NickelChip

I've personally been on both Saxenda and Wegovy. With Saxenda, I lost 20 pounds and my blood sugar and cholesterol improved, but high blood pressure was unchanged. I stopped because the insurance price went from $50 a month to over $200, and my weight loss plateaued so $2400 a year to keep off 20 lbs seemed a bit steep. As soon as I stopped, the weight came back, the A1Cs went up, and the cholesterol went higher than before I started. With Wegovy, I was only ever able to get the first two months of doses before shortages made it impossible. After that, I switched insurance and lost coverage of Wegovy completely, meaning over $1k per month out of pocket if I wanted to continue. I wasn't on it long enough to see how my labs would have been. From everything I've seen, surgery is the only durable option. In my case, the copay is less than a single month of Wegovy, with the possibility of it lasting a lifetime, and the ability to add the GLP-1 drugs down the road if needed. Only you can decide what is right for you, but I think for most people who are at the point of qualifying for surgery, the drugs alone will not be enough, and if you lose access to them, you will most likely go back to square one with weight. Or in my case, square one plus 10 pounds.

The biggest thing that has helped me with being better (not perfect!) about foods was getting all of the temptations out of my house. I went through every cupboard. When crackers or chips were gone, I did not buy more. I've also started ordering my groceries for curbside pickup. I hadn't realized what a huge help this was until this morning when I had to run in for a few things last minute. It was all I could do to walk past the bakery without buying a loaf of fresh sourdough or to keep myself from throwing a bag of Christmas candy into the cart. Shopping online from a carefully curated list is so much less dangerous! At least for me, removing the opportunity to easily access Snacks makes a big difference.

If it helps, remember that this is a completely different surgery than years ago. The reason the risk used to be so much higher was they had to cut you open, exposing you to all sorts of infection risks along with making it really traumatic for your body. Nowadays, they make tiny incisions and even use robotic assistance in some cases. The death rate for bypass is less than 1 in a thousand, and the sleeve is even less than that. Any other statistics are ancient history. It would be like comparing outcomes for diseases today to a time before we had antibiotics, chemotherapy, or insulin.

January 4th for me. I am having some doubts at the moment though xx

I’m 17days post op and very glad to have a group.,

Thank you so much @NickelChip @Arabesque and @MandoGetsSleeved for your responses. I guess you all summed it up in one way or another. I stopped tracking as much, I went back to eating habits I had before the surgery and I was feeling sorry for myself instead of taking ownership.
I needed this - I can’t thank you enough. I will give myself grace and start small with incorporating back habits that helped me lose the weight in the first place. I am really grateful for this community. My family and friends do not know I had surgery so it has been a little lonely.
I am looking forward to getting back on track

I'm a sleeve to bypass revision, and it's honestly the best thing I've ever done. The only time I have dumping is if I eat too many carbs. I only did that twice (holidays both times) and I learned REALLY quick not to anymore. I stick to my diet religiously and have had no issues. If you look at my signature, you'll see I've lost weight with the revision, although nowhere near what I lost with the sleeve initially. I do think your doctor is exaggerating what you'll lose. If you exercise, stick to your diet (or get back on track with it), and get your relationship with food back to where it should be, you'll do fine. My recovery with the bypass was amazing. I've had absolutely no issues with the revision at all. My only regret is that I didn't just do the bypass to begin with. Oh, and I did the revision because of major complications from the sleeve (GERD - never had it before the sleeve - gastritis, esophagitis, polyps all through my stomach and duodenum due to excessively high PPI over a long period of time, etc..).

I highly recommend looking at the videos on the Pound of Cure channel on You Tube, which go into detail about how to eat to lower your body's metabolic setpoint. Foods that are ultra-processed and high carb push your body's setpoint, the weight it wants to maintain, higher, where nutrient dense foods like leafy green vegetables, Beans, nuts, and seeds, make your body want to maintain a lower weight.

As I have been preparing for surgery, I found the Pound of Cure book on Amazon and implemented many of the basic changes it recommends, such as cutting out processed foods, breads, sugar, and artificial sweeteners, and eating more vegetables, fruits, and beans. I lost 15 pounds in around 3 months without counting calories or ever feeling hungry. And I can also say that in the past several weeks, as the holiday treats have infiltrated my house, I have not been as good about eating that way, and to no one's surprise, my weight has shifted upward. I will be returning to better nutrition as soon as the last of the ham, sweet potatoes, and pie from Christmas dinner is out of the house!
I recommend starting with these videos that I've linked below (and then, if you're like me, binge watching the rest of Dr. Weiner's channel). I find his advice to be a common sense approach to nutrition that you should be able to implement long-term without a lot of pain. Hope this helps!
Protein should I eat after Bariatric Surgery?" width="200">

Dr Weiner resources are great as are Dr John Pilcher’s.
Bounce back regain is always a possibility in the second & third year. I believe the average is about 10lb/5kgs so that could be a possibility. This regain can be from not being as vigilant, how you were eating wasn’t sustainable (too restrictive) & didn’t allow you to live & enjoy your life as you want, a change in medication, & your body & new weight set point resettling. And yes, muscle weighs more than fat so some of the regain could be from that too. (Maybe have a dexa scan to compared your fat & muscle mass.)
Start by making one or two changes to your eating & then in a week or two make another change or two. You can start small. Maybe track your food to begin. Then up your Protein & fluids if you’re not meeting your goals. Adjust your portions if they have become larger. Then drop some of your sugar or carbs or swap the highly processed refined carbs for low processed multi or whole grain options. Etc. Small changes are often easier to adopt & adapt to than large all encompassing changes.
Doesn't matter how long it takes you to get fully back on track.

Omg thank you so much for this explanation! This really helped me to understand! You're great! 😊

I highly recommend looking at the videos on the Pound of Cure channel on You Tube, which go into detail about how to eat to lower your body's metabolic setpoint. Foods that are ultra-processed and high carb push your body's setpoint, the weight it wants to maintain, higher, where nutrient dense foods like leafy green vegetables, Beans, nuts, and seeds, make your body want to maintain a lower weight.

As I have been preparing for surgery, I found the Pound of Cure book on Amazon and implemented many of the basic changes it recommends, such as cutting out processed foods, breads, sugar, and artificial sweeteners, and eating more vegetables, fruits, and beans. I lost 15 pounds in around 3 months without counting calories or ever feeling hungry. And I can also say that in the past several weeks, as the holiday treats have infiltrated my house, I have not been as good about eating that way, and to no one's surprise, my weight has shifted upward. I will be returning to better nutrition as soon as the last of the ham, sweet potatoes, and pie from Christmas dinner is out of the house!
I recommend starting with these videos that I've linked below (and then, if you're like me, binge watching the rest of Dr. Weiner's channel). I find his advice to be a common sense approach to nutrition that you should be able to implement long-term without a lot of pain. Hope this helps!
Protein should I eat after Bariatric Surgery?" width="200">

The reason for erratic weigh-ins (and the infamous three-week stall) is that in the early stages of running a sustained calorie deficit, your body does not burn much fat. Your body worked hard to store fat and considers it a precious commodity that it does not want to part with for no reason. For extra energy to make up for a lack of calories in the short term, your body first burns glycogen. 1 gram of glycogen is bound with 3 grams of Water, so as you burn it for fuel, you also flush out this water weight. Only when the glycogen reserve is used up does your body turn to burning fat.

The first few weeks after surgery, you were probably lucky to get in 600 calories per day. Your body was burning glycogen like crazy. When the numbers first dropped on the scale, that was almost entirely water weight. Now that you're a couple weeks out, you're allowed to have some pureed food, and you can probably get closer to your Protein goals with your shakes. With a few extra calories coming in (still nowhere close to what you need every day to power your bodily functions), your body is at least reassured you are not in imminent danger of starvation. It's taking a look at your empty glycogen reserves with horror and doing its best to fill them back up with the calories you are giving it, like a squirrel storing up acorns for winter. For every gram of glycogen your body puts into the storage cupboard, you've got 3 grams of water tagging along for the ride.
Meanwhile, you can rest assured that your body is also burning fat to keep your engines running. However, when you step on the scale, it can't really tell you that you've burned 4 pounds of fat and also stored 7 pounds of glycogen and water. It's just going to tell you that you've gained 3 pounds. But you've done nothing wrong. This is your body doing what evolution programmed it to do since humans lived in caves and constantly had to battle short-term food shortages. Once you've restocked that glycogen, you'll start being able to see the fat loss on the scale again, and in your measurements. As long as you keep doing what you're supposed to do, your weight will move in the right direction. But not as a straight line. Weight loss looks a lot more like a staircase with drops and plateaus, and a lot of small fluctuations that have nothing to do with fat. Try not to let it drive you crazy!

To all my 12/27 buddies - I wish you good luck and can't wait to hear about your successes!
Here is to a new us in 2024! 🎉

The reason for erratic weigh-ins (and the infamous three-week stall) is that in the early stages of running a sustained calorie deficit, your body does not burn much fat. Your body worked hard to store fat and considers it a precious commodity that it does not want to part with for no reason. For extra energy to make up for a lack of calories in the short term, your body first burns glycogen. 1 gram of glycogen is bound with 3 grams of Water, so as you burn it for fuel, you also flush out this water weight. Only when the glycogen reserve is used up does your body turn to burning fat.

The first few weeks after surgery, you were probably lucky to get in 600 calories per day. Your body was burning glycogen like crazy. When the numbers first dropped on the scale, that was almost entirely water weight. Now that you're a couple weeks out, you're allowed to have some pureed food, and you can probably get closer to your Protein goals with your shakes. With a few extra calories coming in (still nowhere close to what you need every day to power your bodily functions), your body is at least reassured you are not in imminent danger of starvation. It's taking a look at your empty glycogen reserves with horror and doing its best to fill them back up with the calories you are giving it, like a squirrel storing up acorns for winter. For every gram of glycogen your body puts into the storage cupboard, you've got 3 grams of water tagging along for the ride.
Meanwhile, you can rest assured that your body is also burning fat to keep your engines running. However, when you step on the scale, it can't really tell you that you've burned 4 pounds of fat and also stored 7 pounds of glycogen and water. It's just going to tell you that you've gained 3 pounds. But you've done nothing wrong. This is your body doing what evolution programmed it to do since humans lived in caves and constantly had to battle short-term food shortages. Once you've restocked that glycogen, you'll start being able to see the fat loss on the scale again, and in your measurements. As long as you keep doing what you're supposed to do, your weight will move in the right direction. But not as a straight line. Weight loss looks a lot more like a staircase with drops and plateaus, and a lot of small fluctuations that have nothing to do with fat. Try not to let it drive you crazy!

Well just got letter from insurance company...surgery is approved...paperwork says Jan 2,2024...tried calling surgeon and weight loss center...no answer..maybe took extra day off for holiday.... Totally excited been long time coming...thank God finally.!!

If it helps, remember that this is a completely different surgery than years ago. The reason the risk used to be so much higher was they had to cut you open, exposing you to all sorts of infection risks along with making it really traumatic for your body. Nowadays, they make tiny incisions and even use robotic assistance in some cases. The death rate for bypass is less than 1 in a thousand, and the sleeve is even less than that. Any other statistics are ancient history. It would be like comparing outcomes for diseases today to a time before we had antibiotics, chemotherapy, or insulin.

I'm supposed to have my surgery on Dec 27th at Mt Auburn Hospital in Cambridge, MA, with pre-op tests scheduled for next week. Today, I get an automated message from my hospital to check MyChart. I did, and it showed my pre-test appointment as canceled. My surgery date is also gone from my upcoming visits. No explanation. Meanwhile, my insurance approval appears to have gone through. I called the weight management center's office and the receptionist mumbled something about surgeries being canceled and someone would call to explain. No one has called all day. I emailed, too, but nothing. Now the office is closed for the day and I'm so worked up over this, I won't get a wink of sleep. It wouldn't be such a big deal if it had to be delayed, except I am currently on an insurance plan through the healthcare marketplace as I am self-employed and my husband has been unemployed for a bit. But he starts a new job in January and I have no idea what the health insurance situation is going to be in terms of coverage. I am so stressed right now I could cry.

I would be very hesitant to get the sleeve, to be honest, in your case. If at all possible, I suggest shopping around for a different surgeon, one who feels confident performing the surgery that you want. In the long run, it would be worth a delay to avoid a nightmare.

I’ll start with your Water issue. Our bodies need water/fluids. Keeps our blood flowing & therefore blood pressure lower, aids flushing toxins out of our bodies, aids brain function, reduce headaches, boosts energy levels, flushes bacteria out of our bladders & therefore reduces chance of infection, benefits your skin (dryness & wrinkling), eases Constipation, etc. All because you didn’t drink that much Fluid before doesn’t mean you weren’t doing the best for your body. In time your body gets used to the amount of fluid you are consuming & you won’t pee quite as often but again peeing is important. Remember feeling thirsty is a danger signal that you are in great need for fluids.
You can add herbs & spices to your cooking to help boost flavour if you find that lacking. The period you are losing weight is an opportunity to try different foods, cooking styles, new recipes, etc. & to get used to eating foods that are not high in fats, sugars & salts, synthetic additives & generally eating more cleanly. You could try making your own sauces too so you control the ingredients. It can be helpful to remember the way you ate before did you no favours & lead t you choosing the surgery.
Being on your current diet doesn’t mean you can’t go out or socialise with family & friends. It’s about making the best choices you can with options available. It’s not something you do every day but if once in a while you aren’t able to eat 100% of what you should is okay. I went to a Chinese restaurant with my mum & old family friends at around 4 months. I chose chicken & cashews & picked at the chicken & vegetables to my appropriate portion draining off what sauce I could. While everyone was sharing all the dishes I stuck to just mine. I took the leftovers home & we ate it the next day or two. I went to restaurants (casual & fine dining), birthday parties, reunions, general social gatherings,… all while I was losing. If I had to contribute food, I made something I could eat. For example at the reunion I made a zucchini bake. All cause you can’t eat something like Christmas Cookies, doesn’t mean you can’t still make & share them with your family. You don’t have to eat them. This will be something that happens after your weight loss too when you work out how you will eat to maintain. I don’t eat cakes, biscuits, sweets, Desserts yet today I made banana bread with my nieces & nephew. We had lots of fun & they all ate some & took the rest home. I didn’t care I didn’t eat any & neither did they (more for them 😁). Socialising isn’t only about eating & drinking. It’s really about spending time with people you love & care about.
You don’t have to give up on your life.

I mean, I guess fear of prison is ultimately what keeps me from actually slapping stupid people... but the way the world is going, something's bound to make me break eventually. Honestly, why is it so hard for people to just be supportive and kind to other people?

Just wanted to follow up on a few things from the post above:

1. DS patients do not typically experience dumping syndrome. We maintain our pylorus valve during the sleeve part of the surgery, so we dump at the same rate as the non-surgical population.

2. Bypass patients have about a 30% chance of dumping, lower if they avoid the food behaviors that trigger it. For all but a few it is a manageable phenomenon.

3. Diabetes goes into remission MUCH more frequently with Bypass and DS patients because of the alterations to the small intestines. As do most other co-morbidities.

4. I don't personally view my DS surgery as "punishing". My body has done nothing wrong. I feel no need to punish it. I personally don't have emotional eating issues but I don't judge those that do, nor do I think it is a reason to punish the body... Having my small intestines rerouted was not a punishment. It was a BLESSING! My fasting blood sugars normalized within 24 hours of surgery. So did my high blood pressure. I'm not on medication for either one. I'm currently 7 weeks post op. I consider remission of those two conditions to be a modern medical miracle... I didn't choose the DS to be harsh to my body. I picked it because it had the best chance of restoring my health and keeping the weight off long term. My surgeon put it best "You have a metabolic disorder. You need a metabolically potent surgery. The DS is the most potent one available..."

My bowels habits have changed, but nothing unmanageable. I have to watch my carbs, that's no different than before surgery. I no longer have to count calories because I malabsorb a portion of them. I'm at risk of Vitamin deficiencies if I don't take my Vitamins, that to me is no different than risking a blood sugar or blood pressure emergency from not regularly taking my meds pre-surgery. Nothing about this process is free. There are always trade offs. Any GI issues that occur with the DS can also happen with Bypass, including vitamin and Protein deficiencies. But protein and vitamin deficiencies are also possible with sleeve patients. They may happen at different rates, but they are unusual across the board. As are serious complications. Gallbladder failure can happen with ANY surgery. It is caused by the rapid weight loss and low fat diet many adhere to post surgery. It is not unique to the DS or Bypass.

I don't think DS and Bypass patients are choosing to punish themselves because they pick these surgeries. They pick these surgeries because of their own individual medical challenges and what they need out of their surgery. Most of us are working to heal various dysfunctional relationships with our bodies, or with food, or both. None of us are exempt from that. These surgeries are ALL support tools, not a punishment for past misdeeds.

I mean, I guess fear of prison is ultimately what keeps me from actually slapping stupid people... but the way the world is going, something's bound to make me break eventually. Honestly, why is it so hard for people to just be supportive and kind to other people?

I will be having gastric bypass done at the end of this month, but when I was trying to decide between sleeve or bypass, one of the resources I used was this risk calculator. In addition to risks, it lets you select your own co-morbidities such as sleep apnea, hypertension, or diabetes to see how likely it is that they will resolve based on which procedure you choose, and shows you a BMI predictor chart at the 12-month mark. I found it pretty helpful. Additionally, I found this video super informative:
The factors that I considered most were GERD risk and the desire to control my blood sugar and blood pressure, as well as feeling like I could benefit from the threat of dumping if I ate too much fat or sugar, my weaknesses! It definitely took me several weeks to decide as I weighed it all.

I mean, I guess fear of prison is ultimately what keeps me from actually slapping stupid people... but the way the world is going, something's bound to make me break eventually. Honestly, why is it so hard for people to just be supportive and kind to other people?

I mean, I guess fear of prison is ultimately what keeps me from actually slapping stupid people... but the way the world is going, something's bound to make me break eventually. Honestly, why is it so hard for people to just be supportive and kind to other people?