Alex Brecher

@@Rvamom, Everyone’s different, and also it depends on how much weight you have to lose, but I think we can pretty much all agree that losing 100 lbs is WONDERFUL! No matter how much weight you have to lose, losing 100 lbs feels fantastic. For me, I had more energy. I could move better. I could do more activities. I liked the way I looked. People treated me better. I had more confidence. It goes on and on. Looking at your starting weight and goal weight, you’ll basically be at goal weight when you hit 100 lbs down. I think you will feel fantastic and will be so proud of yourself when you get there. As for your question about whether people feel thin when they’re down 100 lbs…again, everyone’s different. I see myself as okay. I don’t think of myself as fat anymore, although I do always remember that I don’t want to be back there again! Do remember that even if you’re happy with your goal weight, you won’t automatically look like a movie star or model. You’ll still have flaws. Hopefully you’ll be able to accept and enjoy them. Good luck! Keep us posted! Let us know how it feels to lose 100 lbs.

@@vsgSarah3, Thanks for doing this! It’s such a great motivator! Good luck to all who are participating!

@Dr. Fielding, Thanks for this informative article and for sharing your insights about the lap-band. You have so many great points here about the role of the lap-band, the role of the patient, and the role of the surgeon. I am very impressed that you encourage your patients to come back monthly for 18 months – that’s more than many surgeons ask for, and that may be why your patients are so successful. I like the way you emphasize that the lap-band needs to be properly adjusted and placed for it to work, and the patient needs to follow the rules. I also love that you recognize real life: the patient can and should eat out and enjoy life and eating, and it’s possible to do that while sticking to the lap-band diet. Thanks also for the reminder that it’s okay to go back to the surgeon for an adjustment even if it’s been a little too long since the last one.

Wow, these are great responses! I am so glad to hear there are so many great doctors and surgeons out there, and that you seem to be finding them! I really respect those PCPs who either already know about WLS, or who are willing to learn what they need to in order to help you, their patients, be successful. I also really respect and am grateful for the surgeons who have the integrity to be patient with their patients. They can (am some do) very easily rush you, pressure you, and keep their dealings with you to a minimum. It sounds like many of you have found surgeons who are the opposite.

What does your lunch do for you? Does it keep you full, energized, and losing weight? Or does it leave you feeling sluggish, heavy, and hungry before your next meal or snack? If you’re not careful, lunch can pack hundreds or over 1000 calories, without giving you much nutrition. Some calorie disasters are obvious, like the pizza and soda, sandwich and chips, and Pasta Alfredo. Others, like many Chinese chicken, Caesar, and Chef’s salads, are a little sneakier. The easiest way to beat those sneaky lunches is to make your own. You can control every ingredient to make sure you’re getting the Protein you need, without getting too many calories or too much fat or sugar. You might save a few dollars, too! So get out those containers and get ready to make a grocery list. It’s time to pack a healthy lunch. Protein Power You already know protein is the foundation of every meal and snack you have. When you have protein at lunch, you keep your metabolism up, you feed your muscles, you reduce hunger for hours during the afternoon, and you’re less likely to nod off during an afternoon meeting. Good stuff! Here are some easy protein options for lunchtime. nonfat Greek or regular yogurt: plain or no sugar added. string cheese (cheese sticks) or other hard cheese, preferably low-fat. cooked chicken breast. hard-boiled eggs. canned tuna, salmon, or sardines. Filling up on Fiber Dietary Fiber slows digestion. That means it’s a filling nutrient because it helps keep you full for hours – just like protein. Fiber also helps stabilize blood sugar: so your levels don’t spike as much after a meal, and they don’t drop and leave you starving too soon. Fiber isn’t just filling. It helps lower cholesterol. Plus, it’s a nutrient that comes in healthy foods, so choosing high-fiber foods helps you choose nutritious foods, too. Think of these sources of fiber, and think of the other nutrients they have. Vegetables and fruit have potassium, Vitamins A and C, B vitamins, and tons of antioxidants. Legumes (beans, split peas, and lentils) have protein, B vitamins, and potassium. Whole Grains have Vitamin E, magnesium, and antioxidants. Peanuts, nuts, and seeds have heart-healthy fats, vitamin E, and cholesterol-lowering phytosterols. So what’s easy for lunch? You could take a green salad with chopped vegetables, Beans, and nuts; pinto beans with some cheese and shredded lettuce; stir-fry with any cooked vegetable and tofu, chicken, or fish; fruit salad or whole fruit (optional: with nuts or seeds); or fresh cut raw vegetables such as grape tomatoes and bell pepper strips. Putting It Together If you’re stuck for ideas for balanced, healthy, and portable lunches, these might help you out a little. Any kind of greens-based salad. Pack spinach, spring greens, or romaine or other lettuce leaves in a big container. In a smaller container, pack some healthy additions. Try cooked chicken, low-fat cheese, beans, or hard-boiled egg slices for protein, chopped vegetables or fruit such as grapes for extra fiber and nutrients, and sliced avocado or nuts for healthy fat. You can pack a couple tablespoons of light dressing on the side. One or more homemade “deli” or prepared salads, such as three-bean salad; Caprese salad with tomatoes and mozzarella cheese; marinated artichoke hearts with feta cheese; tuna, chicken, or egg salad with Greek yogurt instead of mayonnaise. Last night’s healthy leftovers such as chicken vegetable stir fry, chili, or veggie burger in a lettuce leaf. Roll-ups with all-natural ham or turkey spread with cottage cheese or non-fat cream cheese, plus carrot sticks. Whole or mashed sweet potato with Greek yogurt. Pack Some Snacks Your healthy lunch should include any Snacks you’re planning to have in the morning or afternoon. Snacks keep your energy up and your metabolism going strong. They also reduce hunger so you’re not tempted to dive for whatever sugary, starchy, or fatty snacks you find in the vending machine or break room. Just like your lunch, your snacks should have some protein and fiber. They should also be calorie-controlled depending on your needs. For most weight loss surgery patients, snacks should have about 100 to 200 calories. These are some easy snack ideas. celery with fat-free cream cheese. almonds. dried garbanzo beans or edamame (green soybeans). carrots or apple slices with Peanut Butter. whole grain Cereal or oats plus Greek yogurt. Use Helpful Helpers Packing your own lunch doesn’t need to be time-consuming or difficult. Feel free to use any helpful items you can find in the supermarket. Examples include salad mixes, pre-cut vegetables to eat or cook, low-sodium canned Soups and beans, pre-cooked Proteins such as ready-to-eat chicken breast strips, and single-serve packets of peanut and almond butter. You can use these helpful products, but beware of the diet saboteurs. Some may come in the form of way-too-big serving sizes, such as many pre-made deli salads. Others may be higher in calories or sugars than you expect, such as dried fruit. Some, such as canned and frozen products, can have hidden sugars and salt that you didn’t bargain for. Always read the label and ingredients! With these lunch ideas, you can easily make your own lunch and set yourself up for a healthy day. It doesn’t take much time to pack a lunch, especially once you get into the habit. By adding a few nutrients and saving a few calories each day, you can expect to see the results on the scale.

Everyone’s WLS experience is different. You might visit your surgeon for a pre-op consultation, then come back the next time for your surgery. Some surgeons have a pre-op program that requires you to attend a few meetings or have some appointments before you schedule surgery. You might even meet your surgeon for the first time on the day of surgery if you’re going to Mexico or another far-off destination for your procedure. So, I’m just curious…how many times did you see your surgeon before surgery? Did you feel comfortable with him or her by the time you arrived for your surgery?

Thanks! I updated to correct URLs.

Choose the right surgeon. If weight loss surgery is the tool, your bariatric surgeon is the one who makes the tool and gives it to you. You want a tool that is made precisely, ready to do the job, and built to last. Your surgeon needs to make the right cuts and place the band properly or make a tight, solid sleeve or pouch. So, look for a surgeon who is experienced and has a good track record of successful patients and low complication rates – don’t be afraid to ask! There’s more to choosing a surgeon than technical skills. Also, consider what else the surgeon will do for you. The right surgeon for you is willing to discuss your options and the procedure with you in a way that you can understand. You’re setting yourself up for extra challenges if you’re afraid to talk to your surgeon or your surgeon is unavailable. Get the scoop on the diet. Your diet is central to every part of the weight loss surgery journey. You may be told to lose some weight before surgery as a test to make sure you’ll follow the rules post-op. Then there’s the pre-op liquid diet to shrink your liver for a safer surgery. Next, for faster healing and fewer side effects, you need to follow the post-op progression from liquids to pureed foods to solid foods. Finally, there’s the nutrient-dense, low-calorie diet to help you hit goal weight and stay there. At best, you will have a surgeon or a nutritionist who gives you plenty of information. Since that’s not always the case, you may need to take steps to figure out the diet for yourself. You can look online, and may need to shell out the money for a few appointments with a nutritionist. Not knowing the right foods to eat can set you up for surgery complications and disappointing weight loss. Take responsibility. It’s nice to depend on a stellar surgeon and complete healthcare team to walk you through surgery and beyond step by step. Ideally, your trusted surgeon would explain your options to you and recommend the best surgery for you, whether it’s the sleeve, band, bypass, or another choice. You’d go back for follow-up appointments and ongoing nutritional and psychological counseling. That doesn’t always happen in the real world, but that’s no excuse to give up. You can take responsibility for finding out the information you need to know about what to expect, how to prepare, and what comes next. Be persistent and do your research in all kinds of places, and you’re more likely to succeed. Face the facts. Weight loss surgery isn’t all fun and games. You don’t leave the operating room skinny. Weight loss isn’t steady. It may take you longer to get to goal weight than you hoped. Recognize the real possibilities to avoid being disappointed and possibly even giving up. These are some other possibilities to consider, so you can be prepared if they happen to you. You may still love sugar, salt, fat, and/or starch. You may still be hungry. Others may not notice your weight loss, or may not be impressed. Others may be jealous of your weight loss or say you didn’t earn it. You may have loose skin when you are finished losing weight. Weight loss surgery doesn’t solve psychological problems. Be Open-Minded If you want to lose weight and get healthy, you’ve got to change your diet. Whatever eating habits got you to this point are not going to get you to goal weight! That may mean you need to be open-minded. Maybe you hated vegetables, or can’t stand the thought of downing protein shakes for 2 weeks on the pre-op liquid diet and up to 4 weeks on the post-op liquid and mushies diets. It’s time to re-evaluate. Can you sneak some veggies into your diet? Can you retrain your brain to love them? Can you force down those protein shakes for a few weeks in exchange for a lifetime’s worth of better health? Learn to see the good. There will be disappointments - guaranteed. The scale may not cooperate, or you may make a poor eating choice, or you might skip your morning workout because you didn’t make sleep a priority the night before. Focus on the negative, and you just may talk yourself out of continuing the hard work and good progress. Instead, learn to appreciate yourself and see the positive sides of things. Maybe you didn’t lose weight this week, but did you eat right? Maybe you downed a piece of pepperoni pizza without thinking about it, but did you pass up the breadsticks and soda that you would have had before surgery? Maybe you didn’t work out this morning, but did you make it to the gym more this month than you did last month? See yourself as a strong, powerful person, and you will act like one. You can build on the positive behaviors you see in yourself so they eventually overshadow the mistakes. You have control over your own destiny. Success with weight loss surgery depends on planning and hard work. The more you are involved and the more responsibility you take throughout the process, the better you can do.

Are you using our App or the TapaTalk app?

It’s a week away…what are your plans? Easter dinner? An Easter egg hunt? Afternoon with the family? A normal Sunday afternoon if you don’t Celebrate Easter? Please let us know how you’re going to get through this Easter healthily. Do you have your own special recipes to share? Do you just stick your hands in your pocket so you can’t use them to eat candy? Please participate even if you don’t celebrate Easter! You can share any food tips for parties or family gatherings, or any of your favorite spring recipes! You can also share tips for handling less-than-comfortable situations when you’re at a family gathering.

@@leanora27801, Congratulations! You look phenomenal! What a testament to your hard work and dedication. Thanks for being such an inspiration.

@lachellelove, Congratulations on your weight loss so far! With that amazing amount of weight lost in such a short time, you must be doing something right! I would say something like 1,200 to 1,400 calories, or even more if you exercise a lot, and probably 65-100 grams of Protein a day. I don’t think it’s necessary to be super restrictive with carbs, but more importantly, to get them from healthy sources. It’s a good time now to establish those healthy carb patterns where you learn to eat small portions of good carbs like oatmeal, sweet potatoes, winter squash, and whole grain Cereal and other grains, so you don’t eventually cave in and depend on big portions of bad carbs like refined sugars and grains. I think a cup of food at a time is fine if that doesn’t make you overly full and you feel good about it. Congrats again on your success!

@@sammielouwho, Congratulations! I’d say the first few days to two weeks tend to be worst with respect to pain. \ They’re usually better when you can get plenty of fluids in you and hit your Protein goals starting as soon as you can after surgery. The next hurdle is the stall that often comes at 3 weeks or so. It’s really discouraging to go through the pre-op diet and the surgery and the post-op liquid diet, only see the scale NOT MOVE! It feels really unfair and makes you want to quit…but know that it happens to SO many patients. Congratulations on joining the WLS club. Keep us updated on how everything goes!

@Imwilla, Some surgeons require a nutritionist and supervised diet, others don’t. Some health insurance plans require it, some don’t. It’s not a red flag or anything if you don’t have that as a requirement for reimbursement. You can always ask for a longer term pre-op plan as a substitute for a supervised diet if you want to test yourself and make sure you’ll do okay post-op. Good luck!

@@lemonpoppyseed2013, Good for you for wanting to get back on track! I don’t think weight loss shakes are necessary to get you losing weight again. What will get you losing weight again is hitting your calories, hitting your Protein, and cutting out the bad habits like grazing. If you feel like a liquid diet will get your mind back on track and help you get back to good habits, then it’s a good idea. Otherwise, healthy foods will do the trick, too. About vitamins: they’re not for weight loss per se. Taking them or not taking them probably won’t show up on the scale, except for maybe very indirectly like if you’re Iron deficient and have anemia and are too tired to exercise so you gain weight. But for general health, you really should take them. Some deficiencies will show up sooner, others will show up later, and some can be long-term or permanent. So take them! Good luck with it!

@@josiek1988, Thank you, thank you, thank you! Most of us have no idea how insurance companies operate. All we know is that we get letters of denial, and get placed on hold when we try to call. Thank you for this piece of advice. I am sure it will literally help hundreds of grateful patients. Some of the others also posted good advice – ask your surgeon’s office to contact them for you, both to get better results and to avoid confusion.

@@Ashoryb, I am sorry. It is such a disappointment. Let us know when you get that letter with their explanation. It’s probably something that will be infuriating, like they didn’t bother looking into it! I am so glad your surgeon is on your side and will take it to the next level. I bet they know how to get through to someone at Cigna with decision making powers, and I bet Cigna will listen to them. I am so sorry. You are not at all a drama queen. You are asking for something life-changing, you did exactly what they said to do, and all you got was a slap in the face with no explanation. Keep on it, if you can face it. Let us know how it goes.

@@sgc, Good for you for asking these questions. The sleeve can help you feel full and keep you from being starving right after your meal. It can also help prevent you from eating at that 30-minute post-meal mark because by that time, you’ll probably start drinking fluids, and you can’t drink fluids while you eat solid foods. The thing that you need to think about if you haven’t already is the difference between hunger and satisfaction. You mostly talk about hunger in your post, but then end by saying you’re not satisfied. It’s possible (likely) that the sleeve will reduce hunger because you’ll have lower levels of hunger hormones and your sleeve will be smaller (and fuller). It’s also possible (maybe even likely) that you won’t be satisfied – that you’ll still want to eat, even if you don’t need it. Maybe you’ve heard people here talking about head hunger. That’s just wanting to eat, but not being physiologically hungry. So, I don’t know if you’ll be able to eat a protein bar and feel satisfied. The others here have some good points. Slider foods can get past the sleeve and interfere with weight loss. Like they pointed out, a protein bar may not be part of your post-op life. Maybe you could even experiment by eating more veggies now and seeing if you’re still hunger and going back for more when your only option is a veggie, not a sweetened protein bar. It sounds like you’re set on surgery, so good luck! Keep posting about which one you choose and how the journey goes for you!

@@rydersmama, Good question, especially when we’re always being told to only weigh once a week and not to obsess over the scale! As others have said, one reason I like to weigh every day is to keep on track. I want to know if the scale creeps up. I won’t panic if it’s up one day, but need to get on it if it stays up for a while. If I weigh every day, I’ll know if it’s staying up or if it’s just a one day spike. If I weighed only once a week or once every two weeks, I wouldn’t know if that high weigh-in was true or just a temporary spike. I also like weighing every day because it keeps me on track. I guess it’s like food logging – the idea is that if you know you’re going to have to write it down (or face the scale), maybe you’ll behave a little better. I try not to worry about each day’s weigh-in. I just use it for information. There are so many reasons to weigh every day…and probably just as many reasons NOT to weigh every day! It’s up to you. You need to find what works best for you

Interesting…quite a wide spread! As I’d thought, a lot of you lost a lot of weight before anyone noticed, but a few of you see to have gotten comments pretty quickly. I guess it has to do with the way we carry our weight…or maybe how observant our friends and family are! The nice thing is that notice and compliment or not, it’s our weight to keep off!

For many weight loss surgery patients, it takes a while after surgery before people notice something’s up. If they don’t know about your WLS, they may not realize you had it or that you’re trying to lose weight until you’ve lost such a big chunk that they can’t help but notice how good you look. One reason not to tell a lot of people is that a lot of us are secretly or not-so-secretly afraid right at the beginning of the WLS journey – what if it doesn’t work for us? For some, we just don’t want to share our personal details with outsiders who may not understand why we made our WLS decision and what we’re going through to lose weight and get healthy. For whatever reason, people may not realize you’ve lost weight until you’ve lost a lot. It may be a couple of months after surgery before anyone notices. It can even get a little discouraging for a while if you think nobody’s ever going to notice your hard work. But then it happens. One day, someone asks you if you’ve lost weight…and after that, you may get asked all the time. It sure feels good…at least, to some of us. Others are shy and don’t like any comments, even the most innocent, on how we look and act. When was the first time someone noticed that you lost a lot of weight? How did it make you feel?

Thanks for all the answers! It is interesting what a range there is in terms of number of times you saw your surgeon pre-op as well as other healthcare providers that were involved. It’s also interesting to see that there isn’t a single right answer in terms of whether seeing a surgeon versus a nurse practitioner or another expert is best. I hope these answers help pre-op patients who are still looking for a surgeon and trying to decide which program is best for them. These answers can also help you think about what to ask for now and for the future that you might not have thought about yet.

That functionality hasn't been added to the mobile apps, yet. Your best bet is to update your profile on your phone or computers browser. It appears that we have lost the ability to search all of the forums on the app like we used to be able to do. Now, I have to go to each individual forum to search. That is ok if I know what forum to look in or if a topic or thread is in the right forum, but not so much otherwise. Any chance you will add back a full site search? I wasn't even aware of this issue! Going to see what we can do to resolve it, thanks!

That functionality hasn't been added to the mobile apps, yet. Your best bet is to update your profile on your phone or computers browser.

At BariatricPal Team MX, we are committed that our patients receive the most comprehensive and complete care for Pre-op and Post-Op follow-Up care. Bariatricpal Team MX is about trust and confidence and working with medical facilities and surgical teams that offer the best and safest care and service. All of our Bariatric surgeon partners have to follow BariatricPal's strict patient care and follow-up guidelines. We have these guidelines in place to ensure your safe and professional medical care. It is our guarantee that you will receive personal care from your surgeon as well as all medical protocols required to assure your weight loss surgery and recovery before you return to the US or Canada. How medical emergencies are handled is a crucial part of our commitment to our patients and members. Upon reinspection of Dr. Carlos Altamirano Cano medical protocols and Guadalajara Hospital facilities, we are not able to continue our relationship with Dr. Carlos Altamirano Cano or Guadalajara Hospital.