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I’m glad to hear you are doing better but sorry you are still struggling. I’m working closely with a therapist (for years now) … since my accident, and talking through my decision to take this step (surgery … I’m scheduled for next Tuesday). I also see a separate therapist with my husband. There are days I feel like both are a waste of time, but usually I feel like it helps and I even look forward to it sometimes. Even sessions when I don’t think are really head on dealing with “things”… usually end up lightening my load and making everything easier to deal with until my next session. My best therapy advice is find someone you connect with and you enjoy talking to. Sometimes you need to go through more than one, and that’s ok. When you find the right person - it will make all the difference in the world. Thankfully my therapist is experienced with bariatric / weight loss issues. If he wasn’t, I would reach out to my bariatric program (they have a great therapist in house) or if I wasn’t comfortable with their person, I’d ask them for a referral. I hope things continue to get better.

So it may be time to take a little break from the ongoing saga of why it’s taken me over two and a half years to get to surgery and instead talk about how I got to the point of wanting to have bariatric surgery in the first place. My lightest weight as an adult was while I was in the Army. Just sheer physical activity and regular PT had me lean down to around 175 from maybe 185 when I graduated high school. Unfortunately I was severely injured in a training accident while in the service and left the military with a bad limp and a knee brace as a constant reminder. Weight wise, things went downhill from there. Being somewhat disabled made it hard to exercise, but meanwhile I was still eating like I did when I was in the service. (Lots of food, very quickly.) This was obviously not a good combination. Several other health scares and life events later, I shot up to around 240. I managed to stabilize things at this point and was even able to get into strength training pretty seriously for a while. Most cardio was still out, though. Life went on for several years, until I got a new job that paid me very well, but also took it’s toll on me physically and mentally. Within 3 years in the new job, I was up to 285 or so and climbing. I knew I needed help, so my wife and I tried just about every possible diet program imaginable. Interestingly, I’ve kept logs of every one of those diets. For at least the past 15 years, the typical pattern was for me to be somewhere between 285 and 300 pounds lose 30-80 pounds, then yo yo right back to my starting weight and then some. In about 2017, I finally asked my Doctor for help. We did all the things you’re supposed to do: talk to dietitians, try medications of various kinds, and even do physician monitored diets. None of that worked any better. The problem was, they just assumed like everyone does that I was weak-willed or to stupid to know how to eat properly. That’s never been my problem. I actually eat pretty well overall, with lots of fresh veggies, and plenty of lean protein. The problem is, in addition to all the good food, I’m also an emotional eater that soothes with sweets. I knew I’d reached rock-bottom when I started hiding food from my wife. As an example, I might buy a box of donuts and plow through it in a matter of minutes. Or buy the boxes of chocolate intended for Valentines day and devour them all in a morning. No box or bag of candy or pastries ever had the dust settle on it around me! About this time, I got up to 330 (my highest weight), and knew I needed to take a different road or I would never live to see my grandchildren. (I may never actually have any grandchildren, but that’s a story for a different day!) This takes us to late 2019 when I discovered, quite by accident, that my new insurance plan starting in Jan 2020 would finally cover bariatric surgery. After about a millisecond of research (okay, maybe a little longer), I decided this might be the thing for me. I think you already know what happened in my saga in 2020, so we’ll stop there for now and start back up next time in the summer of 2021, when I finally got the cardiac clearance I needed to get WLS.

If the GERD is the result of a hiatal hernia, not an uncommon thing and a common cause of GERD, with or without WLS, then that can be corrected, though some surgeons may not be great at doing that with a sleeve - some can, some can't and will route you direct to a bypass instead. A resleeve might be appropriate if the original sleeve was malformed - that used to be more common 8-10 years ago when most bariatric surgeons were still learning how to do the sleeve (as one prominent surgeon put it, "twenty years of doing bypasses and they think they know how to do a sleeve....") but that is less common more lately, but something still to check out. If you are consulting someone who does the DS (particularly the "traditional" BPD/DS,) that's a good thing as they typically are the most skilled at working with sleeves, and can give a good reading as to what condition yours is in. If one of them tells you that the bypass is the way to go (even though they may normally prefer the DS,) then that's usually sound advice.

I still have a double+ chin, but I can flex my neck and see tendons now. I watched a video where a bariatric doctor said that not having fat around your neck/upper chest is a good proxy for loss of visceral fat, so I'm stoked. I keep flexing my neck in the mirror whenever I'm alone with one!

My PCP has never referred me to or mentioned a neurosurgeon before. He just referred me to a pain specialist. We are doing conservative treatments right now. My PCP is only sending me to a neurosurgeon because of the position my neck will be in during the surgery. The neurosurgeon is requiring I have an MRI in the last 6 months before they will see me as a new patient. The bariatric team I am working with called me this morning to tell me that my PCP didn't even talk to my bariatric surgeon he only texted him. He told me he talked to him. I am in shock. I never would have thought he would lie like that. The bariatric team told me not to switch doctors right now as it will hold me up. They will help me do the letter my PCP wants me to write to him regarding my weight loss history and why I want bariatric surgery. They also said my PCP usually listens to the bariatric surgeon. If he is only trying to cover his *** why doesn't he just get me to sign something saying I am not going to sue him.

I'm a fan of the ones that have both footpads and handles that you hold. I don't have any data to suggest that they are any better, but it just seems like having more sensors in more places would be a good thing. The one I have now in an Omron, but I recently saw on Amazon that InBody also makes one for the home market. InBody is the brand my Bariatric Center uses, so I'm tempted to get one of those as well. One thing to keep in mind: none of these home BIA scales are all that accurate. In reality, that's not super important to me. What's more important is that they are consistent; meaning I can actually track from one week to the next if my percentage of body fat is trending in the right direction. When I want a more accurate number, I'll go get a bod pod scan. .

We all come at different angles with this issue. I had no choice, I had to pay up. I couldn't wait till the NHS recovered from Covid and I finally found a Doctor who would recommend me for the surgery. I have been asking for 25 years and several had already side tracked me onto yet another diet. If I had been given your choices then I would wait for the free option. It would be only 4 months longer than I had to wait anyway. The $18,000, I would save towards skin surgery later down the line. What do you spend on food in a week ? Times it by 52. Shakes, protein powder and bariatric vitamins are extra costs that you may need to factor in too. Keep chatting to us on the forum and read the back pages while you decide. Good luck

Hello All. Can I introduce myself. I’m Paul and exactly 4 weeks post gastric sleeve surgery. I’ve been trying to lose weigh all my adult life with varying degrees of success. All ultimately fruitless. There’s very few I haven’t attempted and I was desperate by the time I agreed to surgery. Although a various times I’ve topped 30 stone I was always able to cope with the excess weight. Not so these last few years and severe arthritis in my worn out knees has forced the issue. To get them replaced I have to be lighter. And hopefully ALM will be in less pain and I can move about easier. I was deeply ashamed about having to go down the path of surgery. I’ve loathed my size all my life and it’s had a profoundly negative effect on both my career and personal life. I was a fairly decent footballer in my time (hence the knackered knees) but undoubtedly the excess weight I carried in my younger years, whilst nowhere near as extreme, hindered my performance and damaged my self esteem. I first joined the NHS bariatric programme in late 2015 after encouragement from my GP but I promptly lost 7 stone and decided it wasn’t for me. Life, as always, got in the way and all that weight went back on by 2018\19 after I was made redundant and lost the plot. I was fortunate to get put back on the programme in 2019 and despite the hiatus of the Pandemic got invited to meet the surgeons in January this year. Can’t say I didn’t have my doubts as the date of surgery to nearer but I knew I was probably on my last chance should I walk away. The liver shrinking diet was extremely easy I felt. I stopped any form of alcohol a month before my date of surgery and I’m feeling OK now. I’ve had a couple of incidents of the foamies and have been sick twice trying to progress to purée/soft food. I’ve put that down to eating too quickly and perhaps slightly too much despite my efforts at not doing either. I find I hard to eat the 800 calories a day target I’ve been told to meet, and sufficient protein but I’m working on it. One thing that I do seem to be unusual for reading through this thread. I haven’t weighed myself since the day of the operation. Am I wrong not to do so? I can feel previously tight clothes getting baggy. My view is this is a marathon and not a sprint now and why torture myself if I can see a plateau going on for a couple of weeks. Nice to meet you all.

Yes, the IBI doctor is a bariatric surgeon and the TrueYou doctor said he's a gastrointerologist specialist. I guess I'll go back to the drawing board to find a few more bariatric surgeons and also find a GI specialist. I appreciate everyone's help and insight.

Thank you guys. I just called my insurance and I can change my PCP. The bariatric team I am working with are so nice and willing to help me also. I am so glad I found Bariatricpal thank you guys so much.

I had a full tummy tuck in July 2020 which was covered in part by insurance, as others have mentioned. Typically, the panniculectomy is covered when it's pre-certified, and then the excess fees to convert to abdominoplasty are paid out of pocket. At my very first consultation with my plastic surgeon, the first words out of his mouth were 'If I do just a panniculectomy, you are not going to be happy with the results. I very rarely anymore just do a panniculectomy.' He explained the difference to me: the panniculectomy is the removal of the apron of the hanging belly, or the pannus. The abdominoplasty goes a few steps further and tightens the loosened abdominal wall, and also includes liposuction. It also improves the appearance of the upper abdominal area and the belly button, as well as helping with posture and abdominal strength by tightening the abdominal muscles. However, in the insurance world, they are concerned with the functonality part of the skin removal, and the conversion to the full tummy tuck is beyond what is considered 'medically necessary.' I am pleased with my tummy tuck and my surgeon is very talented. He works closely with bariatric patients, and I felt comfortable with what he was telling me and knew that he knew what he was doing.

Is the surgeon a bariatric surgeon? If so, maybe go see a GI specialist specifically for the GERD and go from there?

Wow, dating at first was very challenging. There were a couple of men I dated who I did not feel comfortable sharing with, and for me, that’s how I knew it wasn’t the right fit. I met my now husband when I was 5 years post-op. We were introduced by a mutual friend and his co-worker. I told my husband pretty early on about having had RNY. He is a counselor, and was in the Air Force and had EMT/medic training and was familiar with bariatric surgery. I was a little rare in the sense of skin removal/plastics. I did not have my first skin removal surgery until I was almost 7 years post-op (mainly because I was single with only my income and could not afford plastic surgery). In July 2020, I had a full abdominoplasty which we were able to get covered by insurance (I work for the government and our plan is pretty solid). In July 2021, I had an arm & thigh lift done together. My husband has been remarkably supportive. He knew me with the extra skin and now sees me without it. He said it hasn’t changed his view of me at all, he just wants me to feel okay in my own body. 🙂 I can just say that when you’re ready to talk about having had the surgery, the right person will be there in support. 🤗

Thank you for your response. I haven't gotten my GERD checked out for a couple of years, but I know it's getting worse. Part of the regain issue is due to binge eating disorder. I'm still getting treated for that and learning to do other things besides eating. It's been helping, but not really a lot of weight loss (3 lbs since last month), but I can't really get below 220 at all anymore. I'm on HBP meds since last Friday and managing to get it down. I'm totally self-pay for now and the surgeon can correct the gerd, but it won't cover anything dealing with bariatrics under my insurance plan. I guess his office doesn't know how to get it to clear the insurance. I have insurance it just won't cover me for surgery.

I can't change my PCP until November. I like his office because they get me in quickly or even call meds in for me. My PCP referred me to the pain specialist because I have previous cervical fusion(2007) and now have a herniated disk below it.. I had an epidural steroid injection yesterday. I have daily headaches and am trying to find a treatment that works. I have a mechanical heart valve and take blood thinners but have had 2 surgeries when I had to stop them and get the shots and didn't have a problem. My heart has been stable since 2015 and got cardiac clearance for bariatric surgery with no problems. I can't believe he is sending me to a neurosurgeon only because of the position my neck will be in during surgery. I am so let down but am writing out notes for my letter.

Hmm, the decision is solely yours and your wife's. I am also in my 30's with no kids and we are financially very comfortable but I feel like the reason why is because we don't spend 18K when we don't NEED to. Get my point? The point of the insurance requirements are to get you focused, prepared and starting the process of your new life long requirements. If you start to make the changes that will be required after surgery, you will not spiral while you wait. You will however get more prepared and ready for your new life. I had a 6 month process that was "fast tracked" and surgery at 4 months. With that being said, I learned a lot about what to expect. I already knew how to eat healthy and how to read nutrition labels etc. (Which both were part of my classes) But what I found most knowledgeable was what to expect after surgery. I have heard stories from people I know who went through WLS but I found a lot of their information was false or they just didn't understand what they were actually being told. Two other people I know had the exact same surgeon at the same bariatric center and have the same support team through the center. (Including the same Dietician) yet both of them had different understanding of things. The best thing I could have done was take those classes myself and get the answers directly from the providers themselves. It is like in Elementary school when we all sat in a circle and the teacher whispered a statement in the first kids ear and by the time it was whispered 13 times, at the end it was completely different. I also have lost and gained over 100 lbs 4 (i think) times before having surgery. Worked with a trainer, bought exercise equipment...etc. I still lost 40 lbs in the pre-op process just by making VERY TINY changes that they suggested starting with. ok ok, I said a lot and probably boring you now. My opinion from a financial standpoint and from a learning/preparation standpoint would be to go through insurance. But really, you just have to make this decision yourself.

You can have your appointment with your bariatric doc, but unless he knows what it is, go to your regular G.P. -- I have found through life that specialists, if it is not in their narrow little field, tend to not be as helpful as you might think. Besides, it is good to play "catch up" with your regular doctor.

Hi all, so I’m having a bit of a dilemma and I was just curious to know what others would do in my position. My wife and I currently have Kaiser insurance here in California. Based on their program, it would be 10 classes (2.5 months) and then I would have to wait to get on the books for surgery, the person I spoke to said it could be up to a year wait. BUT, I have zero copay and the surgery would essentially be free. On the other hand, there’s the possibility of taking out a Care Credit loan at for $18.5k 0% APR and I could get the sleeve at Blossom Bariatrics by next month if I wanted to. I know it seems like a no brainer to just be patient and wait. That is the smarter financial decision. We do have to put a new roof on our house (or we could wait until next year) and we are definitely worried that if I take out an 18k loan… that our financing of our roof would come with a stupid APR and would ding our credit. We are in our 30s… no kids… live comfortably financially but not well off-which is why the 18k seems a little crazy, although the monthly payments are totally doable for me. On the other hand, I’m almost prediabetic, high cholesterol, feel like my eating habits are spiraling each day. I am genuinely upset that I feel like I’m turning to surgery as a last resort and tool. I’ve tried every diet, every app, every diet pill from my Doctor, I have spent thousands at this point for personal trainers, my mind is consumed with the state my body is in, I feel exhausted, not healthy and I also feel like it’s holding me back from progressing in my life/career. My confidence level, well, it doesn’t even exist at this point. I feel defeated and the amount of energy I use thinking about losing weight/getting healthy is maddening and exhausting. I feel as though one can’t put a price tag on health. I feel like the gross amount of money I spend on eating out nearly every day, buying food, paying for this diet or that gym equipment… would also be eliminated to an extent if I have surgery. So, I kind of feel like even spending 18k… I would SAVE in the long run. I have a ton of goals I’d love to accomplish over this next year… and I feel like the thing holding my back is my health/confidence/lack of energy. My wife is wonderful and we have long, real discussions about all of it. She’s kind of the financial whiz of our life and we are both wondering what the best option is. Spend the money… get my health on track ASAP… save money in the long run because I’m not eating out multiple times a day or buying whatever I think will help me finally get on track. (She also feels like this would help her as my eating habits are starting to wear off on her she says)…OR Wait a year stuck in this loop, possibly gaining more. But I'll pay nothing. There’s so much that can happen in a year… but I don’t want to remain stagnant, spiraling for a year… I want to jump start it and move forward and get this over with and move on. But I can’t figure out what the best choice is. Further, I'm so afraid that even using the sleeve as a helpful tool, that'll I'll just fail at that as well. Thanks for reading my vent. Would love to hear some of your thoughts.

Hi everyone. I hope I’m posting this in the correct place. I just wanted to get some insight or any prior experience. I had RNY on 9/9/13. Down from 311 pounds to between 170-180 now for maintenance. Prior to surgery, I was on Metformin, Protonix, and HCTZ. I was off all three meds within three months of surgery. Surgically, I had to have my appendix out and gallbladder removed many years ago, so neither are causing my current issues. About a month ago, I started getting wicked heartburn and reflux. My appetite is diminished. No vomiting, but zero desire to eat. I have cut out spicy foods, I’m not a smoker or tobacco user, and I do not drink alcohol. I’m 38 years old and in otherwise good health. I go to the gym 3-4 times a week. I have tried OTC Omeprazole, baking soda, Tums, and all the antacids. I started drinking decaffeinated chamomile tea in the morning as well. Does anyone have experience with heartburn, GERD, etc. coming back many years after RNY? What ended up being the cause? I have my annual followup with my bariatric surgeon on October 11, but I’m wondering if I should move the appointment up. Thank you in advance for any insight!

I also had problems with this, and they probably want you to renew that sheet. I understand you have them all, but try to find out what they need again - you can let them know again that you have that sheet.

Hey everyone! I’m finishing up my Post Op Day 1, I had surgery yesterday. Pain was pretty bad yesterday, but managed with the IV medication that starts with a D (I’ve already forgotten the name). All I had by mouth yesterday was ice chips. Very tired. Walked around my room a few hours after being post-op recovery. Took loop around the floor later that evening. Didn’t sleep at all at night because they literally were in my room doing tests at all hours of the night. I was also very nauseous so they gave me zofran and I never vomited. Day 2 started with only ice chips until after my barium swallow study was complete. That barium fluid tasted exactly like what Harry made Dumbledore drink during the lake scene. Never have I ever tasted anything like that. My bowels took forever, so I didn’t start on clear liquids until late afternoon. 1 oz per 30 minutes. Lots of gurgling!!! Much less pain by the afternoon Day 2. They took me off the IV pain med and moved me to Percocet pills and they last longer in the system so that’s good. My surgery was at 7:30am so I’ll have been in the hospital Tuesday, Wednesday and at least the morning of Thursday. Looking forward to going home even though this hospital is so nice (it’s brand new with it’s only bariatric wing). i did a week of strict OptiFast shakes only and did a self prescribed bowel prep because I have horrible constipation and I wanted all that out before surgery. I lost 11 pounds in that week, so I was down to 251.1 on my surgery date. full liquid starting tomorrow. They want me to have 3 portions of 2 oz per day. There is no way I’ll come close to my protein goals. let me know if you have any questions!

Yes, I got sleeve. Bypass was not much of an option for me and my reflux before surgery was pretty manageable so I thought it was worth the risk. My sister works at a bariatric clinic, she told me the first month acid reflux was normal but I'm very hesitant when there are a lot of people who don't experience it at all. I hope mine goes away like yours too!

Hi everyone, I hope it's ok for me to be here. I just had my gastric sleeve yesterday. I had it done locally, so I'm back at home already. Trying to adjust to the liquid diet. Did everyone have to do a liquid diet before surgery? I did not. I just had to lose seven pounds before the surgery, which I did without going on a special diet. They suggested that people could do low carb or a diet with mostly crisp bread and lean, protein rich toppings, but that was just a suggestion and liquid diets were never mentioned. So, I'm trying a liquid diet for the first time today. Yesterday, post surgery, I drank water and gatorade at the hospital. Today, at home, I have had gatorade, water, chicken broth and propud. I have occasional pain, but I haven't thrown up since yesterday. I've read that people don't feel hungry after bariatric surgery, but I do feel hungry and I wonder if it's because I didn't do the liquid diet before the surgery.

Im having surgery the same day and I weight the same amount! Bariatric buddies!

My bypass was 6/8/22. Here’s a quick update. I went into surgery at 208 lbs. I had started the liquid pre-op at 222. I came home from surgery on 6/10 at 223… IV FLUIDS from the hospital caused that. On 6/30, I weighed 192. It was my 3 wk visit with the surgeon. We talked about stalls and not weighing every day. Today is 8/10, 2 months 2 days post op and I weigh 178. Historically I am a slow loser, so I’m over the moon at how this is going. I’m averaging about 1/2 lb loss a day. I found meeting my hydration and protein goals challenging and I had to focus to meet them. It took me a few weeks, possibly 5 weeks even. I made sure I made hydration goals first and then I focused on protein. I found that large amounts of anything with artificial sweeteners (crystal light, etc) stalled my weight loss. Except for 2 s/f ice pops per day, I steer clear of artificial sweeteners. I stopped drinking protein shakes when I made the connection between stalls and artificial sweeteners. I put PRO-T (17 G protein) in a bottle of water a few times a day to meet my protein goals. I buy it on Amazon and I used it after cosmetic surgery a few years ago with great results. I was slow (intentionally) to progress through food stages by choice. I have not been hungry, I have to remind myself to eat (I’m thrilled), and I eat what I feel like eating if it’s something allowed I go through phases: cucumbers, hummus, soup, zucchini, pickles, egg salad, tuna, peanut butter. A couple of bites and I’m full. I walk 3 miles a day, 4-5 times a week. I take vitamins my surgeon has prescribed. I am always drinking water. I have one cup of coffee a day and have essentially lost my love of it. UNPLEASANT: I’ve had 3 vomiting episodes. All my fault because I ate too fast. They were basically uneventful and I was immediately fine. One dumping episode. I didn’t realize buttermilk has sugar in it and I made a dressing for zucchini spirals. I never needed pain meds in the hospital post op probably because I was given a 3 day nerve block in the abdomen by the anesthesiologist. I NEVER had a single gas pain. Ask me any questions: I will try to organize this info and perhaps make it easier to follow. In no particular order, my go-to foods are: ricotta cheese, lettuce with skinny girl dressing, tomatoes, zucchini, chicken-crust pizza (recipe from Sugar Free Mom-Google it-its TDF), many recipes from Bariatric Kitchen on fb. There are SO many recipes…more than I could ever hope to prepare in my lifetime. LOL My attitude has reverted to what it had been most of my life: eat to live. The emotional eating is an issue I have dealt with personally and I dealt with it by removing myself from the kitchen and drinking a bottle of water. When you are sipping, it takes awhile to drink a bottle of water and that’s a good thing. Good luck and feel free to ask me any questions.