped/herniated disks and sciatica. I have very limited movement and seem to be stuck in my "snowball". Also because of the weight I am on blood pressure, cholesterol and get happy meds. I do not take pain killers other than occasional 800mg ibuprofen. I have an addictive nature and am terrified of getting hooked. Speaking of which I am an "alcoholic". On the wagon and have it under control but still might as well mention it. Damn I am one F***ed up specimen. Well, I'll leave it at that and hope for any feedback, experience or suggestions/advice that any of you care to give. Thanks so much in advance for reading and feedback. Sorry this turned out so LONG. J

I'm now 11 weeks post op and I drink plain or black cherry seltzer water from time to time and haven't had any issues at all. My surgeon told me that as long as it has no calories or sugar and it's not brown soda (as the caramel coloring is the worst part) it's fine in moderation. The only thing I'm having an issue digesting is salad. Everyone is different though! and it's important to listen to your Doctor! The Doctors give you best advice based on your individual health issues. Like the saying goes "Everything ain't for Everybody" Be safe, Ask First! Also, I haven't experienced any stalls or weight gain. My scale just keeps going down! started at 345 lbs and today I'm 270lbs! 75 lbs in 5 months! I love my sleeve!