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Again, If what you're doing is working, then I don't see anything that needs changing. If you're in the range of 100-115 grams per day, then you're already eating what I'd call protein forward diet and about where I'd typically recommend for most people. Keep in mind what I mentioned, calories are king. You only lose weight when you eat fewer calories than you burn. Thus if you did want to add more protein, you'd have to do so at the expense of other nutrients. When eating as few calories as you are right now, dropping any more on carbs & fat could have negative effects on health. It's important to get sufficient essential fatty acids since your body can't make these (that's why there called "essential". Technically you can live without carbs since your body can manufacture glycogen from fats and protein, but the problem is that if you reduce these even further, you're going to also have to reduce your intake of fruits and veggies and these convey a lot of other benefits to you nutritionally. Here's what I'd ask your nutritionist about. The most up to date clinical practice guidelines from AACE/TOS/ASMBS/OMA/ASA say to focus on protein intake of 1.2g/kg of bodyweight. https://www.soard.org/article/S1550-7289(08)00163-9/fulltext I recognize that you are not from the USA, but I dare say these organizations have a significant level of money and experience going into these recommendations since obesity is rampant in the USA. For what it's worth, some recent data I saw showed that the USA does far more bariatric surgeries than any other country. In fact, it was roughly the same number of bariatric surgeries as the next 10 countries combined. An impressive but sad statistic. Protein is highly satiating compared to carbs & fats, plus protein takes longer to digest, meaning you'll be full longer. Being full longer equals less cravings and better dietary compliance. Protein has a small but meaningful effect on overall energy balance because on average, for every 100 calories of protein you eat, you burn about 20 calories just to digest it. This is way more than carbs or fats which range from 0 to 3 for fats and 5 or 10 for carbs depending of fiber content. This means the more protein you eat, the better your overall energy balance compared to eating the exact same calorie amount of other foods. Granted, this isn't a lot, but it all adds up. Higher levels of dietary protein help you preserve more muscle mass as you lose weight. (It helps prevent muscle catabolism which is a real risk when eating a very low calorie diet.) Because muscle is more metabolically active than fat, the more muscle mass you preserve as you lose weight, the more calories you'll burn, even at rest. Studies suggest anything above about 1.2g/kg (95% CI), is sufficient for most people to stave off catabolism, which is probably where the dietary guidelines linked above came from. You mentioned something about body recomposition, so I want to touch on that briefly. I LOVE the idea, but you need to understand it's extremely hard (bordering on impossible), to add muscle mass while on a very low calorie diet like you're eating right now. For most people, you actually need to be eating a significant surplus to add muscle mass, so I honestly wouldn't even try until you get closer to your goal weight. If you do decide to add mass, then yes, higher protein amounts than what you're eating now would be recommended (Roughly 2g - 2.5g per kg of bodyweight). This also would require a dedicated hypertrophy training plan though, and that's a bit out of scope for our discussion here. Best of luck.

Hello everyone, just wanted to post an update about me. I had my Gastric bypass surgery August 16, 2023. My heaviest weight was 260 lbs, documented weight starting the bariatric program was 249lbs and weigh in on day of surgery was 235.6 lbs. I managed to drop down to 176lbs and I stopped losing between the 6-9 month mark fluctuating between 183-186 lbs and now I did a weigh in at 189lbs. I noticed now I am experiencing more digestive issues like everything I eat is causing bloating, indigestion, heart burn, hyperglycemia episodes and feeling lost of coordination some days. I don't have medical insurance to get a thorough check up from surgeon but the only thing I can account for is me not taking my vitamins, not being as active, still snacking and mentally always ready to eat even when I don't want to because I will feel stomach cramps or light headed, How are you all during your journey?

I realised my response above was a bit lacking on practical recommendations. Let me try to summarize what I'd suggest: Since you're right where I'd want you to be in terms of weight loss per month, don't change anything at this point. Only consider changing if you find the weight loss completely stops for 2 months or more. If weight loss does stop for at least 2 months, I'd actually recommend UPPING calories by 250-300 calories a day. I know that sounds counter-intuitive, especially considering that a negative energy balance is the only way to lose weight, but let me explain. Remember when I said above that one of the main jobs of our metabolic regulation system is to keep us from dying? No matter what we do, our metabolism slows when we diet. The rationale behind upping calories (by a small amount), is that we want to convince that system that the "bad times" have passed, and it's okay to ratchet up metabolic processes again. I'd recommend eating this increased calorie amount for at least a month, but two months would be better. Somewhat surprisingly, most people won't gain weight if they do this because their metabolism will increase to compensate. After that diet break, only then do we drop calories for a month or two in order to drop some more weight. You can keep up this intermittent dieting (not to be confused with intermittent fasting), until you get to your goal weight. I know this sounds like a slow process, but I promise, in the long run it's actually faster than if you just tried to keep cutting calories to get to your goal. Please keep exercising for your health, but also so that once you do get to your goal, you'll have a much easier time maintaining the loss. I would strongly recommend a minimum of 3 days per week of aerobic exercise and 2 days per week of strength training. This will set you up really well to maintain weight, as well as for excellent health as you get older. Don't be afraid to seek out a good mental health counselor. None of us got as big as we were by having a healthy relationship with food. The vast majority of people that fail to lose weight or that regain lots of weight after bariatric surgery do so because they fall back into old poor eating habits.

My favorite tofu dishes are either agadashi tofu ( firm tofu, drain, pat it dry, roll it in corn starch and bake or fry it) mix 2tbs soy sauce, water, mirin in a bowl with 1 tsp ground fresh ginger, drop tofu in and eat immediately. or tofu tofrites: extra firm tofu (drain, pat dry and allow to dry wrapped in paper towels with a plate on top to squish out water, while you make the batter. I have a bunch of batters. Off the top of my head 1c almond meal/flour, 1/2 c coconut flakes, and like 2 tbs Cajun seasoning. Cut tofu into fat fry sizes and dunk it milk or a scrambled up egg then batter and place on baking sheet with parchment paper (or it sticks and is bad ) 15 min at 400 and or until outside is panko crispy. Salt if needed. Good as is or with dips also great with shrimp. Or tofu chocolate pie/ mouse: everyone likes this with different amounts of sugar (if I eat sugar I suddenly can’t think about anything but binge eating for a week). So I just use the darkest and most cocoa powder chocolate I can get and melt 1.5 cups and toss it in a blender with an already prepped block of silken tofu (prep, wrap it in paper towels 2-3 layers till try, so not squash silken to get out water). I then add a sprinkle of salt and a tap vanilla. Scrape it into cups or a pie tin…. Refrigerate for 2 hours. My sister makes this with a cup of sweetener… I skip. Pardon.. seriously all day I think about food. Get a notebook or notecards. Separate it into categories by how long it is to prepare. Start with your under 5 min, 30, or whatever times you need. Put carb, protein, etc info in the back. Make your recipe set. When you are bored with food… a crazy good recipe like sukiyaki with konjac noodles or muscles in a savory broth, spoil yourself. Or mix up your cards you have saved. Add cards as you like things. But make sure you have a ready supply of “crap I can make with on hand pantry stuff when I didn’t go shopping,” “crap I can make under 5 min, I am starving,” and “crap that freezes great for oamc food prep so you are never having to resort to crap take out.” You will feel like you’ve got the Bariatric eating down after you have your recipe book.

To be clear, the gas used in abdominal surgery is not inside your digestive tract, thus medications to address that issue won't help. Typically they use CO2 and it's actually pumped into your peritoneal cavity to help create space between the abdominal wall and your organs. This gives the surgeon room to work more safely, as well as help visually distinguish everything. The reason it hurts so much is because basically your abdomen has been blown up like a balloon. This pushes up on your diaphragm, which in turn irritates the phrenic nerve. It's not uncommon to have referred pain in the chest, shoulder and neck as a result. Eventually the surgical gas will be absorbed into your bloodstream and you'll breathe it out, but until then this can be quite painful. Walking helps, but won't fix it. Overall, it should pass in a few days. I'd also make sure you're drinking enough because headaches are a classic symptom of dehydration. Dehydration is one of the main reasons bariatric surgery patients end up back in the hospital in the early post-op period, so please do everything you can to keep up with your fluid intake.

Yes, it's Bariatric Fusion brand that I used, NOT Bariatric Pal! Bariatric Fusion chicken soup is 27g protein, 10g carb (check with your team because their guidelines say less than 10g carb but they may be okay with it being 10g) and 160 calories. The Cappuccino flavor is 27g protein, 8g carb and 150 calories. I bought mine from Amazon and a tub runs around $45. All the flavors on Amazon fit the guidelines with the possible exception of the chicken soup. Celebrate also makes a meal replacement shake with several flavors that work with your guidelines, but their chicken soup is 24g protein instead of 25g (carbs and calories are within the guidelines). I tried that one and it was okay. I liked the Bariatric Fusion slightly more, but the benefit of the Celebrate brand is you can buy a variety pack directly from their website with 12 single serving envelopes of different flavors so you don't get bored. I also like their Tropical Twist flavor chewable bariatric vitamins if you're still looking for one, and their cherry and raspberry lemonade calcium chews are very tasty.

Just be careful with selecting meal replacements since a lot of them won't meet the guidelines as outlined by your team. As an example, the Bariatric Pal creamy chicken soup meal replacement mentioned above is too low in protein. While there are a few products out there that will meet those guidelines, most won't. They'll either be too low in protein, or too high in carbs. This includes the vast majority of products you'll find at grocery & drug stores.

The meal replacement shakes I liked the best were Bariatric Fusion brand in the cappuccino flavor for breakfast and the chicken soup flavor (made with warm water) for lunch and dinner. A caveat is that I hated both of these when I tasted them the first time. I almost got rid of them. Especially the chicken soup. But after about 3 days on the liquid diet, the soup was the best thing I ever tasted. I was so tired of artifical sweetness. I also can't say enough nice things about Syntrax Nectar Naturals orange flavor protein shake (but this is not a meal replacement shake, just a protein supplement). I quickly tired of the meal replacement shakes within the first month post-op, but I drank an orange protein shake every morning for about 6 months. I had very little appetite in the mornings but specifically the lightness of the orange texture/flavor made me feel like I was having a glass of juice. It's similar to drinking Tang, if you ever had that back in the day. Or maybe like Sunny-D. Not quite orange juice, but kind of a treat. I tried the other flavors and they weren't as good in my opinion, but I would probably still drink the orange one if I needed a supplement.

Is it just me, or is it really odd they'd tell you what not to use, but didn't tell you what you should be using? Surely they must have some suggestions that fit what they want here? As far as I know, all meal replacement shakes contain added vitamins as that's sort of the point. They also contain added carbs and fats that most protein shakes don't have. I'd say the vast majority of people here were told to just use protein shakes. That's typically for a few reasons: First, especially if you also take a vitamin supplement, you're not going to suffer any long term harm using protein shakes instead of meal replacement shakes for a few weeks. Second, most meal replacement shakes are lower in protein than a typical protein shake. We want as much protein as possible to help prevent the breakdown of muscle tissue when dieting. Third, most bariatric doctors don't actually want you consuming very many carbs, since one of the main goals of the pre-surgical diet is to shrink your liver to make the surgery safer. The best way to do that is a very low carb diet. (The liver is one of the main ways your body stores glycogen, so by depleting it of glycogen (carbs), it will get smaller, even if no other changes take place.) TL;DR: Ask your team what they want you to use.

Incredibly honest post. You know that your current approach won't (can't) help you reach your weight loss goal and stay there. It's so good that you're stepping back and evaluating that before your prime period for weight loss flashes past (which it really really does - mine is already way back in the rear view mirror, LOL). I live in Ireland where access to proper bariatric therapists is limited, as i think it probably also is in the UK. But I echo the advice above to find one and work on what's going on in your head so you can make the most of what you've changed in your body. I really hope that you can get back on track. We are all here to help - all human and have all made mistakes as we went along. Lots of us have hit little blips when we find we *can* do things that we shouldn't. What matters is that we stop and call those out and get back on the horse. Keep posting and let us know how you're doing.

This doesn't strike me as self-sabotage, as much as addictive behavior. I should clarify that I'm not a therapist, but even if I were, no one can be diagnosed simply based on a post on a message board. Transfer addiction post-bariatric surgery is incredibly common so I feel like it's worth it to seek help ASAP and get this sorted out.

There's really no reason for your insurance company to deny coverage here. While gastric bypass is obviously performed for weight loss, that's not the only reason. There are normal weight people that sometimes have it done for various issue like severe GERD and issues with gastric emptying. My point is that even though we think of it as a bariatric procedure, in your case, you need it purely for medical reasons. They can't deny it on the basis that they don't cover bariatric surgery, since that's not why you need the surgery.

My surgery is on Monday the 12th, I am excited and nervous as well, but I have a huge community to help me. You will be going through grief of loss or the grief of having to follow a regimen diet. I attend a group every day, just to grab nuggets of information and knowledge. I am a member of Barination, and they have certified licensed and professional mental health care providers, dieticians and nutrition specialists and lots of discussions with physicians and groups or teams from around the country. I would strongly urge you to visit them and see what they are all about. You can find lots of YouTube videos from Barination that are free for all to view. They have one that is on what to expect as a pre-op and immediate post-op patient. Once a Bariatric patient, always a bariatric patient. I wish you well on your surgery on the 9th. Keep us up to date how you are doing and we can provide you with knowledge and understanding of the feelings you are feeling. Start that feelings journal now and write anything that is in your mind, and re-read them for learning and keep them to look back a year out to see where you were before, and where you are a year out. I started that 2 weeks ago and I have come to realize that I still have that head hunger. I'm not hungry but bored, so I think about food to fill the void. That is head hunger. It is a real thing, so as you begin the liquid diet, remember that the #1 problem or complication you will have is dehydration so sip, sip, sip!! If you have protein water, that will help you feel more full than just drinking water. Hope I helped a little bit, hang in there, this is a life-long journey.

Been back on the bariatric / keto train for a month now. Feeling much better already. Getting sugar out of my life has been a relief. Took me a couple weeks to get through the cravings. Once gone, they've stayed gone.

I find the Bariatric diet and keto pretty similar. More fat typically in keto. It was my go to diet for food craving control. If I lick sugar… I can’t stop. So, it helps. As with all restrictive diets many times micronutrients are lost and need supplemented. Kinda lucky we are always testing ours to tailor replacement :). I can’t do carnivore, I just end up wanting to throw up.

I am in the same boat. My surgeon says my hiatal hernia is the largest he has ever seen and is recommending the bypass but I know my insurance covers absolutely no bariatric surgery so I am at a loss.

So I had gastric sleeve surgery in 2017 and ever since I have had severe GERD. I just went through an upper GI endoscopy and it was found that I have a huge hiatal hernia, like half of my stomach! My surgeon says the only real way to get relief is the have a gastric bypass but my current insurance does not cover any bariatric surgery. Is there a way to get them to pay since the surgery isn’t for weight loss? I have BCBS of Alabama.

I would recommend chewable or liquid bariatric multivitamins for the first few months. I had surgery over 4 years ago and I still do the chewable multivitamin.

It wasn’t too hard. My appetite wasn’t 100% gone like with the sleeve but given that I was already on the low-carb for a couple weeks before and the changes it made it was quite a bit easier to stick to it. In fact, it was night and day. The surgery was so much better for me. It actually made metabolic changes that got me up and exercising and that made me feel good. I was eating 100% clean for four months. Then I had some other medical issues that have sort of just put me in the stall mode but I am going to get back to it. I’m actually not allowed to eat like I was eating. I have to maintain my weight because I am in chemo, but I’m still exercising through chemo and before surgery, I was like 100% sedentary so the surgery definitely made some changes, not just to the stomach or the intestines, but to my metabolism to make me start up my exercise again, multiple times when I’ve had to stop because I was in the hospital for 10 days with pneumonia and then I had to stop because of different scans that they didn’t allow me to exercise for a couple of days and then I had to stop because I developed hyperthyroid, and my pulse was dangerously high for a couple weeks and every time I have started up again with my exercise so it’s kind of insane because without the surgery there’s no way I could’ve done that. I really hope it’s the same for you. I mean minus the chemo, of course, but that it changes your metabolism and that it works for you for me I could tell from very early out that it was gonna work this time. I lost 75 pounds and the first four months and I was so motivated that I kept exercising and eating clean through my first month after a cancer diagnosis going to all of the doctors and PET scans and all of that stuff even traveling all around the state I still stayed on my plan. Then with chemo, they didn’t want me staying at a calorie deficit so that threw things off a little bit but I have maintained the 90 pound loss and tomorrow is actually my last chemo treatment so hopefully I will be allowed to start losing again, but we’ll see. According to my bariatric team I need to continue eating enough for radiation, but I’m gonna see what the radiation doctor says. Anyways, I’m not talking about the cancer thing for any reason other than to say there’s no way I could’ve maintained any kind of loss before the surgery because I would’ve been eating for comfort. For a situation like this and definitely used it as an excuse to not exercise. And I have had a couple of days where I’ve eaten for comfort and I’ve used it for an excuse to not exercise, but unlike before when that meant everything was out the window for good I’ve gotten right back on track. Best of luck to you. For me it has been a life changer.

So glad to hear you are doing well. Yea when the cravings come back it sucks. I have been doing okay. Tomorrow is my last day of the infused chemo. Surgery on 3 weeks then radiation in five. I will be on the immunotherapy another year and maybe oral chemo depending on the pathology from surgery. 🤞 I don’t need the chemo because that may mean I’m immunocompromised still and I’m so sick of the isolation of trying not to get sick and miss treatment. I got a tiny little cold that made me septic and spent 10 days in hospital which made me miss two weeks of chemo so I’ve had to be super careful to not get sick again and all along they have told me once I get to radiation I won’t have to be so careful. I mean sick would mean I would miss treatment but only for a day or two while I had a fever or felt really crummy and it wouldn’t be life or death. Anyways, I only read about the oral chemo on the patient portal tonight so I will ask Dr more about it this Friday when we chat. Maybe it’s not a big deal. I have pretty much maintained my weight till recently. I’ve gained a few pounds. I’m still on the heavy steroids and the immunotherapy caused thyrotoxicosis I think it’s called. I was hyper thyroid to start but then like 3 weeks later it went back to normal and then to hypo thyroid and apparently it usually stays that way. I reached out to my bariatric team and asked him if I could start on with Govee to help get me off of some of these processed carbs and he acted like I was being crazy to be worried about my weight at a time like this. I said I’m not trying to lose weight. I know I’m not supposed to and I haven’t Since December when I started the Chemo, but I don’t think that if you’re so concerned about me, maintaining my weight to fuel my body and help myself recover that the foods I’m eating in order to sustain an overweight body weight are really helping me recover from anything. I said all I want to do is be able to stop eating the garbage and start eating healthy nutrition again and I would be willing to log all my food again and check in with you to make sure I’m not losing too fast or anything, but he says no way not until I get the all clear cancer free from my oncologist. But I’m helping my oncologist can reach out to him and tell him that I’m not gonna get that for another year and if I wait that long, I’ll probably be as big as a house again without any help. Or I may just have to go through an endocrinologist or my family doctor or something. Anyway, anyways, trying to not worry about it too much but I didn’t appreciate that. He acted like I have some kind of eating disorder or something and I have like a death wish. I mean, I wasn’t saying that I wanna take something that’s gonna make me starve myself to death. I was just saying that I want to change what I’m eating and eat healthy obviously if the medicine made it where I couldn’t eat anything. I would stop taking it. I’m not insane. 🤣 but it is very discouraging to see the numbers on the scale go up even if it’s only 5 pounds.

Weight loss surgery success journey stories are important because the written word enables us to connect on an emotional basis with others. Telling our journey stories is a way to build a deeper level of understanding. Thinking about and creating our stories regarding our life history, life experiences, and influences on our lives can be related to family, friends, acquaintances, and even strangers. Everyone has different, exceptional life experiences with unique and special stories to share and teach others. My own story is one of redemption and salvation – but my redemption involved turning away from religion, and my salvation came from science. I was born and raised in a religious, conservative Christian home in Charlotte, North Carolina. My parents are both immigrants from Taiwan, and they moved to the United States in the 1980s. Their command of the English language and understanding of American culture were poor. Their acclimation to the United States was heavily dependent on their participation in the Charlotte Chinese Baptist Church. The Christian Baptist church is where my parents first initially met each other. They dated for a short period of time before they made the decision to get married. After marriage, they gave birth to me as their first born, and two years later, my younger sister. As far back as I can remember, my family attended Sunday services at the conservative Christian Baptist church on a regular basis. I was indoctrinated into being a conservative Christian by my family, friends, teachers, classmates, schools, and the conservative Christian church we attended. I was taught to believe in Jesus, Virgin Mary, and the existence of heaven and hell. We prayed in church, and I was taught to "give my life to god" and to avoid "sin." I was taught homosexuality was a sin and that LGBT people went to hell. My parents forbade my sister and me from dating, and I was told by my family, church, and teachers to save my virginity for marriage, which meant premarital sex was a major taboo. When I was in middle school, all of us girls were enrolled in the "Best Friends" program, an abstinence-only "sex education" program. The program merely consisted of "just say no" if boys wanted sex. Throughout my entire childhood, I unfortunately endured extreme domestic/family violence and experienced severe physical, verbal, emotional, psychological, spiritual/religious, and sexual abuse, incest, trauma, and molestation perpetrated by my conservative Christian father. My conservative Christian father was a very active volunteer at church, and he was highly respected by fellow church leaders and members of the congregation. However, he used his outward acts of service for the church as a deceptive mask to harbor many deep, dark secrets behind closed doors. My father was a chronic alcoholic and domineering, psychopathic perpetrator of horrific violence. He was a sadistic sociopath who derived sick pleasure from abusing my mother, my sister, and me in every way possible: physically, verbally, emotionally, psychologically, spiritually/religiously, and sexually assaulting, molesting, traumatizing, and humiliating us. My father weaponized the Bible as a tool to repeatedly abuse, assault, control, molest, terrorize, threaten, and violate my mother, sister, and me. He claimed the Bible justified his abuse, violence, and mistreatment towards us. He was a gun owner who threatened on countless occasions to murder the three of us and burn down our home “to destroy the evidence," so our bodies would never be found. Both my parents constantly warned I would be sent away to a foster home, where I would be treated far worse by strangers if I ever told my school teachers or complained to authorities about the horrific abuse and violence that was taking place at home on a daily basis. As an innocent young child, I wholeheartedly believed every word of my parents as I did not know any better. A middle school classmate noticed a bruise on my arm and asked me about it. I confided in her about the abuse and violence being perpetuated by my parents against me at home. She was sincerely concerned about my safety and worried about my well-being and told our homeroom teacher, who in turn, informed the middle school guidance counselor. After lunch, I was pulled from algebra class and asked to speak with the guidance counselor. Out of my irrational fear of being removed from my family home, the only place I'd ever known, I lied and said I'd injured myself by accident. At the time, I thought I was in trouble because I'd never been removed from class. I wanted only to return to math class to avoid missing any important class material. Back when I was an innocent child, I still believed in a just and merciful God. I used to kneel at my bed every night and fervently pray to God to kill me in my sleep. I desperately wished to die so I would not be forced to endure another day of extreme abuse and violence. It's heartbreaking for me to think back now about how I started seriously contemplating suicide when I was a young child. I did not wish to live and did not want to continue enduring the horrific abuse I experienced as a child at home every day. No one seemed to care about or love me, not even my own parents. I felt absolutely trapped in this living hell at home. As a child, my parents would not allow me to seek mental health care since doing so would reveal their abuse and violence towards me, and they knew they would face severe legal repercussions. My immigrant parents came from a conservative, traditional Asian culture and attached a very negative stigma to psychological services. They viewed patients who sought mental health treatment as "crazy." At the age of 18, I was finally able to move out on my own, and I left my hometown of Charlotte, North Carolina to attend the University of North Carolina at Chapel Hill. I began to meet and learn from people of different races, ethnicities, socioeconomic classes, religions/non-religions, with family backgrounds and histories that were unlike the oppressive, conservative Christian culture I'd grown up with. I was exposed to new, fascinating ideas, thoughts, and perspectives from my university professors and fellow college students. I learned about liberal. progressive Democrats and the concepts of socioeconomic and racial injustice, diversity, equity, and inclusion, women’s rights, and more. I was exposed for the first time to secular ideas. I began questioning the existence of God at this juncture. All the rules and regulations I'd been taught to follow by my conservative Christian family and church as a means to salvation had brought me nothing but painful despair and misery throughout my entire life up to that point. I was exposed to an entirely new world in college in which I learned that I had value as an individual as well as learning critical thinking skills, philosophical logic, and scientific thought. However, the years of abuse had left many scars. I sought help from a psychiatrist who finally diagnosed me with major depressive disorder (MDD), generalized anxiety disorder (GAD)/panic attacks, and complex post-traumatic stress disorder (C-PTSD). My psychiatrist prescribed antidepressant and antianxiety medications for me, and I also began intensive psychotherapy. I sought out trauma-focused mental health counselors and therapists and successfully completed countless mental health treatments and therapies for my healing and recovery. I discovered the abuse and violence I experienced during my childhood was not my fault, and I was not to blame whatsoever despite what my conservative Christian family constantly told me. I also learned about concepts and techniques such as self-care, emotional regulation, and developing healthy boundaries. The mental health treatments I received included Cognitive Behavior Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR) therapy, Somatic Experiencing (SE) therapy, Dialectical Behavior Therapy (DBT) group therapy as well as medical treatments such as Transcranial Magnetic Stimulation (TMS) treatment and esketamine treatment. In addition, I attended support groups for survivors of childhood abuse and incest, sexual assault, rape, and religious trauma. My journey back from the brink had finally begun. However, I was about to take a huge and very dangerous detour in my journey of healing. Food was my drug of choice back then. I used to binge eat massive amounts of food to desperately fill the empty void of nothingness I felt within and to cope with my feelings of depression, sadness, worthlessness, hopelessness, guilt, shame, fear, emotional numbness, fatigue, exhaustion, migraines, stomachaches, anxiety, panic attacks, nightmares, flashbacks, difficulty with focus and concentration, and other symptoms. I preferred unhealthy junk food and fast food that provided me with momentary comfort. I gained prodigious amounts of weight. The antidepressants I took increased my appetite, causing more weight gain. The weight gain made me feel even more depressed, and the depression made me eat ever increasing amounts of food, which became a vicious cycle. I developed social anxiety and hated going out in public because I feared strangers bullying and taunting me for my appearance. I am 5 feet, 6 inches tall, and unbelievable as it may seem to most people, at my maximum, I weighed a staggering 321 pounds at my highest and had a BMI of 51.8. I was super morbidly obese, extremely unhealthy, and unfortunately, developed many serious, chronic health issues over the years. Due to the excess weight, I used to get winded easily and ran out of energy very quickly. I could not stand or walk for more than a few minutes before I began experiencing excruciating pain in my back, forcing me to sit and rest before I could stand and walk again. I suffered from numerous chronic, life-threatening health conditions, which included high blood pressure, high cholesterol, pre-diabetes, obstructive sleep apnea, chronic back pain, knee pain, non-alcoholic fatty liver disease, hiatal hernia, and others. Since I have a family history of even more severe health issues such as stroke, heart disease, diabetes, and cancer, I saw the writing on the wall. My super morbid obesity was literally killing me, and my future seemed bleak and hopeless. Due to my ever growing weight and developing serious, chronic health conditions which made my life excruciating painful and miserable physically and psychologically, I still had suicidal ideation, conducted detailed research on methods for ending my life, and even began to make active suicide plans. Fortunately, President Barack Obama successfully passed the Affordable Care Act, commonly referred to as “Obamacare.” Obamacare was the first time in my life I had the opportunity to obtain health insurance as an adult. Luckily, I also discovered Dr. Peter C. Ng, MD, FACS, FASMBS at Rex Bariatrics and their amazing UNC Rex Health bariatric surgical team in Raleigh, North Carolina. On Monday, October 6, 2014, I underwent a form of bariatric (weight loss) surgery called the duodenal switch with Dr. Peter Ng at UNC Rex Hospital in Raleigh, North Carolina. Thanks to Dr. Ng and his compassionate bariatric team at UNC/Rex Healthcare, my recovery was finally back on track. Science, not religion, literally saved my life. My closest friends volunteered to help me many times, and they're absolutely critical to my success. Cathy took me to all my doctor’s appointments and was my biggest cheerleader. Joni was another amazing mentor and took excellent care of me at home while I was recovering from surgery. I would not be alive today if it weren't for Barack Obama, Dr. Peter Ng, Cathy, Joni, and other dear friends. I learned how to eat a healthy diet and began an exercise regimen to help take off all the excess weight. I worked tirelessly and pushed myself to the limit in terms of my diet, exercise, and lifestyle transformation. It was very difficult to say the least, but I succeeded, not through prayer or faith in God, but through hard work, sheer will, grit, perseverance, determination, and tenacity. Ultimately, I lost 191 lbs – a weight loss I'm very happy and pleased to report I’ve maintained to this very day. I now weigh 130 lbs, which is exactly what I weighed when I was 18 years old, and I have a very healthy BMI of 21.0. Since I've lost and kept off such a massive amount of weight, I no longer have any of the aforementioned health issues; they’ve all completely resolved themselves, for which I am very thankful. I eat a healthy diet, am physically fit, and lead a physically active, robust lifestyle. My friends lovingly refer to me as the "Energizer Bunny." I am happy and healthy now. I continue to take antidepressant medications and to see my psychiatrist and therapist because major depression is prone to relapse without ongoing treatment. I've developed a strong, iron-clad support system of compassionate, caring, kind, empathetic, generous chosen family and loved ones, all of whom I'm incredibly grateful to have in my life. I do not begrudge faith to people who take comfort in religion; however, the toxic form of Christianity that consumed my childhood nearly ended my life. I was saved by science and human compassion. My will to keep fighting came not from a belief in a reward after death, but from learning of the inherent value each of us has here on earth while we are alive and breathing. I visited my bariatric surgeon Dr. Ng for my annual follow-up visit last year on Wednesday, October 1, 2024. I received my blood work test results, and my labs were "perfect." Every year, Dr. Ng laughingly tells me my blood test results are better than his own! Dr. Ng is, without a doubt, my favorite surgeon since he literally saved my life. I’m exceptionally grateful for him and his expert surgical skills in performing the duodenal switch bariatric weight loss surgery on me, and I’m also tremendously thankful to the entire UNC Health Rex medical team. Sunday, October 6, 2024 marked a significant date in my life; it was my ten-year surgiversary. In case you aren't aware, a surgiversary is the anniversary of a surgery, most commonly associated with bariatric (weight loss) surgery, a medically necessary surgical procedure which profoundly changed my life with the best possible outcome. I’ve been grateful and fortunate to find peace, bliss, happiness, and joy in life without the need for religion or belief in a god or higher power. I absolutely love my life, and I'm beyond excited and thrilled to experience all the fantastic joy and happiness that life has to offer. I finally love and truly believe in myself. I'm an outgoing, hardworking, highly energetic Taiwanese American leader and activist. I’m self-employed and work tirelessly at multiple contract and freelance paid positions. My roles include working as a private military defense contractor with the U.S. Department of Defense by assisting active duty U.S. military personnel with their Mandarin speaking skills at a U.S. military base, as a Mandarin speaking private tutor, as an independent film & media contractor for Rob Underhill Productions, as a freelance writer & editor, and as a social media marketing manager. I'm a multicultural individual with a global mindset. I'm known for my values and strength of character: ethics, integrity, perseverance, resilience, and tenacity. Brimming with confidence, commitment to excellence, fervent drive to succeed, innovative thinking, and positive, can-do, go-getter attitude. My passions and strengths include professional networking, social media marketing, event planning, business development, communication, leadership, writing/editing, and team building. I'm well-connected politically and socially including CEOs, VPs, C-Suite executives, elected government officials, directors, leadership, management, business owners, entrepreneurs, physicians, attorneys, engineers, sales & marketing, real estate brokers, creatives, musicians, artists, innovators, and other powerful community leaders at local, state, and federal government levels, U.S Department of Defense (DoD), Fortune 500 companies, and nonprofits in Raleigh/Durham/Chapel Hill/RDU/Triangle, North Carolina, United States, Taiwan, China, and elsewhere around the world. I'm passionate about personal growth, living a fulfilling, purposeful life, and highly value community engagement. Most importantly I love volunteering, inspiring and motivating others, “paying it forward,” and having a positive impact on the community and world around me. I spend much of my free time performing charity work, volunteering at my alma mater UNC-Chapel Hill, promoting business owners, and volunteering and canvassing for Democratic politicians and elected government officials at local, state, and federal levels of government. I'm active in volunteering with many nonprofit organizations, mainly secular and non-religious, although I've cultivated and maintained dear, loving friendships with Called to Peace Ministries, a Christian-affiliated nonprofit organization that provides advocacy, education, support, and practical assistance to domestic violence survivors. In addition, I love volunteering to help people who are struggling with their own weight loss challenges, and I always hope my own story will inspire them. The causes I hold closest to my heart are ending domestic violence and abuse, ending poverty, promoting secular humanism, critical thinking, and science education, advocating for separation of church and state, supporting mental health advocacy and research, supporting social, economic, and racial justice and diversity, equity, inclusion, and helping people who are overweight and obese in their journeys to lead healthier, more physically active lives. I'm extremely active politically and have volunteered countless hours for Democratic political candidates' campaigns in Wake County/Raleigh/Triangle/RDU/RTP, North Carolina with their successful election and re-election to elected government office positions. In addition, I'm very active in the secular humanist movement by participating in local, state, and national meetings and conferences with my favorite organizations including The Freethought Society, Recovering From Religion, American Humanist Association, and countless others. I also enjoy volunteering for other liberal, progressive organizations that support ending domestic violence, advocating for mental health, women's rights, gun control, comprehensive sex education, socioeconomic and racial justice, diversity, equity, inclusion, and more. I enjoy cultural arts such as traveling domestically and internationally, learning about different languages and cultures, attending plays/theater and comedy shows, visiting museums, and going to concerts and hearing live music. I've traveled all over the United States, Canada, Mexico, Caribbean, and Asia including Taiwan, Japan, and Singapore. I'm physically active, love adventure, and enjoy experiencing nature and being outdoors. I love spending time in nature and exercising outdoors, especially hiking and ziplining. I've also done parasailing, flyboarding, canoeing, kayaking, sailing, cruising, whitewater rafting, and been given countless opportunities to experience many other awesome adventures I'd never received before. I absolutely live life to the fullest. This is the happiest I've ever been in my entire life, and I want to help others improve their lives and feel the same joy as I do. If I can do it, you can too! Even if life seems bleak and dark and you feel like quitting, DON'T GIVE UP! I promise you, life gets better; I'm living proof of that! I suffered through countless seemingly insurmountable adversities, barriers, challenges, and obstacles in my lifetime, but I also became a more empathetic, compassionate, loving, and kind human being. I'm a resilient and tenacious survivor and thriver. I'm an unstoppable force of nature to be reckoned with; there's absolutely nothing in the world that can stop me. My experiences have made me absolutely fearless: I fear nothing and no one. My long-term goals are to become a published best-selling author, a highly sought after public motivational speaker, and to give TED talks. I want to speak to audiences around the world about my journey, grit, perseverance, resilience, determination, strength, and tenacity, and to inspire and motivate others to do the same. Thanks so much for reading my story; feel free to share if you’d like and reach out to me if I can help! I attached a photo of Dr. Peter C. Ng, MD, FACS, FASMBS and me at UNC Rex Bariatrics Healthcare taken on Wednesday, October 1, 2024. (10-year surgiversary celebration of my duodenal switch, a bariatric surgery that Dr. Ng performed on Monday, October 6, 2014)

@MrBeeswax I'd say the same thing, there are no limits here. I've looked through a number of scientific papers on weight regain and insufficient weight loss after bariatric surgery and about the only thing you'd find if you do the same is that the data is all over the place. I've seen numbers from as low at 10%, all the way up to 80% of patients regain some weight. The reason for that is there's very little consensus on defining what weight regain even means. If, for example, I lose too much weight, then gain back a bit, some studies would include me the the weight regain numbers. I'd say that's a healthy thing to have happened. I suspect @SouthernSleever fits into that category, though I obviously don't know for sure. One other thing you'll find in those studies is that a lot of the patients that regain a lot of weight or failed to lose enough weight tend to be "non-adherent", meaning it's their behaviors, not the tool that's the real issue. We say this a lot here on this board, but it's worth repeating: Bariatric surgery does not fix your head. If you're not willing to commit to learning how to eat better and move more, then you too may be one of those that "fails" bariatric surgery. I would strongly urge you to keep that in mind if you do pursue surgery. You absolutely can reach a healthy weight, but surgery is not a miracle cure. I takes a ton of hard work and commitment to be successful.

There are no limits to what you can lose, nor is there anything that says you will regain any specific amount, or frankly that you will regain anything at all. I think we do ourselves a HUGE disservice (and bariatric doctors are bad about this), by thinking in terms of what's "normal" or "average". Keep in mind that averages are determined by people that regained everything, as well as those the are clinically underweight. I would strongly urge you to stop thinking about what you can expect, and start thinking about what you want.

@WendyJane made a great point. I sort of assumed you were getting your protein other ways, since it's certainly possible to do so without eating meat. That said, transitioning to vegetarian or vegan would be really hard to do right after bariatric surgery. While that sort of diet can be a healthy choice, getting enough protein has to be your main goal. Hopefully your team gave you a minimum protein goal. If not, at 3 months out I would want to see at least 70 grams per day minimum, with 100 as a better goal. As you get to 6 months, 120+ would be ideal, though even more is beneficial. We focus on protein during weight loss for several reasons: Protein is essential to your body. While you also need a small amount of essential fats, you could in theory get those from a supplement. Dietary carbs are not essential because your body can convert protein and fat to glycogen to fuel your body. Protein is highly satiating compared to carbs, plus it takes longer to digest than fats, meaning you'll be full longer. Protein is actually harder to digest, meaning on average, for every 100 calories on protein you eat, you burn about 20 calories just to digest it. This means the more protein you eat, the lower your overall caloric intake compared to carbs and fats. Higher levels of dietary protein help you preserve more muscle mass as you lose weight. Because muscle is more metabolically active than fat, the more muscle mass you preserve as you lose weight, the more calories you'll burn, even at rest. In short, protein, protein, protein. You really can't eat too much protein at this point after surgery.

You said that you stopped eating meat, are you taking Protein supplements like shakes? You should be having a high protein diet and not so much in carbs, and some veggies are carbs, like peas for example. Fruit has natural sugar in them, you should be focusing on protein. I strongly urge you to talk to your dietician with your surgical team, and make a better diet plan than what you are on. Something you can do in the meantime is to look at the bariatric bowls and plates available on Amazon, and look at the portion sizes of fruits and veggies, then look at the size of the plate for protein. It may not be what you are eating, but could be your portion size. But based on your initial post, you are eating fruits and salads, you are not focused on protein. I say again, check with your nutrition specialist with your surgical team. I will say what others have, 60 pounds is a good amount of weight to lose. Remember that your surgery is a tool, and not a cure. It takes time to gain the weight, it will take time to lose it, when you are eating correctly and as your nutritionist says, contact your surgical team. Congratulations on your journey, you are doing great so far!!