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This is such a great perspective, I'm gonna try to reframe it as an opportunity during those long weeks. And to remember that I will feel very differently about food post-op than I am right now during liquid diet. Thanks for the advice & words of encouragement!

Routinely knock out 60hr weeks. I think I took three weeks off after the sleeve and that was largely due to a massive abdominal hernia that was repaired at the time of the sleeve surgery. It was my 3rd such repair...and has held up great these last 9 years. You may be able to flip the script......and make those 80hr weeks your best weight loss weeks. There is going to be a time when the protein shakes are the ticket...then maybe those small foil packs of tuna and salmon. Food won't be an issue that occupies your thoughts. You'll laugh at the vending machines and shoot 'em the bird. Make sure you buy all your necessary supplements & shakes and tuna packs and load up your desk or locker. Having those on hand will be one more way to keep food off your mind. You'll not be wondering what you are going to have for lunch every day. You'll have that covered. 8 weeks will be a great amount of time to recover and acclimate. You'll lose a pile of weight in those 8 weeks, too. Those 80hr weeks are going to feel much, much shorter from this point forward. Congrats. Go kick some ass. You got this.

I'm glad you found something that's working for you. I tried Contrave years ago and it worked for a while, but then the effect faded. Hopefully that won't happen for you. I also wanted to comment on sugar. There's a lot of evidence that our bodies were designed to seek out calorically dense foods (like fat and simple sugars), since historically food was a lot harder to come by. We see this even today in traditional hunter-gatherer societies. Honey is sometimes a significant part of their diet. Imagine having to climb a tree, meanwhile getting stung multiple times, just to pull out a few handfuls of honeycomb. Interestingly, these people know to only take a part of the hive because they want the bees to stay at this location so the hunter can return to it over and over. My point in telling you all that is that it's perfectly normal to crave sugar. If avoiding it for the rest of your life is something you're able to do, then I think that's great. If you know it's not something you can do forever, then you may need to make peace with the cravings and find a way to have some when you can, but be sure to "leave some of the hive alone" till next time. Personally as an endurance athlete, I do consume a lot of simple carbs and so completely avoiding sugar just isn't really something I could do. Keep in mind that glucose (a simple sugar), is the primary fuel that your body uses. It stores glucose in the form of glycogen, but the reservoir is somewhat limited. This means that for longer, harder endurance efforts, it's important for me to consume simple sugars during those runs or rides that will help replenish my dwindling supply of glucose. My normal diet also consists of about 65% of my daily calories coming from carbs to help keep my glycogen supply as topped off as possible. This is a combination of both simple sugars and more complex carbs like fruits, vegetables, bread, pasta, potatoes and rice. If I didn't do this, I simply could not exercise for the duration or at the intensity that I do. My point here is that I've had to come to grips with the fact that for me, carbs are not the devil. They are in fact a necessary and healthy thing. This was a big change for me since historically as an obese individual, I tried to eat low carb most of the time. I now believe there are no bad foods and the best thing for me is to eat a wide variety of foods like most normal weight healthy folks do. Please don't think I'm trying to tell you what you should do! If what you're doing is working, that's fantastic!. I'm more responding to the comment you made that sugar was bad and we shouldn't eat it. For you that may be true, but it's not true for everyone, and certainly not for me.

I don't have experience with that personally, but I'd suggest talking to your dietitian about it. Coming up with meal plans for diverse patients is literally a big part of what they do. As I think through possible issues, a couple of things come to mind that you should discuss with them: What can you eat to meet your nutritional needs that don't require a lot of meal prep? Obviously there are protein shakes and meal replacement shakes, but as much as possible, it would be good to eat more real food. Are your caloric or macronutrient needs different due to the long work hours? The kind of work you do will probably dictate this to a large extent, as a physically demanding job like construction would be really different than what you'd need to power through long hours in front of a computer where mental acuity is important. Best of luck.

I am set to have my gastric sleeve next week (hooray!), and it has me thinking about my post op diet. I’m currently working a very demanding job, where every other month I’m working 80 hour work weeks for a month at a time. In the next few months I will also be starting night shifts as well (anticipate 3 months of night shifts per year). In preparation for the surgery, I’ve taken two weeks off pre op, and am taking 8 weeks off post op, but my biggest worry is the time after that. Last year my worst food months by far were the long hours working, where I felt I had very little time to do anything, much less prep food. Does anyone have experience with working long hours and how they kept up with their post op diet?

Definitely don't proceed if you're having doubts. My surgeon advised against the sleeve because of my pre-existing GERD, and I got the Omega Loop/Mini bypass instead. While my GERD thankfully didn't get worse, it still happens every so often so I'm still on Pantoprazole daily (which also stops stomach ulcers which I'm prone to). For what it's worth, I also have ADHD and take an antidepressant for chronic vestibular migraines. I make sure I take them after food and ease off water for a bit so they don't go down too fast, and don't really have any issues. I can't take any slow-release meds though, so Vyvanse and extended release Ritalin are out. I take Ritalin 10, which works fine.

I went away for a long time, got diagnosed with ADHD (suddenly my life makes so much sense...), and over the last five months I began to lose my grip on my diet and regain. My lowest was 65kg, my "happy place" was 67kg, and I regained back into the 70s at 73kg. The culprit? I allowed sugar back into my life. Never let sugar back in! It has no manners, touches your stuff and doesn't want to leave. Problem is, thanks in great part to my ADHD, I get addicted easily and tend to eat the same thing every day. When that thing is chocolate, I have a problem. I also have impulse control problems and when the food noise is raging, that's bad news. Solution: GLP1s or Contrave. I have a great GP who understands me and didn't reject my request for help to get back to my "happy place" 67kg. We decided against GLP1s and went with Contave instead, which works on countering addiction. The food noise that was driving me crazy has stopped, I quit sugar week 1 and am back in control. I'm nearing the end of month 2 (of 4) and am just over 1kg away from being back to where I need to be. I've stopped being hard on myself for needing help, because even if I could control my impulses there's nothing wrong with medication that's designed to help. Oh and the other thing that's been a game-changer for me: my partner got me a Fitbit. I realise I'm so behind on this it's like screaming "cars have computers?!?!" at a dealership, but being able to track my calories and see the deficit has made a huge difference. So if you're neurodivergent and regaining, hopefully my experience with Contrave can help a little.

I LOVE that you're losing at a sustainable rate. There is so much data to suggest that crash diets almost never work, so losing ~1-3% of your total body weight per month is the sweet spot. I'd take it even further and say 1-2%, which is right where you're at. If I could give advice to anyone either trying to maintain after initial weight loss, or fighting regain like you are, it would be threefold: Focus more initially on learning to eat a healthy diet and less on the weight loss itself. People that follow the fad diet du jour when losing weight almost always regain because they very quickly go back to their old eating habits. If instead you focus on first learning to eat like a normal weight person that eats a healthy diet, you'll be setup for real success. Many people find that if they do this first, they don't really have to "diet" because their bodies actually start to self-regulate calories. Part of this is because when we eat a wide variety of foods that are nutrient rich, our bodies don't fire off signals to eat more. If that doesn't happen for you, there are strategies to slowly reduce intake while still maintaining your healthy diet. The second thing is to focus on instituting a regular physical activity routine. I feel like way too many people skip this, but the data is clear: up to 90% of people that have lost a lot of weight and successfully kept it off for years do a lot of exercise. In fact, the average for those successful losers is ~1 hour per day on most days of the week (roughly 300+ minutes a week.) This is twice the minimum recommended amount to stay healthy, and twice what someone needs that was never significantly overweight. I want to be clear, this is not really a huge factor in weight loss, but in weight maintenance, it's critical. Finally, focus on behavioral modification. Let's be honest. Most of us got as big as we did because we had an unhealthy relationship with food. We may never actually "cure" ourselves of that, but we can learn to fight back. Probably the best thing to do is work with a therapist that specializes in behavior modification, especially regarding weight. I realize this is not an option for everyone due to cost or availability, but there are also lots of good resources available online. Anyway, best of luck and keep up the good work!

I use Isopure. That's the brand name. As SpartanMaker, it does clump if you dump it into a hot cup of anything, and it is hard to unclump. Warm water is okay, but better in room temps or cold foods if you are adding it. You can also sprinkle it on top of meat and cheese, and there is not any flavor. I got mine through Amazon, like I do most of my protein. Best of luck.

First of all, great job so far. You're doing fantastic! My understanding is the same as @catwoman7 regarding insurance companies. They typically don't want to pay for anything they don't absolutely have to and that definitely includes anything they consider purely cosmetic. Aetna may be different, but I doubt it. Up front, I wanted to mention that not everyone actually even needs plastic surgery. The younger you are and the less weight you had to lose, the more likely it is that eventually your body will adjust to the weight loss. Yes, it can take a few years, but you may find in the long run you're better off not going down that route. I also wanted to comment on your timeline. I think there's a bit of a misunderstanding that we somehow stop losing at 1 year, 2 years, or some other defined date. That's rarely true, so I would suggest not thinking that your weight will stabilize at 12 months. You may get to 12 months and decide you'd like to go lower. Heck, I'm 2.5 years out and still losing (albeit really slowly). I'd suggest waiting until you you feel like you want to start maintaining, rather than just going by an arbitrary date. If your weight stays stable for a while (I personally would go longer than 6 months, but that's me), then looking to plastics may be appropriate. I mention this because I think it would be awful to have plastic surgery, especially if self-pay, then lose even more weight and still end up with sagging skin that you dislike.

Hydrolysed Whey Protein Isolate (also known as Whey Protein Hydrolysate), tends to dissolve a little better than regular non-hydrolysed whey, so that might be something to look for? The hydrolyzed version is also a bit more bioavailable, so that's also a good reason to choose it. Unfortunately it's typically more pricey, so keep that in mind. You can also look for "Clear Whey". As far as I know, clear whey is all whey protein hydrolysate, but you should double-check before buying anything. I don't really have any brand recommendations, but as long as it's pure 100% hydrolysed whey protein isolate, brand shouldn't matter. Plus, I don't know this for sure, but I've been told by others that most whey on the market is produced in just a few manufacturing plants and thus most of the "manufacturers" are not really making it themselves. They just contract out the work to one of these plants. My point is, I'm not sure there's a ton of difference between any of them. One caution here. No whey is going to dissolve well into hot liquids (like coffee). Think of it sort of like what happens when milk curdles if put into something really hot. What happens to whey is somewhat similar (the proteins start to clump), so the best bet in this instance is to dissolve it first into a little bit of cool water before adding it to anything hot.

P.S. the amount of vitamins recommended are often just a starting point. It's common to have quarterly blood tests the first year, and then annual tests thereafter. I think being allowed to go off all supplements isn't all that common (although it's true for some people), and I'd be surprised if it's true of ANYONE who had bypass, since that surgery has a malabsorption component. At any rate, vitamins and amounts of vitamins required are sometimes adjusted depending on the test results. For example, I require more protein than most patients because we discovered early on that my pre albumin level tanks unless I average 100 g a day. Also, I had to quit taking calcium a few years after surgery because it was clear I had no trouble absorbing it from my food and regular multivitamins, and the overage by taking additional supplementation was not only unneeded, but was also putting me at risk for kidney stones or damage. So your particular needs may change as time goes on - that's why it's important to keep up with any required testing.

Not 5+ years post op but I also have foods that definitely sit badly in my new stomach, 3.5 years on, mainly (but not only) carbs. Pasta, bread, crisps (chips for some of you) but also lettuce, seeds, and some meat products (offal especially). I get full quickly and stay uncomfortably full for a long time. I don't eat white carbs often - my usual diet is fairly low carb these days - but sometimes nothing else is on offer.

For anyone that may be confused by this thread, here are some things to think about related to vitamin supplements: The most important thing is to follow your doctor's recommendations. All bariatric programs I've seen have specific recommendations and you would be well advised to follow these. The vast majority seem to recommend a bariatric specific vitamin supplement. Some may also recommend specific brands of over-the-counter vitamins as well. That said, at least from what I've seen, typically when recommending over-the-counter options, they will suggest taking these twice a day (AM & PM) instead of just once. There are a few reasons for the above recommendations. First of all, you'll be eating a very low calorie diet and thus vitamin supplements formulated for "normal" people may not be sufficient. Also, while malabsorption for bypass patients is a concern, sleeve patients aren't immune to reduced absorption. Some vitamins & minerals are dependent on stomach acid to be properly absorbed. Since all WLS patients will have reduced stomach acid production (at least for a while, if not forever), higher than normal amounts of some vitamins are needed. From a cost perspective, yes, bariatric vitamins tend to be more expensive, but if you have to take twice as many of an over-the-counter supplement, the costs aren't very different after all. Especially if you take advantage of subscriptions like those offered by sites like bariatricpal, the cost of a good quality bariatric multivitamin isn't that much. Keep in mind your food bill should also drop, so at the end of the day you should still be spending less per month. If for some reason you still think vitamins are just too much for your budget, please discuss this with your surgical team. They may be able to help you find a less expensive option that still meets your needs. It's never a good idea to make decisions that can impact your health simply based on things you may have seen on the web. Aside form the cost concerns I mentioned above, there is very little to no downside of taking bariatric specific vitamins, even though some have really high levels of certain vitamins. For some specific vitamins, there is no established upper limit, meaning there's no health risk in taking too much. If you take in more than your body needs, then you'll just safely eliminate the excess. Yes, there are established upper limits for a few vitamins & minerals and this is taken into account in the vitamin formulation. Iron, is an example. The established upper limit is 45 mg/day, which is also the max you'll see in most supplements. Keep in mind this upper limit was established because some people had digestive upset at higher doses. You'd have to take considerably more than 45 mg/day to actually have a significant impact on your body. Further, remember when I said that some vitamins & minerals need stomach acid to be properly absorbed? Iron is one of those, meaning that you're probably not actually getting a full 45 mg/day dose as a bariatric surgery patient. Regardless of which surgery you have, you should be getting regular blood tests for life that check for nutrient deficiencies. if you don't get these from your surgeon (for example, you went out of country for surgery), then please get them from your primary care physician. This is really important because some studies have shown up to 30% of WLS patients end up with nutritional deficiencies post-surgery. Don't be a statistic. Human bodies are not all the same, nor are our diets. This means one person may be successful stopping vitamin supplementation, whereas someone else that had the exact same surgery from the same doctor won't be able to do that. Please don't decide what you should do based on another person, even if it's your best friend, a family member, etc. Only with your doctor's blessing should you consider changing or stopping your vitamin supplementation routine. Regardless of which surgery you have, there is a real possibility you may need to take at least some form of supplements for life. The effects of nutritional deficiencies can be severe, so think of your vitamin supplements as insurance against potentially debilitating or even life threatening problems. Best of luck.

If you want to talk about it, join www.Barination.mn.co it is only $40/month and there are nutritionists, movement specialists, Licensed social workers, counselors and there is a lot of community and support groups that can help you through this difficult time. Something to think about anyway. I now pay less in food, so I put it towards my membership and knowing that Obesity thrives in Isolation, I joined the group and has been great. Just another way to obtain information, knowledge and deal with your fears. They do not make decisions for you, but asks great questions. Try it for one month, see how you like it. Just another option for discussions.

Your worry is going to give you a stroke or higher blood pressure if you are not careful. I'm concerned about that so here are my thoughts. At 61, I finally had the RNY. Initially I wanted the GSleeve, but was educated by my surgeon about RNY and that made the most sense, it is well researched, it is done laparoscopicly and if you need the other part of the stomach removed, you can ask your surgeon to do that. The Y portion of the RNY might need to be attached somewhere else. I'm not sure. I had no pain and have been able to tolerate all of my walking and light housework during my 2 weeks off work. I tolerated the clear liquids and the full liquids well and now I am on solid foods and doing well. With RNY you tend to lose more, but it is dependent on you and what you eat. With RNY, I was taken off more than half of the medications I was on, and taking none of my diabetes meds and insulin. Having a fear of the GERD with GSleeve, I also opted for RNY. Because you are already on pantoprazole and still have issues, I would suggest the RNY because there is a higher risk for those who already have indigestion issues or suffer from too much stomach acids. RNY you can't have NSAIDS, but with my arthritis, I am allowed to take it only as needed, and I take a capsule of Celeobrex, and it works fine for my painful arthritis. Just talk to your surgeon about that. Being down 40 pounds already with the GLP1 medication is good, and it will reduce fat on your liver as a side effect. I too have renal problems, stage 3, but was encouraged by my kidney doctor to have the RNY, and yes, the kidney doc also doesn't want me on NSAIDS, but allows me to do so. I need to get down in weight so I can have a hip replacement. Then, I might not need NSIADs any more. I hope I have been able to give you some information and encouragement to re-look at the different surgeries. RNY is just one step further than the sleeve, and with the history of your family, I'm sure the surgeon will be able to compromise and do a revision to the typical RNY as needed. Having stomach cancer history in your family would be one reason to just take the stomach out that is cut off, like in the sleeve and attach the Y end of RNY elsewhere. A modification should be easy to contemplate and do. Just another thought, your surgeon may want to meet with you because the ulcer in your stomach is evident on the series of pictures taken, and wants to move quickly to get that part of the stomach taken out? It is possible? Already having an ulcer starting may also be the reason they postpone the surgery and put you on healing meds, and get you to "calm down" because worry makes ulcers worse too. There are all kinds of reasons and things to factor in, but I would say you definitely need to find out what the surgeon wants to talk about, and go in with some knowledge. I suggest you take a look at some of the YouTube videos by BariNation. You may find out that they help you. I wish you the best, keep us posted after you talk to your surgeon.

For the record, the ASMBS guidelines do differentiate between surgeries. For some nutrients, the recommendation is the same and for others it varies. At this point in time, their recommendations do not vary between RYGB and SG. It's only for DS/SADI that they recommend higher levels of certain nutrients. This is why the market has approached things in the way they have. There are "generic" bariatric vitamins, as well as ones specifically for DS/SADI that meet the needs of those patients. I do feel like you may still be missing that these vitamins are intended specifically for patients during the immediate post-surgical phase when they are probably eating very little food. The bulk of the nutrients they are receiving are from these products. Those needs don't vary for SG and RYGB patients. I'm certainly not trolling. To be frank, I have a real problem with several things you've stated as I feel they are irresponsible. You need to keep in mind that for every one of us responding to this thread, there are hundreds, if not thousands of people reading this. When misinformation is spread, especially as it relates to something critical like nutritional needs post-surgery, that may lead people astray and can create a real danger. Look, you do you. If you want to take a vitamin from the grocery store, that's your choice and I wish you the best. For most people the smart choice is to take a bariatric vitamin, at least until given clearance by your surgical team to modify or stop doing so. There is really very little downside to taking "too much" of these nutrients, whereas there is significant risks of some pretty nasty side effects involved in taking too little. Feel free to research some of the nasty things that have happened to real people that failed to meet their nutritional needs post-surgery. It's not pretty.

My purpose of doing this surgery so late in life (I'm 46) is to be healthier. I have multiple co-morbidities including hypertension, left ventricular hypertrophy, sleep apnea, CKD 2, and hyperlipidemia. There is a family history of stroke and cancer, including colon a stomach cancer. I meet with my surgeon for the second time Tuesday. The staff said the surgeon wanted to meet with me because had questions, but that did't make sense because they've responded to my questions. The only new information was from my EGD pathology report. My EGD found asymptomatic HP negative gastritis. The GI Doc didn't know what may cause it but tossed PPIs at me and I will learned Tuesday if I need another EGD or what. If I have contra-indicators for Sleeve Gastrectomy I'm considering backing out of surgery because that means my only option, anywhere would be RYGB. I'm afraid of having a remnant stomach that could continue down the path of inflammation. Apparently I was on the path to stomach ulcers. Maybe I'm being unreasonable, I'm just afraid of my remnant stomach being a time bomb. I'm also concerned about dumping, not being able to take NSAIDs, and perhaps having to change my other medications. I've committed to having a procedure including buying vitamins, typing protein shakes, losing weight in advance, learning more and more about the procedures, my relationship with food, and continuing to exercise with my personal trainer, and attending support groups. But I have this fear of RYGB and maybe it's silly. I know people, good friends, with RYGB. I get the sense they like the results, but not the down sides. One even told me they are surprised hospitals still perform RYGB because of the issues they had. I don't really know what I'm walking into on Tuesday and I am nervous. I've been taking 80 mg or pantoprazole daily. I learned my insurance company will only pay for 90 pills, so my refill was tricky. I don't know how longer I will have to take it or what that all means, and i don't know what impact all this will have on the surgery (if any). I'm terrified of having come this far, made peace with the decision to have surgery, over come the shame, had to deal with the doubts and fears of other people including my own spouse to find myself with the possibility that it's all a no-go. I won't have surgery until the fall, and normally the second appointment with the surgeon is closer to the the surgery point. Even the program staff weren't sure why it was being scheduled. My RD follow up, last week as also much sooner than it should have been, and after the meeting the RD said it wasn't the actual required follow up. I'm left scratching my head, being coming anxious, and I feel some slight indigestion which is wild since I've been on the PPI since early last month. I doubt my experience is unique so I open to learning from others. I'm currently on Zepbound and losing weight, but it's expensive with insurance and the insurance could decide to not cover even with the insurance and a coupon it's about the amount of a car note every month. So that's not sustainable for the rest of my life. Ia also need to lose more than the 20% max it would get me to. So if surgery is a bust, I I don't know. The gastritis is a contra-indicator for Endoscopic Sleeve Gastroplasty and it's not covered by insurance anyway. Thinking about all of this makes me kinda nauseated.

Not the same starting weight, but have been obese all my life and this has been the best decision of my life, other than the man I married. He loves me no matter what I look like. But, I did this for health reasons and not to be skinny. I feel healthier, and my diabetes medications are no longer. I had the bypass, because I didn't want to deal with the possibility of GERD. I had some issues with it, but not any more, and mostly because I'm eating the right food. I wish you well.

How much are you able to eat at one time without stomach pain? We don't need to eat a lot at one time, but we do want to eat the most nutritious food we can, so that every bite benefits us as much as possible. Glad you are on a better track!

Just take some time out. You are right not to procede if you feel rushed or feel your surgeon is not the one for you. You will know when its your time to do this. If you have had GERD in the past then I think they recommend a Bypass. I ended up with Gerd after surgery. Its not a major issue if I eat early in the evening and avoid very spicy foods. We all felt anxiety before this surgery because it is a leap into the unknown. The after surgery meds and routines do seem all to much to take in. After surgery it all becomes clear as you progress along the different stages what you need to be doing. It really is not something that you need to worry about. There are people on this forum with your medications and have managed very well. If they are about they will chip in to reassure you. What ever you decide this forum will help you any way it can, you will only find kindness here

Men’s and women’s bodies are different, but for reference—I started at 297 lbs and am now between 165–170 lbs. I went from a size 20 to a size 4 in pants and from a 3X top to an XS–S. I do have loose skin, but it’s not as bad as it could’ve been because I started strength training about 3 months post-op and never stopped. I’ve always made cardio a priority too. Here’s what my weekly workout routine looks like: 2 upper body days 2 lower body days 1 full-body HIIT (with weights) 1 cardio-only day Even on my lifting days, I still include some form of cardio—walking, Stairmaster, biking, or whatever I’m in the mood for that day. It keeps things balanced and helps me stay consistent in my fitness journey. My biggest advice is really take that time to get your relationship with food in check, even though I'm in maintenance mode, I still have issues sometimes with binging- just being truthful- but I am able to control it and get myself in check the next day. Pre-op I would've just given up and kept the binge fest going. Stick to foods that you know you enjoy but also fuel your body. Track! I know its not for everyone but it sure helps me stay accountable. No diet is perfect, its not a thing- the main thing is if you fall off track dust yourself off and get back at it!

Detoxes are a fallacy. Don’t get caught up in social media ******. If your kidneys and liver are functioning correctly your body is already detoxifying itself. Was it your surgeon who did the upper GI and barium test? If not, as @WendyJane, suggested, I’d go back to the to see what might be the cause. No one should suffer pain. An elimination diet like fodmap may be helpful to see if a specific food is causing you the discomfort or do some tests for food allergies or sensitivities . It’s not uncommon to develop sensitivities or allergies to specific foods after surgery. Something to consider or to discuss with your surgeon anyway. In the meantime maybe try some less dense foods like soups or like the purée stage foods for few days and slowly introduce more solid foods and see if texture or density is an influence on the pain and your inability to eat more than a couple of bites. Hope you can find some answers soon.

I had been part time following the pre ops diet and cutting down on my food sizes a few weeks before I got news of my operation date : may 26, the same date 5 years ago I knew I was going to gain weight because of pregnancy complications. So the first two and the half weeks I just did more pre- ops eating (modifast in 4 different flavors) . They are quite tolerable. I usually had a normal (small sizemeal) in the evening with the kids. Now starting last Sunday, (18 may) I am on a full water fast for 5 days. Meaning my fast ends today at 19:20. I have my modifast oatmeal ready should I really need to eat something at that hour. Tomorrow Saturday I shall be on liquid pre ops meals as prescribed. Sunday will be another day on liquid only in preparation for my operation on Monday. I tell you what this is my body and I am determined to get it back. The operation is not a magic pill. It is just a tool in my toolbox. The way I think about food and how and why and when I ingest it- that to me is the magic. I am focusing very much in discovering my cues and knowing what triggers my eating habits. I am learning to say no all together when I am invited to that snack moment at work to eat what so ever what when I truly know I do not need it. - I am learning to say ’No’ and knowing it will be okay. I take it a minute at a time. We shall get through this and we will not turn back. I want to be able to jump into every photo without cringing I want to feel good and run about with my kids without feeling pain, exhausted and above all guilty. I am doing this for my boys and then for myself. We will be alright guys. We got this.

I feel like you may be overthinking the malabsorption component of RNYGB? Yes, this does elevate the risk of nutritional deficiencies for some vitamins & minerals since absorption sites are somewhat bypassed. You've got to keep in mind though that ALL bariatric surgery patients are going to be nutritionally deficient, at least during the weight loss phase when you'll be eating a very low calorie diet. Very low calorie also means very low amounts of most vitamins and minerals. Even if your diet were perfect (virtually no one has a perfect diet), you just can't consume sufficient food to make up for your nutritional needs. Yes, you'll eventually get back to eating more normal amounts, but until then, bariatric multivitamins have been formulated to make sure you don't suffer from nutritional deficiencies. Keep in mind too that the supplementation recommendations are all based on averages and in reality very few of us are average. The volume of food and the nutritional quality of said food, as well as genetic and epigenetic factors all influence what you'll be able to get from diet alone, as well as how well supplementation works for you. As a result, ALL supplementation recommendations are set up to ensure ~95% of patients will have no nutritional issues. Bariatric multivitamin manufacturers also tend to over-rotate on anything that does not have an established upper limit since they know that their consumers will be having frequent labs done. If someone were to be deficient in a particular vitamin, then they're likely to seek out a different product. You can see this pretty clearly by simply looking at something like the ASMBS recommendations vs the massive amounts of many vitamins found in bariatric multivitamins. Know too that it's entirely likely your bariatric team will have you adjust your supplementation after your labs are done post operatively. Many will want to do labs around 90 days, 180 days, then annually thereafter to monitor for nutritional deficiencies (or sometimes even excesses). I for example had to modify what multivitamin I took because my B12 level was sky high. I get the cost concern, and you may be fine with just a regular multivitamin, but keep in mind your overall food bill should drop since you'll be eating so little. This should more than cover the cost difference, so personally I'd err on the side of caution and take a bariatric specific multivitamin at least while you're in the fat loss stage. Once you're in maintenance, you might be able to adjust that (with your doctor's blessing).