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Dropping into ketogenesis you will go through a “keto flu” which is different for everyone, but sweats, nausea, body aches/muscle aches, fatigue and headache are common for those. It often hits between day 3-7, but everyone is different. Salt here helps. Dig out your electrolyte drinks, your salty broth, etc. with the coffee drinking you’re just adding insult to injury, losing a lot of water that way. Though withdrawal is a jerk.

Dropping into ketogenesis you will go through a “keto flu” which is different for everyone, but sweats, nausea, body aches/muscle aches, fatigue and headache are common for those. It often hits between day 3-7, but everyone is different. Salt here helps. Dig out your electrolyte drinks, your salty broth, etc. with the coffee drinking you’re just adding insult to injury, losing a lot of water that way. Though withdrawal is a jerk.

I did keto a lot before surgery, it was vogue as we’ve all done a million diets in our lives... It works, but cravings. The preop and post diet are similar. Just way more liquids. For the fatigue and headaches, broth was the key. You would dehydrate rapidly and would suffer without the salt. The sugar detox is real, often once it passes you are a ton less Hungery. For those like me, and sugar can start the cravings. 100% agree with others who posted. It takes me about a full week for those to stop. Distractions help, exercise helps, just going to bed helps. I am always less hungry after mild exercise, mostly sweaty and thirsty. It helped stopped the food focus more than plain distractions. Heavy exercise increased the hunger the next day. This might sound crazy, but I had to constantly know when my next meal was. Lunch done, wait 2 hours then sugar free jello, then 1 hour and sugar free popsicle, then start to prep dinner, etc. knowing I was eating something in 1-2 hours helped. I tend to panic eat. Food was scarce as a kid and I tend to stuff myself if it’s not readily at hand and I’m hungry… my next meal is 3 bananas as fast a I can shove them in and I remain food panic triggered and have to talk myself down. I’m working through my hunger panic. I’m 100% not super thin now, I’m huge and need help… it’s why we are all here. :). To give and get support. And trying to not be a clean your plate club, eat any meal you are offered, all meals need a dessert, eat till you have pain and call that “full” kinda gal. I’d also make sure I got all of my sleep. I’m a 10 hour person. Plan a small exercise before you know your mega Hunger hits (I’m lunch). A 15 min walk helps divert my blood to my limbs and gets me craving fluids. Call your food what it is. A popsicle is a dessert. A pudding is a dessert. Sometimes reframing these help, ok in 2 hours I’m having protein pudding as a dessert, followed in 2 hours by a dessert popsicle. We are all different, so need different things. If after dinner I have a popsicle every night before bed, I call it dessert and I always know it’s coming and I will be getting more food… and I’m ok not being as full at dinner. This.. might have been too personal, but… helps me.

I did keto a lot before surgery, it was vogue as we’ve all done a million diets in our lives... It works, but cravings. The preop and post diet are similar. Just way more liquids. For the fatigue and headaches, broth was the key. You would dehydrate rapidly and would suffer without the salt. The sugar detox is real, often once it passes you are a ton less Hungery. For those like me, and sugar can start the cravings. 100% agree with others who posted. It takes me about a full week for those to stop. Distractions help, exercise helps, just going to bed helps. I am always less hungry after mild exercise, mostly sweaty and thirsty. It helped stopped the food focus more than plain distractions. Heavy exercise increased the hunger the next day. This might sound crazy, but I had to constantly know when my next meal was. Lunch done, wait 2 hours then sugar free jello, then 1 hour and sugar free popsicle, then start to prep dinner, etc. knowing I was eating something in 1-2 hours helped. I tend to panic eat. Food was scarce as a kid and I tend to stuff myself if it’s not readily at hand and I’m hungry… my next meal is 3 bananas as fast a I can shove them in and I remain food panic triggered and have to talk myself down. I’m working through my hunger panic. I’m 100% not super thin now, I’m huge and need help… it’s why we are all here. :). To give and get support. And trying to not be a clean your plate club, eat any meal you are offered, all meals need a dessert, eat till you have pain and call that “full” kinda gal. I’d also make sure I got all of my sleep. I’m a 10 hour person. Plan a small exercise before you know your mega Hunger hits (I’m lunch). A 15 min walk helps divert my blood to my limbs and gets me craving fluids. Call your food what it is. A popsicle is a dessert. A pudding is a dessert. Sometimes reframing these help, ok in 2 hours I’m having protein pudding as a dessert, followed in 2 hours by a dessert popsicle. We are all different, so need different things. If after dinner I have a popsicle every night before bed, I call it dessert and I always know it’s coming and I will be getting more food… and I’m ok not being as full at dinner. This.. might have been too personal, but… helps me.

French toast made with keto bread

Homemade (turkey) burger w/onions on a keto bun

Your surgeon (or their team) should provide you with a list of the liquids you can consume during the pre surgery stage. If they haven’t yet, ask for a list so you can start to prepare. There are variations between surgeons as to what you can and can’t have at this stage. For example some are three meals of protein shakes a day & that’s all. Others are four shakes. Some are two shakes plus one meal of a lean protein & vegetables. Some are not shakes but milk. Mine was keto. So you can see we can’t really tell you what your surgeon may require for this diet or require specifically for you ( your current weight, pre existing health concerns, etc.) But as a help, start weaning yourself off caffeine, carbs and sugars now because when you start the pre surgical diet the withdrawals from those foods can be pretty tough (headaches, lethargy, irritability, poor concentration, etc.) It usually passes after five or so days but that first week wasn’t called hell week for nothing by my surgeon’s patients. All the best.

Hi there! I’m Kelly I’m 42 and in January I made the decision to pull the trigger on bariatric surgery. I have been battling my weight my entire adult life. Things started getting really out of control when I was a junior in high school and my mom was diagnosed with cancer. At her behest, I joined Weight Watches when I was 20 years old and I have been a member off and on with mixed results ever since. I managed to lose weight easily after having my first two children but between my second and third child I had a miscarriage, gained 15 pounds and it’s been downhill since. My third child is 11 years old and I still haven’t lost the baby weight despite trying weight watchers, 21 day fix, keto during the keto craze. In 2023 I saw a doctor to inquire about trying at GLP-1 at pretty much exactly the same time as the shortages began. Between shortages and having a doctor tell me that I could never take a GLP-1 because of my mom’s cancer I spent about 6 months researching and trying to get on. GLP-1. I managed to join a telehealth company that fall and I was able to get my hands on prescription and box of Saxenda to hold me over until seeing my new PCP. I did pretty good on Saxenda and my new PCP was able to transition me to Wegovy. I managed to lose almost 35 pounds with Saxenda and Wegovy. Unfortunately, my insurance did away with coverage for all weight loss meds starting January 1 of this year. So I made myself an appointment for myself with a bariatric surgeon. I’ve already accomplished my sleep study, an abdominal ultrasound, an upper GI, and 4 of my 12 ‘lifestyle classes’. My surgeon originally suggested a sleeve for me, but after my scope I think it’s going to be a RnY because despite me thinking I did not have reflux, I had grade B esophagitis. I’m kind of kicking myself, that I didn’t start persuing this when I was messing around trying to get a GLP-1, but hindsight, you? Anyways, I’m happy to be here and happy to get ready to start my new life.

I'm an old VSG Vet, had my surgery in 2014. Initially lost a successful amount of weight. had some serious 'life' events- change of job, change to night shift, loss of parent, went to grad school and graduated, went to a second grad program, changed career path, etc. I was told in 2017 I had a serious metabolic issue with my liver and that helped me really get focused, went to keto and lost all the regain I had plus much more, resulting in 100lb total loss. Since then, though, I've regained probably 50-60 lbs. I still feel some restriction which is great. Long time issue has been GERD, it was severe PRE surgery but my quite renowned surgeon assured me that with the weight loss, the GERD would subside. It did. But with the weight gain over last 2 yrs, it's back and BAD. I have EGD and colonoscopy coming up in a few weeks to assess the damage. I'm very scared due to the ongoing severe nature of the symptoms I'm having. I'm a healthcare provider so I know all of the 'things' that could present. Because of all this, I'm heavily considering a revision. I have been on PPI for over 20 years. While my magnesium is fine, my bones are already having a lot of issues AND I'm scared to death of the brain effects. What should I consider with revision, same doctor, different doctor, etc? Also I know that weight loss can be slower, but what type of rate of weight loss can be expected? Lastly, what kind of time off from my career can I hope for? I took 6 solid weeks with my VSG and it helped get my brain, behaviors etc really corrected before going back into the workplace.

Maybe check out Dr. Matthew Weiner’s pound of cure weight loss book. He goes over a handful of things that you can change and you can pick which one you want to start with. For me, the fruits and veggies was a good one because I actually like fruits and veggies. Replacing a lot of the process carbs with healthy carbs for me is the most important component to weight loss not just to cut calories in the short run but to stop cravings in the long run. For me processed carbs, make me crave sugar. One cookie and I want pasta I want cake. I want it all and I crave it for a week. Natural carbs do not do that to me and they can help reduce the cravings a little while I get through the week or so to detox from them. Once I am off of the processed carbs so long as I get my protein, I stay feeling full so it’s much easier to sustain a healthy diet. Keto never worked for me either and I have learned post surgery that is most likely because of not being able to eat hardly any carbs at or it was all the processed junk I was eating instead of natural food. They alter things by adding more fiber to cut the carbs and all of that and that may be reducing your calories to help you lose weight, but for me it wasn’t the same for my body as a veggie with fiber. It’s not sustainable because my body was still craving the carbs. I would lose weight in the beginning, but the cravings were horrible and eventually I would give in to them and then I just wanted even more. Anyways, you may not be able to replace every unhealthy carb with healthy carbs on your own before surgery, but if you can reduce some of them by trying out different recipes to find fruits and veggies that you like, it may cut enough to lose your 10% and be a good start to finding healthy carbs that you enjoy

All great advice and much appreciated! Thank you all. @SpartanMaker thanks for the number crunching! I am definitely trying to cut portion size. We got rid of all the sugary stuff in the house and things like my tortillas. I've started walking (I have been completely sedentary for years- I work a very stressful, 40 hour week desk job from home.) I can't walk for 30 minutes straight. My low back and knees are trash. I carry most of my weight in my belly. I joke to my husband that I need a rolling cart to set my belly on so my back won't hurt so much. I walk as long as I can & fast enough to get my heart rate up and be breathless to the point that I cannot carry on a conversation. I'm looking for a treadmill so I can walk inside. I tend to turn my ankle & fall if I'm not super careful while walking on the gravel road. Thinking about pulling up some of those old Sweating to the Oldies videos by Richard Simmons LOL That might be a good way to do some cardio. I've failed at losing weight for so long. Today I'm feeling kind of emotional just thinking about what I'm facing. I said in an earlier post that keto & low carb didn't work for me.... fact is, they do work... as long as I stick to them. The minute I stop, I regain the weight I lost. sigh. Seems like I gain weight if I breathe in the aroma of baked goods.

Congrats on taking the first step! As @FifiLux pointed out, the keys are really going to be reducing portion sizes and making good food choices. These will be really important after surgery, so getting started on them sooner rather than later is the right approach. By the way, fad diets like Low Carb and Keto may work for some people, but as you said, they don't work for you so there's no point going there. It's also really critical you don't try to make drastic changes all at once. What you need to focus on is one sustainable positive change at a time until it becomes the new norm for you. People almost inevitably fail when they make wholesale changes to their diet and activity level simultaneously. Also, If after implementing a particular change it still feels like a challenge to you, then keep at it until that one is just part of what you do. Once you get to that point, only then is it time to try to make another change. My suggestion is to pick no more than 2-3 things per month you want to change about your diet and activity level and start with the ones you think will be easiest first. Changing subjects a bit, let's do some math here. To lose 6 pounds a month, you'd need to reduce your energy balance by -750 calories a day. This can be made up of lower intake, greater activity, or most likely both. At your current weight, walking ~3 miles an hour would burn ~200 calories per mile. Thus a 30 minute walk would burn ~300 calories and an hour walk would burn ~600. Add in smaller portions of the same things you're eating now and 6 pounds a month will be easily attainable. Keep us updated as you progress and the smart folks here will be glad to help.

My advice is to make changes to your diet and exercise in the next few months that you feel you can maintain for the rest of your life, as opposed to trying a fad diet (Keto, paleo, etc.) that is likely to be too extreme. Focus on basics like reducing your simple carbs and sugars, increasing your lean protein and veggies. Start measuring your portions to make sure you are not eating more than you think. Start getting your 64oz or more of water every day and cut out any sugar-sweetened drinks that you might drink (and also alcohol) because it's just empty calories. Walking and light weights are really great, but remember that about 80% of your weight loss comes from your diet, and only 20% from exercise, so don't feel like you have to go crazy with joining a gym and working out, especially if you're starting from sedentary. Regular walking every day does amazing things. At this stage, small changes can make a big difference. One thing I did right away was go through my cupboards and get rid of temptations. I stopped buying crackers, pretzels, cookies, and sweets. I would still have a treat when I was out, but I would try not to bring it home. Since I work from home, not having things in the cupboards to tempt me was a huge help. I was not required to lose weight before my surgery, but by making these little changes, plus the strict 2-week liquid diet, I ended up going from 251 lbs to 225 lbs in about 6 months. You can do it!

Had my consult at Banner University Medical center in Tucson. The team seems really nice and eager for you to succeed. My first appt with the dietician is Jan 29th and is supposed to be about 90 minutes. Lots of tests I need to have completed asap; sleep study, cardiology clearance, endoscopy, barium swallow, psych eval, chest X-ray, and a ton of labs. Gotta complete the 6 month supervised diet and lose 10% of my weight throughout the 6 months. They want to see a little each month and not a lot at real quick. I weighed 344 yesterday and they want me at 310 before surgery. I shared this in a Facebook forum and the 1st comment was, "Really, how do they figure you can lose that much in 6 mos? Wow. Good luck with that!" (Nothing like a little encouragement right off the bat! 😬 ) I replied that it's only 34 lbs & I need to lose 6 lbs a month. She said if she could lose 6 lbs a month she wouldn't need surgical help! I looked at her profile & it turns out she's a failed ESG from September because 'she likes food too much'. BUT now it's in my head that maybe I can't lose the 34 lbs in time. I'm definitely ready to get this going! I have studied this for so many years! I'm super excited to have finally taken this step & have saved money for the last several months to cover my deductible & most of my Out of Pocket max. The fat girl in me decided I needed a food funeral, so I had my last ever buffet yesterday. I hope this 6 months goes by quickly! I'm ready to feel better & move better. My knees & back need a break LOL! If y'all have any tips for losing the 34 lbs in 6 months, please share them. I know low carb/sugar free & keto..... but I've obviously never been successful with them or I wouldn't be this big.

I didn’t read all the replies but 800 calories doesn’t sound like a lot until you break it down and supply your diet with nutrient dense foods over energy dense ones. Here’s what I would do for an 800 calorie day- Breakfast- 6tbsp egg whites, a medium diced tomato, 2 cups of fresh spinach and 1oz reduced fat cheddar with 1/2 cups blueberries Lunch- a tuna packet mixed with 1tbsp light mayo, on one slice 35calorie keto bread with 2 cups salad greens and half a cup sliced cucumber afternoon snack- protein shake dinner- chili made with 1/2 cup canned kidney beans, 1/2 cup tomato sauce, 1/4 cup diced onion, and 1/4 cup diced bell pepper dessert- 1/2 cup nonfat plain greek yogurt mixed with sugar free, fat free pudding mix. Total count- 803 calories, 77g carbs (24.5g fiber), 16g fat, 95g protein

I think I used the wrong sweetener and it was a bit too dry which is hilarious because keto recipes usually love butter and this one doesn’t require any.

Guess who decided to cook and it was a total fail 🤣 Tarta De Santiago (keto version) 4 eggs 2⁄3 cup (5 oz.) erythritol lemon zest or flavor 2 cups almond flour 2 tbsp powdered erythritol for decorating Either I’m just not used to erythritol anymore or i just never liked it. Next time I will try a different sweetener.

Such good advice above. I so love this forum. 😍 OP I hope you can judge yourself less and forgive yourself a few lapses - you are human, as are the rest of us. You have done the best thing you could for your health and have gone to enormous trouble (and expense?) to do it! We ALL have slips and do things that we know aren't good for us. If we can look back and analyse why we did what we did then sometimes that can help us avoid the same mistakes in future. I am 3 years post sleeve and I carry protein-based snacks wherever I go - usually nuts or seeds in little packs that I can carry in my bag. If I am hungry (and I do get fierce hunger at quite short notice a couple of hours after eating) and I'm in danger of eating something I shouldn't, then I will eat those. I know they will help stop me eating the rubbish that my head wants but my body doesn't need. It works a bit for me so I hope will help you. I never leave home without them. In addition I have stock phrases to 'explain' (not that I have to but - yunno) why I am not indulging in the delicious sugary fatty rubbish along with everyone else. I learned those phrases here. Oh I ate before I came! I'm just not hungry right now. I'm doing strict keto so I'm avoiding sugar at the minute. And so on. IME people completely lose interest if you say 'a thing', LOL. I wish you the best of luck. You've stumbled a little this week, that's OK, it's a marathon not a sprint. I hope you can use some of the resources suggested above. It's hard. It's hard every day, even after WLS. Take one day at a time and be kind to yourself. We are all here for you.

@Mspretty86 girl good for you!!! I tried to do that but I became too lethargic and cranky! hahaha I wake up at 4am make myself coffee, unsweetened almond milk and a couple of pumps of sugar free sweetener. I also make myself keto toast with Nuttzo butter ,half a banana sprinkled with cinnamon. It starts my day and I know I eat more calories than the average sleeve person (1800-2000 a day) but hey I got to where I am at doing this. Have you found that fasting helped in other ways?

Soooooo healthy fats, always have been scared of peanut butter but omgsh I found this nut butter called Nuttzo and its AMAZING!!! I made PB balls with Nuttzo, pure maple syrup, unsweetened shredded coconut and rolled oats. let me tell you these things are the most amazing snack (usually post workout for me. Anyone else have any other recipes they like with nut butter they want to share? I have been eating it 2x a day. In the morning with my keto bread only tsp and half a banana, but I would like to find other stuff to do with it. Thanks!

Even though plans are fundamentally the same, surgeons will have their own requirements many based on you, your health and your needs. Best advice is always follow the plan you have been given. Of course, if you are struggling with the plan, contact your team and discuss alternative substitutions you may be able to include. As for the pre surgical diet I was one who put on a keto diet for those two weeks. (I did about 2.5 weeks.) But I know a friend with the same surgeon, who had a higher starting BMI was on 3 shakes a day. Another, again same surgeon, was put on 2 shakes & one meal (protein & vegetable/undressed salad) a day. If you are concerned speak to your team.

No keto ice cream for me either, I think I have an allergy to monk fruit and the one brand I like made my mouth itchy. Also it seem to like unpopular or ice cream flavors of bygone eras: mint chocolate chip (but it must be mint flavored vanilla, not green), rum raisin and custom ice cream shop flavors of lemon poppy seed and lavender honey (which I was told was the most requested by their octogenarians patrons).

Oatmeal, rolled oats & porridge are the same thing. Just a culturally differently named food. And I eat them every day. I eat traditional oats. Initially after surgery I was advised instant which are a little more processed then I transitioned to traditional. (Check the ingredients on your pack if it’s just oats your fine.) Then add your own flavours. I add yoghurt, collagen powder, dried cranberries, fresh blueberries and yes seeds. Otherwise seeds on yoghurt or in salads are good too. You could sprinkle them on anything you may use breadcrumbs too like a cauliflower gratin or add them to any crumb mix for breaded whatever. Try mixing some in your meatballs or meat loaf for a little crunch. PS. I’ve noticed a few influences being anti oats (probably either being paid to promote an alternative likely a supplement or are pro keto) but they’re fibre & fibre is good for you. It’s filling, helps you poop, can help reduce cholesterol so is good for cardiac health, can help regulate blood sugars, can lower risk of stomach cancer.

I suppose I'm one of the few people after reading responses to the OP's post who haven't had their past food cravings or the food they love change. I still want pizza, phad Thai and Chinese food etc. No, grilled fish doesn't suddenly appeal to me anymore than it did before surgery, in no way is grilled fish comparable to fish and chips to me. I don't suddenly find a piece of fruit better than a brownie. There are times I'd kill for a roll or a sandwich with actual bread (not keto tree bark full grain bread) and yes I become resentful. I'm being totally honest, healthy alternatives don't taste as good (to me) and trying to change food I love/loved to a "healthier" version just isn't the same and doesn't taste anything close leading me to; 1. A waste of time and energy and cost, cooking/cleaning afterwards 2. Total disappointment and yes anger. I explain this because I found myself becoming upset because I wasn't and haven't experienced the sudden love of healthier food like others here on this forum leading me to be upset with myself. So, I'm being honest about my personal experience. There are some alternatives I have found such as Yasso "ice cream" bars and Wilde chicken chips, but that's about it. Unfortunately, I find myself just not eating opposed to stuffing yet another high protein non tasty food into my mouth. To combat this I stick to a few things I do like (you should know I've had food issues my whole life, in fact I almost died as a child because I'm an extremely picky eater - food texture issues). So, this is on me. I do get the required protein or close by drinking a fairlife protein drink. I say all this because the taste for healthier food doesn't happen for everyone and I don't want you thinking it most definitely will for you then if not wondering what's wrong with you!. I've only experienced dumping one time, but for the most part I can eat what I used too, the difference is I chose not too. Being thin to me is by far better than eating something I love and enjoy. Does it take a lot of joy out of my life? Yes, celebrations/holidays just aren't the same. I'm not trying to depress you, I'm sure you have enough of that as it is, but I am being realistic. You need to determine what your real priorities are; 15 mins of eating enjoyable food or 24/7 of being thinner and healthy? It all comes down to the mentality of it. Having your head straight on what you really want. I truly hope you're one of the lucky ones as all those who've responded thus far and you find healthier alternatives you like or you just don't like your old food loves, but be aware that might not happen and start getting it straight in your head now. Thinner/healthier/longer life/decreased co-morbidities vs. 15 minutes of food enjoyment and weight gain? Lastly, If I really want something I get it, take a few bites and physically walk away from it. I throw it away before I eat more or give it to my husband.. either way I get away from it. It all comes down to choices and what's really important to you. Good luck, you got this, you've haven't gone through all this just to throw away your opportunity for a healthier thinner life. It would be a tragedy for getting a few good tasty bites in. I really hope I haven't burst your bubble after reading others more positive your tastes will change posts, I wanted you to also read there are others who aren't that lucky but still do what's right for a healthier thinner life. Its all getting the mindset down and if all you read was just the your food tastes will change posts and that never happens you'll blame yourself like I did. I hope this helps you. Some may condemn me for my less than positive post, but I've always been a realistic no rainbows flying out my backside type and I would have appreciated both sides of it right after surgery so I knew all possibilities. Lastly, don't condemn yourself if you do cheat occasionally, just up step up and eat right next time!

Just echoing what the two very experienced forum members say above. A regain in 2nd and 3rd year post op is almost the norm. Please try not to worry about it unduly. Your set point is the weight/body composition that your body wants to hover around. The video below is short and might help. Your set point gets lowered drastically by WLS. But - processed food raises it. Eating cleaner keeps it lower. Building muscle mass keeps it lower. Might those be things you can work on a bit? Lots of people focus on cardio and that's brilliant, but lifting weights or using resistance bands (even if you never do cardio!) can add another really significant layer to that. Do you or have you ever tracked your intake? If that has slipped just tracking again might make you aware of what you're taking in and what you're using up. I am saying this as someone just about 3 years post op who regained 16lbs this year. I personally wasn't happy with that because it didn't stop as others' seems to, so I lost 10lbs by strict keto and am now back where I want to be. I had dietary lapses I needed to correct too and am working on that. I had this surgery to stop dieting - I feel like I can tweak things to keep me where I want to be without that and that I've learned a lot by stepping back and really analysing my intake the last few months. Also huge kudos to you for thinking about this with only 9lbs on. Much easier to look at what you can change now, if you even need to do that, rather than further down the line. I wish you the very best.