Alex Brecher

Hello All-
i posted for the first time just about three years ago with some anxieties as a spouse with my wife prepping to undergo the gastric sleeve. I originally noted being concerned about our lifestyle changes, relationship impacts (I had heard all the horror stories) and most of all health concerns into the future.
The community was incredibly supportive and I had learned tips and useful knowledge that helped me coach and support my wife through it. I am happy to say we are better than we ever have been and her self confidence is through the roof. However the MAIN reason the surgery ever was even considered was to get her diabetes that started while she was pregnant with our first child and got very concerning bad with our fourth has still stuck around and caused issues…..
First- this is Life changing not just for the partner getting the surgery, but the spouse too. We used to be foodies and that all had to go out the door. Same with alcohol. Two bites and you are full, a pint and you are drunk. So activities, dates, etc. and new hobbies should all be prepared for well in advance. Luckily we are both athletes and coaches and this allowed to have an outlet that wasn’t our prior foodies and beer/ brewery culture pastime.
Two- Relationship, anyone who tells you that this leads to automatic divorce/ break up is paranoid or lying. Out of her support group offered by our health network, I think only 1 or 2 of about fifteen women ended up separating and that was from the other spouse cheating. I have to say that in many ways, after four kids and all our activities, youth sports and coaching- it created a second honeymoon period for us and really strengthened our romance and relationship because we both focused on our health again jointly and the magnetism increased dramatically.
Third- It might not fix the problem…. We did not jointly go into the surgery for cosmetic or weight loss reasons. It was the diabetes and the doctors said it was a solid shot to cure or mitigate the disease. It was for a while, but it keeps back up. despite healthy eating, despite exercise and coaching, despite the surgery- medications came back into the picture and so did the celebrity weight loss drug (which is really supposed to be for diabetes…) This has been keeping everything under control but is a case of the cure being as bad as the sickness. The side effects are brutal and definitely have a quality of life impact, but we both want to live to see grandkids someday…..
Fourth- dysmorphia is VERY really. We are both naturally larger people. I was a lineman in high school and college and she was a softball catcher in high school and college and ended up also playing women’s rugby there as well. Even with the surgery she went from an XL to L but she got her college/ high school figure back and as such her confidence went through the roof and started dressing like she hadn’t in years. With the medication though??? Her figure, face shape, everything changed. Down to a Small or Medium. For almost a year and a half she hasn’t recognized herself in the mirror. It’s a double wham with the surgery and the medication.
Between her best friends and myself (we have all been in the same friend/ team group since college) the support was to have fun with it and go with the flow. Instead of worrying about it (the dysmorphia) it was embrace the change. All new clothes she could never wear before, she’s been a redhead now and then blonde and still is. Cut her hair shorter, started wearing makeup (never really did)- all just to try and put a positive spin on it. I’ve been the spoiled recipient of having a brand new girl (don’t think I haven’t romanced and spoiled the you-know-what out of her), but at the end of the day it’s been mitigation of all the life changes.
The last part has been the most detailed because it’s the most recent and to me has been the most impactful- NOT having the surgery do its intended purpose and the dysmorphia we’re both very difficult given the efforts and life changes made. We’ve done everything we can to make lemonade out of those lemons though. We had an anniversary vacation better than our honeymoon this past summer (she has always been way out of my league and these days it’s very much over the top- I feel incredibly spoiled) and we have made time to ride our bikes together with our oldest babysitting the kids and we come to each others games when we coach.
I would tell any spouse; husband or wife of someone who is going to have the surgery and then or also do all the meds:
1. Support. It’s a huge deal and you need to show up.
2. Don’t get insecure about your relationship because of the surgery. If you are worried it means you might not have a great relationship to start with….
3. You will need to change your life too. Because of my size and my weight lifting, I need a lot of Protein and calories. I will never look like a Hollywood star (like she now does) and always an NFL lineman- BUT- if I bring a cannoli, pie or a full growler into the house in addition to steak/ salmon, etc it’s teasing and not fair. You will need to learn self control to support your spouse…
4. Inspire and come up with ideas for positive re-enforcement. If the dysmorphia or depression sets in, you need to find fun things to do, supportive steps to take and positive angles to keep things going.
5. If you are doing all this as a spouse, what about YOU??? Are you going to die a martyr? Take care of YOURSELF too. I go lifting 3 times a week, go fishing in season. And for my 40th birthday when she asked what I wanted?? I got us a long weekend on the Cape, bought her some dresses I wanted to see her in and sent her to get her hair, nails, toes, eyelashes, etc.. done. Said I wanted a long weekend with my movie star wife. It was a great time, kid free and continued to strengthen our marriage.
Anyways- why am I writing this? Posterity? Self reflection? Not really…. I just want to give Spouses a roadmap. It’s a huge change and you need to navigate the waters well. If you do you will benefit as much as your loved one.
Good luck.

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Absolutely, the FDA's approval of Eli Lilly's Zepbound™ (tirzepatide) is a game-changer in weight management! It's the first medication that works on both GIP and GLP-1 receptors, making it a novel addition to obesity treatments.
Clinical trials have been impressive, with participants losing an average of 22.5% of their body weight. For many, this could be a transformative non-surgical alternative that might reduce or even eliminate the need for bariatric surgery.
That said, it's important to consider the potential side effects, which can be quite serious, as well as its high cost—although Eli Lilly is working to increase accessibility.
As this medication rolls out, it could redefine treatment plans, offering a new, potent tool for weight loss both before and after bariatric surgery. It's an exciting time for both patients and healthcare providers in the field of weight management!

Additionally with the anticipated revenue in mind, this can catapult further research and innovation. Hopefully insulin resistance, metabolic syndrome, obesity and their related comorbidities can be cured in our lifetime.

Absolutely, the FDA's approval of Eli Lilly's Zepbound™ (tirzepatide) is a game-changer in weight management! It's the first medication that works on both GIP and GLP-1 receptors, making it a novel addition to obesity treatments.
Clinical trials have been impressive, with participants losing an average of 22.5% of their body weight. For many, this could be a transformative non-surgical alternative that might reduce or even eliminate the need for bariatric surgery.
That said, it's important to consider the potential side effects, which can be quite serious, as well as its high cost—although Eli Lilly is working to increase accessibility.
As this medication rolls out, it could redefine treatment plans, offering a new, potent tool for weight loss both before and after bariatric surgery. It's an exciting time for both patients and healthcare providers in the field of weight management!

Eli Lilly’s Zepbound (Tirzepetide) has been approved by the FDA
https://www.fda.gov/news-events/press-announcements/fda-approves-new-medication-chronic-weight-management

It can be challenging to stick to a liquid diet, especially when you are surrounded by tempting food aromas. You are doing great by trying to drink more Water to help combat your cravings. You can also try distracting yourself with activities you enjoy, such as reading, exercise, or spending time with friends and family.
Regarding bowel movements, a liquid diet can lead to changes in bowel habits, including softer and more frequent stools. This is because the liquid diet does not provide the same bulk and Fiber as a regular diet. It is important to stay hydrated and speak with your doctor if you have any concerns.

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I understand that you are feeling overwhelmed and regretful after your weight loss surgery. It sounds like you went through a difficult and confusing time both before and after the surgery, and it's understandable that you are feeling frustrated and sad about the experience.
You mentioned several points in your message, and I'd like to address each one:
Pre-surgery preparation: It sounds like you did not feel fully prepared for the surgery, both in terms of understanding the prerequisites and the potential physical and emotional effects of the surgery. This can be a common experience for people who undergo bariatric surgery, as the process can be complex and confusing. Hospital experience: The experience you had in the hospital sounds particularly challenging, with language barriers, physical discomfort, and a lack of support from the medical staff. This can be difficult to manage and can impact one's recovery and overall feelings about the surgery. Eating habits and diet: The changes in your eating habits and diet can be a significant adjustment, especially when combined with the physical side effects of the surgery. It's understandable that you are feeling frustrated with having to eat smaller portions and chew food thoroughly, as well as the headaches and nausea that come with eating. Mental and emotional impact: Your mention of having a history of eating disorders is important, as bariatric surgery can bring up old thoughts and feelings related to self-harm and negative self-talk. It's important to have a support system in place and to reach out for help if you need it. Overall, it's clear that you are going through a difficult time and that your experience with bariatric surgery has not been what you expected or hoped for. I would encourage you to reach out to your bariatric surgeon or a mental health professional for support and guidance. They can help you understand the physical and emotional changes you are experiencing and provide you with tools to manage them.

It's understandable that you have concerns about the possibility of gaining weight after having another child, especially after working hard to lose weight and reach your goal. However, it's important to remember that every person's experience is different and it's hard to predict how your body will respond during and after pregnancy.
It's essential to have open and honest communication with your doctor and/or bariatric team before getting pregnant, they can help you establish a plan to ensure that you are getting all the necessary nutrients during your pregnancy and to help you set realistic expectations. They can also provide you with guidance on how to maintain your weight after giving birth.
It's also important to remember that weight loss is a journey and it's not uncommon to experience some weight fluctuations. Even if you gain some weight during pregnancy, it's possible to lose it again with a healthy diet and exercise after giving birth.
Keep in mind that your weight loss journey does not end after surgery, it's a lifestyle change that requires maintenance, and it's important to be prepared for that.

The holidays are upon us. If you are a weight loss surgery patient or someone who’s working on losing weight, knowing that it’s that time of year can fill you with dread. Let’s face it: it does not seem like much fun to pass up your favorite foods while watching what seems like everyone else eat them, or drag yourself to the gym while the rest of the world is dreaming in their nice cozy beds, or go to doctor’s appointments when you think everyone else is on a care-free vacation from work.


How you may wonder, can you make this the most wonderful time of the year if you cannot Celebrate it with the same food, drink, and abandon that you may have before your WLS journey started? Keep your chin up! We’re not promising that these holidays will be the same as ever, but you can make them great. They may even be better! Here are our thoughts on loving the holidays while staying healthy.
We’re Not in Kansas Anymore!
As with the rest of your life, the success of the holidays can no longer best be measured by how much you ate. There is so much more to it than that! Now, pleasure from food contributes to “success,” but so do so many other things, including the activities you do, the quality of your time with loved ones, and the pride you have in yourself. Give up your former conceptions of what holiday happiness is, and you will have a lot to gain (but not weight).
Just Say, “No!” – But How?
There is no denying that a good deal of the holiday cheer – and the holiday struggle – revolves around food. Eat it with abandon, and you will set yourself back months. You are almost sure to be offered more than you should eat and foods that are not on your diet, so you will need to learn to say no. Be prepared with different ways to say, “No,” without hurting anyone’s feelings, and practice the before-hand so you are not caught off guard.
“No, thanks.” “No, thanks. I’m not hungry.” (If you’re in the middle of lunch so you cannot claim that you are not hungry:) “No, thanks. It’s not in my diet.” “I would love to, but my doctor said I cannot have that!” “Thank you! How kind! I will save it for later.” Later, give it to someone who will love it. Be Confident.
Be polite but firm when refusing food or insisting on getting in your afternoon walk. You may be surprised at how easily people accept your decisions. They may even make them easier once they see you are serious by, for example, offering to bring you a diet-friendly version of a treat or asking to come on your walk. If you waver initially, though, they may not take you seriously, and instead, keep prodding you to abandon your good intentions.
Be Proud of Yourself.
A barrier to success that is present year-round, but more intense during the holiday season, is the natural desire to help others – and this can come with a feeling of guilt if making your health a priority makes you worry that you are not giving your best to your family. Remember that you can give your best only when you are at your best, and to be at your best, you need to be healthy. You will have more energy, think more clearly, and even be happier when you are taking steps towards health, and all that will enable you to give more to others.
You Are Not Alone
The grass may seem greener on the other side of the fence, but is it really? It probably is not, even though you may feel that your holiday season is hard while others have it easy. The truth is that millions of others are facing the same challenges as you. Even people who appear not to have weight problems are sure to have major concerns in their lives. They may be fighting just as hard as you to avoid eating the whole pie, or they may have non-food challenges. You do not know, but what you can safely assume is that everyone has challenges. You will feel better about yourself if you always treat others with respect and not with jealousy.
Rather than feeling sorry for yourself, you might as well embrace the holidays for what they are worth: an opportunity to overcome hurdles and strengthen yourself; a magical time of year when people come together; and a chance to experience new feelings and participate in new activities that may not have been possible before you got serious about your health.

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I'm so sorry you had to go through such a harrowing experience with your sister. Experiences like these can shape our decisions, and I can understand your concerns.
I personally lived with the lap band for 15 years. Over the years, it slipped twice, eventually eroded, and had to be removed. While it did help me maintain my weight, it was uncomfortable and caused other health issues, and in hindsight, it's not something I would recommend given my experience.
That being said, it's clear you're considering the lap band due to your specific circumstances and past experiences. If you're set on going forward with the band, you might want to wait a little longer for a new option on the horizon. ReShape has recently submitted a Premarket Approval (PMA) to the FDA for a next-generation lap band, known as Lap Band 2.0. I saw it firsthand at ASMBS in Las Vegas recently, and it addresses some of the issues associated with the original band.
Wishing you all the best in your journey.

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...

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

I'm so sorry you had to go through such a harrowing experience with your sister. Experiences like these can shape our decisions, and I can understand your concerns.
I personally lived with the lap band for 15 years. Over the years, it slipped twice, eventually eroded, and had to be removed. While it did help me maintain my weight, it was uncomfortable and caused other health issues, and in hindsight, it's not something I would recommend given my experience.
That being said, it's clear you're considering the lap band due to your specific circumstances and past experiences. If you're set on going forward with the band, you might want to wait a little longer for a new option on the horizon. ReShape has recently submitted a Premarket Approval (PMA) to the FDA for a next-generation lap band, known as Lap Band 2.0. I saw it firsthand at ASMBS in Las Vegas recently, and it addresses some of the issues associated with the original band.
Wishing you all the best in your journey.

I have recently received alarming reports from patients who have sent deposits or paid in full for surgeries in Tijuana to a patient coordinator named Bill Yanez. He is now working once again as a coordinator for Dr. Jalil Illan in Tijuana.
Please exercise extreme caution when dealing with Dr. Jalil Illan at BC Hospital and coordinators Bill Yanez. They have a history of financial misconduct, having embezzled significant sums of money from me during their tenure as coordinators at BariatricPal Hospital/BC Hospital. Furthermore, I have personally experienced severe surgical complications under the care of Dr. Illan, who botched my surgery not once but twice.
There are many reputable and trustworthy options for bariatric surgery in Mexico. Please do not risk your health and finances by entrusting them to a surgeon and coordinators with a track record of dishonesty and malpractice.
If these individuals have victimized you, I urge you to report them to your local authorities and the FBI. Their actions are unethical and illegal, and they will face the consequences of their actions in due course.
Stay safe, everyone. Let's look out for each other and ensure we all have access to safe, reliable, and ethical medical care.

I have recently received alarming reports from patients who have sent deposits or paid in full for surgeries in Tijuana to a patient coordinator named Bill Yanez. He is now working once again as a coordinator for Dr. Jalil Illan in Tijuana.
Please exercise extreme caution when dealing with Dr. Jalil Illan at BC Hospital and coordinators Bill Yanez. They have a history of financial misconduct, having embezzled significant sums of money from me during their tenure as coordinators at BariatricPal Hospital/BC Hospital. Furthermore, I have personally experienced severe surgical complications under the care of Dr. Illan, who botched my surgery not once but twice.
There are many reputable and trustworthy options for bariatric surgery in Mexico. Please do not risk your health and finances by entrusting them to a surgeon and coordinators with a track record of dishonesty and malpractice.
If these individuals have victimized you, I urge you to report them to your local authorities and the FBI. Their actions are unethical and illegal, and they will face the consequences of their actions in due course.
Stay safe, everyone. Let's look out for each other and ensure we all have access to safe, reliable, and ethical medical care.

I have recently received alarming reports from patients who have sent deposits or paid in full for surgeries in Tijuana to a patient coordinator named Bill Yanez. He is now working once again as a coordinator for Dr. Jalil Illan in Tijuana.
Please exercise extreme caution when dealing with Dr. Jalil Illan at BC Hospital and coordinators Bill Yanez. They have a history of financial misconduct, having embezzled significant sums of money from me during their tenure as coordinators at BariatricPal Hospital/BC Hospital. Furthermore, I have personally experienced severe surgical complications under the care of Dr. Illan, who botched my surgery not once but twice.
There are many reputable and trustworthy options for bariatric surgery in Mexico. Please do not risk your health and finances by entrusting them to a surgeon and coordinators with a track record of dishonesty and malpractice.
If these individuals have victimized you, I urge you to report them to your local authorities and the FBI. Their actions are unethical and illegal, and they will face the consequences of their actions in due course.
Stay safe, everyone. Let's look out for each other and ensure we all have access to safe, reliable, and ethical medical care.

I have recently received alarming reports from patients who have sent deposits or paid in full for surgeries in Tijuana to a patient coordinator named Bill Yanez. He is now working once again as a coordinator for Dr. Jalil Illan in Tijuana.
Please exercise extreme caution when dealing with Dr. Jalil Illan at BC Hospital and coordinators Bill Yanez. They have a history of financial misconduct, having embezzled significant sums of money from me during their tenure as coordinators at BariatricPal Hospital/BC Hospital. Furthermore, I have personally experienced severe surgical complications under the care of Dr. Illan, who botched my surgery not once but twice.
There are many reputable and trustworthy options for bariatric surgery in Mexico. Please do not risk your health and finances by entrusting them to a surgeon and coordinators with a track record of dishonesty and malpractice.
If these individuals have victimized you, I urge you to report them to your local authorities and the FBI. Their actions are unethical and illegal, and they will face the consequences of their actions in due course.
Stay safe, everyone. Let's look out for each other and ensure we all have access to safe, reliable, and ethical medical care.

I continue to have ulcers and take medication daily to keep the pain down.
Dr. Jalil remove ulcerative tissue but there is something fundamentally wrong with the ulcers returning

I have recently received alarming reports from patients who have sent deposits or paid in full for surgeries in Tijuana to a patient coordinator named Bill Yanez. He is now working once again as a coordinator for Dr. Jalil Illan in Tijuana.
Please exercise extreme caution when dealing with Dr. Jalil Illan at BC Hospital and coordinators Bill Yanez. They have a history of financial misconduct, having embezzled significant sums of money from me during their tenure as coordinators at BariatricPal Hospital/BC Hospital. Furthermore, I have personally experienced severe surgical complications under the care of Dr. Illan, who botched my surgery not once but twice.
There are many reputable and trustworthy options for bariatric surgery in Mexico. Please do not risk your health and finances by entrusting them to a surgeon and coordinators with a track record of dishonesty and malpractice.
If these individuals have victimized you, I urge you to report them to your local authorities and the FBI. Their actions are unethical and illegal, and they will face the consequences of their actions in due course.
Stay safe, everyone. Let's look out for each other and ensure we all have access to safe, reliable, and ethical medical care.

Behind paywall, here is verbiage:
Ozempic is under review by European drug-safety regulators after they received reports of suicidal thoughts linked to the popular weight-loss drug and another medicine in the class.
The European Medicines Agency said Monday it is evaluating the safety risk for patients who take the drugs, manufactured by Novo Nordisk, after learning that three people who took the medicines reported thoughts of self harm or suicide.
Suicidal behavior isn’t listed as a side effect for Ozempic—and a related drug called Saxenda that is also subject to the review—in the European Union, the EMA said.
Novo Nordisk said the company’s studies of Ozempic and Saxenda, as well as its continuing monitoring of their use, haven’t shown a link to suicidal thinking or thoughts of self harm.
“Novo Nordisk remains confident in the benefit risk profile of the products and remains committed to ensuring patient safety,” a Novo Nordisk spokeswoman said.
Depositary shares in Denmark-based Novo Nordisk were flat in trading on the New York Stock Exchange midday Monday.

Ozempic, Saxenda and other drugs targeting a gut and brain hormone called glucagon-like peptide-1, or GLP-1, have exploded in popularity after studies found they can help people lose significant weight.
Companies initially developed the class to treat people with diabetes. Ozempic, which is approved for diabetes treatment, has a sister drug named Wegovy that is cleared for chronic weight management in people who are obese.
The U.S. food and Drug Administration said it doesn’t comment on external research or individual reports, but may evaluate them. It said clinical trials for Wegovy didn’t support an increased risk of suicidal thoughts or behavior.
Prescribing information for Wegovy, however, includes a warning and precaution for these risks because it has been reported in clinical trials for other weight-management drugs, the FDA said.
The EMA said it would consider whether to expand its inquiry to other GLP-1 drugs.
The agency said it began its review after the Icelandic Medicines Agency reported suicidal thoughts by one user of Ozempic and similar thoughts by a user of an older drug in the class called Saxenda.
A third case reported by the Icelandic agency involved thoughts of self-injury by a user of Saxenda.
Write to Melanie Evans at melanie.evans@wsj.com

Most medications that regulate the appetite can have an effect on the brain and mood; when you take away someone's coping mechanism/dopamine source (a lot of overweight/obese people self-medicate depression and other demons with food), it makes those feelings you were stuffing down come roaring back to the forefront.
If anything this is a cautionary warning that those who use it who struggle with their mental health should probably be under the care of a professional therapist or psychologist during their treatment with this medication.

The BariatricPal Store carries a huge selection of Bariatric friendly Protein Soups and Broths at https://store.bariatricpal.com/collections/soups-bouillons-broths.