SpartanMaker

To be clear, the gas used in abdominal surgery is not inside your digestive tract, thus medications to address that issue won't help. Typically they use CO2 and it's actually pumped into your peritoneal cavity to help create space between the abdominal wall and your organs. This gives the surgeon room to work more safely, as well as help visually distinguish everything. The reason it hurts so much is because basically your abdomen has been blown up like a balloon. This pushes up on your diaphragm, which in turn irritates the phrenic nerve. It's not uncommon to have referred pain in the chest, shoulder and neck as a result. Eventually the surgical gas will be absorbed into your bloodstream and you'll breathe it out, but until then this can be quite painful. Walking helps, but won't fix it. Overall, it should pass in a few days. I'd also make sure you're drinking enough because headaches are a classic symptom of dehydration. Dehydration is one of the main reasons bariatric surgery patients end up back in the hospital in the early post-op period, so please do everything you can to keep up with your fluid intake.

I'll do my best to help, but I'm going to have to start by asking some questions: When you say the weight is "barely coming off", can you be more specific? How much in the last week, two weeks, last month? Can you clarify what your goal weight really is? In your profile, you're showing that you're currently at 78kg and your goal is 75kg. That's only about 6-7 pounds, not the 33-44 you listed. I'm thinking you probably have a new goal and have not updated your profile, but it's important to understand what you really are trying to do. When you say you are "eating pretty well", can you give some examples of what a typical day looks like? What is your daily caloric goal? What about protein, fat and carbs? How are you determining your what you caloric and macronutrient intake should be? How are you tracking your intake? Do you weigh everything in grams before it goes into your mouth? Let me explain why I'm asking these questions. Typically when people are struggling with weight loss, we see a few common issues: Unrealistic expectations. Especially if weight loss early on after surgery was easy, people tend to think it will continue that way until they reach goal weight. Unfortunately, that's not how this works. The heavier we are, the more we'll lose at first. The closer we get to goal, the harder it becomes. It can take months just to lose a few pounds if you are already pretty lean. You also have to really have your nutrition dialed in at that point.. I won't get too deep into the physiology here, but there are multiple reasons for this and it's 100% normal for this to happen. My point is that you may be right where you need to be. It's hard to know just that just based on what you posted above. Eating more than you think. Study after study shows that almost everyone thinks they eat less than they really do, even those that log their food using calorie tracking apps. It's sometimes simple things like those little tastes while preparing a meal, or that handful of nuts they forgot to log. Others, they just guess at calories because accurate tracking is really hard. Burning less than you think. Most people have absolutely no idea how many calories they actually burn in a day. We often use estimates based on height and weight, but these can be off by may hundreds of calories depending on age, lifestyle, percent body fat, etc. Further, your calorie burn isn't the same all the time. It can vary by hundreds of calories per day even before you consider exercise. Speaking of exercise, we drastically overestimate the impact of exercise calories. For the vast majority of people, the calories they burn in a day don't actually change all that much due to exercise. Blaming things outside your control. It's natural for people look for causes for problems. If we take ownership of the problem, we can then take steps to correct it. It's when we place the blame on something we perceive to be outside our control that we can run into serious problems. Let me give you an example here. We can't escape simple physics. If you burn more calories in a day than you consume, you'll lose weight. Eat more than you burn and you gain weight. If I take responsibility for this, then it means I need to eat less or burn more to lose weight. I realize that's easier said than done, but without first taking responsibility for the problem, I'd have no hope of fixing the issue. If on the other hand, I were to say "I have a slow metabolism", I'd essentially be saying this issue is outside my control, even though the solution is the same as before: eat less than you burn. Thinking a particular diet/macronutrient is more important than calories. I noticed you hinted at that in your post. Calories are king here. Specific diets that emphasize one or more macronutrients can help, but they never trump calories. I can go into more detail later, but this post is already getting overly long so I think I'll stop here. Please provide some additional detail and I may be able to provide better guidance.

Just be careful with selecting meal replacements since a lot of them won't meet the guidelines as outlined by your team. As an example, the Bariatric Pal creamy chicken soup meal replacement mentioned above is too low in protein. While there are a few products out there that will meet those guidelines, most won't. They'll either be too low in protein, or too high in carbs. This includes the vast majority of products you'll find at grocery & drug stores.

Is it just me, or is it really odd they'd tell you what not to use, but didn't tell you what you should be using? Surely they must have some suggestions that fit what they want here? As far as I know, all meal replacement shakes contain added vitamins as that's sort of the point. They also contain added carbs and fats that most protein shakes don't have. I'd say the vast majority of people here were told to just use protein shakes. That's typically for a few reasons: First, especially if you also take a vitamin supplement, you're not going to suffer any long term harm using protein shakes instead of meal replacement shakes for a few weeks. Second, most meal replacement shakes are lower in protein than a typical protein shake. We want as much protein as possible to help prevent the breakdown of muscle tissue when dieting. Third, most bariatric doctors don't actually want you consuming very many carbs, since one of the main goals of the pre-surgical diet is to shrink your liver to make the surgery safer. The best way to do that is a very low carb diet. (The liver is one of the main ways your body stores glycogen, so by depleting it of glycogen (carbs), it will get smaller, even if no other changes take place.) TL;DR: Ask your team what they want you to use.

This doesn't strike me as self-sabotage, as much as addictive behavior. I should clarify that I'm not a therapist, but even if I were, no one can be diagnosed simply based on a post on a message board. Transfer addiction post-bariatric surgery is incredibly common so I feel like it's worth it to seek help ASAP and get this sorted out.

There's really no reason for your insurance company to deny coverage here. While gastric bypass is obviously performed for weight loss, that's not the only reason. There are normal weight people that sometimes have it done for various issue like severe GERD and issues with gastric emptying. My point is that even though we think of it as a bariatric procedure, in your case, you need it purely for medical reasons. They can't deny it on the basis that they don't cover bariatric surgery, since that's not why you need the surgery.

In honor of spring, I made Vietnamese Spring Rolls with Peanut Dipping Sauce tonight: These take a lot of work to make, but they are quite tasty. I at ~1 3/4 rolls. For contrast, my wife had four.

@NickelChip made a great point about photos. Another really good way to "see" the difference is to take measurements with a tape measure. I wouldn't do so more than about once a month, personally. There are multiple places you can measure and you certainly don't have to do them all, but I'd say the most common would be: Neck (probably more for men since this is good to know for dress shirts) Bust / Chest (at widest part) Under Bust (mostly for women only since this is needed for bra size) Each Upper Arm (either at the largest point or midway between the shoulder and elbow if you can't tell) Belly / Natural Waist Under belly (especially for men since this is where casual men's pants typically sit) Hips / Butt (you can do both if your hips and your butt are perhaps larger at different places) Each Thigh (typically at the widest point) Each Calf If you do this, it's important to try to be consistent in where and how you measure. It can also be really helpful to have help for some of these.

Wow, that's a bit concerning for sure. Hopefully you've already seen a doctor and discussed this issue? There are some medical conditions completely unrelated to weight that can cause a sudden rise in blood pressure, so I would think it's worth a visit to your doctor to discuss what may have caused this. Also, have you noticed any patterns where it's high vs. low, or is it just high all the time? For example, times of day, before vs. after eating, sodium intake, life stresses, that sort of thing?

My "American take on a Greek salad" from dinner last night:

Simple answer, Yes. Slightly more complex answer, ALL protein is made up of amino acids. That's sort of the definition of a protein. I suspect what you may be asking is does protein powder contain all the essential amino acids? For those that don't know, there are some amino acids that our bodies can manufacture themselves, and others, called essential amino acids (EAAs), that we have to get from dietary sources to stay healthy. For the most part, protein powders do contain all the EAAs. Some are better quality than others however. I personally would focus on "Whey Protein Isolate" because it's fairly pure and has a more rounded amino acid profile compared to some other sources. If you are vegan or just prefer to avoid whey for some reason, soy also is pretty good, but pea and rice tend to be a bit lacking in one or more EAAs, so caution is advised there. A mix of various sources is probably the way to go for vegans

You didn't know it @AmberFL, but this statement has been stuck in my head almost all day. Let me explain. Earlier I spent ~1.5 hours running in a cold hard rain and frankly it kinda sucked. My mind started wandering (as it often does when I run), and I was asking myself why I was out there running in such lousy conditions. That's when determination popped into my head and that's when I remembered this thread. It made me think of all the folks that say "I just don't feel motivated to do XYZ today". I was thinking on my run though that I wasn't feeling motivated either, but I was still out there running (and partly questioning my sanity). It occurred to me that it was in fact determination, stubbornness, perseverance, resilience or just plain refusal to quit. I wasn't out there because I wanted to be, or because it was fun, I was out there because I HAD to be to be. I guess my point here is that I think of motivation as fleeting. It's the spark that sets me off to accomplish hard things and set lofty goals, but it's determination that keeps me going toward reaching those goals day-to-day. I short, your statement above was perhaps more spot on and profound than you might have realized. Of course it's your determination to do hard things that's keeping you going. That's perfectly normal and as it should be! Anyway, thanks for motivating me through a hard workout!

@MrBeeswax I'd say the same thing, there are no limits here. I've looked through a number of scientific papers on weight regain and insufficient weight loss after bariatric surgery and about the only thing you'd find if you do the same is that the data is all over the place. I've seen numbers from as low at 10%, all the way up to 80% of patients regain some weight. The reason for that is there's very little consensus on defining what weight regain even means. If, for example, I lose too much weight, then gain back a bit, some studies would include me the the weight regain numbers. I'd say that's a healthy thing to have happened. I suspect @SouthernSleever fits into that category, though I obviously don't know for sure. One other thing you'll find in those studies is that a lot of the patients that regain a lot of weight or failed to lose enough weight tend to be "non-adherent", meaning it's their behaviors, not the tool that's the real issue. We say this a lot here on this board, but it's worth repeating: Bariatric surgery does not fix your head. If you're not willing to commit to learning how to eat better and move more, then you too may be one of those that "fails" bariatric surgery. I would strongly urge you to keep that in mind if you do pursue surgery. You absolutely can reach a healthy weight, but surgery is not a miracle cure. I takes a ton of hard work and commitment to be successful.

Just got done with a long cold rainy run and needed something to warm me up, so it's leftover Japanese curry time. This is around a cup of curry and roughly 1/2 cup of rice.:

There are no limits to what you can lose, nor is there anything that says you will regain any specific amount, or frankly that you will regain anything at all. I think we do ourselves a HUGE disservice (and bariatric doctors are bad about this), by thinking in terms of what's "normal" or "average". Keep in mind that averages are determined by people that regained everything, as well as those the are clinically underweight. I would strongly urge you to stop thinking about what you can expect, and start thinking about what you want.

@WendyJane made a great point. I sort of assumed you were getting your protein other ways, since it's certainly possible to do so without eating meat. That said, transitioning to vegetarian or vegan would be really hard to do right after bariatric surgery. While that sort of diet can be a healthy choice, getting enough protein has to be your main goal. Hopefully your team gave you a minimum protein goal. If not, at 3 months out I would want to see at least 70 grams per day minimum, with 100 as a better goal. As you get to 6 months, 120+ would be ideal, though even more is beneficial. We focus on protein during weight loss for several reasons: Protein is essential to your body. While you also need a small amount of essential fats, you could in theory get those from a supplement. Dietary carbs are not essential because your body can convert protein and fat to glycogen to fuel your body. Protein is highly satiating compared to carbs, plus it takes longer to digest than fats, meaning you'll be full longer. Protein is actually harder to digest, meaning on average, for every 100 calories on protein you eat, you burn about 20 calories just to digest it. This means the more protein you eat, the lower your overall caloric intake compared to carbs and fats. Higher levels of dietary protein help you preserve more muscle mass as you lose weight. Because muscle is more metabolically active than fat, the more muscle mass you preserve as you lose weight, the more calories you'll burn, even at rest. In short, protein, protein, protein. You really can't eat too much protein at this point after surgery.

I eat a lot of soup, especially in the winter. Now that it's warming up, I don't eat nearly as much soup, but we had a cooler day today, so I made Moroccan-Style Chickpea, Carrot, and Spinach Soup. It's topped with some chopped pistachios. I served myself about one cup, but couldn't eat it all: We also had some toasted Pita slices with Muhammara. This is a shared plate. I only had one slice: We ate alfresco on the porch to enjoy the nice weather. All In all a nice evening meal. 😊

This is the most important thing of all! Well done.

But you are smaller! By my calculation, you've lost ~15% of your overall bodyweight in just 3 months! That's an amazing amount of weight loss. If you were thinking you'd be at a normal weight in 3 months, that's just not even close to realistic or in fact possible considering where you started. Most people will continue to lose for at least a year, some for much, much longer. You're doing great so far and as long as you keep following the plan outlined by your team, you'll continue to lose for some time to come.

If you want to try collagen supplementation, you certainly can, though the scientific evidence is a bit of a mixed bag. Some studies seem to show benefit, but I think we have to keep in mind this condition is also a temporary issue brought on by the stress and dietary deficiencies you went through. In short, it's going to resolve by itself over time and thus it's really hard to know if the collagen is actually doing anything. IMO, the best possible thing you can do for your health, for your hair loss, as well as to speed your weight loss would be to really double down on dietary protein intake and not supplements. For those about to jump in and mention that collagen IS protein, yes that's true, but it does not contain all the essential amino acids. As such, you really should not count it toward your daily protein intake. Plus, a capsule isn't going to contain very much protein anyway. I'd guess less than a gram per capsule, though I suspect it might vary based on the source and size of the capsule itself.

Am I understanding you've lost over 60 pounds in 3 months and you think that's "not much weight?" By my perspective, you're doing fantastic and should be very proud of your success so far. I'm not sure where your expectations came from regarding weight loss, but I feel like maybe you had unrealistic expectations here?

You make an important point and I would encourage @AmberFL to think about this more and perhaps search their feelings. There is certainly a lot of danger in moralizing food by labeling things "Good", "Bad", "Healthy", "Unhealthy", etc. The flip side is that totally ignoring nutrient density can also be really problematic for some people. Left unchecked, it can be permission to eat nothing but highly-processed foods or to completely ignore macro and micronutrient content. It also can be a trigger for some people in that they lack the self-control to just eat one piece of that cheesecake. Instead, they eat the entire thing. (Not ragging on cheesecake, I had a piece last night, so it was top of mind.) Instead of moral judgements, I think a better guideline might be how what you're eating makes you feel physically. Especially for athletes, are your food choices making you feel energized and ready for your workouts, or are you always dragging? Are you recovering well? These are the main things to focus on. We can successfully eat a wide variety of foods and be healthy, happy and maintain at our optimal weight. The trick is finding that balance.

Please talk to a doctor ASAP. This is not normal and you could be having a serious complication. Now is not the time to be looking for advise on the internet.

As a general rule, I would not recommend eating back calories burned for a few reasons: People misunderstand metabolism. Our bodies are highly adaptable and our non-exercise calorie burn is also highly variable day-to-day. We know from recent research that your body tends to try to conserve energy balance, meaning unless your burning over ~400 calories per day in exercise, your body will lessen your calorie burn elsewhere during the day to try to "make up" for the exercise calories. In short, you're not burning as many overall calories on those exercise days as you think you are. Our ability to accurately determine calorie burn from exercise is hard and often we think we've burned more calories than we actually have. For example, you may think you've burned say 400 calories, but it may have only been 250. We also aren't very good at accurately tracking caloric intake, so you may be eating a lot more than you think you are. Adding in even more calories to "eat back" your exercise calories is not going to be accurate, even if the two points above were not true. Something here is not adding up for me. You mentioned you're trying to do a body recomp, but also that you still have a lot of weight to lose. That just doesn't make sense. It's fine to say you want to lose fat and gain muscle, and as a newbie to weight training, you can do both, but you really need to make fat loss the priority here. At best as an untrained woman, you might be able to add 10 or 12 pounds of muscle in the course of a year, but in all likelihood it will be less. I don't mean to discourage you, but most obese people already have more muscle mass than a "normal" person, so you can't expect to add as much muscle as they might be able to. My point is that when we talk about a recomp, what we really mean is trying to stay at about the same weight, but simultaneously lose fat and gain muscle. In my opinion, you need to focus on fat loss first, then try a recomp once you're closer to your goal weight. My suggestion would be to focus on two things: Most importantly, are you still losing weight? If not, then you're eating too much. If you are still losing, is it at a reasonable and sustainable rate? I'd want to see no more than about 3% per month considering that you should hopefully be also adding some muscle mass. This factor is really the primary determinant of where your calories should be. If you're losing faster than ~3%, then it's probably a good idea to eat a bit more, but don't change things by more than a couple hundred calories a day. If you're not losing weight, then as I said, you're eating too much and need to consider scaling back. The second factor here is how you're feeling. If you're eating so little that you can't even think about completing your workouts, or you're just exhausted all the time, then that's a sign you probably need to be eating more. Even so, take it slow here. Add in a couple hundred calories a day and see if you feel better. You can go up to where you need to, but keep in mind, you may also slow or even stop the weight loss. If that happens, you may need to modify your workouts. The flip side of this is if you are feeling good, but not losing, that's probably a sign you're eating too much. In the end, it's a balancing act of eating enough to fuel your workouts, but no so much you stop the weight loss. It will take some time to find the right point for you. Best of luck. (Oh, and in the future, I'd strongly recommend just starting a new thread. This one is several years old.)

So sorry you're struggling right now. I think if we're all being honest, we're ALL been there. I've said this before, but I strongly believe anyone that is or was obese has an eating disorder or at least suffers from disordered eating. You simply don't get that big unless you have an unhealthy relationship with food. The thing is, none of us magically got better by having bariatric surgery. If you think you need it, please reachout to a mental health professional to help you get back on track. If you don't feel ready for therapy, that's okay too. You have to do what's right for you. Just know that there is help out there if you need it. I want you to know that I personally have faith in you, even if you don't right now. You are an inspiration to many people here, me included. You've already shown how strong you are and how hard you're willing to work for your goals. I know this is just a temporary setback, and I'm guessing a lot of it was brought on by extra stress due to surgery and your routine being thrown off. As they say, this too will pass. I know you can get your mojo back, so please give yourself some grace. We're often our worst critics. I'm honestly just guessing based on your previous posts, but I'd think you're a very goal-oriented person. It might be beneficial to stop thinking "I need to get back on track". That's just too nebulous. Instead set yourself small, time-bound concrete goals. Only you can decide what those should be, but it might be as simple as "get at least 120 grams of lean protein tomorrow". Forget everything else that part of your personal idea about what "back on track" means and just work on that one small goal until it's become habitual. Only then, add in a new goal to work on. Just keep them small, easily attainable based on where you're at today, and make sure they have a time component such as my goal for tomorrow is..., or my goal this week is... you get the idea. If you need any help with diet or exercise as you work through this, please feel free to PM me and I'll do my best to help. Wishing you all the success in the world!