Search the Community

I'm at wits end , band done 2012 done really well until 2016 , horrendous pain down port side going into pelvis, after NHS diagnosis tube disconnection and embedded between pelvis and uterus , hospital group wanted more cash and then advised a new band operation , I didn' have enuf money , doc offered full removal but I was scared , weight gain was rapid , 2017 saw surgeon at Nuffield who offered repair costing 3000 but it hasn't worked , constant pain feel tummy is full of hernias I need this out of me and I'm looking for advice , wish I'd had sleeve done now

Seems a bit of a weight gain is normal. June I will be four years out. It took a bit of finagling for me to find where I start losing weight again. The weight loss is slower. But this is maintenance I gain a bit. I now know I can get it back down. This years resolution was not freaking out over small weight gains..lol My menu: Morning:(broke up into two meals) Scrambled eggs with leftover sauteed mushroom,onion and garlic. Jimmy dean turkey sausage Lunch: Smoked salmon salad Pre workout: fresh bartlett pear. Lee labrada homemade sweet potato muffin. Post workout: Run fast eat slow - homemade trail mix dinner: lentil stew - Ground turkey, beef broth, lentils,carrot, green beans,diced tomato, celery, onion and garlic snack: Quest cookie..It is processed but I had a sweet tooth.

Hello All! I have been looking into getting surgery for years now. I have a job that covers the surgery so long as I meet the requirements. I have Cigna and one of the requirement is that I follow a weight management program for >89 consecutive days or 4 visits. I have my last visit on March 13th and I am nervous because my surgeon advised not to gain weight. I gained 2 lbs my last visit so now I'm working towards losing those 2 lbs I gained plus an extra pound or two. My question is did anyone go through the weight program with Cigna and gain and still got approved? They don't specify whether you need to lose during this time or you will be denied so I just wanted to ask others on here to see what your experience was.

How do you expand/stretch out your stomach? I will be 3 months post op on the 20th of February and I just want to make sure I'm not doing this since I am eating a little more solids. SW 280 CW 235 5'6 and believe it or not I have no goal weight yet. However, I want to get to my ONEderland. Maybe 180/160. Sent from my SM-G955U using BariatricPal mobile app

What follows is a narrative of my personal experience with the vertical sleeve gastrectomy (VSG) and my subsequent weight loss. It is specifically written for both preoperative and recent postoperative patients. This is my way of thanking Bariatric Pal for the wealth of valuable information I gleaned before undergoing the surgery. I need to underscore that my story is not intended to provide weight loss advice or suggest that the way I did it is the only or even best way to lose and maintain weight loss. I have broken and continue to break most of the postoperative rules I was given by my surgeon and, yet, I’ve been able to maintain a weight loss of 88 pounds over four years (my weight fluctuates within a five-pound range). There are too many self-proclaimed experts on this forum: I am not seeking feedback or a critique about the particular path my journey has taken. There are a few things I would do differently in retrospect. Perhaps others will benefit from my story. Back Story Obesity runs in my family. My parents were chronically 30 to 60 pounds overweight throughout my entire life. My father died at 62 from arteriosclerosis (years of cholesterol plaques broke free and clogged his valves: he suffocated to death). My mother died at age 61 from a massive stroke. Three of my four grandparents died in their late 50’s and early 60’s. I am 63-years-old and thank God every morning for giving me another day. I was a skinny kid but my mother forced me to finish a large glass of eggnog every day even though I would spend over an hour trying to get it down. Her plan worked: At age twelve, I weighed around 30lbs more than I should have. The year was 1967 and Weight Watchers had just opened a branch in my hometown. My mother joined and I decided to follow her program (there were no teen programs at that time. Back in those days, one weekly serving of liver and three daily doses of that foul-tasting Malba powered fat-free milk were mandatory). I lost the excess weight in a relatively short period of time because I was consuming far fewer calories than a growing boy needed and I was active with sports throughout high school. I kept the weight off until after I was married. Throughout my young and middle adulthood, I would continuously lose 30 pounds over a period of a few months and then slowly but surely regain the weight over a two-year period. However, the total amount of each weight gain increased with age and losing the weight became increasingly difficult. At 57 years of age, at a height of just under 5’7”, I weighed in at 244lbs reaching a BMI of 38.8. Bariatric Consultations My initial plan was to obtain a gastric balloon (I wasn’t quite ready to accept that I needed a permanent solution). I consulted with three bariatric surgeons who each told me that a gastric balloon was not the answer as, first, I had too much weight to lose and, second, each physician anticipated that I would regain the weight as soon as the balloon was removed (in six months’ time). Two surgeons recommended the vertical sleeve; one was in favor of the gastric bypass. I eventually decided on the VSG as I didn’t want to have to worry about nutrient absorption (although, as it turned out, I still have to take daily supplements as I just can’t hold enough food in my stomach to receive the minimum daily requirements of vitamins and minerals). My decision to undergo the surgery was not based on vanity. I would have continued to let my pants out if that had been an option as I loved to eat. The surgery was a medical necessity: I had developed obesity-related diabetes (type II) and was taking 1500mg of Glucophage daily and it was only marginally successful. I was functionally crippled: I could not walk more than 100 yards without feeling as if the soles of my feet were on fire. I would need to stop and sit down to give my feet a chance to recover. I was miserable. I could do nothing but lie in bed, watch TV, and eat. In addition, as my weight increased, my blood pressure continued to spike. I was taking five different antihypertensive medications daily and my pressure was still in the high-normal range (155/90). My wife lost her partner in that I was physically unable to do the things with her that we used to do together. She often referred to herself (with me only) as a widow. I hit rock bottom emotionally during the summer of 2012 while visiting Disney World because I needed to rent a scooter (I could not keep up with the others and would hold them up while I rested for a few minutes). I was deeply humiliated although my companions were thrilled that we were able to skip the long lines and enter the rides through the handicap entrance. I scheduled the surgery well in advance for the winter break of 2012 as soon as we returned home (I’m an academician and a university student counselor). My eventual choice in a surgeon was based on a recommendation from my stepson, an emergency room physician, who heavily researched various doctors for me. This particular surgeon was the first to ever perform bariatric surgery in our state and, most impressively, has a “leak rate” of zero percent (even to this day after five years). The Good, The Bad, and The Ugly The operation went smoothly although I awakened to four incisions instead of the expected three because the surgeon could not see his way around my fatty liver without that additional entry point. My mild to moderate pain was sufficiently managed with a pushed IV dose of morphine and tramadol followed by regular intervals of more tramadol. I was very comfortable during my two-night hospital stay. I was sent home with only liquid Panadol and it worked. What pain I had was negligible by the fourth day, when I was able to get out of bed without help. I attribute this outcome to my surgeon’s skill. What I did not anticipate, from having read these forums, was just how damn thirsty I would be before I was cleared for liquid intake. My mouth and throat were so dry that the Barium liquid they gave me to drink for the leak test was literally a welcomed respite from my thirst. I was one of the unfortunates to suffer chronic diarrhea for three-and-a-half-months. This condition is not uncommon after vertical sleeve gastrectomy. I went to work every morning wearing a diaper. I also did not anticipate how weak and dehydrated I would be. I was readmitted to the hospital after two days of dehydration and syncope, a condition that persisted for weeks. I lost my balance a couple of times while at work, which led to speculation among my colleagues that I had either contracted alcoholism or cancer (the latter guess was reinforced by my rapid weight loss). I chose not to broadcast my surgery to anyone other than a few close relatives. My healthcare issues are no one’s business but my own. I also don’t discuss my hypertension, benign prostatic hyperplasia, and reoccurring planters wart with relative strangers such as waitresses and coworkers. (There is a great deal of debate on this forum about the merits of telling the world about one’s bariatric surgery. I do not necessarily believe that one approach is better than another. I only know what was and is best for me). I lost weight too quickly because I didn’t prepare sufficiently for the postoperative 14-day liquid diet. I couldn’t stand the taste of the liquid protein drink I purchased and there is only so much clear broth one can tolerate without feeling as if you’re drowning. By the ninth day, I broke my first postoperative rule and had my wife make me a simple poached egg without seasoning. To this day, that single poached egg was the most delicious meal of my life. I was starving. I believe I lost 30 pounds within the first five to six weeks, followed less dramatically by another 40 over the course of the next six months. Unfortunately, a significant percentage of that weight loss was muscle. Consequently, by the time I reached my initial target goal, I was disheartened by the fact that I looked nothing like I did the last time I had weighed 170lbs. My pants size never changed as my weight decreased from 185lbs down to goal weight, owing to this apron of loose skin in my lower abdomen: I have had to wear 36-inch waist pants regardless of weight. That has been an enormous disappointment. The last time I weighed 170lbs (back in 1997), I wore a 33-inch waist. Over the course of the five years that followed, I gradually lost another 15lbs while not particularly trying to. I have a hunch that my surgeon removed more stomach than he let on, although a gastroenterologist told me that I had about 50 percent of a normal stomach after she performed an endoscopy to rule out stomach cancer. I developed a terrible case of acid reflex and must take antacids every day. During the summer of 2012, my wife and I went on a five-week culinary retreat, including a 10-day cruise. I returned home to discover that my weight had climbed to 180lbs from the 168lbs I had started my vacation with. It was a harsh wake-up call that I could not eat with total impunity. The fear of regaining my weight gripped the pit of my stomach like a heavy duty Craftsman’s vise. I made a decision and commitment to myself that exact moment to never allow myself to gain this kind of weight again. I made a concerted effort to reduce my daily intake of food until my weight fell back down to goal weight. My weight has remained fairly constant from the beginning of 2013 to present day, fluctuating from 155 to 160 pounds. When my weight hits 160, I make a decision to become acutely mindful of what I eat until I see 150-something on the scale. As for the apron, I will go in for liposuction this summer. I gave serious thought to an abdominoplasty but the surgeon talked me out of it, claiming that I would require a four to five week recovery period. In addition, he felt that the loose skin would eventually retract after the underlying fat was removed. In fact, my apron has slightly decreased in size over the past year, an effect of regular activity I think. The Aftermath I am convinced that my metabolism has increased as a result of having been able to maintain my lower body weight over several years. It seems to me that I can eat more now than I could one year after the surgery without gaining weight (my wife, on the other hand, thinks that this isn’t necessarily true, i.e., that I am not really eating more than I had). I am amazed by all the energy I have today: my wonderful and beautiful wife is no longer a widow of obesity and diabetes. Today, I seize every opportunity I can to accompany her to the malls and stores. Today I can walk for hours without pain or fatigue: my diabetes went into permanent remission after a weight loss of 30 to 35 pounds. My BMI varies from 24.6 (normal) to 25.4 (slightly overweight) depending on where I am in my five-pound weight range. My blood pressure is currently maintained in the low-normal range (i.e., 120/70) on just one-fourth the medication I used to take when I was fat. I am on the scale every single morning. I do not like surprises. I want to know immediately when my weight starts to creep upward so I can nip it in the bud. I know myself: I would not be able to rationalize that personal failure away. I am a big fan of the reality TV show “My 600lb Life” on TLC. According to bariatric surgeon Dr. Nowzaradan, less than five percent of his patients enjoy long-term success. Based on the scientific literature I have read, patients with a starting BMI of less than 40 have the highest long-term success rates. Those who were morbidly and super obese (BMIs of 40 to over 50) at the start of surgery have a tough nut to crack. In most cases, they will need to consult with a psychotherapist who specializes in the treatment of obesity to change their emotional relationship with food. Aside from eating solid food after just nine days, I started drinking carbonated beverages at six months after the surgery, e.g., diet cokes and vodka tonics. I am not aware of any change in my stomach’s capacity and I’ve been drinking carbonated beverages every day for almost five years. (Please note: In no way am I encouraging anyone to do the same. Follow your surgeon’s guidelines. I do not want to read any criticisms or dire admonishments from this forum’s formidable food police about how I am inadvertently sabotaging other people's weight loss program). I am simply sharing what has worked for me for the last five years. Many forum members claim that their taste for certain foods changed after the surgery (and, quite fortuitously and even miraculously, it’s always foods high in carbs and fat that members seem to lose their taste for). I cannot claim such good fortune. All foods taste the same to me as my surgeon refused to remove even one of my 10,000+ taste buds: What has changed, however, is my appetite for certain foods. Prior to the surgery, I used to put away four to five 16oz Angus ribeye steaks every week. Today, I don’t find red meat as appetizing as I used to because of its density. I prefer fish because I can digest it easily and without suffering from an agonizing attack of acid reflux. Chicken is also good. Sometimes I do feel frustrated that I can’t eat more than three to four ounces (including fluids) at a time. The good news is that my surgery paid for itself in about 18 months owing to dramatically reduced grocery bills (my insurance did not cover the surgery). I was thrilled when—by fasting all morning long from food and liquids—I was able to finish an entire half of a Second Avenue Deli pastrami sandwich while visiting New York City (and a few sips of their beef barley mushroom soup as well). I have not restricted or eliminated any foods from my life. As a behavioral therapist with over 37 years of clinical experience, I don’t believe in abstinence from food or alcohol as a lifelong strategy. Abstinence is not an effective alternative for moderation. My diet is predominantly the same now as it had been before the surgery. I still eat candy, cake, and pizza, for example… just a lot less than I used to. The only genuine difference in my diet, as stated before, is a decrease in the amount of red meat I consume because it’s harder for me to keep down than fish and chicken. My stomach is very sensitive to overeating: the difference between digesting my food in peace and having to run to the bathroom to cough up a silky combination of excess mucous and gastric acid is literally one bite or a single sip of beverage. Would I have the surgery again given what I know now? Absolutely and in a New York minute. The only regret I have is that I didn’t commit to the surgery sooner. What I learned from my experience I urge anyone planning on having a sleeve gastrectomy to invest the time and money to experiment with different brands and flavors of protein drinks before the surgery. You need to have a reliable source of protein and sufficient calories or you will lose muscle along with fat as I did. The only regret I have is that I lost the weight too quickly, leaving me with an annoying apron and lots of loose skin on my arms, stomach, and hips. There is an implied assumption on this forum that all bariatric surgeons and results are the same, i.e., if one patient supposedly sprung a leak by eating solid food on day 13 (instead of day 15) or allegedly gained back half the weight by allowing him or herself to eat M&M’s again, then everyone should expect the same results. This is simply not true. No two surgeons are the same and no two patients of the same surgeon will have identical results. One size does not fit all when it comes to bariatric surgery. I suggest to friends contemplating the surgery that they find the best surgeon they can regardless of cost even if it means traveling. You don’t shop for bargain basement prices when you’re about to have more than half your stomach removed. The risk is too great. My stepson, the emergency room physician, after looking into the first surgeon I had selected advised, “I wouldn’t let him operate on our dog.” The “less than one percent leak rate” is not an immutable or predetermined statistic: There are bariatric surgeons who boast a zero percent leak rate. Find one of those. I hope my story has been informative and helpful.

As others have said - check with your program. It could be intentional to help keep your blood sugar from crashing and keep you out of ketosis during a short period pre-op and/or post-op. I know my program advocates for small amounts of 100% apple or grape juice for those reasons (yes, my program tries to keep us out of ketosis which is different from others). If you are only taking in clear liquids the amount of sugar you are getting from a moderate amount of apple or grape juice is not going to cause significant weight gain. Moderation is the key though - I wouldn't drink gallons of apple or grape juice all day long.

I would call for clarification. That is a lot of sugar dumping back into your system. Sugary drinks is what contributes to weight gain. Sugar free it makes no difference to the body the brain registered it as regular sugar which increase your desire to want to eat more. Please check with your nutritionist Good luck.

I had the IUD after I had my surgery. Prior to my Pre-op, I was advised to get off my hormonal birth control (At the time was on Depot for Endometriosis). I do not believe that the Mirena affects weight loss or weight gain like other birth controls do. I did not see any difference in my weight or it affecting my weight. However, everyone is different and it could affect your weight.

Hi Chel, Sorry to hear about the allergic reaction to the glue, I hope you are feeling better. I know you already found out about the weight gain being attributed to surgery. I am 15 months post gastric sleeve and I had my gallbladder out about 7 weeks ago. I was pretty surprised that my weight went up almost 9 lbs two weeks after gallbladder removal. After I kinda freaked out about it, I calmed down and thought to myself that the surgery was probably the culprit, and it was...you know, fluid retention etc. Hope you have a speedy recovery!

I had my follow up with the surgeon and discovered I as having an allergic reaction to the glue. I am happy to say @AceBlaque you were right. I am now 6lbs down from my presurgery weight. So all the surgery weight gain is gone plus another 6 lbs. Thanks again for your response. 💕

One other thing to consider (if you haven't already done so) is to have your thyroid checked. I was super active in high school but could not seem to lose the 15 - 20 extra pounds I carried around unless I went on a severely calorie restrictive diet. I was diagnosed with hypothyroidism at 17, and once on medication, I lost that extra weight in college. [Now, I ended up gaining about 50 pounds in grad school thanks to some mild depression resulting in inactivity, over eating and poor food choices. This and weight gained since is what I'm struggling with 25 years later resulting in my considering the surgery now.]

I haven't had any major complications, but there are definitely mental aspects to post-surgery life that I didn't really think about. First, you can't overeat - even if you have the worst day ever, you can't turn to food for comfort. Is that a con? Not really, but it does mean you have to find new ways to deal with your issues. Prepare yourself. Second, there are times that you are going to be pissed off that you can't eat what others are eating or as much as they are eating. I didn't expect that at all. You just have to change your way of thinking! You can't take a break from your new lifestyle. You will get sick and/or potentially cause harm to yourself if you don't follow your diet guidelines. This is 100% commitment for the rest of your life. I'm not saying you'll never eat normal foods, but you have to be committed to eating nutritious foods in the right quantities. Make sure you are ready for that before you take the plunge. I didn't have any major food issues before surgery . . . I just neglected myself for too long, which led to my weight gain. That being said, the mental aspects have still affected me from time to time. They are all manageable, but I definitely think this is more of a head game than people realize before surgery. Good luck with your decision! Even with all of the above, I do NOT regret my decision. I feel better than I have felt in years, and I'm really happy I went through with my surgery!!

Not me, but I'd suggest changing up your lifestyle a bit (diet, exercise, etc). Seems the stress of moving/jobs is what stalled your scale weight, I'm assuming. Stress is a huge contributor to weight gain. Do you best to not worry, find some peace and rest hon.

I am about 10 months post op and have lost about 60 lbs, which includes some weight gained back. I am starting back to the gym which got derailed due to a big out of state move, new jobs, etc. I need to get back on track as I can tell a difference in energy level and don't want my health to start suffering again. Did anyone have this happen to them? What did you do to get back on track? Any advice would be appreciated! Please no lectures... I'm human, after all.

Sorry I haven't been on much but no, there was no weight gain issue, i just chickened out TWICE, now I'm bigger than ever so it's time to get sleeved!

It is common to have some limited weight gain after gastric bypass surgery. They call it a 20 pound bounce. The important thing is not let go beyond it. According to my nutritionist, meals should consist of equal parts of protein, fats and carbs after the first couple years post-op. Snacks should be limited to primarily whole food options: nuts, natural nut butters, fruits, veggies, boiled eggs, string cheese, yogurt with berries and almonds, tuna pouches. Avoid processed packaged foods as much as possible. So I guess my advise is to document what you eat in a food journal and figure out what is the cause. I had RNY gastric bypass whereas you had the sleeve. I am 5 years post-op and this is the approach that I use. http://www.breadandbutterscience.com/Surgery2.pdf

I am almost 5 years post op VSG (surgery date: 06/2013). I started at 272lbs and was at 268lbs the day of surgery. I was able to get down to 199lbs but I seemed to plateau at 215lbs. I stayed at 215 for about 1- 2 years and then all of a sudden the weight started to come back. Today I have gained about 95% of the weight back and I am not sure why. I went back to the doctor and they did the barium test(?) to see if my stomach stretched and they said it did not. They said it was the same size it was after surgery, the doctor was actually quite impressed by it for some reason. I still eat small portions, so much so that my friends that don't know I had surgery think something is wrong when I don't eat all my food. I've tried a few different things to lose the weight but I can't seem to lose more than 20 lbs and it always comes back. I've considered that there could be something else wrong. I have been symptomatic of Hypothyroidism for years now, however, when my doctor runs blood tests (TSH and Free T4) it comes back normal. My doctor refuses to give me a referral to an endocrinologist (I had hormone problems when I was a kid) or do a full thyroid blood test. I feel like I am out of options and I am not sure what to do. Any advice or words of wisdom are welcome! Thanks!

I know you can and will take PPIs, in the long run the are gastroprotective Most surgeons surgeons discourage carbonated beverages. A they encourage weight,gain, many of us got fat from overindulgence in Coke, Pepsi and their evil soda cousins. B. Do you enjoy pain? That stuff will bloat up your sore little stomach. If it doesn't cause you to vomit you'll have to belch or blow it out the other end. Alcohol doubtful you'll be allowed to indulge very soon. I've heard 6 months, a year down the road. You have been a workaholic , you do not want to exchange one addiction for another. You'll become drunk on less. And a final note, although I am pre surgery I have gastritis, booze hurts and burns the lining in your stomach and it hurts like the walls of Hades. Sent from my VS880PP using BariatricPal mobile app

I have yet to look him up and see what he’s about, but I wonder, what’s your take on why he is? Update: well I couldn’t find much other than the book being for sale and I couldn’t find what he really promotes lifestyle wise either. But I did find some kind of Dr V challenge which is just terrible. I’m guessing the challenge is for normal stomachs...and even if so, it’s still terrible. Way too low of calories, that’s a recipe for weight gain. Anyone has any input on this this guy, I’m intrigued, but not so much as I am with Garth and Weiner and Greger.

Not to be the bearer of bad news, but no surgery is going to fix head hunger. In the early stages, yes, you're experiencing actual hunger. I've said this a half million times on here, but my example is this: I can eat right before I leave work and feel super full. An hour later when I get home I feel hungry again. Why? Because it's head hunger and old (bad) habits of always eating as soon as I got home from work. No different than my old smoking habits. Got done with a meal. Had to smoke. Didn't matter if I had a smoke five minutes before dinner. I always had to have one right after. It's the habit of it and my brain telling me I "need" it even though I actually don't. Studies will show differently, but on average water in an empty stomach can pass through in 5-15 minutes. Yes, there are a host of things to take into account but the point is people act surprised when they drink and don't feel a full sensation. Grazing is one of the hardest battles to fight. That can easily lead to weight gain and slow down your progress. If you aren't doing a food journal do one. If you aren't actually measuring your food get a scale and measuring cups. The mental side to WLS is something that (IMO) isn't stressed enough to many. My doc's office did a pretty good job of prepping us for it, but it's still difficult when it actually comes time to fight back against old habits.

I am hoping you make an appt with your dr, maybe a small fill ? Perhaps load up on Protein Drinks, Protein Bars , eggs, tofu. Whatever you know works for you...i think half the battle is at the store! Please don't mistake me for someone who has the right answers....ive been at this 11 years and just experienced a weight gain I never thought i would have again....now, i do have a bit of a fill, but it is a long journey! I try to remember that I don't have to be at my destination ,but need to be on the road headed the right direction...and moving Best of luck Ps. You are not a failure! Sent from my iPad using the BariatricPal App

I'm not sure how much direct help I can be, as our metabolisms are likely quite different (between a 5'10 man and a 5' woman) but I'm stable at around 2000 calories per day, give or take depending upon how routinely active I am, typically split up between about five meals per day. I do about an hour of dedicated exercise per day, usually split between a half hour or so of running the dogs woods or canyon in the morning (they run, I hike) and a half hour or so of swimming or strength training in the afternoon. I don't keep track of the fluids anymore, but it is at or above the typical 64 oz recommendation (I down a 1.5 liter bottle of water per day, plus ice and whatever other incidental fluids I have - iced tea or milk products; more if I am doing something specifically dehydrating during the day. There is a series of videos from one doc that has some relevance - I'm not entirely up with everything in his program, but he is one of the few that I have seen that discusses the increasing meal volume that we typically see over time, and offers a way to handle it. I do something similar in that I have a fairly vegetable rich diet, and do more of his "veg first" approach rather than the traditional protein first that we see in the bariatric world. It does make some sense in that veg is typically high bulk, high nutrition and low calorie, so does a good job of filling that extra capacity that we develop over time in a way that minimizes the caloric load that leads to regain. The more typical low carb (and worse, low carb, high fat) diets that are all the rage today have some weight gain built into them as they are typically higher caloric density which can lead to regain if one doesn't keep on top of the overall caloric load. So, that is something to consider if that can fit with your dietary personality (something that you can stick with long term.) He has some other vids on related topics that may also be useful. He seems fairly down on revisions as a solution, which fits my experience as there seems little that can be done to a bypass that isn't just a short term fix; a revision to a DS seems to offer the best results but is a very complex procedure that few surgeons can perform, so that tends to be a last resort.

@FluffyChix: The weight gain is indeed because of "not following the rules". However, as with other strict diets this whole bunch of strict rules can't usually be followed forever. Willpower wears out. There might be a few exceptions who can follow the whole book of rules forever (as there is with other diets; after all there are people who maintain their weight with WW etc. as well). To not make WLS into just another diet or diet in disguise that gives you great success in the beginning and makes you miserable a few months or years down the road: implement rules that you can follow forever.

Hi, was the weight gain an issue? At my last appt with surgeon, I was up 5# from holidays (ugh), but I've almost lost it now. Still I worry that I havent actually lost weight. Still another 3+ weeks until I start the pre-op diet, where I actually get to eat food -- 1200 kcal, 60g carb, 120 g protein, 4 meals a day. For that I am thankful. OTOH, post surgery is 1 week clear liquids, then 2 weeks full liquids. So surgeon is easier on the upside and harder on the downside. Want to add, I personally am on the fence about Premier Protein -- its too thick for me.

Does the reason why any of us have a weight gain matter? Could be many things. Your body settling, medical issues, major life changes or old behaviors creeping back in. It's more important that we recognise a gain and work to get back to healthy. I can relate. I feel the need to control my weight. I have to admit my fear of regain is not a normal level. I felt out of control with food and my weight most of my life. I now over think maintaining. It's a bit obsessive on my part. It's something I'm working on.