biginjapan

@tiffany44641
I have been a low carber, Keto person off and on for about 16 years.
I would lose weight but plateau and I didn't understand stalls so I would quit. I also had a Portion Control issue. People in the keto community feel like you can eat without portion control as long as it is high fat.
Being sleeved helped me control my portions. In the beginning when I was healing I just followed a normal low carb diet.
Around 6 months when I was healed, I switched to keto. Personally I feel like if I didn't switch to Keto I would not have lost this much weight. I would have topped out at about 100 pounds lost and bounced around like most WLS people.
Just as importantly eating keto has allowed me to maintain my looks. I have lost 182 pounds and I look very young and healthy. I do not look sickly. My face looks amazing. Keto is great for women because the fat is great for your skin. If you look in keto groups the women that keto almost glow.
I am a strong advocate for Keto. If you can portion control you can lose a lot of weight on keto. If you can't portion control wls is a great option to help you with that. The sleeve has helped me with portion control and made making the right food choices easy.

Most people that long term Keto are calories aware, even if they aren't strict even with non restrictive stomach. Long term successful people fast also, which I do. A high fat diet makes it easy to fast (the original purpose of bulletproof coffee, to extend a fast). Fasting has its own benefits and I'm not even going to go too far into that
First it is really important to know your body composition you can calculate your macros correctly. Most people that really Keto track (I notice anyone that is successful at any kind of way of eating or diet tracks). I use a Keto calculator and peg my Protein to my lean mass 1g per 1 pound.
This one is good
https://ketogains.com/ketogains-calculator/
The math on that one is supposed to be better but I use this one because I like it better because of the loss projection chart.
https://keto-calculator.ankerl.com/
As a sleever if you are meeting your protein goals, it is going to be almost impossible to get your calories too high just because of the low calorie count of protein, the density of protein and restriction. If I didn't use heavy cream in my coffee, I would never hit my fat goals. 120 grams of protein a day doesn't leave much room for anything else.

Nope.
Although Atkins was close to Keto. The original Atkins diet by Dr Atkins, the diet has been really bastardized since his death. All those trash products they sell in the store are pretty against his teaching.
Keto has a lot of science and studies to back it up.
I feel like if people can't process or understand the science of running the body on fat they shouldn't even bother. I see so many people making bad choices on Facebook etc and they don't understand the science. If you understand the science it is so easy to make the right choices.

@Sherrie Scharbrough
This book
http://www.4yourtype.com/eat-right-for-your-type-book/
Helped me a lot. I don't eat the way I should for my blood type because the meats suggested are expensive and boring. The one thing I did take away from that book was my body does not react the same way to exercise as other people. It triggers stress in me and I don't lose weight. This book along with Dr. Matthew Weiner changed how I thought about exercise and I get amazing results with very low stress exercise like yoga and walking.
There are so many components to weight loss and how our bodies work. Just like having WLS success is partially based on genetic disposition.

I went for my 6 week post op visit today. I have lost 14 pounds and was told that I am right on target. In fact, I'm ahead of target! The expectation is 2 pounds/week. The problem is that we think we should be losing quicker when we read about others. My NP said that a lot of people include the pre-op weight loss numbers in their total to-date number so it appears that they are losing more. Ten pounds a month!!!

I would imagine that the more you have to lose, the greater your loss will be on a monthly basis. I started with only 70-80 lbs to lose, so it will go much slower than someone that has 100+ lbs to lose. Keep it in perspective and know the numbers of the calories in vs calories out don't lie.

Everyone is different - just because others had no energy, doesn't mean you will too (and vice versa). You have no idea how you feel until you are post-op. I had a ton of energy - I ended up walking over 15,000 steps after they dropped me off at my hotel on day 3 (I didn't fly home right away). The next day I did over 20,000. At the same time, the other solo woman in my group who got dropped off at the airport on the same day was in terrible shape - and she had been the entire time post-op. We all had to help her at the hospital, in the van, and even at the airport (where she finally got a wheelchair). Maybe it's something you (or a friend/family member) can arrange quickly if you don't feel you can get around by yourself. Also, take a look at airport maps and see if you can find out how long it is to the gate/transfers, etc. As I recall, Seattle is a pretty big airport, but maybe your connections will be close together. That said, walk, walk, walk. If you have the energy, don't sit down until you get on the plane (that's what I did). The aisle seat is good, it makes it easier to get up every 30 minutes or so to move around. Make sure you wear your compression stockings.
I flew out of LAX instead of San Diego, as it was a much cheaper flight to Japan. I had 14 hours of travel time. In that time I had two Protein Drinks - I brought 3 single serving packets of Protein Powder and a Blender Bottle and just filled it up at the airport (or got the flight attendants to do it on the plane). The rest of the time I drank Water (you need that too). It worked out well and I felt good (but jet-lagged) when I returned to Japan. Anyway, long story short, all of your plans seem spot-on to me.

Everyone is different - just because others had no energy, doesn't mean you will too (and vice versa). You have no idea how you feel until you are post-op. I had a ton of energy - I ended up walking over 15,000 steps after they dropped me off at my hotel on day 3 (I didn't fly home right away). The next day I did over 20,000. At the same time, the other solo woman in my group who got dropped off at the airport on the same day was in terrible shape - and she had been the entire time post-op. We all had to help her at the hospital, in the van, and even at the airport (where she finally got a wheelchair). Maybe it's something you (or a friend/family member) can arrange quickly if you don't feel you can get around by yourself. Also, take a look at airport maps and see if you can find out how long it is to the gate/transfers, etc. As I recall, Seattle is a pretty big airport, but maybe your connections will be close together. That said, walk, walk, walk. If you have the energy, don't sit down until you get on the plane (that's what I did). The aisle seat is good, it makes it easier to get up every 30 minutes or so to move around. Make sure you wear your compression stockings.
I flew out of LAX instead of San Diego, as it was a much cheaper flight to Japan. I had 14 hours of travel time. In that time I had two Protein Drinks - I brought 3 single serving packets of Protein Powder and a Blender Bottle and just filled it up at the airport (or got the flight attendants to do it on the plane). The rest of the time I drank Water (you need that too). It worked out well and I felt good (but jet-lagged) when I returned to Japan. Anyway, long story short, all of your plans seem spot-on to me.

I agree - my nutritionist told me that the pre-op was to shrink the liver and get used to eating the right foods, and not to worry about weight loss. I did lose 23 pounds in 3 weeks though!

Everyone is different - just because others had no energy, doesn't mean you will too (and vice versa). You have no idea how you feel until you are post-op. I had a ton of energy - I ended up walking over 15,000 steps after they dropped me off at my hotel on day 3 (I didn't fly home right away). The next day I did over 20,000. At the same time, the other solo woman in my group who got dropped off at the airport on the same day was in terrible shape - and she had been the entire time post-op. We all had to help her at the hospital, in the van, and even at the airport (where she finally got a wheelchair). Maybe it's something you (or a friend/family member) can arrange quickly if you don't feel you can get around by yourself. Also, take a look at airport maps and see if you can find out how long it is to the gate/transfers, etc. As I recall, Seattle is a pretty big airport, but maybe your connections will be close together. That said, walk, walk, walk. If you have the energy, don't sit down until you get on the plane (that's what I did). The aisle seat is good, it makes it easier to get up every 30 minutes or so to move around. Make sure you wear your compression stockings.
I flew out of LAX instead of San Diego, as it was a much cheaper flight to Japan. I had 14 hours of travel time. In that time I had two Protein Drinks - I brought 3 single serving packets of Protein Powder and a Blender Bottle and just filled it up at the airport (or got the flight attendants to do it on the plane). The rest of the time I drank Water (you need that too). It worked out well and I felt good (but jet-lagged) when I returned to Japan. Anyway, long story short, all of your plans seem spot-on to me.

I agree - my nutritionist told me that the pre-op was to shrink the liver and get used to eating the right foods, and not to worry about weight loss. I did lose 23 pounds in 3 weeks though!

Intuitive eating for food addicts is like saying heroin in moderation. In my Keto groups people say eat until you are satisfied, and I have to speak up and remind people that some people are never satisfied because they are food addicts and they just need to Portion Control. If WLS could be successful at eating intuitive, they would not be WLS patients in the first place.
Everyone isn't a food addict, I don't really think I was, I am just very carb sensitive and a glutton. I like to indulge and pamper myself. Post-op I switch how I do that pampering and treating myself.

Everyone is entitled to their opinion but I'm not a fan of "intuitive eating." I WANT to eat chocolate candy, cake, brownies. I love sweets and eating a high carb diet got me to obesity. I didn't even realize it until I started eating low carb. I'm two years out and to maintain I have to eat mainly veggies, meat and fruit. I eat limited dairy (Greek yogurt or cheese), and grains. I gave up rice, Pasta and potatoes and don't miss them. I still track daily and have to exercise. I'm post menopause and hypothyroid. I can't afford to eat intuitively.

I never had an eating disorder or needed therapy but understand that others do struggle and encourage those who need help to get it! My morbid obesity was caused primarily by poor food choices, genetics and lack of exercise. The surgery was a godsend for me and I'm grateful every day for this wonderful tool.

To the newbies I say: beware of anyone who tells you can eat anything you want, anytime you want. That's a bullshit lie if you want to succeed at losing and then maintaining your weight loss.

@I'm Changing 4 Me
I created a spreadsheet to help me figure out what I wanted. Personally, I contacted each and every one of these companies/doctors. How are you going to know if you like them unless you deal with them directly? I think in reality, you have to go through some kind of coordinator. Do you expect your surgeon to be dealing with email and phone queries all day? (In fact, out of all these doctors, the only one I was in contact with was Dr. Illan - and while he seemed very nice, the wi-fi connection was so bad I have no idea if he actually answered any of my questions). So, while it would be nice to talk to them, it's not always possible. However, in some cases the coordinator will contact the doctor if you have any specific questions.
This is far from a full list, but based on this, and other sites, I felt that these were the most consistently well-regarded companies and surgeons. As I've mentioned in other posts, I think the biggest reason for price differences are the reputation of the doctor, the hospital used, and the hotels used.
Unless otherwise mentioned, all these doctors are in Tijuana, and these are quotes I got for a Gastric Sleeve (prices may vary depending on your personal health conditions):
Bariatric Pal Team MX: Dr. Jalil Illan ($4399)
Endo Bariatric (in Piedras Negras): Dr. Alvarez ($8900)
Mexico Bariatric Center: Dra. Louisiana Valenzuela ($5500) and Dr. Ismael Cabrera ($4995)
Obesity Control Center: Dr. Ariel Ortiz ($6500-$9000)
Pompeii Surgical: Dr. Sergio Quinones ($4500)
Ponce Bariatric: Dr. jaime ponce de leon ($5000)
Tijuana Bariatrics: Dr. Fernando Garcia ($4250)
WLSC: Dr. Ramos Kelly ($4870-$7710)
Another option seems to be Trinity Medical, also promoted by a pretty active member here, but unfortunately I didn't come across that company until after I had made my decision.
In my particular case, I live in Japan so unlike most of you in the US and Canada, I have some pretty long international flights, and my pear-shaped bottom can no longer squeeze into a 17" economy seat. I might have done that one-way, but I definitely did not want to be squeezed in for 14 hours after major abdominal surgery. Knowing that I would have to buy a business class seat on an international flight meant that I couldn't afford the more expensive doctors - so anything over $6000 was out. I did not like the way I was treated with Tijuana Bariatrics - all I got was a form letter "you've been approved - send money" - and all requests to speak to a coordinator or doctor were completely ignored. In the end the surgeons I was most interested in were Dr. Q, Dr. Ponce, and either Dr. Valenzuela or Dr. Cabrera at MBC. What swayed me the most was how well I was treated by the coordinator, and the amount of information they could give me about the operation, hospitals, etc, how many surgeries the doctor does daily (some doctors work out of more than one hospital, so make sure you find out the daily total and not the hospital total), and finally the price. Oh - and whether or not the surgery could be done on a day that was most convenient for me (for some reason it seems like a lot of the doctors will be away or on vacation or are already booked in February).
I know in the beginning it seems overwhelming, but the best thing to do is bookmark the sites you like, fill out the forms, and see what happens from there. I started with 3 different companies, but over time I expanded my search a little. That said, the problem is the paradox of choice: the more options we have, the more difficult it becomes to choose. Keep it small for now as you get your feet wet. Ask questions. Do research (other bariatric forums, Facebook, etc.) It should get better as you go along.
My surgery is less than 6 weeks away, so I can't tell you how it went, but I'm confident enough that I will be treated well. Anyway, I hope this helps.

@j15big: I was similar to you post-op. I lost about 13 pounds in my first 2 weeks post-op, then stalled for 3 weeks. Over those three weeks my weight would go up and down, usually between 1-2 pounds, almost daily (but never going below the "low" weight). Finally, my stall broke and I lost another 5 pounds. Then stalled. I just recently broke my 3rd stall. Now, I'm exactly 2 months out from surgery and have lost 30 pounds (54 in total including pre-op). Like you, I have almost no restriction. I can eat 2 eggs or 4 ounces of any meat (usually chicken or salmon) at one sitting, and still have room for some veggies. I recently flew to Germany and was given a very nice lean steak for my "diabetic" meal (I thought it would be the most bariatric diet friendly). I was able to eat most of it, I'm guessing around 4 ounces (that was one month post-op). Unlike other people's programs, my nutritionist recommended never going below 800 calories a day (not that counting calories is important) to avoid going into starvation mode. That said, regardless of how much I think I'm eating, the end result is that I usually stay between 8-900 calories a day, with over 100g of Protein (I let fat fall where it may). I have no problems eating Protein Bars, but try to avoid them - just use them for emergency situations.
I agree with the others though - your "food" in your daily sample seems to be a lot of artificial food - like the diet drinks and protein bars. Even though I drink one (sometimes 2) homemade Protein Shakes a day, my meals are always with real food - eggs for Breakfast, chicken for lunch, salmon for dinner (and veggies on the side for each). All other liquids are Water or herbal tea (I like mint tea because it's good hot or cold). Although I'm getting better at recognising when I feel full, it's not like how others mention here, feeling sick or nauseous or in pain. I try to be conscious that just because I don't feel these symptoms, that it's not necessarily good to keep on eating. Also, I try to finish eating within 20-25 minutes. If I can't, it probably means I have too much food and should save the rest for later. I don't really get hungry (only when I eat things I shouldn't, like protein bars), so I find that I can get by with eating less rather than mindlessly cleaning my plate while watching YouTube videos, which is how I got here in the first place.
Anyway...just my take from the peanut gallery.

@j15big: I was similar to you post-op. I lost about 13 pounds in my first 2 weeks post-op, then stalled for 3 weeks. Over those three weeks my weight would go up and down, usually between 1-2 pounds, almost daily (but never going below the "low" weight). Finally, my stall broke and I lost another 5 pounds. Then stalled. I just recently broke my 3rd stall. Now, I'm exactly 2 months out from surgery and have lost 30 pounds (54 in total including pre-op). Like you, I have almost no restriction. I can eat 2 eggs or 4 ounces of any meat (usually chicken or salmon) at one sitting, and still have room for some veggies. I recently flew to Germany and was given a very nice lean steak for my "diabetic" meal (I thought it would be the most bariatric diet friendly). I was able to eat most of it, I'm guessing around 4 ounces (that was one month post-op). Unlike other people's programs, my nutritionist recommended never going below 800 calories a day (not that counting calories is important) to avoid going into starvation mode. That said, regardless of how much I think I'm eating, the end result is that I usually stay between 8-900 calories a day, with over 100g of Protein (I let fat fall where it may). I have no problems eating Protein Bars, but try to avoid them - just use them for emergency situations.
I agree with the others though - your "food" in your daily sample seems to be a lot of artificial food - like the diet drinks and protein bars. Even though I drink one (sometimes 2) homemade Protein Shakes a day, my meals are always with real food - eggs for Breakfast, chicken for lunch, salmon for dinner (and veggies on the side for each). All other liquids are Water or herbal tea (I like mint tea because it's good hot or cold). Although I'm getting better at recognising when I feel full, it's not like how others mention here, feeling sick or nauseous or in pain. I try to be conscious that just because I don't feel these symptoms, that it's not necessarily good to keep on eating. Also, I try to finish eating within 20-25 minutes. If I can't, it probably means I have too much food and should save the rest for later. I don't really get hungry (only when I eat things I shouldn't, like protein bars), so I find that I can get by with eating less rather than mindlessly cleaning my plate while watching YouTube videos, which is how I got here in the first place.
Anyway...just my take from the peanut gallery.

Early on I didn't weigh that often 1-2 times a week.
I try to weigh every day now or every other day. I only count my weight once a week.

@Delta_35
My concern is that with do many people qualifying for surgery now that seem to be obviously bad candidates and failures that it will skew statistics and make WLS seem less effective than it is meaning long term, surgery may not be covered by insurance or harder to maintain.
I had an evaluation but it was a joke. I was prepared for surgery but no one prepares you for the end. The losing phase is easy, the end and loose skin is tough.

Some regain is normal. I gained 15 lbs back from my lowest. Guess what? I don't care. This journey taught me there are more important things to worry about than weight. There is so much more to life. I hope anyone who has regained will be kind to themselves. Ones worth is not determined by ones waistline. Maybe some people leave because they just don't need to focus on weight any more.... like me. I let it go. Now I'm back to help others if I can. Let's keep this a positive place like julie said. Support. Always support. No judgement.

Well ... now there are new people that are becoming
Veterans every day... so this can be a safe place to just relax and talk about things that come up years down the road....
I suspect some leave from regains.....
Personally that is always challenging for me. Good months. Not so good months.
Ps. I do know there was some kerfuffle months back. But I am ignoring it.

I left because I was bashed upon a ton by others at my same stage, who are veterans now, like me. I believe that this is a journey that is different for everyone and we should practice empathy and kindness. A lot of "newbies" have poor pre-op support. There are more and more wls docs now and not all of them give nutritional advice. Also, the mindset of having to eat on a rigid diet type regime forever post surgery simply won't work. People reach their goal weight and regain when they try and do that.
During my weight loss I did not always follow the rules. I certainly cut my caloric intake but I was never a perfect patient. I still lost to my goal and then some. Perhaps I had an easier time because I did allow myself some leeway. This is not an all or nothing journey. It's really hard to expect someone to live on a diet 100% of the time forever and be able to have any real quality of life.
Newbies are looking for advice and we can give it to them and still be kind and have empathy. Maybe they won't lose all their weight. Maybe they will regain. Maybe they will suffer. That's their journey. Who ever said being overweight was a crime anyway? Props to them for trying and for asking for advice.
I feel a moderate approach is always best and I feel many of the vets on here are rude, patronizing, and just plain mean- all in the name of "tough love". You know what? Sometimes it's better to just give a little love. Weight issues are painful. Be kind.
I'm here to help who ever I can with what I've learned and I refuse to judge anyone else's life decisions.

I left for a long time because I got tired of the drama and needed to focus on myself. I'm back now with a healthier perspective and happy to give my two cents to anyone needing support.

Hi Erica, how long has it been since your surgery? I know people will judge me for doing this, but no one knows the struggle I have been through. I sure hope you get to where your goal is.

I had a BMI of 31 and self funded which cost me a shit load of money.
I have had no problems losing weight except now for the last few kgs.
My dr warned me that some people would be very opinionated about the surgery because I never looked like I needed it lol.

Hi Wareaglex5, we may be similar in BMI and why we are getting the sleeve done. My consult was done over the phone. I am cash pay, traveling about 6 1/2 hours to Louisiana to have my surgery with Dr. Borland. There are a lot or pre op test that I have to get done where I live and then have the results faxed to his office within 30 days of my surgery, which is scheduled for April 11th. I am very nervous and excited. Like so many others on the board, I have struggled with the yo-yo.
A deciding factor for me, was to hear my 70 year old mother constantly talk about her weight and how much she would like to have the WLS. I am almost 40 and do not want to wait any longer. I would like to permanently lose 55 pounds.