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Sucks that nobody replied thus far. Perhaps drinking a protein shake first thing each day will help kick start your system. Hopefully the intake will help get your system functioning

I’ve run into similar issues with ambiguous insurance code stuff, especially when it comes to newer or non-traditional procedures like ESG. It’s super frustrating calling and getting different answers each time. I had to push a lot for coverage on something once, and only got traction when the billing office from the provider contacted the insurer directly with suggested codes. If you're planning more procedures or looking into broader health coverage in the future, especially for your family, I found this info on https://premierpmi.co.uk/health-insurance/health-insurance-for-a-family-of-4/ pretty helpful when we were comparing options. It gave me a clearer picture of what to expect.

The hair loss can be shocking and frustrating but save your money on supplements, special shampoos & treatments. Unless you’re lacking in the specific nutrients you require for hair growth they won’t help. The hair loss is temporary and for most lasts 3-4 months (regardless of taking supplements or not). During this time of stress and hormonal changes, your usual hair loss cycle is accelerated so you lose more hair but it is hair you would lose at some point. Your new hair is continuing to grow just at its usual rate. Meet your protein goals and ensure you’re getting in the nutrients, take a vitamins you’ve been advised to take. A blood test will show if you’re lacking in anything. Many of us cut our hair shorter as shorter hair always looks thicker and bouncier than long. And it will take less time for your new growth to reach the length of your shorter hair. Also there is no real evidence in support of collagen for hair growth (hair is made of keratin not collagen). Want to take it for your skin, go for it. I agree with @SpartanMaker: as collagen isn’t a complete protein it can’t be counted as part of your protein intake and you’ll get more collagen per dose/serve of a collagen supplement in powdered form than a capsule. It dissolves well & isn’t filling like a protein powder. If the hair loss persists or the loss is excessive, a dermatologist will be the best for you to see for help and other causes of the loss than just weight loss.

Oh I never said I didn’t consume any protein lol. I have whey protein powder, and I eat things like eggs and the plant based meat that I eat has protein in it as well.

@WendyJane made a great point. I sort of assumed you were getting your protein other ways, since it's certainly possible to do so without eating meat. That said, transitioning to vegetarian or vegan would be really hard to do right after bariatric surgery. While that sort of diet can be a healthy choice, getting enough protein has to be your main goal. Hopefully your team gave you a minimum protein goal. If not, at 3 months out I would want to see at least 70 grams per day minimum, with 100 as a better goal. As you get to 6 months, 120+ would be ideal, though even more is beneficial. We focus on protein during weight loss for several reasons: Protein is essential to your body. While you also need a small amount of essential fats, you could in theory get those from a supplement. Dietary carbs are not essential because your body can convert protein and fat to glycogen to fuel your body. Protein is highly satiating compared to carbs, plus it takes longer to digest than fats, meaning you'll be full longer. Protein is actually harder to digest, meaning on average, for every 100 calories on protein you eat, you burn about 20 calories just to digest it. This means the more protein you eat, the lower your overall caloric intake compared to carbs and fats. Higher levels of dietary protein help you preserve more muscle mass as you lose weight. Because muscle is more metabolically active than fat, the more muscle mass you preserve as you lose weight, the more calories you'll burn, even at rest. In short, protein, protein, protein. You really can't eat too much protein at this point after surgery.

You said that you stopped eating meat, are you taking Protein supplements like shakes? You should be having a high protein diet and not so much in carbs, and some veggies are carbs, like peas for example. Fruit has natural sugar in them, you should be focusing on protein. I strongly urge you to talk to your dietician with your surgical team, and make a better diet plan than what you are on. Something you can do in the meantime is to look at the bariatric bowls and plates available on Amazon, and look at the portion sizes of fruits and veggies, then look at the size of the plate for protein. It may not be what you are eating, but could be your portion size. But based on your initial post, you are eating fruits and salads, you are not focused on protein. I say again, check with your nutrition specialist with your surgical team. I will say what others have, 60 pounds is a good amount of weight to lose. Remember that your surgery is a tool, and not a cure. It takes time to gain the weight, it will take time to lose it, when you are eating correctly and as your nutritionist says, contact your surgical team. Congratulations on your journey, you are doing great so far!!

My hair was coming out in chunks around 4-6months -I thought I would be lucky but sigh nope!. My hair is coming back thick and I'm 15months post op. I make sure I eat 100+ grams of protein a day (usually closer to 150g which might be too much but that is something I am trying to figure out), take all my vitamins and I put 2-4TBLS of this in my coffee or incorporate it into my food every single day: https://www.gnc.com/powders/542500.html?ogmap=SHP|NBR|BING|STND|c|SITEWIDE||{B_PMax_NB}|All Products - Holiday||396351403|1244648496726018&gclid=4eaca2547a921363fd6aca455842f355&gclsrc=3p.ds&msclkid=4eaca2547a921363fd6aca455842f355&utm_source=bing&utm_medium=cpc&utm_campaign=B_PMax_NB&utm_term=2329590261827342&utm_content=All Products - Holiday

If you want to try collagen supplementation, you certainly can, though the scientific evidence is a bit of a mixed bag. Some studies seem to show benefit, but I think we have to keep in mind this condition is also a temporary issue brought on by the stress and dietary deficiencies you went through. In short, it's going to resolve by itself over time and thus it's really hard to know if the collagen is actually doing anything. IMO, the best possible thing you can do for your health, for your hair loss, as well as to speed your weight loss would be to really double down on dietary protein intake and not supplements. For those about to jump in and mention that collagen IS protein, yes that's true, but it does not contain all the essential amino acids. As such, you really should not count it toward your daily protein intake. Plus, a capsule isn't going to contain very much protein anyway. I'd guess less than a gram per capsule, though I suspect it might vary based on the source and size of the capsule itself.

I didn't expect this much hair to be coming out. I don't want to lose more. I know I don't eat enough protein but making it a huge priority now and ordered collagen pills. I get full too fast and so can't add it to coffee.. I never can finish a cup. Anyone losing hair or lost it around this time? What helps? I'm 190.6 today. And in Nov last year before surgery I was 244. Feeling way better but I want to keep my hair too! LOL! Thanks for any advice and insight!

See I think you are very determined and committed (at least what I gather from your posts and replies) and I believe you have great awareness and the ability to make the right choices for yourself. I pretty much know that you haven't come this far to let go completely and go back to old habits. I would also argue that the shame and guilt that accompany you are as detrimental as eating all the processed food in the world. I am not a role model. I eat chips, I eat chocolate, I eat carbs, I eat everything. But I also eat my protein, salads, fruit, veggies. I workout and take my whey, creatine, I take my supplements. I think I have achieved a good balance - that allows me to indulge daily - so I do not sweat the little stuff. IF AND WHEN (sorry for the caps) I see a change in the scale that I don't like, then I address it and evaluate what I can tweak. What does balance look like to you? Living with guilt will never help you achieve a balanced state, worrying too much won't either. Continue doing what you've been doing (you have done fantastic), but get rid of the shame and guilt. These are my thoughts, take them with a grain of salt

Did you go in to the clinic and did your doctor do a full physical? If not I would consider a second opinion especially being 9 weeks out. At 9 weeks you should be on solid foods unless you were advised to do liquid/puree for longer and you didn't? A second opinion can never hurt. You said mentally food makes you want to "gag"and you find food " disgusting ", perhaps not only having a complete physical but talking to the dietician or a mental health professional would also help... Also, you never stated what your average meal menus consist of...and quantity..other than low fat meats and protein drinks. Are you getting enough fiber to assist with those " accidents"? I'd at the bare minimum set up an appointment with the dietician. Good luck hope you start doing better soon!

New here but usually trolling,I'm having such a hard time with food no matter what it is fish,chicken, lean meats etc. Some days or should I say most days just the thought and smell of food wanna make me gag,lately I have been passing days of not eating just supplementing with protein shakes. My situation is everytime I do eat something I'm spending the next whole day visiting the bathroom 8-10 times a day and feel terribly crabby and have no value of life as I cannot leave the house without having an accident os two. I am getting very frustrated and getting depressed of this situation. I'm 9 weeks out this coming Tuesday and have lost 55lbs and down 2 pants sizes but not very happy about this bathroom thing and my quality of life as I can barely leave the house unless I don't eat a couple of days,and I don't even get hungry or feel like I can eat anything right now food just disgust me. Any help I will appreciate.

So sorry you're struggling right now. I think if we're all being honest, we're ALL been there. I've said this before, but I strongly believe anyone that is or was obese has an eating disorder or at least suffers from disordered eating. You simply don't get that big unless you have an unhealthy relationship with food. The thing is, none of us magically got better by having bariatric surgery. If you think you need it, please reachout to a mental health professional to help you get back on track. If you don't feel ready for therapy, that's okay too. You have to do what's right for you. Just know that there is help out there if you need it. I want you to know that I personally have faith in you, even if you don't right now. You are an inspiration to many people here, me included. You've already shown how strong you are and how hard you're willing to work for your goals. I know this is just a temporary setback, and I'm guessing a lot of it was brought on by extra stress due to surgery and your routine being thrown off. As they say, this too will pass. I know you can get your mojo back, so please give yourself some grace. We're often our worst critics. I'm honestly just guessing based on your previous posts, but I'd think you're a very goal-oriented person. It might be beneficial to stop thinking "I need to get back on track". That's just too nebulous. Instead set yourself small, time-bound concrete goals. Only you can decide what those should be, but it might be as simple as "get at least 120 grams of lean protein tomorrow". Forget everything else that part of your personal idea about what "back on track" means and just work on that one small goal until it's become habitual. Only then, add in a new goal to work on. Just keep them small, easily attainable based on where you're at today, and make sure they have a time component such as my goal for tomorrow is..., or my goal this week is... you get the idea. If you need any help with diet or exercise as you work through this, please feel free to PM me and I'll do my best to help. Wishing you all the success in the world!

While usually used for males, it is also used for females with the issue. I’m not sure if it has ever been used for post surgical telegenic effluvium. Typically it lasts 3-6 months. Sleep helps, protein in the diet helps, stress reduction helps, keeping up with iron,zinc and biotin/b vitamins helps, omega 3 fatty acids in fish or flax oils, sulfate free shampoos, gentle brushing/washing, avoidance of sulfate free shampoos. Tricoaphere F kit, hair top peptide serum or bontress pro serum, reducing hair length. :/. Pardon I’ve been reading about this because I love my hair. It’s the only pretty thing I’ve had for so long now. I’m worried I’m going to trade it.

I did keto a lot before surgery, it was vogue as we’ve all done a million diets in our lives... It works, but cravings. The preop and post diet are similar. Just way more liquids. For the fatigue and headaches, broth was the key. You would dehydrate rapidly and would suffer without the salt. The sugar detox is real, often once it passes you are a ton less Hungery. For those like me, and sugar can start the cravings. 100% agree with others who posted. It takes me about a full week for those to stop. Distractions help, exercise helps, just going to bed helps. I am always less hungry after mild exercise, mostly sweaty and thirsty. It helped stopped the food focus more than plain distractions. Heavy exercise increased the hunger the next day. This might sound crazy, but I had to constantly know when my next meal was. Lunch done, wait 2 hours then sugar free jello, then 1 hour and sugar free popsicle, then start to prep dinner, etc. knowing I was eating something in 1-2 hours helped. I tend to panic eat. Food was scarce as a kid and I tend to stuff myself if it’s not readily at hand and I’m hungry… my next meal is 3 bananas as fast a I can shove them in and I remain food panic triggered and have to talk myself down. I’m working through my hunger panic. I’m 100% not super thin now, I’m huge and need help… it’s why we are all here. :). To give and get support. And trying to not be a clean your plate club, eat any meal you are offered, all meals need a dessert, eat till you have pain and call that “full” kinda gal. I’d also make sure I got all of my sleep. I’m a 10 hour person. Plan a small exercise before you know your mega Hunger hits (I’m lunch). A 15 min walk helps divert my blood to my limbs and gets me craving fluids. Call your food what it is. A popsicle is a dessert. A pudding is a dessert. Sometimes reframing these help, ok in 2 hours I’m having protein pudding as a dessert, followed in 2 hours by a dessert popsicle. We are all different, so need different things. If after dinner I have a popsicle every night before bed, I call it dessert and I always know it’s coming and I will be getting more food… and I’m ok not being as full at dinner. This.. might have been too personal, but… helps me.

I did keto a lot before surgery, it was vogue as we’ve all done a million diets in our lives... It works, but cravings. The preop and post diet are similar. Just way more liquids. For the fatigue and headaches, broth was the key. You would dehydrate rapidly and would suffer without the salt. The sugar detox is real, often once it passes you are a ton less Hungery. For those like me, and sugar can start the cravings. 100% agree with others who posted. It takes me about a full week for those to stop. Distractions help, exercise helps, just going to bed helps. I am always less hungry after mild exercise, mostly sweaty and thirsty. It helped stopped the food focus more than plain distractions. Heavy exercise increased the hunger the next day. This might sound crazy, but I had to constantly know when my next meal was. Lunch done, wait 2 hours then sugar free jello, then 1 hour and sugar free popsicle, then start to prep dinner, etc. knowing I was eating something in 1-2 hours helped. I tend to panic eat. Food was scarce as a kid and I tend to stuff myself if it’s not readily at hand and I’m hungry… my next meal is 3 bananas as fast a I can shove them in and I remain food panic triggered and have to talk myself down. I’m working through my hunger panic. I’m 100% not super thin now, I’m huge and need help… it’s why we are all here. :). To give and get support. And trying to not be a clean your plate club, eat any meal you are offered, all meals need a dessert, eat till you have pain and call that “full” kinda gal. I’d also make sure I got all of my sleep. I’m a 10 hour person. Plan a small exercise before you know your mega Hunger hits (I’m lunch). A 15 min walk helps divert my blood to my limbs and gets me craving fluids. Call your food what it is. A popsicle is a dessert. A pudding is a dessert. Sometimes reframing these help, ok in 2 hours I’m having protein pudding as a dessert, followed in 2 hours by a dessert popsicle. We are all different, so need different things. If after dinner I have a popsicle every night before bed, I call it dessert and I always know it’s coming and I will be getting more food… and I’m ok not being as full at dinner. This.. might have been too personal, but… helps me.

Late to the party, but if anyone is still looking for puree options, some options from my program that werent blending meats include Pureed soups Refried beans Hummus Yogurt Applesauce Babyfood Oatmeal, cream of wheat, or grits made thin. For bonus points add in a scoop of protein powder Thin mashed potatoes. Add bone broth gravy for protein and moisture. Mashed sweet potato Fauxtato style cauliflower puree

Hello, just found site and joined. I am on my 2 week pre op diet and surgery is on May 2nd, out patient. I have supplements, protein water, unflavored protein, 1 ounce, 2 ounce disposable containers obtained as well, scale and still trying to figure out the whole sips to intake at least 64 ounces of water, i currently drink over 124 ounces daily but again, not by sips but gulps, lol. will figure once i get to that stage. Just now we all got this! Karen

Thank you, I'll take all the luck I can get! I have just the "normal" shedding most complain about after major surgeries, except it has continued past when it should have stopped or gotten better 12 month - 16 months. Sometimes its a brush full sometimes lots of hair fall. I don't have any bald spots as of yet <fingers crossed>🙏 I just happened to go in for my yearly skin check and mentioned it to my dermatologist (surfer, scuba diver, life guard, sailing ) so lots of sun in my past). My doctor said she saw a few small scars and thought to just be on the safe side decided to do two punch biopsies. She has me on antibiotics and then in 10 days I go in for follow-up diagnosis (I diagnosed myself based on pathology slides - I'm a pathology lab director) and treatment options. I just wanted to put it out there for people so if they were losing hair to not wait to long jic. There is a cut off that can be blamed on typical bariatric surgery for hair shedding, but if it continues the sooner you get treatment the better outcomes.

Well, I finally decided to join the fun here in this thread: I pretty typical breakfast for me: This is ~3/4 cups of 2% Greek Yogurt, some thawed frozen cherries and some protein boosted granola. I don't really log my food, so I'm just guessing as to nutrition, but I'd think this is ~250 cals and ~22 grams of protein. Why 2% Greek Yogurt? Because that's what my wife prefers, so that's what we buy. I don't have a strong preference, but personally would probably buy full fat if I were buying it just for me. Note that I often change out the fruit based on what we have and what's fresh in the store.

To everyone who has responded....thanks, lets keep in touch and get a good start to our journey. I look at this surgery as a new volume in my book, not a new chapter. I'm not looking back and I will be able to not only lose weight to feel better, but I will be able to get the much needed hip replacement. I'm due to have surgery on the 12th of May, signed my consents today, got my pre-op class done and met with the surgeon and he was quite pleased with my weight loss and my A1c both have gone down. I'm just as eager to get rolling on this new journey. What is next is the clear liquid diet a few days before surgery as they found I do not need to be on a liver reduction diet. I have my supplements as instructed, I have protein water for after surgery. We have 4 days of clear liquids only, then we can go on a soft diet, we don't have a puree, which is a blessing, I can't imagine eating chicken in a puree form, can't have meet until day 11. I'm taking this seriously, and will follow all the rules. I think I am more excited than anything for the 12th of May to come. Ealbers, you are right on track, let's get on with the journey. CJPom, you are first on the list being May 7th, let us know how you are doing post surgery. Jena, we will do this as a team, let's keep each other motivated!!! Congratulations to everyone! Every week, find a win other than is on the scale. Don't check your weight every day, it will fluctuate as your body adjusts and changes. Find other wins to celebrate, but don't stop celebrating. This is not just weight loss, but it is a metabolic shift in our bodies. Movement is important so let's keep walking. WendyJane

Research does support the idea that BMR will be lower in a formerly obese person vs. someone of the same body composition that was never obese, but the magnitude of the effect was only 3-5%. I'm not discounting the 300-400 calorie number entirely, I'm just saying that if it's accurate, only maybe 50-70 calories of that is coming from BMR. The rest is coming from something else like activity level. Keep in mind that the most common way to quantify total daily energy expenditure (TDEE), is with a 4 component model: Basal Metabolic Rate (BMR). This is sometimes listed as Resting Metabolic Rate (RMR), although that is slightly different. Either way, this is a way of quantifying how much energy your body burns just to keep you alive. Exercise Activity Thermogenesis (EAT). This is calories burned in intentional exercise, such as running, cycling, etc. Non-Exercise Activity Thermogenesis (NEAT). This is all the other activity you do aside from intentional exercise. You can think of this as things like cooking, cleaning, shopping, etc. Some people refer to this type of thing as "activities of daily living", although other things also fall into the NEAT bucket like fidgeting, how much you stand vs. sit, etc. Thermic Effect of Food (TEF). Note there is no such thing as a negative calorie food. That said, it does take some calories to digest the food we eat. On average, it's about 10% (so if you eat 1500 calories, it takes 150 calories to digest that). Note that protein tends to be a higher percentage, yet another reason to eat more protein. While it's potentially possible that formerly obese people are somehow more efficient at digestion (meaning some of the effect could come from here), this could only account for a very small difference since TEF is just a small percent of your overall calorie burn to start with. The reason I wanted to list all that is if BMR of formerly obese people is only downregulated 3-5%, then any potential 300-400 kcal/day difference would have to come from somewhere else like NEAT. Since NEAT is known to be lower in obese people as well, it's likely the bulk of the difference here is simply coming from less daily movement (perhaps habit?). This also means it's likely highly variable. The good news to me is this should also mean it's changeable as well. Food for thought.

Getting back to the OP's question about what do do: If they really feel they are accurately logging and are also having a hard time eating less, then the option would be to take steps to increase metabolism. Yes, GLP-1 drugs can do this, but there are other options. First, would be adding muscle mass from strength training. Estimates are that each pound of muscle increases calories burned per day by roughly 6 calories, Each pound of fat contributes ~2 calories burned per day. This latter fact surprises some people, but fat is metabolically active tissue. It's just that muscle is more metabolically active. If someone were to gain ten pounds of muscle and lose ten pounds of fat, that would lead to an increase in BMR of roughly 40 calories. That doesn't sound like much, but it adds up over time. If you also add in EPOC (Excess Post-exercise Oxygen Consumption), from the strength training needed to add muscle mass, then I'd estimate this would over time lead to ~400-450 extra calories burned in a week. That would lead to a loss of ~6 pounds in a year even while eating the exact same amount of food. If this is not a sufficient amount, then one can always reduce calories a bit as well. Alternately (I know this will sound counter-intuitive), but the OP might well want to consider UPPING their calories a bit for a while. Our bodies were designed to upregulate our metabolisms slightly when calories are available and downregulate it when calories are scarce. This means our bodies can maintain weight at a wide range of calorie intake. If we're constantly in a calorie restrictive diet, our bodies do downregulate metabolism to keep us from what it perceives as starving to death. What I'd recommend instead is going up 200-300 calories per day for about a month. After this "diet reset", drop down again to 1200-1400 for no longer than 2 months before cycling back up again. You can keep this cycle going on indefinitely. One of 2 things will happen here. Most likely the OP won't gain anything during the increased calorie intake diet reset because their metabolism will increase to compensate. However, when they start back at the ~1300 calorie range, their metabolism may not drop immediately, meaning they'll lose a little bit in the following 2 months. If they do find that they gained during the diet reset, but fail to lose when back in the diet phase, then worst case it shouldn't be more than about 2 pounds (less than 1% of body weight). This isn't likely, but even if this does happen, it will at least tell us that 1300 won't work for weight loss for them and they'll need to go lower. I'd also be remiss if I didn't come back to exercise here. I mentioned that low levels of exercise (30 minutes of cardio), really are not going to do anything toward weight loss. It's obviously going to be different for everybody, but current research seems to suggest that the tipping point is about 400 calories per day. What I mean by that is if you can burn OVER 400 calories in exercise in a day, the body can't suppress your metabolism enough in other ways to keep you from going net-negative for the day. Said differently, you'd need to do something that burns more than 400 calories before it "counts" for weight loss and the only part that counts is the part above 400 calories. Unfortunately, 400 calories is A LOT for most people. The good news is the heavier you are the more you burn, but even at 215 pounds, you'd probably have to run over 3 miles to hit 400 calories. Keep in mind, this would just be to break even, so if you're actually trying to burn more calories this way, it will take even more. I'll use myself as an example here. I'm not trying to lose weight right now, but I have found that if I run over roughly 28 miles in a week, I tend to lose weight. If I run less miles, I maintain. Do the math, and for me that's right at about the 400 calories a day mark. In my use case of one, I'm pretty close to the statistical average as shown in the research. Best of luck whatever you decide.

Good morning. I'm not discounting anything SpartanMaker posted above. However, I was in the exact same boat as you. I was eating 1200-1400 calories, religiously measured/counted everything, plenty of water, I played with my macros till I was blue in the face and for 10 months I did not lose and I did not gain. I'm a nurse so I probably have more background in nutrition than most, so I'm confident in how I was eating was appropriate and what most providers would "recommend". In February I went to my two year follow up. My labs were perfect, my vitals on point and I had not lost one ounce since the last visit nearly a year prior. After having a long conversation with my bariatric provider, the only change since the losing stopped was I was pretty much into full menopause. We discussed options and ideas on how to "overcome" the hormone influencing my insulin processes that was affecting my metabalism hurdle I may possibly be facing. She said based on her research zepbound might be a great option as it also can help in reducing "hot flashes" which I was having twice a day, everyday. Long story short, even with my insurance, zepbound would have been around $700 a month, so I choose to do the my budget friendly compound tirzepatide route (the compound equivalent to zepbound) with my provider's blessing. I have been on the weekly injections for 6 weeks and have already been able to shed 19#. I have not ate any differently, no change in my physical activity AND the hot flashes are gone. I'm not suggesting this would be the answer you need, but it's been a game changer for my journey. Good luck ❤️

It's been a while since I've been active on here, but I'm really struggling. Any advice or encouragement would be a huge help. 😥 Almost right at my year mark post-op, I stopped losing weight. My doctor said that I should still be losing 1-2 pounds a week. Around this time I was eating 1400-1500 calories, so they recommended I scale back to 1200. I try to eat whole, unprocessed foods about 80% of the time, I still track what I eat, count my calories, prioritize protein, and exercise 4-5 times a week for 30 minutes (usually cardio, but I do resistance train, just not faithfully). I am eating 1200-1400 calories a day, and I'm struggling so bad. My weight sits somewhere between 211 - 219, depending on water retention, my cycle, travel, stress, etc, and it really hasn't changed since I saw my doctor last. I would love to try the GLP-1 class drugs to see if that could help, but my insurance doesn't cover it, so that's not an option. I'm really depressed over this, which I know doesn't help things. I feel like I've worked so hard, and I've just barely gotten halfway there. Now I'm terrified I'll start gaining weight again, and I've caught myself obsessing over my eating to the point it's feeling disordered and mentally unhealthy. Has anyone else had this struggle? If so, what helped you - either with losing more weight, or just coping with being at a plateau? 😭