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One just has to look at how much weight people really lose on these drugs. Many people will most likely just be "less obese" but not "no longer obese", even if one could afford taking the drug for life. Those drug won't "end obesity" - just as WLS never did.

I’ve had the gastric sleeve January of 2015, gained a good amount of my weight back. Decided to take another approach and do it RIGHT this time around. 2 week pre op was tough but possible.. Now I’m post op 11/9/23 I had the switch. Thanks god everything went well! Just here with some pain and anxious to start my next phase :puréed 🤮

Hi @texasmade88 Welcome!! Congratulations on the 22lb weight loss!! is that after your surgery? Currently, I have been stalled and I am trying not to get stressed out (although there is a small thought of omg what if I did this surgery and nothing changes for me). I won't be a month out until November 27th so I am just telling myself to chill. How are you feeling about the upcoming holidays with food and stuff? I am actually glad I will not be able to eat Thanksgiving dinner this year, it takes a lot of pressure off of me to hang out with the family.

Fascinating article. Despite having taken several of them myself over the past few years, (including Saxenda and Wegovy), I'm very hesitant to embrace a world where weight loss drugs are the first line of defense against obesity. I say this knowing that at least some of my issue comes down to poor nutrition choices, made far too easy by an environment swimming in garbage foods and a culture that values quick convenience over everything else. When I commit to good nutrition, my weight decreases. I don't get skinny, or even "not obese" but I do lose weight. When the snacks and junk food make their way back in the house and I have stressful weeks with work where I'm at my desk for 12 or more hours and fast food feels like my only option because I'm too tired to cook, I gain weight. In about the past 60 years, we've gone from 13% obesity to 40%, with a 10x rise in severe obesity. This isn't just a weird thing that happened in a vacuum. There are pretty obvious reasons for this, some that could possibly be solved with significant changes to our food policies and investment in real nutrition instead of lining the pockets of pharmaceutical companies and massive food corporations. Much of our so-called food today has been designed to be addictive, by the same folks who brought us cigarettes, no less. That should give people pause the next time they're in the grocery store looking at all those shiny boxes and bags. On the other hand, in the days when only 1% of the US population was morbidly obese...that was my family. And some of my family lived really long lives, into their 90s. Except the ones who didn't and died young. And you don't know which you'll be until it's too late. Up until my 40s, I was one of those people who had healthy bloodwork despite being 90+ lbs over my "ideal weight." I didn't worry about my weight because I was healthy. But that changed rapidly with middle age as my weight went even higher. Now I take blood pressure meds and am prediabetic. My feet and joints ache and I worry what that means as I age. I wish I had done more to keep my weight lower when I was younger and developed better habits early on. I can't believe how ignorant I was of nutrition facts when I was in my teens and 20s. One thing I know is I can't afford $12k or more a year for the rest of my life to take these "miracle drugs." I'm not sure who really can or should. I'm grateful for surgery being an option, but it's not for everyone, and neither are the drugs. As a society, I would like to see more acceptance of humans in all sizes, and more focus on real health and nutrition instead of fads and gimmicks that make a few people really rich.

I'm going the self pay route with Blossom Bariatrics, but was given similar timelines when I spoke with folks with Dr Shillingford and the Nicholson Clinics, but generally scheduling could be done 3 weeks out with 2 weeks of pre-op diet for a Sleeve procedure. From first call to the surgery is generally 1 month, but sounds like it could be less in some cases. RNY, DS, and revisions required considerably more time to plan for. Far fewer hoops to have to jump through going this route, though. I'm only going this route because my insurance declines anything related to bariatric surgery. My previous employer's insurance would only cover a lap band, and it required a year of meetings. If I missed one, or gained any weight between sessions, I had to start over, which is ridiculous. Also they didn't cover any counseling, which I definitely recommend signing up for! It's just as much mental as it is physical! I'd rather not have the equivalent of a car payment hanging over my head, but my health has been declining significantly the last few years and I need a change. My job isn't forgiving with PTO either, and it was all I could do to take the 3 days off for the week of Thanksgiving to get mine done next Monday. It's a small business, so FMLA isn't an option, so I have to go back to work the next Monday.

Pre-op weight target and surgery still in front of me I had to lose a certain weight before I could continue to the "next step". Okay then as long as the mulitvitamin has it, then I dont need the extra? just calcium citrate and iron?

I was allowed carbs on my diet plan but my office goes by calories instead of size of meal. I think at 4 weeks it was around 400 to 600 calories but by 8 weeks they wanted us to be around 800. I would see how many calories you are actually taking in and just keep following your plan. Every time I hit a stall I gain 3 pounds and my last stall I actually gained 5 lbs. My stalls are usually 3 weeks long but once it was 2 months. When I think I'm in a stall then I only weigh myself once a week at most because stalls can be rough mentally. The mental part of this weight loss was the hardest part for me. Good luck and take care!

I was sleeved in 2017. In hindsight, bypass would have been better given my history of GERD. Fast forward years later, COVID piled the weight on (working from home, lockdown, job stress (worked in healthcare during pandemic) and I'm up 65 lbs. That i can deal with though. I know the bariatric lifestyle, and I know what I need to do to lose the weight healthily and such. It's the GERD. I'm up to 60-80 mgs of Prilosec daily, plus antacids and other H2 blockers as needed. I sleep elevated and just always generally feel like I have a pit in my sternum. I've subsequently relocated to a new state since my surgery, so I feel like I'm starting all over. I have an appointment with my PCC this week to discuss the GERD issue. Given what people are stating on this board, it seems like that a RNY may be an option. Honestly, I just want to know why it has escalated so bad over the last several years. It doesn't matter what it is; it comes up. I drank some unsweetened almond milk two hours after dinner, and about 10 mins later I literally burped it up like a baby. No warning, nothing... All over my bed. Other times, it's that hor burning awful acidic in my throat and chest. Makes me cough. I try to eat crackers to help absorb the acid, which is not healthy. I'm really quite scared that's something serious. What have your experiences been like? Will I go through a whole program again? I just want relief. What questions should I bring up with my doctor. What tests will they run? This is still a fairly new PCC relationship and several thousand miles away from where I first was treated/sleeved.

I don't know how much this will help. My highest weight presleeve was 283 pounds(p) in 2014. When I got to the table, my weight was 243p. My lowest weight postsleeve was 181p. 2017 started gaining weight and really bad GERD. It took until 09/25/2023 to have revision. I am now GERD free and losing weight. I have no regrets. Fight for your health like your life depends on it, and that's what I did. Yes, sleeve to bypass. Sent from my SM-G996U1 using BariatricPal mobile app

I don't know how much this will help. My highest weight presleeve was 283 pounds(p) in 2014. When I got to the table, my weight was 243p. My lowest weight postsleeve was 181p. 2017 started gaining weight and really bad GERD. It took until 09/25/2023 to have revision. I am now GERD free and losing weight. I have no regrets. Fight for your health like your life depends on it, and that's what I did. Yes, sleeve to bypass. Sent from my SM-G996U1 using BariatricPal mobile app

Obviously, I'm not a medical professional so take anything I say with a grain of salt. Tbh, during this weight loss phase, I would try to stay focused on losing weight. Continue to monitor your eating challenges, but there will be time to sort that out after you've lost the weight. As long as you're getting sufficient nutrition and calories, you'll be fine for now. Do your best to meet the protein goal, but if you fall short, it's not the end of the world. Listen to your body, and feed it what it can handle. I'm 19 mo post-op, and even now, solid foods can be a challenge. I generally still eat a soft(ish) diet. It works for me. Obviously, if you are continually getting sick, feel bad, and/or are unable to eat enough to meet your needs, that's an urgent problem. But if you can handle it, give it time and stay focused.

Oh I can't think that your mother saying that comes from a place of any 'best' intention OP. Sorry your mum has this approach. I've had SO many people ask me whether or not my weight loss was intentional (subtext being- are you ill??) I beam them a beatific smile and say yes, absolutely intentional - hard work but so worth it! Perhaps get yourself ready to counter the next inappropriate comment and move on?

There is some data I've read that says that aggressive working out can release stress hormones, particularly in women, which can slow weight loss. This is not the sort of working out that you enjoy, but really pushing hard in the gym with HIIT and not properly recovering. Me personally, I have enough stressors to add another one. So I'm inclined to do what workouts feel good and that I enjoy, give myself break days when I need it, and leave the hardcore workouts to those who like to put in time at the gym and don't mind stressing out their bodies. I get enough sympathetic activation in traffic. 😂

I think some get around this by having their insurance approve the staged treatment plan ahead of time, that way it isn't considered a revision, it is considered the second step in a primary surgery. This happens most often when a person's weight is high enough the surgeon believes the intestinal part of the surgery will be easier and safer at a lower weight. I've seen a number of people do this on the DS groups so it is possible, but my guess is not every insurance company lets their patients know it is possible and I'm sure there are some that outright refuse to because insurance companies like to be difficult. I wish you much luck with your surgery!!

Thank you all for the kudos. I'm wondering if my dramatic weight loss is partly due to malabsorption; I'm pretty vigilant about taking my supplements and focusing on protein. I'm going to go get tested for SIBO tomorrow- I had it before surgery and it was pretty awful. This time, it isn't quite as acute, but despite my care in diet, I find that food passes through. I did that crazy expensive anti-B the last time-- rifaximin-- not sure I want to spring for that again (cost is over 2k for a bottle of pills with a $700 co-pay-- the retail price for the drug outside of the States). Anyway, I should know the results quickly- the gastro I've been using is very good. And I cannot stress enough getting in some strength training, particularly if you are older. Even though I felt sort of lousy thing morning, working out made me feel better.

Are you meeting your protein goals at 400 calories a day?? Some programs will give you calorie goals, but others tend to focus on macros. Which does your doctor/dietician use? I know at 400 calories I'd be waaay below my protein goals, and those protein goals are very important to maintain your muscle mass as you lose weight. By 3 months out you should be able to hit them most days, or at least get close.

That seems about right especially if your normal eating had a high sodium intake. Sodium holds onto the water so once you get on a strict regimen that cuts that drastically down you will release the water weight. I lost 15 lbs last week during week 1 of my preop diet and will be done with it on Wednesday but when I weighed myself this morning I am down an extra 6.2 lbs from last week’s weigh-in.

Also don't forget possible "excess weight" from any loose skin and also fluid retention from certain foods, but also from building muscle during your workouts. You can continue to burn fat, which is the weight loss you want, but may add pounds on the scale since muscle weights roughly 1.5x that of fat. That's why the NSV's become more important towards the end. You may not be the goal weight number, but your BMI may already be there.

So I for sure had this issue, but on just one side - my right side. I had always had some version of numbness/hyper sensitivity on the outer side of my right thigh. I had lost a bunch of weight naturally and it did improve. Then with gaining the weight back I felt it far more when I would stand still for too long. I've always equated it to a pinched nerve. After surgery, I had felt that sensation on 1000 often feeling like electricity running through from hip to knee and would not allow me to sleep well for some time like lightning bolts. I did bring it up to my surgeon and he could only offer that it could very well be due to the length of time spent on your back during surgery could have impinged a nerve. His advice was to just give it a little bit of time, with weight loss it should ease up. If it persisted or got worse to consult my PCP. I gave it time and it started to lessen. I had to find some other ways to lay and stretch for a bit, but the weight loss has definitely taken the load off wherever this nerve is. Hope it improves for you.

I second what everyone has said so far. Unless you started in excess of 400 or 500lbs you’re doing fine. If the number in the scale is bothering you (&it can do a number in some people’s heads), maybe reduce how often you weigh yourself - you don’t have to do it every day. Weight loss is never one straight downward line on a graph. It zigs & zags, goes up & down, & plateaus. Our bodies have different needs each day, we don’t eat & drink the exact same things every day, our activity is different day to day so our weight loss won’t be exactly the same day to day. We may be retaining fluid (hormonal or diet related), constipated, have diarrhoea, etc. as well which will affect the number on the scale. Also don’t forget you can include your shakes & soups in your fluid intake for the day so you may be closer to your fluid goal than you think. My plan was also no bread, pasta, rice like most are. I still don’t eat them as like @Spinoza they sit heavily in my tummy and limit what else I can eat & I’m 4.5 years out. I still follow the eat my protein first, then vegetables. (I only have two serves of carbs a day & they’re whole/multi grains - complex carbs - not the more highly processed simple carbs.) If you are concerned speak with your team. I always told myself if my surgeon & dietician were happy with my weight loss I should be too. All the best.

I did gastric bypass + hiatal hernia repair June 6. I have had very few "issues"-- a couple of "one step over the line," one incident of the dreaded foamies, but generally, smooth sailing. I was at around 274 lbs and now am at around 206-7, depending on scale and time of day. That's crazy! I look at the stats for how much folks lose on average and this seems to be beyond the norm. I'm not complaining-- I not only walk, but got into a rigorous exercise regime with a trainer. His focus, for now, is balance, and "whole body"--I do some weights but the "balance" stuff has been a real blessing. I have checked the boxes with the M.D.s- my cardiologist has no problem with testosterone treatment as a means to build muscle mass. I need to get my surgeon to sign off on that, just to be sure. But man, this has been an amazing journey in a very short time. I'm way more mobile, fit into clothes I forgot I had (I used to buy really nice stuff, turned into a slob, and now I'm caring about my appearance again!). I'm closing in on 70 years-- and have not felt this vigorous in a long while. My taste buds have definitely changed. But it's worth the trade-off in health and fitness. And no more GERD!!!

I'm just going to list things in no particular order: 1. When sharing weight loss numbers many folks count from their highest weight rather than from day of surgery, or whatever starting point yields the biggest number; 2. There are many, many variables that go into how much weight one might be expected lose post-op. Such as highest weight, how much weight was lost pre-op, starting weight, expected total weight loss, how much of your excess weight is fat vs muscle, how active you were pre-op, genetics, and on an on; 3. Most people will lose weight in the first few months no matter if they follow plan or not. This is why following plan now is so important. When you follow plan you get the positive reinforcement of losing weight. Those folks not following plan also get the reinforcement. In a few months when the weight gets harder or stops altogether, who is going to be able to stay on plan? For you who followed plan it's now a habit. For those that didn't follow plan, they are back to going on a new crash diet just like before surgery, with about as much success; 4. We each manage our meals in different ways. Personally, I don't eat until I am full because it's not a comfortable feeling. Early out it was tough to figure out. With time I learned to eat until I feel like the next bite will make me full. Not unlike your method for avoiding being full. Good luck, Tek

Oh yes I get the comparing yourself to others. That is REALLY HARD. I say celebrate the 18lbs in 2 weeks (when have you ever lost even close to that on any diet?), get to know how the three week stall hits almost all of us (and can last a few weeks) and then settle into your programme and enjoy the big losses to come. 3lbs gain in a month is nothing to worry about - honestly. I am really surprised that you're allowed bread at such an early stage. My plan was protein then veg and no carbs for many months. When I did start earing bread it sat in my stomach like a lump of lead - so did pasta and rice. Less so 2 years on but I honestly only use them like a weapon in certain situations - not for daily consumption even now. I wish you all the best

first of all, 18 lbs in three weeks is normal. Most of us lose around 15-25 lbs the first month post-op. Thirty pounds in three weeks is way above average - did they start out at 400+ lbs or something? If so, that would explain it. Starting BMI is a huge factor in how quickly you'll lose weight - at least at first. soup and cheese both have a lot of sodium in them. So does store-bought bread. That three lbs might be water retention from the sodium.