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I am 11 months post sleeve, sometimes when I eat I feel like it's stuck in my throat. Anyone else have this problem?

Give me your update. Was sleeved 7/15 2019 I have gained 10 pounds feeling disappointed Sent from my SM-G950U using BariatricPal mobile app

Coping with Stress During COVID-19: What Bariatric Patients Need to Know May 1, 2020 by Harold Bays, MD, FOMA, and Lydia C. Alexander, MD, FOMA Dr. Bays is Medical Director and President of the Louisville Metabolic and Atherosclerosis Research Center in Louisville, Kentucky. Dr. Alexander practices obesity medicine at Kaiser Permanente Medical Weight Management Group in San Francisco, California. Funding: No funding was provided. Disclosures: Harold Bays, MD, FOMA is Trustee, Chief Science Officer, and Lydia C. Alexander, MD, FOMA, is Secretary/Treasurer for the Obesity Medicine Association. During this most unique of times, as frontline healthcare workers and hospital staff, we frequently face difficulties when treating patients threatened by a rapidly increasing pandemic. This is made even more difficult with the stress of limited essential medical supplies. Among all the turmoil and disruption, the emergence of COVID-19 has created special challenges for patients with obesity. Many patients with obesity have impaired immunity, impaired lung function, sleep apnea, and hypoxia, making a virulent upper respiratory tract infection especially perilous. Added to this are obesity-related debilitation, immobility, orthopedic changes, polypharmacy, more limited access to medical/preventive care, and adiposopathic complications of diabetes mellitus, and cardiovascular disease.1 Collectively, patients with obesity are more susceptible to COVID-19 disease and have worse outcomes once infection occurs. For many bariatric patients, the rise of the novel coronavirus has created additional challenges, such as the effect of mental stress on their lives. Increased mental stress can worsen complications from obesity, such as hyperglycemia, high blood pressure, dyslipidemia, and might also worsen obesity itself. The good news is that if clinicians are attuned to the physical impacts of mental stress, then proactive measures can be taken to mitigate the potential adverse consequences of mental stress. Acute Stress, Chronic Stress and COVID-19 Acute, or short-term, stress is a function of the natural “fight or flight” response. One of the systems activated by the stress response is the sympathetic nervous system, which increases production of hormones epinephrine and norepinephrine. The acute stress response can be beneficial—it can increase visual acuity, decrease pain, increase blood flow, and boost the immune system. This complex sequence of hormonal changes and physiological responses helps people when they need to fight or flee to safety. Conversely, chronic, or long-term “submit and stay” stress has the potential to worsen health outcomes. Chronic stress can increase cortisol production, which might promote visceral fat accumulation.2,3 Symptomatically, chronic stress can cause decreased cognitive ability, diminished healthful decision-making, and more pronounced pain. Physiologically, chronic stress can impair immune function, impair sleep patterns and increase blood sugar, high blood pressure, and body weight.4 The Toll of Chronic Stress on Patients with Obesity During COVID-19 Stress and anxiety are understandable during the COVID-19 situation. We are living in a time of an unprecedented global pandemic crisis. Doom and gloom are everywhere. Good news is rarely reported. Stress is to be expected. However, clinicians can assist patients with proactive stress management techniques, especially for people living with obesity. Many patients are staying home to keep themselves and others safe and limit the spread of the novel coronavirus. Other patients are staying home because of governmental mandates. But while “distancing” from others could have potential benefits in preventing viral spread, staying home might result in less healthful nutrition and reduced physical activity. As we navigate the unparalleled COVID-19 crisis, it is critical that clinicians, including bariatric surgeons, counsel patients to recognize the signs of mental stress, as well as its potential negative impact to health. This would include increased blood sugar, high blood pressure, increased body weight, and challenges fighting viral respiratory infections. Bariatric patients should receive specific and actionable guidance on safely optimizing nutrition and physical activity during periods of shelter-in-place orders.5 Coping with Stress During COVID-19 As we await a cure or vaccine for the novel coronavirus, one of the most important measures clinicians can take in the interim is to address potential mental stress head-on, as one of the first topics of discussion during patient encounters (e.g., via telemedicine or otherwise). When appropriate, clinicians can then recommend patient-centered stress management techniques that might prove helpful. Here are some ways to get started: Feel your feelings. While it might seem intuitively obvious, many patients might not truly recognize the degree by which mental stress is altering their behavior, lives, and overall health or might be avoiding addressing feelings of sadness or loss of previous routines and lifestyle. This should be a prime topic to discuss during any patient encounter. Patients should be educated to become in touch with their feelings and recognize how those feelings might be affecting their behavior. Negative or unproductive feelings and the potential adverse effect on behavior cannot be resolved until it is first acknowledged. Take it one moment at a time. At this time, no one knows how or when the COVID-19 crisis will end. It is likely nothing will ever go back to “normal.” This might be a daunting notion to patients with obesity, who might already have a sense of hopelessness. Thus, instead of focusing on the seemingly unending days of isolation ahead, patients should be encouraged to focus on manageable, demonstrable, and accountable healthful measures that can be accomplished today. Behavior changes that are doable, accountable, and sustainable represent the mainstays of a behavior modification plan. Perform a food inventory. It is common that patients with increased mental stress resort to “comfort food,” which is often energy dense and highly processed. Temptation to consume these foods is increased if these nutrition-deficient foods are in the location where people live. Thus, patients might best be advised to perform an inventory on the nutritional quality of food where they live. When ordering food or grocery delivery, patients should virtually shop when they are not hungry or exceptionally stressed. Having friends or family review the list might also be helpful for some to ensure healthy foods are chosen. Stay physically active. When shelter-in-place regulations prevent leaving the house, patients can be advised to look for novel ways to keep moving. Pacing while on the phone, putting the laundry away one item at a time, listening to music and dancing, and taking a lap around the house or backyard are all ways to remain physically active while sheltering in place. Passive stress relievers, such as surfing the internet, watching television, and playing video games might seem like an ideal way to pass the time. But these do not contribute much to energy expenditure and might worsen anxiety. Too much time spent with passive screen activities can have a negative impact on health. It is a good idea for clinicians to specifically talk to their patients with obesity about limiting screen time. Stick to routines and care plans. Now is not the time for patients to fall out of previous healthful routines and self-care that was either promoting health, or helping with health maintenance. Patients should be encouraged to think beyond COVID-19. They should avoid having these few months negate years of potential progress that were so hard to achieve. Patients should especially be advised to monitor their sleep patterns. Poor sleep can contribute to worsening metabolic disease, cardiovascular disease, and obesity. Closer clinician contact with bariatric patients at this time is critical to identifying early maladaptive behaviors and routines and ensure continued long-term success Practice active stress reduction. Patients should be encouraged to explore activities, such as walks (where permissible), puzzles, books, yoga, meditation, and other hobbies. Maintaining social connection via phone and video calls while physically distancing can be an important method of stress reduction. These pastimes can have a soothing effect during this stressful time. Look for the helpers. Fred Rogers said it best, “Look for the helpers. You will always find people who are helping.” During times of crisis, finding a way to join the helpers can be gratifying not just for the one being helped, but also the one doing the helping. Participating in community efforts to improve the lives of those affected by the COVID-19 crisis can have a relieving impact for everyone. Maintain social connectivity. While the recommended jargon of “social distancing” is prevalent, perhaps the implication of this approach is not what was intended. Perhaps a better term is “physical distancing.” Remaining socially distant is not always the best plan, especially for patients with obesity who are already stressed and who might already feel isolated. For many patients, it might be best to recommend to seek and maintain social connection via a simple phone call, or FaceTime, Zoom, Google Hangouts, or any of the myriad digital communication solutions available. As clinicians continue to look for ways to help their patients during these stressful and uncertain times, bariatric surgeons can empower patients via implementing simple techniques, such as the ones described here. The Obesity Medicine Association (OMA) offers a trove of resources for clinicians and health care professionals, including continuing medical education, American Board of Obesity Medicine (ABOM) exam preparation, Obesity Treatment Proficiency Badges™, and The Obesity Algorithm®, which offers comprehensive clinical guidance on the latest obesity management trends and evidence-based medical approaches to treatment.6–8 To become an OMA member, visit: https://obesitymedicine.org/join/. For more obesity medicine resources, visit: www.obesitymedicine.org. References Scott KA, Melhorn SJ, Sakai RR. Effects of chronic social stress on obesity. Curr Obes Rep. 2012;1(1):16–25. Joseph JJ, Golden SH. Cortisol dysregulation: the bidirectional link between stress, depression and type-2 diabetes mellitus. Ann N Y Acad Sci. 2017;1391(1):20–34. Kyrou I, Tsigos C. Chronic stress, obesity and gonadal function. Hormones (Athens). 2008;7(4):287–293. Yaribeygi H, Panahi Y, Sahraei H, et al. The impact of stress on body function: a review. EXCLI J. 2017;16:1057–1072. Bergmann N, Gyntelberg F, Faber J. The appraisal of chronic stress and the development of metabolic syndrome: a systematic review of cohort studies. Endocr Connect. 2014;3(2):R55–80 Obesity Medicine Association. https://obesitymedicine.org/badges/. Accessed March 24, 2020. Obesity Medicine Association. https://obesitymedicine.org/. Accessed March 24, 2020. Obesity Medicine Association. https://obesitymedicine.org/obesity-algorithm/. Accessed March 24, 2020

I’m having so many mixed thoughts swirling around my head. I hesitate to post this today. I am grateful for having gastric bypass to have the tool to combat metabolic disorders and inability to exercise due to disability (post exertional malaise) and I was at the point it was all or nothing. All my fight was getting me nowhere fast. I know I’ve come a long way, I’ve also paid a hefty price physically and am still dealing with many health challenges. But I also know my body could not carry the burden of all that weight. And I will do everything in my power to maintain the weight loss. i reached goal Sometime last month. I overshot it a little. Although based on my height of 5’ I’m within my goal range. I haven’t been actively trying to lose for a few weeks. I raised my calories somewhat but not drastically. I started out at 208lbs with a BMI of 40.6 and today am 102.4 and a BMI of 20. its Funny though, I write my weight on a calendar daily, and write Daily log of my weight, meals, calories and protein to Track and plan what I will eat the best I can based on what’s available in the fridge, freezer, pantry. I haven’t given solid thought to my progress, I’ve just taken it one moment at a time. My weight fluctuates slightly and that’s ok. Other things weigh on my mind though. I hesitate to call it a celebration when even my birthday this month went unmentioned and Covid-19 will be around for the foreseeable future. It’s not impacted my odd daily routines of living with lifelong chronic illness and disability. I’m homebound much of the time as is. It’s risky going to get groceries but a necessity. But It’s had more of an impact on healthcare. i Had an early one year follow up with my surgeon February 11 and discussed continuing severe pain and spasms in left side under ribs along with other symptoms along with my history of ulcers in the remnant stomach and small intestine, they said I needed a double balloon enteroscopy. But I had to see a different doctor for the test. I couldn’t get an appointment until March 12 to see that doctor, I asked if they could schedule the test since it takes a while but no I had to wait to see the doctor first, who of course ordered the test. Which was then scheduled for April 27. And what happened, of course no one called until the last minute and it was then canceled indefinitely. And I’m left in pain, I sent them a message and they tell me I could go to the ER to be evaluated. First of all how is that a good idea? And evaluated for what? That’s why I saw the doctor and he ordered the test (actually both doctors did) I’m at a loss as to what to do and meanwhile I’m just trying to move ahead. i don’t even want to discuss this. I’ve other health issues that I’ve been waiting months to deal with. My doctor gives me attitude. Even things are obviously a problem. I saw my general doctor February after waiting a few weeks. I had sudden severe pain just lightly touching the front of my throat. I had a thyroid ultrasound. I also saw an endocrinologist. I was supposed to go to the hospital for further tests. But this was cancelled indefinitely. I’ve also been having nosebleeds and I don’t know why ... but it’s all been put on hold and none of the doctors care to follow up. I have been making plans about having skin removal surgery. Since it’s the only thing I can manage to do right now. The excess sagging skin is very problematic especially my thighs. A thigh lift, and Having a Belt lipectomy/Butterfly lift to remove excess skin might also help benefit strengthening my core which I can’t do with exercise. I’ve been working on this with Hospital BC that is part of BariatricPal and they are so helpful in the process. I’m trying to think of it as a vacation in Mexico with benefits. I’ll need financing of course. I’m far away from rich. It’s a goal to have a body I haven’t as long as I can remember. I haven’t been this weight as long as I can remember either. I could never reach this goal on my own before even as hard as I tried with strict low carb and calorie counting. I only managed 124lbs and it didn’t stay there long. So taking that last step of getting rid of ugly sagging, rashy problematic skin feels like part of the journey to finish. A crazy thing in times like these. I’ll be pinching pennies as hard as I can. But part of me is determined. And also ... trying to ignore the rest. I had wanted to deal with the other health issues first but looks like that won’t happen so I’m going to try to roll with it and see what happens. maybe it’s dumb for me to write this. I don’t know anymore. I’m exhausted. But I think that I want others to know that if I can do this with my chronic illness and disability And despite how hard it has been for me ... that others can succeed and reach their weight loss goal.

The ASMBS held a webinar yesterday for bariatric surgeons discussing the topic of how and when to resume bariatric surgery in the COVID-19 era. You can watch the webinar at https://asmbs.org/resources/restarting-surgery-issues-to-consider If your surgeon called you tomorrow to schedule surgery within the next 1-2 months, are you comfortable having your surgery?

I posted a while ago about my weight loss, and regain and taking control again. Started at 320 or there abouts 5'2" and 54 years old 10 years ago. VSG. Lost weight and got to 180 pounds. Over 8 years I regained to 220. Started slow weight loss / getting back into control in mid July this past year. I have now lost 30 pounds. Back to 190. I started my weight loss with a BMI over 54 in the 300's. I am still considered obese at 190 and a BMI just under 34; but darn it, I am so flipping proud of myself. Yes, I am 64 years old. No, I can't really exercise ... but I do some short walks and I garden and vegetable garden, take care of my chickens. I had to get a local teen to help me lift 40 pound bags of feed this year; but I can still haul the 25 lb bags.... and I continue to work full time in my career. Life is good. In my weight loss journey this time out, I stopped at 20 pounds lost and took a break. I experimented with adding in more foods, and balancing out what I needed to do to maintain that 20 pound loss, and did that for a month, then decided to lose some more. I think that i never really paid all that much attention to how much, what kinds of foods how I Prepare them.... and exactly how my body reacts to it. I use very little salt at home. When I eat out, I gain weight from the added salt. Yes, it is water weight from the salt; but being on lock down at home and working from home, with no lunches out for meetings.... going to have to find places to lunch that cut the sodium out !!! Going to continue what I am doing. Taking breaks, slow weight loss and maybe make it down to overweight, or not.... but will be pleased to keep that 30 # off !!! Still using my VSG. 10 years later.

Need help since staying on track while at home because Covid 19. surgery was done 08/01/2018 highest weight 196, lowest 134 September 2019 I'm struggling gained 5 lbs. What are others doing to cope with boredom hunger and limited excericise

hi everyone. I'm beyond frustrated. I am just over 4 months post op with gastric sleeve. I have lost close to 60 lbs already so I can't really complain how ever, I have been doing everything right and have not lost ONE lb in over 10 days now. In fact, I gained 1 lb as of this morning. I am doing everything right. Has anyone gone through this? I thought a stall wasn't supposed to last this long??!! Thanks!

For the past ten days, I have been experiencing constant dull nausea in my lower abdomen. It worsens when I eat (so I'm only getting about 400 calories a day) and sometimes I have to lay in bed because sitting and eating can increase the nausea. I messaged my bariatric surgeon last week and only heard back from his nurse on Monday. She was rather dismissive, saying that I might have the stomach flu and I should write again in a few days if I'm not feeling better. I also messaged my PCP who does not have a bariatric background, and she hypothesized that it might be heartburn (I don't think so -- I have no pain in my chest or upper abdomen) but said if the nausea continued, she would see me in her office. But again, she's not familiar with the surgery and possible complications, so might not know what tests to order. I spent time researching through Dr. Google and got worried about internal hernias, which could be life-threatening if left untreated. Apparently, sometimes the only symptom is mild nausea. Or maybe I have an ulcer. Am I worrying too much? Has anyone else had a long episode of nausea (lasting over a week) that resolved on its own? Or was from another cause? As you can see, I am already seeking proper medical advice, so only would like to hear anecdotal information and suggestions. Thanks.

Hello, I have gone through menapause and after that happened I have gained a lot of my weight back. Very sad. I need some good information and ideas what to do. Not having any problems with my Band. Had it looked at a few years ago to make sure. The RD that the office has is Horribe. She is No help. I did have to have my band fluid reduced years ago due to Acid Refux. Now I only have Acid reflux every now and then. I really need a NEW starting point. Any help would be great. Thanks

So happy to be alive and on the road to being well and fit. Happy anniversary to all my fellow March 2019 sleevers! To everyone else! Let's keep it moving!!!

Soo. I started my weight loss journey over 10 years ago. I am 5'2" I had surgery and was, if I remember correctly about 320 pounds. (and I had lost weight before surgery..) I was 54 years old. I lost over 100 pounds. I got down to 180 pounds. I could never get lower than that. But my doctors were pleased and so was I. Over 10 years I managed to gain weight and this past July, got mad at myself when I realized I weighed 220 !!!! I told myself that I needed to reverse the trend, and get back to a healthier weight. My initial goal was to lose 10 pounds in a year. Well, I lost 10 pounds in 4 months and then lost another 12 in the last 4 months, and for the first time in about 6 years am just under that 200 pound weight at 198. ( I will claim those last 2 pounds ! ) I refuse to do any drastic dieting, just "going back to my sleeve eating." More protein, less carbs, more vegetables. occasional treats. Cut out the popcorn and chips which are my slider foods.... and although I really cannot exercise with my other physical issues, I am moving more and feeling better. I would be happy to be in the mid 190's for this coming July - but focusing more on making sure I don't backslide again.... I am posting because .... well, how do you explain to anyone that you have already lost over 140 pounds and gained back 40, and now have lost 20... 10 years later and it's all connected ? And at my age, no one really notices.... although I did go buy new jeans/slacks for work because darn it, I didn't keep the smaller clothing !!! Anyone else as far out as I am ? Having issues ? Getting back on track this late in the game ?

Let me start out by saying that I know this is a really trivial concern. I have a friend in quarantine after a potential exposure at work, and a friend of a friend in the hospital on a ventilator. But darn it, it's still driving me crazy that I'm home in self-isolation (after returning from travel for my surgery) without a scale. I haven't weighed once since my surgery. I don't have/didn't buy a scale on purpose - for long term weightloss, having a scale in the house is a really bad idea for me. I get obsessed, and then after a few months I get mentally exhausted. I need to adjust to a new lifestyle where I don't think about food all the time, and personally, weighing every day doesn't help me with that. I was planning to weigh at a gym or doctor's office every week or (preferably) two. Anyone else missing their scale access?