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Must meet one of the following three criteria: 1. Must have a minimum body mass index (BMI) of > 30 with a diagnosis of Diabetes Mellitus. 2. Must have a BMI of > 35-39 and must have at least one of the following conditions: a. Degenerative joint disease of major weight bearing joint(s). The member must be a candidate for joint replacement surgery if weight loss is achieved. b. Other rare chronic conditions (for example, pseudo tumor cerebri) in which there is medical evidence that bariatric surgery is medically necessary and that the benefits of bariatric surgery outweigh the risk of surgical mortality. 3. Must have a minimum BMI of > 40 Here is their wording. I’m obviously number 3 I’m just worried it’s a case by case basis and they won’t approve me.

I had gastric Bypass in 2019. I have gained about 13 pounds back, but pretty happy overall. Last year when I was laying flat on the floor and went to sit up I felt the oddest sensation. It was a pain and pressure along with a knotty feeling protrusion that popped out in my stomach right below by right ribs. I was able to push it back in. I saw my gastric surgeon, who couldn't feel anything but sent me for a CT. The CT showed nothing. However, this protrusion has happened many times since. I even had my husband feel it last time to ensure I am not going crazy. Has anyone else had anything similar? What are your symptoms and what has been done for you? Any advice? Thanks! Lynda

this is very thought provoking for me! you know, it never even occurred to me that getting wls would/could have re-inforced negative body issue ideas to my daughter at the time i had it. like the other poster above, i just told her point blank (she was 12 or 13 at the time). i think it was along the lines of "i'm having surgery to reduce the size of my stomach to help me lose weight". and i remember her asking me why i wanted to lose weight and me saying that i am fat and i'm getting old and being fat and old will probably stop me from getting older....AND i just wanted to not be fat anymore and surgery will help me alot in achieving this. and that was that. now, my daughter is familiar with the concept of surgeries so maybe that is why she presented as aloof when i told her. when she was 5 or 6 she asked about my breast reduction scar and i told her i had surgery to make my boobs smaller because they were too big before and hurting my back, and now my back doesn't hurt anymore. also when she was younger she asked why she doesn't have younger brothers or sisters and we explained Mr.'s vasectomy. she was 10 when my mom had double bypass surgery and she knew that the doctors took a vein from grandmas leg to put in her chest to help her heart work better. she is also like her father, slim and naturally active and fit, so i dunno if me doing something to my body to "fix" weight would trigger her in any way... BUT i totally see now how WLS in particular may touch on self-image issues and ideas that we may perpetuate or even create about our kids bodies. i'm gonna go ask her about her thoughts later.

As the weeks & months pass we slowly but surely increase our intake so I wouldn’t think the low calories we consume is truely sustained as it’s continuously increasing. And it affects our metabolism in the way you’re thinking either. The recognised benefits of weight loss surgery include resetting your body’s set point, digestive hormones & metabolism. Of course the resetting is different for everyone but there is improvement fir everyone & I so love & appreciate how it did that for me. I spent years & years eating one meal a day or skipping lunch & only eating two meals a day. That is sustained low calorie in my thinking ( years not months) & yes it did wreck my metabolism. I could barely lose anything even following those 500 calorie a day diets (talking a couple of kilograms over 6 or more weeks). Similarity to @ms.sss, in the first weeks after surgery I was eating around 200 then 300 calories. By 6 months, at my goal I was barely consuming 900. My weight finally stabilised at 18 months when I was consuming around 1300. Now at 5 years post surgery, I eat about 1600 calories yet am still the same weight I was when I stabilised. And unlike @ms.sss, I’m not what anyone would describe as active. Just do a series of exercises using residence bands & stretches at varying times through out the day. I wouldn’t burn 30 calories. BMR calculators do give you an idea of what your caloric needs might be but as @ms.sss said the results are based on averages much like BMI & the calculators that suggest how much weight you may lose after surgery are. The averages only take into account some basic factors & don’t consuder your individual needs, medical & weight loss history, genetics, activity levels, muscle density, etc., etc. Actually, have you considered doing a dexa scan just to see where you are in regards to muscle & fat density now & repeating it in the future to see your progress? Weight loss can continue for 18 months to 2 years after surgery so don’t give up yet and you won’t actually know what your caloric needs are until your weight has stabilises for some time - months or a year. PS - My surgeon & dietician also didn’t advise to count calories. I just did it randomly out of my own interest & curiosity. Quality of the food I was consuming was more important.

as for whether subsisting on a very low calorie diet for a prolonged period of time affects your BMR (metabolism) in the future, there are arguments for AND against. one particular study that i found intriguing was the "Biggest Loser Study"..that found that contestants that participated in the study ALL ended up with lower BMR's than before weight loss...EXCEPT for the one contestant who ended up getting WLS. that one person's BMR did not lower like the rest after his wls, in fact, in went back up. obv, the sample size was very small, and the subjects were only observed for 6 years, but still. something to ponder. you can read the study here if you are interested: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989512/ or, if you want an easier NYT-read of the same study, here is a link to a more reader-friendly version: https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html now for a personal anecdote: i was 300 calories A WEEK for the first two weeks, then 300-400 calories a DAY for a couple months, then 500-600 the next couple months, then 700-800 until i reached goal at at 7 months. i'm 5'2" and at 7 months i was 127 lbs. fast forward almost 6 years post op and i am consuming 2200+ cals a day and i'm just under 120 lbs. however i also do quite a bit of dedicated exercise (1.5 to 2.5 hours daily), plus other active stuff i just do for fun in daily life. BUT...when i wasn't exercising as much as i am now, i was maintaining at about 1800 calories a day...so at least for me, i don't think my BMR/metabolism was negatively affected after a sustained low cal diet...if anything, i think it got better...though i probably have all the exercise to thank.

according to this internet calculator: https://www.calculator.net/bmr-calculator.html ** at your current height and weight, if you did nothing but stand still and breathe, you would burn 1,478 calories a day (i assumed you are are a 30 yr old female to fill in the blanks). so THEORTICALLY if all you did was merely EXIST, and you ate less than 1,478 calories a day you would be in a deficit and lose weight (how much weight exactly would depend on your activity level, your genetics, your health and metabolism speed). with that said, i'm with @catwoman7 in that i agree that 2100 cal a day for someone with your current weight and height may be more than maintenance level cals (i.e, you will GAIN weight), unless you are exercising at least 4-5 times a week. see screenshot from the above calculator's results below. ** p.s. as always, pls don't think that this calculator is the be all end all of truth, its just a guide based on AVERAGES. roughly 99% of people with your similar height and weight will fall above or below this number produced by this calculator.

Did another closet purge over the weekend and cleared out 5 huge bags of clothes. It's a nice feeling to let the old stuff go, and happily, thanks to a few shopping trips, a bin of smaller clothing I had saved from a few years ago, and some hand me downs from a friend, I have plenty to get me through the warm weather. Once winter arrives, I will definitely need to buy clothing because I've gotten rid of about 90% of my long sleeve clothes and sweaters! Is anyone noticing what you prefer to wear is changing? I was really favoring loose, flowing items that hid my extra weight before. Especially those wraps or kimonos you can find so many places that you wear over a tunic, partly because they are one-size so I could buy them even when the store didn't carry my size in anything else. But the other day, I actually tucked a t-shirt into the waistband of a denim skirt and wore it out with nothing over it! And I'm loving sundresses with a belted waist. Obviously right now I'm not spending too much and trying to stick with basics just to get me through, but I'm really curious what I'll end up buying when I get to my final weight. If I could reach a US size 12, I can't even imagine how it would feel. Right now, I'm wearing between a 16 to 18, depending where it's from and the cut. That's down from probably a size 22. I say probably because I started going for stretchy stuff and would buy a 2x or 3x so I didn't have a lot of stuff that was an actual numerical size.

all good comments thank you! I am on plan 90% if not 95%. I do eat the alternatives but sometimes they aren't the option (such as this restaurant) and I wasn't sure If I was alone but it seems like everyone has a different perspective. My hubs even asked if it was okay that he could eat it another time without me or something (he has no weight problems). I am proud of myself that the meal didn't end up being going into an uphill battle to get back on track. I felt guilty eating them and felt like I messed up, but just continued the next day. I feel as though that mindset is getting me out of the "diet" mentality and allowing me to live this way forever.

I think a maintenance level of 2100 kcal/day for someone 5'7" who's had WLS would only work for someone who was super active - or was blessed with great metabolism. A dietitian I worked with years ago told me people who've lost a lot of weight almost always need about 300 +/- fewer calories to maintain their weight than a person of the same weight and stature who's never been obese. I heard that again from a nutrition professor last summer when I was auditing a university-level course on weight loss and obesity. There's some scientific explanation behind that that I can't remember at the moment, but it's disappointing - but that's the way it is, evidently. that said, a couple of thoughts. First of all, you may or may not be done yet. After the first year, there were several times my weight loss seemed to stop and I'd think "well, I guess this is it..", and then I'd suddenly drop a couple of lbs. Also, you are very close to a normal BMI. Weight loss at that point is EXCRUCIATINGLY slow. I remember the last 20 lbs being a BEAR for me to lose. But I kept at it and finally got there.

Thank you so much for your tips @JennyBeez👍 I did wonder if things could be diluted but wasn’t sure if it would alter the composition of it or not? Will definitely try adding a dash of lemon or lime juice though, that sounds great. Hubby has the job of mixing powders as he has used them previously so has ‘the knack’! I lack patience at times and would just drink it, lumps included… I’ve found some frozen beef bone broth discs at M&S which sounded ideal as you can just use one disc at a time. I haven’t bought any yet as I’d thought I’d leave it until I tried making some soups in the colder weather…actually that could really be now as it’s stupidly cold in the north of England 🥶 I’m trying to get organised as I can get overwhelmed with things sometimes (many thanks menopause anxiety 😡) so trying to avoid that if I can. I’m also trying to work on the mental gymnastics that my mind can go through when it comes to weight, diet, food blah, blah, blah. I want to eventually draw a line and just have a somewhat reasonable relationship with myself, before it gets too late!

same. and "anything i want" includes chocolate and chips and fried foods and sauces/gravvies and high-fat things and desserts and pizzas and bread, etc. etc. BUT not in copious amounts (for the most part). BUT i also eat salads and veggies and lean meats and cottage cheese and tofu and fruits, also not in copious amounts (for the most part). mind you my weight loss phase days are long behind me, but even during weight loss phase, i would occasionally have foods that were "off plan". like mentioned above, i was closer to maybe eating "what i was supposed to be eating" maybe 75-80% of the time. though my total average calories were always low regardless of what i was eating.

I feel like as long as it doesn't bother you (in terms of digestion, or mentally/emotionally), it's fine. I love what @NickelChip said about it being a "planned indulgence". Back when I was in my twenties, one of my nutritionists said that it was good to have one moderately high calorie meal a week (ie a couple slices of pizza) because it would keep your body from going into 'starvation mode' in which it thinks it needs to save and store any calories it can. It made sense at the time, but I was also at the healthiest weight I had ever been and she worked for a local gym, so take that all with a grain or two of salt. For me, I know I can't have a planned indulgence, at least not without being pretty darned strict about said indulgence. For example, I 'indulged' today in a piece of soft-dried sweet potato -- but because I know it's basically just a little strip of 'healthy; sugar and carbs, my dinner tonight will be lower carb to make up the balance. My personal issues are less of a willpower - slippery slope but more of a mental anguish thing. In the past, whenever I've felt like I've done something 'wrong' diet-wise, I usually would end up either in a depressive spiral in which I blame myself, harangue myself and then end up eating my feelings -- or I'd end up punishing myself (either with more unhealthy food or by not eating at all for a few days -- neither of which were healthy reactions). ((I've been on both sides of the eating disorder spectrum, lol)) I feel like I'm probably in a good enough headspace these days that I could avoid all of that (from not feeling like I've done something wrong to begin with) but I'm just not confident enough to want to put myself in that position.

One of my favorite resources is Dr. Weiner's videos (as well as his book The Pound of Cure and his weekly podcast). He talks about the type of food we eat being more important than the number of calories we eat. Here is one video that I watch probably once a month just to get it into my head. But he has hundreds of videos, so I encourage you to check out all of the playlists on his channel. Having said that, there's a good chance you're in a stall as opposed to being done. Your BMI is low enough now that you're approaching "normal weight" and weight loss at that point gets really slow and difficult. But it doesn't mean you can't do it!

I really don't, and that's because it's a very slippery slope for me. I have found so many alternative foods that taste good and don't leave me feeling deprived that it's not worth the inevitable guilt, the possible weight gain, and extra work it'll take to get me back to where I am now. I'm 2 years out from my original surgery and a year out (at the end of this month) from my revision surgery. I'm so use to how I eat that I can't imagine trying to eat any of the stuff I use to eat. There's keto bread, keto bagels, keto English muffins, keto brownies, keto blueberry muffins, Legendary pop tarts and cinnamon buns, mashed cauliflower (works beautifully in place of mashed potatoes), crustless pizza, pizza with cauliflower crust, riced cauliflower instead of regular rice, monk fruit sweetener instead of sugar, sugar free tropical popsicles, Real Good Foods keto protein chicken nuggets, Atkins 1 person meals, Real Good Foods 1 person meals, the list goes on and on. We get creative with what we cook (still have steak and chicken and stir-fry), chocolate milk has now become almond milk, 1 tbsp cacao powder, and 2-3 packets of monk fruit sweetener. Use a frother and it's AMAZING. There's chips you can get at Whole Foods that are made with soy flower or almond flower and tastes EXACTLY like regular chips (I love the BBQ and the sour cream cheddar ones). For ice cream, I get Rebel ice-cream. Low to no carbs, nearly no sugar at all, low calorie, lactose free. Tastes AMAZING. I just have no need for any cheat meals.

Hello! I had the sleeve gastrectomy 9.5 months ago. I've been working on exercising and eating right, but I've been in a bit of a stall these past 5 weeks. I went down from 290 to 170 pounds, but I've been stuck at 170 for 5 weeks. I've been eating 1200-1500 calories a day and still not losing weight. I've done some research, and apparently, your body adjusts to low calories after a while of eating at that rate. At the beginning of my post-op phase, there were some complications on my end. I didn't eat ANYTHING for two months straight, not even protein shakes, and I was only hitting about 20oz of water daily (which landed me in the ER, but I'm fine now lol). I've looked online, and it says for my height, age, and weight, a good maintenance level would be 2100 calories. I'm eating well under that in a deficit and heavy weight lifting, so I don't know why my body won't drop anything. I'm worried that my body adjusted to the 0-calorie few months I had, then the 500-1000 calories three months after that. I've only started hitting my 1200-1500 calories in March when I joined the gym. I know the stall is not due to "muscle gain" because I'm not eating in a surplus, and I'm only eating 65-80 grams of protein in hopes of simply maintaining while I drop fat. I also read online that apparently people who go through rapid weight loss have even lower calorie maintenance than the average person, and that makes sense, but surely it cannot be under 1200, right? The majority of bodies need 1500 to operate. I'm so confused! When I ask my surgeon about calories, he says not to worry about them and eat healthy, which I'm doing. It's just frustrating because I want to work on building muscle, but I want to lose some more fat before that. I guess my question is, does anyone know anything about calories after surgery, and/or how many calories are you eating after surgery to help lose weight?

SO I am pretty early in my journey. I am about 5months post op and have about 11lbs to get to "goal" I may be okay where I am at. I did increase my calories by 100 to see if that would help things. I do weight lift and workout so I am starting to look on the side of "too thin" We will see what this week looks like I weigh in on Wednesday. Its the first week I increased them. I may go back down, but I have been consistently losing 3-6lbs a week so I was worried that I was withering away LOL

This usually means you lost some fat and gained some muscle mass. Which is a good thing! yay muscles! over the last several months (due to my increased exercise regime i assume) my 7 day running weight average has increased by about 3 lbs, but my pants are falling off me again like those fun early weeks immediately after WLS (and my pants are already pretty small to begin with omg). but i also think this is a good thing though:...yay shopping for new pants! lol do you take your body measurements regularly? sometimes looking over historical body measurements over time paint a better picture than the number on the scale....

I lost for about 2 years then I decided that I felt ok with my weight and size. I then increased my calories to 1500 a day and I am stable at this weight. I don't do strenuous exercise, just gentle walking. Oddly enough I have dropped a size in the last 6 months ?? but no weight.

@Missy4391 congratulations on the beginning of your journey I remember thinking that the waiting was one of the worst things, but trust me, it comes around quickly! As others have said, taking before pictures & measurements is a good idea! And I would also advice getting your head into the right space where you don't rely on the scales. I think it is all too easy to get addicted to weighing yourself, especially in the first 4/5 weeks after surgery when your body just needs that space to heal without the added strain of any stress you may feel if your weight fluctuates. This forum was amazing for me to prepare for the surgery and also what to expect after, so I really do recommend reading as much as possible One thing I wish I had done is trial some vitamins to see if I liked the taste pre-surgery. I know people say that your tastebuds can change, which is true, but some of the vitamins are just unbearable 🤢I bought Bariease powder supplement and my god it was the worst thing. I now just take dissolvable orange A-Z vitamins and let the fizz die down and it is so much better! @MrsFitz I think I may have already said this, but I am also in the UK so if you want to chat or have any UK specific questions please do let me know!

Your weight loss is not over until it’s over. Losing for 18 months to 2 years isn’t that uncommon. Your weight loss will naturally slow as you’re able to eat more (this is supposed to happen) & you get closer to your final weight (your new set point) & closer to consuming the number of calories your body needs to function effectively. When it happens to you depends upon those things & some other factors. I reached my goal at 6 months. Like @ms.sss, I too took a while to work out what my maintenance calories were & to be able to eat that much so also did not intentionally mean to lose more. I continued to lose for another 11 or so months. Definitely noticed slowing down at about 5 months (maybe a little before & it got slower & slower. I lost another 11kgs over those last 11 months & in the last of those months I was losing grams in a week and maybe half a kilo a month. So I lost for about 18 months in total but it was obviously where my body wanted me to be (my new set point). I ate a bare 900 calories at 6 months. Got to around 1300 at 18 months. I eat about 1600 calories a day now yet I still weigh the same as I did when my weight stabilised at 18 months.

Hey there @Star1234 ... I think a lot depends on your starting weight and BMI and your goal weight and BMI. I'm nearly 4 months out and have lost 21.9kg and have 15kg left to go until I hit my goal but I've been pretty much stalled for the last 3 weeks.

Oh…I had hubby taking my ‘before journey’ pictures last week and I hated them so much. I don’t know about anyone else but I never really look at myself from the neck down in any mirrors at home. I know I’m fat, I just don’t need the constant reminders! I don’t try things on in a shop, just order online and hope for the best (does it fit? Yep, that will do) This time I actually looked at the photos and oh boy, it was awful. BUT I just have to keep reminding myself that I will NEVER get that big again. Hubby will take more photos if my weight decreases before the surgery, just so I have something to look back on and compare. We have to keep finding the positives!

Congratulations! I'm almost 4 months post-op from gastric bypass and my advice is to watch every video from Dr. Matthew Weiner (Pound of Cure Weight Loss) and Dr. John Pilcher on YouTube. These were by far the best resources I found, and I go back and watch many of them (especially Dr. Weiner's, and also his new podcast) all the time even now. Especially the ones on how to build lifelong behaviors to keep the weight off. One thing I did early on, right after my first bariatric appointment where I weighed in at my highest weight ever (yikes!) was order Dr. Weiner's books. There's The Pound of Cure, which gives a detailed, step by step way to make healthy changes to your diet, plus a second book explaining how bariatric surgery really works and then his bariatric cookbook (I also really like Bariatric Meal Prep Made Easy by Kristin Willard). I made several of the changes recommended by the Pound of Cure (I didn't start with the 2-week diet, just started implementing changes I thought I could manage) and over time I lost about 12 pounds, plus just felt healthier and more in control of what I was eating. One other piece of advice: don't over-buy protein supplements. So many people on this board will tell you this, and I did not heed the advice. Now my cupboard is full of protein supplements I stopped liking after surgery and will never use. I've barely needed supplements after the first month or so, honestly. I feel guilty at how much money I spent on them, but I will likely end up throwing them all away (most are opened so can't be donated). If you want to stock up on anything, an unflavored protein powder is much more likely to be useful to you in the long run than the flavored shakes. But if you're buying flavored ones, consider trying a soup flavored one because the sweet ones get old really fast, even pre-surgery. Oh, and take "before" photos! I know taking photos can be so uncomfortable, but you will want them. Choose something very form fitting to start. I went with a pair of exercise leggings and a tank top that was so tight it was like skin. I took photos about a week after my first appointment, so around my highest weight, and then on the day before surgery and at each month-marker thereafter. So far, I've worn the same clothing each time, although I may need to change that as it becomes too baggy to show the progress clearly. Take your measurements the same day you take your photos. You may struggle to see (or refuse to believe) the changes in yourself, but the photos and measurements don't lie. Even if it's painful to see the photos now, you will be so grateful to have them later. I was in shock and wanted to cry when I truly looked at my highest weight photos, but I'm so glad I took them.

I will have knee replacement surgery in October. I'm working out a lot to keep my knee strong and have a faster recovery post-op. Also, since losing so much weight I feel great. I want to move all the time. While at work I'll knockout some pushups or something just to keep moving. My job is physical, but I have down times as well. So, during the downtime I'll move when I can. If the knee replacement will allow after fully healed and recovered, I want to start either riding a bike or running. I feel like running maybe out after having a knee replacement. I know I want to do something physical and make it a life long regiment to make sure I don't go back to the old me. Looking at some of my old pics sort of makes me disgusted with myself for getting as big as I did. That is my motivation to keep moving. The more I move the better I feel. By the way, you look great! Safe travels.