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As far as getting ready: I've got a binder my doctor gave to me. It has basically all the information that I should need going forward. I do look at it periodically to refresh my memory about what is expected of me. For the dietary changes and stages, I write everything I need to stop/start on a calendar. For example: I need to stop drinking coffee and need to taper off to avoid headaches. I am also weaning myself off carbonated water and need reminders. I'm struggling with a few things such as taking small bites, so I like to put reminders in my calendar so i have to see them every day. I'm also changing my vitamins over to different brands and also needed reminders for that as well. (I'm forgetful!) I've made a list of the things I need to buy such as different kinds of protein powder, unjury protein, chewable vitamins, calcium chews, small utensils, small plates, a drink blender, etc. I've made a list of things to pack for the hospital (thanks to several threads here on this website, I have a list going). As I purchase them, I mark them off. Along those lines, I have fairly good ideas of the types of things I will be eating in each dietary stage so that I can plan ahead for grocery shopping when I get to that point. I purchased several books off amazon that were used, and very inexpensive. Things like bariatric cookbooks and bariatric mindset success books. I do try to read a little bit each day and then journal about what I read. I drive a lot for work so I have plenty of time to listen to podcasts. There are several that I enjoy that I feel are science-based, supportive and informative. I've learned many things from these podcasts about bariatrics. They're free and it's easy to just put one on a few times a week. Besides bariatricpal, I am trying to avoid other websites that deal with bariatrics at this point. It felt overwhelming and felt like I kept going down a rabbit hole of horror stories and it was not helping with my anxiety. There is one person on youtube that I enjoy watching because she's many years out and is very inspiring. Now that I have a date for surgery, this all feels very real and scary. I am trying to not give into the fear too much and remember why I am here at this decision. I need to take charge of my health. I have ONE precious life. I want to live the rest of my life in the best health that I can. I've tried desperately since I was about 20 (in my late 40's now) to lose the weight and keep it off. I've had high blood pressure for 15 years and no matter what I do, It continues to be an issue for me. I've been warned that I am pre-diabetic and likely someday soon that will catch up to me and I'll officially be diabetic. I cannot do this on my own and maintain it. It's that simple. This is my second chance and I will not turn back. This is honestly a story about saving my own life by asking for help. I hope this helps.

Mine came after an open conversation with my sleep doctor of all people. I was seeing him because I was getting set up with a CPAP machine due to my sleep apnea. In addition to my sleep apnea I had developed several other obesity-related health conditions including pre-diabetes, chronic pain in my knees and back, some minor heart issues and the worst of all, scrotal lymphedema (I wouldn't wish that on my worst enemy). My doctor pointed out that losing weight would help all of those issues and he added that his mother was quite heavy and was dealing with a lot of health issues and that the sooner I could lose weight, the better my long-term health would be, and he recommended I look into bariatric surgery. That was the first time the idea had even crossed my mind. I did some research on it, but found out my insurance wouldn't cover it and it would be around $20,000 to pay for it out of pocket. But 3 years later I started a new job and got on their insurance, and it covered the surgery, so I began the process at that point.

I'm answering your question as a nurse who works with both bariatric patients and diabetic patients. First, these are two completely different meds, two different classes, two different ways of affecting the body. Phentermine is an anoerectic medication and is an amphetamine that decreases the appetite. Tirzepatide (generaic name for zepbound) is GLP-1 agonist and GIP agonist (it's a dual agonist vs typical single GLP-1 agonist like Ozempic) which stimulates insulin production with the purpose of lower blood sugar levels and helps someone feel full longer. Second, there is a nationwide shortage of Zepbound since early April because of it's popularity. Patients have started choosing compound pharmacies to create this formula for them instead of discontinuing or changing to different medication. With that being said, the FDA doe NOT regulate compound pharmacies. Historically, compound pharmacy are popular with patients needing hormone replacement therapy and these pharmacies abilities to customize said medications. Third, medically speaking, the only medication interaction of concern between the two would be once a patient lost considerable weight, that hypoglycemia would be an issue. In my own experience, yes medical providers will write scripts for dual medications like this for various reasons, circumstances and medical conditions.

I have to be honest about my experience so far with dietitians, and with post-bariatric advice and counseling in general. If you ask 100 dietitians what we are supposed to be doing, you will get 101 different responses. And if you ask them a second time, you will probably get even more. Too much protein, not enough protein, carbs are the devil, carbs are fine, low fat, don't worry about fat, count calories, only count macros, work out more, don't exercise too much... You've lost over 100 pounds. You are 12.8 pounds from your goal at only 5 months post-op, work out 6 days a week, and look and feel great. You seem really happy. I fail to see why you should change anything if you are happy with your results, unless you think the advice will benefit you. You know your body and what works for you, and unless your dietitian is a bariatric patient, she's never been through what you are doing first hand. Take what she says with a grain of salt, except salt is bad, unless it isn't because electrolytes are good...who knows?

First time posting on these forums, so hello everyone. Glad to have found this space to talk about my experience as I find it very hard to communicate with everyone else in my regular day to day life. I'm exactly 15 days post op (Gastric Sleeve) as I type this. And honestly, after reading many replies on here, I almost feel survivors guilt, but I do feel blessed as I thankfully did not experience many issues whatsoever. 24 hours after surgery I walked out of the hospital on my own, sore, but proud. I guess my biggest issue has been sleeping as I move around a lot while I sleep and at the beginning it would wake me up from pain for twisting and turning while I slept, and even then, that's no longer an issue. But, I never had nausea, or vomit, did not take any pain medication past the first 48 hours, I'm not trying to brag, just feeling fortunate after reading some stories on here. Everyone has their own stories and journeys, for me I was obese my whole life. This was ok through my 20s as I felt invincible, and eventually those checks I was writing on my body came back to collect. Back pain and diabetes were first. But it wasn't until a week before the world shut down that things went really off the wall. A long term relationship ended, and as the world closed, it kept me from my support groups, and led me down a dark path of basically eating and drinking myself almost to death with nowhere to go. At my absolute heaviest I thought I would die at a staggering 407 pounds. Poetic as that's the area code for my city lol. Knowing I had to make a change or I would not make it to 40 I went to a doctor, which led to a cancer scare. At that moment my life changed, and I knew change needed to happen now. I began diet and working out and made it down to about 375-380 where I had been hovering for over two years. Bariatric surgery is what I knew I needed to help me, and after fighting with insurance for two years, I finally got a new job last November, and the insurance there covered the surgery 100%! So I began the process in January. And on May 30th, 2024, at 10AM, I went in for surgery. To say that life has changed, for the better, is an understatement. In two weeks I have dropped almost 30 pounds. I'm feeling amazing as far as my stomach (kinda weirds me out to say pouch lol) is concerned post surgery. Still in the liquid diet though looking forward to chewing something this weekend, as I'm absolutely sick of Jello. I am still not hungry, and almost feels like a miracle. My blood sugar is stabilizing without medication. My blood pressure is improving almost daily. Walking a mile a day does not leave me searching for oxygen, and I can't wait to start the gym on June 30th and really kick this into high gear. TL/DR: This is a second change at life, and I will not waste it. Look forward to learning more from others through this process. Onwards and upwards.

I spoke with my surgeon today and was glad I'd read a few people's experiences with trying to get the SADI-s/Loop! I felt knowledgeable enough to discuss the difference and did encounter a bit of pushback as though they really wanted me to just go along with the game plan rather than introducing a new obstacle of insurance pre-approval before being able to move forward. Which, from their perspective, I completely understand. The surgeon told me at different points that 'there wasn't much difference' and implied I'd need more Vitamins than with the Roux-Y surgery. I'm glad I read several medical studies and the Centre for Bariatric recommendations that this surgery be approved by insurance, explaining how for some folks it is MORE beneficial. I may have to get to the SADI-s/Loop via a two step method; getting the sleeve and later a modification (if not satisfied) to the SADI-s/Loop. Time (and insurance requirements! will tell!) It's definitely worth it to feel informed and in control of what choice I'm making regarding such a major surgery. I did make sure to let him know that I appreciated working with him and tell him that I certainly didn't consider myself an expert because of things read on the internet, and that I made sure to read reputable medical journals. I feel like he was much less dismissive after I spoke at length enough to make it clear that I actually knew what I was talking about.

i love to eat. i also love to go out and eat and try new restaurants and go to parties with food and outings with friends and date nights with the Mr. or The Kid. i love to travel and for me and my fam and friends, travel == food. given my preferred lifestyle, i can't (won't!) really do all the switching in of alternative foods. i mean if i'm in Italy, there is no way i'm opting for a cauliflower crust pizza. nor will i forgo butter or effing high fat cheese when in france. i looooooove tasting menus, and i have yet to find one that caters to the "bariatric diet", nor would i want to. for me, i just control portion size (and total calories) and its worked very well for me (so far). i realize that alot of people can't do this in fear of slippery slopes and whatnot, but for ME, its sustainable. its been said time and time again on here: do what works FOR YOU. it may not be what most are doing, or even what your medical team is saying...just find the place you are comfortable operating in and LIVE IT. you may not be perfect, but you can be perfect ENOUGH for YOU.

Chicken wings!! My whole family eats it this way, then we all add the sauces we want or keep sauce-less. I dip mine in Bolthouse Ranch Dressing. So good! Also found this site that I might try next week! https://wow.bariatriceating.com/air-frying-recipes-for-bariatric-eating/#lp-pom-box-229

I am 4 months post-op and after spending way too much time researching, I finally got myself an air fryer! It's the combo type that is built into a toaster oven, so I can keep it out year-round without losing more counter space to appliances. I was also gifted an Instant Pot last Christmas and I will be the first to admit I have barely used it despite hearing so many people rave about them. Now that it's summer and too hot for the regular oven and stovetop, could you help me out with your (preferably simple) favorite bariatric-friendly recipes that use the air fryer or Instant Pot? I don't have any food restrictions except the usual "low carb, low fat" post-surgery recommendations, and try to keep things as minimally processed as possible.

- I found a small digital kitchen scale was my best investment, it helped me get a better idea of portions and made it so much easier to track nutrition stats throughout the day. - tracker apps are great! it took me a while to find one that worked for me personally, but there's a lot out there. I'd suggested testing a few free versions out ahead of time so you're ready before you get there. - bariatric portion plates or just tiny dishes. I actually couldn't find a portion control plate that worked for me (in Canada), but I found a bunch of cute little appetizer dishes and tiny bowls that make me happy to eat from. - if you don't have it, nab a blender or a handmixer when it's on sale. Makes the puree stage much easier, and also helps with smoothies and shakes in the liquid stage. Don't spend a lot of money on one though (unless you honestly feel you'll get a lot of use out of it after you're through those stage).

Must meet one of the following three criteria: 1. Must have a minimum body mass index (BMI) of > 30 with a diagnosis of Diabetes Mellitus. 2. Must have a BMI of > 35-39 and must have at least one of the following conditions: a. Degenerative joint disease of major weight bearing joint(s). The member must be a candidate for joint replacement surgery if weight loss is achieved. b. Other rare chronic conditions (for example, pseudo tumor cerebri) in which there is medical evidence that bariatric surgery is medically necessary and that the benefits of bariatric surgery outweigh the risk of surgical mortality. 3. Must have a minimum BMI of > 40 Here is their wording. I’m obviously number 3 I’m just worried it’s a case by case basis and they won’t approve me.

I went with the Spire group in the UK. My package lasted 2 years so I had all the help I needed. I paid about £12,000 as well. I had excellent care. I know of people who have gone to Turkey for the surgery and have no after care. I have heard on here that others have had aftercare. If you are going that route its a question you may need to ask. As this surgery affects us all differently its impossible to help others when specifics are needed. Only a bariatric dietician can help. Turkey is advertising the surgery for £2000, I don't know if I would risk it though.

I’m just beginning my second week of my pre op learning and it’s been a fun, interesting week (for me anyway!) I started eating a little better, getting more protein in to my daily diet and logging everything. Good news is that I’m 9lbs down in the first week so I will take that win thank you very much. I’ve also been practicing mindful eating too. My approach to eating was to hoover food up as quickly as possible but, after reading about WLS and what I need to concentrate on post-surgery, I have made sure that every meal has taken 20 mins to eat, that I eat off a plate, put my cutlery down between bites, don’t put more food in my mouth when I already have some food in there etc. Being a sceptical kind of person, I wasn’t really sold on the benefits of this but I gave it a whirl, just to see. I will definitely hold my hand up and admit that my scepticism was misplaced. My head and stomach now recognise that I have actually eaten something and it’s registered with them. I now have a feeling of fullness that I didn’t have before, which really is an eye opener. I know it probably sounds strange but I honestly cannot remember having this? Disordered eating has been such a part of my life for a very long time. I’ve also been giving different sources of protein a try, not for post-op as I’ve really taken on board people’s findings of tastes etc changing after surgery, but for the liver reduction diet and to give myself some variety now as I move towards that. I have tried protein water (a bit sweet but doable) protein yoghurts and protein puddings. Hubby recommended some PHD whey protein but I haven’t tried that yet. The bag isn’t yet open and all I can smell is overpowering vanilla 🤢 I will try it at some point this week, just to see if it tastes better than it smells! I’ve also ordered some 0%-everything flavour drops to try in Greek yoghurt etc, just waiting for those to arrive. My Bariatric plates arrived this week, plus measuring cups and spoons. I’ve been consistently taking my multivitamin, vitamin D and folic acid (because of pre-existing meds) have taken the dreaded ‘before’ photos (and managed not to cry) and generally had a positive week. I know my surgery may be a long way off but things are moving in the right direction and I’m happy about that. Onwards and downwards!

Well, bariatric surgeon did not find anything wrong with my pouch (inside my pouch, no scar tissue causing problems, no hernia/bleeding inside pouch, etc.). Ironically unlike the 3 incisions that I had during my gastric bypass surgery, I have FIVE incisions. I guess he REALLY looked around. I look like I got attacked by a knife-wielding assailant with very precise aim..lol. I have my follow up with the surgeon tomorrow to talk about the procedure (he only saw my husband after the procedure as he had back to back surgeries lined up) as I have not officially spoken with him. I am trying to remember to ask him about their stance/experience on semiglutide/similar meds for their patients.

Congratulations! I'm almost 4 months post-op from gastric bypass and my advice is to watch every video from Dr. Matthew Weiner (Pound of Cure Weight Loss) and Dr. John Pilcher on YouTube. These were by far the best resources I found, and I go back and watch many of them (especially Dr. Weiner's, and also his new podcast) all the time even now. Especially the ones on how to build lifelong behaviors to keep the weight off. One thing I did early on, right after my first bariatric appointment where I weighed in at my highest weight ever (yikes!) was order Dr. Weiner's books. There's The Pound of Cure, which gives a detailed, step by step way to make healthy changes to your diet, plus a second book explaining how bariatric surgery really works and then his bariatric cookbook (I also really like Bariatric Meal Prep Made Easy by Kristin Willard). I made several of the changes recommended by the Pound of Cure (I didn't start with the 2-week diet, just started implementing changes I thought I could manage) and over time I lost about 12 pounds, plus just felt healthier and more in control of what I was eating. One other piece of advice: don't over-buy protein supplements. So many people on this board will tell you this, and I did not heed the advice. Now my cupboard is full of protein supplements I stopped liking after surgery and will never use. I've barely needed supplements after the first month or so, honestly. I feel guilty at how much money I spent on them, but I will likely end up throwing them all away (most are opened so can't be donated). If you want to stock up on anything, an unflavored protein powder is much more likely to be useful to you in the long run than the flavored shakes. But if you're buying flavored ones, consider trying a soup flavored one because the sweet ones get old really fast, even pre-surgery. Oh, and take "before" photos! I know taking photos can be so uncomfortable, but you will want them. Choose something very form fitting to start. I went with a pair of exercise leggings and a tank top that was so tight it was like skin. I took photos about a week after my first appointment, so around my highest weight, and then on the day before surgery and at each month-marker thereafter. So far, I've worn the same clothing each time, although I may need to change that as it becomes too baggy to show the progress clearly. Take your measurements the same day you take your photos. You may struggle to see (or refuse to believe) the changes in yourself, but the photos and measurements don't lie. Even if it's painful to see the photos now, you will be so grateful to have them later. I was in shock and wanted to cry when I truly looked at my highest weight photos, but I'm so glad I took them.

Hi 👋 I’m just starting my journey too! My appointments are over the next couple of months but no indication of when I could expect surgery. It could be up to a year apparently but I’m hoping that everything is straightforward with the appointments and tests so there’s no delays (and therefore my surgery is sooner 🤞) Where are you based? I’m UK 😊 I’ve been reading everything I can, downloading bariatric recipe books, ordered a couple of bariatric plates (advised by dietitian for portion control) plus measuring cups and spoons to make weighing a bit simpler. I’ve started to eat a more protein-based diet and I’m learning to slow down my eating (20 mins) so I’m not overwhelmed when I have to start the liver control diet and then surgery! Good luck with your journey, hope everything goes smoothly for you.

I think that's why I feel exhausted at times, working out and not fueling enough. Maybe I need more. But, I'm trying to follow the dieticians directions as close as I can. She has more experience at this than I do. I haven't ate food to fuel my body since I was a kid. My fear is, if I eat too much I'll resort back to bad habits. I'm sure that is most everyone's fear after bariatric surgery. 

So relieved to report I finally dropped to a new "lowest weight" after my 2-week stall. Weighed in at 198.6 this morning, a drop of 0.6 since yesterday. I really hope that might continue a few days at least before I hit the next rough patch. The cravings for sweets and carbs are real! I'm fortunate that I do feel a lot of restriction, or at least I do if I am eating the right kinds of foods. I can only manage about 2-3 oz (60-85g) of heavier proteins, which include salmon, poultry, beef, and pork. I also get full at around 4 oz (100g) veggies. Sadly, if I do eat bread or crackers, they seem to go down easy. Same with ice cream or candy. I had really hoped that wouldn't be the case. It makes it that much more important for me not to keep those types of things in the house. I'm struggling with what to eat, especially for breakfast. Nothing sounds good. I'm tired of plain yogurt and cottage cheese. I'm tired of protein shakes and smoothies. I was enjoying smoked salmon with cucumbers on rye crisp bread until last week when it made me violently ill. I've become repulsed by eggs. Plus, I don't usually get hungry until later in the morning. Today, I decided to wait, and I finally started to feel some real hunger at 10:00am. So, I'm having a leftover big Italian meatball from dinner a few nights ago. Lunch and dinner options aren't much easier. Cooking is a hassle when you can eat so little, and my kids don't like the kinds of things I can eat. But I worry it sets me up for grazing when I don't have a plan. I'd really like to do some meal prep and have a list of maybe 10 go-to meals that are bariatric approved and easy to make any time of day. I'd like to spend a few hours roasting a sheet pan of veggies and cooking some chicken to store in the fridge for the week and incorporate into meals. I need to clean out the fridge and pantry. I just don't seem to have the motivation to do any of it. It's like all my energy has run dry, although my bloodwork came back good so it's not an issue of something being off. Just my attitude, I guess! I'm feeling stressed and a little overwhelmed, and it shows in my environment because my house is getting cluttered and I have a pile of laundry that is quickly going to consume me. What I wouldn't give for a housekeeper to keep the place tidy and my own cook to make healthy meals and deliver them to me at appropriate times during the day.

@BlondePatriotInCDA and @SleeveToBypass2023 This discussion has inspired me to talk to the bariatric surgeon I switched to here in Fort Worth when I see him on a post-op follow up appt on 6/10/24 as I want to discuss how his practice is managing this new set of 'tools' with their bariatric surgery patients. I wish he'd been my original bariatric surgeon. Due to abdominal pain I've been chasing for 2 yrs (right side) I ended up referred to him. TOMORROW, he is performing an investigative laparoscopic procedure to 'scope' the inside of my pouch and see if some of the occasional 'old blood' I have in my er..stools and the pain that hits out of nowhere that feels like my intestines are knotting up, is related to any issue inside the pouch or with scar tissue. I've already done an upper & lower GI in May, gall bladder has been gone for 2 yrs, had a CT-scan, etc. Wish me luck tomorrow. I'm looking at it as very nice and expensive nap with hopefully useful information obtained. I'm also curious what he has to say about my pouch now that it has been 5 years. Is he gonna say 'wow, you sure managed to stretch that sucker!'...lol

I don't plan on being on them for a lifetime, I just need the head hunger to stop and help with the constant hunger...I've been good at fighting it..but I can foresee starting to cheat if I don't get some help. I've tried the alternatives to side track my brain...doesn't work. $250 is way better..hopefully my doctor who's had bariatric surgery will prescribe something to help!

OMG! I'm so thrilled for you!! I remember this!! You are looking so great in your pics!! AWESOME JOB!! I noticed your highest weight was 421. My highest was 400. When I joined here, I only entered 390 as that was the weight I was at when I started trying to lose some more 'on my own' as I was going through the insurance process (SO LONG) to get approved for bariatric surgery. 5 years later and I'm wondering if I should have changed my weight to the highest I ever was or if that is confusing to anyone. Again, I'm just so very happy for you!

Yeah, I worry that people, including 'us bariatric surgery patients' who haven't done the mental/headspace work (and I don't mean this in reference to the 2 people you know that have done the weight loss injections) that most of us try to look or are 'made to look at' at when preparing for gastric bypass will have to stay on them 'forever'. Of course, doing a sleeve or gastric bypass is a very permanent 'anatomical' decision that can, if we are not vigilant also not be successful in the long term for people who feel the surgery is the 'only fix' needed. Since all of my health issues are already under control after my gastric bypass - I NEVER had high blood pressure despite weighing almost 400 lbs and I was not a diabetic but I could tell the toll that being that heavy was taking on my body (my knees, sleep apnea, DVT's/PE's, etc.) I was leery of doing anything that would require 'forever' outside of the bypass surgery. I'm looking for a new therapist right now that specializes not only in anxiety and depression but in working with bariatric patients/weight loss as I know I can I have to be constantly vigilant with my headspace or NOTHING will work. I also am not willing to take the shots for the rest of my life for myself. For other people weighing risks versus benefits I can see this being a highly individualized and personal decision especially if weight loss surgery is not an option for them no matter the reason (leery of it, insurance won't pay, BMI not high enough, etc.). Everyone's journey is their own. The only thing I advocate is for everyone to be as informed as possible and to do their research and make the best decision for themselves. I need to do more research about long term implications of these drugs, but I haven't found much data out there (too new to have that much historical data yet). I'm within 10 lbs of when I told the clinic I'm going to that I would be tapering off and ending the weekly shots. Will try to remember to post more when I've been off the shots for more than a couple of months to talk about struggles or successes I have.

It took about 2 to 4 weeks worth of injections for the true total benefits to settle in and when it did, it was so FREEING. I still absolutely am delighted I had gastric bypass. I also could not afford to pay $1000 a month. I found a local 'wellness' clinic here in Fort Worth where I pay roughly $300 a MONTH for weekly injections. I skipped their package of B12 and Semiglutide as I'm already on an inhalable B-12 supplement. Definitely shop around. I do worry about it causing long term complications (unsure what those are at this point outside of blurbs I've read) but I'm also not wanting this to be something I end up needing to do every week past this 6 to 9 month window. They have other clients that after they got where they wanted, they tapered off completely or come in for monthly or bi monthly injections only. I'd like to taper completely. I have gone a month with no injections after i started and while I had a slight hunger increase, the food chatter was so dang muted. I actually ended up reducing my dosage as I got to a point where I was not eating enough which is ALSO NOT my goal. My protein intake plummeted simply because I was not taking in enough calories. Luckily the place I work with is conservative with dosing and they have multiple patients that had bariatric surgery years ago and they are always ready to discuss 'what is the least amount of semiglutide that you need to be sudcessful'.

Agreed catwoman7 - that was my BIGGEST concern. I was trying to remember how high into the 180's I hit and I found my paperwork. I had gone up to 187 (17 lbs over my weight I had been holding stable on and mentally remembering the 'brief period' at 167, I felt I had gained 20 lbs but it was really more like 17 from my 'stable weight). Prior gains I had ALWAYS kept within a manageable 5 to 10 lb window. We have an adult daughter with multiple mental health issues that moved back in with us over a year ago and the combined stress between her needs and my job was seriously impacting every aspect of my life. I'm also seeking a new therapist that also specializes in clients who are considering or have had bariatric surgery who can help me with multiple issues as I never want to return to food again as a 'medication' for stress and heartache.