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I realised my response above was a bit lacking on practical recommendations. Let me try to summarize what I'd suggest: Since you're right where I'd want you to be in terms of weight loss per month, don't change anything at this point. Only consider changing if you find the weight loss completely stops for 2 months or more. If weight loss does stop for at least 2 months, I'd actually recommend UPPING calories by 250-300 calories a day. I know that sounds counter-intuitive, especially considering that a negative energy balance is the only way to lose weight, but let me explain. Remember when I said above that one of the main jobs of our metabolic regulation system is to keep us from dying? No matter what we do, our metabolism slows when we diet. The rationale behind upping calories (by a small amount), is that we want to convince that system that the "bad times" have passed, and it's okay to ratchet up metabolic processes again. I'd recommend eating this increased calorie amount for at least a month, but two months would be better. Somewhat surprisingly, most people won't gain weight if they do this because their metabolism will increase to compensate. After that diet break, only then do we drop calories for a month or two in order to drop some more weight. You can keep up this intermittent dieting (not to be confused with intermittent fasting), until you get to your goal weight. I know this sounds like a slow process, but I promise, in the long run it's actually faster than if you just tried to keep cutting calories to get to your goal. Please keep exercising for your health, but also so that once you do get to your goal, you'll have a much easier time maintaining the loss. I would strongly recommend a minimum of 3 days per week of aerobic exercise and 2 days per week of strength training. This will set you up really well to maintain weight, as well as for excellent health as you get older. Don't be afraid to seek out a good mental health counselor. None of us got as big as we were by having a healthy relationship with food. The vast majority of people that fail to lose weight or that regain lots of weight after bariatric surgery do so because they fall back into old poor eating habits.

1kg a month is perfect right now. Instead of thinking in terms of a specific number you should be losing, think in terms of a percentage of your overall weight. This has an advantage in that the actual number to shoot for drops as your weight goes down. The ideal amount for most people would be one to two percent per month (and certainly no more than three percent). This is right where you're at. Believe it or not, slower is actually better here. The faster your weight loss, the more likely you are to be causing your body to decide you're starving to death. When this happens, your body starts doing things that slow down your metabolism to try to keep you from dying. Of course we know intellectually that we're not actually dying, but your body's metabolic regulation system doesn't know that. It's an amazing system, but it was designed before we had almost instant access to unlimited amounts of highly palatable foods. Thanks for clarifying on the new goal. 65kg sounds like a good goal for now and there's nothing wrong with adjusting up or down even more as you get closer to that. Regarding diet, calories and macros, I'd obviously tell you to defer to your dietitian, though I will say I'm very surprised by the recommendation to lower your protein. When dieting, there are literally hundreds of studies that show the advantages of eating more protein. You should know that overall, I personally am not a huge fan of tracking calories. I know that some people here seem to do so effectively, but for me it just does not work. As I mentioned, most of us aren't very good at actually tracking calorie intake accurately. Even more important to me, none of us have any way at all to know how many calories we are actually burning in a day so tracking intake is only showing you one side of the energy balance equation. Plus, energy expenditure can be highly variable day to day, so even if you did somehow know the exact amount you burned today, it's not going to be the same in one month or one year from now. With all that said, if tracking is working for you, don't change it. Do keep in mind that you may have to reduce calories as you continue to lose since the biggest contributor to metabolism day-to-day is body size. Regarding exercise, I'm going to recommend you stop thinking of exercise as part of your weight loss goal. It simply doesn't work. I don't say this lightly, nor to discourage you, simply to state fact. We have a huge amount of evidence now to show that our bodies tend to slow down in other ways in response to exercise. This is something called the constrained energy model. On a practical level, exercise is still critically important for your overall health. In addition, we do have a lot of data that shows people that have lost a lot of weight are better able to maintain the loss if they exercise on average 1 hour or more per day. In short, do it because you'll feel better, because you'll live longer, AND because once you reach goal, you'll have a much easier time keeping the weight off. I think I can speak for most of us here on this board that we have experienced the exact mental anguish you're feeling. It's normal to worry and let doubt creep in, so know that you are not alone, Mental health is not my area of expertise, so my advice will always be please seek help from a mental health professional if you think you need it.

Hi! Thank you for the detailed questions — I appreciate the time you took to break things down. Here's a full update from my side: 1. Weight Loss Progress: I’m currently losing around 1 kg per month. I know that’s on the slower end post-bypass, but I’m trying to be patient with the process. 2. Goal Weight: My initial goal was 75 kg, and I’ve now revised it to 65 kg. I haven’t updated my profile yet, but that’s the target I’m working toward. 3. Typical Daily Intake: I eat clean, home-cooked food, and I really focus on quality over quantity. Breakfast: 2 eggs and a small side like labneh or some veggies Snack: ½ scoop of whey protein or something light Lunch: Chicken breast or thigh (120–150g) with cooked dhal or sautéed vegetables Dinner: A high-protein meal like steak, paneer, or fish with non-starchy veg I do snack or “cheat” here and there — I’m no angel — but I genuinely try to make good choices most of the time. 4. Caloric and Macro Goals: I was aiming for 115g protein daily, but just yesterday my dietitian told me to reduce that to 65g. I’m adjusting and seeing how my body responds. I try to stay between 1000–1200 kcal, but again, I focus more on food quality than strict numbers. 5. How I Track: I track everything using ChatGPT, not traditional apps like MyFitnessPal. I log my food manually, with weights in grams, and I try to stay mindful and consistent. 6. Activity Level: My workouts have reduced lately. I try to weight train twice a week, and I walk or move throughout the day, but I’ll admit I’ve been slacking a bit. I’m trying to get back on track. 7. Mental State (the honest part): Physically, I look fantastic. But mentally, I feel like I’m failing. I have really bad anxiety that I’m doing something wrong — that I should’ve reached my goal already — and that maybe I’m overeating without realizing it. This fear honestly clouds my progress. I know I’m not alone in this, and I’m trying to work through it. Any advice, especially from others who’ve had slow progress or battled this anxiety, would mean a lot.

Sometimes we are afraid of success. Sometimes we don’t think we deserve it. Do you have a pattern self sabotage? Hope you find someone with whom to work through these issues. They are important, apart from weight loss.

if you're sticking to your plan, then it's probably just the typical slowdown you experience as you get closer to a normal weight. I lost weight until month 20, but after the first year, it was S-L-O-W. Just a couple of pounds some months. So many times I'd think "this must be it", but then my loss would start up again. I'd look at the list above, too, though (Spartan's list) - he's listed some other potential reasons for it.

I'll do my best to help, but I'm going to have to start by asking some questions: When you say the weight is "barely coming off", can you be more specific? How much in the last week, two weeks, last month? Can you clarify what your goal weight really is? In your profile, you're showing that you're currently at 78kg and your goal is 75kg. That's only about 6-7 pounds, not the 33-44 you listed. I'm thinking you probably have a new goal and have not updated your profile, but it's important to understand what you really are trying to do. When you say you are "eating pretty well", can you give some examples of what a typical day looks like? What is your daily caloric goal? What about protein, fat and carbs? How are you determining your what you caloric and macronutrient intake should be? How are you tracking your intake? Do you weigh everything in grams before it goes into your mouth? Let me explain why I'm asking these questions. Typically when people are struggling with weight loss, we see a few common issues: Unrealistic expectations. Especially if weight loss early on after surgery was easy, people tend to think it will continue that way until they reach goal weight. Unfortunately, that's not how this works. The heavier we are, the more we'll lose at first. The closer we get to goal, the harder it becomes. It can take months just to lose a few pounds if you are already pretty lean. You also have to really have your nutrition dialed in at that point.. I won't get too deep into the physiology here, but there are multiple reasons for this and it's 100% normal for this to happen. My point is that you may be right where you need to be. It's hard to know just that just based on what you posted above. Eating more than you think. Study after study shows that almost everyone thinks they eat less than they really do, even those that log their food using calorie tracking apps. It's sometimes simple things like those little tastes while preparing a meal, or that handful of nuts they forgot to log. Others, they just guess at calories because accurate tracking is really hard. Burning less than you think. Most people have absolutely no idea how many calories they actually burn in a day. We often use estimates based on height and weight, but these can be off by may hundreds of calories depending on age, lifestyle, percent body fat, etc. Further, your calorie burn isn't the same all the time. It can vary by hundreds of calories per day even before you consider exercise. Speaking of exercise, we drastically overestimate the impact of exercise calories. For the vast majority of people, the calories they burn in a day don't actually change all that much due to exercise. Blaming things outside your control. It's natural for people look for causes for problems. If we take ownership of the problem, we can then take steps to correct it. It's when we place the blame on something we perceive to be outside our control that we can run into serious problems. Let me give you an example here. We can't escape simple physics. If you burn more calories in a day than you consume, you'll lose weight. Eat more than you burn and you gain weight. If I take responsibility for this, then it means I need to eat less or burn more to lose weight. I realize that's easier said than done, but without first taking responsibility for the problem, I'd have no hope of fixing the issue. If on the other hand, I were to say "I have a slow metabolism", I'd essentially be saying this issue is outside my control, even though the solution is the same as before: eat less than you burn. Thinking a particular diet/macronutrient is more important than calories. I noticed you hinted at that in your post. Calories are king here. Specific diets that emphasize one or more macronutrients can help, but they never trump calories. I can go into more detail later, but this post is already getting overly long so I think I'll stop here. Please provide some additional detail and I may be able to provide better guidance.

I did the Fast Metabolism Diet (Haylie Pomroy) to reach my goal weight. I wasn’t able to eat the amount of foods it requires but eating them in the phases was enough & I dropped the last stubborn 15 pounds!

Thank you for the support! Once I put my mind back in track it’s actually felt really good to refocus and put myself 1st. I've also been much more aware of medications and side effects that affect weight and advocating to not use them. I should have listened to my guy originally, I would have saved myself a lot of pain.

Hi all, I am almost 8 months post op bypass. I'm down 68 lbs (31 kg) I feel and look fantastic and I'm quite happy but I still need to lose 33-44 lbs and well it's barely coming off these past months. Now my question is I'm eating pretty well and counting calories and protien content. I'm focused on calories mostly but I think that's where the problem is. I should focus on my protien only which means I should eat 115g of protien daily which might mean more calories and it scares me.. I m active and go to the gym too (not as gym rat but not lazy) so what am I doing wrong? Do I need to up my protein? Also how much of the food is actually absorbed? Does bypass really mean ill def lose and maintain the weight? I need reassurance. Help me understand what to do now and if I'm safe

It sounds like a very stressesfull time and the only way we know or remember how to make ourselves feel better is food! It's just so comforting and I'm so sorry you're going through it but I can feel the strength through your words and u will fight this .. I think it's smart that u want support to maintain ur weight and make u eat better it will help ur health too so yes let ur doc speak to the bari team to support the idea if it won't harm you. Health is health weather losing the extra weight or being cancer free im rooting for you

Incredibly honest post. You know that your current approach won't (can't) help you reach your weight loss goal and stay there. It's so good that you're stepping back and evaluating that before your prime period for weight loss flashes past (which it really really does - mine is already way back in the rear view mirror, LOL). I live in Ireland where access to proper bariatric therapists is limited, as i think it probably also is in the UK. But I echo the advice above to find one and work on what's going on in your head so you can make the most of what you've changed in your body. I really hope that you can get back on track. We are all here to help - all human and have all made mistakes as we went along. Lots of us have hit little blips when we find we *can* do things that we shouldn't. What matters is that we stop and call those out and get back on the horse. Keep posting and let us know how you're doing.

I am going to ask you a question that I also ask myself when I have periods of consuming things I know I should not have. How did it get in your house? It's one thing to be in a place where temptation strikes. Maybe you go to a wedding and you are handed a glass of champagne. Maybe you go to your friend's birthday party and you take a piece of cake because everyone else has one. Okay, fine. This is not likely to be an ongoing issue unless your social calendar is booked constantly (in which case you need a plan). (But also, not fine because you are at 8 weeks out and your stomach is like a delicate baby that you are feeding trash. More like fine a year from now.) But if you are on day 6 of drinking wine while watching TV at night, all snug on your sofa... why is there wine in your house? Did you buy it? Did someone else bring it in? Is it left over from something? The easiest way not to drink alcohol casually is to have no alcohol in the house. The easiest way not to eat chips, or chocolate, or ice cream is... to not have it around. Get rid of it. I know a lot of us have issues with "wasting" food or drink. What I've come to realize only slowly is that there is no difference between me eating junk I don't need that is not good for me and putting it down the garbage disposal. Except in the second scenario, I don't gain weight. After Easter, I bought a big bag of jelly beans on clearance. They weren't very good. Even so, I kept eating them. I put them in the cupboard and kept getting a handful every time I walked past. And then I would eat a few and say these are really not very good. And then I would KEEP EATING THEM! Finally, after I did this several times, I stopped and asked myself what I was doing. Why was I eating these? Why did I buy them? And my only answer was because I was bored, and a little stressed, and they were there. Also, I like jelly beans. Only I didn't like them. So, I threw them away. An almost full bag, in the garbage. I know! The waste! But I didn't need them, I didn't like them, and they were making me crave all sorts of other sweets. I just kept thinking about the fact they were there. It made me want them. When they were gone, I could no longer eat them, and I didn't care enough to go buy more. For the first year, I did most of my grocery shopping through curbside pick up. I planned what to buy based on a menu plan, and that's all I got. No impulse buys. No clearance bins. No getting a dozen bags of something bad for me because it was on sale. I gave away all my alcohol or poured it down the drain. I threw away the junk food and organized my pantry so I could find things at a glance. I made a list of healthy things that were easy to eat or take along because I know I will always eat what's easy and not what's difficult. I meal prep for the week so that I don't have to cook and prep every single day and I have no excuse to eat out. I'll also be honest that the hardest times for me were before surgery when I was trying to follow a nutrition plan but had a lot of hunger and cravings, and from around 9 months out when weight loss had slowed and my appetite was becoming more noticeable and my weight loss naturally slowed. The fact that you're feeling like this at 8 weeks is concerning because this is the time when your ability to stay motivated should be highest (constant reinforcement when you step on the scale and lose weight almost every day), and your ability to eat is the least. Don't let this drag on without addressing it. Talk to your team. Because it's only going to get harder. Maybe you're bored. Or scared of change. Or you don't believe the surgery will work and you're turning it into a self fulfilling prophecy because that's easier emotionally than trying and failing. Or you just can't help yourself when the food or alcohol is in the house because you're addicted. Whatever it is, the best day to fix it is today. And ask your family and friends for help. Be accountable to others and to yourself. Because you can fix this, but if you don't, you won't reach your goal.

Me either. Why go through all that's needed to get the surgery then stop doing what's needed to achieve the goal? Determine your goal and get some counseling to change your mindset. Addictive personalities tend to substitute the food for something else. Alcohol, etc. I had to chuckle at how many times @The Greater Fool called the surgery, the MAGIC SURGERY. lol. It was kind of magic for me TBH. It fixed whatever was causing all of my weight loss efforts to fail. I exercised and dieted for years with limited results. So, it was extremely satisfying when it all finally actually worked, and I got healthy. I don't kill myself with dieting anymore or with extreme exercise pre-op. I walk 2 miles a day and try to stay moving and do some weights. I eat normally now (2 years out) but stay within the guidelines of the plan and treat myself on occasion with a drink or a piece of chocolate. I do know some people who believe the shot (GLP-1) are magic too. LOL They eat whatever they want without moving and then wonder why it's not working. People can out eat the drugs one DR told me while discussing my RNY. I have never used them but know it has helped others in addition to their WLS. Bottom line, neither WLS nor the drugs will work all on their own. But it sure helps to get you there. Do what you need to do now to become healthy again. Which in the end is really the most important thing. The honeymoon doesn't last foreva..... GL @Claire D I wish you the best!!!

A couple things related to my weight gain - when I gained weight it was due to eating fast food/junk food during nursing school and then the pandemic (people sending goodies to hospitals) and the stress of the job. I also had two traumatizing relationships in that mix - what was 30lbs would have been 60lbs pre-wls When I was gaining weight, I wasn't stepping on the scale. So now, I do this often to keep me accountable. You are going to regain some, your stomach is tiny and then the swelling goes down and you can eat more (and you should)! I feel like wls is the only way I could have kept this off. The best thing is that the food noise is gone! I would redo the surgery once a year, every year, if I had to. That's how important is been to me.

One issue many post-ops have is high expectations pre-op. We think with the magic surgery we will be able to follow the draconian diet plan, or even just the strict diet plan, we are expected to keep that we've never been able to keep before. We think the magic surgery will make us keep the exercise plan that we've never been able to keep before. In short, the magic surgery will make us enjoy doing the things we hate doing and have never followed through on before. Then we run smack into the wall of reality and think less of ourselves because it seems we are sabotaging ourselves. My personal philosophy for post-op life was only to do things I felt I could follow through on. When I was considering surgery I evaluated the eating plans to ensure I could follow through and that it wouldn't feel like torture or even a hardship. I looked at exersise that I didn't dispise. If I didn't think I could/would sustain it I wouldn't commit to it. During this 'honeymood period' you will lose weight almost no matter what you do. Now, this reward of weight loss is being associated with bad eating habits and bad drinking habits. As @catwoman7 says, now is the time to build good habits that get associated with weight loss rewards. Later, when the going get's tough it will be the good habits you associate with weight loss which will keep you going. We also make the big mistake thinking that the magic surgery will fix our heads when, in fact, it often makes what's going on in there worse. We often make the mistake of thinking we can do these big changes on our own. This is why support is so important. Family support, if it's truly available is helpful. Friends can be another help, again if it's truly available. Professional support can be invaluable. Therapists can have vast experience with the coping issues you may not even know you are facing. They can provide you with new insights and new coping mechanisms to replace those the surgery took away. Good luck, Tek

Hi - if you aren't able to get back on track alone, I'd seek out the help of a therapist. This is your big chance of losing a ton of weight, so you don't want to blow it. It'll never be this easy again! (not saying it's easy, but way easier than it has been or will be once you're past the so-called "honeymoon stage"). You need to take full advantage of that, so do whatever you need to do to get back on track!

Hi lovelies, I hope you’re all doing well? You were all so supportive with the question I asked a few weeks ago that I thought I would come here and see if you have any advice for me now! As of tomorrow I am eight weeks out from the gastric bypass procedure. I have lost quite a bit of weight (2 stone) which I’m absolutely delighted about (and people are starting to notice which has been a really good feeling). However, I must have THE most stubborn self sabotaging streak because I have started to drink alcohol again (and not just on special occasions) as well as not following the food rules and not exercising. I can’t understand why I’m being like this because my family are so happy that I’ve done this and have been so supportive, and my friends (even though they don’t know about the operation are really starting to notice) so WHY am I doing this to myself? I just wondered if you guys knew of a reason I may have hit the wall so early (I really do not want to fail) and especially if you have any advice, book recommendations apps or anything that I might be able to do to help me get back on track and find my way again. Really appreciated as always thank you xx

you lost way more than I did in the first three months - and I started out around the same weight..

most people do have a rebound after hitting their lowest weight. Ten to twenty lbs is pretty common - but like others have said, some people don't gain back any at all and some regain everything. If you commit to keeping your eating under control for the rest of your life, though (not that you can never have an occasional splurge - but keeping things in control at least most of the time), it's very doubtful you're going to gain a ton of it back. It's definitely a life-long effort.

Always check with your doctor if something is unusual for you. In saying that, you store estrogen in your fat & as you lose weight it is released into your bloodstream. So it’s not unusual for women to experience heavier or lighter, or more or less frequent periods, more or fewer PMT symptoms like mood swings & emotional highs & lows after surgery. It seems to persist until your weight loss starts to slow or you’ve lost more than half the weight you were hoping to. Your spotting could be related to that but do check with your doctor.

There's really no reason for your insurance company to deny coverage here. While gastric bypass is obviously performed for weight loss, that's not the only reason. There are normal weight people that sometimes have it done for various issue like severe GERD and issues with gastric emptying. My point is that even though we think of it as a bariatric procedure, in your case, you need it purely for medical reasons. They can't deny it on the basis that they don't cover bariatric surgery, since that's not why you need the surgery.

the experience of one person is no way indicative of what YOU will experience. only way to know for sure how YOU will end up is to go through it yourself. there is no future-reading here, unfortunately. all i can say for sure is that if you make an honest effort to lose weight after wls, you will. and if you make an honest effort to keep the weight off in the following years, you *most likely* will. its easy to lose the weight...its exponentially harder to keep it all off. the vast majority of wls folks will regain SOME amount of weight after reaching their lowest point. exactly how much more is up to you and your habits, as well as your genetics, age, health, etc., etc.,... good luck! ❤️

Just jumping in to say that 60lbs in 3 months is a tremendous amount of weight to lose! Have you ever lost that much in three months before? Or at all? Pre-surgery, I could never lose more than about 40lbs before I plateaued and then slowly started to regain. But, I understand you have a long way left to go, so it probably feels like you'll never get there. Focus on building the good habits now, like you are. If you can, go for a daily walk. That may be plenty of exercise for now if you are currently sedentary. But protein, vegetables, and fruits are great choices. Also, take photos of yourself to see the progress. I swear that even at over a year out and within 10 lbs of a normal BMI, I still FEEL obese sometimes. And then I see a recent photo of myself and I am shocked to see a normal weight woman who kinda looks like me. How can I see myself so wrong in my own head? In the first year, I took a progress photo every month on the 21st so I could compare. I'm so glad I did.

The effects of surgery appear to be more durable than meds. So if you take Zepbound and stop, most people regain most to all of the weight over a relatively short period of time because nothing about your body has changed once the meds are gone. It's like your blood pressure going back up after stopping blood pressure meds. If you get surgery, it's permanently altering your physiology, so it keeps working for you long after the surgery is done. You don't go back to having a larger stomach or your intestines being rerouted in the case of a bypass. Your hunger and capacity do increase, so if you don't make lasting changes, yes, you can overeat and make poor choices over time that can lead to weight regain. It's a tool, not a cure. Some doctors will say that a bypass is more durable and "stronger" than a sleeve in terms of how much weight you can lose and how easy it is to keep off over time. The combination of surgery now plus adding GLP-1s sometime in the future (if you need them) seems to be an approach that more doctors are looking at for longterm maintenance. Of course, this assumes nutrition and exercise guidance is being followed.

So I had gastric sleeve surgery in 2017 and ever since I have had severe GERD. I just went through an upper GI endoscopy and it was found that I have a huge hiatal hernia, like half of my stomach! My surgeon says the only real way to get relief is the have a gastric bypass but my current insurance does not cover any bariatric surgery. Is there a way to get them to pay since the surgery isn’t for weight loss? I have BCBS of Alabama.