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Yes, any crisps or crisp like foods such as pepperoni crisps or Serrano ham crisps mentioned above are all a big no for the purée stage. Sure look at them for when you’re much further out but ensure serve the portion recommendations. They can be moorish and before you know it you’ve eaten 2 or 3 serves and there’s 200, 300 calories. (I’m looking at you those pork crackling/scratchings.) It takes at least 6 weeks for your tummy to heal. (Think of all those sutures and staples holding it together.) The staged diet of liquids, to purées, to soft is all to protect your tummy/digestive system and not damage your it or impeded your recovery. Remember too any desire for crunch is a craving and thus a head hunger. It’s got nothing to do with real hunger. The first weeks after surgery are stressful and emotional & naturally your head tells you to seek something to comfort you: food and often crunchy or salty food. Look for distractions at these times: craft, read, play a game, call family or friends, sip a warm drink, go for a walk, etc. It does help. You will get through it and learn to better manage cravings in the future.

Oh for crunch. Toast up some pepperoni in the air frier or bake them till crispy. Use the “chips” to scoop some hummus or mashed black beans or whatever. Or eat plain. But watch calories :). They are addictive.

Honestly the variation in post op dietary advice never ceases to amaze me. I had very few rules - 2 weeks liquid, 2 weeks puree were I think the only guidance I was given. I got most of my information here! I am an outlier in that I adored the puree phase. My first proper food, not yucky protein shakes, for about 2 months. My pre-op 800 calorie a day diet had to be extended when my surgery date was cancelled and I had to be in a state of preparation for a cancellation (that took weeks!) I made family dinner and then just pureed that in a blender with extra gravy. No fibrous veg but I had everything else. I hope you can make it through.

Hi everyone, kinda new here but I figure I should share my personal experiment in the guys room since it involves "strange" elements. I’ve noticed my cut stalls whenever the late-night dopamine loop hits: doom-scroll, snack, repeat. Decided to run a one-week reset to see if trimming *stimulation calories* can help actual calories. **Reset checklist** □ 8 p.m. screen cap: phone goes in desk drawer, watchface only. □ 90 % whole-food rule (any “fun food” must fit before 2 p.m.). □ 3-min cold rinse after workouts. □ Picked up a silicone cage to keep wandering hands + browser tabs in check. (if you're wondering where it goes, the cage is from a funny shop called lockthecock so I'll let you figure that out) □ Lights-out meditation playlist, then bed. **Tracking** • Target intake: 1,950 kcal • Steps: >10 k daily • Sleep (Oura): aiming +45 min average • Craving score (1–5) each night **Starting numbers (Day 0)** Weight: 164 lb Waist: 31.8″ Sleep: 6 h 05 m avg Cravings after 9 p.m.: 4/5 I’ll loop back on Day 4 with a quick note (good, bad, ugly), then final results on Day 7. Anyone tried something similar—phone jail, NoFap streaks, cold therapy—to rein in nighttime nibbling? Drop tips! Cheers

Thanks for clarifying. This may become important if you do go down the surgical route. You didn't say where you live, or what it might look like in terms of paying for surgery, but this may also play a role in your decision-making. What I mean is that if you're in the US, whether or not your insurance plan covers weight loss surgery is an important thing to note. Almost all insurance plans that cover surgery also require some prerequisites that may include a history of previous weight loss interventions. Of course if you're not in the US or you don't have coverage with your insurance plan, then YMMV. @summerseeker makes an important point for you to consider as well. ALL medical and non-medical interventions for weight loss work by reducing calorie intake (for the record, I'm including malabsorption in that bucket since it also reduces the number of calories you functionally have available for your body.) Whether it's surgery, pharmaceuticals, or specific dietary plans, they all work by creating a negative energy balance. With that in mind, it's not so much which is "best" for everyone since they all can work, it's about which is best for you individually to safely lose the weight and keep it off long term.

If you opted for the surgery - you would loose weight for sure. BUT once at target you would still need to increase your calorie levels to a maintenance amount. Without much exercise my maintenance level is around 1500 - 1600 cals a day. To eat more I would need to increase my exercise drastically or I would gain. So when you maintain on similar calories, you will gain if what you say is true. If that is so, baritric surgery is not a fix for you.

I differ from what SpartanMaker says, I wouldn't try any more of the options that are out there. Obviously you first need to recognize that obesity is a disease and it never goes away. You tried to starve yourself to death and the body will automatically save every morsel you put into your body and store it as fat, especially on a 300 calorie diet. Increasing the calories is not necessarily the fix either, you need to look at the foods you are eating. Is it protein heavy or are you still eating salads, which are carbs by the way? Are you thinking that a baked potato is a veggie, it is not it is a carbohydrate, then add all the stuff you put on the potato. Diet wise, you may be choosing the wrong foods. And certainly the amount. You passed out probably because your glucose levels went into the basement with such a low calorie intake. I agree with SpartanMaker, and seek out a Bariatric center that has a whole host of options. Surgery is a tool that the obese person uses and it is a life long commitment to make lifestyle changes. You may need to see a therapist and nutrition expert both to help you, and maybe they have other options other than going straight to surgery, but for certain I feel you need better education on what is an appropriate "diet", and not all "diets" are really diets but ways to spend more money that is just wasted. You obviously have the willpower and stamina to take hold of a new life, it won't hurt to inquire. I would also urge you to watch some of the YouTube videos from BariNation, they have Podcasts with bariatric physicians and other healthcare providers every week and most recently there was discussion about Obesity being a disease and using something other than weight or BMI (Body Mass Index) to determine if someone is obese. My plan has always been to go the cautious or conservative route first. In my case I jumped right in and happy for it. I had an excellent surgeon and team that all worked together to ensure I had a good experience and did. Never had any pain with my surgery, and have had good results so far and today is Post op week 3, day 1. I wish you the best in your journey to seek out further information and a good bariatric group!!

Here we go, currently 35 F. Since I was 21 I have seen an endocrinologist for what seemed like an unknown hormone disorder. They didn't diagnosis with anything but monitored me for years. I had severe cystic acne, Hidrianitus suppurativa hirsutism and I struggled with my weight (always). My weight was not that much of a problem at the time (I was 160, 5'7) but I felt like I was heavier than I should be for what I ate. I was not diagnosed with PCOS because I had regular periods and normal test results. But the doctor told me he wanted to continue to see me. Years later in 2022 my weight skyrocketed to 230 pounds in about a 18 month period. It was shocking, never have I been that heavy. It was awful. I didn't change me diet. The sent me to a nutritionist but I didn't lose weight. It was like weight-loss was impossible. The endocrinologist has no answers and I got a second opinion. Again no answers. Then in 2024 I was the same weight but my asthma was becoming incredibly severe. My lung function was down to 70 present and I was frequently hospitalized last year. They told me my weight was worsening my asthma. I told them I couldn't lose weight. I got desperate and from June to November I ate 400 calories a day and only drank water. I lost 30 pounds. I had no choice but to do this. It was crazy, it was dangerous and I passed out twice but I had no choice. I was dying anyway. By December I started upping my calories to 700 and by January I was eating 1200 calories. My lung function improved to 86 percent and my asthma was suddenly improving based on test results. The troubling thing recently is in the last two months I've regained 11 pounds. I'm only eating what my nutritionist recommends. I'm now at the point of wondering if Gastric Bypass is for me. I clearly can not lose weight easily on my own, worsening obesity makes me sicker. The weigh comes back far too quickly. Would this be the right decision for me?

I'm team both? My diet mantra is 80/20. What I mean is: I try to focus on getting ~80% of my calories from minimally processed foods. (AKA, I try to eat clean.) I don't really track this, I just focus on making good food choices when I can. I try to eat a wide variety of foods, so nothing's off limits. To me, there are no bad foods, there are just some that provide more nutritional value than others. Plus, the more variety i have in my diet, the better overall nutritional profile I'll have. I try to shoot for 80% of what I eat being things that have a bit more nutritional value. For example, most of the time, I might pick spinach or kale over lettuce. I eat carb centered. It's not quite 80%, so my mantra may be a bit off? I suppose between carbs and protein, it probably is 80%, so I'll settle for that. I know this one will be controversial here since the bariatric dietitians push protein so heavily (and don't misunderstand me, protein is critically important), but as endurance athlete at maintenance and 2.5 years out from surgery, I need more carbs than I did during the weight loss phase. Critical to the above is that I don't obsess over any of it. I guess my point in the above is that if you're trying to determine the "best" protein source, maybe the real right answer is there is no best. Once your body starts breaking down the protein you consume into the component amino acids, your body doesn't know where those amino acids came from. The advantage of not focusing on just one source of protein is that there are vastly different micronutrient profiles across foods. The more variety you eat, the better off you are nutritionally.

Did you have any psychological input during your Tier 3? (I don’t know if you had to go through Tier 3?) I had about 4 sessions with an NHS bariatric psychologist, but I believe I’ll still be having a Tier 4 psychological consultation to sign me off 🤞 for the MDT. Also, two weeks post-approval for the LRD! That is AWESOME! I think my trust tends to do the two-week milk diet. Even though I currently eat fairly low calorie keto, I think the milk diet would help lose a bit of pre-surgery weight at least. 💗

Been drinking green tea for about 24 years now and believe me it never did a thing to help with my losing weight. Was drinking it when I had my greatest weight gain periods. Only reason people may notice a little weight loss over time is you drink it plain without extras so no milk, cream, creamers, syrups, sugar, honey, etc. that many add to their coffee so fewer calories. I began drinking green tea for one reason: caffeine was kicking my butt specifically sleep issues & reflux. Tried decaf for a while but felt it was a sacrilege and it would make me a little nauseous. Interestingly the smell of the leftover coffee dregs in a cup turned my tummy too. I also thought if I get any anti oxidant benefits yay but not really a factor. I enjoy it. However, I don’t like the grassy, grainy texture of matcha nor any of the green and fruit blends: bit of a purist. Don’t miss coffee at all. Not all green teas are the same in regards to caffeine content but generally it’s about 1/4 the caffeine as coffee or black tea. So if I have a cup/mug too late it can affect my sleep as it will if I drink more than two a day. Personally I prefer Tea2 green teas (sencha and Buddha’s tears). I believe you can but them online in the US. They have a cleaner taste and tend not to get that bitter dry taste that some brands do. Note the tea bags are large and a single bag gives me a good strong 450ml (almost 2cups) mug. Funny story: Back about 20 years ago, my hairdresser asked an apprentice to make me a cup of green tea. He went out the back & was gone for a little while. He returned and asked how do you make tea green? He was being serious. Still makes me chuckle. Never forgotten his name either: Luke. Bless him.

As a general rule, the effects of supplementation of any kind on weight loss will be extremely minimal. If I had to hazard a guess, I'd say for most people, 90-95% of weight loss is calorie intake alone. Other factors like exercise might make up a few percent, and supplements would be down at the bottom of the list probably only making 1% or less of the impact. Since 1% might mean something like 20 calories a day, you can see how it would be really easy to overcome that effect just by eating a tiny bit more. Keep in mind there is no overcoming basic physics. If you want to lose weight, you have to consume fewer calories than you burn. Things people worry wat too much about in my opinion instead of placing the focus where it matters on calories: Types of diets: Things like keto, low fat, low carb, intermittent fasting, etc. may help with compliance, but otherwise make no appreciable difference in weight loss. Bottom line, eat the way you want as long as you meet your nutrient goals and eat less than you burn in a day. Exercise: Exercise is critical for overall health and fitness, but as a general rule, you are not going to lose much if any weight from exercising. The reason is that your body is really good at stabilizing your overall calories burned in a day/week/month. What I mean is that studies show that for the most part, your body will slow down other processes to "make-up" for the exercise calories you burned, so whether or not you exercised won't actually mean you burn more calories per day. Exercise CAN help in weight loss for some people, but as a general rule, you'd probably need to be doing something that burned more than 400 calories a day, every day for you to see any impact at all. One place where exercise really comes into its own is in weight maintenance post-weight loss. Here the data is super clear. Those that exercise at least 1 hour per day were significantly more likely to maintain their weight loss than those that don't exercise. Supplements: As I pointed out above, at best, supplements might have a very small impact on on weight loss and this impact is really easy to negate by simply eating more. Typically weight loss supplements fall into two categories: Thermogenics (things that increase metabolism), and Appetite Suppressants. Some claim to have both effects. Without going into too much detail, the vast majority of thermogenics work simply because they are stimulants. Caffeine is the most well known and well studied (and frankly probably the most effective), but since you already are a coffee drinker, you're pretty unlikely to get any additional benefit from switching to another source such as green tea. Appetite suppressants are really a mixed bag. These sometimes work for some people, but again, the effects are really small. This is a little old, but I still think worth taking a gander: https://pmc.ncbi.nlm.nih.gov/articles/PMC8406948/#:~:text=A total of 1945 participants,morbidity%2C costs or patient satisfaction. It's a meta-analysis of the impact of green tea on weight loss. The conclusion they came to after looking at 15 different studies: "Green tea preparations appear to induce a small, statistically non‐significant weight loss in overweight or obese adults. Because the amount of weight loss is small, it is not likely to be clinically important." Best of luck.

I'm glad you found something that's working for you. I tried Contrave years ago and it worked for a while, but then the effect faded. Hopefully that won't happen for you. I also wanted to comment on sugar. There's a lot of evidence that our bodies were designed to seek out calorically dense foods (like fat and simple sugars), since historically food was a lot harder to come by. We see this even today in traditional hunter-gatherer societies. Honey is sometimes a significant part of their diet. Imagine having to climb a tree, meanwhile getting stung multiple times, just to pull out a few handfuls of honeycomb. Interestingly, these people know to only take a part of the hive because they want the bees to stay at this location so the hunter can return to it over and over. My point in telling you all that is that it's perfectly normal to crave sugar. If avoiding it for the rest of your life is something you're able to do, then I think that's great. If you know it's not something you can do forever, then you may need to make peace with the cravings and find a way to have some when you can, but be sure to "leave some of the hive alone" till next time. Personally as an endurance athlete, I do consume a lot of simple carbs and so completely avoiding sugar just isn't really something I could do. Keep in mind that glucose (a simple sugar), is the primary fuel that your body uses. It stores glucose in the form of glycogen, but the reservoir is somewhat limited. This means that for longer, harder endurance efforts, it's important for me to consume simple sugars during those runs or rides that will help replenish my dwindling supply of glucose. My normal diet also consists of about 65% of my daily calories coming from carbs to help keep my glycogen supply as topped off as possible. This is a combination of both simple sugars and more complex carbs like fruits, vegetables, bread, pasta, potatoes and rice. If I didn't do this, I simply could not exercise for the duration or at the intensity that I do. My point here is that I've had to come to grips with the fact that for me, carbs are not the devil. They are in fact a necessary and healthy thing. This was a big change for me since historically as an obese individual, I tried to eat low carb most of the time. I now believe there are no bad foods and the best thing for me is to eat a wide variety of foods like most normal weight healthy folks do. Please don't think I'm trying to tell you what you should do! If what you're doing is working, that's fantastic!. I'm more responding to the comment you made that sugar was bad and we shouldn't eat it. For you that may be true, but it's not true for everyone, and certainly not for me.

I went away for a long time, got diagnosed with ADHD (suddenly my life makes so much sense...), and over the last five months I began to lose my grip on my diet and regain. My lowest was 65kg, my "happy place" was 67kg, and I regained back into the 70s at 73kg. The culprit? I allowed sugar back into my life. Never let sugar back in! It has no manners, touches your stuff and doesn't want to leave. Problem is, thanks in great part to my ADHD, I get addicted easily and tend to eat the same thing every day. When that thing is chocolate, I have a problem. I also have impulse control problems and when the food noise is raging, that's bad news. Solution: GLP1s or Contrave. I have a great GP who understands me and didn't reject my request for help to get back to my "happy place" 67kg. We decided against GLP1s and went with Contave instead, which works on countering addiction. The food noise that was driving me crazy has stopped, I quit sugar week 1 and am back in control. I'm nearing the end of month 2 (of 4) and am just over 1kg away from being back to where I need to be. I've stopped being hard on myself for needing help, because even if I could control my impulses there's nothing wrong with medication that's designed to help. Oh and the other thing that's been a game-changer for me: my partner got me a Fitbit. I realise I'm so behind on this it's like screaming "cars have computers?!?!" at a dealership, but being able to track my calories and see the deficit has made a huge difference. So if you're neurodivergent and regaining, hopefully my experience with Contrave can help a little.

I LOVE that you're losing at a sustainable rate. There is so much data to suggest that crash diets almost never work, so losing ~1-3% of your total body weight per month is the sweet spot. I'd take it even further and say 1-2%, which is right where you're at. If I could give advice to anyone either trying to maintain after initial weight loss, or fighting regain like you are, it would be threefold: Focus more initially on learning to eat a healthy diet and less on the weight loss itself. People that follow the fad diet du jour when losing weight almost always regain because they very quickly go back to their old eating habits. If instead you focus on first learning to eat like a normal weight person that eats a healthy diet, you'll be setup for real success. Many people find that if they do this first, they don't really have to "diet" because their bodies actually start to self-regulate calories. Part of this is because when we eat a wide variety of foods that are nutrient rich, our bodies don't fire off signals to eat more. If that doesn't happen for you, there are strategies to slowly reduce intake while still maintaining your healthy diet. The second thing is to focus on instituting a regular physical activity routine. I feel like way too many people skip this, but the data is clear: up to 90% of people that have lost a lot of weight and successfully kept it off for years do a lot of exercise. In fact, the average for those successful losers is ~1 hour per day on most days of the week (roughly 300+ minutes a week.) This is twice the minimum recommended amount to stay healthy, and twice what someone needs that was never significantly overweight. I want to be clear, this is not really a huge factor in weight loss, but in weight maintenance, it's critical. Finally, focus on behavioral modification. Let's be honest. Most of us got as big as we did because we had an unhealthy relationship with food. We may never actually "cure" ourselves of that, but we can learn to fight back. Probably the best thing to do is work with a therapist that specializes in behavior modification, especially regarding weight. I realize this is not an option for everyone due to cost or availability, but there are also lots of good resources available online. Anyway, best of luck and keep up the good work!

For anyone that may be confused by this thread, here are some things to think about related to vitamin supplements: The most important thing is to follow your doctor's recommendations. All bariatric programs I've seen have specific recommendations and you would be well advised to follow these. The vast majority seem to recommend a bariatric specific vitamin supplement. Some may also recommend specific brands of over-the-counter vitamins as well. That said, at least from what I've seen, typically when recommending over-the-counter options, they will suggest taking these twice a day (AM & PM) instead of just once. There are a few reasons for the above recommendations. First of all, you'll be eating a very low calorie diet and thus vitamin supplements formulated for "normal" people may not be sufficient. Also, while malabsorption for bypass patients is a concern, sleeve patients aren't immune to reduced absorption. Some vitamins & minerals are dependent on stomach acid to be properly absorbed. Since all WLS patients will have reduced stomach acid production (at least for a while, if not forever), higher than normal amounts of some vitamins are needed. From a cost perspective, yes, bariatric vitamins tend to be more expensive, but if you have to take twice as many of an over-the-counter supplement, the costs aren't very different after all. Especially if you take advantage of subscriptions like those offered by sites like bariatricpal, the cost of a good quality bariatric multivitamin isn't that much. Keep in mind your food bill should also drop, so at the end of the day you should still be spending less per month. If for some reason you still think vitamins are just too much for your budget, please discuss this with your surgical team. They may be able to help you find a less expensive option that still meets your needs. It's never a good idea to make decisions that can impact your health simply based on things you may have seen on the web. Aside form the cost concerns I mentioned above, there is very little to no downside of taking bariatric specific vitamins, even though some have really high levels of certain vitamins. For some specific vitamins, there is no established upper limit, meaning there's no health risk in taking too much. If you take in more than your body needs, then you'll just safely eliminate the excess. Yes, there are established upper limits for a few vitamins & minerals and this is taken into account in the vitamin formulation. Iron, is an example. The established upper limit is 45 mg/day, which is also the max you'll see in most supplements. Keep in mind this upper limit was established because some people had digestive upset at higher doses. You'd have to take considerably more than 45 mg/day to actually have a significant impact on your body. Further, remember when I said that some vitamins & minerals need stomach acid to be properly absorbed? Iron is one of those, meaning that you're probably not actually getting a full 45 mg/day dose as a bariatric surgery patient. Regardless of which surgery you have, you should be getting regular blood tests for life that check for nutrient deficiencies. if you don't get these from your surgeon (for example, you went out of country for surgery), then please get them from your primary care physician. This is really important because some studies have shown up to 30% of WLS patients end up with nutritional deficiencies post-surgery. Don't be a statistic. Human bodies are not all the same, nor are our diets. This means one person may be successful stopping vitamin supplementation, whereas someone else that had the exact same surgery from the same doctor won't be able to do that. Please don't decide what you should do based on another person, even if it's your best friend, a family member, etc. Only with your doctor's blessing should you consider changing or stopping your vitamin supplementation routine. Regardless of which surgery you have, there is a real possibility you may need to take at least some form of supplements for life. The effects of nutritional deficiencies can be severe, so think of your vitamin supplements as insurance against potentially debilitating or even life threatening problems. Best of luck.

The doctor responded to my question in writing a few weeks ago that there is no good answer because there is no way to know, but saw the value of having access to my stomach to monitor, i don't think she had a chance then to review the EGD pathology report and now suddenly I have a meeting with her. The program coordinator couldn't explain to me why it was so early. 15 years ago I had a bladder cancer scare, and the urologist reacted the same way after they got a pathology report. In that instance they had access to my bladder and did a scope and did not find anything really abnormal. I know the risk is rare, and I look forward to learning about the alternative ways to monitor. And I hope you're correct. RYGB in general would be something I'll have to warm up to because of the increased complications associated with it. The great news is there is a lot of data on it, and surgeons are very familiar. Sinceit's not novel, and if I move I will surely find a doctor familiar with it vs SADI-S or even BPD/DS. For example in my area very few surgeons do either of those two. My insurance doesn't cover SADI-S or OAGB. My preferred surgery is SG. If I'm not a good candidate for it, then I'm glad I'm waiting because I need to do some deep thinking. Dumping sounds terrible. Arthritis runs in my family, and at time even at my age my knuckles and joint hurt. Nevertheless the nephrologist advises against NSAID but they are not off limits with RYGB they would be mostly off limits. I'm not SG or bust really, but I just had a relative share they have precancerous cells in their stomach. That two of my father's siblings with either stomach cancer or precancerous cells. It is a little too close to home. I may be, however, more at risk of dying by slipping in the bath tub, or driving on the highway than getting stomach cancer in my remnant stomach. So I have to be realistic. If I do nothing and get kicked off of Zepbound my weight will return, and my heart will enlarge, and I could die of heart failure or a stroke (in the last 5 years 3 close family members had strokes, and my grandfather die of a stroke years ago). Those are conditions I have now. The enlarging heart may not get worse, but it likely will. My cardiologist is why I aggressively started losing weight to lose 40 lbs since my bariatric first appointment weight-in in February. I've now been taken off one of my four hypertension meds, but I'm still on three. My other concern about RYGB is how will it impact my ability to take sustained released meds. all this I'll talk to my surgeon about in my meeting Tuesday. I've been considering bariatric surgery since 2018, and i put it off. 2022 after a few health scares and being diagnosed with mild but concerning LVH I started seeing a dietician and working out. Later I battled shame to start Wegovy in 2023 and worked with an obesity specialist's practice. In 2005 due to insurance I switched to Zepbound. After my cardiology follow up in January I went for my first bariatric consult. I briefly considered ESG, but after researching decided against it and insurance doesn't cover it. I witched Weightloss clinics and aggressively started tracking and living in a calorie deficit. I'm under no illusions about being able to keep this weight off w/o surgery long term. I don't know if the co pays next year will be even higher already $500 $360 with a coupon, or if my financial situation will change. ifI do nothing, the I'm not sure if I'll make it to my mid sixties if I go back to 315-320. So I have to do something, the question is what.

My number one piece of advice would be not to compare yourself to others. I get it, it's comforting to know someone else went through the same thing as you, but when you factor in genetics, epigenetic, diet, exercise, starting weight, % lean mass, etc. any comparisons will fall short. This will become even more important after surgery when the process becomes really hard and you feel like it's not working like it should. We see multiple posts a month from people who are losing weight, but it's coming off slower than they expected and they want to know why. The response is always the same. Trust the process, we're all different and how we lose weight is going to be different. I think it's fantastic that you're losing so well right now. Keep in mind that the rate of loss WILL slow down some as you lose more. That's perfectly normal, so don't let that discourage you from continuing to eat well and exercising. I would caution you about fasting. There's no scientific evidence that it works any better than any other method of calorie restriction. Normally I'd say do what works for you, but fasting is not something you'll be able to do post-WLS (at least early on), so it might not be the best thing for you right now. Especially since your real goal at this point is to learn how to eat better, I'm not sure fasting is the best plan currently. I also think you need to include more cardio into your exercise routine. I love resistance training for lots of reasons, but cardiovascular endurance is the number one predictor of all cause mortality, so please don't skip it, even if you don't like it as much.

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).

Clean Simple Eats is really good. You can get the variety pack- adding them into Greek yogurt helps because that tang balances out the sweetness in my opinion. Isopure is great and very low carb, Premier protein is good. Latte one with decaf coffee makes an excellent cold brew. Making shakes and adding them are "ok" just have to be careful they can end up being high in calories and not super filling. You can do unsweetened almond milk, scoop of powder, 1/4 of banana, 1/4C of Greek yogurt, handful of spinach if you wanted to keep is low cal, and high protein. But are you trying to protein shakes/ powders due to the stage you are in your journey? I am 16months post op and am able to get all my protein from food. (I am able to eat probably more food than the average post op patient)

HOLY ISH! A year already?! Time has flown! I still remember the beginning of your journey and those first posts—wow, you've come so far and done so incredibly well! I'm seriously so proud of you!! I totally agree with @SpartanMaker—maintenance is no joke, and exercise really does make all the difference. Weight lifting has been key for me too. It helps so much with maintaining, even more than cardio sometimes. Build that muscle and you're burning calories just by existing. Cardio is still super important,! I’m still figuring out maintenance myself, but my workouts have been consistent and even through my 2month spat of not being able to get my nutrition in control, making sure I kept up with exercise has been key I have been consistently doing this and its been great: 35–45 minutes of strength training, 5 days a week, At least 30 minutes of cardio daily (treadmill, dog walks, biking—whatever tickles my fancy), 2 lower body days, 2 upper body, 1 full body and one day a week my doggy and I do a 5-mile walk (she gets a walk every day, but that’s our long one). You’ve been so fabulous through this whole process, and I can’t wait to hear about your continued journey!

Thank you!! I have been trying to beef up my meals instead of eating small "snacks" I can eat more than the usual bariatric patient I think? lol I am still eating around 1700-1800 calories a day but what I am filling those calories with are very much different and I am glad I am back at it!

I realize this is an older thread...but it is still near the top of page and I suppose the "most recent" of it's type ? A pile of stuff has occurred in my life since I was active here on B,Pals. My 10th year sleeve anniversary is coming up later this year. Lost a ton of unwanted weight as a result of the sleeve. Daily trips to gym were the norm. no longer drank beer, but found that sugar free mixers and high grade tequilas and vodkas made for some FUN fuel for many adventures. Storm clouds loomed heavily over my marriage. Some unresolved issues resurfaced in a big ugly way. It appeared divorce was most probable. The storm finally broke....my ship hadn't crashed on the rocks... my wife still my first mate, ally, friend and lover....marriage was stronger than ever. 6 years ago she received a diagnosis for stage 4 breast cancer. Immediately stopped drinking when that diagnosis was delivered. 4 years ago she succumbed to the evil hell of cancer. She fought it with superhuman strength and courage. I will live the rest of my years in awe of her bravery and grit. It has been an incredibly tough go of it since. Her unshakable faith stoked my own faith. That is what I leaned on heavily....and will continue to do so. Early last month, the anniversary of her death was approaching. I was filled with this feeling of guilt in addition to the ever present loss & grief. The guilt was spurned by the realization that I had taken zero steps towards what she had told me to do...afterwards. She was clear that she wanted me to live. I was going to work every day and that was the extent of it. I'd maintained zero friendships and seldom contact my family, other than our son. The hurricane damage had been repaired on the house, yet I'd done nothing towards moving stuff back into the rooms that were repaired. Was living off take out and drive through garbage because I couldn't bring myself to cook...painful memories of meals made & shared together. ENOUGH. That was the word that hung heavy in the air. I could almost hear it as if she'd spoken it loudly. ENOUGH, GREG...IT IS TIME TO MAN-UP I began taking inventory right then. I vowed to not let another year go by with me still living in a bubble...not treading water, but sinking. I have remained alcohol free since quitting those six years. Clear headed and no monsters to address there. Good. Doctors appointment for annual checkup had revealed several things....top of which was my blood panel looked like trash...precisely because that is what my diet consisted of....pure trash. There had been some weight regain...but nothing that I felt like would be too difficult to lose....if I would get my arse in gear and make the lifestyle changes needed. Things were going okay on my job, simply because I'd let it be my focus...the only thing I rallied for. Spent way too much time there. Immediately scheduled some vacation time off and road tripped to visit family Visited my wife's grave....our gravesite and did so with a different feel....loss and missing her....but, feeling more stable for the first time since losing her. She'd forced me to sit down, months before passing, and listen to her on a certain subject matter that I was avoiding. told me to live...how to live....wanted me to continue on with all aspects of life and was very descriptive. She would make ongoing instruction in the months ahead. I couldn't speak in reply...just nod that I understood. She was so brave that she could accept things and love me enough to coach me how to live....afterwards. I was too much of a coward to discuss it....just sat there and listened and acknowledged. She would KICK my arse if she saw the state of low I'd been to. One day, perhaps, I will be able to show her that I heard her and rallied. That time will be at the end of my days, however. Until then, there is much life to live. RESETTING THE SLEEVE WAS EASY: I simply swapped over to strict keto. After two weeks I felt much better....after a month I no longer wanted the crap foods and I no longer wanted big meals. The smaller meals reset things for me. There is a noticeable restriction and feeling of full that occurs now. I haven't finished a meal in a month...unless it was a 1/2 sized meal. Sipping water all day...cutting off prior to meals and 30 mins after. Zero sugar intake an damn few non-fiber carbs. Supplementing with vitamins, iron, potassium and calcium. Moving more....but still not ready for the gym and all the people. Slowly feeling emotionally more "awake". Keto, with an eye on the overall daily calorie intake is how I live now. I don't see changing that. By the time that 10th surgery anniversary arrives, I suspect I will be at my all time lowest weight since college. The sleeve is still there. It just needed me to treat it right and not override it with trash food.

I’ve been here for 6 years now and I’ve see a variety of protein goal recommendations so I don’t believe there is a right number or a wrong number only what you & your team thinks is best for you. For example I was told 60g was my goal from the beginning. Certainly in the first months when we’re healing and not eating large portions focussing on protein is very important. Now at 9 months, you’re eating more and a greater variety of foods ensuring you’re getting in a balance of all your nutrients is just as important like @spartanmaker mentioned. Maybe this is why your dietician has reduced your protein goal or did they mean 65g is more a minimum goal??? As for should you count calories or other macros, my feeling is you have to do what you feel most comfortable with. Another case of you doing what is best for you & much like what you said about exercising. Focussing on counting calories messes with me so I’ve always done just random checks of calories & portions. I probably was & still am more concerned with specific food choices and ensuring I was consuming some complex carbs, fruit and vegetables every day, reducing added sugars. Though I know others who value the accountability of calorie and macro counting and feel doing so keeps them on track - what’s best for them. @SpartanMaker has given you some fabulous information for you to consider &/or adopt or for more rigorous conversations with your team.