Alex Brecher

It's understandable that you may be feeling frustrated and confused by the response you received from your friends regarding your decision to have gastric sleeve surgery. It's important to remember that everyone has their own beliefs and opinions, and not everyone may understand or agree with your decision. It's important to make decisions about your health that are best for you and that you feel comfortable with, regardless of what others may think or say. It's also important to remember that gastric sleeve surgery is a medically accepted and effective treatment for obesity and can have a positive impact on one's overall health and well-being. It's also important to keep in mind that some people may have strong beliefs about health and wellness that may not align with your own, and that's okay. It's important to respect others’ opinions, and to surround yourself with people who support and understand you.

It can be challenging to overcome weight regain, especially when it feels like a snowball effect. However, it's important to remember that weight loss is a journey and there will be setbacks along the way. One of the first things you can do is to identify the reasons for the weight regain. Is it because you have been eating more than your body needs? Are you not getting enough physical activity? Are there emotional or stress-related reasons for overeating? Once you have identified the reasons, you can start to develop strategies to address them. One strategy is to focus on developing a healthy and sustainable lifestyle. This may include incorporating regular physical activity into your routine, eating a balanced diet that includes plenty of fruits, vegetables, and lean proteins, and finding ways to manage stress and emotions in a healthy way. Another strategy is to track your food intake and exercise. Keeping a food diary can help you identify patterns in your eating habits and make adjustments as needed. Tracking your exercise routine can also help you stay accountable and motivated. It's also important to surround yourself with a supportive environment, including friends and family who will support you in your weight loss journey, and consider seeking professional help such as a dietitian, a therapist or a bariatric professional. Remember that progress may not be linear and it takes time to see results. Be kind to yourself, and don't give up on your goals.

It's understandable that you may be feeling frustrated and disappointed about your weight loss stall after your recent revision surgery. It's important to remember that weight loss can vary from person to person, and the rate of weight loss can also depend on factors such as the type of surgery, the individual's starting weight, and their adherence to post-surgery dietary and exercise guidelines. It's also important to keep in mind that weight loss is not always linear and it can be normal to experience plateaus or stalls along the way. Additionally, it is important to focus on the progress you have made so far, such as losing 26lbs, and not just the stall in your weight loss. It may be helpful to consult with your surgeon or a dietitian to review your dietary intake and ensure that you are getting enough protein, staying hydrated, and not consuming too many calories. They may also be able to provide you with strategies to help break through the stall, such as increasing your physical activity level or adjusting your dietary intake. Keep in mind that weight loss journey is not a linear one, and it may take time to see progress again. But it is important to stay consistent with your healthy habits, and not to get discouraged. Remember the reason why you decided to undergo the surgery and focus on the long-term benefits for your health.

It's great to hear that you're feeling good after your gastric bypass surgery! In general, it's important to follow the guidelines provided by your surgeon and dietitian for when to introduce different types of foods, including spicy foods, into your diet. Spicy foods can be difficult for some people to tolerate after surgery because the smaller stomach size and changes to the digestive system can make it harder to handle certain types of foods. Some people may be able to tolerate spicy foods sooner than others, but it's best to check with your surgeon and dietitian to see what they recommend for you specifically. It's also important to remember that when introducing new foods, you should start with small portions and pay attention to how your body reacts to them, and if you have any issues like stomach discomfort, nausea or vomiting, it's best to avoid these foods for a while. It's worth to mention that some people do have more stomach sensitivity after surgery so you may need to be more careful with certain types of foods even after 3 month, if you have any concerns it is best to speak with your surgeon and dietitian.

Congratulations on getting your surgery date! It's great that you are feeling excited and motivated to make positive changes in your health. Remember, weight loss surgery is a tool that can help you achieve your goals, but it's important to remember that it's not a quick fix. It will require a commitment to making lifestyle changes, such as eating a healthy diet and getting regular exercise. Your surgical team will provide you with guidelines and recommendations for your pre- and post-surgery diet and exercise plan. It's also important to remember that weight loss is not always linear, and you may experience plateaus or fluctuations in your weight. It's important to focus on your overall progress and health rather than just the numbers on the scale. Remember to take care of yourself both physically and emotionally during this process, and don't hesitate to reach out to your surgical team or support group for help and guidance.

It's not uncommon for people who have experienced emotional trauma to have additional challenges or changes in their emotional and mental health after a significant physical change such as gastric surgery. It's possible that weight loss surgery may trigger the reemergence of memories or feelings that were previously repressed. Also, the surgery may affect the way the body processes and stores nutrients which in turn can affect the way the brain functions and can lead to changes in mood and mental state. It's important to note that every individual's experience is unique and it's hard to generalize. It's important to have a open communication with your healthcare team, and also to have a good support system in place before and after surgery. It's also important to be aware that the post-surgery period can be an emotional rollercoaster, with a lot of changes happening both physically and emotionally. It's important to be mindful of that and not to be too hard on yourself, and seek help if needed.

It's normal to have concerns about weight loss after bariatric surgery, but it's important to remember that weight loss can vary from person to person, and it's not uncommon for there to be fluctuations in weight in the early stages of recovery. The weight loss process after bariatric surgery can be slow and steady, and it's important to be patient and to focus on the long-term goal of achieving and maintaining a healthy weight. It's also important to remember that weight loss is not the only measure of success after bariatric surgery. Other health improvements, such as improved blood sugar control, improved blood pressure, and increased mobility, are also important indicators of success. It's also important to talk with your surgeon or bariatric team to understand more about your individual case and to address any concerns you may have. They can also help you with your diet, exercise and follow-up plans to ensure you are on track and provide you with guidance. It's also important to note that everyone's body is different and that some people may lose weight faster than others. It's also possible that you may not have lost weight yet due to water weight or swelling from the surgery. It's also important to focus on the long-term goal of achieving and maintaining a healthy weight, and not to get too caught up in the day-to-day fluctuations in weight.

It's important to note that the recovery period following bariatric surgery can vary from person to person, and the specific instructions given by your surgeon should be followed closely. During the first few weeks after surgery, it's important to avoid any activities that put a strain on the abdominal muscles, as this can increase the risk of complications and delay healing. This includes activities such as heavy lifting, strenuous exercise, and singing. You should avoid singing for at least a month or even more, as your abdominal muscles and diaphragm may be weak after surgery and using them to sing can cause pain, discomfort and delay healing. It's important to listen to your body and avoid any activity that causes pain or discomfort. Consult with your surgeon or therapist, they may be able to give you more specific advice based on your individual case. It's also important to remember that the recovery period is an important time to focus on healing and taking care of yourself. It's important to follow the post-surgery instructions, getting enough rest, and allowing yourself time to recover both physically and emotionally.

Gurgling or rumbling sounds in the stomach after eating or drinking is a common symptom in the early stages of recovery after bariatric surgery. This is because the stomach and intestines are adjusting to the changes in the digestive process caused by the surgery. This can be caused by the formation of gas in the stomach and intestines, which can be a normal part of the digestive process. Eating too quickly, not chewing food properly, or drinking carbonated beverages can also contribute to this symptom. It's also normal to experience a lot of gas and bloating after surgery, as your body adjusts to the new diet and the changes in your stomach and intestines. It's important to follow your surgeon's and dietitian's instructions and to take it slow with the introduction of new foods. Also, drinking enough water and taking small sips during the day can help to reduce the formation of gas. If the symptoms persist, or if you experience severe abdominal pain, vomiting, or fever, it's important to contact your surgeon and/or dietitian to rule out any complications.

Mounjaro (semaglutide) is a medication that is approved for the treatment of type 2 diabetes, and it is currently being studied for its potential use as a weight loss medication. The medication is a glucagon-like peptide-1 (GLP-1) receptor agonist, which means that it mimics the effects of a hormone that helps to regulate blood sugar levels. It is not yet approved by FDA as a weight loss medication and its use in weight loss is still under research. The studies that have been done on semaglutide for weight loss have shown promising results, with people losing a significant amount of weight and reducing their risk of obesity-related health problems. However, it's important to note that everyone's experience with weight loss surgery and medications is different and it's important to work closely with your healthcare provider to determine the best treatment plan for you. It's also important to note that weight loss surgery is not a magic solution, it's a tool and it's important to follow the recommendations of your surgeon and dietitian, to maintain a healthy diet, adequate protein intake, and regular physical activity. It's also important to keep in mind that weight loss is not linear, sometimes we may experience Plateau, and even weight regain, it's important to work with your healthcare provider to evaluate the reasons and address them.

It's not uncommon for people to experience changes in their relationship with food and their emotional responses to eating after bariatric surgery. Some people may find that they no longer crave certain foods or that their emotional association with food changes. Reverse behavioral conditioning, as you've described it, is a phenomenon where the physical discomfort associated with eating too much or eating certain foods can change the way a person feels about those foods and their overall relationship with food. This can help to reduce cravings and change the way a person thinks about food, making it easier to maintain a healthy diet and weight in the long-term. It's also common for people to experience a change in the way they feel about their body and their self-esteem. The weight loss and the change in the way they look, can help them to feel more confident and comfortable in their own skin. It's important to note that this process is unique to everyone and some people may not experience a change in their emotional relationship with food. It's important to continue to work with a therapist or a dietitian to help you manage and understand your feelings about food and your relationship with it.

It's generally safe to eat raw fish, such as sashimi, 5.5 weeks after gastric sleeve surgery, as long as you are tolerating regular foods well and do not have any complications or sensitivities. However, it's always important to check with your surgeon or dietitian before consuming raw fish, as they may have specific recommendations for you. It's also important to note that while you may have been able to tolerate rare seared tuna over the weekend, it's important to listen to your body and stop eating if you experience any discomfort or difficulty swallowing. Also, it's important to keep in mind that it's recommended to eat small and frequent meals after bariatric surgery and avoid overeating, and raw fish like sashimi, tend to be low in calories, so it's important to not overdo it, also consume it with other nutrient-dense foods such as vegetables. Finally, it's also important to make sure that the fish you're consuming is properly handled, stored and cooked to avoid any foodborne illness.

Thanks for the update. We appreciate your feedback and will take it into account. Here's a photo from the side of our newest boxes. The BariatricPal logo isn't very noticeable.

It's not uncommon for weight loss to slow down or plateau after initial rapid weight loss. There could be a variety of reasons for this, including physiological changes in the body, changes in activity levels or physical activity, changes in diet, or even certain medications or medical conditions. It's important to remember that weight loss after surgery is a journey, and it's not uncommon to have ups and downs along the way. It's important to focus on making healthy lifestyle changes that are sustainable over the long term, rather than trying to achieve rapid weight loss. If you're concerned about your weight loss progress, it's a good idea to talk to your surgeon or another healthcare professional for guidance. They can help you identify any potential issues and work with you to develop a plan to help you reach your goals.

I understand that you are feeling frustrated and regretful about your decision to have surgery. It's normal to have ups and downs after any major procedure, and it can be especially difficult to adjust to the changes in your body and lifestyle that come with bariatric surgery. It's important to remember that everyone's journey is different, and what works for one person may not work for another. It's also worth keeping in mind that while surgery can be a helpful tool for some people, it's not a magic solution and it requires a lot of hard work and commitment to make lasting changes. It's important to communicate your concerns and feelings with your healthcare team, as they can offer support and guidance as you navigate your recovery. It can also be helpful to seek out support from other people who have had bariatric surgery, as they may be able to offer insight and encouragement. Finally, try to be patient with yourself and remember that it takes time to adjust to the changes that come with surgery. It's okay to have difficult days, but try to focus on the progress you have made and the improvements in your health that you have experienced as a result of the surgery.

Thanks for bringing to my attention. I had them update to B.P Store.

According to previous ASMBS guidelines from the ASMBS website, "Q: Do I need to avoid caffeine after bariatric surgery? A: Caffeine fluids have been shown to be as good as any others for keeping you hydrated. Still, it is a good idea to avoid caffeine for at least the first thirty days after surgery while your stomach is extra sensitive. After that point, you can ask your surgeon or dietitian about resuming caffeine. Remember that caffeine often comes paired with sugary, high-calorie drinks, so be sure you’re making wise beverage choices." The BariatricPal Store carries a large selection of bariatric friendly coffee options at https://store.bariatricpal.com/collections/coffee .

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I use BariatricPal Multivitamin ONE “1 per Day!” flavorless capsules from https://store.bariatricpal.com/collections/bariatricpal-multivitamin-one! BariatricPal has a special offer where it’ll cost you only $99 for an entire year's supply! Check it out at https://store.bariatricpal.com/99 With just ONE convenient & affordable BariatricPal Multivitamin ONE each day, you can get the bariatric vitamins and minerals you need to stay healthy! BariatricPal Multivitamin ONE was designed and developed by a team of the world’s leading Bariatric medical professionals. Please take a calcium supplement separately to prevent interference with the absorption of iron. You can view a large selection of bariatric-friendly Calcium supplements at https://store.bariatricpal.com/collections/calcium. You can also find MANY other brands of bariatric multivitamins at https://store.bariatricpal.com/collections/multivitamins. The BariatricPal Store carries a huge selection of Bariatric friendly Calcium at https://store.bariatricpal.com/collections/calcium. Check out the newly released BariatricPal Sugar-Free Calcium Citrate Soft Chews 500mg with Probiotics at https://store.bariatricpal.com/collections/calcium/brand_bariatricpal+vitamin-form_soft-chews . They come in 8 AMAZING flavors: French Vanilla Caramel, Chocolate Mint, Belgian Chocolate Caramel, Orange Creamsicle, Strawberry Watermelon Twist, and Wild Grape. You can get Calcium in many different forms: Soft Chews: https://store.bariatricpal.com/collections/calcium/vitamin-form_soft-chews Chewable: https://store.bariatricpal.com/collections/calcium/vitamin-form_chewable Powder: https://store.bariatricpal.com/collections/calcium/vitamin-form_powder Liquid: https://store.bariatricpal.com/collections/calcium/vitamin-form_liquid Tablets: https://store.bariatricpal.com/collections/calcium/vitamin-form_tablets Patches: https://store.bariatricpal.com/collections/calcium/vitamin-form_vitamin-patch

The BariatricPal Store carries a huge selection of Bariatric friendly Protein Snacks & Desserts at https://store.bariatricpal.com/collections/bariatric-high-protein-low-calorie-snacks-and-desserts Here are some other bariatric friendly ideas as well: Chips and Crunchy Snacks: https://store.bariatricpal.com/collections/protein-chips-and-crunchy-protein-snacks Chocolate Bars & Candies: https://store.bariatricpal.com/collections/bariatric-friendly-chocolate-bars-chocolate-candies Cakes, Cookies & Wafers: https://store.bariatricpal.com/collections/cookies-wafers Sugar-Free Candy: https://store.bariatricpal.com/collections/sugar-free-candy Cheese Snacks: https://store.bariatricpal.com/collections/cheese-snacks Meat & Jerky Snacks: https://store.bariatricpal.com/collections/meat-snacks Fish Snacks: https://store.bariatricpal.com/collections/fish-snacks Protein Bars: https://store.bariatricpal.com/collections/protein-bars Pretzels: https://store.bariatricpal.com/collections/pretzels Nuts: https://store.bariatricpal.com/collections/nut-snacks

Medical Groups Replace Outdated Consensus Statement that Overly Restricts Access to Modern-Day Weight-Loss Surgery NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery. The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it. The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world. "The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.” In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied. New Patient Selection Standards — Times Have Changed The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.” But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5. Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.” It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide. Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S. “The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.” The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.” About IFSO The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity. About ASMBS The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

Here is a screenshot of a conversation I had with Dr. Ramos Kelly from Tijuana moments ago.

Sounds like a bait and switch to me! I know Dr. Verboonen but have never heard of this other surgeon.

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