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So I’m 3 days into keto. I’ve lost 3lbs already. I’m dealing with a bit of keto flu (dizzy and insomnia) but I feel good otherwise. I have about 30g of carbs a day. 100g of protein. And 180g of fat daily.

you obviously have no understanding of keto, most wls patients are meant to do low carb/keto as it is carbs that help you put on weight via gluconeogenesis in the liver when you have insulin resistance from a diet too high in carbs. it is not a fad.

I'm weirdly excited to have someone else to talk to about this too! I had my sleeve with no complications back in 2013. At the time, I was morbidly obese and had a new dx of high blood pressure, but was otherwise healthy and had no health issues to speak of. The sleeve recovery was fine and I lost about 150lbs. Then... I got pregnant. Pregnancy was good, baby and I were healthy, my son was born and life was great. Except that I had allowed about 50lbs to creep back on. So last spring/summer, I decided to kick start my weight loss and went on a keto diet. Shortly after, I started having symptoms of achalasia, which I didn't know what it was at the time, and just attributed my indigestion and vomiting to eating too dense of protein too often with my sleeve. I wasn't seeing my bariatric doc anymore due to insurance changes and just thought I needed to be more careful about what I was eating. In January, I experienced sudden onset of chest pain on my right side, that was so intense I would've thought I was having a heart attack if it were happening on the left side of my chest. I went to the ER, was checked for a pulmonary embolism (which it wasn't) and had a CT of my chest. I had empyema and pneumonia. I was admitted, the next day I had 2 liters aspirated from my lung, and it wasn't enough. I had to have surgery (thoracotomy), and during that surgery I aspirated. I ended up being put on a ventilator, sedated until they could stabilize me and operate again. I had my second surgery which was successful, but left me in so much pain! After that, I ended up with sepsis in my blood, my kidneys failed and I needed dialysis - all while I was too drugged up to know what was happening. I was referred to a university hospital in Chicago by the GI that saw me in the hospital. I had all the testing and confirmed I had achalasia - which now that I know what it is and have read up on it, I realize that my symptoms were all pretty spot on for this condition. My new bariatric surgeon says that the sleeve will cause reflux if he does the myotomy without converting to bypass, so that's what we're doing. I totally understand what you mean that some days are better than others. There are days I can eat just about anything with no problem, if I try to eat the same things the next day, it's a disaster and I'm miserable all day. Unfortunately, the easiest thing to get down most days are CARBS. If I continue to have swallowing problems after the myotomy/bypass, I have no idea what I'll eat! I also have problems with protein shakes, water, yogurt... stuff you would *think* goes down easily, doesn't. I'm quite nervous about what comes after this and why I developed this in the first place. Knowing that it's an auto-immune disease has me worried I may develop others, as you did. I'm sorry for us both suffering from this awful condition! Losing 50lbs in 4 months is fantastic, especially given the disadvantage of eating problems. I hope for similar results - I figure if getting this condition is what prompted me to do something about the remaining weight that I never lost with my sleeve, then it's not all bad. If you have any links of resources for this condition, please share. I've done my own research, but then I see other people referencing having "atypical achalasia" or "type 2 achalasia" and I have no idea what that means!

I had my surgery 3/9, then got no support. Was stalled the first month. It was more than frustrating. I think I’m down 40 pounds, including the presurgical loss. I had hoped it would be faster. I reached out to the doctor. All he said was, Do you want to be a pile of skin?” The office support is non existent. I am using the ProTracker, Keto/calorie, free app. If I go no carb, I stall. Too much protein, I have a gout attack. Have been diligent about keeping carbs under 50, Calories under 1000. Exercise is sporadic, as I had a serious leg injury, in April. I have no desire to binge, which is a big plus, no cravings for anything. I’m doing all I can, and focus on that. A pound-a pound and a half, a week, will have to do. It’s the mystery up a pound, that’s hard to take.

Thank you for sharing. I’m going to try a few things. Strongly considering Keto

I don't judge anyone, in fact I mind my business (unless they ask me a direct question, then I will tell them about surgery, keto or intermittent fasting) After all I don't go around providing fashion, makeup, business, financial and child rearing tips to strangers that didn't ask for it. Why should I give tips for weight loss (It seems like an incredibly narcissistic thing to randomly do)

I love eating the keto diet, but it does have some negatives. For me, it's constipation and bloating. They are constant companions for me lately. I have been getting in 75-100oz of water and have been upping my fiber consumption, but hasn't been helping much. Have you had any issues like this?

It looks like there have been a lot of ppl who don't read. I eat 1000 calories or less and weigh 280. I was bulimic for years. I got the band and list then regained even though I was under 1000 caliries a day. I'm considering the surgery because the doctor says it changes your body's set point. My fear isn't that I won't lose, but that once again I'll regain because my body really wants to stick at this weight. I eat a whole foods diet, not a SAD. I do keto. I just don't lose. Sent from my SM-G935P using the BariatricPal App

No it really isn't "super high fat" in the original derivation. Atkins in his original derivation had food plans that averaged between 55-75% fat. That's a "skewed" percentage cuz whenever you take 1 macro down, the others go up. It didn't equate to gobs of fat like today's modern "Dave Asprey" world where you add butter to coffee, live on fat bombs, etc. The modern LCHF which is now just called "Keto" is a minimum of 70-75% fat. So yeah, much much higher fat. And agreed it. It's only ever been "protein adequate" and can be very low carb, but can also go as high as 50-70g of carb whole, non-netted. I can eat 50g of carb with most coming from low glycemic veg and leafy veg and I will still be in ketosis all the live long day. Swearsies!!! Also, I think the definition or experience of keto differs greatly based on surgery type and amount of bypass (how much of the intestine that handles fat and sugar was actually re-routed). With VSG, you have no malabsorptive problem. So you can handle the extra fat very efficiently. I swear. I've studied this for about 18 years and read almost every book on the subject from the leaders in the fields. Congrats on losing your regain and doing so well!!!!

I am not in Ketosis. All my Jell-O and popsicles have sugar in them and I was eating cream of potato soup just to make sure I stayed out of it. I drink a strawberry Snapple everyday as well and have since surgery. Also I should say I have left over Keto Strip that you pee on just to make sure!

I do modified keto - cut out all sugary and starchy carbs (sugar, rice, potato, bread etc) but eat whatever fruit and veggies and legumes I like. So, not really true keto but keto-ish. Facing said that, I've just started the Jan challenge and want to keep my net carbs under 50 a day so that means no fruit most likely. Sent from my SM-G930F using BariatricPal mobile app

My thoughts about this are: "Why do so many patients seem to feel the need to go on special restrictive diets after having WLS? Aside from allergies, intolerances or ethical reasons - why make a diet more restrictive than it has to be? Especially when thinking about that neither going "keto" nor "low carb" nor "low fat" solved our weight problems."

I wouldn't call my diet a true therapeutic keto diet, since I am basically doing 1:1 fat to protein. I would call it more of a keto inspired diet. It's the best I can do keto, while I am limited to about 1000-1200 calories a day at this point. Since I still have to get around 120-150g of protein to meet my daily needs (since I am working out a lot), I just can't eat enough fat and still stick to my calorie goals (and I don't want to go too high on calories this early post-op). Nevertheless, I am still in ketosis, but I get kicked out if I have too much protein in one meal. Since I am hitting my protein goals daily, I do try to prime the pump by eating some good fats first (like avocado) before I eat my protein. As for keto sticks, they aren't the most reliable tests, but if you're in your first month to 6 weeks of a very low carb diet (20 or less grams), they are helpful in letting you know if you're in ketosis. However, if you get a reading on them doesn't show acetate (which is a by product of ketosis) in your urine, that doesn't mean you're not in ketosis--so, in the sense they aren't reliable. Of course, they are only reliable in the beginning. Once you become fat adapted, you shouldn't have any acetate in your urine. The blood test is obviously the most accurate way to check, but I am just not up for spending $60 bucks for a blood meter kit and just 10 test strips, since the test strips are so freakin' expensive. The keto sticks are good enough for my purpose and there are plenty of physical signs that you're in ketosis after the 6 week mark anyway. Frankly, with or without a ketogenetic diet most early bariatric patients are going to be in ketosis anyway because they are consuming barely any calories. A ketogenetic diet essentially stimulates the benefits of a fast, without having to actually fast (although you would want to mix in intermittent fasting with keto if you want to maximize losses---if you are NOT a bariatric patient or are more than a year post-op). Also, even you are a bypass patient, you can still do keto--but you have to start a little differently by phasing in fats over the course of a few weeks rather than making sudden transition which a non-bariatric patient might do. There are plenty of resources online for bariatric patients (including bypass patients) that would like to transition to a keto diet.

Thanks for the tip on the MCT oil. I am going to look into getting some. It's pretty high in calories though?? Does that concern you at all? Even on keto, you still have to watch your calories.

I am just over 3 months out and most days I am able to get all of my protein from whole foods. I always eat my protein first, then veggies if I have room. At this point, I'm still not eating any starchy veggies or simple carbs, simply because I don't have room for them after my protein & fibrous veggies. Occasionally, my restriction is higher which further limits how much I can eat, or if I'm out and about, I'll drink a shake or have a protein bar, but that's definitely not the norm anymore. As for bariatric foods, I do not and have never used them. When I decided to have surgery, I committed to eating regular, whole foods as much as possible and completely get rid of "diet" foods. I don't do keto/bariatric/low carb/low fat/whatever diet foods or substitutes. I didn't have surgery to eat crappy diet food for the rest of my life; I want to eat GOOD food. Stuff that tastes good and is good for my body. That is just a personal preference though, and lots of people use bariatric foods with great success and truly enjoy them. You have to find what works for you!

@Proud2BeMe Nice to see you posting again! I'm glad you worked out your alcohol issues, we were worried. I think that those of us that were super morbidly obese and lose to normal or close to normal size really face special issues. Most of the people that post here now are not and have not been super morbidly obese They start in the 200s if that. So their opinions to me don't carry that much weight (ha!) There are very few people that are in the situation that people like you and I are in. People can't and don't understand. It is a really huge mental trip, and most people will never experience it. I would normally say seek counseling but I am going to be honest, it isn't going to be very useful. Not many of them are going to have experience with what you are going through. You have to really just work through your feelings and emotions in your own way on your own path. I would rather see you abusing carbs than alcohol, but the fact you feel the need to go overboard on anything is an issue. I think time to adjust to yourself is the best and only realistic solution. I eat keto/low carb (less than 25G per day) because it keeps me upbeat and my moods balanced. I enjoy it and it is healthy. You should eat in a manner that makes you feel good and is healthy for you. You probably just lost weight because you upped your calories, not the carbs. So just eat more protein. I'm going to PM you.

Wow, that's a drag. I'm just the opposite. I'm on day 8 of pre-op and have nearly no hunger. I do pump a lot of water through me though because I learned sometimes when I feel hungry I'm actually thirsty. My only issue, and it's minor is that I am having trouble sleeping at night. I understand it isn't uncommon with Keto and high protein diets, but I wish I could get a really restful night in. All the best!

Thank you! Point taken. I am in need of some variety and am trying to find meals that are simple, tasty and on plan. But as you say, my priority is to maximize weight loss at this stage. It’s been going fairly well so far and I don’t want to disrupt the steady progress I am seeing. But I’ll keep that keto pizza in mind for some time in the future.

Damn i thought i replied but it never up loaded...https://www.healthline.com/nutrition/protein-for-vegans-vegetariansPea protein, hemp hearts, tofu, chia, etc. Not single source. Its going to cost you calorically but it can be done. Usually you have to plan very well and make your own foods. Example if you make falafel you can add ground hemp hearts, chia seeds, flax, pea protein, spices,etc. Stir fry mushrooms with fluffed buckwheat and quinoa. Eat with a hummus spread. You will work harder (especially if you don't like legumes) but its possible. I have come to the very real conclusion that my time with animal protein is almost over, but I'm interested in keto, I stopped by to see if I could do it for a short burst then try to vegetarian/vegan keto for a burst to break through anticipated plateaus VSG2017 HW 249 SW 238 CW 167

I like xylitol in my black tea - just a little sweet and it doesn't make me crave sweets all day. My husband went hardcore keto when I had surgery and giving up his honey was tough - he used my xylitol for a week or two and then discovered pastured cream. He tried new (stronger) teas until he found a combo he likes and doesn't use any sweetener at all any more. The fat seems to help him with carb cravings, too. He's lost about as much weight as I have, btw. Sent from my iPad using the BariatricPal App

Keto may really help you kick the sugar. When I eat keto or close to keto, I do not have cravings. High fat really works well for me. High protein sometimes leaves me feeling more hunger. So, for example, if I don't eat enough fats and eat chicken (high protein but lean) for a couple days, I get hungry or cravings. Fats mainly come from avocado, cream and nuts. Sometimes butter.

Sorry if I'm repeating myself, I've lost track of which threads I've posted on. My doctor said to keep it under 10g total carbohydrates per serving, and target 50-60g total max per day. Not low enough to go into Keto, unless that's your intent, but low enough for the body to prioritize burning fat first. I know on days that I've blown past this, I'll feel more irritable a few hours later and I'll crave more bread and sugar for 2-3 days afterwards, so go lightly on it! Personally, I've had trouble with some artificial sugars causing cravings and irritability. Not everyone will have this intolerance, but pay close attention to any sugar alcohols or substitutes in ingredients and see which ones affect you. I've had luck tolerating monk fruit and stevia, but Sorbitol and Xylitol hit me as hard as normal sugar.

My kids and my husband and one friend know. My son told his fiancee. That's it. Too many judgmental people in my life. Everyone has been trying to talk me into doing keto, not knowing I've done the surgery. It bothers me that people are trying to push me into it. Plus I'm so emotional post op. I've lost nearly 30 lbs in a month and a half and I feel like them pushing me means I haven't lost fast enough for them. So if I tell them I've had the surgery what will they think? That I can't do anything right? No thank you. I'll keep it to myself. Sent from my LGL59BL using BariatricPal mobile app

Today, Monday, Dec. 16 Maintenance : 5'2" / 1yr PO Sleeve / 115.3 lbs ---------------------------------------- Logging my food now as I am done eating for the day (am feeling a little bloated and am in need of a good poop 💩) ---------------------------------------- 10:30am - Coffee-Tea-Cayenne w/ stevia 12:00pm - salad w/ vinaigrette + cucumber + 1 oz honeydew + 1 oz canteloupe + 5 oz pan fried chicken + 3 tbsp tzatziki + 1/4 cup shelled pistachios + 1.5 oz candied ginger + 1 choco-coconut Keto Fat Bomb 3:40pm - Coffee-Tea-Cayenne w/ stevia 6:30pm - salad w/ vinaigrette + 3.5 oz pan fried chicken + 1.5 tbsp tzatziki + 1/4 cup sausage gravy 8:00pm - 1 Soft & Chewy Keto Ginger Cookie (with candied ginger in the batter) ---------------------------------------- Totals: 845 cals - 63g Protein - 64g NET carbs - 34g fat

Yesterday, Wed, Nov. 20 Maintenance : 5'2" / 1yr PO Sleeve / 115.6 lbs ... so I bought a bag of candied ginger a couple days ago because the Kid made a request for me to make a batch of ginger cookies. Well, turns out me and Mr. love candied ginger and have been snaking out of this bag enough that now I have to go buy some more. I'm going to have to bake these cookies as soon as I replenish our stash because we can't stop eating them!! ...went to bed early last night which was a good thing as 1) I was super tired and 2) I avoided the late night snacking hour. 8:00am - earl grey tea w/ stevia + coffee w/ stevia 2:00pm - salad greens w/ vinaigrette + 1 oz apple + 1/4 jalapeño pepper + 3 oz grilled steak 4:00 pm - 1 Love Good Keto Chocolatey Almond Bar + 1 oz candied ginger 7:00pm - salad greens w/ vinaigrette + 1 oz almonds + 1 fl oz pumpkin seeds + 5 oz grilled chicken Totals: 981 cals - 85g Protein - 50g NET carbs - 42g fat