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Yeah! I did Keto for awhile prior to getting surgery and would end up with a metallic taste. Of course, if you have any other symptoms alongside it - definitely go see a doctor

Of the mainstream procedures, the sleeve will be the most benign of them when it comes to supplement needs and the amount of trouble one can get into by ignoring them and the labs. Supplementing with the sleeve is largely an individual thing - there is much more influence by individual variations and dietary habits than there is from the surgery. I've never heard of B1 being a particular problem, but given that the primary dietary source is from the grain complex, and many people are into low carb dieting (Atkins, Keto, etc.) that minimizes that food group, it isn't surprising that such deficiencies would be showing up - not from the procedure, but from the chosen diet. My wife is chronically low in Potassium, but that is just her, not her WLS (as DS in her case.) That is managed by checking levels periodically and adjusting supplements as needed - just as if she had never had WLS. I have heard it hypothesized that there might be some iron absorption issue with the sleeve owing to the somewhat more rapid transit times of food through the stomach, but I haven't seen any validation of that concern. The malabsorbing (RNY, DS) procedures specifically do malabsorb minerals such as iron to varying degrees as much of the mineral absorption happens in the duodenum which is bypassed entirely (in the RNY) or partially (in the DS) so iron levels can certainly be more of a challenge with those patients. I had a bleed a few years ago that sapped my iron/ferritan levels, but was able to restore them to normal in a few months by doubling my oral iron supplement; most with an RNY or DS would need iron infusions to recover from those levels. I tend to lose a bit of D normally so have been supplementing that since before my VSG and continue to do so at moderate levels (2-5k IU) both from that perspective, and also our surgeon prefers to see us in the higher end of the normal range on the blood levels; some in the malabsorbing camp will use 50k IU supplements to keep things in line (particularly the DS folks who specifically malabsorb fat soluble vitamins such as D) I know quite a few long time DS people (10-20+ years) and have seen very little problem as long as labs are regularly taken (annually usually) and responded to; however ignore those at your peril as weird things can happen if you don't. And that's with the DS, which is the fussiest of the procedures in that regard. With a sleeve, you are much more likely to get into trouble by something that you bring to the table - whether that be intrinsic or behavioral - but that is good reason to keep up with periodic lab checks just the same (my labs are a lot simpler than those of a typical DS or RNY person, as there is less that is needed to be monitored with the VSG.)

I could never handle the high fat part of keto. Since surgery, I definitely have fat malabsorption and if I eat too much fat, I pay for it in the bathroom. I also had fatty liver disease prior to surgery, and from what I've read, hitting the liver with even more fat is probably not a good idea. Poor liver is working hard enough to break down all the fat from the weight loss process. Maintaining a low carb approach is still a good plan, but for me the priorities are protein and then veggies, but without the high fat of keto.

People have no idea I've had it. Why? Because months before my surgery I started the keto diet, and working out. I was losing weight like crazy! I haven't changed one thing since my surgery, including my portions. Everyone assumes it's just the keto diet. (which is it, along with portion control). I've lost 65 lbs total and I go to the gym 6 days a week. It's obvious that I'm working my ass off to lose weight. So, no, people don't just "know"

I count everything. I was diagnosed with congestive heart failure in 2022 and was put on a sodium restriction. Just two months before my projected VSG surgery date my A1C was 9.6% and I was put on diabetic meds(Metformin and Semaglutide), given a blood sugar meter with instructions to check my blood sugar twice daily, and told to cut out all sugars in my diet. Around the same time as my Type-2 Diabetes diagnosis my Bariatric Surgeon had me go on a Keto/Atkins very low carb diet prior to the liver shrinking diet due to my extremely high 71.5 BMI. That was my first time on a 'low carb' diet since I tried South Beach in 2004, and I really liked it for how it made me feel and how much easier it has become to find low-carb substitutions for common foods. So I decided to stick with it post-surgery. I am two weeks out from my surgery and I am at the point where I can eat 800-1000 calories a day, where 50% is from protein, 40% fat, 10% Net Carb, and sodium between 1,500mg and 2,000mg. I track my Daily Food Intake in an Excel Spreadsheet, listing Calories, Total Fat, Protein, Net Carbs, Fiber, and Sodium of each. I also track my fluids, noting if the beverage has any sodium. I avoid sugars like the Plague, except when it comes to fruits. I will on occasion eat fresh strawberries, raspberries, or some honeydew melon. I don't feel the Keto diet is suitable for Post-op due to the high reliance on Fats. I like a more even distribution favoring protein over fat, but still keeping enough healthy fats in my system so entering Ketosis is a possibility. My carbs are always under 25g a day, most of the time between 15g and 20g. I was only in Ketosis once for a brief few days, and it was right after surgery. I check my ketone level regularly with those over the counter 'pee' strips. I like my method of tracking my nutrition manually instead of using an App or Website, although there is a lot more work looking up nutritional labels for everything I eat, or general nutritional information for those items without labels. The plus side of it is I am amassing a database of my frequently eaten food items so logging is becoming easier. I agree with the general consensus that 'Diet' is an ill-fitting word for what we are doing. I like the term 'Lifestyle Change' much better. A diet, to me, is finite in its duration. It has a beginning and an end. A Lifestyle Change goes on indefinitely.

Oh No sorry to hear that you were so sick, I'm glad your doing better now and are able to keep things down.... The keto thing makes sense with the high fat causing gallbladder issues. I recently learned that the gallbladder helps break down fatty tissue. So maybe a high fat diet can overload your gallbladder... that my doctoring for the day lol. I did the keto thing for a while before surgery but as i stated before I'm in love with carbs and we have a bad relationship its one sided... I get all the bad stuff out of it. Anyways I really hope those videos help and you get past your stall soon.

I am 15 months post op (sleeve). I went to see my nut, recently, because I hit a wall. We spoke quite a bit about the Keto plan. She said that we who have had WLS not longer absorb the way we once did. She had the concern even though I take all my vitamins daily. She said that we as WLS patients need to have the protein over the fruit and veggies (think eat proteins first then the rest of the meal). If I keep up with the protein and reduce the fats, she is ok. Of course, this does change Keto a lot. So, I continue to investigate those who have had surgery and have done Keto without any issues.

Hi guys, I ran a search but not much popped up. I've been on a ketogenic diet (high fat, moderate Protein, very low carb - basically the induction to Atkins except you keep it up forever) for the last 15 months. I know it's not a very well-understood diet and gets a lot of flak, but it's been great for me. I'm healthier than I've ever been and I adore this style of eating so much. The only problem is I hit a wall hard in the weight-loss department, hence the surgery. I'm wondering if anyone has had experience eating this way post-op? I know low-fat gets pushed a lot in surgeon-recommended diets, but I'm not sure if that's because low-fat is part of the government's idea of a healthy diet, or if there's an actual physical purpose? I think some people have mentioned fatty foods made them sick, but are they talking about doughnuts, or ribeye? If it's not possible then I'll accept it and just stay as low carb as possible, but I would really like to stick with keto after surgery if possible and am looking for reasons it might not be a good idea.

I like to see everyone getting a minimum of 700 calories after the first month or so. That would be 80g protein, 33g fat, 20g net carbs. This still results in ketosis, but provides the minimum fatty and amino acids required. (I set protein a bit higher to offset the low carbs and fat. More calories (1000) allows less protein.. but never drop below 60g protein). A true ketogenic diet provides a lot more fat and calories than 700. Personally I was over 800 at 4 weeks, and 1000 at 8 weeks (non-keto), but some people can't lose well on a thousand. 700-800 is a sweet spot for maximal losses while still hitting nutrient goals.

So the original "keto" as developed in the 60s and 70s by Dr. Atkins was much lower than todays' present iteration of the diet. For a normie Keto Diet based on Atkins 72, most fat % were in the 60-75% range. When I followed it as a normie, I had to be between 55-65% fat in order to lose the best. Most of the LCHF/keto docs agree that the amount of fat in your diet entirely depends on the amount of adiposity on your body. That means, that even with a keto diet, you still must operate in a caloric deficit so that you burn the fat stores in your body rather than the fat in your diet for energy. And for the most part, you must expend the energy from your diet before you tap into your fat stores. As @AZhiker and @KarenLR75 say, there is no need to inflate our fat to "today's keto" range. For most of us PO, it would be difficult due to surgical malabsorption. Even VSGers can have difficulty with higher fat. By simply reducing carbs to 20g net or below per day and putting your personal prescription for protein into the equation (given to you by your surgeon), then you can back into your target calorie goal and figure out your fat grams/percentage based on that. Any additional fatty acids you need (and the ketones produced through lipolysis) will then be able to come from the fat strapped to your booty and middle (and total body) rather than the fat bomb or MCT oil, or butter coffee -- or whatever ridiculous bolus of exogenous and unnecessary "keto bs" you consume. I knew that in order to lose I needed to maintain a range between 650-850 calories/day. I know, because when I got to 850 calories or above, I would stall out and not lose anything. I also knew from my surgeon and RD that I had a broad protein range (in the early days) of between 60-80g protein daily--with an optimal amount at 74g for my LBM and are based upon height, sex, age, physical status. Males and females of a different size will have different macros. Here are the macros I've used to lose 157lbs:

My pre op diet was keto so high protein too but also high fat which I struggled with. No calorie limit though. Why are you focussing on mushy food? After surgery you only eat purées & then soft foods for about 4 weeks & believe me that’s too long! Ensuring you meet your protein goals will be life long thing so I say enjoy any & all proteins in all forms. The protein snacks I go to are cheese, high protein yoghurt, hummus, liverwurst or pate (with crudités or a couple of multi grain crackers), protein bar (be careful some have a lot of sugar or artificial sugars). Occasionally I’ll have nuts or roasted fava beans or chick peas. You can also nibble on some meat like some chicken (watch deli meats that are cured or fatty like ham, salamis, etc.) or a boiled egg. Hope you get a surgery date soon.

@Lolo2020 Sounds like you're doing great!!! Only five pounds from goals is pretty awesome!!! That's pretty much there if you ask me. For weight, I set my goal at 174 so that I would be under 25 BMI. When I set that goal, I figured that's the weight I would need to be to wear a size 32 pants and to have a body fat% under 15 (which were my real goals). I already hit those goals so I am not sure my goal weight is realistic at this point, but we'll see. I am about 11-13 pounds away from my goal weight (depending on the day). I still may be losing weight but it' snot like it's a steady stream of weight loss every day. It just seems that my heavier days are less heavy and my lighter days are a little lighter and it's just trending down a little bit at a time (maybe a half pound a week for the past few weeks). I'll take it. @coexister If you're struggling with carbs, maybe you need to reevaluate whether they should be in your diet and, if so, what kind of carbs should be in your diet. I think the best approach to food is to plan out your menu in advance (the night before or something like that). If you have a plan of what you are going to eat and how much of it (you need to weight things out so you know what you're consuming), then you're more likely to stick to the program and not go off the plan. You can't blame "saboteurs" for screwing up your diet. Ultimately, you're responsible for what you put in your mouth. I have got an 8 year old and a 3 year old, so we have plenty of cookies and bad things in the house that I can't eat. For me, it may as well be like I am deathly allergic to that stuff--like a peanut allergy type thing. Eating that crap isn't an option for me anymore. Instead, I a make sure my diet has enough volume foods like lettuce, spinach etc. along with nutrient dense foods to make sure that I am getting the nutrients I need and I still feel satisfied (which I really do). I can live on a keto style diet forever--although I have added more carbs because I need more fiber (but the net carbs are now kept under 40 a day--I was at 20 or less for the first three months that I was on solid food). As for exercise, you just do the best you can. If all you can do is walk, walk as much as you can and make part of your routine each day. Once you have a routine that blocks out 1-2 hours a day for exercise (walking in your case), then you can add other types of exercise once you're healthy enough. The scheduling change will make that possible so you're still used to a healthy routine. This is the time to fine tune your lifestyle while you're still getting the full benefit of your sleeve.

Ditto! I did keto as well. I didnt lose as much as sleevediva2022 but I did gain it all back as soon as I stopped tracking everything I ate and I got back up to my highest weight again. I believe I had lost 40 lbs and gained 45 lbs back.

Not imo. It works for some people but I think you need a certain psychology around food I just don't have...not to mention guts of steel haha I did keto like 2 years ago in one of my many pursuits to lose weight. I had diarrhea every single day all the time. I did lose 10 lbs in 3 weeks but when I stopped, I gained it all back plus more! Not my proudest moment. Sent from my SM-G975U using BariatricPal mobile app

yes. Indeed I am looking for someone still. Since my original post, I have visited my doctor for month 2 of 7 required before I can submit for authorization with my insurance. My doctor has advised me to try a keto based diet. Ordinarily this would be awesome for me. but for whatever reason I can't seem to stop craving the things I can't have: fruit, juice, sweets, snacks, breads. But I keep trying. Had a first cheat day this past day. had some pasta and pie. but I monitored my portions so that made me feel better. Back to the diet now. I have been regularly getting my 7k steps in. Most days I have closer to 10k steps. So I been doing decent enough on my activity aspect of all this. I just need to nail down this nutrition side. lol. I don't know what we can and can't share on this site as far as personal info goes, or how that works. do you?

I do keto but it Is very much carnivorous lol

I am averaging between 15-25g net carbs daily. Net carbs are total carbs minus the fiber. Many people do well on a low carb keto diet. I get most of my daily carbs from vegetables and the rest from dairy.

No problem. I guess I'm referring to insulin resistance effect on different diets mentioned in the book. I certainly don't agree that the keto he pushes is sustainable or healthy.

I tried the following recently: Truely Cereal - Fruit flavor. It wasn't bad, but it has a weird texture. It's made to look like fake fruit loops. Catalina Crunch - Keto friendly- Honey Graham. It's a very hard cereal so it required a long soak in my (oat) milk. Tasted fine, a little too sweet but not excessively so. Quaker High Protein instant oatmeals. I've tried a few flavors. Luckily my father likes them so he took sll the leftovers. Consistency and texture were fine, but they taste salty? Also they have actual (if reduced) sugars so I was hesitant to begin with. Didn't find it worth it. I've got an unopened box of Premier Protein - Mixed Berry cereal that looks promising. Fingers crossed. But that multigrain Special K looks right up my alley -- will be seeking that out.

So this is what I was thinking too.... bulky clothes and drink a ton of water beforehand BUT my next appointment (and last appointment) is with my new nutritionist before they send it in to insurance. I've been doing a diet (keto) under doctor's supervision but then my surgeon's nutritionist specifically said "I need to know that you can follow OUR lifestyle plan in order for me to sign off on you"... so then that makes me think that she needs to see that I can lose weight following her specific rules [emoji86][emoji86][emoji86] ughhhh. I'm in such a pickle. Do you think maybe if I call her and I am just transparent about it that she would be understanding of my situation? Or talk to the PA and ask them if they can send in one of my higher weights instead when sending in the approval packet? I'm not sure how morally sound it is to even ask them [emoji51] Honestly, I am desperate. This whole conversion surgery is something I've put so much time and effort into. It's been years in the making. I've changed my lifestyle because I know that it is just a tool... thinking that if I change my habits now that it will make it easier for me to adjust when I do have restriction again. It just sucks to know that that is not being taken into account

I do a mostly Keto diet by happenstance. I like it. I don't buy low fat items, but I stick with lean meats. I really follow the protein first, then veggies. I do have the occasional whole grain and some fruit as a treat. But a lot of the recipes I make are Keto based. It just seems like an easy thing to follow since it falls within the guidelines for eating after surgery.

@@Clarevoyant You should be fine. They have Protein shakes and bars in the UK just like in America. You can get a salad with grilled meat and eat the meat off anywhere. 2 months post op your energy levels should be rising. You will have to make sure you get enough calories in each day for energy. In London you will be forced to walk a lot, unless you already live in NY or Chicago, it should really help with your weight loss. I am really excited for you that you have this opportunity. I wouldn't pass it up. Things to remember eating out, you can always get a sandwich, they usually have 2-4 ounce meat portions, and just eat the meat I do it all the time. It is an easy way to control how much you are eating out, and to get cold cuts. You can eat the top off of pizza. Like I said before get a salad with meat and eat all the meat first. This keto blogger lives in the UK so you might find some hints on here where to shop. http://ketodietapp.com/Blog 2 low carb UK restaurant reviews http://ketotheukway.blogspot.com/search/label/Restaurant%20Reviews Keto UK boards https://www.reddit.com/r/ketouk Just do your research and have a plan. If you have a plan you can always stay on plan. For example I know almost every restaurant has a chicken Cesar salad, so if there is nothing else I can eat on the menu I know I can get one and eat the meat off. Even slumming it at a casual place, they will have some kind of sandwich with cold cuts I can eat. If push comes to shove and you are stuck with street vendors, a kabob is better choice than fish and chips. Also the food in Europe tastes so much better than the US, you will really enjoy that post-op. Good Luck!

I am 4 yrs post VSG. I have regained a good amount of weight- I got back into drinking soda and I really believe it is a major culprit. Unfortunately i'm really struggling in that area, and I work a night shift job which goes against every grain of my being ( I DON'T sleep days, I have a terrible time staying awake at work, but only have about 15 months left because i'll be moving into a different career path after my post-graduate education is done). Anyway, my hubs and I both have about 40 lbs to lose. I tried doing a 'bariatric' type diet, with lean proteins and veg. didn't work too well, I was starved and only lasted 3 days. I tried going back to shakes- I have developed lactose intolerance and vomited from the smell/taste of whey even when I used almond milks. I tried doing a 'low carb' type approach which worked decently (only lasted about a week before I had to go back to work and that blasted soda grabbed hold again). I tried just stopping the soda but it didn't make a huge dent in my weight loss either (I drink mostly diet). My hubs would like to try Keto. I am very nervous about it. I definitely buy into the major science behind it, but i'm scared with all the fats that i'll be in misery. I am very leery of dumping syndrome and think that the high levels of fat might have me bent over in pain. I don't have a gall bladder so dumping is a definite concern. while most people dump from sugar, my body is actually pretty tolerant to sugar, and I get dumping from fat and dairy (milk and ice cream only). Has anybody had any success with keto, specifically for regain? thanks

You can make your own sugar free gummie bear candy out of sf gelatin. And you can flavor it with essential oils, liquid stevia, and add citric acid to make them like sour patch. Then you start stepping down from the candy. But you will likely need to replace the cals with some other source cuz otherwise you will likely start losing again. Also, you can make keto candy like fat bombs with healthy oils/fats + cacao powder, nut butters etc. They add up VERY quickly. But they are usually more satiating. SF peanut butter cups are the bomb. You can also try getting delicious protein bars, cutting them in 8 pieces then freezing them. Pop them like a candy bite. I think you're in a pretty special situation because of your super endurance exercise. I think @Healthy_life2 and @BigViffer could help you with this. They are both power athletes and have to eat in a method to keep their cals high enough for training. Congrats on your losses. The candy is an addiction. Addiction to sugar is as powerful as heroine addiction. I'd also see your doc/RD and ask for help. They may have a temporary medication that can help you with cravings as you try to detox.

Your having issues being compliant. I would quite soda continuesly. Also try going back to the plan you're team gave you. Keto works but not for chopping and changing.