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My surgery is scheduled for November 3rd and I am now on my 2 week pre-op diet. I have SO many people trying to talk me out of the surgery and telling me I don't need it. I have so many questions and I am just praying I make all the right choices as I have tried everything previous to this decision. Any and all suggestions and advice is appreciated. I have Multiple Sclerosis so this decision was for health reasons. Sent from my SM-S515DL using BariatricPal mobile app

Hi all. I've been lurking the past few weeks, researching heavily. My insurance has cleared me for sleeve but I'm not as sure now as I was when I chose that surgery. My last hurdle is labs and upper GI. I'm bouncing back and forth between sleeve and bypass. My doubts about the sleeve include the risk of developing GERD. I see a lot of revision stories and I don't want that. My main reason for choosing the sleeve was to keep the pyloric valve intact and avoid dumping. It also seems to allow normal medication action - I take a number of meds. I'm creating a list of questions for my surgeon because I want to make the best choice but man, I must admit to feeling dizzy with all this information. It's a big step. I'll save my dietary questions for another post. Thanks already for the great information I've gotten from reading through this forum!

Nothing other than walking. It can last a few days to a week or so. Mine lasted about 5 days. Pain killers do nothing. Just walk it out and it will get better. If the pain becomes unbearable then i suggest calling your surgeon and see what they say

I went down to 200lbs the day of surgery, I'm 3 weeks out & have lost 15lbs. I read a passage in my bariatric handbook that basically said, 'Your metabolic rate is higher when you weigh more, meaning you lose more doing less. Weighing less will slow that down. Essentially, the surgery will help you when losing weight is at its hardest.' Aka, this will help us lose those stubborn last pounds! Its very encouraging for me

Medical Groups Replace Outdated Consensus Statement that Overly Restricts Access to Modern-Day Weight-Loss Surgery NEWBERRY, FL – Oct. 21, 2022 – Two of the world’s leading authorities on bariatric and metabolic surgery have issued new evidence-based clinical guidelines that among a slew of recommendations expand patient eligibility for weight-loss surgery and endorse metabolic surgery for patients with type 2 diabetes beginning at a body mass index (BMI) of 30, a measure of body fat based on a person’s height and weight and one of several important screening criteria for surgery. The ASMBS/IFSO Guidelines on Indications for Metabolic and Bariatric Surgery – 2022, published online today in the journals, Surgery for Obesity and Related Diseases (SOARD) and Obesity Surgery, are meant to replace a consensus statement developed by National Institutes of Health (NIH) more than 30 years ago that set standards most insurers and doctors still rely upon to make decisions about who should get weight-loss surgery, what kind they should get, and when they should get it. The American Society for Metabolic and Bariatric Surgery (ASMBS) is the largest group of bariatric surgeons and integrated health professionals in the United States and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) represents 72 national associations and societies throughout the world. "The 1991 NIH Consensus Statement on Bariatric Surgery served a valuable purpose for a time, but after more than three decades and hundreds of high-quality studies, including randomized clinical trials, it no longer reflects best practices and lacks relevance to today’s modern-day procedures and population of patients," said Teresa LaMasters, MD, President, ASMBS. “It’s time for a change in thinking and in practice for the sake of patients. It is long overdue.” In the 1991 consensus statement, bariatric surgery was confined to patients with a BMI of at least 40 or a BMI of 35 or more and at least one obesity-related condition such as hypertension or heart disease. There were no references to metabolic surgery for diabetes or references to the emerging laparoscopic techniques and procedures that would become mainstay and make weight-loss surgery as safe or safer than common operations including gallbladder surgery, appendectomy, and knee replacement. The statement also recommended against surgery in children and adolescents even with BMIs over 40 because it had not been sufficiently studied. New Patient Selection Standards — Times Have Changed The ASMBS/IFSO Guidelines now recommend metabolic and bariatric surgery for individuals with a BMI of 35 or more “regardless of presence, absence, or severity of obesity-related conditions” and that it be considered for people with a BMI 30-34.9 and metabolic disease and in “appropriately selected children and adolescents.” But even without metabolic disease, the guidelines say weight-loss surgery should be considered starting at BMI 30 for people who do not achieve substantial or durable weight loss or obesity disease-related improvement using nonsurgical methods. It was also recommended that obesity definitions using standard BMI thresholds be adjusted by population and that Asian individuals consider weight-loss surgery beginning at BMI 27.5. Higher Levels of Safety and Effectiveness for Modern-Day Weight-Loss Surgery The new guidelines further state “metabolic and bariatric surgery is currently the most effective evidence-based treatment for obesity across all BMI classes” and that “studies with long-term follow up, published in the decades following the 1991 NIH Consensus Statement, have consistently demonstrated that metabolic and bariatric surgery produces superior weight loss outcomes compared with non-operative treatments.” It is also noted that multiple studies have shown significant improvement of metabolic disease and a decrease in overall mortality after surgery and that “older surgical operations have been replaced with safer and more effective operations.” Two laparoscopic procedures, sleeve gastrectomy and Roux-en-Y Gastric Bypass (RYGB), now account for about 90% of all operations performed worldwide. Roughly 1 to 2% of the world’s eligible patient population get weight-loss surgery in any given year. Experts say the overly restrictive consensus statement from 1991 has contributed to the limited use of such a proven safe and effective treatment. Globally, more than 650 million adults had obesity in 2016, which is about 13% of the world’s adult population. CDC reports over 42% of Americans have obesity, the highest rate ever in the U.S. “The ASMBS/IFSO Guidelines provide an important reset when it comes to the treatment of obesity,” said Scott Shikora, MD, President, IFSO. “Insurers, policy makers, healthcare providers, and patients should pay close attention and work to remove the barriers and outdated thinking that prevent access to one of the safest, effective and most studied operations in medicine.” The ASMBS/IFSO Guidelines are just the latest in a series of new recommendations from medical groups calling for expanded use of metabolic surgery. In 2016, 45 professional societies, including the American Diabetes Association (ADA), issued a joint statement that metabolic surgery should be considered for patients with type 2 diabetes and a BMI 30.0–34.9 if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. This recommendation is also included in the ADA’s “Standards of Medical Care in Diabetes – 2022.” About IFSO The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) is a Federation composed of national associations of bariatric surgeons and Integrated Health professionals. Currently, there are 72 official member societies of IFSO, as well as individual members from countries that thus far have not formed a national association. IFSO is a scientific organization that brings together surgeons and integrated health professionals, such as nurse, practitioners, dieticians, nutritionists, psychologists, internists and anesthesiologists, involved in the treatment of patients with obesity. About ASMBS The ASMBS is the largest organization for bariatric surgeons in the United States. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.

It sounds to me like you've already identified some things you know you could change. I'm a big believer in making lots of small, but sustainable changes, rather than huge diet "resets". By that I mean, maybe for the next couple of weeks, you simply make sure you stop at only one glass of wine at night. Then maybe it's cutting the wine down to every other day, or maybe limiting yourself to 1 or 2 bags of chips a week. Try and make just one small change every 2-3 weeks until each small change becomes the new normal for you. Only then, add in another change. I think most people try to drastically change everything all at once and that rarely works. Again, I think you know what you need to do to get back on track, the trick is taking it step-by-step and turning the "bad" habits into good ones.

Thank you. This is very helpful. I don't eat a ton of "bad" food, but I eat one of those small kids chip snap bags several days/week. I pick at food as I prepare dinner. I have a glass (or 2) of wine with dinner, and then night eating puts me over the top. Not bad food, but too much food. I have to get this situation under control. I have to increase the vegetables and go back to protein shakes to cut back on calories. I already go to the gym twice per week and get very respectable workouts in. My goal has never been to be skinny. I'm ecstatic at size 8 and very satisfied at a size 10. I'm at least a 14 at this point and I'm beside myself!

Well I’m guessing your maintenance diet is a little different than your weight loss phase of the diet. I’m thinking you just have to go back to the weight loss phase. I have gained too and that’s my plan. I am going back and forth as to whether I should start with a week of my liver shrink diet which was basically two shakes and a lean protein and veggie dinner.

Same thing with the lack of sugar cravings. If I start getting a craving for chocolate I just have part of a Fairlife chocolate shake. The other part that's been easy for me is the lightened mental load of this weight-loss process. I used to agonize over calories and carbs eaten. I would track everything and make a point to workout several times per week. I would beat myself up over slip-ups and cheats. I was always thinking about my next meal. Now I'm less stressed and making better choices in general. The weight is steadily coming off and for the first time I don't have to fight my metabolism tooth and nail.

So, my surgery original date was scheduled for September 15th, 2022 for bypass. But unbeknownst to me found out i have condition called Situs Inversus, which is basically all my organ are on the opposite side of my body. My surgeon had not ever seen or yet had any experience with this and decided not to proceed with the Gastric Bypass. So i was closed back up and sent home 😕, and disappointed 😞. Last week my care coordinator sent me some referrals from Christiana Care in Delaware, PA, i live in North Carolina so just wondering if anyone here has had any experience with the providers at this facility and if they could help me with my awesome anatomy. I've done some research on 2 that interest me but there bio really doesn't go into detail 😕. So just trying t figure this out and hopefully not get disappointed and discouraged again thanks all

Also, the written instructions are sometimes just boilerplate, created for general cases, and sometimes not even bariatrics, and sometimes they just go obsolete and haven't been updated, so certainly go with what instructions you get personally from your doctor or RD (and sometimes even that will vary.) The post op discharge instructions given to you by the hospital can be some of the most generic (often written more by lawyers than be doctors....) and can conflict with what your doctor will tell you - go with the doctor's instructions. Sometimes the guidebook given to you by the bariatric program may be a bit out of date - I have seen some be told by their doctors to advance to the next stage now, even though that may be a week or so in advance of what the book said, with the doc telling them that "we have learned that the patients are doing better by going a bit faster, and we'll change the book next time we print some..." Again, go with what the doctor tells you.

+1 i had like 4-5 partial drinks during entire weight loss phase. Now, i am what one would call a regular drinker (some may even, dare i say, call me an alcoholic). I was a drinker before surgery as well. (Though before surgery I would drink lots in a short amount of time, every few weeks, now i drink less at a time, but more often). My increased drinking frequency had a lot to do with Covid lockdowns starting in 2020 though. From a weight-loss perspective, what little i did drink during weight loss phase did not seem to affect ME in getting to goal. Nor does the amounts i drink now seem to affect my ability to maintain my current weight (note though that i simultaneously keep an eye on my total calories - alcohol or otherwise- , so there’s also that) I get tipsy quite fast post-wls (and on small amounts), but I also sober up in record speed. As others said above, if you really want to, try it out and observe how you react, and then decide if want to again. Or, don’t. Up to you…you know yourself best. Sincerely, An alcohol-drinking-DRINKER (from Canada). (i also smoke, drive above the speed limit, and am late paying my taxes this year…)

I am planning on using short term with FMLA. I just used for hysterectomy and they called me at two weeks to see if I was back to work kr if they should extend claim. It could vary by policy. I am calling today to get things started as they will have paperwork mg dr needs to fill out so I want to take it to my preop appointment. Sent from my SM-G998U using BariatricPal mobile app

Doctors are all over the map with their opinions on drinking post WLS, probably similar to their views on drinking to begin with if I had to guess. My team said it was okay at three months for a special occasion. I have to say it’s not the same as it was pre WLS. I may be one of the few willing to admit but when I drink I do it to get a buzz, lol. Post WLS the buzz comes and goes in like ten minutes for me. I can’t drink fast enough to maintain it and probably would kill myself trying. It’s almost not worth it to me. Waste of calories. That being said my real advice is if you do decide you want to do it try it at home first. Your body may react welrd and the last thing you want is to feel sick or get sloppy drunk on your birthday off one drink. And make sure there is a designated driver around. I still worry about how long it stays in our system and all that being different than before.

I'm 5 weeks post op and live in Sydney Australia. I'm feeling quite good no serious side effects from my banded gastric sleeve. Started my journey end of July and have lost over 20kgs so far. I set myself a goal and decided that when I hit 20kgs loss I would go and get my hair done professionally. Haven't been to the hairdresser in about 5 years. Set yourself small goals and reward yourself because you deserve it. This is not an easy process to go through so make sure you follow through with your rewards

The truth of the matter is not everyone reaches the goal weight they have chosen. And not everyone maintains that weight if they do attain it. Remember the average weight loss at three years post surgery (bypass or sleeve) is about 65% of the weight you had to lose to put you in a healthy weight range. Genetics, your body’s set point, lifestyle choices & preferences, age, gender, health & medications, etc. & yes a little complacency. But there’s nothing wrong with any of this. Any weight loss is a win. You may find a conversation with your surgeon, doctor & dietician helpful.

2 weeks post op now, feeling great. I moved on to puree food today- cottage cheese never tasted so goo!!

Hello all so.my original surgery date was September 15, 2022, was on the made.it through my 2 week pre op diet. Even made it to the surgery table , cut open only to find out i have a rare anatomy called Situs Inversus which means all of my organ are on the opposite side. The surgery had never seen anything like it before and i didn't even know i am like this,and you dont until you have a surgery. So my bybass didn't happen because the surgeon didn't have experience with my unique 🙃 anatomy a nd wasn't comfortable performing the procedure. But on a good note was recommended to another facility with hopefully surgeons that have the experience to perform the surgery so im starting all over agian. Im a little discouraged, but at the same time keeping a positive attitude 😌 🙂

I hit my 1 month today. I’m down 8.7 lbs since surgery, almost 27 from sept 5 when I started my preop diet. I started at 220 and I’m at 193.3. Last week I hit the stall and it was starting to be discouraging and then boom more drop. I was cleared to work out so I have been back in my peloton. I want to go biking outside while the weather is still nice but I’m still afraid of getting hurt. My incisions have healed and I started using a scar remover to try to lighten the scar. My family has noticed my weight loss as have my coworkers. My clothes are starting to actually fit me, instead of being so tight. I also took my kid to an amusement park and was able to walk the whole day- 15,000 steps and while I was exhausted, my knees didn’t swell up and my feet didn’t give out as they would have 27 lbs ago.  I’m having challenges in learning what satisfied feels like. I’ve been basically either hungry or just stuffed. The only thing I’ve been asked not to eat is a salad so I have been prioritizing eating the protein in my plate. My partner made my favorite- rice and lentils with chicken- and I couldn’t even get a bite of the lentils in- the chicken was the priority and it kept me full for hours. My biggest struggle right now is eating slowly. I eat on the go- I’m working consistently and eat at my desk (im a lawyer) so it is hard to find the time to eat a meal for 30 minutes 3 times a day. I think once I get to do this, then maybr I’ll learn the difference and learning when I am satisfied. I’m still struggling with Water intake- it’s hard to take small sips and get through 64 ounces bc I’m busy. And big gulps are just a no no. Getting there though. Today my therapist asked if I had made the right decision. I told her yes. I believe the surgery saved my life and quality of life. I was down a spiral and would have easily found myself heavier, more depressed and with pain everywhere. My chest pains are gone; my joint pain is gone, and while I am exhausted (more due to long days and I think less due to surgery), I know that my quality of life is improving. All in all, not bad for a month ;)

Thanks, I definitely do feel like some days I am way hungrier than others. I have gone from the 600s to 700-800 in terms of calories but that’s with adding exercise back in this week so it probably makes sense.

I’m finally feeling “normal”?? I started a stall at 3 weeks and this week (my 5th week) it FINALLY broke. Thanks to helpful advice here especially the post from @SpartanMaker describing the why’s of stalls. It was water retention...and how do I know this? Because it started at 3 weeks and also this week the volume of pee vs consumption just went to a whole new level! I should have realized something was way off with that because I was drinking the recommended amounts but not peeing nearly as much as I would prior to surgery. I also upped my protein just because 40g wasn’t cutting it so I’m really really trying for 60 now. Also, started a MiraLax every couple of days and Benefiber daily program....big help there also. All of these things have made a huge difference and I feel so much better. I, too, am making an effort to get walks in every day. I’m working on weights twice a week but I need to get with my team on that. I was told no more than lifting 5 lb weights but that seems insanely ridiculous. Also, not sure when I can resume any ab work (not that I’m begging to do planks and sit-ups....) I hear you all on the fluid intake when we can only hold so much AND there are hours around meals when we can’t drink...it’s really hard. The mathematics that it takes to keep all the timing, portions, tracking and vitamin regimens is something else! 😂😂 We all need a pat on the back for determination and perseverance - good job everyone!

This is what I wore to school on Tuesday this week.

I am five weeks, in a stall and lost 30 as well We got this.

I am 5 weeks post op and have been stalled for the past couple weeks. I guess I can’t really complain about that though cause I did drop 30 pounds in the first few weeks. Things got so much better for me as far as nausea when I decided to go against the plan of puréed food and just skip to soft food. My body tolerated that a whole lot more. Is it why I am stalled? Maybe… but in the long run I had to do what was best for my body. I was not getting the nutrients I needed to even survive. Hopefully I am on the back end of the stall and about to start dropping again. I have been super busy at work and at home. I did have an upset by losing a baby(puppy) but she was my baby! Life goes on though and we persevere! Y’all all keep up the good work! No one has left that I know of I think we have all just been busy in our own ways! And for those that wonder about the earlier dirty and sick posts that situation seems to be better since I moved to soft foods as well!!🤣

doing low carb of 50 total carbs now for pre op diet and it’s hard!! (If i could minus fiber it wouldn’t be so bad) and it has caused some intermittent issues due to reduced fiber intake (consuming some supplements now that i don’t count towards my 50 total, but would much rather use dietary fiber in foods) i went through the “keto flu” back in August (foggy head, achy feeling , low energy) in about three days. I also was ravenously hungry early on. my brother suggested that I increase my fat intake and that did the trick. I made cream cheese and peanut butter “fat bombs” with sugar free chocolate chips and monkfruit… scooped them with a 3/4 ounce scoop and ate two of them a day as snacks and it made the hunger disappear! i do not think i could do this low long term, personally, but will be integrating the low carb approach into my post op dietary lifestyle. Being very selective with any sugars, flours and starches is fine.. but it’s hard for me without being able to have much beans/legumes/peas/etc. I would kill for a big bowl of refried beans for dinner, but the total carbs are just too high pre op unless I am super cautious all day.