Alex Brecher

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 .

The BariatricPal Store carries a huge selection of Bariatric-friendly Protein drinks at https://store.bariatricpal.com/collections/protein-powders. Here are some popular options: BariatricPal Protein ONE: MultiVitamin, Calcium, Iron, Fiber & Meal Replacement from https://store.bariatricpal.com/collections/protein-powders/brand_bariatricpal Syntrax Nectar Protein Powder Sampler Variety Bag - All 17 Flavors! from https://store.bariatricpal.com/collections/protein-powders/products/syntrax-nectar-protein-powder-sampler-variety-bag-all-17-flavors GENEPRO Medical Grade Unflavored Protein Powder - 3rd Generation! from https://store.bariatricpal.com/collections/genepro/products/genepro-medical-grade-unflavored-protein-powder-3rd-generation Bariatric Advantage HPMR High Protein Meal Replacement - Available in 8 Flavors! from https://store.bariatricpal.com/collections/protein-powders/products/bariatric-advantage-high-protein-meal-replacement Protein tubs from https://store.bariatricpal.com/collections/protein-powder-tubs Protein Smoothies from https://store.bariatricpal.com/collections/smoothies Hot Protein Drinks & Soups are great alternatives to protein shakes: Hot Protein Drinks: https://store.bariatricpal.com/collections/hot-protein-drinks Hot Protein Soups: https://store.bariatricpal.com/collections/soups-bouillons-broths

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.

If you have an emergency, the hospital MUST treat you. Dr. Illan removed my lap band and converted me to an MGB a few years ago. I had a leak after two days, lost tons of blood, and required multiple transfusions. Dr. Illan then converted me to a complete gastric bypass in Mexico. A little over 3 years ago, I had a lower bowel blockage related to Dr. Illan's surgeries. I was rushed to a local hospital in Long Island, NY. A bariatric surgeon performed a gastric bypass reversal. It took over 6 hours in the OR. They treated me even though they knew I had my surgeries performed in Mexico. Regardless, you should do lots of research and select an excellent and reputable surgeon. Good luck!

He’s a good surgeon. Many PCPs are open to their patients having surgery across the border these days. Have you discussed your decision with them?

Oasis is a great hospital. You just need to make sure the surgeon you use is also great. They’ve worked with some not great surgeons over the years so be careful who you use.

I do not recommend using Hospital BC. Dr. Jalil Illan Fraijo is the surgeon currently running the hospital, and he, along with surgical coordinators Bill Yanez and Stacy Eckel, embezzled a lot of my money. You have many great options in Mexico. Don’t use a dishonest surgeon like Dr. Jalil Illan Fraijo.

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

I just received multiple reports from patients who sent deposits or paid in full for surgeries in Tijuana to patient coordinators named Bill Yanez and Stacy Eckel. They're currently working as coordinators for Dr. Ramos Kelly and other bariatric surgeons in Tijuana. The patients have all lost their deposits or the amount they paid for their surgeries. Bill Yanez and Stacy Eckel have pocketed these funds, have not given them to the surgeons, and are refusing to refund the patients. This is not the first time Bill Yanez and Stacy Eckel have embezzled money. They stole hundreds of thousands from me while working as coordinators at BariatricPal Hospital/BC Hospital. If these two thieves have fleeced you, please report them to your local authorities and the FBI. This will catch up to them one day...

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

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 has just added over 400 bariatric-friendly brands to its store! Check them out at https://Store.BariatricPal.com or click on the STORE button at the top of this page. So many new brands.mp4

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 Protein drinks at https://store.bariatricpal.com/collections/protein-powders. Here are some popular options: BariatricPal Protein ONE: MultiVitamin, Calcium, Iron, Fiber & Meal Replacement from https://store.bariatricpal.com/collections/protein-powders/brand_bariatricpal Syntrax Nectar Protein Powder Sampler Variety Bag - All 17 Flavors! from https://store.bariatricpal.com/collections/protein-powders/products/syntrax-nectar-protein-powder-sampler-variety-bag-all-17-flavors GENEPRO Medical Grade Unflavored Protein Powder - 3rd Generation! from https://store.bariatricpal.com/collections/genepro/products/genepro-medical-grade-unflavored-protein-powder-3rd-generation Bariatric Advantage HPMR High Protein Meal Replacement - Available in 8 Flavors! from https://store.bariatricpal.com/collections/protein-powders/products/bariatric-advantage-high-protein-meal-replacement Protein tubs from https://store.bariatricpal.com/collections/protein-powder-tubs Protein Smoothies from https://store.bariatricpal.com/collections/smoothies Hot Protein Drinks & Soups are great alternatives to protein shakes: Hot Protein Drinks: https://store.bariatricpal.com/collections/hot-protein-drinks Hot Protein Soups: https://store.bariatricpal.com/collections/soups-bouillons-broths

The BariatricPal Store carries the Premium Abdominal Binder for Bariatric and Plastic Surgery by DeRoyal at https://store.bariatricpal.com/products/premium-abdominal-binder-for-bariatric-and-plastic-surgery-by-deroyal. I didn't use one after either of my weight loss surgeries. Still, patients tell me that it makes a HUGE difference.

I use BariatricPal Multivitamin ONE “1 per Day!” flavorless capsules from https://store.bariatricpal.com/collections/bariatricpal-multivitamin-one! BariatricPal has a special offer that will cost you only $99 for an entire year's supply! Check it out at https://store.bariatricpal.com/99 You can view a large selection of bariatric-friendly Calcium supplements at https://store.bariatricpal.com/collections/calcium.

I've had reactive hypoglycemia for the last 4-5 years. Definitely talk to an endocrinologist. I got a prescription for the Libre 2 wearable device that allows me to monitor my sugar levels in real-time. The Libre will notify you when your blood sugar is dropping or spiking. You'll learn which foods trigger low blood sugar soon enough. For me, it's sushi and alcohol or any high-carb food.

Collagen protein is great for you but is not counted towards the daily amount of protein you're required. Clean Whey by BariatricPal is a whey protein isolate, which is optimal for bariatric patients https://store.bariatricpal.com/collections/bariatricpal-clean-whey-protein . Protein ONE by BariatricPal has vitamins in them https://store.bariatricpal.com/collections/bariatricpal-protein-one-multivitamin-calcium-iron-fiber-meal-replacement .

I'm familiar with all available flavors and brands and there aren't any pure vanilla calcium citrate chews available on the market at the moment. As you said, there's French Vanilla Caramel but these taste very Caramel and not so much Vanilla.

You clicked on the unsubscribe link for all BariatricPal.com emails a while back. I corrected that and had your reset email resent.