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Just echoing what the two very experienced forum members say above. A regain in 2nd and 3rd year post op is almost the norm. Please try not to worry about it unduly. Your set point is the weight/body composition that your body wants to hover around. The video below is short and might help. Your set point gets lowered drastically by WLS. But - processed food raises it. Eating cleaner keeps it lower. Building muscle mass keeps it lower. Might those be things you can work on a bit? Lots of people focus on cardio and that's brilliant, but lifting weights or using resistance bands (even if you never do cardio!) can add another really significant layer to that. Do you or have you ever tracked your intake? If that has slipped just tracking again might make you aware of what you're taking in and what you're using up. I am saying this as someone just about 3 years post op who regained 16lbs this year. I personally wasn't happy with that because it didn't stop as others' seems to, so I lost 10lbs by strict keto and am now back where I want to be. I had dietary lapses I needed to correct too and am working on that. I had this surgery to stop dieting - I feel like I can tweak things to keep me where I want to be without that and that I've learned a lot by stepping back and really analysing my intake the last few months. Also huge kudos to you for thinking about this with only 9lbs on. Much easier to look at what you can change now, if you even need to do that, rather than further down the line. I wish you the very best.

Yes, liquid diet is HARD and makes you feel like crap. But if your surgery is Wednesday, it's just right around the corner!!! You might be going into ketosis, known as the "keto flu". It's not a real flu, so no worries there. But yes, you'll feel like a$$. At least you're almost there!!! Did you ever settle on a surgery?? I can't remember if you did or not.

Well It’s not super easy to do both if I’m being honest. I had the SADI and I was supposed to be good to do a diet similar to KETO but they took my Gallnladder out so I can’t do high fat now. I am early out still so I don’t know exactly how much fat I can have without issue but I’ve been looking at recipes and there isn’t a whole Lot that actually looks good and doesn’t have one or the other. I have more of a reason to do it now though. I have to keep from trashing my liver so I guess I will just have to get used to it if I am one of the many that fat does cause issues for.

Hello everyone. My name is Tom and I have been a lurker for years. I had my surgery 11-22-22 at 471lbs. I weigh 214, for the moment, as I continue to lose. What a powerful tool this has proven to be! I am so blessed and thankful I couldn't possibly articulate it. With that being said, I feel I could help anyone that needs it just based on my own research for years into nutrition, fasting, and the many diet plans out there. I would be happy to give my own anecdotal experiences as well through losing the 255 lbs so far. But the point of this post is for me to lean on some of the vets of duodenal switch. I am approaching maintenance phase in around 35-40 more lbs. Does anyone do low carb in maintenance? If so what does that look like? Am I right to assume for us keto is out correct? The fat would be an issue or maybe someone has tried it? My concern when asking about low carb, for me specifically, I have protected my pouch size. I can still barely eat a few ounces of meat or whatever. I could, and may consider, actively stretching it a little when I get to maintenance, but as of right now I am not sure I could sustain on just meat once I am down to maintenance. I have Bilateral knee surgeries coming starting in Jan. I have lost all this weight in the recliner due to health issues. I am lifting, once I hit 300lbs weight, hard 4 days a week. But 0 steps for the most part. That's important because my exercise will skyrocket once I am healed from the surgeries and I will need more calories eventually. Carbs and fat are obviously the most calorie dense so.. Any thoughts or advice would be appreciated!

I would agree that it’s wise to contact your doctor but while waiting for your appointment you may as well work to rule out a few things. How many carbs are you having? Could it be keto flu? Especially if you are burning all that you are eating you could be in ketosis on more carbs than someone who isn’t active. Less than 50g is what they say for ketosis for the average person but the more active you are the more carbs you can have and still achieve ketosis. Some very active people can be in ketosis on 200g of carbs, even. Maybe try adding some healthy carbs for a couple of exercise days and see if that helps alleviate your symptoms. Unless your team wants you in ketosis, in which case I guess you just have to kinda wait it out. My NP told me to increase my carbs because I am walking around 5-7 miles a day and I showed her my food log app and my activity app and she said you need to be eating more carbs and protein as long as you keep up this level of activity. It kinda tough. Seems counter productive but I increased mine and I am still losing. I usually get them from vegetables and fruits so I get a variety of nutrients but I will add a small amount of brown rice (1/3 cup) to my dinner if my carbs are too low for the day. My calories went up a bit too but she said that was okay.

Excellent thread - thank you @JamieLogical! I got sleeved almost 3 years ago. I hit my goal weight well within my first year. I lost another 10lbs very slowly in my second year to reach a BMI of 20. I was absolutely thrilled - I had lost just over half my body weight and was well beyond wildest dreams territory after a lifetime of obesity. But I started to regain this year. Initially I thought it was just the classic '3rd year regain' of the 10 - 20 lbs that so many people seem to experience. I asked lots of questions here and was reassured by the answers. I hadn't really drifted *that* much off the path (I thought). However, I continued to regain with no let up and was getting really worried. I eventually reached 16lbs over my lowest weight a month or so ago. Finally, I decided to go back to absolute basics and see whether that might reverse the regain. Carbs had crept in a bit (NOT A LOT, honestly) so I started every meal with protein, ate veg next, and stopped all bread, rice, pasta, potatoes etc. Just as I would have 2-3 years ago. Guess what? I have lost 9lbs of that regain in just over a month. My current diet is pretty much strict keto and not hard at all. I totally agree that the tool is there, we just have to use it and not eat around it. I'm so happy that I caught myself before I regained much more, but I can also totally see how I might have undone much more hard work. I wish you all the very very best with your new loss. I suspect you'll greet every milestone with just as much joy as you did originally.

Hello everyone!! I know I did a bit of a vanishing act, but I have things to report in. First of all - I hit a really frustrating plateau that lasted about 3.5 weeks from around weeks 7-10. That had me feeling pretty bummed, as it was post-two month check in and I had been feeling great about my progress before switching from purees to solids. I had last posted about hearing somewhat contradicting information from the nurse and Nutritionist. I had been told that I didn't need to really worry about staying on keto because I wasn't eating much as long as I hit my protein goal and by the nurse to try to stay Keto because eventually I'd get this great burst of energy from going into ketosis. WELL -- After doing some research I found out that the thing your brain tells you would be the worst thing to do - EAT MORE - was actually the solution. I started bringing in more vegetables and an occasional grains while sticking to mostly lean meats, plus using a protein shake for breakfast to keep me on track with my protein goals. I was already using Genepro; and I since picked up one of the Whey protein powders in a chocolate plus some of the PB2. That did the trick! I have started allowing myself an occasional 'cheat' type meal on days that I'm locked in on my protein, and find myself often meeting my protein goal and then some - more like 70g of protein per day rather than the minimum of 60g/day. The result of spreading my meals out - breakfast, three hours later lunch, three hours later 'dinner' and three hours later 'protein snack' if I'm still hungry - DID IT. My energy is up now that I've been walking more and giving my body more fuel. I am seeing the weight loss finally, and even when the scale doesn't show it right away I'm seeing my measurements shift and the way my clothing fits feeling different. I had purchased a cute pair of jeans about a week before my surgery and a button down short sleeve gingham shirt. At the time I couldn't get the jeans all the way up over my thigh; and now they fit loosely. My bras don't fit properly and I already had to buy one in a smaller size. I'm turning down plus sizes clothes I like that I find at the thrift store for pretty much the first time because - they're too big. I'm borrowing shirts from my Mom that I handed down to her previously and other friends handed down to her rather than me because she was a 2x/3x for a long time (mostly due to her chest) and I was a 4x+. I can feel where my arms have gotten smaller in the way shirts don't feel snug in the arms, shoulder, and chest area. I've gone down 2.5 ring sizes! All in all, I've found that portion control is still a big deal, but so is listening to your body and remembering that if it sends you a message about hunger, there is a reason. I DO have to focus on making sure I drink enough water, but the Baritastic app has helped me keep my sugar low. Even if I do hit over 30g of carbs in a day it's rare and because of something like beans, rice, or vegetables. I'm feeling more comfortable loosening the reins a bit on how strictly I adhere to my diet - although I still don't do anything carbonated, do minimal caffeine, and keep sugar very low. The idea to bring your own tupperware to restaurants along with a cooler is really smart. I'm not in an organized group exercise of any kind yet but I do have personal goals like trying to get in over 10k steps three times per week. I'm working my way up and have gotten to an average of around 5k steps each day, which I'm very proud of. My calorie deficit is usually 800+ calories less taken in than what I'm burning via exercise per day, and this week I have lost almost 6 lbs due to exercise and losing the bloat from my first period post surgery. I wanted to mention that - I did miss my first month's period and my second month's was late. As to exercise - I feel the activity in my back and as a low ache across my lower abdomen mainly, which I think is a result of using those core muscles and the way my figure is redistributing the weight on my joints. I'm shopping Marketplace to add weights to my exercise and still use my exercise bike when the weather isn't nice enough to walk. OH! And Old Navy has an amazing 50% off sale on their website right now and I just finally ordered myself some pants in two sizes below my pre-surgery size! I'm so excited for them to get here. Best wishes all, keep up the amazing work and be kind to yourselves!

Two weeks is the usual length of the pre surgery diet. But there are difference in what format the diet actually takes. Some are all liquid like yours (can be shakes or milk based drinks or other liquids) or two shake meals & one meal. Mine was keto. It, as @ShoppGirl said, can be influenced by your staring weight & how much weight they want you to lose to reduce the size of your liver before the surgery. It may be your general health status. It can also just be your surgeon’s preference. My two friends & I were each on a different pre surgery diet but all were two weeks long (2 of us had the same surgeon .) Each of us were in different places (health, weight) when we began.

I’m 5 years out & maintained since my weight first stabilised. I’m also one who finds some carbs sit more heavily in my tummy & are too filling. Specifically simple carbs like the rice, pasta & bread were advised to avoid while we’re losing. It’s not a big loss even though I used to love eating them before surgery. But I don’t consider myself to be low carb. Lots of carbs in fruit & vegetables. I eat a good two serves of whole or multi grains a day sometimes a little more if I say throw barley or lentils in what I may be cooking too. I usually say I’m lowish carbs, lowish fats. I also think the quality of these food types are an important consideration too like the whole/multi grain, less processed complex carbs vs white, more processed, simple carbs. Same with fats like good fats vs bad fats. One of the big learnings I had was that you have to work out a way of eating that works for you. That is it allows you to maintain your weight, complements your lifestyle so you don’t feel like you’re missing out or making sacrifices and is sustainable. It may be high fat or low fat, high carb or low carb, paleo, keto, vegan, vegetarian, carnivore or a mix of eating styles. Just what works.

I bought a ninja creami machine and I get the keto chow mix and I make a yummy protein ice cream. I tend to use milk or water instead of heavy cream because of the calories but it still turns out ok. I also love just fruit in it too, my favorite is pears. Coffee with a protein shake also makes great ice cream. It's fun to throw in weird things and see what happens lol.

Sleevetobypass2023 - I've mentioned it a little & I have months and months of weight charts on my Carb Manager account. I used to track all my meals there when I was doing Keto & Low carb. I got tired of tracking all the meals and started just tracking my weight on there a couple times a month. I think I'll print that out and take it to my PCP. Can't hurt I guess. I did hCG diet back in 2010 (too long ago). In the 90's I did fenphen / phenfen - whatever it was, & dang near got a divorce because I got really mean. Tried just the phentermine about 6 years ago & it affected the same (my boss finally asked me if I wanted to work somewhere else-I quit taking it that day). Been fooling with keto or low carb off & on for the last 8 years. sigh. Through it all I just keep losing and gaining the same weight, over & over. Gosh I'm tired of it. WEIGHT LOG.pdf

I have never tried it but if you haven’t already I would strongly suggest telling your doctor that you are on this diet or even a strict keto diet and ask them to do the appropriate labs to monitor things. There is a book called Brain Energy by Dr Christopher Palmer that talks about the Keto diet and how it can help with mental illness. I found this very interesting so I listened to a podcast on which he was a guest and he cautioned that the keto diets should always be under the care of a physician. He named off a number of things that need to be monitored while on the diet. Some of the things that need to be monitored can be quite serious if left unchecked.

Thank you very much! Congratulations to you as well for your successful journey. It's amazing to finally be free of the fat and, more importantly for me, the addiction to food and the total control/power I have over food now. It's seriously my lifelong dream at 55 so staying motivated was baked in.. Thank you again. I am sure I didn't elaborate or explain my reasons enough but actually I am concerned about slowing down the weight loss. I still eat very small portions and am worried it would be hard to sustain on just protein, without carbs. I like my body running more ketogenic than carbed up with the ups and downs of carbs. Without adding fat, and with our malabsorption aspect of the surgery, I am wondering if its possible or not so much..If I am being honest, at 240lbs, I started eating dirtier with carbs to try and stabilize at 240 until I got my knee surgeries, but then just dropped another 20+ within a month and a half or so. My steps and activity increased, small by normal people standards, but a lot for where I have been, after I got another Cortisone shot to the knees. This just illustrates my concern once I reach goal weight and I am rucking, hiking, and lifting. Those three things will be lifelong for longevity and mobility going forward. Obviously everyone is different as far genetically and such, but I have been extremely low calorie, plenty of short fasts up to three days, and have plateaued at certain points during my weight loss, and after doing a refeed with carbs and basically whatever I want to eat, I recharged my metabolism for another huge run of weight loss. The refeed was usually only a couple days to a few days but less than a week. Now with this approach remember I am lifting weights. I mean hard as I can weight lifting 4 days a week. It sucks! Low energy lifting is not fun but the recomp.. I really believe the built-in calorie burn from lean muscle mass is the most efficient way to permanently stay in shape. Male or female doesn't matter. IMHO if your metabolism is slow and you are struggling with the last few pounds, I mean the literally like 5-10 pounds from goal BF, man or woman, start lifting weights. The body recomp will floor you. And that weight or really I think just your body composition after significant weight loss without adding lean muscle mass leaves you looking(Sometimes) like a no muscle bag of skin. Flat. It's not fun but the results.. Anyways thank you for the reply and just to make clear if any of the vets care to weigh in, the WLS gave me the tool, the only tool I will ever need again to lose weight. It's so powerful for me that I need to think about slowing down my weight loss combined with, if possible, being low carb and more ketogenic as a lifestyle choice I prefer. I just don't know if low carb is sustainable without the fat calories. that specifically is what I am looking for. Does anyone prefer low carb/ketogenic after surgery and is it possible? I already realize that fats can be problematic, is anyone doing carnivore after DS Sadi. Not my preference but the only option it seems for low carb without the keto fat plan. Thanks in advance for any tips.

I suppose I'm one of the few people after reading responses to the OP's post who haven't had their past food cravings or the food they love change. I still want pizza, phad Thai and Chinese food etc. No, grilled fish doesn't suddenly appeal to me anymore than it did before surgery, in no way is grilled fish comparable to fish and chips to me. I don't suddenly find a piece of fruit better than a brownie. There are times I'd kill for a roll or a sandwich with actual bread (not keto tree bark full grain bread) and yes I become resentful. I'm being totally honest, healthy alternatives don't taste as good (to me) and trying to change food I love/loved to a "healthier" version just isn't the same and doesn't taste anything close leading me to; 1. A waste of time and energy and cost, cooking/cleaning afterwards 2. Total disappointment and yes anger. I explain this because I found myself becoming upset because I wasn't and haven't experienced the sudden love of healthier food like others here on this forum leading me to be upset with myself. So, I'm being honest about my personal experience. There are some alternatives I have found such as Yasso "ice cream" bars and Wilde chicken chips, but that's about it. Unfortunately, I find myself just not eating opposed to stuffing yet another high protein non tasty food into my mouth. To combat this I stick to a few things I do like (you should know I've had food issues my whole life, in fact I almost died as a child because I'm an extremely picky eater - food texture issues). So, this is on me. I do get the required protein or close by drinking a fairlife protein drink. I say all this because the taste for healthier food doesn't happen for everyone and I don't want you thinking it most definitely will for you then if not wondering what's wrong with you!. I've only experienced dumping one time, but for the most part I can eat what I used too, the difference is I chose not too. Being thin to me is by far better than eating something I love and enjoy. Does it take a lot of joy out of my life? Yes, celebrations/holidays just aren't the same. I'm not trying to depress you, I'm sure you have enough of that as it is, but I am being realistic. You need to determine what your real priorities are; 15 mins of eating enjoyable food or 24/7 of being thinner and healthy? It all comes down to the mentality of it. Having your head straight on what you really want. I truly hope you're one of the lucky ones as all those who've responded thus far and you find healthier alternatives you like or you just don't like your old food loves, but be aware that might not happen and start getting it straight in your head now. Thinner/healthier/longer life/decreased co-morbidities vs. 15 minutes of food enjoyment and weight gain? Lastly, If I really want something I get it, take a few bites and physically walk away from it. I throw it away before I eat more or give it to my husband.. either way I get away from it. It all comes down to choices and what's really important to you. Good luck, you got this, you've haven't gone through all this just to throw away your opportunity for a healthier thinner life. It would be a tragedy for getting a few good tasty bites in. I really hope I haven't burst your bubble after reading others more positive your tastes will change posts, I wanted you to also read there are others who aren't that lucky but still do what's right for a healthier thinner life. Its all getting the mindset down and if all you read was just the your food tastes will change posts and that never happens you'll blame yourself like I did. I hope this helps you. Some may condemn me for my less than positive post, but I've always been a realistic no rainbows flying out my backside type and I would have appreciated both sides of it right after surgery so I knew all possibilities. Lastly, don't condemn yourself if you do cheat occasionally, just up step up and eat right next time!

I can absolutely understand where you are coming from - I have a friend going through this about a year past her Gastric Bypass and it is one of the reasons I opted for the SADI instead (not that I know this will make a difference in terms of weight loss!) I'm a bit worried about getting to this point myself, where the weight keeps coming off - but then again, I seem to always need SOMETHING to worry about. My surgery is Monday morning. There are a lot of knowledgeable people who have commented here and I'm taking notes on their suggestions! That said - it kind of sounds like you might be remaining in ketosis from being so low sugar / low carb and I wonder if that's what is causing your continued significant weight loss? When I went shopping for all of my sugar-free items for my liquid diet I noticed there were keto versions and low-carb versions of some items. The advice given to add a small serving of potatoes or healthy fats like avocado sounds really smart and might help with that. I bet it also gets tiring hearing people comment on your weight loss. Has that been hard? Just curious - and honestly, even if you aren't right where you want to be atm - congratulations! It's a HUGE accomplishment to have reached this point and know what weight you LIKE your body at, and I hope you give yourself lots of pats on the back!

My favorite no-cook meals are salads. I like to start with a salad of baby spinach, matchstick carrots, fresh edamame, chickpeas, beets, feta or goat cheese, a sprinkling of sliced almonds, and top with a drizzle of balsamic vinegar. It pairs well with chopped chicken breast (buy rotisserie to avoid having to cook it), smoked salmon, or thawed pre-cooked shrimp. Regarding the honey in your recipe, I would start by cutting the amount in half and see if you like the flavor of the glaze like that. Depending how you feel about artificial sweeteners, you might also try one of the no-sugar keto "honey" substitutes that are out there.

Have you ever mentioned to your doctor, in the past, the things you did to try and lose weight? I have BCBS and they had the same requirement. But I had mentioned to my pcp that I did keto, weight watchers, calorie restriction, and the mediterranean diet. When I mentioned this, she put it in the notes that went to the insurance company and they accepted it and that took 6 months off the process. My pcp was very supportive and was happy for me to do the surgery. I gave her all the requirements from my insurance company (I needed to pass a ekg, her form stating what I've tried to lose weight, my comorbidities, etc...) he jumped right on that and got it done asap. By the time I went to my 1st appt w/ my surgeon, she had already sent all of this to their office. So I was 3/4 of the way finished on day 1 of seeing my surgeon. All I had left to do was the psych eval, blood work the surgeon needed, and then waiting for it all to be submitted and approved by insurance. My first appt with the surgeon was Feb 28th, 2022. My psych eval was March 7th. Everything was submitted to my insurance on March 10th and I got my approval on March 14th 2022. The longest part of this was honestly actually getting to the surgery date because I couldn't have it until May 3rd due to the surgeon's schedule. So honestly, the better prepared you are, the more you do behind the scenes, the faster the whole process will go.

Now that I've made the decision to have WLS & am waiting for my appt with my PCP my mind won't shut up! I know my insurance requires a 6 month supervised diet, but what if I lose weight on the diet and my insurance decides that I don't NEED to have WLS to lose weight since I was (theoretically) able to lose weight for this requirement? I was told after a colonoscopy that I have sleep apnea and need to have a sleep study done & that I should really be on a cpap, but what if sleep apnea is a reason to deny me the surgery? I take omeprazole for acid reflux because I have a hiatal hernia. What if that prevents me from having the surgery? What if they just say NO? After making up my mind to do this, I just don't think I could take it. I'll be 60 in Oct & I'm 5' 8" - used to be 5' 9" - & I weigh 338 lbs. On my own I have fooled with hCG diet, keto, low carb, etc, etc, etc for sooooo many years. I lose weight & gain it back. I know what I'm supposed to do, but can't stick with it. I need this. Period.

I love salad. My husband usually barbecues a few times a week and I just ask him to make a couple chicken breasts and I can add whatever to make it a meal. Fruit and Chicken salad or “Market Salad” and low carb ceaser salad wraps are both in the rotation. I haven’t tried fish on salad. I don’t like salmon that much sadly. I know it’s so good for me but I think I will try it with mahii. I really hope that I can tolorate salads post SADI. Someone told me that they cannot post DS. That and the ones that say they can’t do a lot of fruit scare me a little. In terms of healthier food, they are my faves. With the sleeve I didn’t have any foods that gave me issies though and the sleeve part is already done so fingers crossed I will be okay with them. I never thought of looking for keto homey. I eat it so rarely. Thanks for the idea.

Don’t think the small amounts you eat in the beginning is how much you’ll eat forever. After surgery your stomach muscle is very tight so it can’t tolerate much. But as it heals, and you start to introduce more foods, it slowly starts to soften (not stretch) & is able to tolerate more. I was told, though I began with 1/4 - 1/3 cup from the puree stage, by about 6 months I’d be up to about a cup. Which was pretty accurate for me. I’m 5 years out & from about 2 years, I was pretty much eating a recommended portion size. Check the nutrition panel of processed pre prepared foods and google recommended portions of other foods or ingredients to give you an idea. Generally about 3-4ozs of protein & a cup of vegetables, 2 eggs, a small apple, etc. Some days I can’t/not interested in eating that much, other days it’s the perfect portion. The liver shrink diet is not to actually shrink the liver but the fat around the liver. This is to allow your surgeon to have better vision of & access to your tummy during the surgery. This diet does differ surgeon to surgeon, patient to patient. Generally it’s two weeks of a shake three times a day. However, some are four shakes, others two shakes & one lean protein & steamed vegetables meal. Others are only for a week or a couple of days. Mine was keto for two weeks (I started a couple of days earlier). Some people lose seemingly a lot of weight, others only a few pounds. It’s one of those things linked to how much weight you carry. It can be tough as you may experience withdrawal like symptoms (from stopping/reducing sugar, carbs, caffeine) for about 5 days. Apparently my surgeon’s patients who did the two week all shakes called the first week hell week. While tough, remember it is only for two weeks and the big picture benefits & wins makes it so worth it. All the best with your surgery.

I have been overweight my whole life. My highest weight was 284 back in October of 2022. I have tried many weightloss directions including keto, fasting, tracking calories, appetite suppressing drugs, and even weight watchers. I start off good and end up just spiraling downward and stop. I really think this tool is going to be my key to success.

I don't know where my other post went - I swore I typed one up earlier. Oh well - Here we go again! So, I'm at 3 weeks out exactly today from my SADI (Sleeve + Intestinal shortening) surgery and I'm definitely starting to feel less pulling and pinching with movements. I'm beginning week two of my puree diet, and I feel like it's going pretty well. During the Protein shake / liquid post diet for two weeks I did deal with constipation. It's still leveling out, but as I eat more 'regular' food (Even as a puree) that seems to be lifting a bit. I did still take some milk of magnesia yesterday out of caution because I hadn't 'gone' in two days, and didn't want to worry about it worsening. I'd say the hardest part for me continues to be the 'No drinking 30 mins before/after meals' but I use the Baritastic app to set a timer. I also use the timer to make sure my 'meals' take at least 30 minutes. Want to make sure I don't rush and end up feeling poorly afterward. Things that have worked well for me during my puree stage include egg drop soup, chicken/tuna salad made with puree chicken or tuna, light mayo, and sometimes a bit of relish, and for added protein a boiled egg or two, with or without the yolks per preference. (Dill relish is healthier than sweet relish). I did allow myself 2-3 saltines with those, usually about 3.5 oz of the tuna or chicken salad makes me feel sated. Other recipes that have worked include the ricotta bake and unstuffed cabbage rolls, pureed low fat/0 sugar yogurt or cottage cheese with Genepro powder and cooked, strained strawberries or blueberries (I added a bit of 0% Milk to make it more of a smoothie), Riccotta pureed with either a bit of fruit or avocado, small serving of oatmeal pureed with fruit (test yourself with an ounce or two less than you normally eat for oatmeal because it sits heavy and often swells - add some zero or skim milk to make it thinner if needed. Other recipes include homemade no-noodle chicken soup of sorts with rotisserie chicken, chicken broth, and pureed carrots w/a little bit of onion powder or diced onion. I also made a homemade 'philly cheese steak' filling of sorts with some sautéed bell peppers and a bit of diced onion, some roast beef lunch meat, and cream cheese. Others speak highly of pureed refried beans with a bit of seasoning to taste more like taco meat, adding either a bit of mild salsa or a combination of onion powder and perhaps a bit of cumin. That's a personal choice, and definitely suggest going slow with your seasoning due to possible heartburn. You could add a bit of shredded low-fat/skim mozzarella or even low fat sour cream to round it out. Today I made 'chicken pot pie w/no crust' which was basically just cooked carrots and finely diced celery and onions with finely diced rotisserie chicken with a can each of 98% fat free cream of celery and 98% fat free cream of chicken. I haven't had any yet because I'm a little unsure about the celery, even cooked, but pureed and in a small serving I'm sure it would treat me fine. The Ricotta Bake I made was super simple and I know there are a lot of variations to the recipe online. I made my own marinara sauce by peeling about 5 smallish tomatoes, dicing them, and simmering them with a little less than equal parts water, Italian seasoning, and a bit of diced onion. The ricotta mixture was easy; just used 8oz ricotta cheese, 1 egg, 1/2 cup of grated parmesan (I used the shaker but fresh is better) and 1/4 cup shredded mozzarella cheese. I put a layer of half the mix on the bottom of a buttered baking dish, topped it with 1/2 lb cooked and seasoned ground beef, then put the rest of the mixture on top. Poured about 3/4 of the homemade marinara over it then covered the dish with aluminum foil and baked at 400 degrees for about 20 minutes. It's basically a no-noodle lasagna. The Unstuffed Cabbage Rolls I made were equally easy - I used a rotary grinder (Works SO well, bought on Amazon for around twenty bucks) to grate half a head of lettuce. Instead of canned diced tomatoes I once I again peeled about 5 small/medium tomatoes and diced them, adding to the skillet along with maybe 1/8 cup diced onion and another 1/2 lb of the ground beef. For seasoning the recipe I used just had me add a packet of Italian Dressing Seasoning mix. The family enjoyed it and after pureeing the ground beef a bit I found it fine to eat, although slowly and very well chewed (same with the ground beef in my ricotta bake). Both it and the Ricotta bake probably make about eight 1/3 cup servings with about 22g of Protein each. I want to respond more to folks - @Pepper_No_Salt I hate that you're dealing with so much nausea! I absolutely second talking to your care team about that. There are some nausea pills that dissolve under the tongue and work more quickly for me than the Zofran, they'd probably be willing to call you in some. Things that made me feel queasy were taking meds or vitamins before my meal had hit bottom, drinking too quickly, not walking around after I ate, and taking calcium and my multivitamin with iron too close to my Calcium. Not sure if any of that helps - I am also taking Prilosec for heartburn in the mornings and they had me add Magnesium Citrate at bedtime to help with constipation. Sometimes when I'm due to pass gas or have a bowel movement working its way through my system I'd start to feel a little icky and not really nauseous but more anxiety / feelings of fullness. I found that for whatever reason putting an ice pack on my chest or low back helped. I hope you find some relief! Oh, I also found that as soon as my thirty minutes post-meal is up it helps me to sip on REALLY cold water or Gatorade zero, especially if I do it while standing and moving around a little bit. I equate it to the need to get the burps out after eating, just like I had to do post-surgery. @ShoppGirl - Thanks for all of your support and input. I continue to read your posts and while I'm low energy on responding right now I hope the details of my recipe for the unstuffed cabbage bake is helpful! @draikaina8503 - Congratulations on your walk! I still wear out quickly even at three weeks out, but I knew the first month or two would be a slog and do feel my energy is rebounding. @Onemealplan - Sounds like you're doing great and I hope you enjoy the heck out of your vacation! I second what you said to @ShoppGirl about trying the crab, and hope the meals you do get to taste on vacation treat you well. I think her advice to just explain you're recovery from stomach surgery should more than reassure any staff concerned about your small portions. @AndreaJD I'm so glad your sister has been supportive! My 'chosen' brother and best friend has likewise done the same. He's been on a Keto journey for about two years with great results and I worried at first that he would think I was taking the 'easy way out' and now that he's heard more he's been great in reassuring me that he does NOT think that is the case at all, and in fact believes I chose a great option for myself that moves things along quicker but certainly with a lot of sacrifice and hard work. I also completely agree with you on the 'mind hunger' vs 'body hunger'. I'm lucky that I do feel a bit of pressure in my chest that I now identify as a feeling of 'fullness' as opposed to anxiety and I'm less worried about my protein goals now that I have the Genepro protein powder. I love that it isn't gritty when I mix it in with things as long as I mix it with something room temperature FIRST. That's on the instructions, actually, as is the fact that for your macros to count it as like 30-ish grams of protein per scoop rather than the 'weight' listed in Nutrition facts of 11g/scoop. Just wanted to make sur eI mentioned that! Oh - in regards to weighing - I get on the scale every day or so to kind of 'reinforce' what I'm doing, but remember that sometimes you see more from your measuring tape at the waist, hips, etc than the scale will show. Also head's up, a lot of folks plateau for a handful of days around week three and it will happen on and off moving forward, so don't be discouraged by that! @RRenaeL23 - I hope these recipes and suggestions for your puree diet work well! I'm still finding myself comfortable eating no more than about 3-4 oz at a meal, and certainly am following the no drinking 30 mins before/after meals. It's absolutely easier for me to do if I make sure my meal is on the moist side, even if it means adding a little extra water. It's better to add protein powder (Can't speak highly enough of the unflavored Genepro) to hit your protein goal than to overeat to make it, that's for sure! I'm always eager for my 30 minutes to be up so I can sip on icy cold water or Gatorade Zero. @Meme Campbell - Best of luck to you on your surgery tomorrow! Don't hesitate to ask for ice packs and pain relief and take advantage of the pain relief to get some walking in, especially the first couple of days. The pain lessons as you walk because it works the gas out. I also strongly suggest sipping your shakes / water / propel sitting as upright as is possible and not laying back until about ten minutes has passed or you've burped a few times! Keep us updated! Most of us in this thread have already had our surgeries but if you read through the first 3-7 pages you'll get a pretty good idea of what to expect if you don't already feel prepared. It's a bit of a process but the pain WILL start to lessen in the coming weeks! Don't be surprised when you get tired super quickly and be gentle on your body. Across the board surgeons seem to agree that your #1 priority fresh out of surgery will be walking as tolerated, focusing on your hydration, and getting as much protein as you comfortably can. Don't let yourself go more than three days without a bowel movement - Milk of Magnesia works wonders for that. I let myself go 5 days post surgery and that was a somewhat painful and unpleasant process to reverse. Colace makes your bowel movements 'smoother' but is NOT a laxative. If you deal with heartburn talk to your team - they put me on Prilosec for now. We're rooting for you! Sorry for anyone I missed; not sure what happened to my other post. Wishing you all the best in surgeries and recoveries!

I think in the last 2 years I talked to my nutritionist 3 times. And that was because I had to. It was included with the surgeries and she worked in my surgeon's office. She's nice and helped me come up with some cool recipes, but that's really it. I stayed mostly within the surgeon's dietary recommendations, but as time went on, I learned what my body likes and dislikes. For example, I'm extremely sensitive to carbs but not at all to sugar. I still stay away from sugar for the most part, but I'm not afraid of it like I was. I won't turn something away if it has sugar, but I typically go sugar free as much as I can. As for carbs, I use to do keto, so I was ok with low carb meals (I would have maybe 60-80 carbs per day). Now, though, I can't have more than 25 without feeling sick. On heavy workout days, I tend to go higher (45-50) but I pay for it because, again, I'm SUPER sensitive to them now. I respond well to high protein, moderate healthy fats, and high fiber foods. I'd say just do what you're doing, ignore the nutritionist, and keep kicking ass and taking names. You're doing AWESOME, so don't worry about the rest of it.

Adding my info! 1. Pre op weight, BMI or measurements 249-250 lbs BMI of 44 2. Surgery type VSG in 2017 then RNY in 2019 3. Lowest post op weight, BMI or measurements and when it occurred 150lbs BMI 27 around 1 year post op 4. Maintenance weight, BMI or measurements and when it occurred 155 lbs BMI 27 around 18 months post op 5. Bounces (up or down) in weight, BMI or measurements and when they occurred I can bounce up and down 5-10 lbs depending on the season but my lowest was a 20 lb drop during an E.Coli infection 6. Methods used to maintain and what has/has not worked What works for me: Weighing daily/weekly, spot checking calories, low cal/keto substitutes, 90% disciplined eating and 10% debauchery. What does not work for me: gym membership as motivation, unsustainable diets and GLP-1 meds (as of now) 7. How your life has changed (losing vs maintaining perspective) During the losing phase I was very rigid almost never went off plan, now everything I want can be worked into my plan and I’m more relaxed. 8. Words of wisdom/cautionary tales/stories of beating the odds Cautionary tale: Don’t suffer in silence with reflux, push for answers and relief. Absolutely never compare yourself to anyone else. Don’t guilt spiral after a little weight gain, try to correct it as soon as you notice. A small gain is very likely in our population after reaching your absolute lowest weight. I remember when I first joined there was a some chatter about being absolutely perfect or you’ll gain it all back and it made me really anxious. Don’t be afraid to ask for help and other tools from your team. We are not quite the same as the never obese population so our bodies may play by different rules. Word of wisdom: Document your journey if you can. I don’t really remember what it was like to be in my obese body anymore, I only vaguely remember feeling bigger. Have other goals apart from losing weight. Once the newness of WLS wears off you may want to continue the momentum of achievement. If you want plastics (and there are no obstacles beside fear) definitely go for it. The recovery can be tough but it completed the journey for me and others I know.