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Dr Weiner resources are great as are Dr John Pilcher’s. Bounce back regain is always a possibility in the second & third year. I believe the average is about 10lb/5kgs so that could be a possibility. This regain can be from not being as vigilant, how you were eating wasn’t sustainable (too restrictive) & didn’t allow you to live & enjoy your life as you want, a change in medication, & your body & new weight set point resettling. And yes, muscle weighs more than fat so some of the regain could be from that too. (Maybe have a dexa scan to compared your fat & muscle mass.) Start by making one or two changes to your eating & then in a week or two make another change or two. You can start small. Maybe track your food to begin. Then up your protein & fluids if you’re not meeting your goals. Adjust your portions if they have become larger. Then drop some of your sugar or carbs or swap the highly processed refined carbs for low processed multi or whole grain options. Etc. Small changes are often easier to adopt & adapt to than large all encompassing changes. Doesn't matter how long it takes you to get fully back on track.

That is so ridiculous that the south is targeted as eat poorly… all of America is obese.. America should really think twice of all the fast food places on every street corner.. I haven’t touched a fast food joint since my surgery 3 yrs ago but I’m amazed of how many there are

All things are possible. Not all things are probable. Horror stories are least likely of all. Prepare for the worst, hope for the best, and focus to doing your best either way. I've only had Bypass so I can't address going from Sleeve to Bypass. But I am responding because I do have some of the issues you fear... I dump on both sugars and fats, and it doesn't take exceptionally large quantities to kick in. I actually wanted to dump so that sugars and fats wouldn't be things I could eat with impunity. I hoped dumping would put my body to work for me on this and I have to admit I'm very happy with the result. It took an amazingly few dumping episodes for me to change my habits. Throwing up is an entirely different beast than pre-op. The only time I throw up is when food get's stuck going down. Again, it took an amazingly few episodes of doing it wrong to learn to take my time and do it correctly. I can't recall the last time this was an actual issue. Once the food goes down, it's pretty much impossible for me to throw up. If my body insists on it, I just end up with dry heaving, which is less fun than it sounds. On balance things could be worse. Try not to borrow troubles from tomorrow. Good luck, Tek

I'm a sleeve to bypass conversion. I had a hernia, that complicated matters. I'm over a decade out from the horror of that sleeve. I'm just over 3 months out with the bypass. The hernia caused issues and the longer healing time was due to it. If I have any pull or ache, its in that area. For 3 months gone, the reflux (was like yours, actually worse, I had carafate to eat anything) is gone. I've had 1 time where some stuff came up like reflux. A mild little one for the 2nd time it happened. That's it. I control how much food goes in. When I dont, I throw up. I've had a bean get stuck (wow was that painful), couple of times I've swallowed 3x instead of 2 for liquids and it was too much. I've thrown up but nothing like before. If I'm really really careful, watch the time and amount of food at one time frame, I'm good. Stay at 2 swallows, I'm good. After the misery of before, this is great! That having been said, I dropped to malnutrition level because of some other medical problems. As of end of last week, I am 8 pounds from being overweight for my BMI. 36 pounds from being normal weight. So I don't think I'll be dropping it like I did my sleeve. I dropped 27 pounds the first month, and that was 27% of the excess body weight.

only about 30% of bypass patients dump, and it can be prevented by not eating a ton of sugar or fat at one sitting. I've never dumped and I know lots of other bypass patients who've never dumped, either. I had some food intolerances the first few months but now the only thing my stomach doesn't seem to handle well is a really fatty meal. Something like a fish fry with fried fish, tartar sauce, French fries, a roll with butter, and coleslaw (as is a popular Friday night meal here in Wisconsin) would not sit well with me and might even send me into the bathroom. I could handle one or two of those things, but not all (like I could pre-surgery). I also can't eat tons of pasta or rice since it sits in my stomach like a brick, but I can eat SOME of it. I had some vomiting episodes the first couple of months after surgery if I ate too much or too fast or something that didn't agree with me, but since then, I don't think I vomit much more often than I did pre-surgery. Diarrhea isn't that common with bypass - and the adult diaper thing would be really rare - I almost never hear of that, and I've been on this site for about nine years. The opposite, constipation, is really common, though. A lot of us have to take daily Miralax or stool softeners to keep on top of it. yes I suppose constant vomiting could rot your teeth, but I'm not sure where you got that idea that bypass patients experience daily vomiting. I probably vomit 2 or 3 times a year. Plus vomiting now is much easier than it was pre-surgery. Your stomach is really small, so not much comes up. And besides that, you don't have nearly as much acid in your stomach (you can tell because what comes up tastes just like it did going down - you don't get that awful "vomit-y" taste any more after you vomit). Also, GERD is what can lead to Barrett's esphagus an/or esophagus cancer, and bypass usually improves if not outright cures GERD. That's why it's usually recommended over VSG for patients who have GERD. I should add that I'm not a revision patient, but I know of a lot of people who are from this site and similar sites. Most of them are very happy with their bypasses and aren't experiencing the complications that you're worried about (in fact, most don't have any complications at all). I hope you don't take this wrong, but you might want to do more research on the bypass because I think your views on it aren't that realistic. I wouldn't go so far as to say that no one has every experienced any of that stuff because I don't know for sure - maybe someone or a few people have - but we just don't hear about those things on here. If they happen, they're very rare, otherwise we'd hear about them given all the thousands of people who've been on this site over the years.

Hello - I had gastric sleeve in June of 2015 and lost over half my body weight initially, getting down to well below my initial goal in the first year. Started having issues with acid reflux pretty early on, and it's gotten steadily worse, especially in the past 3 years. I'm currently on omeprazole and famotidine, plus Tums in addition. A 24-hour PH study showed that I had over 100 episodes of reflux in that period. So I was approved to revise to a gastric bypass. I also have regained over half of what I lost, mostly since my reflux has gotten worse, and am about 50 pounds heavier than my ideal weight. The reflux makes me feel hungry all the time, and I'm eating way more carbs than I should because they seem to tame the acid somewhat. I understand that it's pretty much a pipe dream that I'll be able to lose anything close to that with revision, but I guess any weight loss would be better than where I am right now. My new surgeon said she expected that I'd get back down to 110-120 after revision (my preferred weight personally is around 125), but based on all the posts I've read here and on reddit, she is definitely exaggerating to make me more willing to go through with the surgery. The best it sounds like I could hope for is to lose maybe 15-20 pounds over the course of a year or more? I am scheduled for surgery on Jan. 18th, but I'm having second thoughts after reading so many horror stories of unpredictable dumping episodes and ever-changing food intolerances. I guess maybe my reflux isn't as bad as others, since the reality of daily life with RNY seems unbearably miserable to me in comparison to my life currently. I'm afraid that I won't be able to do my job anymore (or even leave the house at all) if I am unable to eat or drink anything without the risk of vomiting/foamies (I have pelvic floor issues, so I pretty much always lose bladder control when I vomit or dry heave) or having uncontrollable diarrhea. After revision, do you have to wear an adult diaper all the time? Has anyone developed an eating disorder based on fear of getting sick after consuming anything? Do you have any "safe" foods, or is it always a (literal) crapshoot? I know that continued GERD can cause esophageal cancer down the line, but wouldn't the same be true of daily vomiting? Has anyone who is several years out from revision developed cancer or precancerous damage to their esophagus due to the constant vomiting? Likewise, have your teeth been ruined from it? For those who revised from VSG to RNY and are past the initial healing stages, would you do it again or has it made your life even worse?

I highly recommend looking at the videos on the Pound of Cure channel on You Tube, which go into detail about how to eat to lower your body's metabolic setpoint. Foods that are ultra-processed and high carb push your body's setpoint, the weight it wants to maintain, higher, where nutrient dense foods like leafy green vegetables, beans, nuts, and seeds, make your body want to maintain a lower weight. As I have been preparing for surgery, I found the Pound of Cure book on Amazon and implemented many of the basic changes it recommends, such as cutting out processed foods, breads, sugar, and artificial sweeteners, and eating more vegetables, fruits, and beans. I lost 15 pounds in around 3 months without counting calories or ever feeling hungry. And I can also say that in the past several weeks, as the holiday treats have infiltrated my house, I have not been as good about eating that way, and to no one's surprise, my weight has shifted upward. I will be returning to better nutrition as soon as the last of the ham, sweet potatoes, and pie from Christmas dinner is out of the house! I recommend starting with these videos that I've linked below (and then, if you're like me, binge watching the rest of Dr. Weiner's channel). I find his advice to be a common sense approach to nutrition that you should be able to implement long-term without a lot of pain. Hope this helps!

The reason for erratic weigh-ins (and the infamous three-week stall) is that in the early stages of running a sustained calorie deficit, your body does not burn much fat. Your body worked hard to store fat and considers it a precious commodity that it does not want to part with for no reason. For extra energy to make up for a lack of calories in the short term, your body first burns glycogen. 1 gram of glycogen is bound with 3 grams of water, so as you burn it for fuel, you also flush out this water weight. Only when the glycogen reserve is used up does your body turn to burning fat. The first few weeks after surgery, you were probably lucky to get in 600 calories per day. Your body was burning glycogen like crazy. When the numbers first dropped on the scale, that was almost entirely water weight. Now that you're a couple weeks out, you're allowed to have some pureed food, and you can probably get closer to your protein goals with your shakes. With a few extra calories coming in (still nowhere close to what you need every day to power your bodily functions), your body is at least reassured you are not in imminent danger of starvation. It's taking a look at your empty glycogen reserves with horror and doing its best to fill them back up with the calories you are giving it, like a squirrel storing up acorns for winter. For every gram of glycogen your body puts into the storage cupboard, you've got 3 grams of water tagging along for the ride. Meanwhile, you can rest assured that your body is also burning fat to keep your engines running. However, when you step on the scale, it can't really tell you that you've burned 4 pounds of fat and also stored 7 pounds of glycogen and water. It's just going to tell you that you've gained 3 pounds. But you've done nothing wrong. This is your body doing what evolution programmed it to do since humans lived in caves and constantly had to battle short-term food shortages. Once you've restocked that glycogen, you'll start being able to see the fat loss on the scale again, and in your measurements. As long as you keep doing what you're supposed to do, your weight will move in the right direction. But not as a straight line. Weight loss looks a lot more like a staircase with drops and plateaus, and a lot of small fluctuations that have nothing to do with fat. Try not to let it drive you crazy!

The instructions I was given were 48 hours of pre-op liquid, with total fasting beginning the evening before surgery. The longer liquid diet is to promote rapid weight-loss and shrink your liver, but some surgeons don't find this necessary, or only apply it to patients over a certain BMI. The 24-48 hours of liquid-only and/or fasting prior to surgery is just to clear your digestive tract prior to operating. Also, some surgeons don't require a puree stage and go from foods like yogurt and ricotta directly to moist proteins and fully cooked veg that you are instructed to chew for 30 seconds to a minute before swallowing (essentially pureeing them with your teeth).

I am currently on the pureed stage and it has been a struggle... I am living on yogurt, cottage cheese, scrambled eggs, soups, protein lemonade, protein pudding and protein shakes. it has been hard but I am understanding the process. I did try to cheat the process and have something I thought I could handle and well.. that did not end well... There is light at the end of the tunnel, a more food will become available to you.. I am finding the first 2 months are the hardest but you will soon find your groove and foods.. Also 13lbs is amazing.. your body has gone through to much in such a short amount of time.. give yourself grace and get excited about every little thing your body does.. Also I am sure that you are losing inches along with pounds.

Nope you didn't ruin anything. Your journey will be all ups and downs and it is really best to get used to it. Throw in lots of stalls and you will be worrying like crazy if you don't believe your teams advice. You should be in a calorie deficit. Once you are on real whole foods as against puree your restriction will kick in big time. Then you will be on reduced calories again because you just can not eat much. You could have gained three pounds because of a few reasons. Have you been eating salty foods, Having a really stressful time, Have a full bowel or is it just the time of the month.

**Update** Hey everyone! Sorry for being MIA for a while. I really appreciate all your responses and well wishes. I will be 2 weeks post-op tomorrow, which is kind of nutty to think about. My 9 day post-op follow up appointment went really well. Incisions are healing well, and they seem quite happy with my food diary. I started my bariatric vitamins about 4 days post-op as well and been doing great so far with those. I use Paravita bariatric multivitamin 3x daily and I take Vitamin D3 2500 IU one drop daily. Plus of course the medications needed temporarily prescribed by my surgeon. I got to say though that it's been HARD going through Christmas day and not being able to enjoy our traditional Christmas breakfast, or our amazing turkey feast. Least I got to smell it though lol. I feel a lot more strong, so I have been able to have a lot more normalcy in my life. I make my family their food, while also preparing my clear liquids and full liquids. Unfortunately I'll be on the liquids until January,10th as it is 4 weeks with the gastric sleeve. Then eventually pureed foods, then soft, then finally regular healthy eating for life lol. I am making turkey soup today with our turkey carcass, onions, carrots, celery, and some seasoning, so I can at least enjoy the broth of our Christmas dinner my spouse and out kiddos had yesterday lol. I hope you all are well. I am fighting my brain and always will, and I am still having some regretful thoughts over having this surgery. I am taking one step ahead at a time and trying to look towards the positives. As I've said in other posts I just was so set on Gastric Bypass for my acid reflux issues, and I liked that it could be reversed if needed, plus I hear it has a higher success rate. So when I found out they gave me the sleeve, I just been having mixed thoughts since, and now I can't go back even if I wanted to down the line. So it's been weighing on me a lot. Please know I am not trying to discourage anyone from WLS, and the sleeve can be just as successful, everyone is different. I also thoroughly did my research on WLS prior. Lots of great things about these surgeries. I hope you all are well and that you all had a very Merry Christmas, or Happy Holidays if you celebrate. Much love. ✌

Hello! I had my surgery on the 11th so we’re not far apart! I won’t lie I didn’t last long on the liquid diet I kind of went on to puree around day 8 post op. I don’t think many people are as honest. I cheated and so what. I’m so glad for the surgery and I wish many more losses for the both of us whether it be fast or slow! Weight loss is weight loss !!!

It will get better. The first 6 weeks are really difficult. It's a lot. Once you settle into normal foods and a bit of a food routine you'll feel a lot better physically, mentally and emotionally. I found that the normal food stage allowed me to rediscover food in an enjoyable way. If pain continues get it checked out though, pain when eating isn't normal.

Hi all I am now 23 days post op and on my 2nd week of puréed foods. I hope Xmas 🎄 has not been too hard on you. I lost my mum back in April, so this is my first year without her and it has been tough. I'm keeping myself busy preparing meals for my husband and it's not really bothered me that I have to purée anything that I am having. What does bother me is that I don't seem to be losing much weight 🤔. My husband and sister say they can see change in me but the scales say otherwise. Since my pre op assessment I have lost a total of 16lb and it just doesn't seem much at all. I don't know if I have an unrealistic expectation of what I should be losing. I think the only thing I maybe doing wrong is not eating enough. I have been lucky ... Although I had bad nausea during my first week post op, I had no sickness nor dumping. I just feel like I am doing something wrong. My dietiy suggested dropping out the homemade smoothies made with fruit which I have done. Is anyone else going through the same issue?

I feel you, three weeks out and I have lost that joie de vivre, nothing taste's good, I have sn awful taste in my mouth, can't stomach purees or protein drinks, when I eat something it's painful, water tastes horrible to me, but then again this is why we lose weight I can honestly say I am not having cravings more of a repulsion, hanging in there since everyone says it gets better.

Ay, cheers to that! Yeah, patiently working towards that feeling of hitting that goal! I’m enjoying the NSVs. For example, being able to wrap a regular ‘ole towel all the way around me. I can definitely relate. Just last month, I hit a stall but it happens. Can you handle any type of carb based food? I ask because trying to talk to the NUT about reintroducing them in my diet.

I’m in my second week of puréed diet. I also had two weeks puréed. My VSG was 12/04 and I’m looking forward to moving to soft foods next week. During the puréed, I have eaten ricotta bake; mashed potatoes; grits and eggs. Otherwise, protein shakes….

So, Ill be 2 weeks post op on Wednesday. Last week on Wednesday I was from 247 down to 227. Now, I'm currently at 230 !!!??? Why? ?? It's so stressful to see that 3 pound gain. I have been following my diet well, with the exception of not always eating 5 or 6 times a day. Is that why? But shouldn't I still lose?? Honestly I just forget because I don't get hungry. Or I'll be busy trying to wrangle 3 children. I can't eat what they eat and it's not very convenient to make pureed foods all the time. It's a process ya know. Some days idek how much liquids I drink. I'm not great at tracking. But I've had a mix of juice, milk and water. Anyway, has anyone else experienced this? Did I already ruin the good thing I had going??? Please help friends! Thank you!

So 5 days post op I was put on pureed from full liquid. The chili my doctors gave examples of is Wendy's chili. I made my own, beef, red and kidney beans, tomato sauce and paste, and seasonings. Even in my binder it was clear liquid for 3 days, full liquid like pudding, cream of wheat, jello, ect for 10 days....so that would only be 13. But I had 3 days of full liquid and was clear for puree. Now that's my doctor, for roux en y. Maybe yours has you on a different plan for specific reasons, and maybe there's a misunderstanding about your liquid diet time period, because yeah I couldn't do 17 days with only liquids.

Puree can be tough. For some it’s a textural issue for others like me it’s a taste thing (everything tastes disgusting). You can puree a lot of things just add enough stock, milk, water, mayo, gravy, etc. to keep it the right dollopy texture/consistency. A friend told me she survived on pureed chicken with gravy. I mashed eggs with Mayo, was allowed thin instant oats, thin scrambled eggs, yoghurt, soups, etc. I tried pureeing tinned fish but blah! During soft foods I ate a lot of minced meat based dishes. Just made sure there was enough sauce/gravy to keep the meal wet. Also soft white fish, omelettes & made a couple of casseroles/stews & meat & vegetable soups. Yep, stalls can be frustrating & demoralising but remember an important step in your weight loss (when your body takes stock of your new needs & adjusts digestive hormones, metabolic rate, etc.). 17.5lbs in about 4 weeks is still pretty darn great. Even with the stall that’s an average of more than 4lbs a week. Can’t be upset with that.

I sympathize. I had to drink liquids for 2 weeks. Now I'm nearly a week into the puree stage. 3 more to go. I started detesting anything sweet. Why in the world do all shakes taste like some sort of cake, powder or premades. Even the flavorless powders aren't truly flavorless. Puree stage is difficult too because I don't enjoy most foods the consistency of babyfood, but its only a season.

Here to give you hugs and a shoulder. I have dealt with the 3 week stall and I’m just here to say, before you know it it’ll be over. Think about when was it the last time you even lost 13lbs in a month? Even in my best place with diet and exercise I can say that was a stretch. But also, this really isn’t a sprint, it’s a marathon. We are in it for the long haul though our brains feel like this “tool” is an instant fix. It is probably harder around the holidays and I truly can’t say I’ve had to experience that end so early on, but just remember that the holidays are about so many other things. Hold on to the experiences outside of food. Remember that the food is truly not going anywhere and think of how you feel (and look) this time next year. Reach back to your whys. The greater reasons why we did this to begin with. I can’t help too much with full on menus, but one thing that helped a lot with puréed to soft was the ricotta bake. It felt like pizza/lasagna after I was sick of all the sweeter liquids and broths. It feels eternal now, but it will be such a small blip of time before you know it. Much love and wishing you a happy holiday and strength.

I started the eating out once a week after my honeymoon. I kept it reasonable, but it gave me something to look forward to and variety (and taste). When I started getting hungry again I took out the high calorie low protein nuts (which I added because they told me to go from 800 to 1200 calories when I wasn't even able to consume 800 yet and upped me to 100g of protein from 80) and a scoop of protein powder (high protein, low cal) and added in peanut butter toast, raison toast and another serving of ham. I don't mind eating the same thing every day when I'm at home because it's easier. If you put all your food in a spreadsheet and figure out the calories and protein per ounce, then you can switch it around easier if you need a change. Once I met my goal they told me to add 100-200 calories a day to stop my weight loss. I added in the daily cheat. I still have my spreadsheet, meal plan and measure everything, but when I eat out I can't figure the calories and protein, so I just count it as a meal and a cheat and watch my weight. My weight stayed within 1 pound of my goal weight for over a month when I was going to Halloween parties, Thanksgiving and going out with friends. I've lost another 2 pounds in the last month since I was not going out much. I'm OK with losing a little more weight for now even though I like the way I look at my goal weight because I know most people gain a little back, but I will have to maintain my weight after I get the skin removal surgery next month, so I will probably watch my weight and add in more fruits and vegetables. I'll still count the calories so I can figure out how many I need and make sure I get my protein, but at least I won't have to cram in high protein for EVERYTHING. I saw a different nutritionist when I went in earlier this month and she was surprised my regular nutritionist had told me to avoid fruit and only eat 2 servings of veggies a day. I told her I thought it was because she wanted me to get extra protein due to not being able to exercise much because of my back issues and fruit isn't a protein source. Note, if you get too much protein, your farts smell really bad.

Newbie here, first post! That said I have done my fair share of reading and creeping and have come to understand the 3 week stall is pretty common. That said... Tomorrow marks the 4th week post op and this entire week has had 0 loss. I have now lost 13 pounds post op bringing me to 17.4 in the last 30 days, and I feel like the surgery and the recovery was it worth 13 pounds? I feel stuck, I feel discouraged living like this during the holidays and not able to eat all the treats and food around. Now with the rant done, I am looking for a good puree to soft solids daily menu with food ratios that anyone can point me too? I am good at following a plan but suck at just making something up in a pinch, I have been planning but you know how it goes, sometimes you just don't feel like the things you made previously. I guess I just needed to vent, and in a space where others maybe have dealt with this themselves..