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Today's podcast episode was really good in addressing weight loss plateaus and making reasonable dietary changes:

I’ve been very slow to lose weight and it hasn’t dropped for days. Currently 13 days post op and lost a combined weight of 16 lbs. Gastric Sleeve. I am still on liquids. My nutritionist said my body is in shock and trying to hold on to everything including water. so well see… but i understand the feeling of slow.

I'm almost 3 months post op and gone from a UK24 to size UK16. I haven't been that weight in years. This time last year, I never would have even thought it was possible. This time 6 months ago when I was approved for surgery, I never even thought any of this would be possible! My knees hurt less when walking, although my butt hurts because I have less padding, so sometimes I actually prefer to stand. Never thought I would do that. I do sometimes still grieve food but not for the reasons I thought. I grieve the way I used to be in some ways because my best friend and I would get together and eat and we don't really have that anymore. We are still trying to find other things we can do together. But also, sometimes I grieved I can't order a pizza or other takeaway anymore because I live alone and don't have anyone to share it with so to avoid wastage, I actually need to cook even if I'm too tired. This year, I'm going to get my health on track and finally move out of London. I can't afford to live here anymore and I want a new start. Now that I know goals that seemed impossible are now achievable, I want to start new goals.

Just echoing what the two very experienced forum members say above. A regain in 2nd and 3rd year post op is almost the norm. Please try not to worry about it unduly. Your set point is the weight/body composition that your body wants to hover around. The video below is short and might help. Your set point gets lowered drastically by WLS. But - processed food raises it. Eating cleaner keeps it lower. Building muscle mass keeps it lower. Might those be things you can work on a bit? Lots of people focus on cardio and that's brilliant, but lifting weights or using resistance bands (even if you never do cardio!) can add another really significant layer to that. Do you or have you ever tracked your intake? If that has slipped just tracking again might make you aware of what you're taking in and what you're using up. I am saying this as someone just about 3 years post op who regained 16lbs this year. I personally wasn't happy with that because it didn't stop as others' seems to, so I lost 10lbs by strict keto and am now back where I want to be. I had dietary lapses I needed to correct too and am working on that. I had this surgery to stop dieting - I feel like I can tweak things to keep me where I want to be without that and that I've learned a lot by stepping back and really analysing my intake the last few months. Also huge kudos to you for thinking about this with only 9lbs on. Much easier to look at what you can change now, if you even need to do that, rather than further down the line. I wish you the very best.

We should be proud. Even though some ignorant people don't realize how much work goes into losing the weight after WLS. If they even know we had it. At first, I told everyone. I didn't care who knew. But now, like Catwoman, I only share with those I feel can benefit from my experience. The comments were hard for me to take at first too. I even had someone tell me I need to learn to take a compliment. I took that advice and simply say thank you and smile. But if anything negative or passive aggressive is said, all bets are off. LOL

Yikes but good luck! I really think that if you want to have some then make sure you're aware of the quantity. Like make sure you choose one option and have 1 cookie or like half or 2 options.. we really must build some kind of system so we can sustain it FOREVER. R we never going to have cookies? I've been indulging very small portions of things I want and trying to be mindful about it. That i will try that cake but only half a spoon. Or whatever it is.. so do what works for you! As long as you're not isolating yourself... Otherwise, how r u doing? Health wise? Food after thanksgiving and ur walks? I don't have any events coming up so I'm all clear till my bday i guess 2nd Feb.. I do have an app on 23rd with my surgeon office and I am nervous about what he says about my weight loss l, last time he said he expected more so I hope he's ok with my loss. I can't handle disappointment and more anxiety.. Also keep writing on this group so we don't lost track of what needs to be done. We are in this together ❤️

I just started doing this because I can't work out as much as I use to because of how much I work now. We walk 2 miles to the lake, walk around the lake twice, then sit and have a small picnic lunch (that's all the stuff I carry in the backpack - food, drinks, blanket, weights, speaker for music, etc..) then we walk the 2 miles back home. I also wear 2 pound leg weights and 1 pound wrist weights.

What you are experiencing are very normal worries - I think we all would have had some form of concern or anxiety leading up to the surgery! Just my personal experience, I started talking about surgery YEARS before I even booked a consultation with a surgeon. I am talking like 3 years worth of "umming" about whether or not I should go for it, and subsequently talking myself out of it. I would berate myself saying that I should be able to do it the natural way, I should be strong enough and surgery is risky etc, but I think I was just making excuses for myself really! I'd tried to lose weight since I was a teenager to no avail, and I honestly wish I had just had the surgery sooner! It was my first operation as an adult, so I was definitely scared of the pain and of the whole experience itself but honestly, it was all manageable and it didn't last long! You'd be so surprised how quickly you get used to your new way of living - and genuinely this forum has been an amazing place to just not feel so alone in your experiences. So, ultimately, think about the pros and cons for each potential decision and make sure it is the right one for you. You've got this!

Wanted to share my experience and echo the other commenters here. I am 9 weeks out of my gastric bypass and I am right where you are almost exactly weight loss wise- Pre surgery and liquid diet I was 260lb (117kg) After liquid diet in surgery day I was 244lb (110kg) Now after 9 weeks I am 99kg. I haven’t weighed in a few days so I may be a pound or two more but I’m trying to limit myself to only weighing every few days so I don’t hyperfixate. I definitely feel like I’m losing slow- but last week in my bariatric programs’ support group on zoom, almost EVERY patient had that same feeling. It was very validating and most of us were feeling disappointed and impatient. After hearing that it made me feel a lot better. I keep reminding myself that I haven’t even been this weight in a long time and that it’s going to keep going down on its own schedule, when it’s right for my body. Keep fighting the good fight and showing love and kindness to your body and we will all get there.

It seems to be all carbs that give me trouble, although "bad" carbs make me sick almost immediately. My body went from constantly craving carbs to seemingly not being able to process them anymore. It's really weird. And frankly, annoying. And I agree, a few of my doctors are seeing numbers on the scale and bmi and not me as a person and my overall progress. I've lost 246 pounds from my highest weight. And 213 pounds from my original surgery weight. And that still doesn't seem like it's good enough!!! My current weight is lower than some other people's final ending goal weight. THEIR doctor's are ok with that, yet MINE seem to think I need to lose more, more, MORE!!! This is how people fall into disordered thinking and eating. I'm trying very hard for that NOT to happen to me again, and this is not helping. Also, yes I have started adding a Chobani Complete liquid Greek yogurt to my snacks. They have 20g of protein, 15g of carbs, and 180 calories per serving. I've got myself up to 40 carbs per day with that (without working out) and seem to be doing ok, so I'm going to go up to 45 carbs daily without working out (that's where I was at but with workouts) and then sloooowly try to increase from there and see if I can. My body just really resists carbs, so it's really slow going.

I didn’t loose any weight with the liquid diet because I had already been following the bariatric plan for a whole year before the surgery so my body was used to being calorie restricted. The salt levels sound kind of high… like others have said. Don’t be surprised if you gain weight while in hospital because the IV fluids are full of salt too. Just keep drinking water and it will come off. Best of luck with your recovery!

I'm 6.5 years out and still have a very restrictive sleeve. But I definitely seem to be an outlier. I can eat about 4 oz at a time. For instance a Taco Bell taco or small McDonald's hamburger. But even with small stomach capacity, it's easy to regain. My stomach empties quickly so there's nothing stopping me from eating to excess. I've had to make a conscious effort to maintain a weight I'm happy with. I use both IF and GLP meds. Along with calorie tracking for accountability.

Its good (and bad) that I'm not the only one experiencing the aches and pains! Thank you for sharing, it helps knowing this. I understand about the doing "A number" on myself with my goal and trying to over achieve. That being said, the goal I chose is in the middle of a healthy BMI, I still have quite a bit of fat on my frame and I'm still classified as "over weight." If not my weight goal, I'd like to at least get to a healthy BMI where I'm not overweight. Overweight IS unhealthy. I don't feel I'm being unreasonable to at least try for healthy, not just healthier than I was..that make sense? I wouldn't say I'm "hyper focused" on my weight goal, no more than anyone else is who's on this forum and gone through wls. Lastly, we've all set goals regarding our weight and health, its something to shoot for. I know I may not achieve it, but its a goal nonetheless. Just as walking 5 miles a day, or finally being able to do my yoga Vrischikasana, Astavakrasana and Eka Haste Vrksasanav poses again! Which, with all my new aches and pains who knows if I will ever be able to do them again, but I still want to strive to do them since I once enjoyed them - its a goal!

Not that uncommon and comparatively not more strict. There are variations between surgeons and surgeries with many of these things. Sometimes it’s also related to you, your health, how much weight you have to lose, your relationship with food, etc, Not being allowed carbonated drinks is common. The differences arise in length of time of this avoidance and then whether you can tolerate it. Also you may be allowed sparkling water that you let go flat a bit but not sodas. Same with alcohol avoidance but there are three main reasons often behind this. One is concern for addiction transfer which can occur after weight loss surgery. Secondly, alcohol is calorie dense and offers no nutrients which are vital while we are losing and eating small portions and lastly it will slow your metabolism & dehydrate you. Again some surgeons just put a time frame on it but it does depend on your surgery too. Caffeine is another thing that is allowed by some surgeons and not by others and again there can be differences in for how long you should avoid it. Deconstructing meals is not a forever thing. Certainly while losing, focussing on eating the protein component of your meal first is very important. If you are able after you’ve eaten the protein in your meal. you then can eat your vegetables then any carbs you are allowed. (There were many times I could only eat my protein at a meal and nothing else.) This is because of the small portions we can eat initially & the necessity of getting that protein in to meet your protein goals. It does make tracking your food much easier too. When you near your goal, and are eating larger portions, it’s not as important to eat your protein first but you must continue to hit your protein goals forever so it will be something of which you are aware when you’re eating. In saying that I often ate soups, stews & casserole type dishes, omelettes, etc. which combined protein & vegetables while losing but not every meal and not every day. Actually not allowing protein shakes is also not uncommon. For example, in the UK, many aren’t allowed protein shakes in the pre surgery diet (they drink milk instead). Protein shakes aren’t the sole source of protein & nutrients in that first stage after surgery. Bone broths, consommés and cream soups are also options. Thank goodness too because after surgery those protein shakes can be disgusting. I found them unpleasantly grainy and crazy sweet & struggled to drink one a day. Best advice is to follow your plan while you are losing.However, if you find it difficult to tolerate your food options or to reach your goals ask for alternatives that will allow you to still meet protein goals & other nutrient requirements within any calorie guidelines you are given. How and what you eat once your weight has stabilised is up to you, what you’ve learnt about your eating and relationship with food and if it allows you to maintain a lower and healthier weight & lifestyle.

On Sunday morning, I was 118kg. Monday I was 118.8 and now I'm 119kg again! I'm still sticking with the diet! I don't understand it! My scale is a smart scale with body composition and says I'm losing muscle, but not fat! I'm getting more than enough protein? I've heard of stalls, but you shouldn't gain during a stall, right?

Well if you’re only eating one salad every two days and buying another on the third you are probably eating too little calories and your body is in starvation mode which sometimes you can actually gain. BUT, if you were to eat THAT same salad a couple of times a day and had breakfast too you would probably be eating too many calories to lose. Salad is very deceiving. They can actually have more calories than a bacon cheeseburger meal if you just add the good tasting stuff without measuring and counting and nutrition wise you aren’t getting a whole lot of what you need in a tiny portion of one salad as prepared. If I was you I would talk to a dietician about what choices are healthier options and how much protein you need. What you’re eating even though it’s a salad which sounds good is not the most nutritious option. First start by measuring and tracking what you’re having in an app. You would be surprised what you learn about what you eat by doing that. Most prepared salads have more than a serving of things like full fat cheese and croutons and the dressing packets they give you is far more than one serving as well. it sounds kinda silly but if you bring home your favorite salad and take the time to deconstruct it just once you can measure each thing and figure out exactly what’s in it (assuming they make it the same way each time). It’s always best to make your salad at home if possible so you can use lean or reduced fat protein and lower calorie dressings and choose healthier toppings but if you have to get it while your out you can use less of the dressing and ask for them to go light on the cheese and skip the croutons. Also, opt for grilled chicken and if possible ask for an extra fillet of chicken or two and add that to your leftover lettuce for your next meals. I do that at chic fila all the time. I make two meals out of a salad by getting a second fillet of chicken and making a grilled chicken Cesar salad with my leftover lettuce. But your focus will always need to be protein first since you do have a tiny stomach. Ask your doctor your personal goal but You should get probably be getting around 3-4oz of lean protein a meal and then fruit and veggies and then the lettuce is a filler if you have room. I prefer to bring my salad home so I can take off all the toppings and add just a tiny bit of lettuce and put that into a container. I prefer the toppings to the lettuce anyways. Also a good way to use less dressing is to mix any salad in a bowl like you would do ceaser salad and you get a bit on all the lettuce using less than you would if you just pour it over. And try to avoid the sodas like mentioned above. If you must eat and don’t enjoy water, try to find a drink mix that you like and keep a box of drink packets in your car to grab when you go in. Order water and mix in your drink packet. It’s way less calories and it’s cheaper. Note that the drink packets do have artificial sweeteners and there is evidence they aren’t the best for you either so plain water is best but they do have some made with stevia which my dietician says is the best option if I must have them. Tru lemon is one of the better ones. So many of us think we are making good choices when we are eating a salad or soup but they are not all created equal. And just eating a tiny portion of a less nutritious food isn’t the best option because you may lose weight this way but you’re not getting all the vitamins and protein your body needs. If you don’t get enough protein you may actually just be losing muscle mass and as we get older that is really hard to build back up. If you aren’t doing strength training this can be really bad. Measuring and putting things Into the Baritastic app and really looking at how much protein is In something and how much fat and carbs are in there as well as added sugars has really helped me to learn what foods are more nutritious choices. I think my protein goal with my sleeve was 60 grams minimum and with the SADI revision it is 90 grams. I was told that protein was the very most important thing but you also need to get fruits and veggies for the vitamins. And check your labs regularly to make sure you are getting what you need. I hope this helps.

Had my dietitian appointment this morning and it went really well 🥳 I’m a healthy fat person, which was good to hear. All my tests have come back good, no issues with diabetes, high cholesterol, heart disease etc. We had a really good talk, told her about this forum and the ongoing support everyone receives, showed her my two food diaries - one pre-watching what I eat and one for now. She was very happy to read both, laughed at some of my comments regarding how I was feeling when I was eating, and congratulated me on the changes I have already made. She asked if I had a surgery in mind and why. I explained that I felt that a bypass would be more beneficial for me due to not feeling full, snacking etc, and she agreed. Thankfully she has no issues with me, and was happy to refer me to the surgeon, which was such a relief to hear. Honestly, I felt quite apprehensive and anxious this morning (thanks menopause 🤨) and was definitely snappy with hubby. I went in on my own as I didn’t want him to know what my weight was/is - does anyone else keep their weight secret from their other half? I know it’s just shame that makes me not want to tell him 😕 The dietitian thinks a reasonable target post-surgery for me is around 14stones (196lbs) but reckons I will sail past that as I am fully onboard with it all. I’m glad that she hasn’t given me an unrealistic expectation and I do feel it’s fully achievable. We discussed lowest adult weight plus weights my body had ‘stuck’ at previously. She also went through the post-surgery diet - will be 6 weeks on the purée diet due to having a bypass, and gave me the info for that. She also explained about the bounce back once the body has reached its lowest weight and that it did not signal a failure. Next steps: appointment with the surgeon, which should be September (eek, next month!!) After I’ve seen the surgeon it’s then the MDT weekly meeting for everyone to agree that I’m OK to go ahead. As long as they agree, I will get my surgery date which is looking to be either Jan or Feb next year. She’s put that I would like to see the surgeon ASAP and will take a cancellation for both his appointment and also for surgery as long as I have one day to get ready for the 3 week liver reduction diet. She warned me that I could be on the LRD over Christmas but I’ve said that it’s fine, I’m truly not bothered in the slightest. I asked about going away next September and she said everything will be done and settled down by then but not to buy holiday clothes until the last minute! Just to wait for the next stage now. I’m certainly glad I lost some weight pre-appointment though as the weight the Dr gave and the weight I was actually was a 5kg difference, and not in my favour 😮 I’m still 7kgs lower than the wrong weight given and it’s the initial referral weight they go off so I could coast now if I wanted to (but I won’t ) A relief all round!

Thank you @GreenTealael 💛 Woo Hoo for being sub-target once again @FifiLux👏👏👏 It does give a bit of a boost doesn’t it? Especially knowing that the odd gain can be tackled in a timely manner and be rid of. I had some beginner Pilates classes donkeys years ago and actually enjoyed them. Wouldn’t manage them now because of my knees but I would like to try it again once they are sorted out. I can definitely feel the difference in my muscles from upping my levels at the gym on Monday. Like you say, it’s a *good* pain! It’s interesting that your gym offers a body scan process? Mine certainly didn’t! @Bypass2Freedom I had prosciutto and burrata mozzarella to start, fillet steak with pepper sauce, small chips, mushrooms, grilled tomato for main and then chocolate fudge cake for dessert. I was happy with my choices and it really was a lovely meal 🙂 Our weather really isn’t good at the moment but then I read about how bad other places have it and I know we don’t have it that bad in comparison. Winter clothes? Mmm…I’m looking for jumpers but nothing is catching my eye particularly. At least with winter clothes you can get away with coming down a couple of dress sizes before having to bag them up and donate them! Did you get sorted for the gym?

So totally true.....its more about what you put in your mouth and less about exercise. Exercise is good for your muscles, heart, lungs, joints, but as far as weight loss, you can do it without exercise by watching what you eat and stay within your calories suggested by your doctor/nutritionist - low fat, low carb, high protein.

I'm 35 and I've always been overweight. I think I was even born overweight! lol! My mother always said I was her heaviest baby, but the doctor said I had a large frame. Being active and exercising always physically hurt after I developed a hip problem around 12 and then getting bullied about not being good at sports just made me stop trying. Up and down with every diet and no luck. I'm looking forward to being a "normal" weight for the first time in 35 years!

Yes! This has been my problem. I never want to eat something so badly as when I can't have it. I'm not doing cheat meals at the moment because I need to lose the weight for my surgery, but telling myself "I can have this later" helps. And after surgery, I may not even want it.

1. Basics: GENDER, AGE, HEIGHT: Male, 47, 5'11" 2. Total Weight lost in the 6 months BEFORE surgery (if any): 16.8 pounds 3. Weight on DAY OF SURGERY. 430.8 4. Weight at 1 MONTH POST surgery 400 5. Weight at 3 MONTHs POST surgery 351.6 6. Weight at 6 MONTHs POST surgery 302 7. Weight at 12 MONTHs POST surgery 247.6 (two weeks shy of 1 year) Gastric Sleeve

Had my consult at Banner University Medical center in Tucson. The team seems really nice and eager for you to succeed. My first appt with the dietician is Jan 29th and is supposed to be about 90 minutes. Lots of tests I need to have completed asap; sleep study, cardiology clearance, endoscopy, barium swallow, psych eval, chest X-ray, and a ton of labs. Gotta complete the 6 month supervised diet and lose 10% of my weight throughout the 6 months. They want to see a little each month and not a lot at real quick. I weighed 344 yesterday and they want me at 310 before surgery. I shared this in a Facebook forum and the 1st comment was, "Really, how do they figure you can lose that much in 6 mos? Wow. Good luck with that!" (Nothing like a little encouragement right off the bat! 😬 ) I replied that it's only 34 lbs & I need to lose 6 lbs a month. She said if she could lose 6 lbs a month she wouldn't need surgical help! I looked at her profile & it turns out she's a failed ESG from September because 'she likes food too much'. BUT now it's in my head that maybe I can't lose the 34 lbs in time. I'm definitely ready to get this going! I have studied this for so many years! I'm super excited to have finally taken this step & have saved money for the last several months to cover my deductible & most of my Out of Pocket max. The fat girl in me decided I needed a food funeral, so I had my last ever buffet yesterday. I hope this 6 months goes by quickly! I'm ready to feel better & move better. My knees & back need a break LOL! If y'all have any tips for losing the 34 lbs in 6 months, please share them. I know low carb/sugar free & keto..... but I've obviously never been successful with them or I wouldn't be this big.

Hi there! While there are not many things you can control, there are a few you can. Tracking your lifestyle choices will help you figure out how they may affect your weight loss. Try logging/tracking everything (food, activities, mood, etc.) until you follow up visit with your team. This can help because this study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887647/) supported that adherence to multidisciplinary team follow-up was an independent factor for increased weight loss at 1 year, but not in type of endoscopic procedures. Also try tracking your eating length (how much time you take to eat start to stop) these two things could be significant to your progress because these studies (https://www.cghjournal.org/article/S1542-3565(15)01714-0/fulltext https://www.soard.org/article/S1550-7289(17)30865-1/abstract) show that ESG increased gastric emptying T½ by 90 minutes and delayed gastric emptying for solids. The retention of food after ESG led to early meal termination in 11 minutes and reduced food intake…changes in gastric emptying and time to satiation are some of the plausible mechanisms that lead to beneficial effects of ESG. So your surgeon is giving you great information that the restriction *should* kick in with solids. Please keep us updated ❤️

I don’t know much about the mini gastric bypass but the SADI is now covered by insurance and it has better stats thus far than then bypass and sleeve. Its weigh loss is statistically quicker, more weight lost and more durable than the bypass and it’s considered comparable in terms of safety. It is relatively new so not all surgeons do it and the research is still coming in but Maybe look into it. I have been very happy with it as a revision surgery. I have lost 75 pounds already. I have some other medical stuff that’s slowed my loss a bit because the doctors don’t want me to be at such as calorie deficit right now, but I feel like once I’m back at it I will lose the rest pretty steadily. Also, There was a guy on here that put a whole lot of information out there about the mini gastric bypass a while back. If you search for it you should find some of his posts and if you respond to one of them it should send notifications to the others who were active in the thread so hopefully someone who knows about it will get an email the thread is active and come back and read your questions. I just did a search and he must’ve deleted his account because now it’s listed as guest. His screen name was MiniGastricBypassDude but I guess he won’t receive the.notifications. Others who were active on the threads will though and there is lots of information there to read about the surgery that he posted In the past.