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Dietician had me on keto for a couple of weeks before surgery. My surgeon puts all his patients on a pre-surgery diet to reduce fat around the liver & give him a clearer line of sight during surgery. He put my friend, with a much higher starting BMI than me, on a protein shake diet pre surgery. Maybe too lose a little more pre surgery???

You have to try Peatos, they are game changers. They taste like junk food without any strange health-food texture or aftertaste, but they are healthy. They are made from peas and lentils and taste like hot Cheetos, funyons, etc. I have done keto a lot in my life and try all of the low carb breads, pastas and snacks. These are the best snack for me. Variety 15-pack is 20.00 on Amazon and they have 4g protein and only about 6-11 net carbs a bag (depending on flavor) Sent from my Pixel 2 XL using BariatricPal mobile app

Same. My dietician said to eat higher levels of protein, but other than that, watch my portion sizes and how often I eat and make sure my meals are balanced (so so many fruits and vegs aren't allowed with keto, and I'm excited to learn how to "properly" eat balanced meals again)

I would have said Ketosis. It doesn't matter the amount of calories per day, it's WHAT foods you are consuming. Do u have Keto-sticks to test your urine?

I'm 3 months out from surgery and the only person I told was a friend I used to work with who lives in another country (I felt somebody should just in case something went wrong). She's been very encouraging, but then again, she's lives (and I used to live there too) in a country where being even slightly overweight is seen as a failure. My family doesn't know, and none of my friends or co-workers know. However, I have lost over 60 pounds, and it's very noticeable (to them at least - what I see in the mirror is a different story), so I get a lot of questions. But I have been consistent with my story throughout - no carbs (bread, pasta, rice, etc.), no added sugar, no alcohol, no dairy (except cheese). High protein, low carb, don't worry about fat - even though I'm not specifically doing keto, my daily macros are pretty close to what a keto diet should look like (except that I'm usually higher in protein than fat). I explain (if I need to) that when the body stops getting carbs from food sources, it forces it to go to it's own fat (glucose) stores for energy. And I have a huge pantry (belly, thighs, and butt) full of glucose!! I don't feel that this is a lie. It is what is happening to my body. I lost a pound a day while I was pre-op doing this kind of diet, while post-op it's been more like a pound every 2.5 days. Surgery is a tool, but you have to know what kind of tool it is and how it works. Basically I see the surgery as a body reset - it gives my body a real opportunity to lose weight, without all the handicaps that obese people face (low metabolism (and metabolic set-point, in which your body will fight against your weight loss efforts so that you end up gaining more weight that before you started), food addiction, insulin-/leptin-resistance, etc) that most regular-sized people have never experienced. But I still have to do the work (eat right, exercise), and I will for the rest of my life, or that reset will have been for nothing. Now, if someone I know is struggling with their own weight and they asked me about WLS, I would be honest with them, but of all the people I know, only one or two people fit that bill. For the rest, it really is none of their business (and, like many others here, I'm a private person so would not share intimate details of any surgery with just anyone).

Sustainability is certainly a key factor in long term success in this game - and I wouldn't be so sure that keto would be any faster, and they often are slower if they do it literally as they tend to run at higher calorie levels (they just lose a bit more water weight at the outset, which they give back at the end when they figure out what they are going to do for the rest of their life,) Likewise, I never did any of those diets but rather maintained a more classical balance of fruits, veg, whole grains, etc. along with the requisite protein, consistent with my caloric budget for weight loss - the same diet that I was on before surgery and now, years post-op, calorically adjusted for maintenance. If I need to drop a bit, dropping the calories around 20% does the trick without any panicky "back to basics" or "reset" diets. Funny thing (not really) is that most of the other post ops in our support group, most of whom are 10-20 years out and maintaining a normal weight range, likewise never got into these extreme low carb diets and seem to be a lot more tolerant of the occasional indulgence or unavoidable junk ingestion than those who did these extreme diets and are always worried about slippery slopes and carb monkeys. A couple of years ago we even had an accidental pizza fest when the restaurant we usually meet at closed without warning and we had to go around the corner to a pizza joint. The doc bought a couple of pizzas, some shared while others ordered sandwiches (heaven forbid!), salads or something else. I ordered a lasagna as that is something that just isn't worth making at home anymore. Yet no one suffered irreperable harm.

I swear people make you feel like that though. Like why is it a judgemental thing about how you achieve weight loss? I like to be 💯. It is so draining, being phony for me, but it’s like people want some phony mess like, oh! I ONLY did keto, cardio and strength trained or I got lipo. I guess I could NEVER be an influencer, because I can’t lie and my face tells it all even when I try. But, I really do not try to judge, but I leave some conversations like, judge unto others and you would have them judge unto you…I am a bit petty so I said, F-it I am judge they ass too.

As everyone has said it is to support the healing of your tummy & not to stress & strain it. Remember all those sutures & staples holding your tummy together. Think how you would protect a large wound & sutures on your arm or leg & how long that would take to heal. Purées are thicker which is why they are the stage after liquids. They should still be runny but not watery like the liquid stage. With soft foods think slow cooked, fall of the bone tender, minced meats, braised, etc. Foods that needs some chewing but not a lot. Think how much work your tummy has to do to digest thicker & then more solid denser foods. Plans differ but they also have a lot of similarities too. Some surgeons, like mine, tailor the pre & post diets to their patient. Some have specific requirements based upon their experiences. The best advice is always to follow the one you were given. But of course you can ask your surgeon & dietician why your plan is as it is & you may be able to negotiate slight adjustments based upon your recovery & needs. Yes, some plans recommend avoiding certain foods & liquids to not aggravate your healing. After surgery, we tend to produce extra stomach acid, hence why many are prescribed PPIs for a period after surgery. Carbonated drinks, caffeine, etc. can stir up the acid in your tummy causing discomfort & reflux symptoms. We’re told to avoid foods like rice, pasta & bread because they tend to swell in your tummy, filling you quickly. Remember your focus is on getting in your protein & that can be challenging enough in the post surgical stages. These foods also have little nutritional value. Consuming nutritionally dense food is important while you can eat so little to ensure you’re getting in the vitamins, minerals, etc. your body needs. While losing many of us are advised to follow the rule to eat your protein first, then vegetables as you can, then high fibre carbs only if you are able. If you can only eat 1/4 - 1/3 cup of purée & soft food to begin like I was, why eat food that fills you without giving you the nutrients your body needs. It also gets you starting to think about your food choices & the quality of the food you are eating. I still follow a lot of this: protein first, nutritionally dense foods, etc. Foods like peas & potatoes are considered higher in sugar & in starch (which converts more quickly to sugar). They’re not included in keto diets. Not saying you’re on a keto diet but you’ll notice influences from lots of different diets & eating styles on your food recommendations while losing. The reason why we’re advised to avoid dried fruit is you tend to eat more dried fruit than you would eat them as fresh. We can easily eat several pieces of dried fruits but remember 2 dried apricots is 1 apricot, a prune is a plum. Their sweetness is concentrated too in their dried form so you are continuing to feed your desire for sugar. Same with juice. Honey is just another firm of sugar. This is an opportunity to break some of your food dependencies & cravings. For many of us lots of foods become super sweet & quite awful to eat too during these first months when our tastebuds become extra sensitive. Many are able to go back to eating small amounts of restricted foods while losing or in maintenance. Personally I still don’t eat potatoes, rice, bread or pasta. I find them too heavy & I feel blah on the odd occasion I’ve tried them since I lost my weight. But that’s me. The first months are the most challenging because the food you likely depended upon to comfort, soothe & make you happy has been taken away from you. So you think about & crave them more. But food doesn’t actually comfort you or make you happy you just think they do. Realising & understanding this is part of the head work we all have to do. This whole process is about breaking poor eating habits, poor food choices & establishing new habits, introducing new foods, etc. & discovering what works best for you. The most restrictive aspects of the diet are only for a short period of time & are to benefit your immediate health & recovery. The long term changes you will choose to make are to enable you to maintain a lower weight & live a happier, more active & healthier life long term. Sorry for the 10 000 word response.

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.

Not sure... I'm not doing Keto, just kind of intuitive eating, trying to eat clean. I was doing pretty well, but have veered a bit. I'm very happy that I did NOT gain back the weight I lost on the pre-op liquid diet, so for me that's a win - I've lost 2 pounds since. Not a lot, and I hope I can keep it off during the holidays and make wise choices. After this week I am going to call and see what my options are and then make a decision from there.

That does sound good. A little keto bread and it would make a nice sausage gravy and biscuit with eggs. Yum

Beyond activity levels, such factors include prior dietary history and genetics. There is a genetic predisposition toward diabetes, insulin resistance and genuine "carb sensitivity" that some people have, and they can benefit form low carb diets; for those without that genetic makeup it's just another fad diet. I don't know if I was considered a big exerciser who "should" succeed with a 100g diet, but I couldn't afford the common side effects or nutritional deficiencies of low carb dieting and knew from history and experience that it has little to do with weight loss success. My wife lost 200# without regard to carb counts, and she is exercise averse. Carb counting and such severe restrictions was never an emphasis in our program an no one seems to be suffering from it (sugar, simple carbs and junk food in general, yes, but carbs as a macro, no.) In the absence of WLS, the success rate of losing large amounts of weight and keeping it off is about 5%, whether one does a low fat diet, low carb diet, balanced, Atkins, Keto or whatever one chooses. With WLS, success rates are similar - people have been successfully maintaining massive weight loss for decades before low carb became the fad of the day. In the fourteen some odd years that I have been involved in the bariatric world, I have never seen anyone fail because of "too many carbs". whatever magic number is chosen - 100g, 40g, 20g... Too many calories relative to their metabolism - absolutely; though those excess calories may be from carbohydrates, they can just as easily be from too much fat or protein, or more typically a combination of them all. Excessive fat consumption is often a problem in maintenace as people who adopted the "full fat everything" habit early on when their volume was severely restricted often continue it as their volume increases a few years out and they let their calories slip away from them. They may blame the carbs for "getting away from them" and exceeding the magic 40g. but then ignore the 1000 calories of fats they are consuming, with a 12-1300 cal metabolism.

I met with the nutritionist at my surgeon's office and she told me for the first month of my insurance-mandated three month pre-op diet to limit carbs to just the morning and cut out carbonated drinks. Since I'd tried Aktins/Keto before I figured I'd just go with that. I met with her again five weeks later, having lost 13lb and based on my success she told me not to change a thing for month two. As for my routine: For work days I found the Kirkland (Costco) brand protein bars and have one for breakfast, then a hard boiled egg and/or string cheese for a morning snack. Lunch is spinach salad with carb free dressing, a chunk of some kind of lean meat (often leftover from the previous night's dinner), and some raw broccoli. Afternoon snack is a low carb yogurt and/or another string cheese. If I want a snack when I get home I'll have a chunk of cheddar or some pork rinds. I also bought some Carb-Quik baking mix on Amazon, it's like Bisquick but 95% fiber so very low net carbs and I'll have one or two biscuits made from that a day with butter to satisfy my bread craving. Dinner is more spinach salad, another chunk of meat/fish or a low-carb recipe like sausage and cream cheese stuffed jalapenos and a vegetable. Weekends are similar but I'll have eggs and a biscuit for breakfast instead of the protein bar and I also bought the 5lb drum of Cookies and Cream protein shake mix from Costco which I prefer to make with unsweetened almond milk instead of water. However, twice since I began I felt I ate too much the previous day so I did a full day of nothing but the protein drinks all day and a smaller dinner. Very important of course is getting the 64oz of water a day. I found boxes of 8 packets of Hawaiian Punch fruit punch and Wyler's lemonade for $1 each at a local discount store and stocked up big time to ensure I don't get tired of plain water. I'm also fortunate that my surgeon said I do not need to do a pre-op liquid diet as many surgeons recommend.

I use monk fruit sweetener. Tastes sweeter than sugar but is recommended for those who are diabetic, on keto and low carb diets, and have had bariatric surgery. I love it, and I use it very sparingly, so it lasts a loooong time.

HelloFresh was only 27$ a week for my husband and I -although it was only 3 meals, it did include all of the ingredients so I thought it was a good deal compared to what those ingredients would cost at Walmart. Can you explain Keto to me, please?

Thank you so much for posting your experience with Intermittent Fasting. I read Jason Fung's book the Obesity Code and watched many of his you tube videos as well as Dr. Berg's IF / keto / Insulin resistant videos. They have been very informative. I am insulin resistant as well and carb sensitive. I am 26 months out and up 4 to 8 lbs, depending on the day. My diet is very good, but I believe insulin is my issue as well. I was eating all day long. Great stuff, but never letting my insulin levels drop enough to burn fat. Can't store and burn at the same time. I have experimented with IF and am on 8:16 right now. It does make a difference for me as well. Just started a few days ago for the 2nd time, so I need to give it more time, but please keep us posted on your progress. Not sure I will do the 24 hour fasting, but we'll see. I see a lot of people who have gained and want to take it off, but not many who haven't really gained, but are 2+ years and want to loose more. I still have a good 50-60 lbs before I would be at a normal weight, so I don't feel like I'm done yet, but at 10 months my weight loss stopped and there it has been for the past 15 months. Keep up the good work!!

a type 1 diabetic you would have different needs than me so I do not presume that my way would would work for anyone actually. everyone needs to follow what works for them. but i will add that saturated fat does not cause heart disease (there was actually no evidence of this - documented in Big fat surprise by Nina Teicholz) and i am carb sensitive so try to stay under 50 carbs and 25 sugar grams. i do not go full keto though i use its guidelines. I am sure a true keto person would think I am not on program. skipping meals does not slow metabolism when you actually get plenty of good nutrients when you do eat. not eating for 16 (and sometimes 22) hours actually gives the pancreas and liver a break and lowers the demand for insulin. a lot of that time i am sleeping so it is not dangerous for me who is not on glucose lowering meds. people should research and do what works for them. some people can tolerate more carbs and some cannot. for me this was the solution. 1) don’t put sugar in, 2) eat real food including real fats not processed vegetable oils and 3) time restricted eating. otherwise known as intermittent fasting. I am not perfect in any way but for those who have gained weight back, i recommend giving up snacking between meals and watch added sugar. that was my first step. i know people who have gained much more back than I did so i posted this to give hope to those looking to get back on track and / or stop the craving and stop the gaining. good luck!

My nutritional plan has "moderate" carbs, but I am nevertheless in deep maroon keto at three weeks post-op. I was curious, so I bought some keto sticks (cheap ones, $8 at Walmart). I think the low calories we consume, even if they include carbs, just aren't enough to cover what we burn daily. So the body starts using fat for fuel. If I can help this process along by eating less carbs, that's what I plan to do!

I also start my pre-op diet on the 5th but my 2 weeks are split. The 1st week I can have 1 meal (high protein, low carb ) per day but the second week is only liquids. I also have to keep my calories under 800 per day - yuck. You sound very much like my twin. I have 4 different kinds of premier shakes,5 yummy sounding keto shakes, several different types of broth and canned soups that I can strain, pudding, jello and I'll buy yogurt when it gets closer. I also have a clever fox journal that has spots for pictures and measurements to keep me motivated. I'm as prepared as much as I think I can be. Thinking and preparing keeps me busy and makes the time pass faster. I get more and more nervous the closer it gets, but excited too. Can't wait to have a new me

Hello Everyone! I have been reading all your post to this game & I think its pretty interesting! Im now 9wks post op & this morning my scale showed my weight at 188. My weight b4 surgery was 210. Im happy to loose my weight slowly so that I can stay on top of firming up my flabby skin! Anyway I started eating regular foods at 3 1/2 wks PO but I was having trouble getting my required protein in! I could no longer tolerate any flavor of premier shakes or cheese & i dont like milk. Never have. Finally I started using the Isopure protein powder mixing it in my flavored water. Now I feel much better about my protein intake. I can drink up to 48oz of water but it has to be flavored! Now that Im nearly 3 mos post op & can get more variety of foods, I would like to get my protein requirement as well as cal, carbs, fiber & fats by eating real foods & just limit my protein powder for on my workout days! Also since I still cant eat cheese( except cottage cheese), All porks & tuna, Im going Keto paleo/vegan dieting! I love avocados with my food, all healthy oils, salsas, beans & Ezekiel product are my favorites! Soo please continue to post your meal plans for me to get good ideas![emoji16] Sent from my SM-T530NU using BariatricPal mobile app

Hi guys - I'm in a similar boat. Sleeved March 2015 at 292lbs. Got down to 177lbs. Was pretty happy there but was aiming for 165. Started to gradually gain - by Jan 2020 I was up to 200, and then because of the pandemic and lockdown (boredom eating mainly) I was up to 220 this January. So I've not regained all my weight, but still regained about 40% of it. I'm on week three of trying to lose my regain. Down 10lbs so far (but some of that in week 1 was probably water weight). This is what has been working for me: 1. Keep it simple. It's calories in vs calories out. I tried Keto for two days and was so miserable that it was never going to be sustainable. So I'm just going for a straightforward trying to consume 1000 calories less than I burn each day - i.e. less than 1750. 2. Within that calorie allowance, I allow myself to eat anything I want, subject to the following rules. 3. My first calories get used on a protein heavy breakfast, lunch and dinner. Only after I've logged all of those do I get to incorporate snacks. 4. No drinking with meals or 30 minutes either side of a meal. But otherwise lots of water. 5. No fizzy drinks except at weekends. I never had a calorie problem with fizzy drinks as my weakness was Diet Coke. But now I only drink sugar-free cordial (Robinson's Orange and Mango or Orange and Pineapple for those in the UK). 6. If I want a snack, I have to have a drink (water or cordial) first to see if that stops the craving. 7. Everything - and I mean everything - I eat is measured and recorded on MyFitnessPal before I eat it. It helps me see the impact of a particular choice on my calorie levels for the day, and sometimes leads me to make a different choice. 8. Six days of the week, I must be under 1750 calories. One day a week (usually Sunday) I allow myself up to 2500 calories but only if I have 'banked' enough calories during the week. So if, say, on Monday I consume 1500 calories rather than 1750, those 250 go into the bank and I allow myself to use them on Sunday (up to the maximum of 2500, which is roughly what I burn in an average day of activity). I've been doing that since 4 January, and have gone from 220lbs to 210lbs. I am aiming for 2lb loss a week for the next three months, and then to slow it down to about 1lb a month for another three or four months.

doing low carb of 50 total carbs now for pre op diet and it’s hard!! (If i could minus fiber it wouldn’t be so bad) and it has caused some intermittent issues due to reduced fiber intake (consuming some supplements now that i don’t count towards my 50 total, but would much rather use dietary fiber in foods) i went through the “keto flu” back in August (foggy head, achy feeling , low energy) in about three days. I also was ravenously hungry early on. my brother suggested that I increase my fat intake and that did the trick. I made cream cheese and peanut butter “fat bombs” with sugar free chocolate chips and monkfruit… scooped them with a 3/4 ounce scoop and ate two of them a day as snacks and it made the hunger disappear! i do not think i could do this low long term, personally, but will be integrating the low carb approach into my post op dietary lifestyle. Being very selective with any sugars, flours and starches is fine.. but it’s hard for me without being able to have much beans/legumes/peas/etc. I would kill for a big bowl of refried beans for dinner, but the total carbs are just too high pre op unless I am super cautious all day.

I should add that everyone is different. I'm 45 and missing half my thyroid and underwent a partial hysterectomy (that will slow down anyone's metabolism). So for ME, restricting calories to 500-800 worked at first but if I did that now, my body would revolt and hold onto weight (I also follow a keto diet). If I go over 1500, I gain so (again for me) 1,000 with lots of exercise will get me losing and 1200 with exercise will have me maintaining.

I split the difference and get half my protein from very lean meats and half from healthy low glycemic index carbs. Love me some beans and mushrooms and soy and nuts and whole grains. I keep the calories under 1200 and get the best from both worlds. And fruit. Glorious, delicious fruit...is my friend. Watermelon, I want you, I need you and I love you. Keto is fast, but for me, results don't last. Keto drives me right over the edge to a carb melt down that ends in a stupid binge. I need balance, and I'm glad I have a nutritionist who supports this. To those who do well on Keto...best wishes!

A traditional Keto diet is high fats, moderate to low protein. "The general ratio of macros to follow is 70% fats, 25% protein, and 5% carbohydrates" https://ketodash.com/keto-diet#macros Hard to meet your protein goals and keep your calories low if you are following those ratios.