Search the Community

For CIGNA, it is a 1 bariatric surgery in a lifetime thing. They will never pay for a revision, period. My BMI when i met with 1st dr was 56 (down from over 60 when I started doing keto 15+ months ago). 1st Dr actually said he would do a bypass as well due to my very high BMI and the need to get weight off faster (both knees have severe arthritis and I have to get injections to be able to walk and that is even lately...even with 52.3 lbs lost..getting progressively more painful). Knee orthos (got 2nd opinion) have said both knees are so bad they require full replacement and as soon as my BMI is under 40, they will consider doing the operation. 1st dr though, felt uncomfortable with my clotting history so he said he would only do sleeve at this time and to save up my money (which I don't have) to pay for my own revision to bypass with duodenal switch in a yr or 2. I still have mixed feelings about the 2 different surgeries..things I like and don't like about the both. Do you think I should still reconsider? I'm asking this as I'm wanting to make the best decision..not just what either dr's have said...and I'm torn although both said I needed the bypass originally.

I don't have much time as I'm in a time crunch at work, but thank you for saying this...sometimes when ppl post...especially when new and having a surgery date looming, it is not that in the back of my mind I cannot accept the answer in the end. I'm anxious, excited, fearful, relieved....and so many other opposing emotions all at the same time. These past 15 months doing keto and for a long long period in keto towards the last 6 months, getting to a point where even thinking about food became..more of a chore. Food was just...food. Honestly, I crossed the line into it being almost an inconvenience which I will have to be careful of because unlike keto when I could eat a whole chicken breast (maybe divided over 2 meals) and drink a shake and have well in excess of 80 gms of protein, this won't be ANYWHERE near as easy to do. I didn't express myself well in my post and only let my fear show through. I didn't feel like I was only searching for the negative, but I'm open to the fact that perhaps that is what I was doing. I did not elucidate the fact that I did expect some hunger pains, I just had been trying to soak up more knowledge and was on a thread where the 'true hunger pains/pangs' where...what I would call extreme in the amount of hunger (like basically never had any relief from hunger pangs ever, not even when they have consumed their protein). Maybe something else is going on for them..or maybe I misunderstood. I was just honestly...taken aback. However, that doesn't mean I stay fearful or allow myself to be trapped by the negatives. If that was true, then I wouldn't be on this board still and I wouldn't be pursuing surgery. Thank you to everyone for your input. It gave me time for additional self reflection and to process my concerns.

I do high protein, limited fat keto. So I aim for 60 or more grams of protein a day and limit to 30 or fewer carbs per day. I don;t really worry about the fat because I'm not eating foods that are particularly rich in fat. I have lost 84 pounds and have kept it off, so I know it's working. I started this modified keto plan at about 3.5 months out. It's easy for me to stick to and I'm always full.

There is reddit keto forum that has tons of information and helpful members. The current recommendations over there is to limit fat intake and eat more protein. They no longer seem to think that protein is turned into glucose. So yes, you can absolutely do a high protein, limited fat, keto. I'm currently trying to do low carb in order to increase weight loss from abdomen as that area is being stubborn. Best of luck.

I think a lot has to do with fluid and glucose levels in the muscles. As you deplete glycogen from the liver, the glycogen from the muscle tissue goes next, along with water. Then the fat starts breaking down as the final energy reserve. As we eat a bit differently each week, our glycogen levels will also fluctuate. Say you eat more carbs (starches and fruit) one week. You are going to replenish the glycogen in the muscles and the water will go with it. The next week you eat a bit differently - maybe a bit more on the keto side, and the water is going to leave. I always have slower loss with more initial exercise as well, but this is not fat gain - it is fluid and maybe even a little extra muscle mass that weighs more than fat. So stick to the plan and stay away from sugar. It all levels out. For the longest time, my pattern was 5 pounds one week and 3 pounds the next. Now it is slowing down, but that was my predictable pattern for about 2 months.

I have toyed with the idea of keto recently, too. (I'm 8.5 months out and loss has slowed considerably and I'm not ready to lose momentum). I've found that googling keto calculator brings up a bunch calculator options that can tell you how many carbs, protein, and fat you should be eating. Here's what's stopping me, though... true keto is about eating a high percentage of fat and considerably lower percentage of protein. While it will probably help us drop weight, we have to be concerned about our levels of protein because we're already on a rapid weight loss journey and need higher amounts of protein to help reduce muscle loss and maintain satiety. Just some food for thought. Like I mentioned, I'm considering it myself, but seeing the calculators has me concerned because a true keto diet would not allow me to reach the protein goals set by my physician. Realistically, by following a high protein, low carb diet, we can probably already maintain a low level of ketosis anyway, without compromising the extra protein we need to minimize muscle lost. I also have some reservations about it being a truly healthy lifestyle to maintain long term because of the high percentage of fat (it's supposed to be "good fat", I know, but we know that too much "good fat" is also bad for health) as well as the number of chemical substitutes that people use to maintain the lifestyle.

Looking for information on doing a Keto based plan. I’m 5 months post op and need ideas on how much protein to consume in a day and how many carbs. Any suggestions out there? Thank you

I am 50 and did keto this past year. Well, when I intensely focused on it, in about 9 months and NOT being able to exercise at all due to torn knee and it had not gotten warm enough to get in pool, I lost 45 lbs in that 9 months (although keep in mind I weigh a GREAT DEAL more than you so consider your possible loss on more of a % of ttl basis & if you can manage some things at this time of year like getting on pool, I still think you could lose a nice amt of weight...but I'm also so angry/frustrated on your behalf..but want to encourage you as well if Keto is your only option left) My primary dr. is huge fan of keto but my bariatric dr is not. I actually do not have cholesterol issues but my primary, who I have known now for over 20 yrs, has had other patients whose cholesterol,diabetes, etc. improved. However, I think 'impact' of keto on things like cholesterol can be very individualized. Also, my bariatric dr said if people didn't go to the 'extremes of keto' like eating a ton of beef each and every day, if they limited some of the things that we know often impacts cholesterol, then he'd be more a fan of the general approach. So yes, even at 50, I lost 45 on Keto and that was not working as hard as I could. 18 yrs ago, I lost 80 lbs on Atkins and kept it off for over a decade as I was finally able to be active and yes, was MUCH younger at the time, but hey, I did lose on Keto. I'm torn for you though and I apologize if you've answered this 100 times...does your insurance not have an Appeals process??

Are you sure it is a year before trying again? That doesn’t make sense. I honestly would try fighting it. Get measured again and don’t stand so tall, put on the couple pounds. Ask your insurance company to send you their requirements in writing so you know exactly what you need to do. If you do keto watch you cholesterols because mine went up. My dr said that is not something maintainable for the long term. Does your surgeon office have a coordinator there who can help guide you through this?

Thank yall so much for the support! Even though you have me crying again, it is great to have someone to vent to. I can’t afford the surgery without insurance help. I can reapply next year, problem is, I need to be losing weight for my health not gaining to wait another year and reapply. I am back on Keto this week... not losing yet, but hope to. I am 50 yrs old, much harder to lose than it used to be. I have probably gained and lost 1000 lbs in my lifetime. I NEED the restriction to keep it off. I have never done keto before because doesn’t seem heart healthy at all, but I have to get the weight off. Yall know of any good weight loss support groups online? Thanks again for your support.

Google “90 second keto bread in a mug” it’s a super simple recipe using almond flour. I replace the oil with 0% plain Greek yogurt. It works perfect for sandwiches !

I am sorry but this post really upsets me. You see all the health issues this woman has and fears of a heart attach how can you minimize her struggle? We are suppose to be supportive and come to this group for support and guidance. I am in the 35 BMI and struggled my whole life with ups and downs. I lost 30lbs thru keto and put it back and the dr said that was worse than the weight so I made the decision not for hopes of a bikini but for health reasons. She needs this surgery for the same reasons, so she can lose and keep off the weight. If it was so easy no one would need surgery.

I looked for a "smacks sibling" emoticon but alas, there was none. I've made it clear to my family what foods I consider to be 'trigger' foods - ones that either tempt me...or for now, ones that are just hard to see someone else eating. I seriously have tried to assure my family they don't need to be sneaking their food into other rooms...LOL. We all have to have some version of a 'new normal' life together. If I AM the one having a bad day or whatever is going on in my head, then I will excuse myself prior to the meal and they are not to take it personally. THEY still need to eat. What I do draw the line on in my own house (kids are technically out of the house) is any foods that were not part of the keto way of life my husband & I were followed up until my pre-op. As he has stated he will continue on keto, that is fine. My family knows the things that do NOT tempt me like ice cream or pie. If any of the miscreants bring in cake or cookies, there will be a brawl but it's not because of this surgery, I'd have had an issue with it when I was doing keto. Most of the time even that stuff no longer bothers me but like someone new in recovery from let's say 'alcohol addiction', people who are near and dear should not be drinking around them, especially not when someone is new in recovery (the exception here is that my family needs to eat to live so I do not expect them to abstain, just to be thoughtful). I see the surgery and the first few months after that as being new to a different type of recovery. Recovering from food addiction but NEVER cured just like AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) treat addiction. Everyone is hopefully on some path of recovery but you are never considered 'cured' which keeps you on guard against relapsing although it can happen and you just get back on the proverbial horse. LOL, maybe next time you are presented with a temptation, imagine drinking or eating it in front of your doctor...I was going to say 'in front of a mirror' which is something I've used before when I was...eating WAY too much and that mirror thing has stopped me quite a few times. Whichever would deter you the most...LOL

I don't do Keto myself (I am just unable to get the amount of fat in that is required), but I did some research on it a while back. I found this site a good first step resource (before you get into the more detailed, science-y stuff) : https://www.ruled.me/start-here/

Continue to do your research. Keto is safe. Many say it is not. But when you become fat adapted, you will burn fat. This means cholesterol numbers improve. Yes improve. I successfully reversed type 2 diabetes, lowered total cholesterol. Lowered LDL, raised hdl and lowered Trygliserides. As far as macros, just start by reducing total carbs to 20. Start reading. Ketogenic diet is sustainable. Cracks me up people saying otherwise.

My first question is why you are choosing to do Keto? While the science is valid in the ketogenic diet producing positive weight loss results, the long term results are not sustainable. More over, those who stop Keto, usually do it incorrectly, and risk putting back on all the weight they lost through the diet. Are you looking for a quick fix to drop some weight or a plan you can stick with? A diet that requires you to eat 75% of your meals as fat needs some serious consideration before diving in. Just my opinion.

I’m avoiding all bread products as long as possible but I think there’s some options for this. Cauliflower crust as bread? Or that no carb bread they sell on this site, might work for you. Google keto stuff they’ll be the ones wiith 15 ideas

I'm 1 year 6 mo post OP vsg, I'm considering keto, does anyone know what macros I should be following? Sent from my SM-G960U1 using BariatricPal mobile app

Oh wow, great to hear from you! Ironically...we are at the same point but I noticed today I was foggier than I expected (although yesterday I was LESS foggy than expected..LOL). I have had a bad headache all day today. I did not give up caffeine until..well, I guess since I had 1/2 cup this morning I haven't given it up yet. I'm used to 4 to 5 cups a day though...so that probably has something to do with the headache. I noticed my dr's list is different than the nutritionist he sent me too. They both had soft foods @ first start of the 7-10 days, but since I didn't start until 'Day 8.5', I went ahead and started full liquid diet today (regarding Day 8.5 - on the way out of my doc's office last week, I teased him about being grumpy about 10 days and he said "7"...um...ok, maybe he was kidding? When I realized I should clarify, it was already the weekend so I'm taking a day of soft foods out. I've noticed some interesting variations - there are a few ppl I've seen on here doing a full FOUR WEEKS PRE-OP....I just shudder..LOL. Guess it was good that I already had given up sugar/carbs/etc as I was doing keto. I did something similar last week - one night I went out for Mexican and one lunch at a Chinese place. But it was just 1 meal each day...not the entire days. I did have a drink '11 days' prior but I have not had any alcohol since the 10 days started even though I didn't do the pre-op diet until day 8.5 (that sounds so weird!). I feel the same..nervous..anxious..and right now...a bit hungry..lol. Best of luck to you as well! Stay in touch. I know we have lots of other early July peeps out there!

Oh my gosh...my fellow 'July-ers'......are you in your pre-op 'diet' yet. I figure if you are in the first 10 to12 days of July or actually I've seen some folks post that they have a MONTH long pre-op - how are you hanging in there? I've been doing keto prior to getting approved so protein shakes like Premier were already part of my super busy work life as meal replacements as otherwise I'd have skipped meals which is not good. Gotta say...yeah, I'm hungry! REALLY hungry..the actual stomach true hunger, not head hunger/emotional hunger. I can endure stomach growling, etc. throughout day but I've always found it almost impossible to get to sleep if extremely hungry. Crossing fingers that when I pick up my sugar free popsicles today, I have something to 'chew'. Wonder how many of those I'd need to eat to make hunger go away, but isn't liver shrink based on being REALLY LOW CALORIES - like 600 or less? Are y'all tracking your calories too to make sure extra ones aren't sneaking in..although how many extra can sneak in from sugar free jello, I don't know..but I can see protein shakes adding up! Today is my first day of 'all liquids'! Well, it is odd that my doc gave me 1 set of guidelines; however the nutritionist group we all had to see - he referred us, have a slightly different set of guidelines (making my eyes cross). Going to call his office to clarify but I'm SO worried about my liver not being 'shrunken' enough to operate on me, I'm thinking of sticking with what I got from the nutritionist office anyways. With confusion from my own dr about when to start the pre-op diet - I actually started on day..um..8.5 (not 10 and he had told me '7' verbally..so confused). I figure my liver must be ginormous as my BMI is 56 so.....I decided may be best with 7 days left before surgery (CANNOT believe I'm SAYING THAT!!), that I'm going to do full liquid starting today (so 1 day early) and will follow dr's notes on doing clear liquid only Days 1-3 prior to surgery. Doc Office says: Days 7-10 soft food diet (although dr told me on way out when I teasingly fussed about 10 days, he said '7'?? Days 4, 5, and 6 - Puree Food Diet Days 1, 2, and 3 prior to surgery -Clear Liquid Diet Nutritionist Documentation says: Day 6 - 10 prior to surgery - Soft Diet Days 3, 4, and 5 - Full Liquid Diet Days 1 & 2 - Clear Liquid

Went to Mother's Day brunch at my MIL's upscale retirement center and as I had not yet had my surgery - my surgery is on 7/1, but past 15 months have been primarily keto based, I made my usual no carb/low carb choices although I did have a sugar free dessert (sugar free but it had more carbs than I normally take in). Main point is, I was surverying the usual options noting all the things I could still have at that same time NEXT year on Mother's Day...and also same for a Father's Day lunch we attended at her center - a small bit of ham..maybe...a small bit of slice prime rib..maybe, deviled egg (OH I SURE HOPE SO!), fresh fruit everywhere, a frittata..maybe...point being is there are SO many options at this place every single year that I KNOW (by Mother's Day next year I will be post-op for 10 months. I plan for a while to carry backup protein drink with me to things like this. Her retirement home is ritzy/costly/etc. but my in-laws had some money and the place is not your usual 'retirement community'. Trust me, this is Definitely a place where if I have to whip out my protein drink...could also bring the mocha Ensure one...I will fit in with SO many ppl as the population is primarily 80 and over although there are several in their 60's and 70's...if you are in the Ft. Worth area and have some money, most ppl happily move to this place when they are ready. I could probably ask for or borrow an appropriate drink from one of the residents. I've SEEN several of them with high protein shakes. Maybe we can clink our shake containers together and toast each other If nothing else, I will be there for my MIL even though yes, I'm a Mom too. My Mom is sadly no longer with us after a heart-wrenching 3 year battle with dementia (my Dad is gone as well and my parents were INCREDIBLE people). When anyone complains about having to go visit 'their Mom', and possibly their MIL...trust me when I say, one day that Mother's Day (or flip it for Father's Day) will be SOLELY about you and you will MISS the run-around that happened in trying to get to see all of the other 'Mom's' in your life.

You're doing fabulously, Recidivist! And like you say, men do tend to lose weight a lot quicker than us ladies do... (all you have to do is look at The Biggest Loser to see that!) And to be honest, I think you 'earned' your quick loss with the complications you suffered early on! You had a real rough run of it for a while there, so it's so nice to hear you're doing so fabulously now! ❤️ My dietitian doesn't like the idea of Keto. *sigh* I'm not sure what to do about it. Since cutting out carbs I've dropped quite quickly -- about 5 kilos in the past two weeks -- and I just feel more satiated going for higher-fat options (and a lot less hungry now I've cut out carbs almost entirely). We're quite spoiled here in NZ with our meat choices. The last two Sundays I've roasted a full leg of lamb, spiked with rosemary and garlic. I eat hardly any of it, but my husband and I munch on it throughout the week. It's delicious! Especially cutting off and eating the salty, fatty bits straight from the oven... nom! Hehe. All of our meat here is also grass fed, which is a big bonus. It still boggles me that you'd feed a cow anything other than grass... you don't even have to leave our biggest city, Auckland, to see moomoos snacking on grass! Yesterday hubster and I grabbed a couple of coffees and watched the planes come in to Auckland airport next to a small herd.

I had gastric sleeve in Dec. 2013 after having reached a weight of about 440-450 and everything went according to plan the first 18 months or so. Since the spring of 2015 or so, I have been stuck in the 285-305 range (I'm 6'3" and 43 yo) and have been unable to get out of that no matter what I try, to the point where emotionally, I am basically back where I was at my highest weight. I can't stand to look at myself in the mirror, and I'm either a) obsessively counting carbs or calories or b) not caring what I eat and engaging in secret compulsive eating (though on a much, much smaller scale—instead of a dozen donuts, I'm going for one or two and not telling my wife or anyone else). The latest emotional defeat is this: I've spent the last three weeks doing a keto/Atkins-type thing, which was the only thing that ever worked for me before my surgery. Meticulous tracking, urine sticks showing I'm in ketosis, moderate walking exercise, and—here's the catch—a pretty extreme calorie deficit. Most days less than 2k per day, never more than 2,500, and in one four day period, I basically did the surgery prep diet of only protein shakes and broth, at about 800-1200 calories. After all that, I lost 2 pounds, which, when you're 292 pounds, is nothing. I'm already planning to eat poorly and secretly tomorrow, and I have absolutely no idea what to do. I feel essentially the same way I did before my surgery, though less intense, in that it seems like there's really nothing I can do. This is driving my wife crazy, and she's unable to understand or emotionally support me. I'm also trying very hard to not go back to some other addictive patterns. I know the first thing some are going to say is exercise more. I haven't done that lately, and there are two things holding me back on that point. At various periods in the last 4 years, I have done serious, several weeks-long programs with personal trainers in tandem with calorie deficit, and have had literally no success, other than gaining a little muscle, which resulted in a net weight gain. Also, I have some pretty extreme chronic degenerative disc pain, and it's hard to motivate myself to work past that pain when past results from diet and exercise have yielded little to no tangible benefit after great effort. One other thing that may be a factor: I had my gallbladder removed in 2017, and it had been basically shot since at least fall of 2015. I also had hiatal hernia repair the same time I had the gallbladder out. To be honest, I'm not really expecting any useful feedback. This may just be what life is for me now. But I had to say it somehow to someone.

I'll be bringing my laptop and laptop charger.and my cell phone USB charger. Good call on whomever said to bring a pillow to hold against stomach. Lots of us on here too are also July-ers......lol, right now I'm trying to survive the pre-op diet..I know it's not that bad, but I went from Keto (which I knew I couldn't do after surgery) to now this soft food, tomorrow start on full liquids...and my body is like...what the heck - you usually eat enough protein to keep us feeling ok... My stomach is wondering what the heck happened...well, I have NEWS for my stomach! It's going to be...um....er..not having to worry about most of itself after 7/1. Shhhh!! Right now I'm so dang HUNGRY!

Several of us replying on this post are scheduled for JULY! I'm scheduled for July 1st!! I actually cut out sugar a year to 15 months ago as I was doing keto and trying "one last time" to lose weight on my own and ended up tearing my knee up while exercising so have been trapped with a swollen knee for over a year that needs to be replaced but ortho won't touch me until my BMI is 40 or less. At my highest...I guess my BMI was around 56 to 60? It's closer to low 50's now, not good at all but less than it was. Personally, I'd cut sugar out ASAP as along with coffee it seems to be one of the harder things to 'detox' from to borrrow a word. If I hadn't already been doing a low carb lifestyle, for MYSELF, I would have done basically a keto/low carb approach leading up to my true pre-op diet plan to shrink my liver. That way I could have gotten thru the detox/keto flu from getting all of those nasties out of my system and not have that being an additional thing that makes me feel bad when, if I hadn't done anything prior to my pre-op 8 day diet, and all of a sudden I've just removed sugar, carbs, caffeine, etc. all at the same time and gone down to 600-800 calories a day. That's a BIG HIT to anyone's system and I would rather tackle some of them earlier and kind of smooth out the negative effects (which are temporary but can be a pain in the tush). Sigh..caffeine, my last 'frontier' to give up. Ironically am planning to do what you are doing, switching to unsweetened ice tea. I'm going to have to go look at the JULY 2019 Sleevers thread - hope to keep in touch with all of you. I'm nervous, and hopeful...scared.anxious...and SO ready to get this done.