BigSue

You can ask your clinic for advice, but it's probably going to be up to you to figure out, mainly because you have to work it around your schedule. It can seem complicated at first, but you get used to it. I take a multivitamin with iron plus an additional iron supplement, calcium 3x/day, B12, biotin, and D3. Calcium and iron are supposed to be at least 2 hours apart, and I also take a prescription thyroid medication that's supposed to be 4 hours apart from calcium and iron. I use a free app called Medisafe to track my medications and remind me. It's really useful because you can track what time you took everything, and it also tracks how many of each you have left and reminds you to refill. You can set reminders at whatever time you want. I set reminders as follows, but I usually stay ahead of schedule. 6:00 am - Thyroid prescription 10:30 am - Multivitamin with iron, B12, Biotin, D3 1:00 pm - 1st calcium 3:30 pm - iron 6:00 pm - 2nd calcium 8:30 pm - 3rd calcium I also recommend getting a pill organizer with 3 or 4 compartments for each day, where each day has its own removable box (the one I have looks like this one: https://smile.amazon.com/Organizer-Compartments-Moisture-Proof-Medication-Supplements/dp/B07Q9JSHMP). I distribute my pills in that once per week, and then I can just grab the box for the day.

When I first re-introduced solid food after surgery, I was really diligent about eating slowly. I used a tiny fork/spoon and a timer on my phone to time 30 seconds to chew each bite and then 60 seconds before taking the next bite. It probably took 20-30 minutes to eat a very small meal. I’m 2 years post-op now and I am not nearly as careful about eating slowly (I no longer use a timer), but I’ve gotten into the habit of chewing well and taking time between bites. I use normal utensils and take full-sized bites of most things. Salad and most other veggies go down quickly and easily, but I still have to make sure to chew dense foods like meat well. I used to have frequent problems of a bite of meat feeling stuck on the way down, but that rarely happens anymore (maybe once every few months). I feel like I eat at a pretty normal pace now, maybe a little slower than average, but I usually eat alone, and when I do eat with other people, I notice that I take much longer to eat than everyone else, which was not the case before surgery. I like to eat meals that require some assembly (e.g., tacos on low carb tortillas) or have multiple items (e.g., chili and salad) that I can switch between. I find that helps to naturally slow me down. I also do other things while eating, like watching TV or reading, which some say is bad because you should focus on your meal, but I would go crazy if I tried to eat slowly with nothing to do between bites! It still typically takes me 15-30 minutes to eat a meal, but I am eating much larger portions now than right after surgery.

Congrats on getting your surgery date! If you’re anything like me, it feels like the process drags on forever until you get to a few weeks before surgery and then it feels like it snuck up on you soooo quickly.

Here's what I take: Bariatric multivitamin with 45 mg iron B12 sublingual, 1000 micrograms Biotin, 10,000 micrograms D3, 5000 IU Iron bisglycinate, 36 mg Calcium citrate, 500 mg, 3x/day I take the multivitamin, B12, biotin, and D3 together. Calcium and iron are supposed to be at least 2 hours apart, and I also take thyroid medication that is supposed to be 4 hours apart from calcium and iron, so I take the thyroid medication first thing in the morning, multi/B12/biotin/D3 4 hours later, 1st calcium 2 hours later, iron bisglycinate 2 hours later, 2nd calcium 2 hours later, 3rd calcium 2 hours later. I use an app called Medisafe to track and remind me. It was a lot at first, but I'm used to it now and I have a routine. You may need to take chewable vitamins for a short period of time after your surgery (I was told to take chewables for the first 6 weeks, but you should follow your surgeon's instructions). I think the chewables taste terrible, so I switched to a capsule after the first 6 weeks. The BariatricPal One multivitamin is the best deal I've found if you get the annual subscription (but definitely buy a smaller quantity to try before you commit to buying a year's worth). I get the one with 45 mg of iron, but your iron needs may vary. Another thing to keep in mind about iron is that the most common forms (ferrous fumarate or sulfate) cause nausea for some people, especially when taken on an empty stomach, and can also cause constipation. There's another type of iron (iron bisglycinate) that doesn't cause nausea or constipation, but that's not what most multivitamins have, so you'd have to take it separately. I had low iron even before surgery, so I actually take both. I also highly recommend the BariatricPal calcium chews because they are delicious. They taste like candy and I actually look forward to taking them. French Vanilla Caramel and Belgian Chocolate Caramel are my favorites. You can often get them on sale for 20-25% off (I actually just restocked last week when they had 25% off all BariatricPal brand products). Make sure you get calcium citrate, not calcium carbonate. Most drug store calcium supplements are calcium carbonate, which is not absorbed well by bariatric surgery patients. I buy the other ones from Amazon. B12 (NatureMade) is cherry flavored, and biotin and D3 (Natrol) are strawberry. It doesn't feel like such a chore to take all these pills when they taste good.

I use MyFitnessPal and I just don’t use the “complete diary” function. It really isn’t necessary to close out the day. I’ve been using MyFitnessPal for 2.5 years, so I’m kind of attached to it, but a lot of people prefer other apps such as Baritastic, Lose It, or Cronometer, so you might want to give those a try if you don’t like MyFitnessPal.

Very few pictures exist of me at my heaviest because I always used to avoid being in pictures. Have you ever noticed that a lot of people’s “before” pictures are from weddings (either their own or a part of someone else’s wedding party)? I’m guessing that’s because weddings are among the few times you can’t really refuse to be in pictures. I wish I had more “before” pictures so I can appreciate the difference. It’s certainly jarring to see how big I was. I got passport photos taken when I was at my heaviest (one of the only pictures I have of myself at that weight), but I didn’t get around to renewing my passport until several months later, after I had already lost a lot of weight, maybe 100 pounds, so I decided to get my passport photo retaken, and the side-by-side difference was striking. Well, I look at the SECOND passport photo now and compared to how I look currently (200 pounds down from my heaviest), the difference is incredible. One of the reasons I used to hate being in photos is that I pictured myself as a lot smaller than I was, so seeing myself in pictures forced me to see how big I really was. What’s weird is that now I picture myself as being bigger than I actually am, so seeing myself in photos now is also surprising, but in the opposite way. There’s not that big of a difference between the way I imagine myself now vs. how I imagined myself at my heaviest, even though in reality, I look like a completely different person. The last time I went to my surgeon for a follow-up, the nurse called me back and looked confused when I got up and walked over. She kept looking back and forth between me and my chart and then asked me to verify my date of birth, because my chart had my picture from my initial consultation and she couldn’t see the resemblance. And this is someone who works in a bariatric surgery practice, so it’s not like she doesn’t often see people who have lost a lot of weight!

My surgeon prescribed hyoscyamine after my surgery to treat stomach spasms. I didn’t end up needing to take it (I think they just prescribe it to all patients just in case) and I remember the nurse telling me that spasms are more common for VSG patients than gastric bypass. So yes, I think it is common, and your surgeon may be able to prescribe something that can help.

I’m sorry to hear you have so many regrets. Thank you for sharing your story — I think it is important for people considering this surgery to see the good, the bad, and the ugly. When I was considering surgery, I actively sought people who regretted it because I wanted to be prepared for the worst-case scenario, but it’s hard to find negative information because it’s mainly people who are happy with their surgery who post on forums like this. I started out very heavy (BMI over 60), so it was pretty clear that I couldn’t lose the weight I needed to lose without surgery, but even then it was a difficult decision. I am often surprised that people starting with a BMI under 35 would put themselves through this surgery. I don’t say that to judge, but this surgery is rough, and to me, such a high risk/cost was only worth it for the potential of a high reward. But that cost/benefit analysis is something that every individual has to do for him or herself. I would like to say that I hope you get to the day you don’t regret the surgery, and I think you have a good shot at getting there. It is very common to have regrets early on, even for people who end up being very glad they got the surgery. The beginning is really hard, and it gets easier for most people after the first several months. I hope that once you lose more weight, progress to normal food, and get used to your new lifestyle, you will be happier and not regret having the surgery.

Your goals are great! As nice as it is to see the numbers on the scale go down, I think the non-scale victories are the important ones. You might be interested in this very popular post where people discuss some of their non-scale victories:

You probably just need to wait a bit longer before progressing to soft foods. Different surgeons have different post-op diets; mine didn't start soft foods until week 3 (scrambled eggs and ricotta bake are soft foods, not purees). Can you eat pureed foods like yogurt, pudding, refried beans (when I was in the pureed stage, I was told to puree even refried beans in a food processor until completely smooth)?

My philosophy is that you don't pick a goal weight -- your goal weight picks you. That probably sounds silly, and it's sort of an exaggeration, but when you're talking about the massive weight loss one gets from weight loss surgery, it's not necessarily practical to target a specific number on the scale. I didn't really have a "goal weight" -- nor did my surgeon -- until I went to my psychological evaluation and the psychiatrist asked me. Even that, I think, was mainly about checking to make sure I had realistic expectations. The number I gave was based on the average/typical weight loss for gastric bypass patients. I think I went with 180 pounds, but I actually ended up around 140. To me, the number on the scale is pretty meaningless. And I say that as someone with an analytical mind, who loves numbers and spreadsheets and graphs. The non-scale victories are far, far more important to your quality of life. First, and foremost are the health goals -- things like getting off of medications, having a healthy blood pressure and blood glucose, etc. Then there are the physical benefits like being able to walk a mile without sweating or a few flights of stairs without getting winded, and not having constant pain in your feet and knees. And of course the social benefits of literally fitting into the world -- flying without a seatbelt extension, sitting in a booth at a restaurant, not having to worry about weight limits on furniture. Finally, being more confident and satisfied with your body/appearance, having more clothing options, and being more accepted by people and society in general (which is really sad, but true). I think if you are fixated on a specific number on the scale, you can lose sight of those important non-scale victories. I'm not saying you shouldn't track your weight (I weigh myself probably more than I should, multiple times per day) or that the scale isn't important to your progress, but you don't know what the number will be when you hit the point that you have lost enough weight to improve your life. That's especially true when you start out at a high weight, because your body will not be the same at 220 pounds (after losing 200+ pounds) as someone who has never been higher than 220 pounds, because your body will have more skin and bigger bones even with the same amount of fat and muscle.

You seem to have a really cynical outlook on all of this. I, too, am a scientist by profession, and I've always been a bit of a pessimist, but I think sometimes, it's worth giving people the benefit of the doubt. It looks like you don't think your bariatric team has your best interests at heart. I know you've been burned before, and I also know what it's like to be constantly judged as stupid, lazy, noncompliant, untrustworthy, unworthy, etc. because of my weight, so I can understand your feelings about this, but don't forget that these are people who have devoted their careers to providing weight loss surgery. I'm not saying that they all genuinely care about alleviating the plight of the obese, or that they're sympathetic toward those of us in a position of needing this surgery, but I doubt there are very many medical professionals in the bariatric surgery field who are out to punish and criticize fat patients just for fun (or out of personal dislike of fat people). If for no other reason than their own self-interest, chances are that they want patients to succeed with weight loss surgery, and they are probably doing what they believe will contribute to their patients' success. Another thing to keep in mind is that sometimes people can be right for the wrong reasons. I've run into this in my own job, where someone has told me something that didn't seem to make sense, and I (as someone like you with an inquisitive mind) have gone looking for the real story, only to find that what I was told was correct, even though the reasoning was not. In this case, your dietitian might be giving you good direction even if she doesn't actually understand what she's talking about. Just because that dietitian (or even the whole bariatric team) doesn't know or understand the reasoning behind the rules, it doesn't necessarily mean that the rules are incorrect or arbitrary. Finally, if you hang around this forum for long enough, you will see that many patients want and need a lot of hand-holding. Some people would rather be given strict but arbitrary rules than loose guidelines. People are constantly on here posting questions like, "I had surgery X days ago; can I eat Y?" And honestly, considering that, I can't blame surgeons at all for wanting to make things as black and white as possible so they don't have to spend all their time answering these incredibly specific questions, tailored to each individual patient. Most patients are not medical researchers, and many want definitive instructions from their doctors. Many people would be paralyzed with indecision if they were told, "Some studies say X and others say Y; you figure it out." Ultimately, it's up to you to decide how closely to follow your surgeon's directions, and if you do your own research and believe you have found a better way, you can make that decision. But I would venture to say that you will likely have a better experience if you have a mindset of working WITH your bariatric surgery team instead of taking an adversarial approach.

First of all, 12 pounds in 3 weeks is a lot. You didn't gain the weight overnight and you won't lose it overnight, but be patient and stick with it and the weight will come off. The first few weeks post-op are the hardest because you're still recovering from surgery, very limited in what you can eat, and getting used to major changes, but you haven't yet seen the benefits of the weight loss. It is VERY common to have regrets and thoughts of, "What have I done to myself?!" early on, but as you progress, things will just get better. You'll be able to eat normal food again, and you'll lose more weight than you ever have before and get all the benefits that come with that. Hang in there!

Today is my 2-year surgiversary. I've lost 200 pounds from my highest weight -- a staggering amount when you think about it. I'm literally (less than) half the person I used to be. I should be on top of the world, right?! I don't want to dismiss the many scale and non-scale victories I've had, but it's not all rainbows and butterflies. When I catch a glimpse of myself in a mirror, I'm taken aback by two things: how small I am, and how freaking ugly. I was certainly never beautiful -- not even "pretty for a fat chick" or "would be cute if I lost some weight" -- but now, I look downright scary. I probably look 10 years older than when I was fat. My hair was already fine and flat before surgery, and now I've lost a lot of it and it hasn't grown back and it's a mess no matter what I do. Ironically, people often tell me I look great, which is obviously code for "not fat anymore." Sometimes, before saying I look great, they ask me if I'm sick or if I lost weight on purpose. I don't know what the point of that is; if I said I lost weight because I'm sick, would they instead say, "You look like $h!t"? When I imagined my life after surgery, I thought I would be the same person, but smaller. The same person, but able to wear non-plus sized clothes, fit into an airplane seat without a seatbelt extender, not have to check the weight limit on furniture and ladders. The same person, but without hypertension and diabetes. I guess, deep down, I knew that wouldn't be the case, because that's a big part of what held me back from having the surgery for so many years. I didn't want my life to revolve around my pouch. I didn't want to give up my favorite foods and think so hard about everything I eat. I definitely didn't want to turn into one of those boring a-holes who never shut up about their diet and exercise regimen. But here I am, and I feel like weight loss has taken over my life. I spend so much time and energy preparing and eating healthy foods, working out, keeping up with my supplements, that I don't have room for anything else. There was a period of time after my surgery when I felt great and full of energy, but now I'm tired all the time, and despite being in the best shape of my life, I feel weak because I no longer have 300+ pounds to throw around. People used to be surprised by my strength, but now I struggle to open pickle jars and heavy doors. (Yes, I've had my bloodwork checked and everything is great; the working theory is that the bradycardia due to rapid, massive weight loss is what's causing these problems.) I used to be incredibly devoted to my job, and most people would describe me as the hardest worker they knew (maybe a workaholic), and now I just don't have the same drive that I used to because I'm so focused on my weight. I feel like I'm letting everyone down because I'm no longer up for spending all my free time working. I think I was a better human being when I was fat. If I -- with the benefit of the hindsight I have now -- could go back in time to two years ago, when my morbidly obese self arrived at the hospital, and still had time to change my mind, would I still go through with having the surgery? 100% yes, without hesitation.

Have you tried mixing protein powder into food? You can try unflavored protein powder and mix it into anything, but I personally think it tastes gross. In my early post-op phases, I liked to mix chocolate protein powder into sugar-free chocolate pudding, vanilla protein powder into yogurt, cinnamon protein powder into oatmeal, etc. I found that much more palatable than protein shakes. Also, protein hot cocoa is delicious.

I live alone, hundreds of miles from any family, and I didn’t tell anyone about my surgery other than health care professionals. I really didn’t have any issues. I took a taxi to the hospital and hired a home health care aid to take me home. The hospital said they wouldn’t allow me to take a taxi/Uber home but they didn’t check and I totally could have, but the home health care aid didn’t cost much more than a taxi and she picked up my prescriptions and brought my bag in the house, so that was good. Plus, I had no idea how well or poorly I would be feeling when I got discharged, so it was nice to have that peace of mind. I had surgery on a Thursday, took the next week off of work, and went back the following Monday. I could have gone back much sooner, but it was good to have the week off so I could get used to my new situation (like having to sip tiny amounts to stay hydrated and get protein). I didn’t need any help taking care of myself. I didn’t have any pain by the time I got home. I was a little tired but functional. If I recall correctly, I wasn’t allowed to lift more than 20 pounds for the first 6 weeks, but I didn’t have any need to do so. I think my easy recovery was pretty typical of most WLS patients these days, but there’s always a chance you’ll have complications, so it’s a good idea to have a contingency plan in case you do need help.

I haven’t had a protein shake in ages (I’m 2 years post-op and get plenty of protein from solid food now), but I recall liking the caramel flavor of Equate brand shakes. It’s definitely a matter of personal taste, though!

The beginning is the hardest because you're still recovering from surgery, still getting used to the huge changes to your lifestyle, but haven't seen all the benefits of the weight loss yet. It does get easier, as you progress through the post-op stages and lose weight. You will start to feel "normal" again, maybe a new and different normal, and this weird and difficult post-op period will eventually be a blur in your memory. Hang in there!

Great job on your progress! I’m not generally one to “reward” myself, and I kind of look at the weight loss as its own reward. If you’ve been living with obesity for a long time, some really basic things that most people take for granted can be amazing to experience for the first time — like shopping in a non-plus-size store, traveling on an airplane without a seatbelt extension, or just being able to bend down and tie your shoes. Many of us experience great health improvements like stopping blood pressure medication. There’s a very long thread about weird non-scale victories here: http://sparktrack.bariatricpal.com/f/a/Y50OG68aRzzLR0Yjxz0aTA~~/AABcJQA~/RgRlAveiP0RTaHR0cHM6Ly93d3cuYmFyaWF0cmljcGFsLmNvbS90b3BpYy80MzY3MTAtd2VpcmRlc3Qtbm9uZS1zY2FsZS12aWN0b3J5LWlsbC1nby1maXJzdC9XA3NwY0IKYx-iciBjIPHUHFIRc2FyYTc4MUBnbWFpbC5jb21YBAAAAAA~ I’m not saying there’s anything wrong with buying yourself a nice shirt or new phone or treating yourself to a massage to celebrate, if that’s how you like to reward yourself, but I think it’s also good to appreciate all of the ways your life is improving as you lose the weight.

Welcome! First of all, great job on your weight loss. Even after the regain, you’re still down 130 pounds from where you started, which is a major accomplishment. Secondly, I’m appalled that your bariatric surgeon’s solution was a 10-day liquid diet, as if that’s a realistic long-term weight loss strategy. I do think you’re on the right track to go to a PCP and get your thyroid and vitamin deficiencies corrected. Are you tracking your eating at all? I use MyFitnessPal, but there are other apps like Baritastic that have similar features, and I think tracking your eating can really help you see where you can improve. At least for me, there’s something about seeing the numbers that makes it clear what is or isn’t worth eating.

For something so simple, I had a lot of trouble finding a free bite timer app. I found one that is intended for interval training called Interval Timer.

A lot of people who have never struggled with their weight (or people who have only had to lose, like, 20 pounds) want to think of weight as a personal or moral attribute. They want to believe that their ability to control their weight is indicative of their personal superiority, so they feel threatened by the thought of some of us -- whom they view as inferior based solely on weight -- can "cheat" our way into their category. Many people who haven't looked into weight loss surgery also have no idea how hard it is. I think back to the first time I read about gastric bypass and thought it sounded like absolute magic -- the answer to all my problems! You get your stomach stapled and the weight just falls right off. And then I found out about all the risks and potential complications, dumping syndrome, and the fact that some people still regain the weight, and that was enough to turn me off from weight loss surgery for 15+ years. And even then, it wasn't until I actually started the process that I found out about the pre-op diet and all the post-op phases, having to constantly sip water all day just to avoid dehydration and go for weeks without solid food. I'd be willing to bet that most people have no clue how hard it is to get through all the pre-op requirements and post-op phases. Ironically, it's those people who have never had to think about weight loss surgery who really have the easy way out in that they don't have the propensity for weight gain in the first place. They have no idea how hard some of us have to work to lose weight and/or keep it off.

I'm two years post-op, and my appetite has returned, but not nearly to the extent as before surgery. In the beginning, it was easy to lose weight because I wasn't hungry at all and physically couldn't eat much, but that has gradually changed. It feels upsetting at times to see the portions that I am able to eat because I think, "I shouldn't have room for this big of a salad," but I think my perception is skewed because I'm comparing my current portions to my initial post-op portions, not to what I used to eat pre-surgery. I remember pre-surgery often feeling like my stomach was a bottomless pit, and no matter how much I ate, I could still feel like I was starving. There are times now when I eat a reasonably-sized meal and still feel hungry, but even then, it doesn't take much to get all the way full. I'm probably doing it wrong because we're not supposed to eat to the point of getting really full, but I'm not perfect. And sometimes it's still hard to tell whether it's real hunger or head hunger. I can definitely see how people can regain a lot of weight after a few years, because I feel as though my stomach has stretched out quite a bit and I could over-eat if I'm not careful about what I eat. However, I have COMPLETLEY changed my eating habits and shifted toward low-calorie foods. I've been tracking everything I eat in MyFitnessPal for over two years, and I consider that the #1 key to my weight loss, other than surgery itself (in fact, I lost 70 pounds before surgery this way). I'm not stupid -- I know how to read a nutrition label -- but there's something about actually logging my food intake that makes me confront my choices and think about what is and isn't worth eating. I still track my calories in MyFitnessPal and I'm afraid to stop, but I suspect that I would probably be ok without tracking because I've gotten into good habits. I've also found that at times I've eaten more than I should (e.g., eating at a restaurant or getting hungry between meals and having a big snack) and think, "I need to limit my calories for the rest of the day," I actually end up not being hungry for the rest of the day, anyway. My tastes have also changed since surgery. I used to be kind of a picky eater, and I'm not sure if my actual tastes have changed or if I've just become more open-minded, but I eat all kinds of things now that I wouldn't have touched before surgery. I used to hate seafood and now I love it and eat fish almost every day. I used to hate a lot of vegetables, like squash, peppers, radishes, cauliflower, etc., and now I'll eat just about any vegetable. I consider cauliflower rice to be the greatest diet hack of all time because it simultaneously eliminates a high-carb food and sneaks a vegetable into the meal. Plus, if you buy the frozen stuff, it's faster and easier to prepare than actual rice. Before surgery, I turned my nose up at the idea of cauliflower rice, but now I eat it several times per week. I suspect that a lot of people who regain the weight rely too much on the restriction and don't change their eating habits, so when the restriction wears off, they're kind of back where they started.

Pre-op diets vary from one surgeon to the next, but be prepared for it to suck. There's pretty much no way around it, but you just have to get through it as part of your WLS journey that will be worth it in the end. It feels like an eternity when you're going through it, but eventually, it will be a blip in your memory. My best tip, both for the pre-op diet and the liquid phase, is that you're going to be drinking a lot of protein shakes, so buy samples of different brands and flavors so you can have a variety. Also, you'll learn to appreciate sugar-free popsicles.

I second Built Bars as the best protein bars available. They’re lower in calories and sugar than most other protein bars. I wouldn’t consider them “meal replacement bars,” but perhaps you are using that term loosely. You should easily be able to find a coupon code for 12%-15% off with Honey or Capital One browser extensions. Be warned, though — you will get hooked on them and buy way too many because they keep releasing limited-edition flavors. I personally prefer the regular bars to the puffs, but they are all delicious. Pro tip: a lot of the bars are better warmed in the microwave (10-15 seconds on high, or use the “soften butter” setting if you have one).