Search the Community

I am also experiencing hypoglycemia i had my surgury in december of 2016 and the hypoglycemia started around may 2017 i also went through many complication post surgury Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app

I have been treated for depression for several years now and there are times when you really feel dreadful. After the surgery we put up the meds for a few weeks. The surgeon said its quite common after surgery to have a spike in depression due to hormones and body trauma. I am 3 months out now and I have had a few bad days due to some complications more than anything. I'm OK now seeing a psychologist as part of my plan and reduced meds back now. Even though you probably feel like crap it will pass and is treatable. As the weight comes off there will be more positives to celebrate! Take care x Sent from my CPH1607 using BariatricPal mobile app

So, I decided to get the surgery done back in July after seeing the before and after results of an employee at my wife’s job. He and fiancé had gotten the VSG done about a year earlier, and given my numerous failed attempts to lose weight and keep it off, I decided that this could be my solution. I went to my primary care dr for a consult and a physical. Per usual, all of my labs came back normal with the exception of my glucose screening. This was something new. My labs were always good or “normal” over the years despite my weight. According to my glucose screening, I was considered “pre-diabetic”. My blood glucose level had never been above 70, and after a 12 hr fast, I tested at 102. When discussing the lab results with my pcp, I mentioned to him that I was considering having weight loss surgery, specifically the GSV. His response was, and I quote, “good Idea, that’s very smart thinking.” I never needed his approval, as I had decided to get the surgery regardless of the lab results, as I felt I had no choice. I felt my life was in danger as I had surpassed 400lbs almost 18 months prior and had been unable to get and stay below 400 since. My work/travel schedule isn’t conducive to adhering to a healthy diet and a consistent workout regimen. So, the surgery seemed to be the best option for me to get true and long term results. My health, I believe, was deteriorating. I was having chest pains, swollen ankles, felt sluggish after sleep and overall just felt like crap. I remember several nights while sitting in my hotel room, I would begin toi imagine what it would be like for my loved ones if I had suffered a heart attack and died. The pain I felt imagining the agony and hurt my loved ones would undoubtedly feel if they had to take that phone call, tore at me and often had me crying myself to sleep. I had to do something. That in itself was enough for me to make the decision to have the surgery. I want to live and be here for my family who needs me. My surgery was originally scheduled for 8/25, but I had to reschedule due to last minute work plans. After some juggling and planning, it was scheduled for 9/7, but had to be pushed back to 9/14 as my sleep study had indicated that I had moderate sleep apnea, which if not addressed, could cause complications with the surgery and anesthesia. I had to have some time on a cpap to help prevent any complications from the anesthesia. After all that, the surgery happened on 9/14 and went off without a hitch. i stayed in the hospital over night and after being able to walk around my unit ten times per hour the next day, I was discharged. After three weeks of pre-op protein shakes and veggies ONLY, I had lost 16 lbs prior to surgery. I was 406 at my initial dr visit/pre-screening, and had gotten down to 390 day of surgery. I won’t bore anyone with the usual and likely common struggles with the full-liquid and puréed diet stages post-op, as I’m sure we all had some challenge in that regard. Today, 11/18/17 I weigh 344lbs. My diet consists of mostly protein foods, per the post-op guidelines. So far, so good. Of course there’s been some challenges with eating enough of the recommended protein amounts (70-80 grams per day) and liquid intake, and don’t forget that dreaded acid reflux/GERD bullshit. Thankfully, Prilosec does the trick for me. However, the results thus far speak for themselves. I am sub 350lbs for the first time in probably 10-15 years and I haven’t ramped up the work-out routine yet. I should be going to the unrestricted stage soon and I’m very confident in my continued success as I haven’t had any cravings for the bad foods or eating habits that got me up to 415lbs at one point. I have my 2nd chance and I will not blow it.

I wanted to see if anyone had the surgery while in school? Or right beforehand? I begin nursing school January 8th, and surgery is scheduled for December 11th. I guess my question is how was recovery truly and has anyone had complications where their recovery time was extended? My surgeon requires 2 weeks off like most, but my family is just concerned about if something goes wrong will I have time to make it into classes.

What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. Links https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

Mmmm ... my biggest impediment was that I had a serious MULTIPLE health complication a week after my 32yo son was killed at work on March 1st. I kept up my swimming until about the 6th or 7th of March then became absorbed with the funeral and the attitude of relatives and in-laws. Now that I have returned (TWO DAYS IN A ROW), my head is okay about continuing. Between March 10th (my son's funeral) and yesterday, I had four operations (including the gastric sleeve) and about 18 or 19 visits to health specialists ... combination of obesity and stress mucked me around badly. Anyway, I am in good hands now. The pool is low impact on joints and I had gone down almost 40kg (87 pounds) in the 17 months prior to my son's unfortunate construction accident.

Well my procedure date is Tuesday, really looking forward to it! I have done all the prep, on liquid diet now, have all the meds and protein drinks for after. Thanks to all who have been willing to share their experience. Your openness about the procedure, what is needed to be successful afterwards and lack of complications played a big part in my deciding to proceed. I am looking to lose about 90 pounds and get back to a weight I haven't seen since college. My wife is supportive and that's such a blessing, thank you god, she's more than I deserve! My procedure will occur in Houston at Memorial Hermann Surgical Center, if anyone wants more info about Dr. Todd Wilson or the procedure/process, just let me know I would be glad to share and help others. Special thanks to AlCzervik, JimL, Belle3 and AmyAlexis for your open sharing and frankness!! Regards, Tex

If you’re reading this post, you’ll probably agree that losing weight is one of the hardest things many people will ever do. After months or years of attempts to lose weight (and keep it off), you may be considering bariatric surgery. In 2011, the total number of bariatric surgeries performed in the U.S. was 158,000. By 2015, the number had increased to 196,000. Patients who undergo bariatric surgery and follow all treatment guidelines can expect to lose weight and improve the quality of their lives. More than 85% of patients lose and maintain 50% of their initial weight loss. This post is designed to focus on what I learned, sometimes the hard way. Some things you can’t find out in a doctor’s office, no matter how skille d a professional he or she is. What Your Doctor Can’t Tell You If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor. You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone. I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person. But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned. I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner. The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery. I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar). By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet. Fighting My Way Through I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option. I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered. Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage. If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs. My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary. That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success. Understanding Weight Loss Struggles & Bariatric Surgery Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery In the Hospital The First Few Days at Home Ongoing Recovery Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery Why Do People End Up Morbidly Obese Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own? Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight. Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows. Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration. Weight and Your Wellbeing The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death. Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room. What Is Bariatric Surgery? Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives. The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate. The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S. These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health. Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits. Getting Ready for Surgery Mentally and Emotionally Preparing Convincing others — and yourself — this is the best solution Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul. You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day. Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life. Navigating Relief and Fear You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it? What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time. Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it. You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it. Overcoming Resistance And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge? Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out? These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them. Advocating for Yourself I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight. To succeed, you must learn how to speak up for yourself. Here are some suggestions. Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help. Find Your Team Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision. You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs: Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now. If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help. Be Informed and Follow Your Doctor’s Advice Use the resources available through your medical advisors. Seek out a sympathetic nurse. A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group. And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts. Plan for an Extended Recovery Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery. Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going. Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them. Lose Weight Before Surgery Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery. This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels. Confront Your Fears To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself. Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically. At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience. Immediately After Surgery In the Hospital If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges. During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever, Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects. One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet. Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal. Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us. Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects. It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way. Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there? Your First Few Days at Home Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it. You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite. Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask. Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing. Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.” Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery Physical Issues Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery: Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe. Focus on One Part of Your Body You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all. This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts. It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you! Health Problems It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight. Regaining Weight Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment? About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.” Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction. Plateauing Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau. Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right. Complications I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me? As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care. Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor. Sutures I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right. Hypoglycemia Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet. Nutritional Deficiencies Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician. Dehydration The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com. Clothing Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money: Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships Social Life Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before. Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people. Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way. Different Reactions Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look. Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs. Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing. Getting More Attention Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful. Jealousy If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss. Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you. Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them. Guarding Against Judgment The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before? People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another. It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support. Honoring Your Accomplishment You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life. Embrace Your Future Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways. By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way. Before, immediately after, and long after surgery, remember these key points: Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy. Links https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

@Sosewsue61 ((hugs)) I'm so sorry you're now dealing with another surgery and complication of your eyes!!! Gosh wish I could help, but I will pray so much! Insurance stuff SUCKS!!!! Hugely!!! I'm sorry you have to travel so far to an in-plan doc. But you should perhaps try to get an out of network doc close to you on the grounds of medical necessity. With your vision impared, that should be do-able. It will just take referrals from your GP and paperwork to prove the medical necessity. Still doesn't keep the situation from suckage level though! On the positive side of things, I can only believe the hemorrhages will improve with further weight loss and stabilization of blood pressure. (At least, that's what I'm praying!) And that there are no lasting vision deficits as a result of this latest leak. Take care of yourself and rest!!! We'll leave the light on for you when you're healed and ready to come back and play!

Finally have a date!!! Woohooo! Dec 18th I will be sleeved. I plan on traveling by car to see my family for Christmas (I will rest comfortable in the passenger side as my husband drives). This is assuming no complications and I feel up for it. Other than stopping frequently to get out and walk, and liquids, I am a bit worried. Anyone else getting sleeved mid month and planning Christmas festivities still?!

You are making the right decision. Yes there is always a chance for complications but life is complicated or can be. You stay strong and brave and show your child never give up. Your family and friends should be supportive and most likely will be. You are making a life long decision. I was very scared and pissy before surgery. I almost did not go through with it because my surgeon had an emergency and i was in pre op Forever! I got so mad i just about ripped my IV out. So fast forward 11 months later and 130 lbs skinnier...one of the best decisions I have made. You can do this! Sent from my SM-G920P using BariatricPal mobile app

I did. Best experience EVER! I researched every bariatric surgeon in Mexico. By far.... the best surgeon with lowest complication and morbidity rate is Dr. Illan with BariatricPal Team MX. They ALL speak English, the specialized hospital is BRAND NEW and ONLY FOR BARIATRIC PATIENTS. There is 24 hour security and you have your own personal valet to take you anywhere at anytime. 5' 5" HW: 259 CW: 235 GOAL: Healthy and hard 140-ish?

Ibelloso, I’m sorry to hear about your complications but happy to hear that despite your scar tissue that you are doing good! Hang in there [emoji4] also, I appreciate the encouragement! Niseys4, thank you!! Wow, you are doing great so far! I really enjoyed the support group at the hospital but I also wanted something at home to journal because I live alone and wanted some accountability! Well wishes for you & keep me updated!

hi Rachel, I'm glad you have decided to make a life change early in your life. I am a 57 year old nurse and like you decided to have gastric surgery when I was 47 for multiple health problems. I went for the least invasive surgery there was at that time which was the lapband. Did well for a couple of years untill the band started leaking it was replaced and i was able to maintain myself for several years untill this year I had complications again. I had the band removed in January. Insurance would not allow the conversion to the sleeve so after I gained weight again I tried for the sleeve. It was approved without problem. Don't know what the insurance are thinking. Anyway I am 3 weeks out and looking forward to a better experience I have lost 30 lbs since my revisit x the sleeve. It hasn't been a smooth ride due to all the scar tissue but hope it all gets better. Good luck with yours. I'm sure you will do fine.

I am 16 years out, had a revision that didn’t work. I went through all the motions as those whose surgeries were successful. Mine wasn’t. A dr there told me that I would only lose 40 lbs. He had no idea of the sacrifices I made. Instead of a revision, which took a waiting period of 14 months, I did not get it done. I regained weight after complications of another surgery. We regain weight for many reasons. So, I felt like the only one who left the hospital empty handed and sad. No one is stupid for trying to be healthier. I was so upset at this “another failure” that I decided to “reset” my mind instead of thinking about the stress of regain and revision. My driving force is what motivated me. These textbook doctors and nutritionists don’t know what’s in our head. They see you for 5 minutes, get their $300-$400, and I’m left to deal with this myself. Even my family doesn’t help very well. I decided that since the drs can’t help me, I’ll be damned if I’m going to fail myself. I’m going through the motions as if I’m a brand new patient, regardless of my hunger or very painful legs. I’m going to prove that jerk dr who told me that I would only lose 40 pounds. What an idiot. I lost weight before, regained and they can’t fix it. Well, I’ll start all over, no matter what it takes. If I binge on diet chewing gum to get through the food urge, fine. It is what it is. I know what I could have done better the first time around. We have another chance because I do not believe in failure, no matter what the circumstances are. Plus, I’m probably older than you, so now I’m told more bs about age. I’m going to prove them wrong, and I’ve already done searches like MyFitnessPal.com. We can’t do anything about the past, but we can control our future. I hope this helps you in some way. - Pam

I was recently diagnosed with sleep apnea. I'm having so much trouble with this machine also. It's not just the constant air blowing in my face, but the sound as well. It's not loud by any means, just a hum, but I've always needed complete silence and darkness to fall asleep. The nurse told me that the doctor and especially the anesthesiologist would not perform the surgery if you haven't been wearing it for at least a month as you may be overly tired and it would complicate surgery. So, hopefully I can break this 49 year practice of mine!

I had it done in Mexico as I was too low of a BMI to get it done in the states. I paid about $4900 when it was all said and done. I had it done by Dr. Kelly in his clinic. To have it done by him in the hospital it would have been at least a couple thousand more. Looking back, I should have paid the extra and done it in a safer environment. I had no major complications (other than finding out I didn't react well to general anesthesia and threw up for a day and a half every single hour.), but I had the feeling that if some emergency came up, I could very well die there. I speak some Spanish, which was a lifesaver, since none of the nurses spoke a lick of English (I was in Mexico, after all, but I guess I expected at least a little bit of English since most are English speakers who get the surgery done!). So, yeah, not the sanest decision to have it done in a little clinic, but I came out ok, and it changed my life in such a drastic way that I would still do it all over for the amazing results! The cost included everything, the pick up at the San Diego airport to the clinic. The bloodwork, x-rays, etc, and the hotel stay for 3 nights (I stayed in the actual clinic 2 nights and the hotel for 3. They want you close in case of complications). I was desperate so I took a desperate measure. It took a while for my husband to be on board, but I did a lot of research and found who I thought was the best surgeon. I ended up hating the surgeon as a person, but he did great work!

There are horror stories for the sleeve, bypass, lap-band, douodenal switch, etc. The bottom line is that the horror story is usually only telling one side. Do not let anyone bully you into any one of these options. You have to do it because you want to do it: that is the only way it will work. Your best chance of success is to follow the post-surgery prescription to a 'T'. There may be an adjustment period and you may feel like less than yourself for a while afterwards but these are adjustments, not complications. If you follow the advice of your surgeon, the chances of serious complications are a mere fraction of a percent, or statistically insignificant. The bottom line is this is a serious undertaking and you should be mentally prepared for it. Of the surgeries out there, I believe the lap band is really the one that has the most serious of potential complications - this is why it is not done so much and falling out of favor.

Hi everyone! I am going to be a self-pay patient, and am seriously considering surgery in Mexico, since it is so much cheaper. Has anyone had any success? Complications? Advice on places that are great or places to avoid? I am so nervous, because I had a friend tell me I was crazy to even consider doing it in Mexico. Am I nuts? Those who have had their surgeries, what did it cost? What did the price include? Most importantly, if you have any complications after you get hiome, then what?

Thanks for the breakdown, that seems to be the main differences I'd found so far too. I also want to look more into complications and recovery time differences. I asked people to weigh in on RNY vs sleeve on the Miriam success striders fb page too and am getting a lot of great feedback. People have negative and positives to say about both. There is no clear cut answer, I just need to figure out what is best for me. But even then you never know for sure how your body will react to things, so it's a guessing game to some extent. I thought deciding IF I wanted the surgery was a big decision, but now deciding WHAT surgery is another big one! Sigh... I did know that about the support groups, thanks! I went to one in September, but couldn't make October and will be away this month, so I'm shooting for December now!

I have researched surgeons for the gastric sleeve till I'm blue in the face. I've decided to go with use one in Houston as it's closeat to me in case of complications. Now why I can't decide is who? Help...anyone have experience with any in that area? Mirza, Marvin, Miranda? Someone I haven't listed?

I love reading your posts! They are real and hilariously funny (that part about draging your husband to the pre op appointment and your reasons struck a cord😂😂😂) so i will be doing the same thing. I’m 33 yrs, 5’3, over 250 lbs (meant to weigh in first thing in the morning to be exact and forgot 😅) and dealing with painfully weak knees, thyroid fluctuations, pre diabetic and been TTC for the last couple of years with complications. i finally got approved and my surgery date is Dec 12th!! I still have 3 appointments left, pre op with my surgeon and two appointments/class with the NP and NUT. I'm so nervous and super excited and can’t wait to get to the losing side😍 can’t wait to be healthy and being able to wear what i like, not what barely fits👗 Please keep sharing your daily experiences and/or any tips pre op or post op

I have a chart on my wall at home: --------------------------------------------------------------------------------------------------------------------- 4-8oz cottage cheese 1 piece of fruit 1 egg 3-7oz beans (black, kidney, pinto) 1oz nuts/seeds/peanut butter 4oz meat or fish non-starchy vegetables (unlimited) Optional: 1 cup starchy veg: potatoes, winter squash, etc. ------------------------------------------------------------------------------------------------------------------------ When I eat something, I check it off the chart. Every day looks a bit different, but it keeps me on track, making sure I eat a variety each day, and when everything is checked off, I know I don't get more food (except I can ALWAYS have more non-starchy vegetables.) When I get to maintenance, I'll have to figure out how many calories I get long term. If I eat the largest quantity of everything on this list, it's about 1200-1300 calories. Add in a couple cups of milk or coconut water, and I'm getting up to 1500-1600.. which will likely be close to maintenance. So an extra hungry day has to be balanced out with a day that I hardly eat any of it, or losses won't continue. (I go for protein first on those low calorie days... meat, egg, beans, and cottage cheese.. 650cal). Low-fat dairy helps the calorie totals, as does leaving off the nuts. (Nuts are a LOT of calories for not much food: I can eat the fruit AND 1/2 starchy veg for the calories in the nuts!). Cheese = nuts' macros, but I already have dairy, so prefer nuts for variety. When we eat vegetables, we need to eat fat with them to get all the fat-soluble vitamins. Still working on the best way to food-combine to make this happen. Throwing nuts or cheese with the veggies helps add fat and protein, but can get calorically dense very quickly. It feels like things should be a lot easier once in maintenance and can eat more calories! If this post seems complicated.. well, it's because it IS. The menu is simple, but you still have to think about everything and where each thing fits in. I'm lucky that I like everything and don't have food intolerances. If there are special needs, then substitutions have to be found. It's noon, and this morning I've had a cup of 2% milk, a cup of cottage cheese, an apple, a cup of sweet potato and a small sausage patty. The rest of the day I'll only get an egg/beans and 3oz of meat. (I usually don't even eat until noon, but this morning I was STARVING). Trust me, if I didn't have my list.. today could easily turn into a 2000 calorie day! But, that's why I have the list.. to keep me on track. (Fingers crossed it works!)

What everyone is saying is great [emoji4] I’m 9 months post op vsg and “stuck” at 80 pounds lost. I was 313 pre-op and I’m now at 232. I had some major complications in surgery and almost died. I actually came home with a 50 pound gain because of fluids [emoji24] but now I’ve not lost in 2 months. That being said, I am terrible about my water. This post has helped me to remember why that is so important. It is hard. We want instant and constant loss. The struggle is constant. Every bite I think is this because I’m hungry, bored, or emotional. If you would like to be fb friends, look me up- Shannon Busey. It seems we started at about the same place and I will be happy to walk this walk with you.

Unfortunately, its not as simple as CICO (cals in, cals out). Without going into my complaints, for some, it's become A LOT more complicated than just cutting calories, trust me when I say that. For some, the weight just pours off and it DOES seem like it's as simple as CICO. But for others, many others (me included), just cutting calories isn't doing jack. Constant 'stalls', as some call it, or just no movement on the scale no matter how closely one sticks to the diet plan and exercise regimen given to them by their team. So, just be careful with judgement. WLS doesn't work the same for everyone and every body doesn't take to WLS like one thinks it should.