Buterflymomma

I am at the very beginning of the process and still need to meet with the dietician for 4 months. I am hopeful that they will be scheduling surgeries again once I have met the requirements for my insurance.

....and get this! The summary of my psych testing stated that I have an “inordinate fear of large animals”. For $995 I could have told them that. AND, it relates to WLS how?🤪

that will totally depend on your insurance company's requirements and your surgeon's requirements. Some require it, some don't. A lot of insurance companies (not all -- but many) require a six-month supervised diet. These usually have to be done with a dietitian or a physician. In addition, some surgeons require you to do a quick liver-shrinking diet before your surgery - usually for a week or two. But again, not all insurance companies and surgeons require special diets.

Yes you will need a pre op diet to shrink your liver and make surgery the safest possible.
I was given 800kcals (2 Meal Replacement products and a small low carb meal) as an example.

From my experience, it's a little hit or miss. I think it also has a lot to do with your surgeon and his/her approach
I had a friend who was really encouraging me to get the sleeve. She had a lap band and developed Barrett's esophagus. She got the sleeve and has had no GERD. Her esophageal issues resolved.
I had a history of GERD, also had been banded. Doctors warned me that I may develop GERD after the sleeve. However, we discussed it because like you, I did not want the malabsorptive aspects of RNY. After some testing, we came to the conclusion that my GERD was "situational" meaning that a combination of things were contributing to it: my weight, a small hiatal hernia, overall dietary choices, etc. I went through with the sleeve. About 6 weeks in, I started getting heartburn that eventually advanced to nighttime reflux. It's been easily controlled with Nexium and some minor lifestyle changes like not eating 3 hours before bedtime and sleeping on a wedge. HOWEVER, I do get "flare-ups" of esophagitis and have to take Carafate when it happens.
Other than the occasional esophagitis, I have no long term or lasting consequences of GERD. My GI doctor and I are currently looking into a stretta procedure to thicken the lower esophageal sphincter.

I'd ask if they have a nutritionist as part of the program and what their involvement will be. I found it helpful to meet with one several times and have a nutrition plan for before and after surgery. I also can call her if I have questions or (hope this never happens!) regain weight. Some people seem to leave the surgery with a solid nutrition plan and some people seem like they didn't receive sufficient info.
I also wanted to know where my doctor went to school, did her residency, how many of the procedures she had done, and which she recommended for me. I ❤️ her.

You really should have a long talk with a bariatric surgeon and nutritionist. But let me see if I can help. I will use gastric sleeve for explanations, since that is the surgery I have. This can also be applied to gastric bypass, but please know there is a lot more involved with a bypass than sleeve. I personally don't recommend lap band.
Before you get weight loss surgery, you need to consult a physician and a nutritionist. You usually have a requirement of 6 months of nutrition counseling. During this time, the nutritionist prepares you for your post op diet. They start off giving you education on what you need to eat NOW. What you need to eat in your pre-surgery phase. And what to eat post op. A good program will have you continue nutrition counseling for AT LEAST a year post op, in which they will coach you through the stages of your post-op diet through until you reach maintenance stage where you are just maintaining your weight.
During the pre-op period, you are also seeing specialists and getting testing for any problems that they may need to know about before your surgery. This includes a psych evaluation usually. And if you do have psych related issues driving you to eat too much, you should take this opportunity to deal with them. Many bariatric patients need counseling. Some need medications like anti-depressants or other psych medications. And some like me gained weight for other reasons (physical barriers). You will likely at least get an EKG if not a complete cardiac workup. You may need a sleep study to determine if you have sleep apnea like so many obese people do. If so, you will get treated for it. They will look for how you swallow, do you have a hernia in the stomach, and other issues affecting your surgery. Once you have jumped through the hoops and are treated for anything you need to be treated for... then you will be cleared for surgery (and no... ongoing counseling does not mean surgery will be delayed).
With gastric sleeve, they remove 80% of your stomach, therefore for it immediately restricts how much food you eat. It also resets your metabolism and your hunger/full hormones. In the short term, yes your calories will be VERY restricted. But because you are seeing a nutritionist, they will help you know what to eat during each stage for optimal health. Water and Protein first. Then healthy veggies. And you will learn to either not eat unhealthy carbs or eat very limited unhealthy carbs. It will be up to you to follow the recommended diet and stick with it. If you do follow directions, you will learn to eat frequent small but healthy meals every day. And over time, once you are closer to maintenance, you will start to eat larger portions, but sticking to healthy meals. Your nutritionist will guide you to ensure you do not go into starvation mode and that you eat a healthy amount of calories to maintain your weight. Most people do lose a little more than they need to early on... but then gain 20 pounds back and then maintain your weight there. The key is to stick to the recommended diet so that you don't KEEP gaining.
You will also get blood work done every 3 months or so and have follow up appointments with your surgeon's office for at least a year. So, with the surgeon and nutritionist, you will be closely monitored. They will make sure you don't end up with Vitamin deficiencies or other problems related to rapid weight loss. You will take daily Vitamins and Calcium as recommended. Your diet will be high in protein and low in carbs and fats. (So not really Keto... but many do Keto post op). The carbs and fats you eat will be healthy carbs and fats if you stick to your diet. But this isn't a "diet" per-say... it is a lifestyle change. You are re-learning how to eat healthy. You are re-learning how to eat small to normal portions. And if you stick with it under nutritionist supervision, you will NOT go into starvation mode and you will not gain the weight back.
Problem with all the fad diets is that there is no long term (psych) counseling, nutritional counseling, medical follow up. Most people eventually go back to their old ways. And gain everything back. If you are following the program with the bariatric team, they will help you prevent going back to your old ways. But seriously... only you can decide how successful you will be, based on your willingness to follow through. Again... if you need to, get counseling. See your surgeon and nutritionist regularly and follow their guidance. If you need CPAP for sleep apnea, wear it. If you need other medications, take them. Etc.
I am 2 days shy of 6 months. I am at a NORMAL body weight. I am 6 pounds from my personal ideal body weight. I am following the recommendations of my team. And I can now eat double what I could 3 months post op and still maintain my weight and I am still losing a pound here and there.
Again...talk to your bariatric team for better information, but bariatric surgery is a TOOL for weight loss. It is only successful if you follow your program. But it is also the best tool out there to reach your goals if you have dieted and failed in the past. But if you follow your program, they will give you additional tools to make you successful (nutrition and psych counseling are two of your best weapons... use them!)

This is a journey and a whole new life! So ask him what is going to happen to you? What is the plan? What is the after surgery support you provide?
With this site you have all the information you will ever need, Now its up to the Doc to do the procedure and you to get set up and ready to rumble.
Welcome to the group and ask away
Aj

I'd be asking for their results, my doctor tracks patients for 5 years after surgery and has great data on weight loss/ regain over time. Ask what their personal complication rate is, and how it compares to the average for your locality/ worldwide. Ask about their support services, my surgeons office do support for 5 years with nutrition, exercise and psych (if needed). They also have a "back on track" programme for people who find they are regaining weight within 5 years. I can't believe how many people choose surgeons that have zero follow up.
Ask how much time you'll need off work, when you can start exercising again, all surgeons seem to have different expectations on these factors.