MrBeeswax

My pre-op was a waiting game, and I joined BariNation. I watched their podcasts and thought I would try it for a month. I have been there ever since, and am glad to have people to learn from, licensed therapists to talk to and nutritionists that are registered dieticians to get recipes from and information about nutrition. There are physicians that give answers to questions, and peer meet-ups that keep you involved and are very helpful. I spend most days there because there is always something to attend during the day or in the evening. It is depending on the time zone you are in as to when these zoom meetings take place. There is a lot to learn, and one thing I learned is that I have a lot of Non-scale victories both before surgery and now after surgery. I have made friends that get me, and we talk, instead of write, and some I have numbers for and when we have some head work involved, we call and talk to each other to help us past the hard stuff. I would recommend it to help you during your waiting period. Isolation is not a good thing.
I learned over the months that isolation can actually be detrimental to your work and progress. You want to continue to progress before your surgery that is nothing more than a tool. Being in groups helps to keep you grounded, and you can learn about emotional eating to help you to get some work done in the emotional eating realm of our lives. We used to use food as comfort, and we can't do that now, once you are post surgery.
Wishing you the best.

I've finished my Pre-Operative Program at Bariatric and General Surgery at MedStar Washington Hospital Center. I'd previously felt unsure about the program but it's turn out to be a very good experience. Now, I'm in the window where they will request prior authorization and then at some point I'll get a surgery date and be off. For me due to scheduling the gap is going to be about 3 months. Since I have the time I'm interested in learning what could be beneficial for me to consider in this waiting period. I will continue to lose weight with the goal of losing 8 lbs a month. I will continuing exercising, and seeing my dietician. I've eve reached out to setup sessions with a bariatric therapist. I've purchased six months of chewable multi-vitamins and calcium, an assortment of protein shake flavors. But I know there's more needed so please lay your wisdom on me.

the experience of one person is no way indicative of what YOU will experience. only way to know for sure how YOU will end up is to go through it yourself. there is no future-reading here, unfortunately.
all i can say for sure is that if you make an honest effort to lose weight after wls, you will. and if you make an honest effort to keep the weight off in the following years, you *most likely* will.
its easy to lose the weight...its exponentially harder to keep it all off. the vast majority of wls folks will regain SOME amount of weight after reaching their lowest point. exactly how much more is up to you and your habits, as well as your genetics, age, health, etc., etc.,...
good luck! ❤️

most people do have a rebound after hitting their lowest weight. Ten to twenty lbs is pretty common - but like others have said, some people don't gain back any at all and some regain everything. If you commit to keeping your eating under control for the rest of your life, though (not that you can never have an occasional splurge - but keeping things in control at least most of the time), it's very doubtful you're going to gain a ton of it back. It's definitely a life-long effort.

A couple things related to my weight gain - when I gained weight it was due to eating fast food/junk food during nursing school and then the pandemic (people sending goodies to hospitals) and the stress of the job. I also had two traumatizing relationships in that mix - what was 30lbs would have been 60lbs pre-wls
When I was gaining weight, I wasn't stepping on the scale. So now, I do this often to keep me accountable. You are going to regain some, your stomach is tiny and then the swelling goes down and you can eat more (and you should)!
I feel like wls is the only way I could have kept this off. The best thing is that the food noise is gone!
I would redo the surgery once a year, every year, if I had to. That's how important is been to me.

Goodness I cannot believe that my 15 year surgery anniversary will be in October!
A friend of mine is considering weight loss surgery so I went looking for this forum again and thought I would do a quick update!
I had a VSG in Mexico (Mexicali) in October of 2010. I had zero complications and went from a surgery weight of 276 down to about 125ish. Size 24 to size 0. I had plastics in 2013ish (breast, arms, and tummy). I gained up to about 150/160 and stayed there for many years. Over the past 6 to 7 years I have gained weight thanks to nursing school and the pandemic ? but I'm happy with where I am!
I am currently at 170 and in a size 8. (Lots of weight/skin in leg area). My surgery continues to be the best thing that I ever did for myself. The only drawback is that I have GERD, and cannot skip a day without Omeprazole.
My labs are fantastic. I can eat pretty a normal size meal but still have some restriction if I go over that. I'll try to remember to come back incase anyone has questions but really I don't think about the surgery or food much anymore ?

I can't respond to the particular complications you have (only a doctor can) or how bypass might affect them (ditto), but major complications are pretty rare with bypass. The most common complication (and it's considered minor) is dumping, which 30% of patients get (I've never had it - and neither have a lot of others I know), but that can be controlled by not eating a ton of fat or sugar at one sitting, which none of us should be doing anyway. The next most common complication (also minor) is stricture, which is easily fixed by doing an upper endoscopy and using a balloon-like tool to stretch it out. This happens to about 5% of us, and as being the second most common complication, it gives you an idea how common complications are (I had a stricture, btw). You probably hear about them more because people are more likely to post or talk about them because they're looking for advice or support. People generally don't mention that things are going great unless someone specifically asks them how things are going. So it might appear that complications are more common than they actually are. Other than that stricture early on (and they happen very early on, if they're going to happen at all), I've had zero issues, and I had my surgery ten years ago.
we were told that it was OK to take NSAIDs on a very limited and very occasional basis, but I haven't taken any since my surgery. I've taken Tylenol for any pain, and when I had hip replacement surgery two months ago, they found a non-NSAID alternative to aspirin for me since I had to be on some kind of blood thinning agent for six weeks. As far as your other prescriptions, it could be that there are non-extended release versions available - but again, a doctor would know that. Sounds like you'll be having a long conversation, and hopefully it'll provide some answers to make a decision.
as far as having the surgery "late in life", there are many of us who had it in our 50s and 60s (I was 55 when I had mine), so you're definitely not an anomaly! I wish I would have had mine years earlier than I did. The thing probably saved my life (I weighed almost 400 lbs). I am grateful every day that I had it.
good luck with your appts and decision.

I just want to respond to the issue with iron. Depending on the type of iron, you only actually absorb a certain percentage of what's in the tablet. I take carbonyl iron, of which the body absorbs close to 100% ("elemental iron" is the amount you actually absorb, vs the total amount of iron that's in the tablet, and I believe carbonyl iron is the only version with that high of an absorption rate). In other versions, the body may only absorb half, or 20%, or 60%, or whatever, of iron that is in the tablet. That would explain the incongruence of the numbers that you're seeing (e.g., 45mg tablet when the required amount or iron is 18mg). I just cut & pasted this from an article I just googled:

No, 65 mg of iron is not the same as 325 mg. Ferrous sulfate tablets are often labeled with both the amount of ferrous sulfate (the actual pill) and the equivalent amount of elemental iron (the usable iron). A 325 mg ferrous sulfate tablet typically contains 65 mg of elemental iron. So, while 325 mg of ferrous sulfate contains 65 mg of usable iron, they are not the same in terms of their total weight.

P.S. the amount of vitamins recommended are often just a starting point. It's common to have quarterly blood tests the first year, and then annual tests thereafter. I think being allowed to go off all supplements isn't all that common (although it's true for some people), and I'd be surprised if it's true of ANYONE who had bypass, since that surgery has a malabsorption component. At any rate, vitamins and amounts of vitamins required are sometimes adjusted depending on the test results. For example, I require more protein than most patients because we discovered early on that my pre albumin level tanks unless I average 100 g a day. Also, I had to quit taking calcium a few years after surgery because it was clear I had no trouble absorbing it from my food and regular multivitamins, and the overage by taking additional supplementation was not only unneeded, but was also putting me at risk for kidney stones or damage. So your particular needs may change as time goes on - that's why it's important to keep up with any required testing.

TBH, I'm in a similar boat, I meet with the surgeon next week for my second meeting with them. We'll discuss surgery types. In my hometown all the hospitals only do two (SG and RYGB). So I don't really have a choice unless I got to hospitals out of state, and I'm concerned about getting medical care if I have complications and have to drive a 45 to an hour plus to get to the hospital, also the state south of me won't do telelhealth across the boarder, but they also don't have many in-person appointments because normal practice is telehealth. One hospital that does SG, RYGB, SADI-S, and BPD/DS basically said I was out of luck. My situation is a bit different because I am concerned about stomach cancer because it runs in my family. The idea of a remnant stomach freaks me out, at the same time my EGD found H. Pylori negative gastritis (antral and oxyntic mucosa with mild chronic inflammation). To be frank I didn't know how that impacted anything, and all the GI doc did was put me on a high does of a PPI. I don't have GERD, like most people I have heart burn from time to time and Pepcid complete works and i'm done. Surgery is hella scary, but these surgeries are amazingly safer than a lot of surgeries. I am more scared of the recovery and any complications, than dying from the surgery. At the same time, although I've fished my program's requirements save for the final exam I and waiting until this fall to have a procedure. If Tuesday I learn they was to do the RYGB I may very well back away and continue Zepbound. Not being able to scope my stomach is a fear of mine because the GI had no idea what as causing the gastritis and his report suggested that I was on my way to ulcers. So Joy. The human body is complicated. Take your time, it's your time, your life, your body. If you feel rushed tell them so, and if you're scared tell them so. It's okay to be scared, it's okay to be that annoying patient (I know I'm that patient) that asks questions and needs to feel settled. It's also okay to change your mind, and change you mind again. It's a big freaking deal. And living with obesity is also a big freaking deal. Only you can make the decision that's best for you right now. You'll be fabulous if you have the surgery, and you'll be fabulous if you defer.

I have been keeping up with this thread and vitamin supplements can easily be confused. I can only tell you what I know.
I took advice from my surgeon's team, including the nutritionist. Initially I was told to take 45 of iron, then later to take 18 due to my age and being post-menopause. I was also told that the over the counter medications for the multivitamin may not be enough as the bariatric vitamins. Bariatric vitamins are specifically made for the bariatric patient, so it follows the ASMBS standards usually, but you need to look at the "fine print" and look how many mcg, mg, IU, etc of each of the vitamins are in each of the multi-vitamins.
Iron, B12, B50, B1, Calcium etc. should be based on your surgeon's recommendations.
I have had the RNY Gastric Bypass 2 weeks ago, and I had options to choose from regarding my vitamins, but I followed what my surgeon's team recommended. At my 1 month appointment I am to bring my vitamins with me for the nutritionist to review, and to ensure that I am taking what I am to be taking.
As for what is considered a by pass and what is not....Sleeve is not a bypass, but it is the first part of the SADI. That's all I know because a SADI patient told me this. Otherwise, I don't think it matters. I don't like to get into arguments online.
I wish you well as you determine what vitamins that you should be, or not be taking.

I can totally understand your fears regarding the remnant stomach. They may tell you you're fine and it's okay to proceed with SG. If not and they are recommending RYGB, then I do think you should discuss your concerns and family history of stomach cancer.
Obviously your doctor would be the best source of info, but I did want to mention that the inability to do an endo is probably not as big a concern as you think. There are lots of other ways to monitor for stomach cancer in this instance. It would also be worth discussing with your doctor whether you are at increased or decreased risk of developing stomach cancer currently vs. if you did have RYGB. It's entirely possible based on the endo results that failure to act may also increase your risks, so it would be a good idea to discuss all options.
I do also think it would be unwise to let this particular fear outweigh the real risks of obesity and the other comorbidities you already have. As I'm sure you know, with the issues you currently have your risks of a heart attack are quite high.
Best of luck with whatever you decide.

Your worry is going to give you a stroke or higher blood pressure if you are not careful. I'm concerned about that so here are my thoughts.
At 61, I finally had the RNY. Initially I wanted the GSleeve, but was educated by my surgeon about RNY and that made the most sense, it is well researched, it is done laparoscopicly and if you need the other part of the stomach removed, you can ask your surgeon to do that. The Y portion of the RNY might need to be attached somewhere else. I'm not sure. I had no pain and have been able to tolerate all of my walking and light housework during my 2 weeks off work. I tolerated the clear liquids and the full liquids well and now I am on solid foods and doing well. With RNY you tend to lose more, but it is dependent on you and what you eat. With RNY, I was taken off more than half of the medications I was on, and taking none of my diabetes meds and insulin. Having a fear of the GERD with GSleeve, I also opted for RNY. Because you are already on pantoprazole and still have issues, I would suggest the RNY because there is a higher risk for those who already have indigestion issues or suffer from too much stomach acids. RNY you can't have NSAIDS, but with my arthritis, I am allowed to take it only as needed, and I take a capsule of Celeobrex, and it works fine for my painful arthritis. Just talk to your surgeon about that.
Being down 40 pounds already with the GLP1 medication is good, and it will reduce fat on your liver as a side effect. I too have renal problems, stage 3, but was encouraged by my kidney doctor to have the RNY, and yes, the kidney doc also doesn't want me on NSAIDS, but allows me to do so. I need to get down in weight so I can have a hip replacement. Then, I might not need NSIADs any more.
I hope I have been able to give you some information and encouragement to re-look at the different surgeries. RNY is just one step further than the sleeve, and with the history of your family, I'm sure the surgeon will be able to compromise and do a revision to the typical RNY as needed. Having stomach cancer history in your family would be one reason to just take the stomach out that is cut off, like in the sleeve and attach the Y end of RNY elsewhere. A modification should be easy to contemplate and do.
Just another thought, your surgeon may want to meet with you because the ulcer in your stomach is evident on the series of pictures taken, and wants to move quickly to get that part of the stomach taken out? It is possible? Already having an ulcer starting may also be the reason they postpone the surgery and put you on healing meds, and get you to "calm down" because worry makes ulcers worse too.
There are all kinds of reasons and things to factor in, but I would say you definitely need to find out what the surgeon wants to talk about, and go in with some knowledge. I suggest you take a look at some of the YouTube videos by BariNation. You may find out that they help you. I wish you the best, keep us posted after you talk to your surgeon.

I started the surgery process a couple months ago, and just had my second nutrition appointment....and now I'm getting very overwhelmed and having second thoughts. I have my psych appointment next week and my endoscopy in two weeks and I'm thinking about cancelling them cause I feel like this is really rushed and that this is such a big decision I should take some time to think it through and everything.
I'm very worried about possible complications and things going wrong. I have had GERD in the past (this was several years ago and I did weigh more then) and have been on pantoprazole for years. I am tapering off, so it might not be an issue, but my doc kinda pushes the sleeve and I'm worried about getting bad heartburn afterwards, even tho he said there's a 50/50 chance. I've read accounts of people getting crazy bad heartburn afterwards, or just being ravenously hungry all the time, which would be absolute torture for me. Also, I'm on depression, anxiety, and ADHD meds and I just learned about possible malabsorption issues, or even the difficulty of taking pills after surgery. I'm worried enough about remembering everything you're supposed to do post-surgery and not getting totally overwhelmed, it will pretty much be impossible if my depression gets worse....
I wish there were less permanent options available, the idea that you can't go back if anything goes wrong is terrifying....I know the chances of something going wrong are low, but I don't want to rush into anything and regret it afterwards.

There’s a lot of confusion around which bariatric vitamins are “approved” or recommended by groups like ASMBS or SAGES. The truth is, these organizations publish nutrient guidelines based on research, but they don’t certify or endorse specific brands. BariatricPal Multivitamin ONE was developed to meet or exceed those core guidelines in one simple capsule a day.
It includes high levels of key nutrients like ADEK, iron, and B12 that are essential after surgery. It doesn’t try to cut corners with gummies or “bariatric friendly” labels that don’t actually meet requirements. And unlike chewables that some people struggle to tolerate long term, this is just one flavorless capsule a day.
A 12-month supply is $99, which breaks down to just $8.25 a month:
https://store.bariatricpal.com/99
Because it contains iron, it’s best to take calcium separately to avoid absorption issues. You can find a full range of calcium options here:
https://store.bariatricpal.com/collections/calcium
And if you’re comparing formulas, there’s a full selection of bariatric multivitamins here:
https://store.bariatricpal.com/collections/multivitamins

I'm preOP. After reading form the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Manual of Metabolic and Bariatric Surgery (December 2024) I am confused by the diet supplement recommendations there which are very different than those from my program which they say are from ASMBS (and of course different than the statements of the vitamin sellers). The SAGES Manual of Metabolic and Bariatric Surgery says 1 or 2 regular multivitamins, calcium citrate 1200-1500, 2000-3000 IU vitamin D, at least 18 mg of iron, at least 12 mg of B1, and 350-500 mcg B12. I talked to dietician from my program today and she admitted they recommend the bariatric vitamin to everyone to keep things simple and she said it helped with compliance. I kinda feel misled because. The bariatric vitamins are not cheap, and aside from the calcium, Kirkland or Equate multi-vitamins with iron, a B1, and B12 would meet the basic needs per the SAGES Manual. The price of those three pills for a year costs as much as one month of some of the bariatric specific multivitamin supplements (not including Calcium Citrate).

@SpartanMaker is on point as usual. ?
Many surgeons initially patients on a fairly general supplement regime to begin usually including a multi vitamin, calcium and iron. There are variations. Some may include vitamin D and/or vitamin Bs as well. However, your regular blood tests, medical history, type of surgery all will influence what supplements you’ll need before surgeon, post surgery or in the long term.
Plus some surgeons have restriction on swallowing tablets in the initial weeks post surgery which will dictate how you take the supplement (gummie, patch, …).
While sleeve surgery usually does not usually require long term supplementation due to malabsorption you may be someone whose body reacts in a way that means you will need specific supplements. Or it may be discovered you are lacking in a particular vitamin, or your diet is lacking in certain nutrients. Another consideration is if you also have gall removal with your surgery or after as that can result in malabsorption issues in some. For example, I had a sleeve I was required to only take a multivitamin and a Vit D/K. My pre surgical blood work and subsequent 3 monthly tests (actually I was having more as my GP was monitoring them too) showed I wasn’t lacking in anything. At around 8 months my surgeon okayed going off the vitamins. The regular blood tests did eventually historically show I had a drop in vitamin D in winter (when I hibenate and bundle up). Consequently I take a Vit D/K (as a mouth spray) in winter. My gall was removed two years post sleeve and I now have issues absorbing protein and certain medications.
Yes supplements are expensive especially if you are taking a lot & taking them long term. Finding a balance between economies and quality can be a challenge. I do recommend looking for a reputable brand (ask for referrals from your doctor, dietician, pharmacist or people here like Alex Brecher) as it is an industry in which quality and standards are not defined nor monitored like with prescribed medications.

I feel like you may be overthinking the malabsorption component of RNYGB?
Yes, this does elevate the risk of nutritional deficiencies for some vitamins & minerals since absorption sites are somewhat bypassed. You've got to keep in mind though that ALL bariatric surgery patients are going to be nutritionally deficient, at least during the weight loss phase when you'll be eating a very low calorie diet. Very low calorie also means very low amounts of most vitamins and minerals.
Even if your diet were perfect (virtually no one has a perfect diet), you just can't consume sufficient food to make up for your nutritional needs. Yes, you'll eventually get back to eating more normal amounts, but until then, bariatric multivitamins have been formulated to make sure you don't suffer from nutritional deficiencies.
Keep in mind too that the supplementation recommendations are all based on averages and in reality very few of us are average. The volume of food and the nutritional quality of said food, as well as genetic and epigenetic factors all influence what you'll be able to get from diet alone, as well as how well supplementation works for you. As a result, ALL supplementation recommendations are set up to ensure ~95% of patients will have no nutritional issues.
Bariatric multivitamin manufacturers also tend to over-rotate on anything that does not have an established upper limit since they know that their consumers will be having frequent labs done. If someone were to be deficient in a particular vitamin, then they're likely to seek out a different product. You can see this pretty clearly by simply looking at something like the ASMBS recommendations vs the massive amounts of many vitamins found in bariatric multivitamins.
Know too that it's entirely likely your bariatric team will have you adjust your supplementation after your labs are done post operatively. Many will want to do labs around 90 days, 180 days, then annually thereafter to monitor for nutritional deficiencies (or sometimes even excesses). I for example had to modify what multivitamin I took because my B12 level was sky high.
I get the cost concern, and you may be fine with just a regular multivitamin, but keep in mind your overall food bill should drop since you'll be eating so little. This should more than cover the cost difference, so personally I'd err on the side of caution and take a bariatric specific multivitamin at least while you're in the fat loss stage. Once you're in maintenance, you might be able to adjust that (with your doctor's blessing).

Talk to your medical provider. Yes, GERD occurs in some SG patients, in some others it improves. There are too many factors to have hard and fast simple rules. I’m pre operative and totally geeked out researching, and the more I learn the more I understand our knowledge is evolving and the best we can do is get as much information and make the best choice with the information at hand. Find a good program that does multiple surgeries and talk to them about your concerns l.

Talk to your medical provider. Yes, GERD occurs in some SG patients, in some others it improves. There are too many factors to have hard and fast simple rules. I’m pre operative and totally geeked out researching, and the more I learn the more I understand our knowledge is evolving and the best we can do is get as much information and make the best choice with the information at hand. Find a good program that does multiple surgeries and talk to them about your concerns l.

Is a 30% increase of lowest weight normal? I’m pre surgery so I’m trying to gauge where I could be at. This person losing 151 lbs is amazing. Just trying to gauge where I might end up in 8-10 years if I work the plan

@MrBeeswax I feel that no matter which surgery you receive when we suffer from the disease of obesity and we detour from eating properly then we're gonna experience weight gain. Obesity bodies are different than regular bodies who metabolize food normally. We who suffer from obesity have a metabolic disease, so when we get surgery and start back creeping in those "comfort and emotional eating foods" that we KNOW our body loves to store FAT with such as chips, cakes, cookies, unhealthy CARBS, refined sugars, just SUGARs period in access then we're gonna regain unfortunately we have a horrible disease that requires very proper planning for success. I lost a lot of weight really fast with VSG and I credit my success to 1.Meal prepping for success 2. Being organized 3. Movement.
i honestly don't think the type of surgery matters.
its that HAND TO MOUTH MOVEMENT what are we putting in our mouths ?

I was alone. My family all live in the US, I live in the UK. It wasn't possible for anyone to come stay with me. What I did before I went for surgery was set up a space near my bed that I would be able to put all my medications and vitamins, phone charger etc within arms reach so I wouldn't have to bend over or reach. When I came back home, ( I took the bus because I don't drive) I opened my medications and set everything out. They recommend you walk as much as possible. The pain meds helped and as long as you go slow, it's ok. After the first few days, I felt more normal and it was ok.

I had gastric bypass surgery and did everything alone. I live alone, no husband, no kids, no local family, and I didn't tell anyone other than healthcare providers that I was having surgery. I took a taxi to the hospital. Hospital policy does not allow taking taxis/rideshare or public transportation home, so I hired a home healthcare service to pick me up from the hospital (I was in for one night), take me home, and pick up my prescriptions. After that, I had no additional assistance.
The most limiting thing after surgery was not lifting more than 20 pounds for (I think) the first 6 weeks, and also not bending over, like when cleaning or doing laundry, so I had to be careful with household chores, but other than that, I didn't have any problems. I went back to work (desk job) after a week and I was fine.
I will say I had a very easy recovery with no immediate complications, but you won't know how your recovery will go until you get there. I would recommend to anyone without support to have a backup plan. Is there a friend or family member who could come if needed? Could you hire a home healthcare service if you needed help? Also, if there is any physical labor your normally do, like cleaning or landscaping, consider lining up someone to do that for a while.

I have just started a program at Medstar Washington Hospital Center. The surgeon reviews well, but I am concerned because it feels like I'm on a conveyer belt w/o much support. I don't expect support from the surgeon, but there's no one to guide me through the process. The office staff seem to do great administrative work, but I feel like I'm on my own emotionally/care-wise. The classes are through an app and the support groups are monthly only via MS team and during the work day. I am wondering if I should find another program has anyone experienced the program at George Washington University, Sibley Memorial, Howard University, or Virginia Hospital Center. Are they more personal patient care. The current program I'm in feels like I'm just a commodity. Or is this level of detachment and isolation normal? If so I'm not sure what to do.