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I've done both. When I first started going to a nutritionist 7 years ago, I tracked religiously for calories as well as daily steps and lost about 40lbs. The problem I found was when I stopped tracking, I didn't have enough of a routine to keep eating the right way. When I was tracking calories with a 1500 limit, I would eat whatever and then stop when I hit the limit. Sometimes I was still hungry, other times I would have a glass of wine because I had "extra" calories at the end of the day. So it was effective for losing but not for maintenance. I also got really anxious having to track it all online for some reason. This summer, I started changing the basics of how I ate and forming a routine of the same foods almost every day. I would do a smoothie for breakfast, a big salad at lunch, and then a reasonable dinner, while minimizing the snacks and eliminating processed foods, added sugars, etc. I lost about 15lbs without tracking by keeping to this routine about 28 days out of every 30. The consistency worked for me and I didn't worry about the couple of times per month when I broke the routine and went out to eat or had a treat because it wasn't enough to outweigh the good stuff I was doing. Today, I've started my pre-op liquid diet and I am tracking again, but this time I decided on a notebook instead of an online tracker. I plan to track for several months because I think it's information I will need for my doctor and nutritionist if I encounter anything unusual during my recovery. I bought a Legend Planner Food Journal (pocket edition). It's not too big and it doesn't give me the anxiety tracking apps do. It has 6 months worth of pages, so I plan to track until the book is full and then reevaluate. I feel like if I can establish good habits and continue to track my weight weekly, I can stop tracking food. But if my labs come back bad or my weight starts going up, I will reassess.

Choosing a surgeon and Days 1-3 It's Sunday night and my surgery was Friday morning (1/12/24). My gastric sleeve was 3/24/23. I lost almost half the weight before my Gastric Sleeve surgery. I chose to have my surgery in Tijuana, Mexico because of the cost and I have a friend who lives about 45 minutes away in Mexico and my father lives about 2 hours away. I started my research reading about medical tourism in general to get advice on what to look for and what questions to ask. I started my search with Realself.com and chose surgeons with 4+ stars,10 or more years experience, and who said they were part of the American Board of Plastic Surgeons or the American or International Societies of Aestetic Plastic Surgeons. I read all the reviews I could find, noting all the bad things said, and verified they were actually listed on the board or society sites. One of them wasn't. I made virtual appointments with 3 and chose Dr. Rodolfo Casillo Calderon, who is listed on both the American and International Societies. He originally told me I had to wait until a year after my surgery, but I reached my goal and my weight stabilized in early October so I was able to move the date up. I uploaded a bunch of pictures to myTouchMD and when we did our call he explained in detail what he would do, complete with drawings on my pictures. He explained possible problems and what could be included in my package and that I would have a patient coordinator to walk me through it and answer questions. I had told him I wanted a 360, breast lift with gummy implants, and a BBL (i've always had dents in my butt and got called board butt in high school). He told me he didn't think I had enough fat in the area he was working for a BBL, especially since some of the transferred fat would die, but he would see what he could do. I asked for the best medicine package and told them I didn't need transportation to/from the airport since my dad and friend would provide that). I also told him in the future, I wanted my inner thighs, maybe my arms if I could get a good price at the same time and a face-lift. He told me that was too much to do in one surgery, that the face-lift would be one and the thighs and arms another, and they had to be at least 6 months apart. He sent me a quote for the 360, breast lift with implants and lipo and said it included the mons reduction and lift but not the BBL. The quote included the surgery, labs, cardiology evaluation, compression garments, meds, hospital stay of 1 night, and 6 nights in a recovery home that has 24/7 nursing staff and food. $12,699. I paid a 20% deposit and paid the balance during my pre-op lab appointment. I also filled out paperwork and met my coordinator. When I talked to Dr. Castillo in person, he took the pre-op pictures and told me again that he didn't think I had enough fat for a BBL, but he would see what he could do. I was disappointed, but trusted his judgment. I woke up after surgery in recovery, and they took me to a room and bolstered me well with pillows. I had a catheter, so I didn't have to move. My right toes felt numb and I couldn't feel my left toes, The nurse said it was from the anesthesia and would wear off and it did. I could feel and move my toes again. I had good service ar CER Hospial and spent the evening eating, drinking and watching TV. I asked for a snack and they got me some crackers (the cafeteria was closed and I didn't want jello). The next morning (Saturday) Dr. Castillo came in and talked about my surgery. He put 320cc in my right breast and 240 in my left and explained it would take a while for them to drop. He also told me he did a little fat transfer to my butt and gave me instructions to reduce death of the fat and stressed that there wasn't enough fat for a ful BBL, but he did what he could and it mostly came from my hips. Then his nurse came in and gave me my meds and instructions for aftercare. My patient coordinator from his office also came in and told me I'd get picked up by Casa by Linda's driver at about noon and asked if I have any questions. Shortly before noon they took my catheter and IV out and the nurse helped me sit up and helped put the compression garments on me, then I got dressed. The drive was a bit scary. The driver said it was like driving in New York with people pulling out and changing lanes without enough room. He told me interesting stuff about Tijuana and prohibition, how the margarita came to be made, and about Rita Hayword's history, getting discovered, and changing her name. I was helped out of the car and to my room, which has a queen hospital bed. The head was inclined and my space was pre-padded. I got in bed and they explained the remote and how to call them and asked if I had questions, needed anything, and if I was hungry. They brought me lunch and my friend came with my backpack and snacks. I was able to get out of bed and put my stuff away. My laptop, tablet, and snacks are all in reach. Sitting up is the most painful. Lying down in my nest of pillows is not as painful, but hurts pretty bad. To get up, I put the foot of the bed down, the head up, and roll to the side, then use my arm to push myself up. To get back in bed, I get on the bed on my knees and position my knee at the far side of my nest, then lower myself sideways and roll into the in the nest. My breasts aren't hurting at all. The compression garments has an open crotch, so you don't have to mess with it to go to the bathroom. The staff here respond quickly to requests and bring me my antibiotics and pain meds, and so far the pain is tolerable and I've been able to walk. You walk hunched over and slow. Linda has come in several times to check on me and see if I need anything. She is originally from Canada and is a US citizen, married to a local. This morning, after breakfast, I took a shower. One of the staff helped me with my compression garments (it hooks down both sides) and got the water ready. There is a seat in the shower with the shower head within reach. I hosed myself down and she handed me a washcloth and put soap on it. I didn't have to ask her for help as I was able to bring my legs up to wash them (it wasn'teasy). After I rinced myself off, she put antiseptic on gause and applied it to my incisions. I dried myself and got into bed to wait for the return of my compression garments (they washed the blood out). When she returned with my compression garments, she put gause in my new belly button and over the incisions in the back that had bled, then she helped me hook the garments up, putting a square of gause over my nipples. Nothing else to report. Unlike Friday and Saturday, I slept most of the day.

Hi Im 24 days po, ive been feeling nauseous since Monday cant shift it, also low mood i dont want to leave the house shower or do anything is this normal? Ive lost 35 pounds so far! My gp is doubling my omprazole and giving me anti sickness pick them up later i hope they help? Anyone else experiencing these symptons?? 😔😔

It is strange how we feel the need to explain, when really we owe them nothing at all! Thank you for the advice! x

I am six months out and I still use the Baritastic app to track everything. I find it helpful as a guide to reinforce what I have learned about nutrition and portion sizes, but it requires an internet connection. The times that I have been offline and unable to track, I've practised my "eating right," skills, and haven't worried myself.

I don't know the figures but can say that if you already have GERD, the sleeve is not the surgery for you.

Definitely not in liquids. All you might be able to do is try a peanut butter flavour powder & add it to your shakes. I wasn’t allowed peanut butter until maintenance. Though it has protein it’s not a lot & it’s high fat (even the natural ones) & often high in added sugar. I enjoy a teaspoonful as one of my snack options now but my fat intake is low & sugar is very low so I can get away with it. Check with your team/dietician as to when you can add it & how much you can have.

Exactly this. Why feel the need to explain to judgemental people? Judgemental people will always judge, these are the same people who fail to look inwards or at the mirror. Next time ask "did I ask for your opinion?" Also "I expect support from my family and friends, but f you can't do this - keep quiet!"

My two word response to anyone who comes at me with anything other than less than 100% support... f**k off. It's not my job to educate you or seek your approval. Get on board, or get out of my way.

This is the absolute best written account of medical tourism for plastics I have seen. Thank you for the thorough description. Also congratulations and speedy recovery ❤️‍🩹