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Congrats on your weight loss so far. Feeling hungry could be from diet boredom. Is it real hunger or head hunger? Now you’re on a regular diet, can you switch up some of your food choices? I added seafood (fresh fish, prawns, etc.) to my diet, tried different vegetables & new recipes through out the weight loss phase to keep things interesting. Try some plant based proteins if you’re open. I’d check your protein intake as @Pckeys suggested. Protein will keep you feeling full for longer. You can always add a little more even if you are meeting your goal. My pre surgical diet was keto too but now in maintenance my diet is way more balanced. For example, I still avoid most root vegetables, rice, bread & pasta but do eat small serves of whole or multi grains in other forms. I keep my fat intake low. I did eat rolled oats during weight loss but that was the only obvious carb I ate except for those that occur naturally in foods like in fruit. Some of the readings I’ve done about keto is that it should be for the short term not for life. However, I believe avoiding carbs during weight loss certainly helped me reach & exceed my weight loss goal so I'd be reluctant to add more at this stage but that’s my opinion. It does take time to work out what will work for you for weight loss then maintenance. Good luck.

Although 800 cals isnt going to break the bank, you dont mention your protein intake. Getting too little protein can keep you feeling deprived/hungry all the time. I'd first start adding more protein (either with shakes or real food or combo of both) before worrying about upping calories/carbs. Other thing I'll say, and I'm sure to get flack over it, some interesting studies coming out suggesting a low calorie keto diet will preserve BMR (Basal Metabolic Rate) better than a higher carb intake of equal calories.

I had ESG on June 19th. So far (8 weeks post op) I have lost 25 pounds and I'm half way to my goal of 140 pounds. Average loss the last 4 weeks has been 2.2 pounds a week. I've been able to stick to my meal plan pretty well by consuming less than 650 calories a day and getting in my requirements. I have tried to keep carbs to less than 40 grams per day. I have just started the regular diet phase. The last several days I have felt hungrier and I'm feeling deprived by the lack of variety. I am thinking about increasing my calorie intake to about 800 on a few days each week by increasing carbs. I guess keto for life isn't for me. Is this a bad idea? Any suggestions would be helpful.

All of this low-carb/keto/whatever stuff might be marketed as "healthy" and/or "good for weight loss" but all of these snacks and treats still contain calories (and usually a truckload of various chemicals), a lot of the time not even significantly less calories than the original stuff while having to pay triple the price. I personally think these kinds of foods (the ones trying to mimic something else while claiming to be healthier) are usually a rip-off. Of course there are exceptions and depending on the reason it can make sense to buy the mimicking thing, e. g. buying soy or almond milk or lactose free milk when one is lactose intolerant even though the substitutes are more expensive.

I'm on maintenance and eat low-carb, low-fat snacks to satisfy my sweet tooth. They are harder to find, since Keto is all the rage now, but I get most of mine from the Bariatric Pal store. I still have to watch how much of them I eat. There's a temptation to overdo it because they are "safe" foods.

Are you still in weight loss phase? Keto snacks, while low in carbs, are high in fat, and still pack alot of calories.

Do ya'll think those low carb-keto snacks and desserts are a slippery slope to falling back into bad habits? Those "brownie thingies" sure look good. 😩

If you’re not eating low carb now, I’d suggest trying keto. I usually drop 5-6 pounds in my first week because of the water weight

Did someone say shortbread?! AND low-carb?!? More details pls: was it comparable to hones-to-goodness shortbreads? I have yet to come across a keto/low-carb recipe that can stand up to my high dessert standards, lol. Looks really good though! #yummmmmer

Also, do you guys count your carbs by the full amount on the ingredients list, or do you deduct the fiber & sugar alcohol content, like people do who do Keto (counting macros)... When I say I eat less than 20 carbs - I am calculating it with the fiber & sugar alcohol subtracted.

I am also a 2014 vet. I too had some regain. Here's the story for me...about 18 months after my op I left a long term career position, took a night, started grad school, switched to a leadership job, lost a parent unexpectedly, graduated grad school, went back for PhD, and more. When I had surgery, one of the main issues was a health problem that was considered reversible. In 2017 after some regain, my GI doc gave me some sobering news that it was returning. I had a serious 'come to Jesus' talk with myself. I went online looking for solutions. I sought my team. I went to some support group meetings (even online). I met with my nut. I met with a surgeon. After being given the option of a RNY revision, I realized that I KNEW WHAT TO DO, AND I HAD THE TOOL...I went full on Keto and never looked back. I am now at my lowest ever. I lost all the regain and then some. I realized through the process that FOR ME, I must always identify as a bariatric patient. I will NEVER be able to eat 'everything in small amounts'. I will always struggle. Surgery saved my life, yes, but it didn't fix my weight permanently- it did part of it but the major work was up to me. I would suggest seeking out support from your surgical team, support group, nut, psych, etc. ANYONE who is part of a bariatric practice. And start from scratch. Dense protein. Water. Shakes if necessary. Skip the 'reset' and all those things. Obviously regain comes from EATING so you have to relearn how to eat as a bariatric patient. It is absolutely possible but there are many of us here on the same timeline as you who have already been through this and are willing to help!

I’m having VSG surgery September 4th at Pompeii Surgical in Tijuana Mexico, I don’t have a Facebook and really no interest to create one and I’m looking for a sense of community or maybe some people who are having surgery near my same date? I have a weight loss Instagram (I did keto for a year so it’s mainly from that, I am not telling them about surgery until post op) . Is anybody having VSG near my date or have experience to share at Pompeii Surgical?

I read a few of these when I was considering surgery and I promised myself that I would do the same thing once I was post-op so that maybe I could help anyone who may need to know the details (like me), or anyone sitting on the fence at the time (like me), or just looking for signs that this was the right thing to do (me again). I discussed the sleeve surgery with my doctor over 2 years ago after countless weight losses and re-gains. That's basically been the story of my life forever. I was a chubby kid, I've never been thin. I probably starting yo-yo dieting when I was 15 and I had my 1st boyfriend. I've done all the diets. Starvation, jenny craig, weight watchers, nutri-system, herbalife, keto, low carb, optivia, ideal protein, bars and shakes, etc... the list could go on and on. I'd lose the weight (sometimes), I even got down to a size 6 when I was about 38. But eventually, overeating called my name and I'd be back to where I started plus 10. Relatable huh? It's not even that I eat poorly, to be honest. Yes I love bad and delicious food, fast food, desserts, etc... but 80% of the time, I am eating a home-cooked meal with veggies and protein (and likely a starch), I just eat too much. My appetite is monstrous. I'm 4'11 and I can eat the same size plate as my husband who works out every day. I come from the 'clean plate club' and always finish my meal. In discussing the sleeve with my doctor he agreed it was going to be the solution I was looking for. Then I told him I wanted to go to Mexico and he agreed that travel tourism can be wonderful (he sends patients to Brazil for plastics) and that he wanted to be part of the decision making process for the doctor. So I took my list of 25 candidates that Facebook told me were awesome, and I narrowed them down to 3 choices: Dr Alvarez, Dr Elias Ortiz and Dr Illan. I presented them each to my primary care physician in the states with their resumes and credentials, we got on a zoom call to discuss the 3 of them and he told me that Dr Illan was his 1st choice, hands down. He chose Dr Illan because he is a board certified master surgeon, his anesthesiologist is also board certified specifically for bariatric surgery, his hospital is private and has an ICU, his hospital has been given awards of excellence, and he only performs 3 surgeries per day. So I called, paid my $500 deposit to get my date, and promptly pooped my pants from nerves. The 10-day pre-op came quickly and was not that bad. I was too excited to be annoyed by it. I got headaches and was hungry, but all in all it wasn't terrible. Before I knew it, my flight from Florida to San Diego was the next morning - I couldn't believe it! My bestie and I arrived in San Diego the day before my surgery (arrived Friday, surgery was Saturday) and we were met at the airport by Carlos; along with one of my surgery sisters that I had already met on Facebook. Get you a surgery sister (or brother) - find out who's having surgery the same day as you and you will become friends! We hung out a lot post-op and I've made friends for life. The drive to the border was quick and easy, before I knew it we were at the hospital dropping off the other person b/c her surgery was bright and early the next day. Carlos whisked us off to Hotel Real Inn, only about 10-15 minutes from the hospital. Mexico treats covid more seriously than we do in the US; so feet wiping, temp taking and hand sanitizing is a requirement literally every single place you go. Carlos pointed out that to the right of our hotel was a open-air shopping plaza and to the left was a grocery store. So after we got settled in, we went to explore and had such a great afternoon in Tijuana! I bought a size small goal outfit for $7 at one of the little boutiques and little knick nacks to bring home to my family. I love that my friend and I had that time to settle in and do some safe exploring. I didn't feel unsafe even for a second, its a very populated area with lots of folks shopping and walking around. That night I ordered my bariatric meal (best popsicle ever!) and my friend ordered authentic mexican street tacos from Uber for like $7. The next morning, we were picked up at 9am to head over to the hospital and get ready for surgery <insert panic>. When you get there, more sanitizing and temp checking and then you head off to get your blood drawn after filling out paperwork. Next comes, chest x-ray, EKG and just a general check up from a doctor to clear you for surgery. So I'll tell you that this part is likely the part that doesn't leave me with the best feeling. The doctor that looked at my EKG seemed to glance at it for about 2 seconds. The cardiologist is probably an awesome cardiologist, but lacked that bedside manner that we see in doctors in the states too. He cleared me for surgery and I said "so my heart looks good?" and he replied "yeah its ok" and then left the room. My bestie reminded me that that not all doctors gush all over you and that he was probably just one of those. Suddenly, Dr Illan and the anesthesiologist were in my room and it was almost go time. Dr. Illan explained the procedure and had a lovely chat with us, I didn't feel rushed or like I was asking too many questions. He explained the OR and that the surgical team in the OR were all also bariatric surgeons (not general surgeons). He told me that I was important and my safety was his #1 priority. He was so wonderful. Them standing there suddenly made me very nervous and I started to cry because I was scared. Dr Illan came to the side of my bed and rested his hand on my leg to comfort me and promised it was going to be ok, told me not to cry. It seemed to upset him to see me upset! In the meantime the anesthesiologist called for some anti-anxiety meds in my IV and I was calm again. Before I knew it, I was in the OR being asked to scoot onto the table and the nurse was signaling to me that it was time to go to sleep. I think some of the nurses in the OR don't speak English, but I speak Spanish so I told her I was ready and before I knew it - I was awake and in recovery. Coming out of being under is funny, as I'm sure many of you know. You're there, but you can't quite open your eyes. I was listening for alarm beeps of monitors or conversations on Spanish that something was wrong, but I was ok. I also had no gas pain. Everyone warns you about that gas pain and I had zero. I was in the recovery room for maybe an hour? My BP was a little high so they gave me something sublingually to lower it, but I don't remember much else. Wheeled back to my room, I spent the rest of the day hearing movies played in the background by my friend and dozing in and out of sleep. I don't actually think I slept much though. I was so groggy I could hardly stand. The nurses came to check on me often, they were giving me lots of drugs in the IV (antibiotics, anti-inflammatories, etc) and a chewable gas pill. Here's something no one told me - you do not get to drink anything until the day AFTER your surgery and you've had your leak test. All you can have is an ice cube to put in your mouth and you have to spit it back out. That's it. I had a sore throat from being intubated and I badly wanted a drink of water - but I didn't get one until the next morning. I really only got up to pee once and felt woozy. I didn't do all the walking they said you're supposed to, I definitely physically couldn't have! I was groggy to the extreme. Getting up to pee was hard enough. I didn't have any gas pain though, thank god for small miracles. My hospital stay was uneventful medically. I had low pulse ox, so had some oxygen for awhile (over 24 hours) and my BP went up a little sometimes but was controlled by the meds they gave me. The 2nd day I had my leak test in the AM and was cleared to have some fluid and had the best tasting water of my life! I sipped slowly and that 1st liquid to hit my new belly felt weird. Our instinct is to chug and you definitely can't do that. I did have some internal soreness and they gave me toradol for that and I felt fine afterwards. Sunday morning I was out in the loser's bench area with my surgery sisters hanging out. That day, we had a valet named Julio. He was AMAZING. It was my bestie's birthday and he helped me order a delicious cake to be delivered from Uber and even went to find a sign for it. We gathered our new friends and Julio gathered some staff and we all surprised her by singing happy birthday and another yummy mexican meal. It was awesome! We hung out with my surgery sisters (we met a 3rd) and their companions in the hallway and all got to know each other, it was great. Monday morning came quickly and then we met Bill and Stacy. Dr Illan came back to my room to check on me and we had another lovely chat. He told me that my stomach was big! lol I knew it was. He got a picture of it for me, which of course blew my mind. He had us take a picture together and he wished me all the luck and told me he couldn't wait to hear about my success story. We left the hospital, hit up a pharmacy, and then Miguel drove us back to the Hotel Real Inn around 10am and then we had a whole other day in Tijuana! I felt perfect so we ventured out again, hit a few shops, and went to the grocery store to bring home Mexican goodies for my family. (I had to go and buy a duffel bag for all the fun stuff I got). I ordered my bariatric meal again and took a nice shower and went to bed, ready to travel back to Florida on Tuesday. Julian picked us up at 7:45 for our 12:15pm flight (you never know what can delay you at the border) and we had an awesome drive with him. Some roads were blocked, so we were delayed but still had gobs of time. Julian lived in NYC for a long time, so he's pretty American - we loved him. We laughed and joked around the entire ride and he told us about life living in Mexico. We got on a jet plane and we came home! I've been home 3 days now and I continue to feel awesome. I'm sore and my belly is bruised (where they took my huge stomach out), but I work from home - so rest is all it I need. I haven't been nauseous once or vomited. Day 5 post op and I'm down 13.6 lbs already - since pre-op. So this sounds like a dream huh? Because it was. It was like going on vacation where I also happened to have an organ removed lol. I will tell you that I would give one piece of feedback for the ultimate experience, the only thing I thought was lacking or could've been done differently. I wish I could've met Dr Illan before I got to Mexico. It's pretty standard to have a conversation with a doctor prior to surgery and you don't get that until you're there. I wish he had emailed me personally, or had a phone call or a video chat. He could've even made me a personal 1-minute video and emailed it to me - just so I knew that he knew I existed and was going to be a patient. That would've calmed me even before I got there. I realize that a lot of people consider surgery and probably don't go through with it, so it could be a waste of time - but that's the cost of doing business. I am a business owner and have consultations with people that never hire me either. It's built into my business model and daily schedule. Not meeting Dr Illan ahead of time obviously didn't stop me from choosing him, but it almost did. The other doctors I considered contacted me directly (one with a personal video and one with a whatsapp video call). If you are thinking about doing this surgery, let my testimony help you decide that it is going to be ok. That chances are, it will go amazingly, There is this new life waiting for us that maybe we don't believe is real or we don't believe we deserve. But it is real and we do deserve it! Give yourself the gift of this weightloss to take your life back. I'm so glad I did and I can't wait to see this weight melt off me and stay off me. Having my surgery with Dr Illan was the best medical experience of my life. I felt cared for, safe, attended to, and healthy the whole time I was there. The hospital is like a resort, very modern and very clean. The nurses and valets were insanely attentive. Now go leave your stomach in Mexico!

might be due to low carbing, too. I think I've read about people having that who were doing Keto.

I tried weight watchers lost 12lbs then nothing more and I was on for 1 yr. I’ve done Keto and I eat under 1000 calories a day. I track my carbs and I only use a whole wheat, flax and oat bran pita when I have “ bread” I measure everything but my body just likes to be at 220, I work out 6 days a week. I’ve gone to Dr.’s and nutritionist and I’m still stuck here! I won’t give up tho!

weight gain during year 3 is very common - with or without PCOS. Some people have had luck with Weight Watchers, intermittent fasting, or Keto. Some just go back to what they were doing in year 1 - not all the way back to protein shakes and purees, but the whole protein first, then non-starchy vegetables, and maybe an occasional serving of fruit or whole-grain carb. If you do the latter, start tracking (if you're not doing it anymore) to see where you're averaging calorie-wise, and then start cutting back from that. I find that easier to do if I cut 100 calories at a time rather some drastic cut. different methods work for different people - so just find one that works for you. You CAN lose regain - although it's much slower and harder than it was when you were in weight loss mode.

I did the same thing trying to find different flavors I could handle... I ended up giving most of the powders and premades to a friend doing keto. I made my way through pre-op, then used Boost for diabetics while I was post-op until I didn't need to drink protein drinks anymore, and ditched them entirely in lieu of actual food.

Thanks for the reply, [mention=382689]Pckeys[/mention]. I started a Keto diet July 9th so I'm surprised it took so long to drop, based on your explanation. Anyway, it was high again yesterday so I guess I just need to be patient. SG2020 HW 294 SW 270 CW 270

I gained 20 lbs after hitting my lowest point (138). I really needed to gain the first 10 lbs of it - I'd gotten too thin. But I've been struggling to lose the last 10 because I DIDN'T need or want that part of it (have managed to lose like 3 of it -- since March! It's tough...) anyway, I still track my food intake, but I've been doing that since my surgery in 2015 (actually, even BEFORE surgery). I've made a serious effort to stay within my maintenance calorie range, which for me is 1500-1700 per day - and I'm trying to stay at the low end of that (1500). I also really increased my exercise. My primary exercise these days is biking, which I usually do for 60-90 minutes a day, five or six days a week. It's working, but it's S-L-O-W. I know if I lowered my calories even more, to like 1200, the weight would come off faster - but I'm evidently not ready or willing to do that yet or I'd already be doing it. BUT....I'm sure it would work. at this point I just count calories - and I've been doing that since I was about a year out from surgery. I can eat anything as long as it fits into my daily calorie limit. I know that doesn't work for everyone, though. I know several people who are trying to lose regain doing Keto, or Weight Watchers, or Intermittent Fasting. And many just go back to what they were doing the first year post-surgery (not all the way back to protein shakes and purees, but back to protein first, then non-starchy vegetables - and then maybe an occasional serving of fruit or whole-grain carb) it basically comes down to what works for you and what you think you'll be able to sustain long term. Losing regain is hard and it's slow, but it's do-able

this has less to do with weight loss than it does a drop in baseline insulin levels. It happens exactly as you describe when some people start a keto diet too... when you drop high GI carbs, your baseline insulin drops, your kidneys start excreting sodium instead of holding onto it and your blood pressure drops. Since you're not eating anything at the moment, you're in the same early stages of psuedo ketosis If you return to carbs during/after weight loss, your high BP may well return (although weightloss will certainly help), but it is the high fasting insulin - which causes the kidneys to re-uptake sodium - which will contribute to hypertension. If you're on BP meds, you'll want to watch this over then ext 2 months.. many of us get off the meds within the first month of so.

I agree, no top secret tips here I think the key is to find a sustainable plan that will work for you long term. What works for me (but may not work for anyone else) Logging everything I eat and drink everyday. So I know the approximate calories that I lose, maintain or gain at. Weigh myself on a regular basis. I have weight red line. If I go over that for more then a few days I know I need to make adjustments to my diet to bring my weight back down If I want to lose a little then I can do intermittent fasting which I might combine with calorie restriction. I think it is also important to be aware of what will not work for you long term. I know that I will never maintain a rigorous work out schedule. I am also very susceptible to diet fatigue and will rebel if I feel deprived. So I know that moderation works for me, and not restrictive diets like keto etc..

I only told my brother who will be taking me to the airport, everyone can just get "keto diet" but I don't like when people have wls and go on social media platforms and act like they did it without wls. Don't promote shakes, teas, etc if u r lying. Sent from my SM-N970U using BariatricPal mobile app

I did keto as my 2 week pre diet but found it challenging because I’ve never enjoyed foods high in fats. They used to upset my tummy & reflux so I’ve been low fat for decades. I was also told keto should only be followed short term not as a long term lifestyle choice. I presumed the low fat recommendation post sleeve was because of the potential for gall bladder problems after surgery. Also my cholesterol went up to 6.9 during my weight loss as it was released from my fat. Thank goodness it’s back down now with a good balance of HDL & LDL.

I haven't had surgery yet, just getting used to all this. Thanks for the information! I was on Keto prior to starting this journey so the sugar alcohol was ok for me.

Haven't been doing well the past 5 weeks..no weight loss. Letting calories sneak in during the day. COVID is driving me nuts especially with a spouse home 24/7 eating carbs and many trigger foods that they used to not eat in front of me. Getting back to business as I still have so much to lose. Down 175 lbs from highest weight ever but lost 60 lbs of that in 3 years doing keto off and on before surgery. My 1 year 'anniversary' was yesterday (7/25) so from the date of surgery I lost 115 lbs. If I had stayed on track, that # could easily have been 10 lbs more but that is not something I can stay hung up on.