NickelChip

You're 100 pounds overweight with a BMI of 38.7 (with 20-25 being normal). Only 20% of people can lose even 10% of their body weight and keep it off for more than 5 years through diet and lifestyle alone. You're looking to lose about 25% of your body weight, at which point you will still be borderline obese (29.5 BMI). You might consider asking yourself, how much more overweight would you have to be to see yourself as "very heavy"? And how much worse would the odds need to be for you to think you have no chance with diet?

A small NSV today, and this is just from the pre-op diet. I bought a dress last winter that I had wanted to wear on my birthday because I was going to NYC and going out to dinner. I bought it at a store where I wasn't able to try it on, and when I got it home, it was so tight that every single button gaped ridiculously. But I was optimistic, so I kept it. It's been a year. I pulled it out today and tried it on, and now only one button right at the largest part of my bust has a slight gap. Another 5-10 pounds and I will be able to wear it with no issues. And since my birthday is 4 weeks away, I think I know what I'll be wearing!

Hi Joe! My surgery is in 4 days. I am 5'6" and at my highest weight, I was 250 pounds, which gave me a BMI of 40.3. Since starting the nutrition program and pre-op liquid diet, I am down to 228 pounds, so a BMI of 36.8. I have high blood pressure, prediabetes, and high cholesterol. Like you, I've dieted countless times. In fact, I was enrolled in the nonsurgical program at my hospital for 7 years, starting when I was 42. I found it relatively easy to lose up to about 15% of my total body weight, around 40 lbs, by counting calories, exercising religiously, and not letting my guard down for a minute. After that, I would stall. Then the weight would creep back up. My doctor would prescribe meds (including Wegovy for a while, but it's too expensive for longterm use for me), and I'd lose 10 pounds. Then I would stall, followed by regain. Or the nutritionist would suggest a new approach, and I would lose a few pounds again, followed by regain. A little more each time. After 7 years of trying, I was back to my highest weight ever. I feel like I wasted a whole lot of time with nothing to show for it. And now I'm nearly 50. My blood pressure, blood sugar, and cholesterol all have gotten worse. My feet hurt. My joints ache. I feel older than I am, and I don't want to be old before my time. I know from reading the latest studies in weight loss science that my chance of long term success in reaching and maintaining a healthy weight without the metabolic reset of bariatric surgery is around 5%. I'm fortunate because I've seen my brother go through sleeve surgery 15 years ago. He lost a huge amount of weight (about half his body weight) and though he has regained a fair amount of that, it's nowhere near where he used to be. His appetite is now what I would call the smaller side of normal. Nobody looks at him having dinner and would guess he had surgery. So I know that the most drastic parts of this (like a liquid diet!) are phases you have to get through to get somewhere better. I feel nervous, too. I've never had surgery. I worry about complications. I'm hardly ever sick, so I sometimes think what if I'm trading decent health for problems? But realistically, problems are in my future. I've seen it in countless family members. The writing is on the wall. And the surgery is very safe. So for me, the risk is worth it. I've tried on my own long enough to know it isn't going to happen for me without this. And a BMI of 40 might not be as big as some people, but it's big enough to rob me of good health in my future. I really hope this helps at least give you some things to think about to help you make your decision. Wishing you all the best!

You may want to clarify pre-op vs post-op targets. I've been given two separate handouts. The lists are similar but a little bit different in terms of what is allowed. I've never personally heard of a pre-op limit on how much protein shake to drink in each sitting, but that doesn't mean your surgeon doesn't do things different. Post-op, you'll probably be lucky to get in a full 5oz early on, but that's a different story. Right now I'm on day 11 of my 14 day pre-op diet and I have been having 3 shakes per day plus sugar free liquids and popsicles. My shakes are made from powder, 2 scoops to 8oz of water. My targets were simply to get 60-80 oz of protein per day and 64 oz minimum of water. It wasn't on the handout, but when I asked my doctor, he said try to stay under 1000 calories per day. Definitely worth a quick call to your surgeon's office.

I'm curious what they told you to expect in terms of weight loss, as I've heard revisions for that purpose don't necessarily produce large weight loss (but do help with issues like GERD). I'm afraid I don't know much about gastric bypass and IBS. That's quite a bit of fruit and veg they have you eating preop. I wish you luck, though, and hope you can get answers to the questions you have!

Programs are so different, but you should definitely be eating, or at least attempting, more solid foods by 8 weeks. In case this helps, I've just found this YouTube channel where a bariatric dietician is working through the food stages in the post op diet. I don't think she'll get to where you are until next week, but you might want to check her out: https://www.youtube.com/@BariatricFoodCoach Also, I found this video really helpful in explaining how to approach eating right after surgery:

Filing that advice away for next week. I'm not allowed to have it yet, but cream of wheat in on my post-op diet. I guess they don't want the carbs for the liver shrinking but it's okay after, or something. I already bought some and will welcome anything that isn't the same old stuff I've had for the past 10 days!

In the interim, if all you want is something that sits on your left ring finger and says, "Back off, I'm taken," Amazon has super cheap sterling silver with CZ wedding ring sets that are surprisingly convincing. I stopped wearing my real ring after I began the divorce process (go figure, right?) but sometimes it's convenient to have a ring on, like when you're traveling alone, so that's what I got. I would never in a million years have chosen the ones I did for real, but they do the job and look pretty real.

My surgery is also on 2/21. What kind of a preop diet did your doctor put you on? I'm on liquids, basically protein shakes, broth, yogurt. Not a single fruit or veggie in sight unless you count creamy tomato soup with protein powder in it.

I won't lie, this is hard. After the first couple of days, I was doing okay, but today was a challenge. I've been freezing all day and I keep thinking of favorite foods, just randomly popping into my head. Not even unhealthy things, just things I can't have. Which is basically everything right now. Next Wednesday can't come fast enough! I hit 229.4 on the scale this morning, which is the first time I've made it below 230 in over a year. Just have to stay focused on why I'm doing this!

@RonHall908 Glad to hear you're feeling good and meeting your goals!

See's is so good! I grew up on the west coast where we had it all the time. Now I'm on the east coast and only get it when my aunt ships a box for Christmas. But I used to like that you could go to their shop and buy just one piece. I always went for a lemon truffle. But speaking of Christmas and Girl Scout cookies, my mom bought a box of supposedly Thin Mint flavored candy canes this year and they were beyond disappointing.

Day 9 on the liquid diet. My greatest disappointment so far has been a batch of "natural" jello that didn't remotely taste like lime. My biggest treat has been tropical flavored Popsicle brand sugar free popsicles. I literally yelled at a robot when I had to call FedEx after they mis-delivered an order from Celebrate that had three new flavors of meal replacement shakes in it. Do not mess with me when I'm hungry and sick of fake cappuccino flavored shakes that don't actually contain caffeine! The robot transferred me to a human and I was much nicer.

Good point about the US/UK measurements. I have several UK cookbooks and they do pose a challenge, although most of our scales and measuring cups in the US offer both metric and imperial side by side, so it's just the temperatures that needs calculation. Took me forever to figure out what a gas mark was. I think the portion plate is probably only helpful for those who lean toward over eating during maintenance. Or if you happen to have a family member who preps your meals and needs guidance on the portions. I recall a friend whose husband got a sleeve, she just couldn't visualize the right portion when she would make up a plate for him. She thought she was doing a "small" portion, and it probably was compared to pre-surgery, but totally inappropriate for after surgery. (Why he couldn't just serve up his own plate like a grown up is a totally different issue.)

If you don't already have some bariatric cookbooks, I can highly recommend these three of the several I bought: Bariatric Meal Prep Made Easy by Kristin Willard The Bariatric Diet Guide and Cookbook by Dr. Matthew Weiner The Easy 5 Ingredient Bariatric Cookbook by Megan Wolf All three have sound nutritional advice as they are written by bariatric experts, as well as some really nice recipes. They talk about portion sizes and what to aim for nutritionally as you go through the honeymoon period and into maintenance, and even give you different portions for different phases. None of the books give specific calorie goals, but that's rather standard with many programs. The focus is often for you to discover what works for you and not get sucked into a dieting mindset by counting everything so closely you drive yourself crazy. But the basics are generally to fill one half of your (small, child or luncheon sized) plate with a 3-4oz portion of lean protein and no more than a 1/2 cup serving of starch/grain, and the other half with non-starchy veg. Consume 60-80g protein. Drink at least 64 oz water. (Apologies for not having the metric measurements). Using a small plate is a really great visual cue. Check out the Portion Perfection plates, which are 8-inch melamine and printed with exactly how much of each food goes where. If you need to retrain yourself, this is an easy tool to use. They have bowls, too. (All the books and the plates can be found on Amazon in the US). Going back to liquids is extreme. I would think it would be sufficient to go back to three meals per day as described above, and either no snacks or only fruit and veg or a protein shake as a snack if truly hungry, and make sure you weigh your portions and get all your water in every day. The other thing is to look for processed foods that have crept back into your diet and get them out of your house. You can't be tempted by what isn't there. Good luck to you!

I told everyone the reason I wasn't leaving my house during the two weeks of my liquid diet was so I wouldn't risk catching Covid, but I think a close second is to not accidentally run into the local Girl Scouts and their addictive boxes of delight. Thankfully, I no longer personally know someone I need to order from. But given that I've had nothing but protein shakes and jello for going on a week, I might seriously consider selling my soul for Thin Mint right now. Or a carrot. Seriously, anything crunchy right now would do.

Just be sure to take care of yourself while you're taking care of your MIL, too. I pray she'll find relief from her pain and that your family will have good moments with her while she's here.

Congratulations, and that salmon looks gorgeous! I love the bowl, too!

I have a local consignment shop where I may take a few things if they're still decent, but I have to confess, my wardrobe lately has been absolute crap. I had bought some cute stuff in a 1x back around 2018, but I gained weight and was wearing 2x and 3x when I moved in 2020, so I got rid of everything. I didn't want to buy an expensive new wardrobe at a higher weight, so everything I have now is cheap Walmart stuff that I'm happy to donate. Thinking about the future, though, I am embracing the idea of a capsule wardrobe, where you buy maybe 10 pieces of clothing that can all be worn mix-and-match, and you change up the look with accessories. When I think about how much clothing I will be getting rid of, it sickens me a little to contemplate buying all of it again. Especially since I only really wear a handful of things regularly. If I had two pairs of leggings, a skirt, a dress, 5 tops, and a lightweight sweater, that would pretty much cover me for 99% of my clothing needs each season. Now to remind myself of this when temptation rears its head the minute I can shop off the rack in all those stores that have nothing in my size right now.

There are two responses that come to mind. First, "So what if I did? You don't get a trophy for making your life even harder than it has to be, darling. Be a martyr in your own life if you'd like, but I have better things to do with my time." The second is a the classic quote from Saturday Night Live, "Jane, you ignorant sl*t..."

Oh, hon. My grandma was like that, too. It's so hard, especially if you get mixed messages. Mind you, I take after my grandmother 100% physically. She was a bigger woman from her tee years at least, and on a diet of some kind her entire life (died at 92, though, so despite the obesity, she had a good run). But my God, she would be one minute talking about my weight and the next breath offering me food. Her idea of a portion size was a full 1lb link of Polish sausage. She would put out enough food for snacks to feed a small army. But then, "Oh, you have to watch it or you'll get fat." I swear there needs to be a patron saint for people trying to be polite to their family members under trying circumstances.

Day 5 out of 14 on the pre-op diet and I've settled into somewhat of a routine. I do a Bariatric Fusion cappuccino shake at breakfast with a 20 oz decaf tea that has 1/2 cup Fairlife milk and a scoop of collagen in it. Oikos triple zero yogurt for a mid-morning snack. Bariatric Fusion chicken soup shake for lunch. Jello for snack. 2 scoops Syntrax Nectar unflavored powder in one cup of Pacific Foods tomato basil soup for dinner. Jello for dessert. Sometimes a Good Night protein hot cocoa before bed if I'm hungry. I also take my chewable Celebrate One 45 vitamin, 3 celebrate calcium chews, 2 scoops of Benefiber, Vitagut liquid probiotic, and a liquid omega 3. Believe it or not, all of those supplements add 160 calories and 14g carb to my day! I also drink three 32oz waters with a sugar free flavor packet in each. Total average daily macros: 850 calories, 105g protein, 11g fat, 50g carb Weight loss so far: 7lbs

@LindsayT It's just amazing what a transformation you've had in less than a year. So inspiring! I am counting the days (11!) until my surgery.

You are looking absolutely amazing! So healthy and happy! I can't even imagine what it must feel like to go from a size 18 to a size 4. Lordy, I haven't seen 145 lbs since I was 17. Congratulations! If you don't mind my being nosy (because I am close to your same starting weight and height, and probably age too), how is your loose skin situation? Have you posted your before photos on here somewhere?

Oh yes, I've heard of Dr. Puebla. Great reputation and the prices in Mexico are incredible. My starting height and weight and end goal are really similar to yours, actually. I swear, I just can't picture how I'll look at the end at all. But I guess if there's a chance I'll want skin reduction surgery, I should get going on Duolingo! I wonder how much Spanish I could learn in two years...