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Re: does it really matter I mean, yes. There are other possible bad outcomes besides literally dying. If the effectiveness of bariatric surgery comes down in large part to microbiomic changes, for example, suggesting that I remove all fiber from my diet until over 6 months post surgery and introducing large amounts of artificial sweeteners into my diet could in fact work against positive changes to the gut microbiome. If my ability to lose weight pre-surgery comes down to emphasising foods that extend satiety (fiber, protein, fat), dramatically reducing my fat and fiber intake before surgery could cause me to overeat or binge eat and my weight loss to stall or reverse. If long term success comes from following one's hunger cues, teaching myself to eat according to the clock they've set, whether I'm hungry or not, in order to meet arbitrary goals could limit my weight loss long term or trigger binge eating again. They're not suggesting I take a spoonful of arsenic at bedtime, but that doesn't mean that their suggestions are neutral. They have no systematic evidence that their program creates success for the average patient or not. (The great part of this sort of program, from the practitioner perspective, is that you can almost always blame poor outcomes on non-compliance.) Some of the program requirements for the pre-surgery diet are literally impossible to follow at the same time. I can't take one or two bean-sized bites per minute, finish meals in less than 30 minutes, and eat 2200+ calories per day without a significant portion of those bites being high fat meats, full fat dairy, or, I dunno, peanut butter straight out of the jar, all of which are verboten. So regardless of what I'm doing now, I'm not compliant. It's not possible to comply fully. (The handwavy answer was "healthy fats". I have no idea how much avocado my dietitian expects me to be able to eat. I suppose technically if I ate just chicken breasts with avocado and nothing else...) I'm also not the average patient anyway (it's probably pretty clear at this point that I'm not neurotypical, for example, I understand that people with regular would either comply or lie without much difficulty either way), so even if their arbitrary program did create success for the average patient for whatever reason that means very little for whether it would work for me. The arbitrariness and the ultimatum annoy me. The fact that I'm being asked to disregard everything I know about how I personally deal with change to adopt a post-surgical style diet (low-fat, regimented, and frequent) half a year before any potential surgery date with an intact GI system, that I'm expected to throw away everything I know about what I need to lose weight, stop binge eating, and have the energy to do intense exercise frightens me. I'm terrified that I'm going to gain weight or relapse into binge eating (thus getting denied for surgery) and I feel like they're pushing me into that direction. All because Typical Tammy deals best with gradually introduced changes over a long time period and simple, unambiguous, authoritative instructions from medical professionals she sees as trustworthy experts? Nah. I mean, I'm sure there are, but this is the only one I have access to. And, ultimately, it doesn't really matter, as long as I can jump through their stupid little hoops, I can get what I need from them. It's just.... a long and irritating process of circus training. I'm not really looking for advice or anything, I understand the options and am resigned to them, this is a rant and rave.

update— i got protein20 and that was the best decision i made! i still do a protein shake i just have started adding 4-6 oz of water to the milk mixture to thin it out. i didn’t anticipate hating milk this early in the game 😂

IDK what time it is where you are now but it sounds totally normal. If your protein water is 16oz then it would reasonably take 4-5 hours for that bad boy to get down the first few days. It’s the swelling. There’s not a lot of room in there for anything! My doc had me do four 1oz shots of liquid over the course of an hour. Each shot I took 4 sips every few minutes....those were some tiny tiny sips!!! You’re doing great!

I had my sleeve surgery on Monday the 26th I was relised yesterday, they had done a small nerve block while I was in surgery but it wore off last night, and now I'm having a hard time getting any liquids down, I've been working on the same protein water since 9am and haven't even hit the label yet.... dud anyone els have this issue? Sent from my SM-G996U using BariatricPal mobile app

Hey Guys! I'm at the mid point in my weight loss journey. My starting weight was 241 and now I'm 181 (4.5 months out). I went from a size 22/24 to size 18. My old size 18 pants are slightly lose but nowhere near enough to go down a size. I figured at 65 lbs. down I'd be a smaller size. I've kept up on my protein but really skimmed on exercise, so maybe I should have lost more body fat by now. Can anyone with similar specs share about where they were halfway through the journey? Current Measurements: 5'2" As of 9/14 Waist 38.5 in Thighs 23 in Hips 46.25 in Arms 16 in Neck 15.75 in Size: XL; 18

Hi, Had my surgery on 5/18/2020. I've been able to maintain between 188-191. However, I started adding the THRIVE packet to my my protein shake in the morning. And have lost 6 pounds this week. My question is, is this program ok for us 2 years post op? The monthly consists of a patch, a pill for energy and the vitamin packets. I am 5'3 my starting weight was 310 my current weight is 184. Thanks

I am having Gastric bypass next couple of months want to find the best non dairy protein shakes ready made I can’t drink the powdered ones. I tried fairlife but did not care for it.

Unfortunately, I live in a rural area outside of any major metropolitan areas. This practice is my only real option without restarting the process and driving several hours each way for appointments. And it's really not this practice that's the problem; I had the same problem with the previous practice I tried with. (That one allowed fiber during the pre-op but absolutely forbad cooking your vegetables, because everyone knows that if you steam the broccoli you eat, your surgery will fail and you won't lose weight as well as the people who are chowing down on raw florets pre-op.) I just have a fundamental problem complying with arbitrary and unjustified rules. I definitely don't trust my team, because I don't want to be denied again, so I'm not about to negotiate with them. (The surgeon in particular seems extremely rigid and unwilling to listen or negotiate.) I feel like the questions I've asked have already put me in serious jeopardy of being denied on the grounds that I won't comply. I plan on being a more forthright with the team after surgery, because what can they do then if I ask questions, hit me over the head and put my GI tract back together? But I'm never going to be able to trust a dietitian or anyone else that can't back up what they demand I do.

I had a chart from the doctor office that said the same, two weeks for each stage. I found I had to go slower and spend 3 weeks for each stage. I agree with trying one food at a time. The dietitian kept suggesting scrambled eggs for soft food, but I got foaming and it got stuck. Later I found out eggs and chicken are the most common things to get stuck at first, lol. Now they are my go to proteins, so you can try stuff later after more healing. Reach out to your team if something seems painful or you can’t keep liquids down.

Does anyone else who grew up obese have sad little realizations like this? I'm 22 days post op and yesterday when I weighed in I realized I weigh less than I did at the end of 8th grade, 13 years old. Which is cause for celebration but also makes me a little sad that I was an obese child and no one really tried to do anything about it. My stepdad would just tell me I had to stop eating junk food but not really give me an option (it's not like I was doing the grocery shopping), and my mom had a RNY when I was 12 but didn't try to change my diet with hers. I weigh less than I did at that age, but I'm 30 and still in the obese range, which makes me feel really bad for child-me. I also noticed when I lay a certain way, I can feel bones I've never felt before, which is also kinda sad. I've never seen my hip bones because I went from cute cubby baby body to fat kid body really fast. Idk that's just kind of crazy and sad to me. I have my weekly therapy session today and we're going to tackle these feelings, but I just thought I'd post here amongst people who might have felt some of the same things.

Today is better! I’m having iced coffee w my MM protein shake as the creamer and I feel fine so far, going down well, no pressure or pains this morning.

Starting 2nd week after surgery. I am off my metformin and blood sugar levels are excellent. I do feel a bit week and had only one slight dizzy spell. Wounds are healing quite well. Tiny bit of bruising. Vitamins and Proteins are easy to consume and tracking everything with 'my fitness' app. I did find it not too much fun at the supermarket today. My old brain wanted buy things I know I will most likely never eat again. But I'm ok with that . I have found that Ido have a tendency to swallow air when I drink fluids and I'm working on slowing right down to a crawl with it. I tilt my head back a bit and swallow. Seems a bit weird but it works for me. I've had the gastric bypass Sept 19 . I started at 265.5 lbs 2 weeks before surgery and on the day of my surgery I was 250 lbs. I started to track my weight from then and have slowly lost 5.5 lbs in my first week. I do seem to have not lost anything for three days but I do see and feel my body structure changing. I have been mobile more the last few days and I am starting to track that also. Today I walked about 1km and will be adding more distance daily. Maybe will incorporate the treadmill in my buildings exercise room. I'm glad I found this group and look forward to reading and responding to people questions. I'm sure I will have some and I am happy to answer any I can for others. Thanks. Cheers from Toronto Canada. !!

I'm not to far off from your situation. Starting 2nd week after surgery. I am off my metformin and blood sugar levels are excellent. I do feel a bit week and had only one slight dizzy spell. Wounds are healing quite well. Tiny bit of bruising. Vitamins and proteins are easy to consume and tracking everything with 'my fitness' app. I did find it not too much fun at the supermarket today. My old brain wanted buy things I know I will most likely never eat again. But I'm ok with that . I have found that Ido have a tendency to swallow air when I drink fluids and I'm working on slowing right down to a crawl with it. I tilt my head back a bit and swallow. Seems a bit weird but it works for me. I've had the gastric bypass Sept 19 . I started at 265.5 lbs 2 weeks before surgery and on the day of my surgery I was 250 lbs. I started to track my weight from then and have slowly lost 5.5 lbs in my first week. I do seem to have not lost anything for three days but I do see and feel my body structure changing. I have been mobile more the last few days and I am starting to track that also. Today I walked about 1km and will be adding more distance daily. Maybe will incorporate the treadmill in my buildings exercise room. I'm glad I found this group and look forward to reading and responding to people questions. I'm sure I will have some and I am happy to answer any I can for others. Thanks. Cheers from Toronto Canada. !!

I am one to say follow your program because there are differences as well as similarities. Though I often also say, if the program isn’t working for you, speak to your surgeon or dietician. I recognise there are weaknesses in the American health system & the ridiculous power of insurance companies: If you don’t do what they say & get all the right boxes ticked you can’t have your surgery power. Through reading posts here, there also seems to be many medical practitioners who do not look at each individual case & don’t make adjustments to their program to suit the individual patient’s needs. And dieticians often seem to promote their own ideologies & current fads. I saw a documentary a few years ago that spoke about the influence of large food production corporations on the curriculum in schools & in medical courses at colleges/universities - scary stuff. Things aren’t perfect in Australia, & I’m sad to say, we’re slowly going down the US path, but my experience was much different. I’m sorry yours has been so negative. My surgeon & dietician did consider me, my needs & circumstances. For example, my surgeon puts different patients on different pre surgical diets. A friend was on all shakes while I was put keto. He said I didn’t need to see a therapist (he gave me the name of one if I wanted or needed) but he sent her for several appointments before her surgery. My dietician, though not perfect, was at least open to my preferences & needs. She advised the keto diet only for the two weeks pre surgery saying it should only be followed for the short term to kick start weight loss (something I already believed). She didn’t give me specific macros to reach (apart from protein) but only recommended low fat, low carb (multi or whole grain low processed only), low sugar. I did a lot of my own reading & discussed my thoughts & what I wanted to do. I eventually devised my own way of eating & what foods I wanted (& needed) to eat, avoid, restrict or reduce. She’d make suggestions about alternatives & things I could add to make sure I was getting in my nutrients (she always checked my blood tests). I guess the big difference was my surgeon & dietician wanted to support me & help me achieve my goals. If yours aren’t supportive, don’t listen to your needs & are simply following a genetic ‘one program suits all’, find a new team (if you can). And especially in your case, if they don’t recognise you are an intelligent, well educated & are highly knowledgeable in the medical field, give them the boot. All the best.

I reached my goal & was happy, so I started to increase my intake to find my maintenance point. But I kept losing. More & more slowly of course. By the time I did stabilise I was a good 11kg less than my goal. I was eating three meals a day & 4-5 snacks. I settled around that quite happily for about a year. But with a medication & a dietary change I gained 2kgs & have been there for 9 months. I eat around 1300-1400 calories a day. Still have to snack a few times a day to reach those calories (& get in the extra protein I need) but not as many as initially. I think this is about the weight my body is happy at too - my body’s set point. Maintaining at that lower weight wasn’t/isn’t an issue. How I eat doesn’t impact how I want to live & enjoy my life & doesn't require me to run miles or spend hours in the gym (a big positive to me - LOL!). And I guess they’re the real factors to consider. Are you happy at the weight you reach & does maintaining it allow you to live & enjoy your life as you want without feeling you are missing out or making sacrifices? And is it sustainable? I say this a lot but it is what is working for me.

Another option might be to find a different practice especially if you are uncomfortable with the directions and information. If you are having a hard time being complaint now, it may be worse after surgery if you need more guidance but won’t trust a word the dietitian says. Good luck!

You really made my day and night with those words. I’ve read it a few times already and feel a lil better each time. Thank you so much! And I literally grabbed a notebook just now and wrote out today and yesterday’s feelings and things and I see the differences already. I did feel worst yesterday than today and k tolerated some protein shake this morning compared to yesterday. THANK YOU!!

Thank you everyone. I don't know what I'd do without this board and everyone's support! I really appreciate all of your comments and suggestions. I haven't seen a specialist for this in years because nothing ever really seemed to help it, so I just kind of learned to live with it. Maybe it's time to go back so I at least have that record. I have had other infections that my pcp has treated so there is a record of that. As far as insurance, right now there is not option other than my husband's. I'm holding out hope they'll change it. In 2020 when I had my wls it was excluded, but my husband just had his wls done in May and they cover it now. So I won't give up. I know in time I could pay out of pocket if I have to, but since I'm not getting any younger I'd like to do it asap. But now that it's later in the day I've had time to think and put things in perspective and I do believe everything happens for a reason. It's just not meant to happen at this moment, and I'll be OK. Regardless, my life is infinitely better than it was 2 years ago, and even the hydradenitis is better than back then. Sent from my Pixel 5a using BariatricPal mobile app

This is just a rant. If you have a good deal of faith in medical science, just skip this one. Keep that faith, you'll sleep better at night and the placebo effect will work better on you. I'm intensely frustrated by having to deal with the arbitrary nature of the bariatric surgery process. So, I'm a scientist and I work in medical research. I know from the back end exactly how arbitrary and non-evidence based much of medical practice is, from the trivialities to treatment of life-threatening conditions. (And boy howdy, you would not believe it and it is frightening.) I'm at peace with it; we're working on it and we know that we're all doing are best. What I am not at peace with is knowing this on one hand (and my dietitian openly admitting this), but having to pretend that it's not the case. I hate lying and pretending. It's very difficult for me to pretend that I believe that it's critical that I don't eat consume any fiber during my pre-op diet, which has to be liquid because reasons. (I'm dumb and I asked why it has to be liquid, curious what the justification is. I was a little surprised to find that they don't even make something up. Honestly, disappointed, low effort guys. If you're going to torment us, at least have a plausible rationale.) It's very difficult for me to be presented with an arbitrary set of rules and just... follow them, because. Not because there's a reason to follow that rule or because there's research backing it up, but because people who have power have chosen that set of rules, for no particular reason, and if I don't follow them, they will stand in my way. I understand that this is how the system works. We are noncompliant, untrustworthy, stupid, and, most of all, we are unworthy. I'm losing over 1% of my body weight weekly, pre-surgery, by dieting and exercising, but If I don't stop drinking a cup of caffeinated tea with 15 grams of sugar in it (the only added sugar I consume at all) 6 months before my surgery date, I'm going to be denied. My dietitian was very explicit that she would not approve me. I mean, there's really nothing else she can put on her little goal sheet for me to show that I'm worthy and compliant. And I definitely need to prove that I'm worthy and compliant, even beyond what is necessary because I'm fat, because during my first meeting with the dietitian, she told me to seriously consider whether I wanted to go through with the surgery, because research showed that, unlike with weight lost through diet and exercise, people who have bariatric surgery have radically slowed metabolisms afterward. They did a study with the Biggest Loser people! I was stupid and impolitic and I questioned this, because that study is one of the (many) reasons I'm seeking bariatric surgery. (It showed the exact opposite of what she told me it did, and even more so with the follow-ups.) So naturally I was very concerned that I had gotten my facts wrong and instead of being smart and shutting the $#%^ up and looking it up on PubMed when I got home, I questioned her. (I wonder how many people she's talked out of surgery because she doesn't understand it. Best not think about that!) It chaps my hide extra knowing that her next patient will probably be someone who is barely maintaining their weight, is being coaxed into giving up their multi-can-a-day soda habit and doesn't know what a protein is, while I'm worried about eating too much fruit and having a teaspoon full of sugar set as an ultimatum. And that person will have less difficulty than I do accessing surgery. Obviously, I understand that the answer is to either follow the arbitrary rules or to lie my increasingly saggy butt off like a psychologically normal person. And obviously I'm going to do that, because that's what I need to do to get what I want. But I don't have to @#$ing like it!

It's more like human growth media than bacterial growth media in intent. It's designed to be nutritionally complete; most of the ingredients are either essential nutrients (vitamins, minerals, protein, omega 3 fatty acids, etc.) or stuff to make it work as a powdered "drink" (anti caking agents and emulsifiers). But it's an entirely artificial reconstruction of food, not food. Add in artificial sweeteners, flavors, and coloring agents and you have the grossest stuff imaginable. I have to think that Nestlé gives kickbacks or other perks to doctors who use it.

Actually maybe the correct question is - how did you know when you were done? I am within a couple of pounds of my original (completely arbitrarily chosen) goal weight. Which by the way I never really believed I could reach. I was sleeved 10 months ago and am still losing around half a pound a week on 1200 calories (ish) a day - a bit more at weekends because I drink some alcohol then. I am hungry at times but I can keep that at bay by eating lots of protein snacks alongside my 3 meals a day, which are protein and veg for the main - still not much in the way of carbs. My question is - did you just select a goal weight and stick to that? Did you achieve/maintain this by intentionally increasing your calorie intake once you got there? I'm thinking I could easily go up to 1600/1800 calories a day and probably maintain at that or thereabouts. Or did you just keep going as long as you could, staying on the right side of hunger (AKA deprivation, LOL) and see how low you could go, and does the weight loss then fizzle out? If I did that would I ever be able to up my calories again without gaining? So many questions, LOL. I would really appreciate your thoughts and experiences.

Stalls in the first few weeks, including week 1, are very common and to be expected. My doctor reassured me of that right away. I can tell you that from my plan and in office nutritionist, we were told do not eat or drink anything that has more than 5-10 g of sugar in a sitting. Maybe try swapping some of the carbs for protein, as the body will try to use the carbs in lieu of stored fat for fuel if it can. My program recommends eating your protein, if still hungry, eat good green veggies, and then after that if you really need something, go for a low sugar fruit.

As my post mentions. I have lost two pounds in five weeks. To me that is pretty much nothing. I shouldn’t stall after one week. i log EVERYTHING. i have zero support from Mexico so paid to see a dietitian here instead of the six month wait through a referral. the dietitian said because of kidney issues that landed me in the hospital week 2/3 to avoid protein powder (I’m also allergic to whey) and to keep my proteins around 50-60. She also said to get minimum 1000-1200 cals a day. She also told me not to worry so much about the fibre fat and sugar and carbs right now. But I still do. I won’t eat rice, pasta, or salads. And if I eat bread it’s only gluten free toast low carb. Any crackers are either made from cheese, sweet potatoes, or almonds. we also went through all of my supplements and she said that they are perfectly fine. The colonic cleanser also went through all of my supplements and medication and also said they were fine. I’ve also increased my calories as suggested by two other people who had the surgery by 200 cal the last few days which was really hard but it hasn’t helped any. as mentioned in my original post I literally have never felt restrictions on what I ate I would have to stop myself. It’s only been the last couple weeks maybe even three weeks that I actually feel full. And that was a concern I brought up to the dietician to is that I can eat a whole container of yoghurt and still keep going if I wanted to. I never did though. so I’m at a loss. Either there’s something really wrong with me or it’s completely normal to only lose 2 pounds in five weeks. here are some ss from the app I use

You can eat way more than I could at 6 weeks out. I had a tough time of nausea and sickness. For months I only managed about 300 calories a day. Even now at 10 months out I can only manage 800 to 1000 Cals a day. This made me have slow weight loss because my body was holding on to everything, I managed to give it. So, let's see if we can find out what's going on with you Are you on regular foods now or still on pureed? We are all given different plans so we don't know what yours will be. Can you show a food diary for a typical day ? How is your protein intake ?

At a loss here. went to Mexico and had surgery Aug 12. Less than 24 hours after surgery I had to leave Tijuana because of the civil unrest going there. I have only heard from the dietician once they do not answer my emails or messages through WhatsApp. to the point where I paid a dietician on my own here in Canada. I went from consuming pre-surgery over five 6000 cal a day to now always sticking between 1000 and 1200 as per dietician. I used to only walk 500 to 1000 steps a day and I’m now doing 5000 to 6000 minimum a day. i have not smoked a cigarette even since before surgery. I went for a colonic cleanse last week and I’m taking many many supplements. because of kidney issues when I do take protein powders I cannot take them anymore according to my doctor and dietician so I make sure to get lots of protein through Greek yoghurt and chicken or ham or turkey or other vegetables. I started off day of surgery at 386. after surgery I was 373. When I made it back home to Canada five days later (stayed in California to rest before flight back) my doctor Weighed me at 367. Five weeks later I am at 365. I have never puked, and for over a month I would get feelings of being starving now finally I’m starting to get where my stomach says hey you’re full but I’ve always been very careful to track everything that goes in my mouth from day one. I am making sure to get all my liquids in. I am so depressed at this point I don’t know what to do and I just feel like giving up and saying screw it and going back to my old habits. I’m beginning to wonder if maybe the doctor in Mexico messed up the surgery or if there’s something really wrong with me I’ve gone to my family doctor four times and she doesn’t seem that concerned and said that she’ll keep an eye on it. has anybody else go through this?