NickelChip

I know for me, this is the hardest time of the year. It's cold (-8F this morning according to my car, which is just insane). It's still kinda dark in the mornings and dark pretty early at night, too. The holidays are over so a lot of the fun you may have been anticipating a while back is done and the routine feels hard and boring. It's not a motivation-inspiring season. So my advice is that sometimes it's okay to take care of your mental health, and that can be as important as your physical health. Within reason, of course, so you don't let yourself slide into terrible habits. But if you have 10 things to do and you can only manage 5, pick the 5 that matter most to you. Don't do what I sometimes do and spend so much time stressing and lamenting over the 5 you can't get done that you end up not doing anything at all. 5 things is okay when 10 isn't possible. You need to move your body, but you don't need to walk AND do yoga, AND do pilates, AND... It's okay to pick one thing. It's okay to skip the gym and go for a walk with a friend. Or skip the walk and get a pedicure one day because your body is just tired. Sometimes that's what will give you energy to do the other stuff. As long as your hair is reasonably clean, sometimes you just need a ponytail. Or a hat. Not all days are cute days. Plan to get done what you must get done plus what you really want to get done, until you feel able to do more and pushing yourself to do it only takes average effort. I think sometimes we deplete our energy to the point that our bodies and minds have to insist on recharging. Give yourself the chance to recharge without guilt.

3 lbs in 10 days sounds like water retention. Have you had more salt than usual? I gained almost 4 lbs in a week at Christmas, but it was gone within 2 weeks and now I'm back to slowly losing. If you've had a disruption to your routine, that could explain it. Or hormonal shifts. Or just your body messing with you because you were looking forward to hitting a certain number on the scale and the universe finds it amusing to taunt you (been there).

My advice is to make changes to your diet and exercise in the next few months that you feel you can maintain for the rest of your life, as opposed to trying a fad diet (Keto, paleo, etc.) that is likely to be too extreme. Focus on basics like reducing your simple carbs and sugars, increasing your lean protein and veggies. Start measuring your portions to make sure you are not eating more than you think. Start getting your 64oz or more of water every day and cut out any sugar-sweetened drinks that you might drink (and also alcohol) because it's just empty calories. Walking and light weights are really great, but remember that about 80% of your weight loss comes from your diet, and only 20% from exercise, so don't feel like you have to go crazy with joining a gym and working out, especially if you're starting from sedentary. Regular walking every day does amazing things. At this stage, small changes can make a big difference. One thing I did right away was go through my cupboards and get rid of temptations. I stopped buying crackers, pretzels, cookies, and sweets. I would still have a treat when I was out, but I would try not to bring it home. Since I work from home, not having things in the cupboards to tempt me was a huge help. I was not required to lose weight before my surgery, but by making these little changes, plus the strict 2-week liquid diet, I ended up going from 251 lbs to 225 lbs in about 6 months. You can do it!

Honestly, right before my pre-op diet started, I watched a video from Dr. Pilcher's YouTube comparing actual surgeries where he was retracting a normal liver, a sort of medium-fatty liver, and a really bad fatty liver. It was downright gory, but after watching it, I was willing to do anything to keep from having the bad liver. So if nothing else works, try finding that video and scare yourself into not eating!

I probably should have said more clearly that the minoxidil suggestion was because OP thought some of the thinning was age related. I also had age-related/thyroid related thinning, so when the expected additional thinning happened after surgery, the result was shocking. I decided to use the minoxidil at that point, knowing that it was not going to do anything for the surgery-related loss and that it would be something I would need to continue for the rest of my life. I completely agree that if it's just the temporary weight-loss/surgery related hair loss, minoxidil is not the right choice. But if you already were concerned about hair thinning prior to surgery, it's something to consider. I also had almost no eyebrows (pre-surgery, for many years, because of thyroid) and daily minoxidil treatment has started to bring those back.

The pre-op diet is probably the hardest thing you will do for the next 10-12 months. It's honestly so difficult, but you can get through it! Once surgery was done, 400-500 calories per day felt totally normal to me for months. A few things that helped me were sugar free jello, sugar free popsicles, and the Millie's sipping broth. Almost no calories in any of these, but you get sort of the feeling of eating, which helps combat the head hunger. Is it perfect? No. But it kind of helps. Also, sugar free gum might help. And if you're truly hungry, ask if you can add more non-starchy veggies throughout the day. I wasn't allowed any meals or veg, just liquid, but since you are, the difference between 2 cups of broccoli and 3 cups, calorie wise, is pretty much nothing. You can eat a whole cucumber for barely any calories, or a salad with baby spinach, cucumbers, shredded carrots, and balsamic vinegar (no oil).

I was wearing a 42DD pre-surgery at 251 pounds, and at 165 pounds, I am in a 38DD. If I lose the last 10-15 pounds I hope to lose, I doubt I will change band size, honestly. The reason I say this is I run my hands around the area where the bra bad goes and I have almost no pinch-able fat left. I could see dropping to a D cup because the breasts themselves still have plenty of room to get smaller, but the band size is limited by the size of my ribcage, which I can feel prominently in that area. In the past few months, I dropped more than an inch from my bust and less than 0.25 inch from my band. In an ideal world, I think I would like to wear a 38C, but that's just my preference. And I am so amazed by how well you are taking all of this. I'm really wishing you the best with the cancer treatment and hoping you are well again soon!

My surgery-induced hair loss has only just started to turn around, so I know what you are going through and how distressing it can be. I have done two things to help. One is using minoxidil every night before bed. I found a 3-pack on Amazon of a spray (not a foam, which I find too messy) that is so easy to use and costs under $40. For a woman's dose (4 squirts per day), each bottle is supposed to last 60 days. I find it doesn't last quite that long, but I probably get about 6 weeks out of each bottle, making it cost maybe $2.50 a week. I've been using it about 14 weeks and I am seeing tons of regrowth, I would say definitely beyond what I lost. The hair is all short right now, a couple inches in length, but by the summer I hope it will be closer to my above the shoulder hair length. Which beings me to my second trick: hats. I live in a cold weather climate and I bought a bunch of hats, although I had some wide fabric headbands and crocheted bandanas in the fall when it was warmer that also got the job done. Not sure if you are male or female, but for women's styles, try searching for either "slouch caps" or "chemo headwear" online for some lighter weight hats that can help you hide the thinning until it reverses and that are comfortable indoors. Once your weight loss slows, the hair should regrow even on a maintenance dose of Zepbound. It just takes time, way longer than you think! Oh, I should say I had my surgery in Feb 2024, so in terms of when my major weight loss was happening, I'm betting we're at kind of the same stage with the hair loss. And I'm almost 51, so ditto on the age-related issues. But the minoxidil is a game changer.

It's valid to feel scared about this new experience and really good that you can express your fears to other people. My first thought as I'm reading this, though, is that your size is thoroughly unremarkable. It may not be where you want to it be, and you're doing great taking control of that and changing your life through having gastric bypass. But at your height and weight, surrounded by adults as you will be in college (and not middle school bullies), your weight simply isn't going to be a thing people notice about you all that much. I had my surgery when I was just slightly under where you are now, and I honestly had a friend (who is average weight/skinny) express total shock at my choice because she thought I was "only a little overweight" (while I thought I looked like a Macy's Thanksgiving parade balloon on two legs). Other people do not see us the way we see ourselves. In your mind, you seem to see yourself as worthy of being judged poorly and disliked for your appearance. I would ask, is this how you look at other people? Do you only befriend skinny people? Do you think fat people are terrible? Because if you do, that's a serious personality flaw that I would be way more concerned about fixing than my weight. And if you don't...neither do most people. Also, if they do? See my point about it being a serious personality flaw. Don't give that kind of person power over you. Your existence, exactly the way you are at any point in time, is not the problem. A person who is judging you for existing is demonstrating that their opinion is not worth considering. Most people don't notice weight first, unless maybe when someone is truly remarkable in size. Most people remember a person's confidence, humor, and overall disposition. They might remember a beautiful smile or a charming laugh, or maybe how you wore your hair or a colorful scarf. They want to be friends because they feel a connection to your personality, not because you have the "correct" size tag in your jeans. Again, if this is not the case, ask yourself why this is someone you want to concern yourself with. The person you want to be is not just a "skinny" person. At least, I really hope not. I would encourage you to make a list of 10 qualities right now that you want people around you to see and remember about you, and none of them can be about your weight or similar societal measure of physical attractiveness. Focus on that list. Do you want people to see you as smart? Kind? Funny? You can be all of those things today. You probably are all those things right now, if you let yourself believe that it's true. You don't have to lose a single ounce to make that happen. Do you want to be someone who takes care of your health? You're already doing it. Who eats right? Who exercises? You're that person now. Focus on the things you have control over. You don't get to choose your weight. None of us do. But you can make food and activity choices every day that promote a lower weight. You can't make a specific person or group like you. But you can be the kind of person many people will like. I wish you the very best of luck. I really wish I had known 30 years ago how absolutely, perfectly fine I was without changing anything, and how little other people's judgement actually mattered. It would have made so many things so much easier.

You're looking amazing! Great job!

I'm going to preface this by saying I am not a doctor and definitely in no position to give healthcare advice, but the most recent studies seem to indicate that very occasional ibuprofen use after a bypass does not significantly increase your risk of ulcers. Not all doctors are up on the research and some just don't want to change their advice on the off chance a patient has an issue, but some doctors will outright say that if you take an ibuprofen or two for a really bad headache or that one time you have an unusual pain, it's fine. You just don't want to exceed maybe once in a week or a few times in a month. The study I read looked at outcomes for thousands of bypass and sleeve patients in Denmark who had been prescribed daily NSAIDs for less than 30 days or more than 30 days, and then looked at how many developed ulcers. Only the bypass patients who took them for more than 30 days had an incidence rate higher than the general population.

Another factor is insurance. For example, I know my insurance would happily (as happily as they do anything) cover sleeve or bypass. Meet the requirements and you could have either one of those, no questions asked. Everything else was considered "experimental" and was not covered. Based on my brother's experience of significant regain after sleeve, plus not wanting to risk GERD and the possibility of a revision, I opted for bypass right out of the gate. I felt like that would be a one-and-done surgery, and I have zero regrets. A few key differences to consider are bypass is a stronger metabolic surgery, so you tend to get more durable weight loss if you look at 5-10 years post-op. But weight regain after sleeve can be managed with GLP-1 meds (if you have coverage or can pay out of pocket). If you have reflux or diabetes/pre-diabetes, seriously consider a bypass as this surgery is great for reducing or eliminating these conditions. If you smoke or require a lot of pain meds, seriously consider sleeve because your risk of ulcers with bypass is elevated by smoking and NSAID use, and the ulcers are very hard to cure. Dumping can be unpleasant but managed through dietary choices. I have had a couple very minor instances of dumping. Once after eating too much sugar (I absolutely knew better when I did it), and once after a few bites of a very rich, very fat-filled Thanksgiving side dish (this one surprised me). In both cases, my heart raced for about 15 minutes to the point my Fitbit thought I was exercising and awarded me "zone minutes." For me, that was the extent of it and nothing I couldn't handle. I'll just avoid that green bean dish next time. Some people do get worse responses. A lot of people never dump at all. One thing to consider if choosing a less-known surgery in the US is your doctors outside the surgeon who performs it may not be very familiar with it. Everyone should know what a bypass or a sleeve is. Hospitals or EMTs might not know much about your anatomy with a MGB or a DS, and that could cause delays in treatment, which in an emergency might become an issue. Not to say don't get those if they're right for you, but you may have to spend more time educating yourself and your healthcare team if you do.

My understanding is sleeve is more prevalent as a first time surgery, but a not-insignificant number of people have revision from sleeve to bypass down the road because of GERD or insufficient weight loss. There are reasons you may choose one over the other, and you want a surgeon who is just as comfortable with either. If he is suggesting one because he's better at it (sleeve is a much easier surgery to perform) then he is not the surgeon for you! This video has some good information on both surgeries from a doctor who does both:

If it puts your mind at ease, the only way to gain 10 lbs of fat in 5 days is to eat 7,000 extra calories per day (in addition to your usual maintenance calories). If you ate like 8,500 calories per day, 5 days in a row, you would remember. Swelling, on the other hand, is an easy way to gain fluid weight really fast. Hope you heal quickly and start feeling back to normal really soon! Once you get through the awkward first several weeks, I'm sure you're going to be thrilled with the results.

Love it! This is a very reasonable menu for the day. I like that it relies mostly on real food and supplies a lot of nutrition from veg, fruit, and beans. My dietician would be thrilled with the macros. If you wanted to avoid the protein shake, you could maybe add 3oz of ground turkey to the chili to make up the protein. I'm 10 months post-op and this would be a manageable/very filling amount of food for the day.