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I'm not due to get my driver's license renewed until end of this year (so I still have my bigger face on it), but I did get my health card renewed this summer. My head shrunk. So did my neck, which ironically makes me look like I actually have a neck! Now I'm trying to decide if I should renew my passport early (doesn't expire until 2027) and pay the darned fee. Pre-covid, it was sorta annoying to have to convince the immigration/customs officer that I am indeed me and just 120 lbs smaller....and then have to answer all the regular questions: "how did you do it?" "what do you do to keep it off", etc. etc....

Get to a therapist. A Bariatric therapist would be even better. Good luck, Tek

I guess that I am being a big baby, wishing I would lose faster, but in reality I have never been able to do more than 5 lb in a month, and I've already lost nine!? So I need to behave myself haha! What I do need though is to find a good bariatric dietitian that supports my low-carb lifestyle. The dietitian at the bariatric center does not support anyone doing any diet, but I don't consider low-carb diet as I've been doing it for years, not correctly, but I have been doing it for years. Thank you so much for your reply!

One assumes that the user will be drinking as much water as they can tolerate in addition to protein shakes.. I agree, powdered PB2 could be substituted, but there really is no need to reduce calories during the first couple of weeks after surgery. Later on, yes. (BTW, I did not create this recipe, I copied it from The Bariatric Guide and Cook Book as an example of how one could make their own protein shakes._)

I believe Lennox Hill and Northwell both have bariatric programs.

Thats a hefty amount of cals for that protein shake: 573 calories (not including the optional protein powder)…AND it packs in 24g of sugar and 34g of fat. See calculations below. Does that bariatric cookbook really suggest 1/4 cup of peanut butter? That seems like alot?

Fruit juice is a no-no for ever more. It is liquid sugar. Use whole fruit and berries in your protein shakes. Whole fruits and berries contain fiber which helps metabolize carbohydrates. Using them eliminates the need for sugar and sugar substitutes. Once you are weaned off sugar and sugar substitutes, fruit will taste remarkably sweet! There are recipes for home-made protein drinks online and in bariatric cookbooks. Here is one from The Bariatric Diet Guide and Cookbook, called "The Elvis": It makes 12 oz. You will only be able to drink about 1 oz at a time at first. If you don't drink it all in one day, you can save it for the next. I like variety, so I would switch it with other flavors. 12 oz contains 31g protein, but you can add unflavored protein powder. One scoop of Genepro unflavored protein powder would add 30 g protein. 1/2 C plain Greek no-fat yogurt 1 large ripe banana 1/2 C ice 1 Tbsp unsweetened cocoa powder 1/4 C natural creamy peanut butter 1 small handful baby spinach Optional: 1 scoop unflavored protein powder In a high-speed blender, combine all ingredients. Blend for 2 to 5 minutes until smooth) NOTE: Be sure to use an all-natural peanut butter that contains only Peanuts and salt in the ingredients. The High Protein Bariatric Cookbook says: "The basics of a protein shake include about 1 cup plain nonfat Greek yogurt, or 1 cup milk mixed with 1 tablespoon protein powder and either 1/2 cup frozen fruit or 1 tablespoon nut butter. Then for flavor ad about 1 teaspoon of extract, cocoa powder, and/or flavored sugar-free syrup or low- to no-calorie sweetener. ...If you make your own protein shakes, the flavor profiles are limitless, and you will know the ingredients going into them. Then, when you have symptoms, it will e easier to identify what the possible cause may be. However, there may be times when a prepackaged protein shake will be more convenient, so do what works for you and hooks you stuck ti tier nutrition goals." The Lifebridge Health website contains about 30 protein shake recipes. Google "make bariatric protein shakes" to find many more recipes. Your protein shakes count toward your daily fluid intake. During the first few weeks of recovery fluid intake is your most important priority. Consume protein as you can. "You MUST get your fluids in. You SHOULD meet your protein goals. If you CAN, take your vitamins." Matthew Weiner, MD, The Bariatric Diet Guide and Cookbook.

Thanks, Sunnyway what do I use for the homemade protein shake, liquid, water? Do you put whole fruit and blend or fruit juice? Sorry for being so food incompetent but I got no nutrition counseling from them. It’s weird that they don’t have one. One guy I went to as part of the selection process I had to do mandatory nutrition classes for a month before he would even consider me, even as a self payer, which I was. I found a bariatric nutritionist on my own who I will start seeing next week. I am so afraid of eating anything that isn’t clear nasty broth and water but I have to start getting more nutrients, minerals and vitamins. Thanks for the suggestion!

I recommend this book: Bariatric Diet Guide and Cookbook, by Matthew Weiner, MD. There are guidance and recipes for every stage post surgery.

I wouldn't mix protein powder with milk unless you are deliberately choosing more calories and protein. One normally mixes them with water. There are protein mixes for soup, not sweetened, for example, Bariatric Advantage and ProtiDiet. I prefer plant-protein protein drinks and shakes over whey-based. You can make your own protein shakes by adding unflavored protein powder to smoothies, for which there are lots of recipes online. Google "bariatric protein smoothies" or get a couple of bariatric cookbooks. You probably won't need protein drinks once you are eating solid food.

I've never been to Indiana nor your Bariatric group but I want to lend some support and encouragement. It sounds like the office staff are not doing a good job and you get to suffer and (literally) pay for it. Sometimes it feels personal, doesn't it? It is certainly frustrating. It also sounds like communication is pretty bad. I'd guess that any non-emergency surgeries have been put on hold because of the spike in Covid cases over the summer. Of course, whatever the reason, they have failed in the communication area also. Keep banging the drums to get them moving correctly. You will get there eventually. Good luck, Tek

Hey hello! I’m wanting to find others who have gone through St Vincent for their surgery and just want to share experiences. I’ve had an awful time with St Vincent. Started September 2020 and still haven’t had my surgery. I’ve finally written to their management about my experience and hope to hear back soon but I’m afraid I’m going to have to start all over soon and it isn’t my fault. A little about my situation. I have Healthy Indiana Plan, the surgeon they picked out for me is Dr. Inman, started the 6 month monitored diet/classes September 1 2020, completed and they gave me a list of things to complete before sending my stuff off to insurance which followed: -Psychological evaluation (completely understandable but I will circle back to this later) -TSH blood test/ H. Pylori/ Lipid Panel/Hemoglobin A1c Blood test -Pulmonary clearance from a pulmonologist -Cardiac clearance from cardilogist, EKG too -Chest Xray -and the 3 year weightloss history, statement from primary care giver (all of this makes perfect sense) my primary care doctor is in South Bend since I moved from there to Indy. I contacted someone named Renita who works with all the patients getting their things ready for insurance. I asked if she had any recommendations on where I could complete all of these things and if I could do it at St Vincent. She said no and that I would have to go through my doctor. Ended up scheduling my pulmonologist and cardiologist appointment in south bend. Took off of work, got a hotel twice in one week since they couldn’t see me on the same day, went to a lab in Indianapolis to get my blood work done, my h pylori, my drug test, etc sent all my stuff in. Insurance approved (they declined the first time around but after their one on one with my surgeon they finally approved). I then found out I could have knocked off months because they did all those tests at St Vincent and I have no idea why Renita didn’t inform me this and that I wasted time and money driving to south bend. I went and got my pre-op done this Tuesday and all I had to do was blood work again and an X-ray. All the nurses seemed to be surprised that I had everything done already. They’re still saying I need to wait 3-4 weeks before I even get my surgery date. They’ve had all my results and testing since June (besides the blood work and X-ray I did on Tuesday) — I’ve had a horrible experience with this center. I’m just wondering how everyone else’s experience has been?

Hahaha, I see you have experienced the French cuisine. At leat The Irish staples are very much bariatric op ready! 😅 (banter). That's actually a good point you made. I don't think I've realised what the actual portion size will be or look like in a plate. It might be a bit of a shock reconciling what I see and what I can actuall eat after.

I actually bought a few bariatric books when making my decision. I’m reading Weight Loss Surgery for Dummies right now. Losing weight and keeping it off is definitely in our head. The surgery is only a tool. If we don’t follow the expected guidelines that come with the surgery then we set ourselves up for failure. Those books are perfect to help us on our journey to become healthier. Thank you.

I got some interesting pictures of my insides today. Reason for Multidisciplinary Case Review: lap adjustable gastric band by Dr. Johnson on 6/6/2011. Had emergent fluid removal from band with dr. Svendsen on 9/10/21. She had been experiencing severe reflux, regurgitation, choking at night, night time cough, vomiting nearly everyday and abdominal pain after eating, Some of the symptoms have resolved after the fluid removal. She continues to have heartburn and epigastric pain. A comprehensive review of imaging and relevant past medical history occurred. Upper GI Series (9/8/2021): Gastric band located below the diaphragm with widening phi angle measuring 66 degrees. The proximal pouch has migrated into the chest consistent with a hiatal hernia. There is dilatation of the distal esophagus and esophageal dysmotility Upper GI Endoscopy (10/6/21): - Tortuous esophagus. - Normal esophageal mucosa. Biopsied. - Z-line irregular, 38 cm from the incisors. - 2 cm hiatal hernia. - Gastric band slipped 2-3 cms distally. - Body and antral gastritis. Biopsied. - Multiple duodenal polyps. Biopsied. biopsy Results (10/7/21): A) DUODENUM, POLYPS, BIOPSY: 1. Gastric (fundic) heterotopia 2. Normal background duodenum; negative for celiac disease 3. Negative for dysplasia and malignancy STOMACH, ANTRUM, BIOPSY: 1. Normal gastric antral mucosa 2. Negative for Helicobacter C) ESOPHAGUS, DISTAL, BIOPSY: 1. Normal esophageal squamous mucosa 2. Negative for reflux changes and eosinophilic esophagitis 3. Negative for columnar mucosa Staff present from ANW, UTD, MCY & Shakopee Weight Management including Surgeons, Advance Practice Clinicians, Bariatric Nurse Clinicians, Registered Dietitians, Psychologists She has completed her preoperative evaluation and has been judged to be a good candidate for surgery. Plan: A Laparoscopic conversion of adjustable gastric band to roux-en-y Gastric Bypass and hiatal hernia repair would be an excellent choice to meet her goals for weight loss and comorbidity resolution. The plan is to proceed with scheduling for surgery.

Hang on a tick, I'm stuck on something here. Let me see if I have the facts correct: 1. Your dietitian thinks you're not losing weight fast enough. 2. You have lost 25.5 kg (56 pounds) in 7.5 weeks. 3. Your dietitian refuses to give you guidelines for what or how to eat beyond 60 g of protein and 2 L of water. 4. You're still on shakes at 7.5 weeks out from surgery. I think it is high time you tell the dietitian to shape up or ship out. There are plenty of dietitians out there who don't require their clients to be mind-readers. And who understand how bariatric patients lose weight. I mean, is this dietitian brand new off the wagon from dietitian school? You should be extremely satisfied. Most bariatric patients lose 7-11 kg (15-25 lbs) in the first month and then about 5 kg (11 lbs) a month thereafter, with several stalls that can last a few weeks. Expecting you to AVERAGE 2 kg a week when you have lost 25.5 in 7.5 weeks means that you could be stalled for 3-4 weeks and lose not a single gram and still come out okay. Expecting you to lose 2 kg EVERY SINGLE WEEK is—and I said what I said—daft. If you are stalled, try increasing your calories by about 100 a day for a week to see if that breaks the log jam. Even just 15g of peanut butter or something along those lines could do it. 100 cal a day times 7 days is not enough to make you gain weight.

I have not had lap band but I have had two prior bariatric surgeries that failed. I am now going to have RNY Gastric Bypass revision at age 73. I have learned a lot since I started on this path 6 months ago. Good for you for moving forward toward a healthy weight. However, I'm concerned that you have not learned how to eat differently yet. Consider the possibility that you are a sugar/food addict. If you are, Keto is not the answer for you. You need to change your habits entirely. I strongly recommend some reading for you. Choose at least one book from each of these groups. Finally, conclude with Success Habits of Weight Loss Patients. Get started now. Apparently you have already had the surgery, so there is no time to be lost.

I'm one month out. I'm not someone who can follow a "meal plan". I don't want to decide at the beginning of the day what I'll be eating at each meal; I need to have a choice or life feels deadly dull. That being said, I will cook something a few times a week (right now it's some sort of ground meat or bean-based dish with a spicy sauce eaten with fat free greek yogurt) and then alternate among the ones I've cooked. I portion them out into 5-6 or more servings in small plastic containers and freeze some so I don't get sick of what I've made or it doesn't go bad too soon. I'll eat them three times a day, breakfast lunch and dinner, except I will occasionally make egg product with cheese for breakfast. I would say at most I spent about 40 minutes a day on all three meals, and many days it's less than 10 minutes. Of course, I live alone and don't have to feed anyone else. I do spend some time looking at recipes, but I'll usually do this when as a form of inspiration, mostly it's things I can't have. Most people's ideas of what a post-surgery patient can have seems very bland to me and I wouldn't eat it, so I don't look at bariatric meal ideas - I go to real cooking sites and figure out how to adapt "normal" recipes. My job involves a lot of traveling so my next task will be to figure out how to eat better on the road.

My original surgeon was with kaiser, and he wouldn't give me a revision surgery. I changed to PPO and found a surgeon who said he would give me the surgery but didn't think it would help. I eventually found the bariatric institute in Utah, and Dr. Medlin gave me my yes. Getting approved was a BREEZEEEEEE. I guess it depends on your insurance.

I think a lot of bariatric programs adopt a "one-size-fits-all" strategy because, frankly, it's easier than tailoring it to each individual patient. They go with something conservative and simple that should be fine for everyone, even if not ideal for all patients. To be clear, I don't think there's anything wrong with your asking these questions, and you're probably better off for looking at it this way and trying to optimize your own nutrition. But I can also see how this kind of discussion can be confusing for some patients. Hang out on this site for a while and you'll see a lot of posts from people who have alarmingly little knowledge about what they're supposed to be eating post-op (although I suspect some of these are trolls). Some patients basically need to be micromanaged and told exactly what to eat and drink at every stage. Plus, the surgeon might be afraid that if he tells you that a different shake is ok, other patients will either hear what they want to hear ("If Unjury shakes are ok, I guess that means I can drink any shakes I want, and I like McDonalds shakes!") or start bombarding him with questions about other specific products. That could explain why he is more reasonable when you meet with him one-on-one as opposed to in a support group setting with other patients. Anyway, I'm with you about real food vs. shakes. For the first several months, I relied on protein shakes and other protein-fortified products a lot, but I'm 15 months out now and I can easily get enough protein from real food, so I don't want to waste my calories on protein shakes that I don't even enjoy! I would much rather have a grilled chicken salad or a Mr. Tortilla turkey wrap or a broccoli slaw omelet than drink a protein shake.

A lot of surgeons (of all stripes, not just bariatric) have God complexes, and a lot of patients want to follow a rigid set of rules to feel they're doing things "correctly." I'm in the my-body-my-choices group, myself. If someone can give me a reasonable explanation why they feel I shouldn't make a particular choice, I'll listen and then decide.

4 lbs a week after the first month is pretty extreme, unless you're the size of someone on "My 600 lb Life". Does this dietitian have any experience with bariatric patients? Doesn't sound like it. most "normal" WLS patients lose about 15-25 lbs the first month after surgery, and then it slows down to about 10 lbs (give or take) a month for the next several months - and then it drops even further. Of course you will find people who lose more or less than that, but they're outliers. So you are fine - that dietitian is very misinformed.

I am a person who always wants to know the "why" behind a rule (unfortunately!). So, as I've slowly been progressing through my surgeon's plan (still on pureeds for two more weeks, and I'm 7 weeks out), I've started wondering if we will always have to drink protein shakes. I hate them, they taste gross, and the ingredients list is like 5 paragraphs long full of things I can't even say - besides that, they're full of carbs and often high calorie. And if we do have to always drink them, why? Why can't we meet our protein goals through eating real food? For example, an egg and a morningstar breakfast sausage patty is 16 grams of protein and 150 calories. The protein shake I drink is almost 300 calories (bariatric advantage with PB2 over a plant based milk). Also, bone broth, cottage cheese, greek yogurt, tuna are all high protein, low calorie options that taste way better than protein shakes. If a person is able to meet protein goals and still stay around 600 calories a day during weight loss phase, why the shakes? (I don't know if that's feasible, I haven't tried it - I am still drinking the nasty protein). So, I posted the question to the online support group my surgeon keeps on Facebook. I asked if a person can meet their daily protein goal through real food, are protein shakes still required. Man! You would have thought I asked if I could eat a full meat lovers pizza from Papa John's! People launched on me, accused me of eating too much food, told me if I wanted to lose weight and maintain it I HAD to drink protein shakes for life. Then the surgeon came on and publicly shamed me, said I was way off track and wasn't following the plan. What bomb did I set off??? And nobody ever explained WHY the shakes are required??? The previous time before this when I asked a question, almost the same thing happened. I asked if I could drink the Unjury ready made shakes instead of the powder because they taste so much better. People berated me, and told me the ready made shakes were not good for me. Then the surgeon chimed in and said the ready made were not as good because they are protein caseinate instead of whey isolate. Um, the packaging clearly says the Unjury brand is whey protein isolate. So now why are they bad for me? The next day, my surgeon posted a long post about people having this surgery and not taking it seriously. I can't help but think it was in response to my question about protein shakes. I didn't even have Facebook, I deleted it in 2016 when things started to get so nasty online. I only started using it again to join my surgeon's group. I cancelled following the page. I was really ticked off at the responses. I'm so angry I don't even want to continue with my surgeon's office. AND, by the way, I am not way off track, I've lost 41 lbs. in these last 7 weeks, and I'm really happy with that. Started at 235, now 194 (and have been losing about 1 lb a day for the last few days). I know I'm being a baby, I think I just needed to vent. I do like my surgeon when we meet one on one for appointments. Facebook is evil. Sent from my SM-N976V using BariatricPal mobile app

The BariatricPal Store carries a huge selection of bariatric friendly protein bars at https://store.bariatricpal.com/collections/protein-bars ! Here are some of the awesome protein bar brands they carry: - BariatricPal - Built Bar - Convenient Nutrition - Dive Bar Nutrition - Epic - HealthSmart Foods - IQBar - Keto Wise - Kirkland - Muscle Cheff - Power Crunch - Proti Diet - Quest Nutrition

I had gastric sleeve surgery almost a month ago and I am on soft bariatric foods. The biggest struggle I’ve had is learning to eat slowly! I started working on before surgery but I feel like I am still eating too fast, by the time I feel full it’s already too late and I’ve taken a bite or two too many because I ate too fast and didn’t let my body signal that I was full. Any advice on slowing down when I eat?